Researchers say a new app has the potential to more accurately reflect the nation’s drinking habits.
The ADAC and app researchers hoped the app would be available to download by the end of the year.
Key points :
App developers say it will get a more accurate drinking history than a face-to-face interview with a trained health professional
The Aboriginal Drug and Alcohol Council says the app could replace the National Drug Strategy Household Survey
Researchers say alcohol consumption among Aboriginal women is under-represented by up to 700 per cent in national surveys
The Grog App was designed for use by Indigenous Australians but could be used by anyone.
Dr Kylie Lee, a senior research fellow at the Centre of Research Excellence in Indigenous Health and Alcohol who was also involved in the app’s development, said the new technology would create a more accurate database.
“Aboriginal women, their drinking is under-represented in the national surveys by up to 700 per cent and 200 per cent in men.
“Undeniably we need to do better … this app offers a great opportunity to do that.”
Participants answer a range of broad and specific questions on the app about alcohol and based on that information, they are allocated into a category on a sliding scale from ‘non-drinker’ to ‘high risk’.
Dr Lee said immediate feedback was very helpful.
She said the app could alleviate issues in the way alcohol data was typically collected, for example participants were more likely to be asked about standard drinks but not non-standard containers.
“Like a soft drink bottle, a juice bottle, a sports bottle et cetera so the app has facilities to show how much you put in the bottle,” Dr Lee said.
“It’s very exciting the level of detail you’re going to get.”
Professor Kate Conigrave, the app’s chief investigator and an addiction specialist at Royal Prince Alfred Hospital, agreed the new technology could provide greater clarity.
“I’m aware of the traps,” she said.
“One patient I saw had been recorded by a doctor as drinking three standard drinks a day but when I took a drinking history I said, ‘what do you drink them out of?’, and he showed me a sports bottle,” Professor Conigrave said.
“He was drinking three full sports bottles of wine a day, so that’s about 30 standard drinks a day.”
Professor Conigrave said the national health survey often contained “tiny” numbers from Indigenous communities.
“The sample sizes are so small, it’s hard to get a meaningful picture,” she said.
She said the app would provide a level of comfortability and anonymity which may lead to more accurate data, than an interview with a trained health professional.
“People can be a bit embarrassed about what they’re drinking and it can be a bit hard to admit to someone you know, ‘when I drink I have 12 cans of beer,'” she said.
Taking it to the communities
The app is in its second phase of testing.
In the first phase, Aboriginal and Torres Strait Islanders in remote, regional and urban parts of South Australia and Queensland were asked to describe their drinking habits.
Research on the app has now progressed to the second round, during which the focus was on the technology’s validity as an on-the-ground survey tool.
Scott Wilson, who was leading the development of the app at the Aboriginal Drug and Alcohol Council (ADAC), said the second phase was a “major prevalence study” which would include participants from the local hospital and prison.
The location for the trial has not been made public.
“In the big major surveys people in those areas are always excluded,” Mr Wilson said.
“When you consider that I might be in hospital for an alcohol-related illness or I might be in jail because of an alcohol or drug-related crime, my voice or results are never included.”
The ADAC and app researchers hoped the app would be available to download by the end of the year.
In the meantime, they planned to have discussions with the government over the future use of the app and pursue grant opportunities.
Dr Lee said she was excited for the potential of the new technology.
“Eventually I think it would be a great tool to roll out nationally … using it in the same way as the National Drug Strategy Household Survey,” she said
“Our research found that average annual hospital admissions for assault fell from 32.25 per 1,000 people to 5.7 over 11 years, in line with tightening alcohol supply restriction,
We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance “
The Associate Provost and Chair of Australian Indigenous Studies, Professor Marcia Langton, who co-authored the paper, says since the AMP was introduced there has been a reduction in violent assaults and the severity of family violence across the traditional lands of the Thaayorre and Mungkan peoples on the western coast of Cape York Peninsula
Paper Title: The Alcohol Management Plan at Pormpuraaw, Queensland, Australia: An ethnographic community-based study
Alcohol Management Plans (AMPs), including one that has helped dramatically reduce violent assault rates in the remote Indigenous community of Pormpuraaw in far north Queensland, are under threat.
Coinciding today with the 5th Annual Overcoming Indigenous Family Violence Forum in Melbourne, University of Melbourne researchers have released a new study on the successes and challenges of the Pormpuraaw AMP.
While the dramatic drop in hospital admissions showed the AMP was working extremely well, Foundation for Alcohol Research and Education (FARE) Chief Executive Michael Thorn is concerned that AMPs are under threat and riddled with problems stemming from government inertia.
Mr Thorn said the Pormpuraaw AMP study highlighted the need for genuine government investment overseen by a strong national alcohol strategy for protecting children, women, families and communities from alcohol harms.
“The good news is that an AMP can be an effective tool to significantly reduce alcohol harm, including family violence. But there’s a gulf between the well-intended rhetoric of governments to address harms in Indigenous communities and the unrealistic, unsustainable government action on the ground,” Mr Thorn said.
The University of Melbourne in-depth, community-based study investigated how AMP controls, restrictions and responses are understood and managed with Australian Aboriginal communities.
