A major new report commissioned by the Australian National Council on Drugs (ANCD) will be launched on Thursday 18^th of March at Parliament House by Parliamentary Secretary for International Development Assistance, Bob McMullan MP. The report has highlighted that whilst illicit drugs are becoming an increasing concern in the Pacific region alcohol is still the main issue. 

This report, Situational Analysis of Drug and Alcohol Issues and Responses in the Pacific 2008-09, was commissioned in order to provide detailed country profiles relating to alcohol and other drug issues. In addition, a regional overview has been prepared to highlight where existing regional mechanisms may be, and already have been, employed to address these issues. The report provides a much needed picture of the Pacific Region and the drug and alcohol issues they are experiencing.

The report Situational Analysis of Drug and Alcohol Issues and Responses in the Pacific 2008-09 prepared by the Burnet Institute is based on a review of published and grey literature, key informant interviews and broad consultations on detailed country profiles.

In 2004-05 the previous Situational Analysis of Illicit Drug Issues and Responses in the Asia-Pacific Region included only six Pacific countries, which highlighted the limited data available. The Australian Government subsequently requested that this new report be commissioned detailing the situation in 16 Pacific countries. In essence the report increases our current understanding of substance use issues, responses, data, and program gaps in the region.

Co-author and Professor at the Burnet Institute, Robert Power said “This extensive report clearly highlights on-going concerns in the Pacific region about what is happening with alcohol and other drugs.  It very clearly identifies alcohol as the main substance of concern in the Pacific region and shows that cannabis is the key illicit drug of concern in the region.”

“Significantly this really is the first time we have a much clearer picture of the extensive harm occurring in countries that are our neighbours.  Alcohol is considered to be the major factor contributing to numerous health problems affecting people in the Pacific.  What is also evident is that there is a real need for better quality data and a strong desire throughout the region to acquire an understanding about the best ways to address these problems.  The role for Australia here is very clear.”

Dr. John Herron said, “We see constantly the clear harm alcohol causes to the Australian community.  The rise of alcohol related problems and the potential for it to escalate further in the Pacific is quite ominous – especially if we don’t act now. It’s also clear that alcohol and other drugs are significantly contributing to risky behaviour – particularly risky sexual behaviour amongst young people in our region. The potential harm from this behaviour is great”

The ANCD Chairman Dr John Herron says that developing a response that relies on both law enforcement and health service providers is important.

He said “There is at times an over reliance or over expectation within the region on the ability of law enforcement to deal with these issues. An equivalent health response is essential in order to be able to effectively address the range of substance use issues identified in the region. Treatment in particular requires much higher levels of investment if an effective response is to be developed, again, the role for Australia here is clear.”

The ANCD’s Executive Director Gino Vumbaca added “This is an extremely important report for the alcohol and other drug sector and the aid and development sectors in the Pacific Region as it plays a major role in sharing information throughout the region. It also highlights the need for a separate and distinct Pacific focus due to the differences in alcohol and other drug use patterns, emerging trends and problems which the Pacific is facing compared to Asia. Too often an Asia-Pacific focus has meant the Pacific being overlooked; hopefully this report will contribute to correcting some of the inequity in our response at times.”

Mr Vumbaca added that some Australian and New Zealand alcohol industry corporations seem to have a significant commercial interest in the Pacific and if true then these alcohol problems in the region impose an unquestionable obligation on them and their governments to assist the Pacific in addressing these problems.

Enquiries to Gino Vumbaca on 0408 244 552 or
Tracey Kristiansen on 0424 640 692.

Key issues

Regional:

• The primary substance of concern remains alcohol - however in illicit drugs it is cannabis - this response was fairly uniform across the region.
• In many parts of the Pacific region alcohol is considered to be the major contributing factor in many health problems (e.g. heart disease, liver disease etc).
• There is a growing concern in the region about the impact of drugs – both licit and illicit. This comes from both the burden on the community and the health sectors which are arising from the misuse of alcohol and other drugs.
  There is a growing link between substance misuse and risky behaviour (particularly sexual behaviour) amongst young people in the region.
• Overwhelming throughout the report, the issues of the lack of on-going quality-assured reliable data on alcohol and drug use.
  The over-reliance on law enforcement and under-investment in health or at least a lack of an appropriate health response is raised throughout the region.
• Due to a lack of adequately trained personnel, particularly in the AOD related health sector, there is a need to significantly invest in workforce capacity building opportunities throughout the Pacific Region. 

Country:

