Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Impact of the COVID-19 pandemic on cannabis cultivation and use in 18 countries.
(Elsevier B.V., 2024-11-22) Werse B; Kamphausen G; Søgaard TF; Bear D; Audran M; Wilkins C; Potter G; Fortin D; Hakkarainen P; Faria R; Quintas J; Grigg J; Jauffret-Roustide M; Barratt MJ
Background The COVID-19 pandemic and the accompanying measures to mitigate infection affected many areas of society, including the supply and use of cannabis. This paper explored how patterns of behaviour among people who cultivate cannabis were affected by the COVID-19 pandemic and restrictions. Methods An anonymous web survey of people who cultivated cannabis was conducted from Aug 2020 to Sep 2021, spanning 18 countries and 11 languages (N = 11,479). Descriptive statistics and mean comparison tests were conducted. Results Most cannabis growers reported that their practices were relatively unaffected by the COVID-related restrictions. While 35.2 % reported difficulties buying cannabis from their usual dealer, <10 % stated that access to materials needed for growing was impaired during the pandemic. Over one-quarter (28.2 %) of respondents increased their cannabis use and 21.4 % also increased cannabis cultivation (more than twice as many as those who said they were growing less or not anymore) while COVID restrictions were in place. People who lost their job or were casually employed were more likely to increase use and cultivation. Overall, the pandemic had little impact on reasons for growing, however, difficulties obtaining cannabis were mentioned as the most prevalent COVID-19-related growing motive. A small number (16 %) reported starting their growing activity during the pandemic. Italian and Portuguese growers were more likely to report shortages in supply and increases in their growing activity. Conclusions This study is the first to document an increase in cannabis cultivation activity following COVID restrictions. Increased home cultivation was not only driven by higher use as a result of home isolation, but also by disruptions of wider illegal cannabis supply. Limitations of this study include the non-representativeness of the sample as well as differences in approaches and duration of restrictions in different countries.
Exploring the substitution of cannabis for alcohol and other drugs among a large convenience sample of people who use cannabis.
(BioMed Central Ltd, 2024-11-05) Wilkins C; Romeo J; Rychert M; Graydon-Guy T
Background The substitution of cannabis for alcohol and other drugs has been conceptualised in a harm reduction framework as where cannabis is used to reduce the negative side-effects, addiction potential, and social stigma of other drugs. There is currently mixed evidence with recent reviews suggesting cannabis co-use patterns may vary by age and ethnicity. Yet few studies have had large enough samples to examine this demographic variation in detail. Aims To explore the co-use of cannabis with alcohol and other drugs within demographic subgroups of a large sample of people who use cannabis. Specifically: (1) whether cannabis is being substituted for other drugs, and (2), whether cannabis use leads to more, less or the same level of other drug use. Method Online convenience survey promoted via Facebook™ completed by 23,500 New Zealand respondents. Those who had used cannabis and any of eight other substances in the same six-month period were asked if their use of cannabis had any impact on their use of each other substance (“a lot more”, “little more”, “no impact/same”, “little less”, “a lot less”). Frequency and quantity used of each other drug was compared by co-use group. Generalised logistic regression models were developed to predict co-use categories. Results Significant proportions reported cannabis use led to “less” alcohol (60%), synthetic cannabinoid (60%), morphine (44%) and methamphetamine (40%) use. Those who reported using “less” had lower frequency and amount used of other drugs. Approximately seven-out-ten reported cannabis use had “no impact” on LSD, MDMA, and cocaine use. One-in-five reported using cannabis led to “more” tobacco use. Young adults (21–35-years) were more likely to report cannabis use led to “less” drinking and methamphetamine use. Adolescent co-users (16–20 years) reported mixed impacts. Māori were more likely to report cannabis use resulted in “less” alcohol, tobacco, methamphetamine, and LSD use. Students and those living in cities were less likely to report cannabis use lowering use of other substances. Conclusion Cannabis and other drug co-use patterns are moderated by life stages, lifestyles, cultural perspectives, and urbanicity. Harm reduction initiatives and policy reforms should take account of these moderating factors.
Legal sourcing of ten cannabis products in the Canadian cannabis market, 2019-2021: a repeat cross-sectional study.
