The Health of Aboriginal and Torres Strait Islander People in the ACT 2006 to 2011

This report, produced by the Epidemiology Section, Population Health Division of the ACT Government Health Directorate provides information on the health of Aboriginal and Torres Strait Islander people in the ACT. Some data specific to alcohol, tobacco and other drugs is compiled in this report including:

In 2008, the Australian Secondary Students Alcohol and Drug Survey found that:

• 85.9% of Aboriginal and Torres Strait Islander students surveyed had ever consumed alcohol (very similar to the 86% of other students).
• 73.8% of ACT Aboriginal and Torres Strait Islander students surveyed reported that they had received at least part of a lesson on the use of alcohol in the previous school year and 67.3% reported receiving at least part of a lesson at school about illicit substance use.
• 54.5% of ACT Aboriginal and Torres Strait Islander students agreed or strongly agreed with the statements that getting drunk every now and then is not a problem; 51.1% that having a few drinks is one of the best ways of relaxing; 53.1% and that having a few drinks is one of the best ways of getting to know people.
• 69.5% of Aboriginal and Torres Strait Islander students reported that an adult was supervising them when they consumed alcohol. 30.4% of students reported that they had tried to buy alcohol themselves.
• 34.6% of Aboriginal and Torres Strait Islander secondary students reported that they had ever used cannabis in their lifetime. Aboriginal and Torres Strait Islander ACT students were significantly more likely than non-Aboriginal and Torres Strait Islander students to report that they had ever used inhalants, cannabis or any illicit substance.
• Significantly more Aboriginal and Torres Strait Islander secondary school students reported that they had ever smoked a cigarette (53.5%), compared with other students (25.7%).
• 53.2% of Aboriginal and Torres Strait Islander students indicated that they were certain they would not be smoking in 12 months time.
• 32.7% of Aboriginal and Torres Strait Islander students perceived that smoking less than 10 cigarettes per day was very dangerous to their health; 87% indicated that smoking more than 20 cigarettes per day was very dangerous to their health; and 84.2% agreed with the statement that the health of non-smokers could be affected by breathing other people’s cigarette smoke.

In 2008, the National Aboriginal and Torres Strait Islander Social Survey found that:

• Smoking rates have declined over recent years with 36.2% of Aboriginal and Torres Strait Islander ACT residents reporting being current smokers in 2008, compared with 44.7 per cent in 2002.
• 72.5% reported low or medium risk of usual daily consumption of alcohol in the 12 months prior to the survey. 24.6% of respondents reported that they had never, or not in the last 12 months, consumed alcohol.

The ACT Maternal and Perinatal Data Collection 2001-09 found that:

• The percentage of Aboriginal and Torres Strait Islander women who reported smoking during pregnancy has increased from 39% to 50% between 2001 and 2009. The increase is not statistically significant, however, rates of smoking during pregnancy were significantly higher for Aboriginal and Torres Strait Islander women compared to other women.

To download the full report click here

Is it cost-effective to provide naloxone to heroin users to reduce overdose deaths?

A study in the USA of the published literature analysed the cost-effectiveness of distributing naloxone (Narcan®) to heroin users for use by witnesses at overdoses. The results were ‘6% of overdose deaths were prevented with naloxone distribution; 1 death was prevented for every 227 naloxone kits distributed…Naloxone distribution increased costs by [US]$53…and quality-adjusted life-years by 0.119…for an ICER [incremental cost-effectiveness ratio] of $438’. The conclusion of the report of the study is that ‘Naloxone distribution to heroin users is likely to reduce overdose deaths and is cost-effective, even under markedly conservative assumptions’.

Download the full report from: https://annals.org/issue.aspx?journalid=90&issueid=926144

ACT Findings from the Illicit Drug Reporting System (IDRS) 2011

The IDRS is an ongoing project conducted annually in all Australian jurisdictions. It aims to monitor the price, purity, availibilty and patterns of use of herioin, methamphetamine, cocaine and cannabis and to identify emerging trends in illict drug markets in Australia that require further investigation.
Some ACT findings from 2011 include:

• There was an increase, compared to 2010, in the proportion of respondents reporting recent use of any methamphetamine (73% in 2011 compared to 59% in 2010). This represents a break in the decline of methamphetamine use since 2006. Despite decreased use, there is still clearly a need for targeted prevention and treatment strategies to help minimise the harms associated with crystal use.
• Use of licit and illicit benzodiazepines decreased in 2011. The percentage of participants who reported recent use of licit benzodiazepines decreased from 47% in 2010 to 29% in 2011 and 34% reported recent use of illicit benzodiazepines in 2011, down from 42% in 2010.
• In 2011, 47% of respondents reported lifetime use of illicit oxycodone, an increase from 21% in 2010. There was also an increase in recent use of oxycodone, increasing from 13% in 2010 to 23% in 2011.
• The proportion of participants sharing injecting equipment (e.g. spoons, mixing containers, water and swabs), re-using their own needles and lending used needles remains significant. These results show that continuing education is necessary to inform people who inject drugs (PWID) of the dangers of sharing injecting equipment.

