2011 April 27 - Injecting drug use and associated harms among Aboriginal Australians
AUSTRALIAN NATIONAL COUNCIL ON DRUGS (ANCD) AND THE NATIONAL INDIGENOUS DRUG AND ALCOHOL COMMITTEE (NIDAC)
A major new report on injecting drug use among Aboriginal and Torres Strait Islanders released
The report was prepared for the ANCD by Anex and the National Aboriginal Community Controlled Health Organisation (NACCHO), and was commissioned to record a national picture in understanding the dimensions and characteristics of Aboriginal and Torres Strait Islander injecting drug use and its associated harms, including gaps in knowledge, and identifying opportunities available to improve service responses.
The consultants undertook a review of available literature, as well as consultations with 45 key experts from across Australia, working in Aboriginal Community Controlled Organisations and mainstream health services, drug user advocacy organisations, front-line services, and key researchers.
The report, Injecting Drug Use and Associated Harms among Aboriginal Australians, highlights a number of key findings.
Available information indicates that the proportion of injecting drug users accessing safe injecting services who are Aboriginal and Torres Strait Islander has more than doubled in ten years from a rate of 5 percent in 1995 to 10 percent in 2005.
NIDAC’s Chair, Associate Professor Ted Wilkes says: “limited evidence suggests that over the past 15 years in some jurisdictions there have been significant increases in the prevalence of injecting drug use among Aboriginal and Torres Strait Islander people.”
One of the main findings is the lack of comparable, reliable national data, with very little research available that has explicitly attempted to assess the prevalence of injecting drug use among Aboriginal and Torres Strait Islander people, at a national level. “The fact that we do not have accurate data on prevalence is not good enough. If we are to address this issue and other health related ones we must firstly have good data on prevalence and then what is working in regard to interventions” said Professor Wilkes.
The report also highlights the need to improve service responses for Aboriginal and Torres Strait Islander people who inject drugs. ANCD Chairman, Dr John Herron says: “our funding needs to ensure that people receive the support they need. Injecting drug use obviously has implications not just for the individual and the family, but for the broader community. The harms associated with injecting drug use can have the potential to threaten the social fabric and cultural health of communities.”
Increasing training and support for people working with Aboriginal and Torres Strait Islander people who inject drugs is identified as an effective way of achieving improving service responses. This includes the availability of nationally accredited training for all Aboriginal and Torres Strait Islander drug and alcohol workers, targeted training for Aboriginal and Torres Strait Islander people working in the drug and alcohol sector, and cultural sensitivity training for mainstream health workers.
Issues associated with access to services have also been raised in the report. Increasing access to programs that provide, safe injecting equipment and harm reduction services nationally is seen as an important step, as is the availability of treatment options such as detoxification and rehabilitation services nationally, particularly Aboriginal and Torres Strait Islander specific services. In the case of mainstream health services, increased education is required on the principles of culturally sensitive service provision for Aboriginal and Torres Strait Islander people who inject drugs. The importance of the individual, the family and the broader community also needs to be included as part of this education.
There is also the need for more effective engagement with Aboriginal and Torres Strait Islander people who inject drugs, in both mainstream and Aboriginal and Torres Strait Islander health services, through improvement in service design and delivery. Addressing the stigma and shame often associated with injecting drug use, particularly within many Aboriginal and Torres Strait Islander communities, would assist in reducing potential barriers to accessing services.
This report also notes that Aboriginal and Torres Strait Islanders, and in particular those who inject drugs, are vulnerable to even poorer health outcomes than the rest of the Australian population who inject drugs. The social determinants of Aboriginal and Torres Strait Islander health are clearly negatively impacted upon by substance use, and compounded when it includes injecting drug use.
The report states there are a number of specific issues associated with populations within the Aboriginal and Torres Strait Islander community that require particular attention. These include recognition of the different contexts and therefore different approaches that might be appropriate for Aboriginal and Torres Strait Islanders living in urban, rural and remote areas. It also draws attention to those with particular problems, such as comorbidity and those with special needs, such as prisoners and young people.
ANCD Executive Member and Chair of the ANCD’s Project Reference Group, Professor Margaret Hamilton stated: “the harms associated with injecting drug use among Aboriginal and Torres Strait Islanders appears to be clear from the descriptions in this report. The next step has to be one of action. We need a structured and detailed approach to planning and delivering services with measurable outcomes that deal with the complexities of preventing and responding to Aboriginal and Torres Strait Islanders who inject drugs.”
“This approach needs to incorporate at risk groups such as prisoners where we know there is an overrepresentation of Aboriginal and Torres Strait Islander people in a situation where rates of drug use are high”.
“This report provides recommendations that address policy development, data collection, service responses and workforce development and are designed to provide more targeted attention and resources to improve service responses aimed at reducing the harms associated with injecting drug use among Aboriginal and Torres Strait Islanders”.
Australian National Council on Drugs:
The Australian National Council on Drugs (ANCD) is the principal advisory body to Government on drug policy and plays a critical role in ensuring the voice of the community is heard in relation to drug related policies and strategies.
National Indigenous Drug and Alcohol Committee:
The National Indigenous Drug and Alcohol Committee (NIDAC) was established by the ANCD to provide independent expert advice on addressing Indigenous drug and alcohol issues in Australia to the ANCD and Government.
This work has been supported by funding from the Australian Government Department of Health and Ageing.