(BioMed Central Ltd, 2023-02-17) Wadsworth E; Rynard V; Driezen P; Freeman TP; Rychert M; Wilkins C; Hall W; Gabrys R; Hammond D
BACKGROUND: One of the objectives of cannabis legalization in Canada is to transition consumers from the illegal to the legal market. Little is known about how legal sourcing varies across different cannabis product types, provinces, and frequency of cannabis use. METHODS: Data were analyzed from Canadian respondents in the International Cannabis Policy Study, a repeat cross-sectional survey conducted annually from 2019 to 2021. Respondents were 15,311 past 12-month cannabis consumers of legal age to purchase cannabis. Weighted logistic regression models estimated the association between legal sourcing ("all"/ "some"/ "none") of ten cannabis product types, province, and frequency of cannabis use over time. RESULTS: The percentage of consumers who sourced "all" their cannabis products from legal sources in the past 12 months varied by product type, ranging from 49% of solid concentrate consumers to 82% of cannabis drink consumers in 2021. The percentage of consumers sourcing "all" their respective products legally was greater in 2021 than 2020 across all products. Legal sourcing varied by frequency of use: weekly or more frequent consumers were more likely to source "some" (versus "none") of their products legally versus less frequent consumers. Legal sourcing also varied by province, with a lower likelihood of legal sourcing in Québec of products whose legal sale was restricted (e.g., edibles). CONCLUSION: Legal sourcing increased over time, demonstrating progress in the transition to the legal market for all products in the first three years of legalization in Canada. Legal sourcing was highest for drinks and oils and lowest for solid concentrates and hash.
Exploring Differences in Daily Vaping of Nicotine and Cannabis among People Who Use Drugs in New Zealand.
(Taylor and Francis Group, 2023-06-16) Rychert M; Romeo JS; Wilkins C
Background: Little is known about daily vaping of different substances, particularly cannabis. Aim: To explore daily vaping of cannabis and nicotine products in a sample of people who use drugs in New Zealand. Method: The online New Zealand Drug Trends convenience survey (N = 23,500) was promoted to those aged 16+ via a targeted Facebook™ campaign, with 9,042 reporting vaping in the past six months. Multivariate logistic regression models were fitted to identify predictors of daily vaping of: (i) nicotine e-liquids, (ii) no-nicotine e-liquids, (iii) cannabis e-liquids/oils, (iv)cannabis herb. Results: Forty-two percent of past 6-month vapers used a vaporizing device "daily or near daily" (n = 3,508). Nicotine was most common substance used by daily vapers (96%), followed by dry herb cannabis (12%), no-nicotine e-liquids (10%) and cannabis e-liquid (6%). Daily vaping of no-nicotine e-liquids was associated with abstinence from tobacco use. Frequency of cannabis use was negatively correlated with daily vaping of nicotine liquids and positively correlated with daily vaping of no-nicotine and herbal cannabis. Younger age strongly predicted daily vaping of nicotine and no-nicotine liquids, but the reverse association was observed for daily vaping of herbal cannabis. Māori were less likely to daily vape cannabis herb than NZ Europeans. Daily vaping of both cannabis e-liquid and cannabis herb was associated with medicinal cannabis use. Conclusion: Daily vapers of nicotine and cannabis differed by several characteristics. Younger age group is at risk of daily vaping nicotine and non-nicotine, while herbal cannabis vaping is associated with older and medicinal use, suggesting a need for a nuanced vape policy response.
Global patterns in small-scale cannabis growers' distribution practices: Exploring the grower-distributor nexus.
(Elsevier B.V., 2024-06-03) Søgaard TF; Brummer JE; Wilkins C; Sznitman SR; Sevigny EL; Frank VA; Potter G; Hakkarainen P; Barratt MJ; Werse B; Grigg J; Fortin D; Bear D; Lenton S; Jauffret-Roustide M; Kirtadze I
BACKGROUND: While the supply of cannabis is commonly assumed to be dominated by criminal gangs, a sizable share of the domestic cannabis supply is provided by small-scale growers. This article examines the nature and scope of small-scale growers' distribution practices, with a particular focus on cross-country differences and variations between different types of grower-distributors, i.e., "non-suppliers", "exclusive social suppliers", "sharers and sellers" and "exclusive sellers". METHODS: Based on a large convenience web survey sample of predominantly small-scale cannabis growers from 18 countries, this article draws on data from two subsamples. The first subsample includes past-year growers in all 18 countries who answered questions regarding their market participation (n = 8,812). The second subsample includes past-year growers in 13 countries, who answered additional questions about their supply practices (n = 2,296). RESULTS: The majority of the cannabis growers engaged in distribution of surplus products, making them in effect "grower-distributors". Importantly, many did so as a secondary consequence of growing, and social supply (e.g., sharing and gifting) is much more common than selling. While growers who both shared and sold ("sharers and sellers"), and especially those who only sold ("exclusive sellers"), grew a higher number of plants and were most likely to grow due to a wish to sell for profits, the majority of these are best described as small-scale sellers. That is, the profit motive for growing was often secondary to non-financial motives and most sold to a limited number of persons in their close social network. CONCLUSION: We discuss the implications of the findings on the structural process of import-substitution in low-end cannabis markets, including a growing normalization of cannabis supply.