(Reference from August 2012 Research eBulletin)

Alcohol, drugs perceived to be involved in most assaults

Each year the Australian Bureau of Statistics (ABS) surveys a sample of the Australian population to determine the level of crime in the community. This information is provided nationally and by State and Territory. Crime victim surveys are useful in establishing the profile of groups likely to be victims of crime as well as giving an indication of the amount of crime occurring which is not reported to the police.

The 2010–11 survey was the first time that victims of physical assault and face-to-face threatened assault were asked whether they believed alcohol or any other substance contributed to their most recent incident of assault. Nationally:

• 64% of physical assault victims aged 18 years and over believed alcohol or any other substance contributed to their most recent incident; and,
• 57% of face-to-face threatened assault victims believed the same.

Download the full report from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4530.0Main+Features12010-11?OpenDocument

(Reference from June 2012 Research eBulletin)

Publicly funded alcohol and other drug treatment services are available to people seeking treatment for their own drug use and people seeking assistance for someone else’s drug use. In the Australian Capital Territory, 10 publicly funded government and non-government drug treatment agencies provided 3,156 treatment episodes that were completed in 2010-2011. Some AIHW findings from 2010-2011 include:

• Almost all episodes (98%) were provided to clients who received treatment for their own drug use, and 67% of them were males. The remaining episodes were provided to people who received assistance for someone else’s drug use, and 75% of them were females. People receiving drug for their own use tended to be younger (median age of 32) than those receiving assistance for someone else’s drug use (median age of 45).

• Alcohol was the most common principal drug of concern for clients receiving treatment for their own drug use in a proportion of 54% followed by cannabis (17%), heroin (16%) and amphetamines (6%).

• In addition to the principal drug of concern, clients receiving treatment for their own drug use can have up to five other drugs of concern recorded. Nicotine (12% of episodes) was also a common drug of concern, although nicotine was the principal drug of concern in less than 1% of episodes.

• Assessment only was the most common main treatment type provided to clients receiving treatments for their own drug use (20% of closed episodes), followed by withdrawal management (16%) and counselling (16%). Counselling was the most common type of main treatment for clients receiving treatment for someone else’s drug use (94%), followed by support and case management only (6%).

Comment: The increase in the proportion of episodes with assessment only as the main treatment from 13% in 2009–10 to 20% in 2010–11 was related to one agency’s increased assessments for rehabilitation treatment and some clients failing to attend treatment or being assessed as unsuitable, which results in episodes for which assessment only is the main treatment.

The Australian Capital Territory Government anticipates that the high rate of failure to attend counselling and the increase in the number of people who are assessed as unsuitable for rehabilitation treatment will be reduced with the pilot implementation of an electronic brief screening tool. It is hoped that this tool will reduce the number of unnecessary assessments and ensure that clients are referred to appropriate treatment services.

This pilot sought to implement an ACT version of the eASSIST (developed by Drug and Alcohol Services South across participating ACT ATOD treatment services, and an evaluation report is expected shortly.

Results can be accessed at http://www.aihw.gov.au/publication-detail/?id=60129542757&tab=2

(Reference from April 2013 Research eBulletin)

Alcohol and other drug treatment services in the ACT: findings from the National Minimum Data Set 2009-10

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS-NMDS) was created to assist in the monitoring and evaluation of key objectives of the National Drug Strategy. The AODTS-NMDS captures the number of closed treatment episodes. That is, it does not represent the total number of people in the ACT receiving treatment for alcohol and other drug use because it does not identify when a client receives treatment multiple episodes and/or is treated at multiple agencies.

In the ACT in 2009-10, 10 publicly funded alcohol and other drug treatment agencies provided 3,585 treatment episodes. Alcohol was the most common principal drug of concern (55%), followed by cannabis (17%) and heroin (14%). These proportions were similar to the previous year. Episodes reporting amphetamines as their principal drug of concern dropped by 3 percentage points from 9% in 2008-09 to 6% in 2009-10. The most common form of treatment in 2009-10 was counselling accounting for 30% of treatment episodes, followed by withdrawal management (21%).