Research Fellow and lead author of the paper, Dr Kristen Smith, says most community members in
Pormpuraaw welcomed the reduced violence and community disharmony.
“There is strong community commitment to ‘place-based’ programs, but there are many issues that are being experienced in the community which are not being addressed,” Dr Smith said.
Dr Smith said the biggest concern was government failure to understand the magnitude of the alcohol problem and therefore underestimate resourcing.
“Underfunding is compounded over time through erratic political and policy decisions that fail to reliably meet the community’s needs for treatment services or address issues such as ‘sly-grogging’, gambling and criminalisation,” she said.
Professor Langton said the AMPs were too vulnerable to political and policy instabilities to ensure their long-term success. “We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance,” she said.
” The National Alcohol Strategy 2018- 2026 outlines Australia’s agreed approach to preventing and minimising alcohol-related harms.
The National Alcohol Strategy provides a national framework and highlights a number of opportunities for action under each of the priority areas of focus.
These opportunities are examples of activities or initiatives that could be considered at either local, jurisdictional (state and territory) or national levels, including a mix of broad population approaches and targeted approaches.”
As a sub-strategy of the National drug strategy 2017-2026, the National alcohol strategy is overseen by the Ministerial Drug and Alcohol Forum. The Forum consists of Ministers from across Australia with responsibility for alcohol and other drug policy from the health and justice/law enforcement portfolios from each jurisdiction.
On 27 November 2017, members agreed that the draft National alcohol strategy will undergo a public consultation process to further inform the strategic direction and priorities of the strategy.
The online submission process is now open and will close on 11 February 2018. Feedback from the consultation will be considered by the Ministers at their next meeting in 2018, and the strategy revised.
Overall, Aboriginal and Torres Strait Islander people are more likely to abstain from drinking alcohol than non-Aboriginal and Torres Strait Islander people (31% compared with 23% respectively). However, among those who did drink, higher proportions drank at risky levels (20% exceeding the lifetime risk guidelines) and were more likely to experience alcohol-related injury than non-Aboriginal and Torres Strait Islander people (35% compared to 25% monthly, respectively).26
For this reason, Aboriginal and Torres Strait Islander people suffer from disproportionate levels of harm from alcohol, including alcohol-related mortality rates that are 4.9 times higher than among non-Aboriginal and Torres Strait Islander people.27
The poorer overall health, social and emotional wellbeing of Aboriginal and Torres Islander people than non-Aboriginal and Torres Strait Islander people are also significant factors which can influence drinking behaviours.28
People in remote areas
People residing in remote areas have reported drinking alcohol in quantities that place them at risk of harm at higher levels that those living in less remote regions.
People in remote and very remote areas were 1.5 times as likely as people in major cities to consume 5 or more drinks at least monthly and 2.4 times as likely to consume 11 or more drinks
Pregnant women (or those planning a pregnancy)
Alcohol consumption during pregnancy can result in birth defects and behavioural and neurodevelopmental abnormalities including Fetal Alcohol Spectrum Disorder (FASD). Data from states and territories have estimated FASD rates at 0.01 to 1.7 per 1000 births in the total population and 0.15 to 4.70 per 1000 births for the Aboriginal and Torres Strait Islander population.31 There is evidence that indicates some communities are experiencing much higher incidences of FASD and therefore the lifelong impacts of FASD.32
The relationship between the consumption of alcohol during pregnancy and the expression of FASD is complex, but avoiding drinking before or during pregnancy eliminates the risk of FASD.
Around 1 in 2 women report consuming alcohol during their pregnancy, with 1 in 4 women continuing to drink after they are aware they are pregnant. Of these women, 81% drank monthly or less with 16.2% drinking 2–4 times a month.33
The Ministerial Drug and Alcohol Forum is co-Chaired by the Commonwealth Ministers with portfolio responsibility for alcohol and other drugs (AOD), and justice/law enforcement.
Membership consists of two Ministers from each jurisdiction, one each from the health/community services portfolios (with AOD policy responsibilities) and one from the justice/law enforcement portfolios.
The Commonwealth, State and Territory governments have a shared responsibility to build safe and healthy communities through the collaborative delivery and implementation of national strategic frameworks to reduce AOD related harms for all Australians.
The Forum will be supported by the National Drug Strategy Committee (NDSC) in the implementation and monitoring of these national strategic frameworks.
“It is really heartening to see how much the review has listened to the long-standing policy solutions that AMSANT has been advocating for more than a decade”, he said.
“For a very long time we have been concerned about the harms being caused by cheap grog, too many outlets and take-away licenses, too much alcohol promotion and lack of adequate data, amongst other issues.
“This report addresses all of these issues and goes further, providing a comprehensive response to alcohol problems in the NT. Previous attempts at reform, such as the “Enough is Enough” program, not been far-reaching enough to have a major impact, but we are confident that this report provides the policy options to effectively deal with the NT’s alcohol problems.
“AMSANT thanks the Gunner Government for their immediate and emphatic response to the report in supporting all but one of the 220 recommendations.
The leadership shown by our Chief Minister on this key public health issue is commendable.
“The Territory is on the cusp of finally coming to terms with alcohol and the harm it causes. Instead of being the jurisdiction famous for its “bloody good drinkers”, we now have an opportunity to lead the nation in action to address alcohol.
