Identifying Europe S Information Needs for Effective Drug Policy

Identifying Europe’s information needs for effective drug policy Lisbon, 6-8 May 2009

Parallel sessions: Trends

Monitoring a fast-moving, complex phenomenon

Parallel session B. Drug problems and consequences

Title of the presentation: Problem cannabis use – what is it and how to assess it?

Name: François Beck Affiliation/Institution: National Institute for Prevention and Health Education (INPES) Address: 42, Bld de la Libération 93203 St Denis Cedex e-mail: [email protected]

Bio note:

Head of the Department of Epidemiology and Public Health (comprising ten full-time scientists); PhD in sociology at the Sorbonne University (Paris V); researcher in the Laboratory “Psychotropes, Mental Health and Society” (CESAMES); principal investigator in several surveys on drug use both in the adult and adolescent general population since 1999.

Abstract:

Among illicit drugs, cannabis is quite a peculiar substance. Data from general population surveys show that cannabis experience and even its current use is widespread among the European general population. In the light of increasing treatment demand for cannabis, there is considerable need to inform people of cannabis-related risks. It also appears crucial to be able to distinguish, among cannabis users, those who suffer from a cannabis use disorder, or who manifest patterns of cannabis use that may require a timely intervention. The first challenge is to define problematic cannabis use (PCU). The second is, for epidemiologist, to operationalise concepts of PCU into measurable criteria, both at the population level and for targeted groups. This pattern can be defined as use leading to negative consequences on a social or health level, both for the individual user and the larger community. From this definition, various other concepts can emerge, such as misuse, abuse and dependence, together with difficulties faced in abstaining or controlling use. Harms are either directly linked to the substance itself (loss of concentration in the short term or lung damage in the long term) or to comorbid harms such as those linked to polydrug use or risky behaviour (drug driving, binge patterns). The definition of an acceptable level of cannabis use (with a threshold beyond which the use becomes problematic) is beset with ethical issues. Because cannabis is illegal, establishing use guidelines may be perceived as condoning its use. PCU can emerge from what some groups such as peers, specific generations and subcultures, might perceive as moderate consumption. Today, a number of concepts and tools exist to monitor problematic cannabis use. There is a need to develop screening tests which are more reliable in measuring adverse effects of cannabis use. Several European countries are working at implementing a common tool that could deliver important information for policy makers and for the fields of prevention and treatment. It is hoped that such initiatives will help to develop a reliable and comparable indicator of PCU in general population.

Related publications:

Beck F., Legleye S. (2008) « Measuring cannabis related problems and dependence at the population level » in Rödner Sznitman S., Olsson B., Room R., (eds.), A Cannabis reader: global issues and local experiences, Volume 2. EMCDDA monograph, European Monitoring Centre on Drugs and Drug Addiction (EMCDDA), 29-57. Legleye, S, Karila, L, Beck, F, Reynaud, M., 2007, Validation of the CAST, a general population Cannabis Abuse Screening Test. The Journal of Substance Use, 12 (4), pp. 233- 242. Rehm, J., Room, R., Van den Brink, W., Kraus, L. (2005) ‘Problematic drug use disorders in EU countries and Norway: an overview of the epidemiology’ European Neuropsychopharmacology, Volume 15, Issue 4, August 2005, pp. 389–397. Simon, R. (2004) Regular and intensive use of cannabis and related problems: conceptual framework and data analysis in the EU member states, Final report to EMCDDA, CT.2003.103.P1. Beck F., Legleye S., Obradovic I., Cohen B., Mutatayi C., Karila L, 2008, Drug use among youths: screening problematic uses and institutional response in France Medecine/sciences, 24 (8), 758-767.