Showing posts with label ATODA. Show all posts
Showing posts with label ATODA. Show all posts

Wednesday, November 19, 2014

7th Annual ACT Tobacco and Other Drug Sector Conference 2014 -Report By Susan Westwood

Delegate:  Susan Westwood, Health Care Consumers Representative

Program
What is the drug policy?

Topics
E-cigarettes
Drug driving
New psychoactive substances
Medical Cannabis

What is the Problem?

Preamble

A lot of theoretical ground on the conference topic was covered by the speakers at this conference, the majority of whom had academic backgrounds.  Many important questions and issues relating to drug policy were raised by the speakers, and by the delegates who had the opportunity to discuss and question some of the key points raised by the speakers at the end of each session.  No definitive answers to the questions raised were given, although some suggestions and viewpoints were expressed.  Mr Ross Bell from the New Zealand Drug Foundation provided an interesting insight into the New Zealand experience, describing a political attempt to decriminalise drugs in the public arena.  But the community turned and lobbied against the idea of decriminalisation, due to a bizarre change of political influences and an emotional advertising campaign.

Drug policy is often subject to personal judgment. Formulating the stance taken on this sometimes confronting and demanding topic may depend on one’s own personal background, experience, age, nationality and perspective.  To some extent, it may be difficult to be totally impartial because many lives in the community have been influenced by family members affected by addictions, mental illness and drug intake. 

My personal experience as a health professional has been focused on saving lives and applying the principles of public health, wellbeing and enjoyment of life.  It goes without saying that the huge diversity of opinions, life experiences and life stages of people throughout the world can offer many interpretations of what form a drug policy should take.  In saying this, I am mindful that the problem is not just confined to ‘recreational drugs’ but that certain legally prescribed drugs can be just as addictive and life‑threatening as illicit drugs.

Event Observations

The Portrait Gallery was a good venue for the meeting; however, our table was placed right next to some heavy sliding doors which were constantly being pushed aside by a facilitator to allow persons to exit the room.  At times, it was very noisy in the foyer and this caused some problems in hearing the speakers.  One person at our table left and sat elsewhere. 

The morning tea, lunch and afternoon tea were very good and much welcomed because it was a long and demanding day.  I had the onset of flu so I welcomed fluid intake and food.  I did notice, though, that there was no choice for persons on special diets, e.g. gluten free, diabetic, etc.

The delegates all had a ticket number and a raffle was held at the beginning of each session, with prizes for the winners.  This was fun and encouraged everyone to get back on time for the next session.

The Role of Narrative, Metaphor and Media in Marihuana and Drug Use

Prof. Alison Ritter reflected on the popular trend to define problems according to narrative and metaphor. She questioned whether the use of specific narratives and metaphors contribute to the problem of interpreting drug policy. She believes that the use of narrative and language are central to those who implement any policy on drugs.  She claims that these policy makers can be viewed as ‘actors’ and that their solutions to the problems do not always relate to the problem at hand.

Prof. Ritter suggested that framing and the use of language can often publicly characterise certain drug usage, e.g. What is the image of a ‘vapor’ as opposed to a ‘smoker’? This leads to the question of how do we conceptualise drug usage and users in our modern society?

Emeritus Prof. Laurence Mather talked about the discourse of pleasure around drug usage and that the opposite is also true in reality.  He said that marihuana is often referred to as that ‘demon weed’ and the media have often portrayed marihuana negatively, for example, as in the 1969 novel Marijuana Girl which tells of a young girl who sells her body in order to buy marihuana.  Similarly, the 1936-39 movie production Reefer Madness, an American propaganda film portrays marihuana habitual usage as a gradual personal descent into crime and eventual madness.

There seems to be no doubt that the power of the media can influence public opinion about alcohol and drug issues and produce a fearful reaction among the public.  The media can instil beliefs, attitudes and fears, and can bias public opinion in many different ways about the drug discourse.

What is the Problem?

I refer here to the following Australian National Drug Strategy objective:

‘The aim of the National Drug Strategy 2010–2015 is to build safe and healthy communities by minimising alcohol, tobacco and other drug-related health, social and economic harms among individuals, families and communities’.
(Collins, D. and Lapsely, H., 2008, The Costs of Tobacco, Alcohol and Illicit Drug Abuse to Australian Society’, in 2004/05, National Drug Strategy Monograph Series no. 64.).