Assessing options for cannabis law reform: A Multi-Criteria Decision Analysis (MCDA) with stakeholders in New Zealand
(Elsevier B.V, 2022-07) Wilkins C; Rychert M; Queirolo R; Lenton SR; Kilmer B; Fischer B; Decorte T; Hansen P; Ombler F
Background A number of jurisdictions are considering or implementing different options for cannabis law reform, including New Zealand. Multi-Criteria Decision Analysis (MCDA) helps facilitate the resolution of complex policy decisions by breaking them down into key criteria and drawing on the combined knowledge of experts from various backgrounds. Aims To rank cannabis law reform options by facilitating expert stakeholders to express preferences for projected reform outcomes using MCDA. Methods A group of cannabis policy experts projected the outcomes of eight cannabis policy options (i.e., prohibition, decriminalization, social clubs, government monopoly, not-for-profit trusts, strict regulation, light regulation, and unrestricted market) based on five criteria (i.e., health and social harm, illegal market size, arrests, tax income, treatment services). A facilitated workshop of 42 key national stakeholders expressed preferences for different reform outcomes and doing so generated relative weights for each criterion and level. The resulting weights were then used to rank the eight policy options. Results The relative weighting of the criteria were: “reducing health and social harm” (46%), “reducing arrests” (31%), “reducing the illegal market” (13%), “expanding treatment” (8%) and “earning tax” (2%). The top ranked reform options were: “government monopoly” (81%), “not-for-profit” (73%) and “strict market regulation” (65%). These three received higher scores due to their projected lower impact on health and social harm, medium reduction in arrests, and medium reduction in the illegal market. The “lightly regulated market” option scored lower largely due its projected greater increase in health and social harm. “Prohibition” ranked lowest due to its lack of impact on reducing the number of arrests or size of the illegal market. Conclusion Strictly regulated legal market options were ranked higher than both the current prohibition, and alternatively, more lightly regulated legal market options, as they were projected to minimize health and social harms while substantially reducing arrests and the illegal market.
Predictors of voter support for the legalization of recreational cannabis use and supply via a national referendum
(Elsevier B.V, 2022-01) Wilkins C; Tremewan J; Rychert M; Atkinson Q; Fischer K; Forsyth GAL
Background A national referendum to legalise recreational cannabis use and supply in New Zealand via the Cannabis Legalisation and Control Bill (CLCB) was recently narrowly defeated. Understanding the underlying factors for this result can inform the cannabis legalisation debate in other countries. Aims To investigate predictors of voter support for and opposition to the CLCB. Method A representative population panel of 1,022 people completed an online survey of intended voting on the CLCB referendum, which included questions on demographics, drug use history, medicinal cannabis, perceptions of the health risk and moral views of cannabis use, political affiliation, religiosity, community size and reading of the CLCB. Regression models were developed to predict support for the CLCB, with additional predictor variables added over successive iterations. Results The most robust predictors of support for the CLCB were use of and policy support for medicinal cannabis use, voting for a left-wing political party, having a positive moral view of cannabis use, living in a small town and having read the CLCB. Predictors of opposing the CLCB were voting for right-wing parties, considering “frequent” cannabis use to be a high health risk, and lifetime use of other drugs. Age, ethnicity, education, employment status, religiosity and lifetime cannabis use were not significant predictors after controlling for other variables. Conclusions Support for cannabis legalization was not based on broad demographics, but rather specific views concerning the medicinal benefit, morality of cannabis use, health risk of frequent cannabis use, political party affiliation, and knowledge of the proposed regulatory controls of the CLCB. The influence of moral views of cannabis use on voting behaviour suggest the need to debate the right to use cannabis. The importance of knowledge of the proposed regulatory controls of the CLCB on voting underlines the need to raise awareness of proposed regulatory controls during debate.
