The National Drug Strategy 2010-2015
Pillar 1: Demand reduction
Demand reduction includes strategies to prevent the uptake of drug use, delay the first use of drugs, and reduce the misuse of alcohol, and the use of tobacco and other drugs. This includes providing information and education, for example through school-based programs or public-awareness campaigns. Evidence-based early intervention programs, diversion, counselling, treatment, rehabilitation, relapse prevention, aftercare and social integration can help drug users reduce or cease their drug use. The demand for drugs can also be affected by their availability and affordability which can, depending on the drug, be influenced through supply control, regulation and taxation.
People use drugs for a range of reasons including as an integral part of social behaviour, to experiment, because of peer pressure, to escape or cope with stress or difficult life situations or to intensify feelings and behaviours. Drug use is influenced by a complex interaction of physical, social and economic factors. Disadvantaged populations are at heightened risk of drug misuse and its associated harms. People can also be at risk of different patterns of use at different ages. For example, younger people may be more at risk of short-term harms from alcohol use while older people may be more at risk from chronic alcohol misuse.
The appropriate mix of educational and social marketing approaches will vary by drug type. Whole-of-population strategies may be more appropriate for alcohol and tobacco and for those illegal drugs that are widely used, while approaches targeted to users and at-risk groups may
be more appropriate for those drugs only used by a small percentage of the population.
Settings-based approaches will be an important feature of the National Drug Strategy 2010–2015. The COAG Preventive Health National Partnership Agreement includes a focus on prevention activities for alcohol and tobacco in communities, childcare and school settings and workplaces. Other settings such as prisons also require planned and comprehensive demand-reduction strategies.
No one strategy on its own can prevent and reduce the demand for drugs. Rather, broad-based, multidisciplinary and flexible strategies are needed to meet the varied needs of individuals and communities.
Demand reduction requires the cooperation, collaboration and participation of a diverse range of sectors. It is important to recognise the range of sectors that can influence drug demand and to develop closer links with them.
Objective 1: Prevent uptake and delay onset of drug usePreventing drug use can be more cost-effective than treating established drug-related problems. Prevention efforts can help reduce personal, family and community harms, allow better use of health system resources, generate substantial economic benefits and produce a healthier workforce.
A key step in preventing the uptake of drugs is changing the culture so that drug misuse is no longer seen as a cultural norm. This involves improving community understanding and awareness of the drugs being used, their effects, the harms associated with their misuse and the choice of effective interventions and treatment. For some drugs, such as tobacco, cultural acceptance by a large portion of the population has been successfully challenged, contributing to a significant reduction in use over many years. Harmful alcohol consumption, on the other hand, still remains a challenge.
There is an increased risk of harms associated with the early uptake of drugs. The earlier a person commences use, especially heavy use, the greater their risk of harm in the short and longer term (such as mental and physical health problems) and the greater their risk of continued drug use.
- Explore and implement strategies that contribute to the development of a culture that promotes healthy lifestyles.
- Develop and implement treatment and family-support strategies that can prevent and break patterns of drug use, including intergenerational patterns.
- Work collaboratively with other national policies to reduce risk factors and build protective factors, while recognising the diverse range of influences on drug use.
- Continue to implement and support well-planned social marketing campaigns that address the risks of alcohol, tobacco and other drug use, the risks of specific drug use practices (such as injecting) and promote healthy lifestyles and safer drinking cultures, including targeted approaches and local complementary initiatives for different population groups.
- Use the internet and other media to sustain and strengthen the provision of credible and accurate information about alcohol, tobacco and other drugs to target particular population groups.
- Limit or prevent exposure to alcohol and tobacco advertising, promotion and sponsorship through regulation and, where appropriate, voluntary and collaborative approaches with business.
- Explore ways of influencing responsible media reporting and portrayal of alcohol, tobacco and other drug use.
- Support community-based initiatives, including in Indigenous communities, to change the culture of smoking, harmful alcohol use and other drug use.
- Improve the application of evidencebased whole-of-school drug education policies and programs.
Objective 2: Reduce use of drugs in the communityThe effects of the use of drugs go beyond injury and illness or disease to a range of social and economic consequences. People experiencing problems with drugs can find it difficult to form or maintain relationships, may have their educational and vocational paths disrupted and their general social development hampered. To reduce the occurrence and cost of such problems, interventions need to be implemented early, preferably before problems emerge. For dependent users, reducing and/ or ceasing the use of drugs can help them to lead more stable, healthy and productive lives.
Successfully reducing the misuse of alcohol, and the use of tobacco and other drugs requires a range of approaches across the continuum of use, from experimental to dependent use. It is important to ensure that appropriate treatment is available and accessible. Engaging the support of family and friends for those seeking treatment is an important part of helping people reduce their drug use.
Brief interventions can also be very effective. Brief interventions aim to identify current or potential problems with drug use and motivate those at risk to change their behaviour. They can range from five minutes of brief advice to 30 minutes of brief counselling. Brief interventions are commonly delivered by general practitioners and alcohol and other drug workers, but can also be used by other service providers, police officers, mental health workers, nurses or family members.
In instances of dependence, it is important for people to have access to effective and affordable treatment services and where needed, support for rebuilding their lives and reconnecting with the community. Evidence supports the effectiveness of a range of appropriately targeted treatment approaches. However, people can find it difficult to locate and access the service that meets their needs and people with multiple and complex needs have the added difficulty of finding a number of different, sometimes unrelated, services in a timely way.
A range of appropriate, specialised services should be available to anyone with a drug-related problem, irrespective of personal history, circumstances or socioeconomic status. A 'no wrong door' approach should be adopted so that people are provided with, or are guided to, appropriate services regardless of where they enter the system of care.
