Treatment of cannabis use among people with psychotic disorders : critical review of randomised controlled trials

There is growing and converging evidence that cannabis may be a major risk factor in people with psychotic disorders and prodromal psychotic symptoms. The lack of available pharmacological treatments for cannabis use indicates that psychological interventions should be a high priority, especially among people with psychotic disorders. However, there have been few randomised controlled trials (RCTs) of psychological interventions among this group. In the present study we critically overview RCTs of psychological and pharmacologic interventions among people with psychotic disorders, giving particular attention to those studies which report cannabis use outcomes. We then review data regarding treatment preferences among this group. RCTs of interventions within "real world" mental health systems among adults with severe mental disorders suggest that cannabis use is amenable to treatment in real world settings among people with psychotic disorders. RCTs of manual guided interventions among cannabis users indicate that while brief interventions are associated with reductions in cannabis use, longer interventions may be more effective. Additionally, RCTs reviewed suggest treatment with antipsychotic medication is not associated with a worsening of cannabis cravings or use and may be beneficial. The development of cannabinoid agonist medication may be an effective strategy for cannabis dependence and suitable for people with psychotic disorders. The development of cannabis use interventions for people with psychotic disorders should also consider patients' treatment preferences. Initial results indicate face-to-face interventions focussed on cannabis use may be preferred. Further research investigating the treatment preferences of people with psychotic disorders using cannabis is needed.

Transforming saltbush : science, mobility and metaphor in the remaking of intercolonial worlds

The movement of exotic biota into native ecosystems are central to debates about the acclimatisation of plants in the settler colonies of the nineteenth century. For example, plants like lucerne from Europe and sudan grass from South Africa were transferred to Australia to support pastoral economies. The saltbush Atriplex spp. is an anomaly-it too, eventually, became the subject of acclimatisation within its native Australia because it was also deemed useful to the pastoralists of arid and semi-arid New South Wales. When settlers first came to this part of Australia, however, initial perceptions were that the plants were useless. We trace this transformation from the desert 'desperation' plant during early settlement to the 'precious' conservation species, from the 1880s, when there were changes in both management strategies and cultural responses to saltbush in Australia. This reconsideration can be seen in scientific assessments and experiments, in the way that it was commoditised by seeds and nursery traders, and in its use as a metaphor in bush poetry to connote a gendered nationalist figure in Saltbush Bill. We argue that while initial settlers were often so optimistic about European management techniques, they had nothing but contempt for indigenous plants. The later impulses to the conservation of natives arose from experiences of bitter failure and despair over attempts to impose European methods, which in turn forced this re-evaluation of Australian species.