Welcome to the second issue of Of Substance's e-Bulletin.
It has been a busy couple of months since our last print magazine was published in early July. We've seen exciting events around the placing of a minimum floor price on alcohol in Alice Springs, the release of the National Drug Strategy Household Survey and the recommendation that the new ACT prison trial a needle and syringe program.
The next print issue of Of Substance will be published in early November, so in the meantime, we thought we'd bring you an update of news and issues impacting people who work with alcohol, tobacco and other drug issues.
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A roundup of recent alcohol and other drug news, both within Australia and internationally.
Alcohol labelling debate heats up
Leading health experts are urging the Federal Government to make new alcohol health warning labels mandatory to help reduce the harms caused by alcohol. The Australian Medical Association, the Alcohol Education & Rehabilitation Foundation and the Cancer Council (Victoria) have called for clearer and tougher health warning labels on alcohol products, in reaction to DrinkWises' July launch of consumer information messages. DrinkWise's labels have been criticised for being vaguely worded and voluntary, rather than mandatory as many health experts would prefer.
ACT considers NSP in prison
In July, ACT Chief Minister Katy Gallagher MLA released a report entitled Balancing access and safety: meeting the challenge of blood borne viruses in prison. The report, by the Public Health Association of Australia, has put forward a plan for the introduction of a needle and syringe program in the ACT's prison. The report has made seven recommendations, and the ACT Government will now consider these, and seek the views of the community about the report, prior to finalising its response.
AFP's record drug seizures
The Australian Federal Police has made record drug seizures over the past 12 months. The AFP and partner agencies have seized 1.77 tonnes of illicit drugs in 2010-11, up almost 30 per cent compared with 2009-10. Cocaine accounted for the largest total haul over the past 12 month, with 710kg in 407 seizures. The AFP also seized 334kg of heroin and 284kg of amphetamines. The amounts seized have ranged from 126g of crystal methamphetamine in a children's toy to more than 400kg of cocaine on a luxury vessel. The illicit substances have been found in a large variety of places, including birthday cards, permanent markers, car parts and electronic devices.
Victorian focus on pharmacotherapy
The Victorian Government announced in June that it will invest more than $11 million in an expansion of services to heroin users and other people dependent on drugs to help them get their lives back on track. The government is focused on improving pharmacotherapy services for Victorians seeking treatment for a drug addiction.
Cask wine out of Alice supermarkets
The move in June by both of the major supermarket chains to stop selling two-litre casks of wine and to implement a minimum floor price on bottled wine in Alice Springs has been welcomed by the Central Land Council. Council Director David Ross said that the community had been calling for the supermarkets to take this action for some time, and that the new step was an important one in the range of efforts needed to reduce the harm caused by alcohol abuse in Central Australia.
NT laws target drinkers
The NT Government passed legislation in May giving police and courts the tools to target alcohol-related crime and anti-social behaviour. The laws introduce new bans for problem drinkers, mandated treatment, and a Banned Drinker Register at all takeaway liquor licences across the Territory to enforce the bans at the point of sale.
Alcopop sales drop
Australian Bureau of Statistics data released in June shows a 35.8% drop in alcopop consumption nationwide since the 2008 alcopops tax implementation. The alcopops tax has also resulted in an overall reduction in per capita spirits consumption nationwide.
Poland passes new drug laws
With President Bronislaw Komorwski signing into law in May an amendment to the country's harsh, decade-old drug laws, Poland has taken a step in the direction of the decriminalisation of drug possession. But how much of a difference the new law will make is unclear at this point, and it won't go into effect for another six months. The new law also increases sentences for some drug distribution offenses. Under the old law, possession of even the smallest quantity of illegal drugs could lead to a three-year prison sentence. Under the amended drug law, people would still be arrested, but prosecutors will have the option of not charging people for personal drug possession if the quantity involved is small, if it is a first offense, or if the person is drug dependent.