The ACT results can be accessed at http://www.aihw.gov.au/publication-detail/?id=10737420901

The national results can be accessed at http://www.aihw.gov.au/publication-detail/?id=10737420496

(Reference from February 2012 Research eBulletin)

Dutch Courage: young people, alcohol and alcohol related violence.

Issues

There is strong evidence supporting the link between alcohol and violence. Being a young person is one of the most significant risk factors related to alcohol related violence. Young males aged between 18-25 years are the largest single group of offenders detained for assault on Friday and Saturday night. Alcohol appears to disproportionately affect the likelihood of young people being both victims and perpetrators of violence.

Approach

This research explored the patterns of alcohol consumption, the value, and role attributed to alcohol and alcohol related behaviours in the lives of young people who socialise in Civic, Canberra. Semi-structured focus group interviews and a survey were used with self-selected peer groups of young people aged 18 – 25 years. Youth participants were used as ‘pathfinders’ to identify target groups, facilitate access to their peers, and arrange a familiar venue for the focus groups.

Findings

Two key findings came from the project. Firstly, the study found that for the majority of participants alcohol was considered an important part of socialising, with most viewing alcohol related violence negatively. However, a second smaller group of young people saw violence as a means to obtain status, empower themselves and as an important part of their identity; and alcohol was used to facilitate this violence. Secondly, the narratives of the participants suggested that there were common patterns to alcohol related violence. The incidents of alcohol related violence were initiated predominantly by groups of males who selected victims with an eye for status attainment. However, these incidences of violence needed to be justified by the perpetrators.

Implications

This project highlights the need to understand young people’s experiences, attitudes to and perceptions of alcohol and alcohol related violence in order to design effective preventative and harm reduction strategies.

Conclusion

Attitudes, values and behaviours relating to alcohol and violence vary among groups of young people. This has implications for policy and practice that aim to reduce the harms of alcohol related violence.

To view the complete report visit: http://www.youthcoalition.net/dmdocuments/DutchCourage_Report.pdf

For further information please contact Justin Barker, Institute of Child Protection Studies, Australian Catholic University, justin.barker@acu.edu.au

(Reference from November  2011 Research eBulletin)

The prohibition of illicit drugs is killing and criminalising our children and we are letting it happen

Report of a high level roundtable held at the University of Sydney on Tuesday 31st January 2012 on the topic “What are the likely costs and benefits of a change in Australia’s current policy on illicit drugs?”

Executive Summary

It is time to reopen the national debate about drug use, its regulation and control. In June 2011 a prestigious Global Commission stated that the 40-year “War on Drugs” has failed, with devastating consequences for individuals and societies around the world. It urged all countries to look at the issue anew.

In response to the Global Commission report, Australia21, in January 2012, convened a meeting of 24 former senior Australian politicians and experts on drug policy, to explore the principles and recommendations that were enunciated by the Global Commission. The group also included two young student leaders, a former senior prosecutor, a former head of the Australian Federal Police, representatives of Families and Friends for Drug Law Reform and a leading businessman.

The Australian group agreed with the Global Commission that the international and Australian prohibition of the use of certain “illicit” drugs has failed comprehensively. By making the supply and use of certain drugs criminal acts, governments everywhere have driven their production and consumption underground and have fostered the development of a criminal industry that is corrupting civil society and governments and killing our children. By defining the personal use and possession of certain psychoactive drugs as criminal acts, governments have also avoided any responsibility to regulate and control the quality of substances that are in widespread use. Some of these illicit drugs have demonstrable health benefits. Many are highly addictive and harmful when used repeatedly. In that respect they are comparable to alcohol and nicotine, which are legal in Australia and, as a result, are under society’s control for quality, distribution, marketing and taxation. Australia has made great progress in recent decades reducing the harm from tobacco – a drug which kills half the people who use it.

Download Australia21′s full report

(Reference from April 2012 Research eBulletin)

2010 ACT Inmate Health Survey

The 2010 ACT Inmate Health Survey (IHS) was the first survey conducted in the ACT prison, the Alexander Maconochie Centre (AMC). Results from this survey will provide the best available evidence to form a baseline assessment of the health needs of prisoners in the ACT. These results will inform the provision of health services and policy development to ensure that health service delivery in correctional facilities meets the needs of the inmate population.