“Implementing this report will reduce premature death, hospitalisations, domestic violence and child neglect. It will help significantly to close the health gap in the NT.
Research shows that in any population, the most disadvantaged people are most impacted by alcohol and have the most to gain from an effective public health response”, he concluded.
Riley review: Floor price on alcohol, 400sqm rule to be scrapped in wake of NT alcohol policy paper
Photo: Michael Gunner (centre) says he agrees with nearly all the recommendations of Trevor Riley (left). (ABC News: Felicity James)
The review by former chief justice Trevor Riley could usher in some of the biggest-ever changes to the Northern Territory’s alcohol policies.
Already the Gunner Government has said it will accept in principle nearly all of the 220 recommendations from the review, including a floor price or volumetric tax on alcohol products and a policy shift away from floor-size restrictions.
Major recommendations of the Riley Review:
The NT Liquor Act be rewritten
Immediate moratorium on takeaway liquor licences
Reduce grocery stores selling alcohol by phasing out store licences
Floor price/volumetric tax on alcohol products designed to reduce availability of cheap alcohol
Shift away from floor size restrictions for liquor outlets and repeal 400-square-metre restrictions
Reinstating an independent Liquor Commission
Legislating to make it an offence for someone to operate a boat or other vessel while over the limit
Establish an alcohol research body in the NT
Trial a safe spaces program where people can manage their consumption and seek intervention
“I got that one wrong going into the election and it has been good to see that Trevor [Riley] has come forward with this report with a much more considered, better way of dealing with density and sales of take-away outlets,” Mr Gunner said following the release of the report.
The Government has also said it will enact today a “complete moratorium” on all new take-away alcohol licences, including at greenfield sites.Attorney-General Natasha Fyles said the Northern Territory had the highest rate of alcohol consumption of anywhere in the world.
But the AHA’s opposition to Dan Murphy’s in the NT continues.
“We see that there are some recommendations in there in relation to additional licencing fees… to put an additional impost on businesses above the GST… we would see would be unfair,” he said.
“If the spirit of the review is followed in the Liquor Act, then the end result will be a reduction in alcohol in the volume of alcohol in the community.”
The national branch of the Australian Hotels Association does not support a floor price but the Northern Territory branch is in favour of it and has widely accepted the Riley review.
The figure would be indexed against ordinary wages and evaluated after three years.
“Floor space doesn’t impact on the amount of alcohol out there… it’s the price that makes the alcohol obtainable… if we’ve got people selling bottles of wine for $3, that’s cheaper than water, it seems to me you’ve clearly got a problem,” he said.
It said the relationship between the size of these premises and any increased harm is less clear, dismissing the claim that floor space was a contributing factor to alcohol related harm.
Floor price a more powerful way to reduce harm
He also acknowledged the Territory’s problem with alcohol-related harm and promised to sell liquor responsibly, if the licence was to be granted.
In a statement he said the company planned to move ahead with their application for a liquor licence in the Northern Territory.
Dan Murphy’s will try to operate in the NT
Other reforms include introducing licensing inspectors to help police at bottle shops, a move the NT Police Association has been pushing for.
Once the review is in place, one of the first priorities would be to reinstate an independent Liquor Commission, followed by a complete rewrite of the Liquor Act, which is expected to take 12 months.
“It is time that the Northern Territory gets rid of the tag of being an alcohol-fuelled community,” Ms Fyles said
He said details of how the floor price on alcohol will operate are yet to be determined, and any such price would be abolished if the Federal Government were to introduce its own volumetric tax.
Chief Minister Michael Gunner conceded that he made an error in pushing for the 400-square-metre rule, which had been dubbed a “Dan Ban” because it was seen as preventing Dan Murphy’s from opening a large store in Darwin.
This report expands on the key findings from the 2016 National Drug Strategy Household Survey (NDSHS) that were released on 1 June 2017.
It presents more detailed analysis including comparisons between states and territories and for population groups. Unless otherwise specified, the results presented in this report are for those aged 14 or older.
As Indigenous Australians constitute only 2.4 per cent of the 2016 NDSHS (unweighted) sample (or 568 respondents), the results must be interpreted with caution, particularly those for illicit drug use.
In 2016, the daily smoking rate among Indigenous Australians was considerably higher than non-Indigenous people but has declined since 2010 and 2013 (decreased from 35% in 2010 to 32% in 2013 and to 27% in 2016) (Figure 8.7). The NDSHS was not designed to detect small differences among the Indigenous population, so even though the smoking rate declined between 2013 and 2016, it was not significant.
The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) and the National Aboriginal and Torres Strait Islander Social Survey (NATSISS) were specifically designed to represent Indigenous Australians (see Box 8.1 for further information).
After adjusting for differences in age structures, Indigenous people were 2.3 times as likely to smoke daily as non-Indigenous people in 2016 (Table 8.7).
Overall, Indigenous Australians were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and this has been increasing since 2010 (was 25%) (Figure 8.8).
Among those who did drink, a higher proportion of Indigenous Australians drank at risky levels, and placed themselves at harm of an alcoholrelated injury from single drinking occasion, at least monthly (35% compared with 25% for non-Indigenous).