A web-based service - www.safesharps.org.au - is an interactive and dynamic site that allows sharps users to identify locations where used sharps can be disposed of appropriately. The website is linked to Google maps allowing users to easily plot locations. The information can also be accessed via iPhone, iPad and mobile web. Launched by the NSW HIV/AIDS & Related Programs Unit.
The Pacific Drug and ALcohol Network has a new website: www.pdarn.org. The site is full of regional news and articles of interest, and updates of ongoing work relating to the PDARN region.
Multicultural HIV/AIDS and Hepatitis C Service
A key feature of the new Multicultural HIV/AIDS and Hepatitis C Service website is that it has separate entry points for people living with chronic HIV and hepatitis C, health care workers, journalists working in the ethnic community media and bilingual staff working at the Multicultural HIV/AIDS and hepatitis C Service. Lack of access to culturally appropriate information is considered one of the key reasons why people from culturally and linguistically diverse backgrounds in Australia continue to experience poorer health outcomes than those in the mainstream society. Visit www.multiculturalhivhepc.net.au.
The NO BARS website (www.nobars.org.au) was launched by the Hon Michael Kirby, AC AMG earlier this year at Justice and Police Museum, Sydney. The NO BARS Project developed in partnership between the Community Restorative Centre (CRC) and the Network of Alcohol and other Drug Agencies (NADA) was funded under the Illicit Drug Diversion Initiative, NSW Health. It is an educational and information resource project designed to support drug and alcohol services in their work with people who have become involved with the criminal justice system.
Alcohol: volumetric taxation vs minimum floor pricing?
Alcohol taxation is a controversial topic. We explore two options aimed at reducing the harm caused by heavy alcohol consumption.by Denise Gilchrist, Australian National Council on Drugs Secretariat
Price can influence levels of alcohol consumption and alcohol related harm. Taxation can influence price over and above production, profit and distribution costs. Volumetric taxation and minimum floor pricing are two key approaches governments can use -separately or in conjunction - to address alcohol consumption, and alcohol related harm, which is estimated to cost around $36 billion annually.
These are two distinct strategies and it's important to understand what they involve and how they differ.Volumetric taxation is a flat tax levied on all alcohol content by volume; the higher the alcohol content of a product, the higher the tax imposed on it.
Minimum floor pricing involves setting an agreed base price for alcoholic products. It is a means of targeting cheap alcoholic products and does not have any impact on higher priced products.
Substantial and consistent national and international evidence, collected over many years, shows price has significant effects on alcohol purchasing and consumption levels. Reviews of the evidence indicate that for every 10 per cent increase in price there is a four to five per cent decrease in consumption. As illustrated recently in the Northern Territory, even small price increases can have an effect on consumption and harm. Current modelling indicates that a minimum floor price could also significantly reduce alcohol related harm.
Volumetric taxation contrasts with the complex arrangement that currently exists in Australia where different alcohol products are taxed at very different rates per volume of alcohol. Changing to a volumetric taxation system has been well supported by the public health sector for many years; it was also recommended in the 2010 Henry Taxation review.
However, there are a number of counter arguments to the introduction of a volumetric tax. For instance, there is concern that introducing a volumetric tax could lead to a reduction in the price of some products that are popular with young people, for example 'alcopops'. This is a real concern, but different models of taxation might accommodate this risk. One suggestion is to target certain alcohol products deemed to be of higher risk to the community and tax these products at a higher level. This is what has happened with the recent increase in taxation of alcopops. But critics point out that this is counter to the key intention of a volumetric tax system - pricing alcohol by its alcohol content.
Volumetric taxation has also received criticism from some members of the alcohol industry as its introduction could result in an increase in price for a number of products - for example, some wines. Another argument against volumetric taxation focuses on the potential impact on low-risk drinkers who may be required to pay more for their alcohol.
