Cannabis+is+our+culture!

student number 8708932 student name Fong Ka Yuet,Angel Tutor: Mangalam Sankupellay

Artefact: Cannabis is not our culture! ‘’Cannabis is not out culture’’ was designed by an artist from the Torres Strait Islands, who says, ‘’my painting represents the circle of cannabis in our community. Cannabis is not our culture. I believe everybody has a gift from the day they were brought to this world, cannabis can take away that gift.’’ (Cape York Cannabis Project Artwork Posters, 2011). The text of the poster describes some of the negative impacts of cannabis use and along with the illustration provides a powerful message.

This poster was created as part of the Cape York Cannabis Project and the Weed It Out Initiative, produced by the Queensland Police Service and James Cook University. This poster offers an indigenous perspective on the impact of cannabis use in their communities and on their culture. (Cape York Cannabis Project Artwork Posters, 2011)

**Core Public health Issue** The main health issue represented by this artefact is the negative impact of illicit drug use, specifically cannabis on the health and well-being of the Aboriginal community.

Before 1980s, cannabis was little known to the Aboriginal population (Select Committee on Substance Abuse in the Community, 2007).There was a sharp increase in the rate of cannabis use following a rapid and widespread uptake in these communities from the late 1990s (Clough et al., 2006). This issue needs to be addressed as cannabis use increases physical, mental and social burden on Aboriginal communities which are already disadvantaged by isolation and poverty (Lee et al., 2009). Last but not least, cannabis use can increase the risk of incarceration(Clough et al., 2006).

**Literature review** The most common illicit drug among Aboriginal and Torres Strait Islander people is cannabis (Australian Institute of Health and Welfare, 2011). One-third of Aboriginal and Torres Strait Islander people aged 15 years or older had ever used cannabis and 16% had used cannabis in the 2007. In 2010, indigenous Australians were 1.6 times as likely as non-indigenous Australians to have recently used cannabis (AIHW, 2011). Only a small proportion, 13.4% of Aboriginal and Torres Strait islander people, approved of the regular use of cannabis, but this was higher than among other non-indigenous people (7.8%) (AIHW, 2011).

Over the past ten years, there have been studies analysing the prevalence and pattern of cannabis use and the impact of cannabis use among the aboriginal population. In this literature review, the consequences of cannabis use on - mental, physical, social health and incarceration rate – among aboriginal communities will be analysed. Furthermore, the methodologies used in these studies will be discussed.

Indigenous Australians are four to five times more likely than other Australians to be hospitalised for mental disorders because of psychoactive substance use (AIHW, 2009). Cannabis use can contribute to mental disorders such as depression, anxiety-dependence, psychosis illness and thoughts of suicide (Clough et al., 2006;Conigrave et al., 2009; Bohanna & Clough, 2012). For example, Clough et al. (2006) notes that 33 continuing cannabis users in Northern Territory, who were successfully reinterviewed, reported adverse effects on mental health symptoms e.g. showing anxiety-dependency or psychosis. On the other hand, Bohanna & Clough (2012) states that 23.4 % of current and previous cannabis users in Cape York Indigenous community reported they were ‘stressing out’ when cannabis was unavailable, suggesting symptoms of cannabis withdrawal. Also, anger and thoughts of self-harm were reported in 8.5% and 4.3 % of current or former users respectively. In addition, Lee et al. (2008) reveals that heavy cannabis users were four times more likely than the remainder of the sample (never, former and lighter users) to report moderate to severe depressive symptoms. These studies show continuing or heavy cannabis use associated with adverse mental health impacts among Aboriginal communities.

In 2003, illicit drug use accounted for 3.4 % of the indigenous burden of disease and injury compared with 2 % of the whole Australian population (AIHW, 2011). Between 2003 and 2007, there were 30 Aboriginal and Torres Strait Islander deaths related to illicit drug use (AIHW, 2011). On the other hand, suicide rates among indigenous people aged up to 24 years are five times higher for females and three times higher for males when comparing with their non-indigenous counterparts (ABS & AIHW, 2005). According to longitudinal study from Clough et al. (2006), cannabis users had a significantly higher risk of having a medical record of actual (or intended) self-harm than those who never used it. This requires more studies in research to establish links between cannabis use data and suicide data.

Cannabis is viewed as a major cause of social disruption in Northern Territory Aboriginal communities (Conigrave et al., 2009; SCSAC, 2007) and is linked with considerable financial burdens and acts of violence by users when cannabis supplies are scarce. As stated by Australian Bureau of Statistics (2008), the unemployment rate for indigenous people (16.6%) was more than three times the unemployment rate of the Australian civilian population (5%), meanwhile Ab11 shows that the expenditure on cannabis by indigenous people per week may represent at least 6-10% of the total monetary resources available in these communities. With the wide spread of cannabis use and an absence of employment, this has resulted in a difficult situation. It implies a financial drain on the communities in the long run (Clough et al., 2004) and creates a burden on cannabis users which in turn, leads to pressure on other people around the users, particularly family members, occasionally with violence and intimidation (Clough et al., 2004).