The (rate ratio) gap in drinking rates was even greater when looking at the consumption of 11 or more standard drinks at least monthly. Indigenous Australians were 2.8 times as likely as non-Indigenous Australians to drink 11 or more standard drinks monthly or more often (18.8% compared with 6.8%).
About 1 in 5 (20%) Indigenous Australian exceeded the lifetime risk guidelines in 2016; a slight but non-significant decline from 23% in 2013, and significantly lower than the 32% in 2010. The proportion of non-Indigenous Australians exceeding the lifetime risk guidelines in 2016 was 17.0% and significantly declined from 18.1% in 2013.
Other than ecstasy and cocaine, Indigenous Australians aged 14 or older used illicit drugs at a higher rate than the general population (Table 8.6). In 2016, Indigenous Australians were: 1.8 times as likely to use any illicit drug in the last 12 months; 1.9 times as likely to use cannabis; 2.2 times as likely to use meth/amphetamines; and 2.3 times as likely to misuse pharmaceuticals as non-Indigenous people. These differences were still apparent even after adjusting for differences in age structure (Table 8.7). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016.
1 in 8 Australians smoke daily and 6 in 10 have never smoked
Smoking rates have been on a long-term downward trend since 1991, but the daily smoking rate did not significantly decline over the most recent 3 year period (was 12.8% in 2013 and 12.2% in 2016).
Among current smokers, 3 in 10 (28.5%) tried to quit but did not succeed and about 1 in 3 (31%) do not intend to quit.
People living in the lowest socioeconomic areas are more likely to smoke than people living in the highest socioeconomic area but people in the lowest socioeconomic area were the only group to report a significant decline in daily smoking between 2013 and 2016 (from 19.9% to 17.7%).
8 in 10 Australians had consumed at least 1 glass of alcohol in the last 12 months
The proportion exceeding the lifetime risk guidelines declined between 2013 and 2016 (from 18.2% to 17.1%); however, the proportion exceeding the single occasion risk guidelines once a month or more remained unchanged at about 1 in 4.
Among recent drinkers: 1 in 4 (24%) had been a victim of an alcohol-related incident in 2016; about 1 in 6 (17.4%) put themselves or others at risk of harm while under the influence of alcohol in the last 12 months; and about 1 in 10 (9%) had injured themselves or someone else because of their drinking in their lifetime.
Half of recent drinkers had undertaken at least some alcohol moderation behaviour. The main reason chosen was for health reasons.
A greater proportion of people living in Remote or very remote areas abstained from alcohol in 2016 than in 2013 (26% compared with 17.5%) and a lower proportion exceeded the lifetime risk guidelines (26% compared with 35%).
About 1 in 8 Australians had used at least 1 illegal substance in the last 12 months and 1 in 20 had misused a pharmaceutical drug
In 2016, the most commonly used illegal drugs that were used at least once in the past 12 months were cannabis (10.4%), followed by cocaine (2.5%), ecstasy (2.2%) and meth/amphetamines (1.4%).
However, ecstasy and cocaine were used relatively infrequently and when examining the share of Australians using an illegal drug weekly or more often in 2016, meth/amphetamines (which includes ‘ice’) was the second most commonly used illegal drug after cannabis.
Most meth/amphetamine users used ‘ice’ as their main form, increasing from 22% of recent meth/amphetamine users in 2010 to 57% in 2016.
Certain groups disproportionately experience drug-related risks
Use of illicit drugs in the last 12 months was far more common among people who identified as being homosexual or bisexual; ecstasy and meth/amphetamines use in this group was 5.8 times as high as heterosexual people.
People who live in Remote and very remote areas, unemployed people and Indigenous Australians continue to be more likely to smoke daily and use illicit drugs than other population groups.
The proportion of people experiencing high or very high levels of psychological distress increased among recent illicit drug users between 2013 and 2016—from 17.5% to 22% but also increased from 8.6% to 9.7% over the same period for the non-illicit drug using population (those who had not used an illicit drug in the past 12 months).
Daily smoking, risky alcohol consumption and recent illicit drug use was lowest in the Australian Capital Territory and highest in the Northern Territory.
The majority of Australians support policies aimed at reducing the acceptance and use of drugs, and the harms resulting from drug use
There was generally greater support for education and treatment and lower support for law enforcement measures.
‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson, Matthew James. ‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use.’
About 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing more detailed data on pharmaceutical misuse later in 2017.
In addition to illicit drugs, the report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.
Source: Australian Institute of Health and Welfare
Part 3 Mental illness rising among meth/amphetamine and ecstasy users
Mental illnesses are becoming more common among meth/amphetamine and ecstasy users, according to a report released today by the Australian Institute of Health and Welfare (AIHW).
The report, National Drug Strategy Household Survey: detailed findings 2016, builds on preliminary results released in June, and gives further insight into Australians’ use of, and attitudes to, drugs and alcohol in 2016.
The report shows that among people who had recently (in the last 12 months) used an illicit drug, about 27% had been diagnosed or treated for a mental illness—an increase from 21% in 2013. Rates of mental illness were particularly high—and saw the most significant increases—for meth/amphetamine and ecstasy users.
‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson Matthew James.
‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use’.