Generalist health care and social welfare services should also notice, assess and respond to people with alcohol, tobacco and other drug-related problems. There is a range of brief interventions, for example, that can be delivered by generalist services or over the internet. These could refer people to specialised services where necessary or provide support before harms and long-term dependence occur.
- Build on efforts to increase the range of, access to and links between evidence-based treatment and other support services.
- Sustain efforts to increase access to a greater range of culturally-sensitive services.
- Improve access to screening and targeted interventions for at-risk groups such as young people, people living in rural and remote communities, pregnant women and Aboriginal and Torres Strait Islander peoples.
- Increase the community’s understanding of effective drug interventions by providing factual, credible information.
- Continue efforts in diverting people from traditional criminal justice pathways by providing information and/or referring them to assessment and treatment.
- Increase awareness, availability and appropriateness of evidence-based telephone and internet counselling and information services.
- Strengthen the capacity of the primary healthcare system to manage prevention, early intervention and treatment of tobacco use and harmful alcohol use.
- Develop planning models for treatment services that anticipate needs.
- Develop and implement quality frameworks for treatment services.
- Create incentives for people who misuse drugs or are dependent to access effective treatment and to make healthier choices.
- Encourage family members to access and make use of support services to help improve treatment outcomes for clients.
- Explore and develop opportunities in the criminal justice system, including correctional services, to assist drug users through education, treatment and rehabilitation services.
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Objective 3: Support people to recover from dependence and reconnect with the communityRecovering from drug dependence can be a long-term process in which individuals need support and empowerment to achieve independence, a healthy self-esteem and a meaningful life in the community. Successful support for longer-term recovery after treatment requires strategies that are focused on the whole individual and look across the life span.
While different people will have different routes to recovery, support for recovery is most effective when the individual’s needs are placed at the centre of their care and treatment. Treatment service providers can help individuals recover from drug dependence, help the individual access the internal resources they need (such as resilience, coping skills and physical health) and ensure referral and links to a range of external services and support (such as stable accommodation, education, vocational and employment support and social connections).
In maintaining and strengthening the current system of treatment and other support services across jurisdictions, the following principles will be continued under the National Drug Strategy:
- In designing treatment services, it is important to recognise that drug users are not a homogenous group. Treatment services should incorporate a principle of consumer involvement in planning and operations. Treatment interventions should also be tailored to the varying needs of individuals (including the potential for access to substance-specific treatment and services).
- In designing and coordinating referral pathways, it is important to recognise that trigger points for entry into treatment come from a broad range of sources which should be reflected in those pathways. These include through alcohol and other drug diversion programs and links with primary health care.
- In designing and coordinating support after treatment to help individuals rebuild their lives and reconnect with the community, it is important to recognise that individuals often become marginalised or socially isolated as a result of their drug use, losing touch with their families and friends as well as opportunities for education, vocational, employment, housing and other areas of social participation. Furthermore, all services need to work together to reduce stigma attached to seeking treatment. Drug treatment alone cannot solve these problems which, if not dealt with, can place an individual at risk of relapsing to drug use and related issues. Consequently, it is important that treatment services are linked to a broader range of services able to provide these supports and the necessary relationships and processes developed to better ensure these links are effective.
- Develop new evidence-based national planning tools to help jurisdictions better estimate the need and demand for alcohol and other drug health services across Australia. This should include the full spectrum of services from prevention and early intervention to the most intensive forms of care, and a range of services across the life span.
- Develop a set of national clinical standards for alcohol and other drug treatment services.
- Improve the links and coordination between primary health care and specialist alcohol and other drug treatment services to enhance the capacity to deal with all health needs and to facilitate the earlier identification of health problems and access to treatment.
- Improve the communication and flow of information between primary care and specialist providers, and between clinical and community support services to promote continuity of care and the development of cooperative service models.
- Investigate appropriate structures that could be developed to help engage families and other carers in treatment pathways and ensure that information about the pathways is readily accessible and culturally relevant.
- Identify and link the necessary services to provide those affected by drug use and dependence, such as family members, children and friends, with ongoing support including links to child welfare and protection services.
- Move towards a nationally consistent approach for non-government treatment services including quality frameworks and reporting requirements.
- Develop a sustained and comprehensive stigma reduction strategy to improve community and service understanding and attitudes towards drug dependence, help seeking and the related problems of individuals.
- Improve links and coordination between health, education, employment, housing and other sectors to expand the capacity to effectively link individuals from treatment to the support required for them to reconnect with the community.
Objective 4: Support efforts to promote social inclusion and resilient individuals, families and communitiesSocially inclusive communities and resilient individuals and families are less likely to engage in harmful drug use. Resilient individuals can adapt to changes and negative events more easily and reduce the impacts that stressors have on their lives—and are less likely to use drugs.
Resilient and inclusive communities are characterised by strong social networks and work together to support individuals who need assistance. They also promote safe and healthy lifestyles. Supportive and informed families and communities can prevent the uptake of drug use, identify drug use in its early stages and help individuals access and maintain treatment. A resilient community will support people to avoid relapse and help them reconnect with the community.
Responsibility for building resilient communities lies at all levels—from governments, to communities, nongovernment organisations, families and individuals.
- Support whole-of-government and whole-of-community efforts to build parenting and family capacity, creating communities that support the positive development of children. This may include evidence-based approaches to drug prevention in schools.
- Continue to implement skills training to provide individuals with coping skills to face situations that can lead to risky behaviour including harmful drug use.
- Implement preventive support programs targeting life transition points—primary to secondary school, secondary school to tertiary education, school to work and prison to community—to help individuals develop the skills to manage the next stage of life.
- Support efforts to encourage participation of at-risk groups in community life including recreational, sporting and cultural activities.
- Provide support services to parents in recovery to ensure the needs of dependent children are met.
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