Tuesday, September 25, 2012

Alcohol, Tobacco and Other Drugs Association (ATODA) Election Forum

On 11 September I attended the ATODA Election Forum.  It was an interesting forum, with interesting speakers and presentations.  This is a brief outline of issues raised and discussed.  Members of the ACT Legislative Assembly attending were Ms Katy Gallagher (MLA, ACT Chief Minister and Minister for Health), Mr Jeremy Hanson (MLA, ACT Shadow Minister for Health), and Ms Amanda Bresnan (MLA ACT Greens Health Spokesperson)

The session was Chiared by Justice Richard Refshauge
Justice Refshauge spoke about:
the damaging consequences of secondary harm, particularly its effect on families.
95% of work in courts resulted from use of ATOD
looking closely at evidence was particularly important, in context of policy development, because evidence is not always intuitive
importance of ATOD education in schools
problems of alcohol related violence

Implementing evidence based school drug education
Associate Professor Richard Midford (Centre for Indigenous Australian Education and Research at Edith Cowan University)
young people are a particularly vulnerable group
education in schools especially effective, because they are a captive audience
importance of “inoculating” children before they become “attractive”
it’s cost-effective – prevention far cheaper than cure
alcohol is by far the biggest problem among 14-15 year olds, followed by tobacco
75% of high school children have tried alcohol by age 13
41% are current drinkers by age 17
7% of 13 year olds drink in a manner causing risk
research is important, but Australia needs its own research,and not rely on research from USA and UK, which is often not relevant to Australia
Australia has good reputation in research based on harm minimisation – much of it is exported overseas
cognitive/group learning methods are good, but teachers must be properly trained too
important not to focus on changing attitudes, because this isn’t necessarily linked to changes in behaviour
a Drug and Alcohol Education Program (DEVS) will be rolled out across schools in Victoria from September 2012.  The program for Years 8 and 9, was developed as a partnership between the Department, Edith Cowan University and the Youth Research Centre at Melbourne University and won the Excellence in Prevention and Community Education Award at the National Drug and Alcohol Awards on June 22 
DEVS is based on thorough research and evidence. It’s a good initiative, because Australia does not do well at setting up ongoing drug school education. The results show it improves students’ knowledge and decision-making, increases communication with parents and reduces risky drinking. Students learn about the effects of drugs and alcohol on the body, the social pressures that encourage alcohol and drug use, and practical skills that help them to avoid drug use and how to remain at low risk of alcohol harm
DEVS didn’t convince participants to stop drinking, but did lead to a reduction in amount of alcohol consumed and subsequent harm.

Effective policy responses to alcohol and related violence
Mr Tony Brown (NSW Community Campaigner for the reduction of alcohol related violence)
this presentation focussed on Newcastle
violence is concentrated around licenced premises
alcohol related violence had been reduced by 37% in Newcastle as a result of restricting licencing hours
Proust’s words – “The voyage of discovery lies not in seeking new vistas, but in having new eyes”, highlights the disparity between evidence and what’s actually happening on the ground
ACT and NSW have a balanced approach to the problem
most harm resulting from alcohol consumption is unintended injury (eg falling over/hitting head/traffic accidents)
less than half injuries resulting from alcohol consumption is criminal
the 2008 Intervention in Newcastle was one of the most successful programs in reducing harm caused by alcohol consumption
responsible service of alcohol, reducing trading hours and hotel density are key and has overwhelming community support
the methods the alcohol and hospitality industry have advocated have not worked
a level playing field -  an apolitical, bipartisan approach needed

Addressing tobacco and disadvantage
Mr Ray Lovett (Australian Institute of Aboriginal and Torres Strait Islander Studies and National Centre for Epidemiology and Population Health, ANU)
11% of people in ACT smoke
various strategies to reduce/quit smoking discussed – group therapy is most effective (2.4 times more likely to quit); individual therapy (1.2 – 1.6 times more likely to quit); similar ratios for telephone and motivational incentives
screenings by health professionals are good, but not conducted frequently enough
social marketing and media campaigns effective
where to focus efforts? – justice system; blue collar sector; unemployed; Aboriginal and Torres Strait Islanders
every dollar spent on tobacco control delivers an overall saving of $1.30

Q&A Panel Session
What ideas does the panel have to ensure consumer participation is embedded in drug treatment?
Comments included:
There must be a balance between evidence and reality on the ground.  Consumer voice is important, but there must be a compromise between the solution and meeting consumers’ needs.  Important to listen to consumers and include their views in health policies.
If consumers are involved, you get a better outcome.  ATOD consumer participation is an area that needs development/encouragement and ATODA is working on this.   Depends on the area – eg consumer participation in surgery is poor.  ATOD, as a unit within health, will improve.
Training for consumers is vital.  There is an excellent opportunity to build a good model of consumer participation in the ATOD sector through ATODA working with HCCA to build that model.

What is the panels’ views on holding young people in the Watch House?
Comments included:
Watch House is a last resort.  It’s really a sobering up facility.  Ideally it would be good to have another facility specifically designed for children.  However, this isn’t necessarily easy/practical in such a small jurisdiction.  Agreed young children have range of needs and important to get the model right.
The correct setting for young people depends on the individual/circumstances/behaviour.  Sometimes, the Watch House is a suitable place.
Greens support expanding facilities for young people.  Very important to prevent children becoming involved in youth justice system.  Definitely should be separate service for young people.
$4 million was allocated for random roadside drug testing, but there is little evidence to show that it has been effective.  Would the panel support implementing an evidence-based social marketing campaign? And would the panel support a formal evaluation of the program?
Views differed on efficacy of the program. 1 in 60 people in Australia drive while under the influence of drugs and in ACT it is 1 in 40.  Effective marketing of the program is needed.  Currently the program is in its infancy, but doing well.  
There will be an awareness campaign in 2013 and the Road Safety Trust will do an evaluation.  As the police become more familiar with policy and procedures, costs should be reduced.

What are the panel’s views on the second Australia 21 Report?  Does it agree with one of the outcomes of the recent meeting that there is a need for National Summit on the topic and a referral of the issue to the Australian Productivity Commission?
Ranged from disagreement with Australia 21and believing there is no need for referral to the Australian Productivity Commission (APC), to welcoming involvement of APC, because, this would remove politics from the process.

What are the panel’s views on flexible payment options for vulnerable people/groups?  What about people who are fined who cannot pay?
Policy work is being done on this.  Issues need to be dealt with other than by handing out financial fines.
Balance needed here.  Fines and penalties are there for a reason.  Often they achieve their objective as acting as a deterrent.  But agrees there is no point in fining people who cannot pay.
Is there capacity for more young people to have their problems addressed by the health, rather than the justice system?
There was unanimous support from all parties on this one.
Evidence shows outcomes for young people and the community are better if young people avoid the criminal youth justice system.
Policy needs to be tailored to specific needs.  The availability of alternative programs is important.  

Karen Jameson
Policy Officer

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