Similarly, the report also reveals a complex relationship between employment status and drug use.
‘For example, people who were unemployed were about 3 times as likely to have recently used meth/amphetamines as employed people, and about 2 times as likely to use cannabis or smoke tobacco daily. On the other hand, employed people were more likely to use cocaine than those who were unemployed,’ Mr James said.
Today’s report also shows higher rates of drug use among people who identify as gay, lesbian or bisexual, with the largest differences seen in the use of ecstasy and meth/amphetamines.
‘Homosexual and bisexual people were almost 6 times as likely as heterosexual people to use each of these drugs, and were also about 4 times as likely to use cocaine as heterosexual people, and 3 times more likely to use cannabis or misuse pharmaceutical drugs.’ Mr James said.
Overall, about 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing comprehensive data on pharmaceutical misuse later in 2017.
‘Our report also shows that more Australians are in favour of the use of cannabis in clinical trials to treat medical conditions—87% now support its use, up from 75% in 2013. We also found that 85% of people now support legislative changes to permit its use for medical purposes in general, up from 69% in 2013,’ Mr James said.
In addition to illicit drugs, today’s report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.
The report also contains data for each state and territory in Australia, and shows differences in drug use between the jurisdictions. For example, recent use of meth/amphetamine was highest in Western Australia, but the use of cocaine was highest in New South Wales.
New app makes it easier to find Aboriginal and Torres Strait Islander alcohol treatment services
Launched this, an Android version of a free mobile phone app called AODconnect, which will support efforts to reduce harmful substance use among Aboriginal and Torres Strait Islander people.
The new Android app provides a national directory of alcohol and other drug treatment services for Aboriginal and Torres Strait Islander people and can be used by the alcohol and other drug workforce, and other health practitioners. AODconnectis available free for both Android and iOS devices (iPhones and iPads).
AODconnect is a national directory of alcohol and other drug treatment services for Aboriginal and Torres Strait Islander people.
It has been created for the Aboriginal and Torres Strait Islander alcohol and other drug (AOD) workforce or any health professional working in the AOD sector. This app is also useful for those looking for a specific Aboriginal and/or Torres Strait Islander AOD service.
The app allows you to find a service by state, territory and/or region through an interactive map of Australia or by alphabetical listing. The app has filter options that include:
Focus – Indigenous, Mainstream with Indigenous focus or Mainstream
Treatment categories – counselling and referral, harm reduction and support groups, outreach, mobile patrols and sobering up, residential rehab, withdrawal management, and young people.
NACCHO APP- Locate your nearest ACCHO
Here are the URL links to the App – alternatively you can type NACCHO into both stores and they come up!
“The NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation in your area and provides heath information online and telephone on a wide range of topics and where you can go to get more information or assistance should you need urgent help “
“What responsibility should we have over how welfare is delivered to those in need? Since the introduction of federal unemployment benefits in 1944, the government has provided welfare in cash. The reason is expedience: dropping cash into an account is simpler and cheaper than the traditional church welfare of providing clothes, food or vouchers.
But what happens if the cash is wasted on drugs, alcohol and gambling, leading to catastrophic social consequences?
Our view is the debit card could reduce the social harm welfare-fuelled abuse can cause, while still providing as much individual freedom as possible to welfare recipients.
The government believes this concept is worth trialling and today I will be introducing legislation to implement the idea in two or three regions.”
Federal Parliamentary Secretary to the Prime Minister The Hon. Alan Tudge MP (above right)
Wednesday, 19 August 2015 Opinion
DOWNLOAD and read full transcript of Alan Tudge Interview in Ceduna
This is the question the Abbott government has been grappling with following the recommendation in Andrew Forrest’s Creating Parity report to introduce a cashless debit card for welfare recipients in vulnerable areas.
The logic is inescapable. We have places where welfare is a major part of the local economy and the welfare dollar is fuelling gambling, alcohol and drug abuse.
It’s not just that individuals are wasting welfare payments but welfare abuse is destroying the lives of women and children.
In a place such as Kununurra, the hospitalisation rate from assaults is 68 times the national average. Across the Northern Territory, indigenous women are being bashed every year at a rate of 11 assaults per 100 women. These are just the reported cases. Two-thirds are related to alcohol, nearly all of which is paid for by welfare cash. It is not uncommon for kids to go hungry because there is no food on the table. Not because of poverty — an unemployed couple with three young children could have $800 in welfare cash a week after housing costs — but because the money is wasted in the first few days after “payday”. The National Crime Commission says towns of high welfare dependence are being targeted by criminals selling ice.
Most of the measures taken in the face of such evidence have been on the supply side, tough rules about what can be sold at pubs and what can be imported into a community. Such restrictions typically have halved the rate of violence in those places. But even in remote communities it’s hard to sustain initial gains and stop the grog runners and drug dealers. In urban areas, restricting supply (other than through hours of sale) is nearly impossible.
Forrest’s proposal is to work on the demand side. He argues that in certain areas, all welfare payments — except old age and veterans’ pensions — be placed on an ordinary bank debit card that could be used anywhere to purchase anything, but simply cannot be used at liquor stores or gambling venues. Because cash would be limited, illicit drugs could not be bought.
