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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010
NATIONAL INDIGENOUS DRUG AND ALCOHOL COMMITTEE
SUBMISSION TO THE NATIONAL DRUG STRATEGY CONSULTATION
The high levels of alcohol use and related harms among Indigenous Australians remains a major national
concern and is recognized as one of the major contributing factors to the causes of chronic disease,
family violence and incarceration. Research and consultations with Indigenous Australians and leading
experts, relate that the basis of any approach to the reduction of alcohol-related harm needs to be
holistic and is dependent on consultation and participation with Indigenous Australians. There also
needs to be clarity regarding cultural validity for the use of evidence base models and practices, to be
effective.
The National Drug Strategy Aboriginal and Torres Strait Islander Peoples Complementary Action Plan
2003–2009 (CAP) was developed in recognition of the special challenges faced by Indigenous
Australians. Its principles and actions, developed with regard to both the available evidence and
extensive consultation with Indigenous people and other key stakeholders, remains relevant today, and
continues to be a valuable guide.
NIDAC remains strongly of the view the CAP remain a separate, complementary strategy of the National
Drug Strategy. The reason for this is based on the following rationale:

There is the concern that should the CAP be integrated under the National Drug Strategy, the
principles and actions which are critical to addressing harmful Indigenous alcohol and drug use
will be diffused and diminished as a result.

Until the CAP, no national strategy had specifically addressed Indigenous Australians problems
with the use of alcohol and other drugs. As a separate document it serves as a valuable guide for
the development of other relevant policies and frameworks, which might otherwise be lost if
integrated under the National Drug Strategy.

The CAP can assist the Australian Governments’ commitment to closing the gap on Indigenous
health equality to be responsive in addressing the harmful alcohol and other drug issues that
affect the health and well being of Indigenous Australians.

There is a crucial need to be inclusive of Indigenous Australians involvement, ownership,
responsibility and control in addressing harmful Indigenous alcohol and drug use. Aboriginal and
Torres Strait Islander People were directly involved in the development of the CAP. The CAP also
reflects strong involvement of Aboriginal and Torres Strait Islander Peoples responding to
Indigenous alcohol and drug issues and as a separate strategy is easily identified as such.
Therefore, the CAP is more likely to produce better outcomes than if imbedded as special
population sections into other strategies under the National Drug Strategic Framework.

As a separate strategy, it will be easier to gauge the impacts occurring on the ground in relation
to harmful Indigenous alcohol and drug use and whether there is any sustainable effect.
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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010

The principles and actions of the CAP is a valuable guide for any future development of
performance indicators and Indigenous specific alcohol and other drug measures.

The inclusion of performance indicators within the CAP would allow Indigenous health
outcomes to be easily identified and therefore meaningfully contribute to the National Drug
Strategy, the Australian Government’s “Closing the Gap on Indigenous Health Inequality”
commitment, and the Northern Territory Emergency Response Intervention outcomes. Should
the CAP be integrated under the National Drug Strategy, measurable Indigenous performance
indicators will be needed.

Retention of the CAP as a separate strategy allows greater accountability for targeted
Indigenous specific alcohol and other drug reduction investment.

Harmful Indigenous alcohol and drug use is more complex to address and cannot be adequately
addressed in other existing National Drug strategies without broadening them. The CAP is the
only comprehensive, Indigenous designed strategy under the National Drug Strategy that takes
these complexities into account.

The CAP provides a valuable guide to informing culturally secure practices and approaches in the
prevention, intervention and treatment of harmful Indigenous alcohol and drug use.

