Perth AOD Agency Forum report

Perth AOD Agency Forum report

Background

The Australian National Council on Drugs (ANCD) has determined it will hold an alcohol and other drug (AOD) agency forum in conjunction with its meetings in each State and Territory. These forums form part of the ANCD’s strategy to fulfil its role of ensuring the views of non-government, community-based organisations and associated services working with drug and alcohol issues, are considered as part of drug policy advice.

The ANCD produces a report from each forum which aims to provide a brief description of the issues raised by forum participants. These reports are available on the ANCD’s internet site to enable forum participants and interested others to access the issues that were discussed. The ANCD also provides a copy of each report to the Premier or Chief Minister, as well as the responsible Minister in each jurisdiction to ensure the Government is aware of the issues raised.

It should also be noted that all the issues raised at the forums are not necessarily areas that the ANCD agrees with or are able to address. They do however provide ANCD members with an important insight into community concerns and perceptions about specific AOD issues. In addition, the ANCD believes that it has an obligation to participants to report the issues and concerns raised in an unfettered manner.

Perth 2002

Approximately 85 people from Perth and the surrounding area participated in the ANCD’s AOD agency forum, which was held at The Sebel Hotel in Perth, on 12 September 2002. The forum participants included representatives of local drug action groups, non-government organisations, State and Federal Government Departments and the education sector.

The Chair of the ANCD, Major Brian Watters, welcomed participants to the forum and explained its purpose. Major Watters then introduced the Executive Officer of the ANCD, Mr Gino Vumbaca, and he gave a presentation that:

Explained the role of the ANCD and its position within the National Drug Strategic Framework;
Highlighted some of the projects the ANCD has commissioned;
Outlined progress under the Tough on Drugs Strategy; and
Provided information about a range of AOD issues.

At the conclusion of his presentation, Mr Vumbaca opened the floor for questions and/or comments about current and emerging AOD issues in Perth and the surrounding region. The following issues were raised:

Cost effectiveness of supply reduction versus harm minimisation
A question was posed to the forum about the cost effectiveness of supply reduction measures in Australia in terms of the quantity of drugs seized and the impact this has on the level of drug use and harm caused to individuals/communities. It was then suggested that Australia needs to determine whether it is more effective to put its money into supply reduction or harm minimisation strategies.
Comorbidity
The view was put forward that the use of speed in Perth is increasing and as a result there are growing numbers of people diagnosed with psychosis and that there is a lack of appropriate treatments and services for such people to access. Forum participants wanted to know what is currently happening with regard to comorbidity issues. They also emphasised that there needs to be a holistic approach to dealing with problems that result from AOD use.
Impact of heroin drought
It was suggested that the use of ‘ice’ had replaced heroin due to the heroin drought, but the suppliers of it are still the same. Anecdotal evidence indicates that drug users are now injecting substances other than heroin, such as homebake and/or pills. As a result, Needle & Syringe Programs (NSPs) have noticed a substantial increase in the amount of injecting equipment they are distributing, particularly larger gauge syringes which are often associated with injecting pills. Concern was also expressed for the health of those individuals who inject drugs that are not designed to be injected.
Young people and drug use
The issue of young people and drugs was raised and the impact drugs have on their lives. Forum participants were asked to seriously consider and recognise the wide-ranging physical, emotional and social impacts that drugs have on young people, their families and the community.
WA drug summit
Concern was expressed about the current Western Australian Government’s commitment to the recommendations emanating out of the WA Drug Summit. In addition, there was a perception among some forum participants that debate on drug issues in the community and by those people in positions of power in WA needs to be better informed.
Cannabis legislation
It was suggested that the review of WA’s cannabis laws as recommended at the drug summit does not seem to be happening. As a result, questions were asked whether there is potential for a national framework for cannabis legislation and if the ANCD would look at this issue in order to provide advice to Government.
Cannabis education
Forum participants were of the view that the community is not well informed about a range of issues associated with cannabis. There were suggestions from forum participants that some form of community education resource should be developed to address the lack of knowledge about this drug and its impact.
Use of pharmacotherapies in prisons
The experimental use of naltrexone implants in prisoners was raised as an issue of concern, in particular, whether this process was in contravention of international human rights law or had ethics approval. Discussion then turned to the types of pharmacotherapies used in prisons and the reasons they are used.
Suitability of treatment services
Parent groups put forward the view that treatment services are inadequately equipped to deal with the drug use of children and do not fulfil the needs of the families who attempt to support their child through the treatment process. Additionally, it was raised that there needs to be a more coordinated effort between all of the services that are involved in treatment to ensure that there is long term continuity in the process and that it includes addressing the underlying reasons for substance misuse.
WA heroin trial
Comment was made on the information presented in the ANCD Executive Officer’s presentation regarding the heroin trial in the Netherlands. It was suggested that there is some support from within WA for a heroin trial to be conducted in the state.
WA mental health service
Concern was raised about the state of the mental health service in WA. It was felt that increased funding would solve some of the problems and that the money for this could come from reallocating some of the funds directed to enforcement initiatives. Forum participants suggested that mental health services need to have more flexibility in their opening hours to allow those people in need to have greater access to them. It was also put forward that treatment services should operate with the ‘one door theory’, whereby a wide range of services could be accessed through a single point, offering a more holistic approach to treatment.
Naltrexone implants
User organisations highlighted concerns about the use of naltrexone implants on patients treated by doctors in private practice. These organisations had received several complaints from patients and felt that there should be controls/regulations put in place for private practitioners who administer this form of treatment.

Discussion then turned to the Therapeutic Goods Association’s (TGA) classification of naltrexone and legal issues associated with the use of the drug.
Cost of treatment with methadone or buprenorphine
It was suggested that the cost of methadone and buprenorphine for treatment might be beyond the financial reach of some patients and they are unable to fund their treatment. It was argued that as a result there is the potential that some patients are being ‘set up to fail’.
Treatment
A forum participant emphasised that residential and outpatient treatment programs are successful. In addition, the workers who deliver these services are paid very poorly and their efforts should be better recognised. It was also pointed out that treatment is most effective when the patient is committed to achieving a positive outcome and enters into it voluntarily.
Strategies regarding drug use in the gay and lesbian community
Included in the ANCD Executive Officer’s presentation were statistics about drug use within the gay and lesbian community. As a result, questions were asked about what strategies, if any, were being implemented to address this issue.
Hepatitis C
It was brought to the attention of the forum that there is expected to be a larger increase in the number of Hepatitis C cases in the coming years. Questions were asked about the sorts of strategies that could be implemented to ensure that agencies are sufficiently equipped to deal with the situation. Participants were informed that the ANCD and the Australian National Council on AIDS, Hepatitis C and Related Diseases (ANCAHRD) are soon to release a paper that will cover a range of Hepatitis C issues.
NSPs
Participants recognised the good work being done by NSPs and acknowledged the ANCD’s support for them in its position paper. A need was voiced to consider further financial investment in NSPs so that peripheral equipment could be provided along with injecting equipment, to help combat increasing Hepatitis C infection rates. Further to this was the additional support required in WA to employ more peer support workers. It was claimed that both of these ideas were simple but effective ways to work towards decreasing the rate of Hepatitis C infection.
Reliance on science versus people
The final point raised by a participant was a message for the Federal Government:

“Relying on science and technology alone will not solve drug problems. Drug problems are people problems and there needs to be more focus on people.”

12 September 2002

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