I was interested to observe whether there had been a change to the ‘strategy’ since this report was written and whether our more liberal, humanistic approach to life in 2014 reflects the winds of change in drug reform and strategy.

Common Themes from Conference Presenters

Ms Anke Van Der Sterren, Alcohol Tobacco and Other Drug Association, ACT

Ms Van Der Sterren talked about the health and safety of modern drug usage. She suggested that there is currently insufficient research evidence on the long-term effects of drug usage.  Research outcomes, findings and evidence are often open to interpretation depending upon which ‘slant’ is taken to the research subject.  Pharmaceutical companies, politicians and interest groups all have an investment in the drug issue.  She raised the question of just how applicable the findings are to the ‘coal face’ where health workers are confronted with the everyday reality of the effects of drug usage on users and their families.

Dr Coral Gartner, University of Queensland

Dr Gartner suggested that currently there is no specific legislation or drug policy that is effective in dealing with the drug problem in our society.  She questioned who is affected by current legislation—the policy makers, the enforcement agencies, the criminal system, the list is endless.  This suggests that there is a rather indefinable area in approaching this problem in the A.C.T.

Ms Joanne Baumgartner, Health Care Consumers Association

Ms Baumgartner talked about the social concept of ‘punishment’ and that an authoritative approach has been adopted in society geared towards punishing the drug user and generating negative press.  She suggests that a more libertarian approach to this problem may remove the stigma attached to drug use, as, for example, the legalised use of marihuana in medicine.

Mr David McDonald, Social Research and Evaluation, Australian National University

Mr McDonald posed some interesting questions related to the objective of legislation to reduce costs to the community in respect to injury and ongoing medical support. He questioned the underlying assumptions made by policy makers. For example: What are some of the general and specific deterrents to drug taking? Is it valid to breach human rights?

He also pointed out that, currently, there is a lack of available research in the ACT on, for example, the effects of drug driving.  He said that there is no publicity about drug driving so how does one quantify drug thresholds for, say, drug driving?  Interestingly, synthetic drugs are not detectable in blood or urine analysis.

Dr Monica Barratt, University of New South Wales

Dr Barratt pointed out that there are many cases of teens dying from synthetic drug usage because of lack of legislation in N.S.W and the A.C.T to prohibit easy access to these drugs in drug outlets in shopping centres and so on, and that there are inadequate warning labels on these synthetic products.  Teenagers are unaware that these products are dangerous and can lead to death.
Mr Ross Bell, NZ Drug Foundation

Mr Bell was a straight-talking person who said, in his experience, governments try to control drugs through obsolete laws leading to prohibition. He said that there are many new drug products coming onto the market that produce ‘legal highs’ and that New Zealanders like their drugs.

He discussed the question of prescriptions versus restrictions and suggested it would not make that much difference to recreational drug use in N.Z.  He also highlighted the need for adequate labelling and health warnings on drug products, and the need to restrict retail licenses.

Mr Bell emphasised that any drug reform or regulation needs broad public support and consensus, and referred to a failed recent attempt by the NZ Government to decriminalize drugs.

Emeritus Prof. Laurence Mather, University of Sydney

Prof. Mather reflected on the 1937 AMA findings that concluded that there was no evidence to indicate any benefits from the use of marihuana in medicine. 

He suggested that there are three main fears around legalising marihuana for medical use: (1) political, (2) pharmaceutical and (3) business.  He said that prohibition has not and will not work as a solution.
He strongly suggested based on his experience, that regulation with prescription is necessary to monitor and control recreational marihuana usage.

Similar to popular opinion at the conference, Prof. Mather suggested adequate package labelling, and a ban on both advertising from the outset of legal use, and on all donations to political parties.

He suggested that drug reform is a socially constructed problem that focuses on one substance rather than on the perspective of the drug user as a person and individual.  He questioned the assumptions that underlie policy on drug reform.