The government believes this concept is worth trialling and today I will be introducing legislation to implement the idea in two or three regions. These regions will be chosen on the basis of (a) high welfare dependence and social harm caused by welfare-fuelled alcohol and drug abuse, and (b) willingness of community leaders to participate in the trial. The Ceduna region will be the first trial site and we are in discussions with East Kimberley leaders about that region being the second. Our view is the debit card could reduce the social harm welfare-fuelled abuse can cause, while still providing as much individual freedom as possible to welfare recipients.
We have been negotiating with banks and community leaders over how the card could be designed and implemented. How a card would be issued, how online transactions would occur, how people could get account balances and how fees would be structured to minimise or eliminate costs to the user are issues being worked through. The intent is for the card to look as much as possible like the ordinary debit card most people carry in their pocket daily. Eighty per cent of payments will be placed on the card, with the other 20 per cent continuing to go into the recipient’s bank account.
Where there is a desire to do so, we will implement a local board that will have control over the settings of the card. This board would have power to lift the amount of welfare placed into an individual’s cash account. Key additional services such as alcohol counselling and financial management assistance may need to be introduced.
This proposal is not income management. There will be no compulsion for anyone to spend their payments in a particular way, although of course people will be encouraged to establish a budget. There will be complete freedom, with the exception of two restricted products.
I acknowledge that for some people, using a card rather than cash to pay for everyday items will be an initial inconvenience. The potential upside, however, is a transformed community where women are safer and more money is available for children’s needs. If successful, this will represent a radical new positive approach to the distribution of welfare.
“You need to look at the community. You need to engage the community in the initiatives and the things that can work have to be owned and obviously embraced and I think once you achieve that, the more successful things that I’ve seen, heard about and read about have been ones where there’s been some real leadership from within the community and from the leaders and organisations that are obviously providing services and looking after their community interests
I believe the inquiry is a good opportunity to examine what policy approaches have worked or haven’t worked at combating alcohol abuse in Indigenous communities
Justin Mohamed NACCHO chair speaking on World News Radio
Indigenous organisations have called for effective community consultation as the federal government launches a new inquiry into alcohol consumption in Indigenous communities.
The parliamentary inquiry was initially intended to look at alcohol-related violence across the country but has now been narrowed to deal specifically with Indigenous communities.
Some Indigenous health groups are hopeful the inquiry could lead to more effective strategies to tackle alcohol abuse, providing Indigenous communities are properly engaged as part of the process.
It will look at the patterns of supply and demand for alcohol in Indigenous communities and the incidence of alcohol-fuelled violence.
The inquiry will also examine how alcohol impacts upon unborn and newborn babies and what approaches have worked in other countries to combat alcohol abuse.
The Federal Indigenous Affairs Minister, Senator Nigel Scullion, has told NITV the government is not trying to single out Indigenous Australians as the only group that has problems with alcohol.
“This is about poverty, not ethnicity. But I acknowledge that there have always been and we have never really seen a break, particularly in reports of domestic violence, defence injuries, alcohol, deaths through alcohol…. through cars….and violence.”
Senator Scullion says the inquiry will also look at how socio-economic background could be linked to alcohol abuse.
The opposition Labor Party in the Northern Territory is critical of the inquiry, saying it’s “insulting” towards Indigenous Australians.
However, some Indigenous organisations believe it could be a step in the right direction towards tackling alcohol abuse.
Dr John Boffa is the medical officer with the Central Australian Aboriginal Congress and has worked in the Indigenous health field for over 20 years.
He has told NITV he believes an investigation into Indigenous alcohol abuse is long overdue.
“This is a useful inquiry. Alcohol problems are obviously very prevalent in Aboriginal communities. But I think if the inquiry is done well, it’s got the potential to provide some solutions that will address alcohol misuse, not just amidst Aboriginal people but amongst the broader population as well.”
That’s a view shared by the chairman of the National Aboriginal Community Controlled Health Organisation Justin Mohamed.
Mr Mohamed believes the inquiry is a good opportunity to examine what policy approaches have worked or haven’t worked at combating alcohol abuse in Indigenous communities.
Alcohol restrictions have been in place in remote Indigenous communities in the Northern Territory, parts of the Kimberley region in Western Australia and in Cape York in Queensland for a number of years.
However Mr Mohamed believes it is critical to ensure that any scrutiny around these policies is underpinned by consultation and engagement with the Indigenous communities themselves.
“You need to look at the community. You need to engage the community in the initiatives and the things that can work have to be owned and obviously embraced and I think once you achieve that, the more successful things that I’ve seen, heard about and read about have been ones where there’s been some real leadership from within the community and from the leaders and organisations that are obviously providing services and looking after their community interests.”
Mr Mohamed says while previous government inquiries have looked at social problems like domestic violence in Indigenous communities, it is the first time an inquiry has focused specifically on alcohol abuse.
He says it is pleasing to see that the inquiry will look at what strategies have worked in Indigenous communities in other countries, saying Australia could learn a lot from that.
“Like Canada and New Zealand- obviously there would be things happening around alcohol and how they can manage that and make sure that the community is not affected at levels that are unacceptable. You would have to look internationally as well to make sure that you get a really good idea on what is out there and what does work and how that has worked over the years.”