• Cook Islands: listed as a ‘country of concern’ by the bureau of International Narcotics and Law Enforcement Affairs. Demonstrating increases in under-age drinking, marijuana use, violence, family disruptions, ill-health and disease, injury, and crime.
• Federated States of Micronesia: alcohol is still the major concern. Additionally, cannabis, kava, alcohol and tobacco use (including use with betel) were all on the rise. There are no reports of injecting drug use.
• Fiji: Key drugs of concern have repeatedly been cannabis, alcohol, kava and tobacco. There have been links made between the levels of substance misuse and violence in Fiji, noting that the issue is a growing concern.
• Kiribati: there are reports of illicit drug use in Kiribati but the majority of this is related to seafarers. There is a lack of data for Kiribati, but alcohol still appears to be the major substance of concern.
• Marshall Islands: limited data available. Alcohol is considered a key cause of domestic violence in addition to being a contributing factor for up to 70% of criminal arrests.
• Nauru: Alcohol is the key drug of concern, with noted links to domestic violence, mental health issues and traffic accidents. There is very little, if any, information regarding illicit drug use in Nauru.
• Niue: Alcohol is still the key drug of concern. There is no evidence of other drugs being consumed on the island.
• Palau: has been identified as a country with a number of key risk factors related to injecting drug use and HIV infection, more than for any other Pacific countries considered in the report. Alcohol is nonetheless the main drug of concern.
• PNG: PNG’s illegal drug culture is linked to organised crime activity. Alcohol is still a major concern for PNG, with it being linked to violence against women and health concerns. PNG has the highest rate of reported HIV cases in the region.
• Samoa: Cannabis is reported as the most frequently used illicit drug. Alcohol is still a concern with reports of alcohol-related acts of domestic violence and abuse increasing in rural villages.
• Solomon Islands: There are increasing levels of cannabis use among the youth in the Solomon Islands. Betel and kava are also consumed. However, alcohol and cannabis appear most often as the primary drugs of concern.
• Timor Leste – It is worth noting that Timor Leste remains one of the poorest countries in the Asia-Pacific region, therefore it is not surprising that there is a lack of data and information relating to drug and alcohol in Timor Leste.  Alcohol is still a substance of concern, increasingly so is methamphetamines. Overall poly-substance use has been identified as a concern.
• Tokelau: to date there is almost no information available of drug and alcohol use in Tokelau, although there are reportedly no illicit drug problems in Tokelau.
• Tonga: there is a lack or current data. Key concerns for Tonga are; increase in drug trafficking, rise in kava use, youth risk behaviours and exposure to sexually transmitted infections, HIV and AIDS.
• Tuvalu: is classified as a least developed country. Alcohol is the main substance of concern, with some reported use of kava and cannabis.
• Vanuatu: research has highlighted a significant association between binge drinking and increased sexual risk-taking. Poly-substance use has also been identified as an emerging concern. Additionally a high incidence of alcohol-related interpersonal and domestic violence has been flagged as an ongoing concern. Increase in kava use is also noted and the change in consumption patterns associated with increased urbanisation.

Recommendations from Situational Analysis of Drug and Alcohol Issues and Reponses in the Pacific 2008-09:

Short term goals (6-12 months)

Surveillance

A major problem in the region is the gaps in data and information relating to drug and alcohol. Analysis is rarely focused on substance use trends and impacts therefore this report has highlighted the need for the following points regarding surveillance in the Asia-Pacific Region: 

• building on existing data collection systems to collect regular data on alcohol and other drug production and consumption trends
• advocating for inclusion of specific drug and alcohol questions in the routine surveys which are already set up in the region (or parts of the region)
• collaborating with regional initiatives (e.g. UNODC Global SMART program)
• engaging with international agencies, such as the WHO Western Pacific Regional Office and the United Nations Office on Drugs and Crime, in data collection, and
• assessing the feasibility of developing an early-warning system for emerging substance use in individual Pacific Island countries and regionally.

Research

In regards to research, much of the current research funding is sourced via HIV and other development funding in the region. It is important that targeted funding be made available for drug and alcohol research. The following points were recommended in relation to funding: 

• identify and enhance specific funding sources for alcohol and other drug research in the Pacific region
• build on the existing momentum behind the Pacific Drug and Alcohol Research Network (PDARN) as the network for alcohol and drug research and data collection in the Pacific
• adequately resource and manage the PDARN website as a platform for information sharing and reporting on alcohol and other drug issues in the Pacific region
• identify opportunities for research centre twinning arrangements
• continue to encourage PDARN research collaborations and networking
• promote capacity building in research skills through implementation of research activities, and
• Encourage Pacific Islanders to undertake research, student placements and sabbaticals with established research institutes and centres with expertise in alcohol and other drug research.

 Response Development

While many Pacific Island countries and territories have national alcohol policies, they do not tend to be well implemented. Services and programs are generally ad-hoc. There is external pressure and international funding for regional security and enforcement programs, in order to get policies and programs functioning adequately in PICTs it is essential to: 

• identify and/or advocate for funding opportunities to develop a regionally endorsed Pacific framework for responding to alcohol and other drug issues
• engage current non-government and government service providers in education and training and professional development programs in the alcohol and other drugs field
• establish mentoring relationships between experienced alcohol and other drug services in all stages in the spectrum of care and support, and Pacific-based service providers
• identify opportunities to improve existing treatment and rehabilitation programs and services
• promote capacity building for existing treatment programs and other service providers
• work with current service providers to undertake rigorous evaluation of current interventions, and
• trial and rigorously evaluate a range of alternative small-scale community-based interventions. 

Long-Term Goals (2-7 years) 

Surveillance

The development of a regional surveillance system and reporting framework should include regular and routine reporting of drug patterns and trends supported by the development of national and regional coordination mechanisms. 

Research

Pacific-based drug and alcohol research centres of excellence should be funded and supported via relationships with established research centres in the region. In addition, large-scale research activities should be funded to enhance a local evidence base. 

Response Development

There is a need for ongoing trials for alcohol and other drug interventions subjected to rigorous evaluation and review. These activities may include:

• Supporting legislative review for informed and appropriate legislative reforms;
• Advocacy to improve the balance of funding allocation in favour of prevention and treatment responses over law enforcement and border control; and
• Supporting the development of an alcohol and other drug workforce through vocational training programs, degree and postgraduate qualifications and continuing professional development programs.

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