Aboriginal and Torres Strait Islander Health Performance Framework (HPF) 2012
Why is it important?:Drug and other substance use 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 contracting 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. These include 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 and other substance use 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/or other drugs (SCRGSP 2007).
Glue sniffing, petrol sniffing, inhalant abuse, and solvent abuse are difficult to control because the active substances are found in many common products that have legitimate uses. People that use these 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 et al. 2008).
Findings:In the 2008 NATSISS an estimated 23% of Aboriginal and Torres Strait Islander peoples aged 15 years and over 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 for Indigenous people in non-remote areas in 2002 (24% 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 poly-drug dependence was responsible for 37% of the burden due to illicit drugs (Vos et al. 2007).
Around 23% of Indigenous students aged 12–15 years had used an illicit substance in their lifetime, compared with 11% of all 12–15 year old students. The most common illegal substance used by Indigenous students was cannabis (used by 20%), followed by amphetamines (8%), ecstasy (6%), hallucinogens (5%), cocaine (5%) and opiates (5%). In addition, 24% of Indigenous students had used inhalants (glue, paint, petrol), with 13% in the past month (compared with 8% in the past month for total students) (White et al. 2010b).
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 Evaluation of the Impact of Opal Fuel report undertook data collection on the prevalence of petrol sniffing in a sample of 20 Indigenous communities which have access to Opal (low aromatic) 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 et al. 2008).
For the period July 2008 to June 2010, there were 4,537 hospitalisations of Indigenous Australians related to substance use (excluding Tasmania and the ACT). 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 SA, NSW, Qld, WA, the NT and Victoria. In 2010, the proportion of detainees that tested positive for drugs was higher for Indigenous detainees than for non-Indigenous detainees in all police stations surveyed.Top of Page
Implications:In 2008, almost one-quarter of Aboriginal and Torres Strait Islander peoples 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 among 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. Under the National Drug Strategy 2010–2015, seven sub-strategies will be developed, including the National Aboriginal and Torres Strait Islander Peoples Drug Strategy.
From 2012–13, around 100 Indigenous service providers and 150 non-government organisations across Australia are funded by the Australian government to provide, or support, alcohol and other drug treatment and rehabilitation services. Services provided a variety of treatment models including rehabilitation in a residential setting and drug and alcohol workers in primary care services.
The Australian Government is supporting non-government drug and alcohol treatment services to deliver quality, evidence-based services and build capacity to effectively identify and treat coinciding mental illness under Priority 1 of the Substance Misuse Service Delivery Grants Fund. This includes 22 Indigenous-specific organisations across Australia.
On 1 March 2012, the Australian Government also committed $20 million for Indigenous communities to tackle alcohol and substance abuse under the Breaking the Cycle of Alcohol and Drug Abuse in Indigenous Communities initiative.
The Petrol Sniffing Strategy, launched in 2005, is a comprehensive regional approach to address petrol sniffing in regional and remote Australia. The eight points of the strategy are consistent legislation; appropriate levels of policing; further rollout of low aromatic fuel; alternative activities for young people; treatment and respite facilities; communication and education strategies; strengthening and supporting communities; and evaluation (undertaken by FaHCSIA). The strategy aims to reduce the incidence of petrol sniffing and improve the health and social wellbeing of Indigenous youth.Top of Page
Table 36—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|
|Total used substances in last 12 months(f)(g)|
|Used substances but not in last 12 months(c)(e)(h)|
|Never used substances|
|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.
Source: AIHW analysis of 2002 and 2008 NATSISS.