Tobacco and illicit drug use among inmates of the AMC is high according to the survey of 135 inmates (a 67% participation rate). Smokers represented 85% of those surveyed and 20% of those said they commenced smoking while in prison. However, 80% of smokers surveyed expressed a desire to quit. The vast majority (91%) of inmates responded that they had used illicit drugs at some time and 67% of those had injected drugs. 79% of those surveyed reported that they were under the influence of alcohol/other drugs at the time of committing the offence that led to their imprisonment.

The full results of the survey can be accessed at: http://health.act.gov.au/health-services/public-health/epidemiology-branch/epidemiology-publications-health-series/inmate-health-survey-summary-results

(Reference from December  2011 Research eBulletin)

Reducing the burdens of harm through a collaborative workplace tobacco management approach with the non-government alcohol and other drug, mental health and youth sectors in the ACT

Issues

Tobacco interventions have successfully supported the ACT’s smoking rate drop to the lowest in Australia. However, there are subsections of the population where smoking rates remain unacceptably high (30 – 90%) and where conventional interventions have failed. In 2010, ACT Health funded ATODA to pilot a project to assist ATOD, mental health and youth non-government organisations to implement ACT Health’s Smoke-Free Workplace Policy.

Approach

A staged project approach, with research and project management capacity, to work with each pilot site to identify needs, determine intervention approaches, develop and implement site workplans and record decision pathways for policy and intervention approaches.

Key Findings

Initial surveys identified that 52% of staff working in the pilot sites smoked, 79% reported previous quit attempts and a similar number of staff wanted to reduce or quit. A number of staff misconceptions existed and very few staff had undertaken any tobacco control training. Two of nine workplaces had a tobacco policy. Most organisations had both a formal and informal culture of smoking.  Three month follow-up indicates a reduction in smoking rates and in smoking behaviour amongst staff. At the organisational new workplace tobacco management policies are in place and others are in the process of developing and implementing.

Implications

Tobacco management in workplaces with high smoking rates requires dedicated approaches.

Conclusion

This project approach may have broad relevance for the non-government sector wanting to reduce smoking behaviours.

For further information please contact ATODA, on info@atoda.org.au or (02) 6255 4070 or visit www.atoda.org.au/projects/tobacco

(Reference from October  2011 Research eBulletin)

The extent and nature of alcohol, tobacco and other drug use, and related harms, in the Australian Capital Territory – Fourth Edition, version 3, November 2012

This report provides a summary of information on the extent and nature of the use of alcohol, tobacco and other drugs (ATOD) in the ACT, and on the harms associated with that use and with societal responses to drugs, drug use and people who use drugs. It covers drug use; drug availability; drug-related crime, law enforcement and health; and other types of drug-related harm and finds that on most indicators the prevalence of harms related to psychoactive substances in the ACT are stable or falling. Findings from the report include:

• 86% of ACT adults state that they use alcohol, with 5.4% drinking daily and 20% of drinkers being in the ‘risky’ level of consumption, as defined by the National Health and Medical Research Council (NHMRC).
• The ACT’s prevalence of daily tobacco smoking, 11%, is well below the national prevalence.
• Illicit drug use is not uncommon in the ACT, with 14% of household survey respondents aged 14 years or older reporting using an illicit drug in the year before interview.
• Cannabis is the drug most frequently consumed, with 10% reporting recent use.
• Heroin, MDMA (‘ecstasy’), cannabis, methamphetamine and cocaine are said by users to be ‘easy’ to ‘very easy’ to obtain in the ACT. This is in contrast to earlier years when the level of cocaine availability was low.

The full report can be accessed here

(Reference from July 2012 Research eBulletin)

What do women who inject drugs feel about their health?

A research team based at the National Centre for Epidemiology and Population Health at the ANU and UNSW drew on interviews with 83 Australian women who inject drugs and who are living with the hepatitis C virus [HCV], and examined their attitudes and priorities towards health needs and care. The interviews covered the women’s experiences of alcohol and other drug use, HCV diagnosis and care as well as contraceptive and reproductive histories. The researchers found that ‘…women discussed their health within broader contexts of drug dependence, unstable housing, unemployment, financial strain, other health issues and relationships. Concern about HCV was less pronounced than concerns about other health problems and socio-economic circumstances. Broadening the focus of health beyond drug use alone, women’s narratives strongly suggest that PWID [people who inject drugs] can and do care about their health’. They concluded that ‘Whilst research and policy often focus on health problems and barriers to health amongst PWID, the women in our sample maintained positive health beliefs and behaviours. Much like other members of society, their health priorities are contextualised by cultural, economic and political factors. This suggests that health interventions aimed at women who inject drugs could build upon the salience of a range of health priorities as well as integrating these with structural interventions designed to improve housing and economic status’.