Summary
This conference was a very interesting and well-organised event.  I sat next to a health worker from the mental health area of the Canberra Hospital, with whom I established a good rapport very quickly.  She was exceptional in her area of caring and she shared with me a lot of most informative and valuable information about the role of the worker at the forefront of the drug and alcohol scene. 

Although this conference did not provide all the answers to the related problems ‘of drug and alcohol’ in Canberra, it did pose some interesting questions, outlined problems and occasionally suggested some ideas about how to effectively bring about change in the area.

The speakers, coupled with the practical and frank discussion with the companion who sat next to me at my table, provided me with a new perspective on the drug and alcohol scene. Since attending this


conference, I have spent some time researching some of the issues, i.e. legalisation of marihuana, synthetic drugs. I have also had some interesting discussions with members of the community who have provided me with their views on the topic.

This is certainly a most convoluted and complex problem, which was highlighted at this conference.

References:
 Marijuana Girl by NR DeMexico (Soft-Cover Library S-75124, 3rd printing, 1969)

 A novel about a fresh and fetching girl, who at 17 was ‘hooked’ on the drug marihuana— thanks to an older man.
He did not mean to harm her. He was just setting her up for love! But after that drug-induced ecstasy, her pretty feet trod the path of degeneracy.   Here we study every nuance of her disturbing relations with other teenagers, with mature men out for ‘kicks’, with colored jazz musicians! We watch her resorting to every vile device, trading her self, body and soul for the drugs she had to have!!!

Reefer Madness (originally made as Tell Your Children and sometimes titled as The Burning Question, Dope Addict, Doped Youth and Love Madness)

 A 1936–1939 American propaganda exploitation film revolving around the melodramatic events that ensue when high school students are lured by pushers to try marijuana—from a hit-and-run accident, to manslaughter, suicide, attempted rape, and descent into madness due to marijuana addiction. The film was directed by Louis Gasnier and starred a cast composed of mostly unknown bit actors.

Originally financed by a church group under the title Tell Your Children, the film was intended to be shown to parents as a morality tale attempting to teach them about the dangers of cannabis use.  However, soon after the film was shot, it was purchased by producer Dwain Esper, who re-cut the film for distribution on the exploitation film circuit beginning in 1938/39 through the 40s and 50s.

The film was ‘rediscovered’ in the early 1970s and gained new life as satire among advocates of cannabis policy reform. Although finding a popular audience as a cult film, critics have panned it as one of the worst films ever made. Today, it is in the public domain in the United States.



*Please note that this Report is the Intellectual property of Ms Susan Westwood, HCCA Representative.

Monday, November 17, 2014

7th Annual ACT Alcohol Tobacco and Other Drug Sector Conference (ATODA) Conference Report by Kim Novack



7th Annual ACT Alcohol Tobacco and Other Drug Sector Conference (ATODA)
Wednesday 24 September 2014
                                   
 
Summary:

The ATODA conference comprised of approximately 115 delegates from a variety of ACT Heath Service Organisations, which included ten guest speakers. This conference was highly interactive and provided all participants with the opportunity to raise issues around the current solutions in place.   

“What’s the problem represented to be?”  This was a very clever question raised to initiate discussions and various perspectives around the key topics of e-Cigarettes, Drug Driving, New Psychoactive Substances and Medicinal Cannabis.

ATODA discussed the different approaches that are used to address these Drug Policy problems.  Their focus being: understanding that problems are created by the way we implement policy and solutions. There is no right or wrong decision but there will always be ways to improve the systems and solution in place.
The Policy models comprise of:
  1. Policy as an authoritative choice – decision making by authorities, i.e Pharmaceuticals
  2. Policy as structured interaction – governance networks, i.e King Cross violence and re-structuring alcohol licences
  3. Policy as social construction – of target populations, i.e UKDPC and ANCD consensus

The following notes are a summary of the key points raised by each of the guest speakers on their topic of interest. The conclusion to each of the main topics is somewhat confusing as it appears there are more questions than solutions at this stage. Most issues are still facing much uncertainty and debate in moving forward to obtain consensus and approvals through communities, governments and legislation.    

e-Cigarettes

Speaker: Anke van der Sterren
Organisation: Alcohol Tobacco and Other Drug Association ACT (ATODA)
Topic: e Cigarettes and personal vaporisers also called ENDS, ANDS and E Smokes

Anke raised the current debate around the use of e Cigarettes in our community and whether these are safe or safer than Tobacco cigarettes.  

