Addressing harmful alcohol use amongst Indigenous Australians

Purpose of the paper

To provide expert informed recommendations on the priorities to address the harmful use of alcohol amongst Indigenous Australians.

Introduction

The high levels of alcohol use and related harms among Indigenous Australians and its causes have been well documented. Strategies to address this are a key focus of the National Drug Strategy Aboriginal and Torres Strait Islander Peoples Complementary Action Plan 2003–2009, endorsed by the Ministerial Council on Drug Strategy. The Aboriginal and Torres Strait Islander Peoples Complementary Action Plan was developed with regard to both the available evidence and extensive consultation with Indigenous people and other key stakeholders.

As the leading voice in Indigenous alcohol and other drugs policy, the National Indigenous Drug and Alcohol Committee (NIDAC) endorses the Aboriginal and Torres Strait Islander Peoples Complementary Action Plan and – based on on-going consultation – has affirmed minimisation of alcohol-related harm as a community priority and has identified it as such in its Strategic Plan 2007–2010.

NIDAC is strongly of the view that the Aboriginal and Torres Strait Islander Peoples Complementary Action Plan should remain the basis of any approach to the reduction of alcohol-related harm among Indigenous Australians. Within the framework of the Aboriginal and Torres Strait Islander Peoples Complementary Action Plan and the National Drug Strategy, NIDAC urges consideration of the following evidence-based priorities.

Key principles

Indigenous people should be involved at all stages of the development and implementation of strategies to address harmful alcohol use in their communities.
The capacity of Indigenous communities to deliver alcohol intervention initiatives should be actively encouraged and resourced – including and expanded program of workforce development.
Any strategies to reduce alcohol-related harm should be evidence-based and culturally secure.
Strategies to specifically address harmful alcohol use should be conducted in conjunction with strategies to address the underlying social determinants of such use.

Supply reduction

The Australian Government should act rapidly to introduce a graduated tailored volumetric tax on all alcohol products which also provides incentives for low alcohol based drinks.
State and territory police forces should more actively enforce existing restrictions on the supply/availability of alcohol.
In areas of high alcohol consumption and related harm, there should be consistent application of additional restrictions on the availability of alcohol.
Consistent with the evidence, in areas of high alcohol-related harm, action should be taken to limit or reduce the density of license premises.
Restrictions on hours for the sale of alcohol should also allow for restricted hours on takeaway alcohol and take into account communities concerns about takeaway sales.
All states and territories should either continue or re-institute the collection of alcohol wholesale data – down to the local level – to enable monitoring of consumption levels and the evaluation of intervention measures.
Increased enforcement by police of the Responsible Serving of Alcohol (RSA) provisions related to service to intoxicated patrons.

Demand reduction

A significant proportion of alcohol excise and other taxation revenue should be hypothecated for allocation to initiatives designed to reduce high levels of demand for alcohol.
Establishment of alcohol diversion programs across jurisdictions and improved access to diversionary programs and diversionary initiatives such as conferencing should be provided to Indigenous people.
There should be an expansion of locally and/or regionally appropriate health promotion and preventive programs.
Provision of resources should be allocated to primary health care providers to enable them to undertake an expanded role in prevention of harmful alcohol misuse and the identification and treatment of alcohol-dependent people.
There should be expansion of both community based and residential treatment programs in areas where they do not currently exist and improved access to such services in where the population is to small or too dispersed to support such services.
Adequate resources should be provided to facilitate coordinated case management of alcohol dependent persons and to provide for their on-going care.

Harm reduction

Alcohol social marketing campaigns to decrease tolerance for risky drinking and increase support for safer drinking settings.
In communities which desire them and which are large enough to support them the availability of night patrols should be expanded.
In communities which desire them and which are large enough to support them the availability of sobering-up shelters should be expanded.
Where sobering-up shelters are not available adequate, safe provision of facilities in which intoxicated people can sober-up should be provided in police lock-ups.