Aboriginal and Torres Strait Islander Health Performance Framework - 2010
Why is it important?:Substance misuse is a contributing factor to illness and disease, accident and injury, violence and crime, family and social disruption and workplace problems (SCRGSP 2007). Estimates of the burden of disease and injury in Aboriginal and Torres Strait Islander peoples attribute 3.4% of the total burden to illicit drug use (Vos et al. 2007).
The use of drugs or other substances including inhalants is linked to various medical conditions. Injecting drug users for example, have an increased risk of blood borne viruses such as hepatitis or HIV (ABS & AIHW 2008). For communities, there is increased potential for social disruption, such as that caused by domestic violence, crime and assaults. Community-based research has identified issues arising from alcohol, drug and substance use including loss of control and abusive behaviour ranging from physical to emotional violence (Franks 2006). Reducing drug-related harm will improve health, social and economic outcomes at both the individual and community level.
Drugs or other substance consumption plays a significant role in Aboriginal and Torres Strait Islander peoples’ involvement in the criminal justice system. According to the Office of the Status of Women there is a correlation between domestic violence, and drug and alcohol use in Aboriginal and Torres Strait Islander communities, with 70% to 90% of assaults being committed under the influence of alcohol and other drugs (SCRGSP 2007). These issues are of significance for the Aboriginal and Torres Strait Islander population, whose adult members are almost twice as likely to report being a recent user as non-Indigenous Australians (AIHW 2006b).
Inhalant use, in the form of glue sniffing, petrol sniffing, inhalant abuse, or solvent abuse, is difficult to control because the active substances are found in so many common products that have legitimate uses. People that use these substances as inhalants risk long-term health problems, or sudden death. Continued use can also lead to the social alienation of sniffers, violence and reduced self-esteem (SCRGSP 2007).
There is concern about an apparent recent increase in marijuana use in some Aboriginal communities (Lee et al. 2008; Senior & Chenhall 2008).
Findings:In the 2008 NATSISS an estimated 22% of Aboriginal and Torres Strait Islander people aged 15 years or over living in non-remote areas reported illicit substance use in the last 12 months and a further 20% reported having used an illicit substance at least once in their lifetime. These proportions are similar to the rates reported in 2002 (23% and 16%, respectively). In 2008, substance use was more prevalent among Indigenous males, of whom 51% had tried drugs (compared with 36% of females) and 28% of whom had used at least one substance in the last 12 months (compared with 17% of females). Cannabis was the most common illicit substance used in the last 12 months for Aboriginal and Torres Strait Islander peoples (17%) followed by analgesics or sedatives for non-medical use (5%) and amphetamines/speed (4%). Approximately 16% of Indigenous Australians reported having used one substance in the last 12 months and 6% two or more substances. The study of Burden of Disease in Aboriginal and Torres Strait Islander Peoples estimated that heroin or polydrug dependence was responsible for 37% of the burden due to illicit drugs (Vos et al. 2007).
In 2007, 47% of Indigenous Australians had never used drugs or other substances including inhalants compared with 62% of non-Indigenous Australians (AIHW 2008a). Indigenous Australians were almost twice as likely to report being a recent user as non-Indigenous Australians (24% and 13% respectively) (AIHW 2008a). When cannabis is excluded, a different picture emerges. Of Indigenous Australians, 12% were recent users of a drug or other substance other than cannabis, compared with 8% of other Australians (AIHW 2008a).
In 2008, a higher proportion of Indigenous Australians aged 15 years and over who were recent substance users reported they were currently daily smokers (68%) and drank at risky/high risk levels (9%) than Indigenous persons who had never used illicit substances (35% and 3% respectively). Approximately 5% of mothers with a child aged 0–3 years reported having used substances during pregnancy.
The 2008 report Evaluation of the Impact of Opal Fuel undertook data collection on the prevalence of petrol sniffing in a sample of 20 Indigenous communities which have access to Opal fuel and where baseline data had previously been collected. The study showed that the prevalence of petrol sniffing declined in 17 of the 20 communities. Across the sample there was a decrease of 431 (70%) in the number of people sniffing between baseline and follow-up. The rate of sniffing decreased across all frequency levels including a 60% reduction in the number of people sniffing at occasional levels, an 85% reduction in the number of people sniffing at regular light levels, and a 90% reduction in the number of people sniffing at regular heavy levels (d’Abbs & Shaw 2008).