Questions that have been raised with the Health Services sector include:

  1. Safe for vapour users and the people around them?
Yes, better than cigarettes, less smell, nil or limited nicotine, however no real evidence based assessments have occurred regarding the safety of others.

  1. Effective to help smokers quit?
Possible smoking reduction, however no real evidence based assessments have been conducted as yet.

  1. Is this a gateway for young people to use or start smoking?
Young people could get addicted to Vapours. There is also concern that vaporisers will be used with other illicit substances.

  1. Is this a way to re-normalising smoking activity?
This is undecided. No real evidence based assessments have been conducted as yet.

Issues with the Solution: Group Discussion Perspective:
  • Many studies have been conducted however no real evidence has been produced.
  • It is too early at this stage to determine the effects on indoor air quality and biomarkers in vapours.
  • The World Health Organisation (WHO) recently commissioned a report reviewing evidence on E-Cigs, however this was not considered as substantial evidence based results.
  • The “Big Tobacco Company” is cashing in via advertisements and pushing the use of e-Cigs.  Also developing new e-Cigs and false terminology as “real tobacco” is used.
  • Question if this is a middle class problem? Who does this affect? This information needs to be qualified and verified.
  • The cost associated is very expensive
  • The quality of information must be addressed
  • Is this a distraction and are we misdirecting our efforts?
  • Should we focus on the low socio economic majority, to reduce smoking?
  • Should we be focusing on similar campaigns that were used for the HIV and Condom education?
Speaker: Dr Coral Gartner
Organisation: University of Queensland
Topic: Long term Regulatory goals and minimise nicotine use and the black market trade.

Dr Gartner discussed the legal aspects and the current regulation state around the use of e Cigs in Australia.

There are currently multiple laws in place for States and Federal Government. Queensland was the first to propose regulation of e-Cigs and is currently in Legislation review.  

Personal Vaporisers without Nicotine: are legal to obtain, possess and import.
Current State sale provisions:
  • NT, TAS, VIC, ACT = legal
  • QLD = legal however must be inline with the Tobacco Laws
  • WA = possibly illegal, the appeal outcome is pending
  • SA, NSW = possibly illegal.
Personal Vaporisers with Nicotine: are only legal, where there is a therapeutic claim and a medical prescription must be obtained.  

Issues with the Solution: Group Discussion Perspective:
  • How are we regulating cigarettes in the supermarket?
  • If personal vaporisers are not sold in supermarkets should cigarettes be removed from open sales?
  • Cannabis and other drugs could be used in the vaporiser tool which could encourage further illicit drug use.
  • Only high quality safe products are legally sold, how will this be monitored?
  • Taxation – Tobacco has high tax levies, should vaporisers incur the same?  
  • More research is needed to acquire data on the safety for person using and others and is this good for public health?
  • Economic issue – are people in low socio economic status the focus?
  • Safety and Harm – Is this a legitimate harm control tool with a positive reduction in Tobacco use?
  • Social and Community to obtain information and communications about this product.
Drug Driving

Speaker: Professor Maxwell Cameron
Organisation: Monash University
Topic: Accident Research Centre study on random roadside drug testing in Victoria.

Professor Cameron discussed the effectiveness of roadside drug testing (RDT).  

The Accident Research Centre study has shown that increased drug tests and detection have had a positive deterrent effect on Victorian roads. However, this is a very costly exercise. To become cost effective in the long term the testing tools and technology will need to become cheaper to sustain RDT.

Future focus on a targeted approach to test truck drivers is hopeful as the carnage is severe in most cases in truck accidents due to the high use of Methamphetamine.  