One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa (Congress Aboriginal Health ) a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.
Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,”
IF the Northern Territory were a country, it would rank alongside vodka-soaked ex-Soviet republics in terms of per capita alcohol consumption; not long ago it would have been second in the world.
PICTURE :Police on duty outside a Northern Territory bottleshop. ‘The (alcohol) industry is now being propped up by the Alice Springs police force,’ says head of the police union Vince Kelly. Picture: Amos Aikman Source: News Limited
Alcohol abuse costs the NT about $642 million annually in police time, corrections, judicial support, medical treatment and lost productivity – equivalent to roughly $4000 per person or 4 1/2times the national average – according to research quoted by the government last year. The latest figures show per capita alcohol consumption is again on the rise, ending a six-year decline.
Territory drivers are 20 times more likely than the national average to be caught over the limit; booze is a factor in many road deaths. A majority of Territory assaults involve alcohol and the Territory’s assault victimisation rate is more than 50 per cent above the rest of the nation’s.
In 2011-12, indigenous women were 18 times more likely to be bashed than non-indigenous women, and four times more likely than the Territory average.
Last financial year saw almost 40 per cent more alcohol-related assaults and almost 60 per cent more domestic violence related assaults than the equivalent period five years ago.
Since the Country Liberals took office 18 months ago, Aboriginal groups and legal and health policy experts have accused the Territory government of criminalising drunkenness, ignoring evidence and favouring the interests of the alcohol industry.
The government insists its policies are both appropriate and working, though many cracks have emerged. The CLP campaigned on a pledge to cut crime by 10 per cent annually – which by a slip of the tongue quickly became 10 per cent in a four-year term once it took office. CLP backbencher Gary Higgins recently acknowledged MPs are receiving a “barrage of complaints” about alcohol abuse from the community. His comments drew a quick rebuke from Chief Minister Adam Giles, who said: “We know that there are issues with alcohol in our society, but anyone who has a good look at the statistics will see that things are getting better.”
After repeatedly dodging questions about the saga unfolding on his doorstep, federal Indigenous Affairs Minister and NT senator Nigel Scullion proposed a sweeping national inquiry into drinking habits. The following day he appeared to have been overruled by his colleagues in favour of a tighter probe into Aboriginal drinking that will scrutinise the CLP policies more closely. Giles has already suggested any inquiry would be “navel gazing”. Nevertheless, the process offers his government an opportunity to gracefully adjust its course.
The CLP’s first act in office was to abolish Labor’s Banned Drinker Register, a point-of-sale supply restriction designed to curb heavy drinking. For almost a year, while the new government convulsed with internal ructions, nothing replaced the BDR. Then less than a month after Giles took power in a coup in March, his government unveiled a forced alcohol rehabilitation program called Alcohol Mandatory Treatment. The scheme, which has been running for seven months, involves locking up habitual drinkers in treatment centres with fences and guards.
Associated legislation was passed in the face of vocal opposition. At about $43,000 per drinker treated, AMT is more expensive than many private rehabilitation clinics. Experts think 5 per cent success would be good going. More than 150 people have completed the program; the government has established 120 beds. Alcohol Rehabilitation Minister Robyn Lambley says some patients have had their lives changed, but others are known to have relapsed.
Before Christmas a system of on-the-spot alcohol bans, Alcohol Protection Orders, was also legislated, again despite opposition. These affect people charged with, but not necessarily convicted of, offences in which alcohol was deemed a factor.
The government argues these policies transfer responsibility from society to drinkers, but important figures, such as head of the NT police union Vince Kelly, argue that is a furphy. “If you’re an alcoholic you haven’t got (personal responsibility) in the first place, and if you’re an intergenerational alcoholic you probably don’t know what the concept means.”
Not long ago a doctor who played a key role in establishing AMT, Lee Nixon, walked out in disgust. “A large number of (AMT patients) had little understanding of the process, and at the end of the time when they were there, were still asking, ‘Why am I here?’,” Nixon told ABC’s Lateline. “At the outset it was clear that we were introducing a program with no evidential base for effectiveness.” One drinker had her treatment order overturned by a court on the grounds she received it without proper legal representation. Justice groups say few drinkers appear before the AMT Tribunal with a lawyer.
Priscilla Collins, chief executive of the North Australian Aboriginal Justice Agency, thinks both AMT and APOs unfairly target the most disadvantaged, who are often also the most visible. “They will probably end up going back to the long grass,” she says.
Shortly after taking up his post, Alcohol Policy Minister Dave Tollner openly acknowledged one of AMT’s goals was to push drinkers to “go and hide out in the scrub”. AMT is now being reviewed.
The CLP has trenchantly refused to contemplate imposing any new supply restrictions. Giles told a gathering of hoteliers drinking was a “core social value”, while Tollner said Labor had treated publicans “akin to heroin traffickers”. The latest round of annual political returns to the Australian Electoral Commission reveal the alcohol industry’s main lobby, the Australian Hotels Association, has emerged as the Territory’s largest political donor. The organisation contributed $300,000, split between the major parties in the lead up to the August 2012 Territory election. According to an analysis of declared donations, the lobby donated almost 14 times as much per head of population in the Territory while the BDR was in place than it has in any other jurisdiction in the past decade.
