policy
By hook or by crook
We ’ re not reaching people with problematic cannabis use says Lizzie McCulloch , whose report Black sheep offers a new approach to policy and treatment
Cannabis is now being cited as a problematic substance by 21 per cent of clients going through treatment and figures from Public Health England ( PHE ) show that new presentations for cannabis treatment increased by 55 per cent between 2005 and 2014 . These figures do not paint the whole picture though , as there are also thousands of people outside of treatment who require support .
In response to indicators showing there is an increasing need for support and guidance , Volteface , a drug policy think tank , wanted to find out how effectively existing interventions were supporting people experiencing problematic cannabis use . Drawing on contributions from leading experts and practitioners , and people with lived experience of problematic cannabis use , our newly released report , Black sheep , shines a spotlight on the harms of heavy and sustained cannabis use .
Put bluntly , we found that cannabis has been neglected in public health discourses , which is at odds with the growing number of people in England who
UK Cannabis treatment presentations , 2005-2014
‘ Cannabis has been neglected in public health discourses , which is at odds with the growing number of people in England who are seeking support for problematic cannabis use ...’
are seeking support for problematic cannabis use . It was apparent that there has been increasing attention given to problematic cannabis use , mostly at an operational level , but overall , cannabis has not been appropriately prioritised . What is concerning is that out of non-opiate clients accessing treatment , cannabis users were the most likely to have unchanged use at the six-month review , which equated to 42 per cent of those who entered treatment .
For people who do not enter treatment , it was revealed that the ‘ image ’ of treatment was offputting , whether due to social stigma surrounding treatment or the perception that treatment was only for ‘ extreme ’ cases . However , alternative options were limited as one-to-one interventions were mostly confined to dedicated drug treatment services , with wider community services severely limited in what they could offer . For people who are seeking to manage their cannabis use relatively independently , there are limited public resources available , with added concerns over quality and accessibility .
A unified and multifaceted approach is needed to respond to the cannabis cohort . A wider structural barrier that stakeholders identified , however , was that practitioners do not have a clear strategy for linking people experiencing problematic cannabis use into services . With the current illegal and unregulated market reducing the visibility of cannabis users , one practitioner commented that ‘ we ’ re just fumbling around in the dark trying to find them ’. Among people showing signs of cannabis dependence ,
only ‘ 14.6 per cent had ever received treatment , help or support specifically because of their drug use , and 5.5 per cent had received this in the past six months ’. To respond to these challenges , Volteface have drawn up sensible , innovative policy options , which are grounded in contributions from stakeholders and experts . We identified that a two-stage approach is needed : reforming existing public health measures to tailor support to the needs of problematic cannabis users and the introduction of a regulatory framework that links these public health measures with their intended audience .
Research into the social costs of problematic cannabis use by PHE would provide justification for commissioners , and therefore providers , to appropriately prioritise cannabis within treatment . Moreover , a shift towards holistic service provision and promotion by drug and alcohol service providers and wider community services would aim to increase interaction and engagement with support , while reducing stigma attached to drug treatment .
A move towards a regulated market would offer a targeted dialogue with people experiencing problematic cannabis use , offering opportunities for harm reduction advice to be delivered at point of purchase , and any person in need of support to be linked into reformed public health measures . There would also be the emergence of wider opportunities for more public guidance , packaging controls , products that vary in potency , and research into cannabis culture and consumption . During Volteface ’ s consultation with people experiencing problematic cannabis use , it became apparent that respondents felt ‘ advice from a professional is far better than advice from a dealer ’. Despite numerous examples of good practice taking place across the sector , the collective effort is currently not meeting the needs of people experiencing problematic cannabis use . Change is within our grasp , but we need to be ambitious and innovative when it comes to reaching a growing and diverse group of people .
Volteface ’ s recently released report , Black sheep is at http :// volteface . me / publications / black-sheep /
Lizzie McCulloch is policy advisor at Volteface
8 | drinkanddrugsnews | February 2017 www . drinkanddrugsnews . com