Cannabis withdrawal among Indigenous detainees and inmates

Introduction and Aims: 'Cannabis Withdrawal Syndrome' is proposed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) due for release May 2013. Problematic cannabis use among remote Indigenous communities has been reported in Northern Territory and Queensland studies. When cannabis use is curtailed, many suffer symptoms which can lead to violence, threats, intimidation, sleep disturbances and heightened risk factors of selfharm. Sudden cessation of cannabis use by detainees and inmates could further increase risk. Despite patterns of high cannabis use, dependence and demonstrated risk factors, whether Indigenous detainees/inmates experience withdrawal differently has not been considered. Design and Methods: Dependent cannabis users who identify as Indigenous (Aboriginal and/or Torres Strait Island) aged between 18–40 years will be recruited from far north Queensland police watch houses/Correctional Centres. Interviews with new detainees/inmates will occur on eight different occasions over 28 days. Assessments validated with biological markers, will examine onset and severity of cannabis withdrawal and psychological distress. Results: Retrospective pilot data interviews will be presented along with preliminary fi ndings of the current study. Pilot data revealed 70% (n = 70) of male inmates used cannabis before incarceration with 63% (n = 44) meeting dependence. The average number symptoms using DSM-5 criteria was 2.9 and included irritability/anger/aggression, nervousness/anxiety, sleep difficulties, depression and physical symptoms. Discussion and Conclusions: To improve assessment and timely treatment of cannabis withdrawal within custodial settings, studies are needed to document onset and severity of symptoms and to devise culturally-acceptable resources and support to assist new inmates/detainees to manage withdrawal. Findings from this study will inform the DSM-5, for cultural variations and considerations to the proposed criteria