Criticism from some members of the alcohol industry and potential unpopularity among the community may deter governments from embracing the approach. Indeed we are yet to see a warm reception from any Australian government towards implementing a volumetric tax. The current government has noted in its discussion paper in the lead-up to the October 2011 Taxation Forum, that it has 'committed not to change alcohol tax in the middle of a wine glut'.
Minimum floor pricing
There are several models of floor pricing available. A minimum price can be imposed on particular products or across all alcohol products based on their alcohol content. In general, a minimum floor price targets very cheap alcoholic products. It has been argued that it has greatest impact on the heaviest drinkers of the cheapest products, while having little impact on light drinkers of more expensive products. Those who oppose a minimum floor price say it targets already disadvantaged people.
An example of minimum floor pricing in action was seen in Alice Springs a few months ago, when some retailers set a minimum price of $7.90 on the sale of bottled wine. In the face of arguments that alcohol should not be cheaper than bottled water and soft drinks, this seemed to be some acknowledgement that very cheap alcohol was contributing to harm in this community.
Some claim that the advantage of this type of strategy is that it can introduced at a local or state/territory government level, and is a quick way of reducing the availability of very cheap alcohol. It can of course also be introduced voluntarily by retailers - as occurred in Alice Springs.
A concern about the introduction of a select minimum floor price targeting specific products, in contrast to a universal application across all product types by amount of alcohol, is the potential for displacement. That is, if the price of only some products increase it may encourage people to shift to an alternative cheaper alcohol product. Minimum floor pricing has also been criticised, as it does not affect the price of more expensive alcohol, or the subsequent harms caused by the consumption of that type of alcohol.
If volumetric taxation was introduced into Australia, the price of certain alcoholic products could rise dramatically, with others decreasing in price. In regard to a minimum floor price, unless it was a set price for a set amount of alcohol, irrespctive of product, it could result in a shift in drinking from one cheap alcoholic product to another but with no overall improvement in risky consumption.
Careful modelling is needed before introducing either strategy to ensure that they achieve the desired outcomes.
It is also important to note that while these two alcohol policies are sometimes viewed separately, as 'either/or' options, there is an argument that most impact will be achieved if they are implemented together. Indeed, the position taken by the National Alliance for Action on Alcohol - a national coalition of health and community organisations from across Australia that has been formed with the goal of reducing alcohol related harm - supports introducing them together as part of a broader-based health strategy.
In the meantime, the Australian Government has announced that it has tasked the new Australian National Preventative Health Agency with investigating how a minimum price of alcohol could work to promote safer consumption of alcohol - but no such review has been called for a volumetric tax.
This is disappointing as both strategies could go a long way towards reducing the amount of alcohol that people drink - and the consequences of that consumption - as well as providing the government with extra revenue that could be directed into interventions aimed at preventing and reducing alcohol related harm in the community.
Australian Government, 2011. Tax Forum Discussion Paper, Tax Reform: Next Steps for Australia. p30.
Babor, T, Caetano, R & Cassell, S 2003. Alcohol: no ordinary commodity. Research and Public Policy. Oxford University Press.
Lancet editorial, 2009. UK alcohol policy: a costly decision for public health, The Lancet, vol. 373, April 8, 2009.
National Alliance for Action on Alcohol 2010. Reducing harm from alcohol: creating a healthier Australia.
Purshouse, RC, Meier PS et al 2010. Estimated effect of alcohol pricing policies on health economic outcomes in England: an epidemiological model, The Lancet, vol. 373, April 17, 2009.
National Household Drug Survey
by Jenny Tinworth
The number of people who smoke continues to fall, but levels of risky alcohol use remain unchanged and illicit drug use has increased.
These are the findings of the 2010 National Drug Strategy Household Survey report which was released in late July.Conducted every three years since 1985, the survey provides a guide to Australian attitudes and use of alcohol, tobacco and other drugs. The 2010 survey had more than 26,000 respondents, aged 12 and over. The findings are compared to previous surveys to show trends in drug-related attitudes and behaviours.
