The National Drug Strategy 2010-2015: consultation draft
Pillar 3: Harm reduction
Harm reduction is as important for the National Drug Strategy as supply and demand reduction as it works to reduce the adverse health, social and economic impacts of drug misuse on communities, families and individuals.
Harm reduction recognises that an individual's engagement in drug misuse, illegal drug supply or illegal drug manufacture generally has flow-on health, social, economic, environmental and other consequences for those around him or her including for family, workplace, neighbourhoods and the broader community.
In relation to alcohol, efforts to prevent drink driving and reduce the incidence of alcohol-related road accidents have been a key harm reduction approach over a long period. Programs and interventions to tackle risky drinking, including liquor licensing and responsible service of alcohol arrangements, education and information programs, and community-based approaches, have aimed to reduce alcohol-related public violence. Brief interventions, treatment for alcohol dependence and family support services can help reduce the incidence and impact of family conflict and violence.
In relation to tobacco, harm reduction efforts have included minimising exposure to secondhand smoke through bans on smoking in workplaces and enclosed public spaces and, in some jurisdictions, bans on smoking in cars where children are present.
In relation to injecting drug use, needle and syringe programs have been the main harm reduction approach, helping to slow the spread of blood-borne viruses like HIV and hepatitis C. Readily available needle disposal facilities and other strategies as simple as well-lit streets have helped to improve community amenity in areas where injecting drug use takes place. Some jurisdictions have experimented with other approaches, including a medically supervised injecting centre in one jurisdiction.
For illegal drugs more generally, programs to divert offenders from the criminal justice environment into treatment or other health interventions have helped to increase the chances of recovery and reduce the likelihood of individuals' recidivism creating harms to the community. Strategies to prevent and effectively manage drug overdose have also been important harm reduction responses. In addition, some jurisdictions have implemented road-side drug testing to detect and deter drug impaired driving.
Other harm reduction approaches have included the provision of chill-out spaces, water, information and peer support, and emergency medical services at events where drug misuse may be occurring.
Top of page
Objective 1: Reduce harms to community safety and amenity
Objective 2: Reduce harms to families
Objective 3: Reduce harms to individuals
Objective 1: Reduce harms to community safety and amenityA significant and sometimes overlooked harm from drug misuse is the impact it can have in reducing the extent to which people feel safe in their communities. Heavy alcohol consumption can lead to threats and assaults, vandalism, public disorder and road accidents. Illegal drug use – and injecting drug use in particular – can affect people's perceptions of the safety of their community and the business confidence of an area. The illegal drug trade and drug misuse contributes to significant social costs through property crime and violence.
As higher-density living becomes the norm in our cities, greater attention is needed to public safety and health services, and supporting social connectedness. This also involves improving perceptions of public safety and amenity.
Rural and remote communities, and indigenous communities, are also affected by impacts on safety and amenity generated by alcohol, tobacco, illegal and other drug misuse.
- Make local communities and public places safer from alcohol-related violence and other incidents through stronger partnerships between health, law enforcement, liquor licensing, local government and planning and transport authorities.
- Investigate nationally consistent and transparent approaches on alcohol outlet density and takeaway hours.
- Consider further reforms to drink driving laws and develop effective evidence-informed responses to driving under the influence of illegal and pharmaceutical drugs.
- Provide new supports for frontline workers managing polydrug use and related aggressive behaviours in public places including for police, emergency department workers and welfare services.
- Sustain existing harm reduction efforts including needle and syringe programs and safe disposal of used injecting equipment and improve access for disadvantaged populations.
- Develop awareness in the community and the workforce of the health dangers of clandestine laboratories and the need for remediation of sites
- Work with industry and consider regulation to reduce harms from emerging substances of concern, for example to address the potential for energy drinks to exacerbate alcohol related problems in public places.
- Implement the actions agreed by COAG in response to the Ministerial Council on Drug Strategy's report on options to reduce binge drinking.
Objective 2: Reduce harms to familiesThe families of people misusing drugs – their parents, partners and children – often suffer the greatest impacts of drug misuse. Supports need to be available to families, particularly with children, to help them manage the stresses they may be experiencing and also to help engage them in managing the individual's drug misuse problem and in aiding recovery. Services interacting with people with drug misuse problems need to recognise the impact of drug misuse on families and help to ensure they are provided or connected with the right supports. This applies both to specialist drug and alcohol treatment services but also to policing, social welfare and other services that may be interacting with people with drug problems.
Alcohol is most commonly supplied to minors by parents and other family members. There are mixed community views on introducing teenagers to alcohol, with some support for introduction in a safe family environment. However, emerging health evidence highlights the importance of delaying introduction to alcohol as long as possible.
Drinking during pregnancy can have significant impacts on children in utero and cause a range of disorders known as the fetal alcohol spectrum disorders (FASD), including birth defects and developmental difficulties. FASD has been a particular issue in some indigenous communities. Coordinated education and information campaigns and other clinical and community-led strategies are needed to help prevent FASD, and action is needed to improve the diagnosis and clinical management of affected children and to make available appropriate supports to those children and their families.
In relation to tobacco, families and communities have an ongoing responsibility to protect children from second hand smoke and to help prevent children learning to smoke by example from parents and other respected elders. Efforts to reduce smoking among pregnant women, and prevention of the exposure of pregnant women and babies to secondhand smoke should be particular priorities.
- Enhance child and family sensitive practice in drug and alcohol treatment services and build links and integrated approaches with family and child welfare services.
- Review existing national frameworks addressing the causes of drug misuse, for example, domestic violence strategies, and consider related actions that could be taken under the National Drug Strategy.
- Develop initiatives to reduce the secondary supply of alcohol to minors including through community education and information campaigns advising parents of health and social harms from alcohol and potential criminal justice outcomes.
- Develop coordinated measures to prevent, diagnose and manage fetal alcohol spectrum disorders and make available appropriate supports to children and families affected.
- Continue efforts on preventive approaches to alcohol, tobacco, illegal and other drug misuse during pregnancy, including community education.
- Consider introducing health warning labels on alcohol products, including pregnancy health warnings.
- Reduce the incidence of smoking in cars, particularly with children, and in other places where children may be exposed, through regulation and other appropriate measures.
Objective 3: Reduce harms to individualsSome of the key challenges in responding to the harms to individuals caused by substance abuse lie in making individuals aware of the harms to their health, safety and well-being from drug misuse, motivating them to seek and engage with treatment, and connecting them with appropriate treatment and other support services.
For many individuals, this requires a change of perspective and self-acknowledgement of a drug misuse problem before there is a willingness to enter treatment for example.
Injecting drug use carries additional risks and harms for the individual, requiring particularly focused approaches.
- Strengthen drug education initiatives to ensure they are appropriately targeted and evidence based in terms of patterns of substance abuse through the life span and mode of delivery.
- Enhance treatment and associated service systems to provide help at all stages of drug misuse.
- Raise awareness of the harmful impacts of drug misuse in the workplace including through resources to promote improved practice and better linkages to treatment and other supports.
- Develop and implement internet-based approaches to target individuals who do not think they have a problem and encourage them into treatment and/or other service supports.
- Continue successful illicit drug diversion programs and extend their application to alcohol and other substances where indicated.
- Sustain efforts to prevent drug overdose and other health harms through continuing substitution therapies and withdrawal treatment.
- Continue support for needle and syringe programs and encourage safe injecting practices.