The Australian government, by supporting the CAP as a separate strategy can justifiably
demonstrate recognition of its Indigenous people as identified under the United Nations
Declaration on the Rights of Indigenous Peoples, which Australia endorses. The United Nations
Declaration on the Rights of Indigenous Peoples is consistent with the aspirations expressed by
the current Australian Government through the National Apology, the Statement of Intent to
Close the Gap on Indigenous disadvantage and in supporting the establishment of a new
National Indigenous Representative Body.
Issues and Gaps for consideration
The issues and gaps mentioned below are unique to addressing harmful Indigenous alcohol and drug use
and require special attention. In this regard, the CAP is best placed to address these issues, as a
separate but complementary document to the National Drug Strategy.
The implementation of the Aboriginal and Torres Strait Islander Peoples Complementary Action Plan
There were a number of issues in regards to the effective implementation of the Aboriginal and Torres
Strait Islander Peoples Complementary Action Plan 2003 – 2009. The CAP was to be aligned with other
strategies under the National Drug Strategy to assist them to also be applicable to the needs of
Aboriginal and Torres Strait Islander People. The alignment of the CAP and how it was implemented has
not been clear, or the process of monitoring it. This could be rectified by ensuring there are stronger
links, improved performance measures and processes for the mapping, monitoring, and collection of
information that is specific to Indigenous alcohol and drug use.
The effectiveness of addressing harmful Indigenous alcohol and drug use if integrated into other
National Drug Strategies
The CAP is much broader than any other strategy under the National Drug Strategy in that it recognizes
the complexities, history and social determinants that impact on Indigenous alcohol and drug use. It also
recognizes the need for services to take on a holistic, culturally secure, family approach that can cater to
Indigenous Australian needs. Enhancing the capacity of an Indigenous workforce is a key factor in
providing these services. Should the CAP be integrated, it may be difficult for other strategies to
effectively embrace these factors and account for them.
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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010
NIDAC will be releasing a report this year that identifies the areas of greatest need in addressing harmful
Indigenous alcohol and drug use. The evidence from this report will inform government on what areas
need to be tackled and the gaps in services to address harmful Indigenous alcohol and drug use.
Gaps in the harm minimisation approach amongst the Indigenous population
Supply reduction is an important means of dealing with harmful Indigenous alcohol and drug use. Whilst
there has been improvements in supply reduction strategies (eg in the areas of volatile substance
misuse, kava misuse and alcohol restrictions), there are gaps that diminish their effectiveness. This
includes adequate policing, law enforcement, responsible licensing and use of evidence based practices
that work in Indigenous communities. A greater focus is needed on strengthening supply reduction
strategies.
Supply reduction measures also need complementary demand and harm reduction strategies to be fully
effective. This is important particularly where supply reduction measures have been implemented and
where this is little assistance or services for those with an alcohol or drug problem, or those families
affected by harmful alcohol and drug use. Responsible drinking behavior, responsible sales of alcohol,
inhalants and pharmaceutical drugs, diversion into treatment, alcohol and drug interventions are some
of the many evidence based tactics that can improve the overall effectiveness of tackling harmful
Indigenous alcohol and drug use.
Working at the local level using evidence based research and practices
The principles of the CAP must underlie any action to address harmful Indigenous alcohol and drug use
and its associated harm. It contains culturally valid strategies derived from a strong evidence base for
how alcohol and drug issues should be addressed. The CAP principles of Indigenous Australians being
centrally involved in the planning, development and implementation of strategies and that they have
control over their health, drug and alcohol and related services is critical in securing effective and
sustainable outcomes.
Gaps in service delivery
There are significant gaps in the delivery of alcohol and drug services for Indigenous Australians. These
gaps are influenced by factors such as geography, systemic bias, population demographics, gender and
need.
 Equity of access for Indigenous Australians
Regardless of whether an Indigenous Australian lives in a remote, rural or urban area, as a
disadvantaged population the issue of accessing (suitable) alcohol and drug services remains a
significant problem. Affordability, cultural appropriateness, the need to connect with family,
the lack of available services near where they live, incarceration and carer support are just some
of the issues that limit access.

Adequate proportioned funding and resourcing according to need
Indigenous Australians are overrepresented in the levels of harmful / risky drinking, chronic
disease, incarceration and types of violence and harm where alcohol and drugs can play a key
factor. Funding and resourcing needs to be adequately allocated across Australia according to
the services required to address these problems.(The gaps in funding and resourcing will
become clearer with the completion and pending launch of the findings from the NIDAC report
into 'Identifying Areas of Greatest Need).

Focus on Indigenous Australians with alcohol and drug problems in urban areas
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NIDAC Submission to the National Drug Strategy Consultation
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The focus on assisting Indigenous communities in rural and remote areas is most welcome,
however since the majority of Indigenous Australians live in urban areas; greater attention is
needed for addressing Indigenous alcohol and drug issues in these areas. This includes
affordable and accessible alcohol and drug services that can cater to the specific Indigenous
needs of those living in these areas.

An Indigenous workforce that can meet the specialist demand to deal with the complex issues of
harmful Indigenous alcohol and drug use
A holistic approach to the delivery of Indigenous alcohol and drug services and training allows
for more effective and sustainable outcomes, not only for the clients and their family, but also
for the retention and robustness of the Indigenous health workforce. It is important to increase
the workforce with the appropriate specialist skills that can adequately deal with the complex
issues of harmful Indigenous alcohol and drug use. Because of the increased demand placed on
the Indigenous workforce and services for these specialist skills, greater recognition, appropriate
remuneration and training are important. Also, the workforce is likely to be retained and more
sustainable if there are career opportunities and pathways, good service and workplace
practices in place.