Report data should also be interpreted in conjunction with other key studies of drug use, such as the Illicit Drug Reporting System, Ecstasy and Related Drugs Survey, needle and syringe program surveys and individual state and territory data collections.
Key data from the 2010 National Drug Strategy Household Survey:
In the 2010 survey, the proportion of people aged 14 years or older smoking daily (15.1%) declined, continuing a downward trend that began in 1995. The largest falls in daily smoking were among people in their early 20s to mid-40s.
Despite this decline in the percentage of Australians smoking tobacco, the number of smokers has remained stable between 2007 and 2010, at about 3.3 million.
A positive finding for alcohol use was that more teenagers (12 to 17 year olds) abstained from alcohol (61.6%) than consumed alcohol in the previous 12 months (38.4%) and the proportion abstaining increased significantly from 2007 (54.5%). Daily drinking among those aged 14 years and older also declined between 2007 (8.1%) and 2010 (7.2%).
However, there was little change in the proportion of people drinking alcohol at levels that put them at risk of harm over their lifetime (20.3% in 2007 and 20.1% in 2010), or from a single drinking occasion at least once a month (28.7% in 2007 and 28.4% in 2010).
Around 7% of recent drinkers, especially people aged less than 29, changed their drink preference in 2010, with a shift away from pre-mixed drinks, often known as 'alcopops'.
Recent illicit drug use rose in 2010, with people aged 14 or older who had used illicit drugs in the previous 12 months rising from 13.4% to 14.7% between 2007 and 2010.
There was an increase in the proportion of people who had used cannabis, pharmaceuticals for non-medical purposes, cocaine and hallucinogens. However, recent ecstasy use decreased, and there was no change in the use of meth/amphetamines, heroin, ketamine, GHB, inhalants and injecting drug use.
Males were far more likely than females to use all drugs (both illicit and licit), except for pharmaceuticals which were used by a similar proportion of males and females. Females were considerably less likely than males to drink alcohol daily and in quantities that placed them at risk of harm.
Across Australia, those aged 18-2 years were the most likely to report using illicit drugs and drinking alcohol at risky levels in the previous 12 months. Those aged 40-49 years were most likely to smoke daily.
In terms of attitudes to drugs, excessive alcohol use and tobacco smoking were nominated as the two most serious concerns to the community - and there were higher levels of support than previously for tobacco and alcohol harm reduction policies.
Heroin continued to be the drug respondents most associated with 'a drug problem', followed by cannabis. However, there was also a small rise in community tolerance of regular cannabis use.
The National Household Survey is undertaken by the Australian Institute of Health and Welfare. The survey targets households across Australia, but does not study non-private dwellings such as hostels, prisons, educational institutions or clinical settings such as hospitals, drug treatment centres or nursing homes. Thus, its reach to some marginalised populations is restricted. The sample is weighted to ensure it is as representative as possible of the Australian population in both age range and geographic location.
To see the full report, visit www.aihw.gov.au/publication-detail/?id=32212254712.
Since the last e-Bulletin in May 2011, there have been many developments in the work of the Department of Health and Ageing on drug and alcohol matters.
In May, the Australian Government announced the establishment of 18 new or expanded flexible funds, consolidating some 159 smaller programs. These new arrangements aim to reduce red tape by reducing administrative and reporting burdens on funding recipients; increase the Government's flexibility to respond to emerging issues and change; and deliver better value for money, quality and evidence-based funding. There are two funds relating to substance misuse; one service delivery grants fund; the other for national prevention and service improvement activities under the National Drug Strategy. The first funding under these arrangements will flow from 1 July 2012; existing contract funding for periods beyond that date will continue uninterrupted. Discussion papers setting out details for the indicative operations of the funds, including prospective times for invitations to apply, will be available for both funds from here.