Issues with the Solution: Group Discussion Perspective:
  • How effective is RDT?
  • Consider the cost ‘vs’ time?
  • Is the message of reducing driving under the influence of substances being heard?
  • Are fewer drivers being killed due to less impairment from substance abuse?
  • An expensive exercise however worth the investment as RDT is working as a deterrent. 
Speaker: Mr David McDonald
Organisation: Australian National University
Topic: Social Research and Evaluation on Drug Driving

Mr McDonald raised the current debate into whether the drug driving problem is a road safety or drug law enforcement problem, should it be focusing on prevention or targeted and the issues around prosecution of drug driving is quite different to driving under the influence of alcohol.

What are the underlying assumptions?
  • Some drivers could be impaired by the use of drugs
  • Some drivers use drugs and some drive after use
  • RDT will reduce prevalence of drug impaired driving
  • RDT will reduce the increase of road side crashes
  • Currently only testing for Cannabis, MDMA and Methamphetamine
  • It is valid to breach human rights
  • Community awareness and knowledge regarding RDT and road safety
  • Education is needed in the ACT in regards to the consumption and impairment thresholds - when is it safe to drive after taking drugs.
  • High rates and remain high from past ten years on usage and driving under the influence.

What are we seeking to achieve?
  • Can the problem be thought about differently?
  • Costly, different set-ups could be put in place
  • Safety ‘vs’ Prosecution?
  • Publicity for government and police
  • Proof that testing of Drugs is stopping accidents
  • Prescribed limits – The UK Government is trying to come up with quantitative impairment thresholds for 16 Drugs 

Issues with the Solution: Group Discussion Perspective:
  • Does drug testing take away resources from other police resources?
  • Equipment ‘vs’ police man power?
  • What is the best investment for Road Safety?
  • RDT is still very effective and important
  • Threshold of effect is very complicated and not as simple as testing alcohol in breath and blood samples.
  • Focus on the effect not the level in the system needs to be considered.
  • Look at medicated cannabis and how to monitor if users are safe to drive?
  • Current Legislation any impairment under any substance will be prosecuted
  • What about Opiates? Currently not being tested first hand.
  • What are the varied State jurisdictions?
  • What about new psychoactive substances and synthetic cannabis


New Psychoactive Substances (NPS) 

Speaker: Dr Monica Barrat
Organisation: University of NSW
Topic: Drug Policy Modelling Program

Dr Barrat discussed the use of New Psychoactive Substances; Synthetic Cannabis, Methadrone, 2CI and 2CB and Cathinones in relation to the findings in the September 2014 Senate Committee report and EMCDDA which is monitoring drugs and analogues.

What are the underlying assumptions?
  • Users of cannabis will try synthetic
  • It is not encouraging new addiction or new users
  • People use Synthetic Cannabis as it is legal, easier to get, produce an effect they were curious about.
  • A full import ban on NPS is with the Senate at the moment.
  • Illegal and will produce harm to humans – both social and health related harm
  • NPS is similar in effect or structure
  • Key public messages – it is not safe nor legal
  • Some people may think this is safe.
  • Motivation for use
Speaker: Mr Ross Bell
Organisation: New Zealand Drug Foundation
Topic: Legalisation of NPS in NZ

Mr Bell discussed the process in which the NZ government attempted to legalise NPS use and the problem with governments trying to control illegal substance use through Drug Laws and Prohibition.

Mr Bell is fighting for Regulation rather than Prohibition. Prohibition is not working as there are too many new products being created. Prohibition worked when only a dozen substances existed 40 years ago. NZ tried various forms of controls, including;  banning substances quickly, implementing drug laws, adding illicit substances to controlled analogue lists. Nothing worked.

The NZ Government soon ran out of patience. A review of the current Drug Policy Law commenced. New reform recommendations were put in place and a Regulation model, under tight controls was created.

Industry had to prove their drug is not harmful including; labelling, poison centre line, testing regime and prove that their drug is low risk of harm. A licence to sell the product would only be issued if this process was passed successfully. This would enable the legal selling of these New Psychoactive Substances.