Consistent and quality practices in the delivery of alcohol and drug services to Indigenous
Australians
The quality of service and workplace practices to address harmful Indigenous alcohol and drug
use varies across Australia, as there are no national benchmarks for the provision of these types
of services. National standards based on evidence based research and practice would greatly
enhance and sustain the organization and the workforce delivering Indigenous specific services.
An improved focus on carer support, and disability caused by direct or indirect alcohol and other drug
use.
There are a number of Indigenous Australians who have been incapacitated by direct or indirect alcohol
and other drug use, requiring specialist care, especially those with a chronic disease, acquired brain
injury or fetal alcohol spectrum disorder (FASD). In many cases, care is provided for by family or a
guardian who may not have access to appropriate services or support that can assist them in providing
quality care. This is particularly true of Indigenous carers, and those living in remote areas, or with a
dependant family. The difficulties faced by Indigenous carers can be profound with little recognition for
the complex issues they may have to deal with, or the demands placed upon them to provide quality
care for an individual.
A strong focus on building Indigenous employment in the alcohol and drug and relevant fields.
To strengthen the workforce so that it can meet demand, a greater emphasis is required on attracting
Indigenous people to alcohol and drug fields, particularly in psychology, medical science and research
areas, as well as associated health professions. A coordinated effort by the education and alcohol and
drug sectors is needed to ensure that addressing Indigenous alcohol and drug use is more adequately
addressed in tertiary courses in the relevant disciplines.
A national understanding of harmful Indigenous alcohol and drug use and its associated harms
At present, there is no current national collation of data that can provide a comprehensive picture of
Indigenous drug and alcohol use and associated harm. It makes it difficult therefore, to provide
appropriate responses without knowing the nature, emerging issues, prevalence and patterns of
tobacco, alcohol, illicit and licit drug use that are unique to the Indigenous population. NIDAC strongly
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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010
encourages the establishment of an ongoing national survey to enable government policies and
investment to accurately target those areas where there is greatest need.
Noting the complexity of Indigenous alcohol and drug use and what is needed to address it, data
collected only though police and alcohol and drug services may not necessarily capture the real/whole
picture. To effectively monitor the outcomes of the CAP, it would also be useful to collect information
more broadly from other sources where there is an impact on Indigenous alcohol and drug use (eg
indigenous community controlled health centres, welfare agencies, housing, employment and disability
services).
The National Drug Strategy is unable to accurately measure (the level of) Indigenous alcohol and other
drug use.
Whilst all other strategies under the NDS have some statistical measures derived from surveillance
systems, surveys and data sets there are no meaningful means to capture information that has an
impact on Indigenous alcohol and drug use, nor are there suitable performance measures in the CAP or
other National Drug Strategies to monitor efforts. Therefore, the success of the National Drug Strategy
Recommendation 12, “to fill key gaps in Australia’s alcohol and drug data systems..”, in relation to
Indigenous Australians has been difficult to determine.
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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010
Recommendations and Priorities for Action over the next 5 years
Policy
1. The Aboriginal and Torres Strait Islander People’s Complementary Action Plan remain a separate
strategy that complements the National Drug Strategic Framework with:
 better links to other strategies under the Framework
 a concise format
 measurable performance measures
2. The principles of harm minimisation to remain with an improved focus on 'supply reduction' for
Indigenous communities which is supported by complementary harm and demand reduction
strategies.
3. The principles and actions of the CAP to continue to be recognized as important ways to
effectively address harmful Indigenous alcohol and drug use.
4. The central involvement of Indigenous Australians in addressing harmful Indigenous alcohol and
drug use in their communities.
5. A more strategic approach based on evidence that targets harmful Indigenous alcohol and drug
use in urban, rural and remote areas according to population and need.
6. An improved focus in urban areas where there is a high proportion of Indigenous Australians.
7. A national standard of quality and a minimum benchmark for workplace and service practices
for the prevention, intervention and treatment of harmful alcohol and drug use amongst
Indigenous Australians.
8. Appropriate and transparent allocation of funding that targets areas of greatest need amongst
the Indigenous population.
Service Delivery
9. Continue the development of an Indigenous workforce that has recognized specialist skills and
that can adequately meet demand.
10. Accessible and affordable alcohol and drug services for Indigenous Australians.
11. Appropriate funding and resourcing to Indigenous specific services, according to areas of need
12. A continuation of capacity building for Indigenous specific alcohol and drug services.
13. An improved focus on carer support, and disability caused by direct or indirect alcohol and other
drug use.
14. A strong focus on building Indigenous employment in the alcohol and drug and relevant fields.
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NIDAC Submission to the National Drug Strategy Consultation
24/02/2010
Research and Measurable Outcomes
15. Improved national data collection measures to determine Indigenous alcohol and other drug use
(eg the establishment of an ongoing National Indigenous Drug and Alcohol Survey or an added
Indigenous component to the existing National Drug Strategy Household Survey).
16. A means of collecting information from other sources / service providers where there is an
impact on Indigenous alcohol and other drug use (eg Indigenous community controlled health
centres, welfare agencies, housing, employment, disability services).
17. Develop and improve performance measures in the CAP that specifically relate to Indigenous
alcohol and other drug use.
18. Improved accountability of Indigenous specific policies, strategies, actions and investments that
aim to reduce harmful Indigenous alcohol and other drug use.
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