Foreign investment in emerging legal medicinal cannabis markets: the Jamaica case study
(BioMed Central Ltd, 2021-04-01) Rychert M; Emanuel MA; Wilkins C
Introduction The establishment of a legal market for medicinal cannabis under the Dangerous Drugs Amendment Act 2015 has positioned Jamaica at the forefront of cannabis law reform in the developing world. Many local cannabis businesses have attracted investment from overseas, including from Canada, US and Europe. Aim To explore the opportunities and risks of foreign investment in an emerging domestic legal cannabis market in a developing country. Methods Thematic analysis of semi-structured face-to-face interviews with 22 key informants (KIs) from the Jamaican government, local cannabis industry, academia and civil society, and field observations of legal and illegal cannabis cultivators. Results KIs from the Jamaican public agencies and domestic cannabis entrepreneurs saw foreign investment as an essential source of capital to finance the start-up costs of legal cannabis businesses. Local cannabis entrepreneurs prioritised investors with the greatest financial resources, brand reputation and export networks. They also considered how allied an investor was with their business vision (e.g., organic cultivation, medical vs. recreational). The key benefits of partnering with a foreign investor included transfer of technical knowledge and financial capital, which enhanced production, quality assurance and seed-to-sale tracking. Some KIs expressed concern over investors’ focus on increasing production efficiency and scale at the expense of funding research and development (R&D) and clinical trials. KIs from the local industry, government agencies and civil society highlighted the risks of ‘predatory’ shareholder agreements and domestic political interference. Concerns were raised about the impact of foreign investment on the diversity of the domestic cannabis sector in Jamaica, including the commitment to transition traditional illegal small-scale cannabis cultivators to the legal sector. Conclusion While foreign investment has facilitated the commercialisation of the cannabis sector in Jamaica, regulatory measures are also needed to protect the domestic industry and support the transition of small-scale illegal cultivators to the legal regime. Foreign investments may alter the economic, social and political determinants of health in transitioning from illegal to legal cannabis market economy.
The role of cannabis clinics in the health system: a qualitative study of physicians' views in New Zealand
(BioMed Central Ltd, 2023-01-04) Withanarachchie V; Rychert M; Wilkins C
Background Privately-owned cannabis clinics have sprung up in many jurisdictions where medicinal cannabis has been legalised and provide an alternative pathway for patients who are unable or unwilling to access a prescription for cannabis-based medicinal products from their usual healthcare providers. Aims This study aimed to explore physicians’ views on cannabis clinics, including their perceptions of the role cannabis clinics play in the wider health system. Methods A qualitative study using in-depth, semi-structured interviews with thirty-one physicians affiliated with private and community clinics in New Zealand (including cannabis clinicians, GPs, and specialist doctors). The interviews were conducted from July to December 2021. Data were transcribed and analysed using inductive thematic analysis. Results Cannabis clinicians positioned themselves as (1) “service providers”, facilitating consumer access to cannabis prescriptions and products, and (2) “educators”, providing advice to patients and the wider physician community. While general practitioners and specialists recognised the benefits of specialised cannabis clinics (i.e., knowledge of products and a non-judgmental environment), they questioned the limited evidence of clinical efficacy for cannabis, potential financial conflicts of interests of cannabis clinicians that may blur their clinical judgement, and the risk of compartmentalising patients’ healthcare. Conclusions Our paper raises a number of challenges with attempting to integrate cannabis clinics into the wider health system.
Cannabis use and disorder transitions among a mixed community sample of at-risk adolescents and adults: A prospective New Zealand study
(Bentham Open, 29/11/2013) Bashford J; Copeland J; Flett RA
Introduction and Aims: The trajectories of cannabis use disorder (CUD) require more comprehensive delineation to expedite recognition of incubating dependence among high-risk users. This study examined baseline cannabis use and CUD over 12 months using DSM-IV/ICD10 diagnoses to distinguish transition groups. Design and Methods: In a prospective naturalistic design, 194 heterogeneous cannabis users (128 adolescents, 66 adults) aged 13-61 years were voluntarily recruited and assessed at baseline, and then re-assessed 12-months later. Results: Most participants met criteria for a baseline CUD (70% dependence, 20% abuse), 12 adolescents were 'diagnostic orphans', and 5 symptom-free. At follow-up, 25% adolescents reported using less, 6% the same level, and 69% using more cannabis. Significantly increased symptoms and dependence severity were reported, with no adolescent/adult differences evident. Three diagnostic transition groups were identified. While 84% adolescents (n=108) remained stable, 5% (n=7) had improved, 10% (n=13) had deteriorated. ‘Deteriorators’ scored significantly higher than ‘improvers’ on cannabis use, symptoms, and dependence severity measures. A subjective loss of control over cannabis use was among the earliest DSM-IV features among younger users on a trajectory towards dependence. Most participants (79%) anticipated difficulty trying to reduce/quit their use. Discussion and Conclusions: Younger adolescents can rapidly develop cannabis dependence, reporting similar and equally severe symptoms as longer-term adult users. Impaired control over use occurs early in trajectories towards dependence. The seeming intractability of problematic cannabis use calls for concerted cannabis screening and early intervention (SEI) efforts at an earlier age to avert or reduce harmful consequences of cannabis use in the community.

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