The same study from Clough,et al. (2006) states that cannabis users, compared with those who never used it, had a significantly greater risk of having a history of imprisonment. Indigenous persons in Western Australia were 21-27 times more likely to be in prison than non-indigenous persons (Hunter, 2008). High offending and incarceration rates of indigenous people are directly related to the dysfunctional environments and overwhelming poverty (Hunter, 2008). Indigenous people who live in such environment witness substance abuse (comprising illicit drugs). They consume illicit drugs as a mean of temporarily escaping the frustrations and stress of poor and chaotic living conditions (Hunter, 2008). There are limitations regarding to these studies because Clough et al. (2006) has no clear statistics to show the rate of imprisonment associated with cannabis use and Hunter (2008) only described the incarceration rate in Western Australia.

The methodologies used in all these examples of literature are typically self-reported face-to-face interviews with Aboriginal people within the same communities in Northern Territory (Clough et al., 2006; Lee et al., 2008; Conigrave et al., 2009) or in Cape York communities(Bohanna & Clough, 2012).There are several limitations related to these methods in gathering representative data about the cannabis use for indigenous people. Over two-thirds of Aboriginal and Torres Strait Islander people lived outside the major cities, with 24% living in remote or very remote areas (ABS, 2008). This creates particular challenges for data collections such as increased costs and the need to ensure methods that are culturally appropriate (AIHW, 2011). Moreover, Aboriginal communities are small and isolated with highly mobile population (AIHW, 2011). The complex cultural setting and interactions with the criminal justice system and enforcement have also been highly problematic (Clough et al., 2006).Due to this, the sample sizes were quite insignificant in these studies and also there was a low success rate in follow-up the existing participants interviewed at baseline (Clough et al., 2006; Conigrave et al., 2009). For example, the 2004-2005 ABS National Aboriginal and Torres Strait islander health Survey (NATSIHS) collected information only about illicit drug use in non-remote communities. The 2008 ABS National Aboriginal and Torres Strait islander Social Survey (NATSISS) had relatively large rate (53%) of under coverage compared with other ABS surveys. These limitations in the studies cannot help us to fully understand the situation and redress the health issue among the aboriginal communities.

**Cultural and social analysis** When we are trying to understand and redress the issue of cannabis use among Aboriginal communities, it is important for us to first consider both Australian and Aboriginal society and also their cultures. Australian government has been intervening in Aboriginal communities since Australian colonization.

The cultural politics of Australian colonialism revolve around discourses of paternalism and the protection of Aboriginal people (Probyn-Rapsey, 2007). Nowadays, the whites’ paternalistic attitudes towards Aboriginal people and culture are pervasive. They believed Aboriginal cultures were essentially worth preserving, so they wanted to protect Aboriginal people from contamination by the dominant culture in Australia (Probyn-Rapsey, 2007) and the decline of traditional culture can be avoided. Nevertheless, Paternalism indeed gives more chances to whites than to Aboriginal people, as well as embedding poverty in the Aboriginal community. The white Australian culture dominates over Aboriginal communities and prevents Aboriginal ‘self-determination’ (Probyn-Rapsey, 2007). These underlying assumptions about Aboriginal people reinforce their passive situation and take away their autonomy on having the responsibility for themselves and their communities.

There is one recent example of white paternalism in the aboriginal community. In 2007, Prime Minister of Australia, John Howard, announced an ‘emergency intervention’ into Aboriginal communities in the Northern Territory (Maddison, 2008). The intervention was justified as a response to child sexual abuse among the communities. The intervention was far-ranging which include the quarantining of welfare payments, new alcohol restrictions, compulsory health checks for children, and the acquisition of townships by the government through five-year leases (Maddison, 2008). There are arguments and debates that the federal intervention is a simplistic and unwise response to the complex reality of indigenous political culture. Australian paternalistic policy seeks to control Aboriginal people’s behaviour through intimidation and punishment; this is just the wrong response to problems in Aboriginal communities, as it will further entrench the dependencies that have triggered social breakdown in the first place (Maddison, 2008).

The awareness of cannabis use issue is important because it not only affects the Indigenous users but also their families and the whole communities (Conigrave et al., 2009; SCSAC, 2007). Paternalistic Interventions of the past have not proven successful, it clearly demonstrated that aboriginal people did not have the equal right as the white Australian and had no control of their life (Maddison, 2008). Therefore, when we try to redress the cannabis use issue, we need to consider the people affected by it. Public health experts should focus on encouraging the involvement of Aboriginal people or the aboriginal communities in finding solutions to their health issues, using suggestions from aboriginal people to solve the aboriginal problems.