For the period July 2006 to June 2008, there were 4,333 hospitalisations of Indigenous Australians related to substance use. Indigenous Australians were hospitalised for conditions related to substance use at more than twice the rate of other Australians.
The AIC Drug Use Monitoring in Australia survey reports on drug use among police detainees at 9 police stations in metropolitan areas in South Australia, New South Wales, Queensland, Western Australia the Northern Territory and Victoria. In 2008, at least two thirds of Indigenous detainees tested positive to drugs and, other than in Darwin, the proportion was higher than for non-Indigenous detainees in all police stations surveyed.
Implications:In 2008, almost one quarter of Aboriginal and Torres Strait Islander Australians aged 15 years and over had used substances in the last 12 months. Higher rates of drug use are related to poorer health status and higher levels of psychological distress. The National Drug Strategy Aboriginal and Torres Strait Islander Peoples’ Complementary Action Plan 2003–2009 (the CAP) was developed to help provide a nationally coordinated and integrated approach to reducing drug-related harm amongst Aboriginal and Torres Strait Islander peoples. A recent evaluation of the CAP found it to be an effective policy framework which has guided approaches to policy and program delivery in relation to licit and illicit substances. Future iterations of the CAP will be considered in the context of the National Drug Strategy 2010–2015.
Australian governments are implementing programs under the COAG drug and alcohol initiatives and the National Action Plan on Mental Health 2006–2011. For example, the Australian Government is funding 7 Indigenous-specific projects under the COAG Improved Services for People with Drug and Alcohol Problems and Mental Illness initiative which aims to build the capacity of non-government drug and alcohol treatment services to identify and respond to people with coinciding mental illness and substance abuse issues.
Australian governments are working with relevant non-government organisations to address petrol sniffing in regional and remote communities through the Petrol Sniffing Strategy. This Strategy includes the following components: the roll out of low aromatic Opal fuel; consistent legislation; appropriate levels of policing; alternative activities for young people; treatment and respite facilities; communication and education strategies; strengthening and supporting communities and evaluation.
Table 55 – Aboriginal and Torres Strait Islander peoples aged 15 years and over in non-remote areas: Substance use by sex, 2002 and 2008
|Used substances in last 12 months|
|Marijuana, Hashish or Cannabis Resin (c)|
|Analgesics and sedatives for non-medical use (d) (e)|
|Amphetamines or speed|
|Total used substances in last 12 months (f) (g)|
|Used substances but not in last 12 months (c) (e) (h)|
|Never used substances|
|Not stated (a) (j)|
|Total (k) (l)|
|Persons who accepted form ('000)|
|Persons 15 years and over ('000)|
- Estimate with a relative standard error greater than 50%. Considered too unreliable for general use.
(a) Estimate with a relative standard error of 25 per cent to 50 per cent. Should be used with caution.
(b) The substance use questions in the 2008 NATSISS are comparable to those used in the 2002 NATSISS. However, when comparing between 2002 and 2008 it should be noted that there were changes in the proportion of people who did not accept the substance use form (6 per cent non-response in the 2002 NATSISS compared with 9 per cent for the 2008 NATSISS).
(c) Difference between female rate in 2002 and 2008 is statistically significant.
(d) Includes pain killers, tranquilisers and sleeping pills.
(e) Difference between male rate in 2002 and 2008 is statistically significant.
(f) Includes heroin, cocaine, petrol, LSD/synthetic hallucinogens, naturally occurring hallucinogens, ecstasy/designer drugs, and other inhalants. Includes methadone in 2008.
(g) Sum of components may be more than total as persons may have reported more than one type of substance used.
(h) Difference between person rate in 2002 and 2008 is statistically significant.
(i) Includes 'whether used in last 12 months' not known.
(j) This category comprises people who accepted the substance use form but did not state if they had ever used substances.
(k) People who accepted the substance use form.
(l) Difference between 2008 male rate and female rate is statistically significant.