National Drug Strategy Household Survey
The 2010 National Drug Strategy Household Survey was released by the Australian Institute of Health and Welfare on July 27. The survey of more than 26,000 Australians found that overall smoking rates continued to decline in Australia. There were mixed results for alcohol consumption, and the use of some illicit drugs increased slightly compared to the previous survey in 2007. The report is available on the Institute's website.
New IGCD committees and working groups
The National Drug Strategy 2010-2015, released in March, introduces new governance arrangements that will see the Intergovernmental Committee on Drugs (IGCD) supported by four new sub-committees and three time-limited working groups. The standing committees will provide ongoing guidance and expertise to the IGCD including the development of national sub-strategies for their topic areas. The working groups on the National Aboriginal and Torres Strait Islander Peoples Drug Sub-Strategy, Workforce Development Sub-Strategy and the Research and Data Sub-Strategy have commenced work which is aligned with the priorities of the National Drug Strategy. Each committee and working group will be chaired by an IGCD member.
National Binge Drinking Strategy
Since the Australian National Preventive Health Agency (ANPHA) commenced operation in January, the Department has been working closely with the agency to implement the measures comprising the expansion of the National Binge Drinking Strategy, including a $25 million Community Sponsorship Fund as an alternative to alcohol sponsorship; $20 million for community level initiatives for activities to tackle binge drinking; and $5 million for enhanced alcohol telephone counselling and referral services. On August 6, ANPHA advertised the third round of the National Binge Drinking Strategy Community Level Initiatives Community Grants. For further information, click here.
Tobacco plain packaging
Public consultation on the Tobacco Plain Packaging Bill 2011 concluded on June 6.On July 6, Federal Health Minister Nicola Roxon introudced the bill and associated Trade Mark Amendment (Tobacco Plain Packaging) Bill 2011 to the House of Representatives; these bills were subsequently referred to the House's Health and Ageing Committee for inquiry and report. The Department provided a written submission to the Committee, and also appeared before the Committee at its public hearing on August 4.
A selection of recent resources available to the AOD sector.
Resource for young lesbian, gay and transgender youth
Hot House (Youth Community Team, Alcohol and Drug Service, Queensland Health) with Open Doors Youth Service (a youth LGBT counselling and support service) have developed and launched a new alcohol and drug resource targeting lesbian, gay, bisexual and transgender (LGBT) young people.
The resource can be downloaded at http://www.opendoors.net.au/wp-content/uploads/2011/05/bent-29-04-11-web-size.pdf
Life of a heroin user
Professor Shane Darke's new book, The Life of the Heroin User: Typical Beginnings, Trajectories and Outcomes, was launched at the National Drug and Alcohol Research Centre's annual symposium in August. The book applies a biographical approach to the life cycle of the heroin user from birth until death. Chapters address each stage of the user's life including childhood, routes to use, the development of dependence, problems arising from addiction, death, and options for treatment and prevention.
Drawing on over two decades of experience in the field of heroin research, Professor Darke examines major theoretical approaches to the development of opiate dependence and the efficacy of treatment options for opiate dependence.
For information about ordering, contact NDARC.
Youth Health Worker Support Kit
Hepatitis NSW has developed a Youth Health Worker Support Kit - a resource for workers wishing to address the risks, consequences and choices that young people (14-25 yrs) face regarding body art, injecting drug use and viral hepatitis, espeically hep C. It provides basic information including: the differences between hepatitis A, B and C, actvities to discuss, levels of risk and ways to prevent contracting and transmitting blood borne viruses.
To obtain copies of the support kit in NSW, please use the fax order form.
Outside NSW, please visit the website.
New Hobart drug education centre and website
In June, the Tasmanian Minister for Health, Michelle O'Byrne, launched the statewide Drug Education Network's new resource centre and website, improving access to the latest drug education information. Ms O'Byrne said the centre in Elizabeth St, Hobart, its resources and the new website would help change lives through drug education. Visit the new website at http://www.den.org.au/
Partners in Hope
Partners in Hope is part of a research initiative focusing on the need for effective holistic services for women with young children who are working towards breaking the destructive cycle of substance dependence and mental health problems. The program features a DVD and a research initiative that will examine practice innovation and service redesign in this critical policy area. The project is a partnership between the University of Technology Sydney, the Rotary Club of Drummoyne and Kathleen York House, Glebe.