**Analysis of the artefact and my own learning reflections** The artefact is clearly related to my issue and a good example of a culturally appropriate public health response. From my point of view, those circles on the artefact represent the whole Aboriginal community. The footprints surrounding the cannabis represent a user’s relationship with cannabis. This artefact shows that cannabis influence Aboriginal people’s life journey in a negative way where they can fall into the trap of cannabis use and can lead to imprisonment as the handcuff represents being arrested. I found this artefact is really meaningful and impressive as it was created by an Indigenous person. The message  Cannabis is not our culture  was strong and powerful that it reveals cannabis is not what the Aboriginal community want. They want to convey what truly meant to them.

After doing this assessment piece, I have learnt more about this small and isolated group of Indigenous people. I can see the impact of Australian colonization on Aboriginal communities. I have gained more understanding of the reasons that they are still being disadvantaged and living under poverty nowadays. The sad and harsh reality is Indigenous people not only facing illicit drug abuse but also other problems such as poor health, malnutrition, limited education, alcoholism and lack of gainful employment. Even their situations have raised people awareness and Australian governemnt had intervened in the Aboriginal communiteis, but their problems are still existing and I believe we need to get the Aboriginal people involved in carrying out solutions, listen to their voice and truly understand what they need. therefore, this can help to solve their problems.

**Reference lists** Australian Bureau of Statistics; Australian Institute of Health and Welfare (2005). The health and welfare of Australia’s Aboriginal and Torres Strait islander peoples. Canberra: ABS, Retrieved from []

Australian Institute of Health and Welfare (2007). Aboriginal and Torres Strait Islander Health Performance Framework, 2006 report: detailed analyses. Canberra: AIHW

Australian Bureau of Statistics. (2008). National Aboriginal and Torres Strait Islander Social Survey. Retrieved from http:[|**www.abs.gov.au/ausstats/abs@.nsf/Latestproducts/4714.0Main%20Features72008?opendocument&tabname=Summary&prodno=4714.0&issue=2008&num=&view**]

Australian Institute of Health and Welfare 2011. Drugs in Australia 2010: tobacco, alcohol and other drugs. Drug statistics series no. 27. Cat. no. PHE 154. Canberra: AIHW. Bohanna, I., & Clough, A.R. (2012). Cannabis use in Cape York Indigenous communities: High prevalence, mental health impacts and the desire to quit. //Drug and Alcohol, 31//, 580-584. DOI: 10.1111/j.1465-3362.2011.00405.x

Cape York Cannabis Project Artwork Posters. (2011). National cannabis prevention and information centre. Retrieved from []

Clough, A. R., Lee, K., Cairney, S., Maruff, P., O'Reilly, B., d'Abbs, P., & Conigrave, K. M. (2006). Changes in cannabis use and its consequences over 3 years in a remote indigenous population in northern Australia. //addiction, 101//(5), 696-705. doi:10.1111/j.1360-0443.2006.01393.x

Conigrave, K.M., Lee, K.S.K., Clough, A.R., Dobbins, T.A., Jaragba, M.J., & Patton, G.C. (2009). Five-year longitudinal study of cannabis users in three remote Aboriginal communities in Arnhem Land, Northern Territory, Australia. //Drug and Alcohol Review, 28//, 623-630. DOI: 10.1111/j.1465-3362.2009.00067.x

Clough, A.R., D’ABBS, P., Cairney, S., Gray, D., Maruuf, P., Parker, R., & O’Reilly, B. (2004). Emerging patterns of cannabis and other substance use in Aboriginal communities in Arnhem Land, Northern Territory: a study of two communities. //Drug and Alcohol Review, 23//,381-390. DOI: 10.1080/09595230412331324509

Hunter, D. (2008). How the criminal justice system can be best utilised to reduce the increasing rate of offending and imprisonment of Western Australia’s Indigenous population. //Elaw Journal: Murdoch University Electronic Journal of Law, 15//(2), 134-144.

Lee, K.S., Clough, A.R, Jaragba, M.J., Conigrave, K.M., & Patton, G.C. (2008). Heavy cannabis use and depressive symptoms in three Aboriginal communities in Arnhem Land, Northern Territory. //Medical Journal of Australia, 188//(10), 605-608.

Lee, K.S.K., Conigrave, K.M., Patton, G.C., & Clough, A.R. (2009). Cannabis use in remote Indigenous communities in Australia: endemic yet neglected.//Medical Journal of Australia, 190//(5), 228-229.

Maddison, S.(2008). Indigenous autonomy matters: what’s wrong with the Australian government’s ‘intervention’ in Aboriginal communities. //Australian Journal of Human Rights, 14//(1),41-61.

Probyn-Rapsey, F. (2007). Paternalism and Complicity: Or How Not to Atone for the 'Sins of the Father.'. //Australian Literary Studies, 23//(1), 92-103.

Select Committee on Substance Abuse in the Community. (2007). Substance Abuse in Remote Communities: Confronting the Confusion and Disconnection, Legislative Assembly of the Northern Territory, Darwin

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