Proportions and correlates of high‐risk cannabis use in Australia—A cross‐sectional analysis of the 2022–2023 National Drug Strategy Household Survey

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BACKGROUND AND AIM: Cannabis use is prevalent in Australia; however, limited research has explored the proportion of high-risk, disordered cannabis use within nationally representative samples. This study aimed to address this gap by measuring the proportion of individuals meeting criteria for high-risk cannabis use and identifying its correlates in a representative Australian dataset. METHODS: Observational study using data from the 2022-2023 Australian National Drug Strategy Household Survey on respondents self-reporting cannabis use in the past three months (n = 1504). Cannabis use risk was assessed using the World Health Organization's ASSIST-Lite (WHO-ASSIST-Lite). Multinomial logistic regression examined associations between risk and cannabis use patterns, psychological distress and sociodemographic characteristics. RESULTS: Most respondents had low or no risk of cannabis-related problems [71.6%, 95% confidence interval (CI)_= 68.6-74.6%], with 22.2% (95% CI = 19.4-25.0%) at moderate risk and 6.2% (95% CI = 4.6-7.8%) at high risk. Daily consumption of cannabis was strongly associated with an increased risk of high-risk use [relative risk ratio (RRR) = 5.70, 95% CI = 3.25-9.98, P < 0.001] compared with weekly use. Early initiation, particularly before age 15, was also associated with greater probability of high-risk use (RRR = 2.52, 95% CI = 1.25-5.08, P = 0.009), as was initiation between ages 15-17 (RRR = 2.25, 95% CI = 1.19-4.25, P = 0.013), compared with initiation at age 18 or older. Respondents who reported psychological distress had an increased risk of high-risk cannabis use (RRR = 3.19, 95% CI = 1.66-6.11, P < 0.001). CONCLUSION: A substantial proportion of Australians who consume cannabis appear to meet criteria for high-risk use. Daily use, early age of initiation and high psychological distress may be key risk factors.

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