Click here for more information about this project.
New NADA resource
The Network of Alcohol and Drug Agencies (NADA) has produced a report, A Review of Screening, Assessment and Outcome Measures for Drug and Alcohol Settings, as part of its Drug and Alcohol and Mental Health Information Management Project, which has developed client outcome measures for use by the non-government drug and alcohol sector in NSW.
Click here to download the report.
Dependent on development
The Nossal Institute, with the assistance of the Australian National Council on Drugs, are pleased to be launching a new report, Dependent on Development: The inter-relationships between illicit drugs and socio-economic development. This report was funded by the Open Society Institute and undertaken by the Nossal Institute in collaboration with Family Health International in Vietnam and India. The report examines the relationships of drugs and development, and finds the world is trapped in a vicious cycle where we can no longer ignore the clear links between drugs, development and conflict.
Click here to download the report.
Dual diagnosis kit
Queensland Health has recently published the comprehensive Queensland Dual Diagnosis Clinical Guidelines and Clinicians Toolkit. While the guides are published specifically for Queensland Health staff, they contain a range of useful contacts and information about good practice for people with coexisting mental health and AOD problems.
Click here for more information.
A round up of events and happenings in the AOD sector.
The National Indigenous Drug and Alcohol Committee (NIDAC) is raising funds to support workers to attend the 2012 NIDAC Conference, Beyond 2012: Leading the Way to Action, and is seeking your assistance to help make a difference by purchasing a high resolution limited edition print in either quality print or canvas of the vibrant painting, Diverity of One Working Together, 2010, crafted by well-known Aboriginal artist Mr Max Mansell.
Max is a leading Australian Aboriginal artist from the Oyster Bay area and the Big River language groups in Tasmania. Diversity of One Working Together was crafted by Max on behalf of the National Indigenous Drug and Alcohol Committee to celebrate and acknowledge the importance of the inaugural National Indigenous Drug and Alcohol Conference held in Adelaide in 2010. Max donated Diversity of One Working Together for the purposes of raising funds and awareness of the importance of addressing the harms and impacts of alcohol and other drugs (AOD) issues in Aboriginal and Islander communities Australia-wide.
Odyssey House Victoria's writing competition
Writers of all ages and experience are invited to explore the theme 'How did I find myself here?'
This theme is open to interpretation and does not necessarily need to reflect alcohol and other drug experiences, however writers should make reference to alcohol/drugs somewhere in the story.
Entry from $10 for 1 story (maximum 3 per person). Stories must be 1,500 words or less.
Top entries recieve cash prizes and novels by Australian authors - Helen Garner, Christos Tsiolkas, Luke Davies, Gregory David Roberts and Kate Holden.
Entries close Friday 4th November.
Go to www.odyssey.org.au for details on how to enter.
2011 Contemporary Drug Problems Conference
3 -4 October 2011
Monash University, Prato, Italy
For more information visit: www.ita.monash.edu/
2011 National Drug Trends Conference
17 October 2011
National Maritime Museum, Darling Harbour, Sydney
For more information visit: http://www.ndarc.med.unsw.edu.au/NDARCWeb.nsf/page/Conference
8 - 11 Nobember 2011
Kualar Lumpur, Malaysia
For more information visit: http://www.ifngoconference.org
APSAD 2011 Conference
13 -16 November 2011
For more information visit: http://www.apsadconference.com.au
National Hepatitis Health Promotion Conference
24 -25 November 2011
Grand Chancellor Hotel, Brisbane, Qld
For more information visit: http://www.hepatitisaustralia.com/events/hepatitis-health-promotion-conference