Evidence Drug Policy making was passed through Parliament Law. The Law was passed but Regulation had not been written as yet. Then a new Election year proved to cause trouble and the process stopped.  The Media got involved and pursued a negative campaign against legalising NPS. Advertising a picture of a 17 year old boy called Jesse, coughing up blood into a tissue when detoxing after 4 years of synthetic Cannabis use and possibly other drugs, was an influential campaign in changing the community support for legalisation.  The media then created a new campaign which involved the testing of Synthetic Cannabis on animals, at this stage the public didn’t hear that the products will be approved through an intensive process and only sold under an approved license. The public soon changed their mind on the new Drug Law. Parliament then changed the Law and removed all licences.

Issues with the Solution: Group Discussion Perspective:
  • The professionals don’t know how big the problem is and can’t confirm that NPS are safe for long term use.
  • Public eye – Politicians reputation backlash from community
  • Does this reduce organised crime? 
  • Politicians are too afraid to act
  • Regulations – Education is needed
  • Fear in people with propaganda and corruption from media
  • Keeping prohibition Laws in place is not working
Benefits if Law is passed:
·         Controlled – low risk harm and legally tested products
·         Monitored, tested and licensed.
·         If NZ get the model right this could change the world model. Uruguay is next to implement legalisation of NPS, then Colorado and Washington
·         History of improvement in NZ
·         This will not be built overnight
·         Regulation ‘vs’ no Regulation
·         Disconnect between Policy and the Public
Medicinal Cannabis 
Speaker: Professor Laurence Mather
Organisation: Sydney University
Topic: Advocate for the use of medicinal cannabis


Professor Mather discussed the different types of Cannabis and the critical importance for legalisation of Medicinal Cannabis to give much needed relief for cancer patients. Professor Mather suggests that enough extensive testing and evidence has been produced with the evidence showing huge benefits for patients.  

Crude Cannabis – plant produces 400+ recognised chemicals. A mixture of cannabonoids - THC, CBD, CBN with contaminants such as pesticides, mould and other dangerous chemicals. 
Home growing model – Chemical consistency is a problem. Cannabis Hybrids produce over 800+ strains.

Pharmaceutical Cannabis –  pure chemical entity (biosynthetic or synthetic) in the final dose form. Marinol or dronabinol are the synthetic THC substances.

Issues with the Solution: Group Discussion Perspective:
  • Political
  • Unsure/unknown long term effects
  • Money/ Profit for pharmaceutical companies
  • Does this need more research?  


Speaker: Dr Alex Wodak
Organisation: Australian Drug Law Reform Foundation
Topic: Legalisation of medicinal cannabis

Dr Wodak raised the remaining questions that need to be addressed before the legalisation of medicinal cannabis occurs. How and when will this occur and should this be used clinically or conduct further trials? Dr Wodak also believes that the debate will continue for many more years and will require a campaign to educate the community on the beneficial affects for medical purposes.

Obstacles and moving towards supporting medicinal cannabis:
  • Political – both sides support use
  • Strong growing community support – male, female and all ages
  • Now discussed in all 9 jurisdictions
  • Supply – Import, domestic, Dept of Health Supply?

  • Will medicinal Cannabis cause recreational use? Evidence does not support this contention.
  • Is natural cannabis better for medical treatments ‘vs’ synthetic?
  • Regulating cannabis – enough but not too much, purpose is not to over regulate.

Regulation:
·                     Need TGA approval
·                     Requires application which is costly
·                     Establish ‘office of Medicinal cannabis’ to set standards
·                     20 Countries now provide
·                     USA – 23 our of 50 States now provide
·                     Uruguay starts to legalise use in 2014/2015

Issues with the Solution: Group Discussion Perspective:
  • Prohibition prevents the medicinal properties of this drug to be utilised for great benefit especially for Cancer suffers
  • Denial – people are already using this
  • Legal in ACT – decriminalised but can only grow two plants outside – can not grow plants inside as considered hydroponics growing
  • Do we focus on legalising recreational use and leave medicinal for now?
  • Do we follow the Dutch model which has a vast range available to the public, including high and low level THC
  • What about Medicinal use of MDMA and LSD? This will not be addressed until Cannabis is legalised.
  • Recreational ‘vs’ medicinal use – must keep this fight separate and fight for medicinal use first
  • The use of Cannabis for medicinal use may cause further stigma for those that use it for recreational use?  
 By Kim Novack HCCA Member



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?
Comments:
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?
Comments:
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