a James Cook University , Australian Institute of Tropical Health and Medicine , Cairns , Australia.
Subst Use Misuse. 2019;54(5):699-712. doi: 10.1080/10826084.2018.1504078. Epub 2019 Feb 22.
Heavy cannabis use in remote Indigenous Australian communities potentially contributes to existing health disparities. Community members' perceptions of cannabis harms will support harm-minimization in these settings.
To describe perceived cannabis harms reported by a cohort of Indigenous Australians living in small, isolated communities as an indication of their existing resources for change.
Inductive thematic analysis of 407 semi-structured interviews with participants in a cohort study in three remote communities in Cape York in far north Queensland (Australia) revealed major areas of concern about cannabis. Three attitudinal categories were defined according to reported cannabis impacts and urgency for change: 1- "LOW CONCERN" said cannabis was a low priority community issue; 2- "SOME CONCERN" tolerated cannabis use but identified personal or community-level concerns; and 3- "HIGH CONCERN" expressed strong aversion to cannabis and identified serious personal or community-level harms. The characteristics and the patterns of concerns were summarized across the groups.
"Category 1- LOW CONCERN" (n = 107), mostly current users, emphasized personal "financial impacts" and "stress." "Category 2 - SOME CONCERN" (n = 141) perceived community level impacts warranting systematic action, particularly on "employment"; and "Category 3 - HIGH CONCERN" (n = 159), most of the never users, emphasized concerns for families and youth. Irrespective of use history, the cohort reported financial and abstinence-related stress, overlapping alcohol issues and generally endorsed alleviating impacts on children and youth.
Nearly ubiquitous experience with cannabis harms and impacts in this cohort suggests resources for harm reduction including family and cultural obligation, stress relief, financial management, and engagement are available across all community members, not just users.
偏远的澳大利亚原住民社区中大量使用大麻可能导致现有的健康差距。社区成员对大麻危害的看法将支持在这些环境中实施危害最小化措施。
描述生活在北昆士兰州约克角偏远社区的一群澳大利亚原住民报告的大麻危害感知情况，以表明他们在这些环境中进行变革的现有资源。
对来自北昆士兰州约克角三个偏远社区的队列研究中的 407 名参与者进行的半结构化访谈进行归纳主题分析，揭示了对大麻的主要关注领域。根据大麻的影响和变革的紧迫性，将态度分为三个类别：1-“低关注”表示大麻是社区的低优先级问题；2-“有些关注”容忍大麻的使用，但认为存在个人或社区层面的问题；3-“高关注”强烈反感大麻，并认为大麻对个人或社区层面造成严重危害。总结了各组的特征和关注模式。
“类别 1-低关注”（n=107）主要是当前使用者，强调个人“经济影响”和“压力”。“类别 2-有些关注”（n=141）认为大麻的社区层面影响需要采取系统行动，特别是在“就业”方面；“类别 3-高关注”（n=159），大多数从未使用者，强调对家庭和青年的关注。不论使用历史如何，该队列报告了与财务和禁欲相关的压力、重叠的酒精问题，并且普遍支持减轻对儿童和青年的影响。
该队列中的大麻危害和影响经验几乎普遍存在，这表明减轻危害的资源包括家庭和文化义务、减轻压力、财务管理和参与，这些资源不仅适用于使用者，也适用于所有社区成员。