At the time it was abolished there was little evidence clearly supporting the BDR. However it has since become clearer that although policy did not turn around increases in alcohol-related harm and violence as promised, it may have blunted them. Some quite senior CLP figures talk privately about bringing the BDR back.
One new policy that does appear effective is stationing police officers outside bottleshops. Regrettably this has also stirred up racial tension. The officers check drinkers’ IDs to see if they live in a proscribed area, and confiscate their purchases if they do. John Boffa, a spokesman for the People’s Alcohol Action Coalition, estimates reductions in domestic violence of up to 50 per cent in Alice Springs when police cover all 11 liquor outlets at once.
However the approach is a de facto supply restriction, with responsibility for enforcement transferred from the liquor retailer to the public service, as Kelly points out: “The (alcohol) industry is now being propped up by the Alice Springs police force.”
Combined with AMT’s high price tag, the government’s measures do not look at all cost effective. Assuming the number of people taking up drinking is proportional to population growth overall, the government would need at least five times the present number of AMT beds just to keep the number of alcoholics stable. The cost of that would exceed $1 billion by the end of the decade, or roughly 20 per cent of last year’s Territory budget.
Higgins called for a bipartisan inquiry with measures his government officially opposes – an alcohol floor price, shorter opening hours and BDR-like supply controls – put back on the table. “While they do inconvenience a lot of people, all of them should be considered,” he said. Kelly thinks there is a “gaping hole” in public policy around alcohol supply issues. “Neither the Labor government or the CLP government has covered itself in glory when it comes to that type of thing because they’re simply too close to the industry,” he says.
“There has got to be some serious question about whether (an inquiry) is warranted.”
A serious investigation would need to consider not just the efficacy of a range of policies, but the circumstances in which they are applied. Alcohol bans in remote communities push drinkers into towns, where their drinking often worsens. Proscribed urban areas leave residents who can legally buy takeaway alcohol unable to legally drink it. Stationing police outside bottleshops increases familial pressure on those living in non-proscribed areas to become involved in the alcohol supply trade; anecdotal evidence suggests the black market is thriving.
Some federally administered draft alcohol management plans are stuck in limbo, in part because it is unclear what the basic requirements are for Aboriginal communities to responsibly manage alcohol themselves. Community leaders often blame disenfranchisement for their giving up on the task. Many people familiar with these issues say the solutions lie not in textbooks or boardroom chats, but in the lives of Aboriginal people; another desktop study will not help.
It is also worth considering whether alcohol-related harm can be reduced to acceptable levels soon, or just mitigated and hidden. Not even the last of those has been accomplished so far. NT Attorney General John Elferink argues for stricter controls on welfare to break the link between welfare dependency and drinking: “We can build massive institutions to deal with alcoholism, but while the federal government pours free money into our jurisdiction, spending millions of dollars every fortnight, we as a government are going to be spending millions of dollars every fortnight cleaning up the mess.” Without action on several of these fronts, the NT’s alcohol abuse crisis looks likely to get worse.
The CEO of the Aboriginal Health Council of South Australia (AHCSA), Mrs Mary Buckskin (pictured above) has called for more action to address the problem of alcohol misuse among Aboriginal people in the Ceduna area in the far west of South Australia.
“AHCSA supported the findings and recommendation of the 2011 report of the State Coroner following the inquest into a number of alcohol-related deaths in the area,” she said.
“We are pleased that some of the recommendations have been implemented. In particular, the expansion of the sobering-up shelter managed by Ceduna-Koonibba Aboriginal Health Service is clearly better meeting the need.”
However, Mrs Buckskin stressed that much more must be done, as clearly problems persist. “There is a need for a more strategic approach involving Aboriginal communities and their organisations in Ceduna and surrounding areas, as well as Yalata and Oak Valley.
“Currently, some actions taken by some agencies are ad hoc rather than being part of an overall strategy, and are not necessarily helping the problem.
“There is no single magic bullet to address it. What is required is a range of strategies developed with appropriate consultation, and introduced in a coordinated way.
“We need strategies to reduce the availability of alcohol; we need strategies to ensure that people with alcohol problems have access to health services where they can be properly assessed and offered treatment; we need appropriate rehabilitation services for individuals and families,” Mrs Buckskin said.
She added that people who have alcohol-related brain damage need to be properly assessed and provided with appropriate services.
“Above all, it must be recognised that the people at most risk of alcohol-related harm or death come from the communities further west. A comprehensive strategy to deal with alcohol problems in the Ceduna area must include supporting people to return to their country and ensuring that the communities concerned are adequately resourced to support this happening.
“While this will require significant resources, in the long run a coordinated comprehensive strategy will save lives and money. And this is really an issue of human dignity,” Mrs Buckskin said.
The Aboriginal Health Council of SA Inc. (AHCSA) is the peak body representing Aboriginal community controlled health and substance misuse services, and Aboriginal health advisory committees across South Australia. AHCSA is an affiliate of the National Aboriginal Community Controlled Health Organisation.
ENDS. For further information contact: Mrs Mary Buckskin, Chief Executive Officer, Aboriginal Health Council of South Australia Inc., 08 8273 7200.