(Reference from October 2012 Research eBulletin)

We’re Struggling in Here!

The Phase 2 Study into the Needs of Aboriginal and Torres Strait Islander People in the ACT Alexander Maconochie Centre and the Needs of their Families

This report was released in February 2012 and aims to promote a better understanding of the case management and needs of Aboriginal and Torres Strait Islander prisoners and released prisoners and their families, following a model of holistic health service delivery.

Findings

What are the specific health and social and emotional wellbeing needs of the Aboriginal people in the AMC and are they being met?

The following concerns were raised by the AMC respondents interviewed:

• There are delays and problems with the paper work necessary to consult a doctor in the AMC.
• There are delays in seeing a dentist.
• There are delays in reciving medication on entry to the AMC.
• There is uncertainty about consulting medical practitioners outside the AMC.
• There is reluctance to consult non-Aboriginal, non-Winnunga professionals for mental health assistance.

What are the specific health and social and emotional wellbeing needs required by the family when a family member is in the AMC and on release, and are they being met?

• Respondents indicated that assistance was provided to their families by various support organisations but there is a strong reliance on Winnunga medical and dental, and social and emotional wellbeing services.
• Young mothers coping alone in the community when a family member is in the AMC can experience financial and psychological difficulties of bringing up children alone.
• Grandmothers who are caring for grandchildren when a family member is in the AMC struggle financially and psychologically and suffer ill health.
• There is a high rate of Aboriginal family members being turned away from visiting family members, which they find very stressful in the absence of counselling from the ALO or an Aboriginal staff member.
• Overwhelming consensus from all respondents that the ACTION Bus timetable is inadequate for visiting purposes.
• The needs of families when a family member is released from the AMC are significant and complex.

The report recommends the introduction of the following AMC initiatives in relation to drug and alcohol issues:

• Tobacco programs.
• Pre and post test counselling for blood borne virus testing.
• Blood borne virus testing on admission, three months post admission and at discharge for all prisoners.
• Professional tattooing and piercing program.
• Literacy and Numeracy Programs.
• Provision of bleach and education on its use.
• Needle and Syringe Program.
• Provision of Naloxone on release from the AMC.

For information contact Dr Nerelle Poroch at Winnunga Nimmityjah Aboriginal Health Service at Nerelle.Poroch@winnunga.org.au or visit: www.winnunga.org.au

(Reference from March 2012 Research eBulletin)

Supply, demand and harm reduction strategies in Australian prisons: an update

The Australian National Council on Drugs (ANCD) has recently released the research report, Supply, demand and harm reduction strategies in Australian prisons: An update. The National Drug and Alcohol Research Centre (NDARC) was commissioned to undertake the report which involved a survey of each state and territory’s prison system. The report examines supply, demand and harm reduction strategies in each jurisdiction’s prison system as well as information about post-release services and the prevalence of drug use among prisoners in 2009.

The report emphasises difficulties obtaining relevant information from many jurisdictions, and the result was a less than comprehensive review of the situation across Australia in 2009. The report generally found that there is an overemphasis on supply side drug strategies, such as cell searches and the use of sniffer dogs at the expense of demand reduction measures such as drug treatment and harm reduction measures such as the provision of sterile injecting equipment. The report also noted lack available evaluations of the effectiveness of drug strategies in prisons.

The ACT chapter provides a summary of the supply, demand, harm reduction and post-releases services at the Alexander Maconochie Centre in 2009, shortly after it commenced operations. The report describes the ACT’s drug strategies favourably compared with other jurisdictions and noted the significance of moves to introduce a needle exchange program in the AMC at that time.

Key findings related to the ACT include:

• In 2009, the AMC provided a range of supply reduction programs, including urinalysis of prisoners, cell and area searches, drug detection dogs and metal detection of all visitors to the AMC.
• Between 1 June and 31 December 2009, syringes were seized from prisoners on 12 occasions and from visitors on 8 occasions
• Between 1 June and 31 December 2009, cell searchers produced 20 drug seizures and area searchers produced 17 drug seizures.
• In 2009-10, cannabis was the most common drug detected by urinalysis among inmates
• In 2009, the AMC provided a range of drug treatment programs, including detoxification, methadone and other pharmacotherapies, counselling, and a therapeutic community
• In 2009, the AMC provided a range of harm reduction services, including education programs, blood-borne virus testing, condom/dental damns and disinfectant. The ACT Government was also planning on introducing a needle exchange program.

The report can be found at the ANCD website

(Reference from September 2012 Research eBulletin)