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Health at the heart of ice strategy

The government has put health at the centre of a new plan to tackle what it describes as an “ice epidemic” in Australia, with millions of dollars in new funding for research and treatment pledged Sunday as the national taskforce handed down its report.

Assistant Health Minister Fiona Nash unveiled a $300 million package to combat crystal methamphetamine use after the National Ice Taskforce, led by former police commissioner Ken Lay, found law enforcement efforts had fallen short.

“We cannot arrest our way to success,” said Prime Minister Malcolm Turnbull, launching the government’s National Ice Action Strategy.

Reducing demand is central to the push, with the lion’s share of funds — some $241.5 million — going to PHNs to pay for local treatment services as they see fit.

Other funds include $13 million for new MBS items covering Addiction Medicine Specialists and counselling, $18.8 million for research, evidence and guidelines, and $24.9 million for community-based and online drug education/resources.

Nash also announced that all 160 Commonwealth-funded treatment services would have their current contracts extended to June 2017. You can read her opinion piece for the Huffington Post here.

The Labor opposition accused the government of giving with one hand while taking with the other, noting that close to $800 million had been slashed from Health Flexible Funds supporting drug and alcohol rehabilitation and prevention in the last two budgets.

Lay’s taskforce handed down 38 recommendations across five broad areas:

        1. Supporting families, communities and frontline workers;

 

  • Targeting prevention;

 

 

  • Tailoring services and support;

 

 

  • Strengthening law enforcement; and

 

 

  • Improving governance and building better evidence

 

 

Some of the key recommendations include:

    • funding for research into evidence-based treatment for methamphetamine users, particularly in youth justice centres and correctional facilities

 

  • improved access to integrated, evidence-based, culturally appropriate services for Indigenous Australians

 

 

  • stronger collaboration and intersection between mental health and drug and alcohol treatment sectors

 

 

  • longer funding periods for drug and alcohol services to improve service planning and workforce development

 

 

  • greater access to treatment and care through GPs via improved referral pathways and associated training

 

 

  • rollout of a national training programme for screening and brief interventions for paramedics, ED staff, primary care physicians and community workers

 

 

  • a single national ice hotline as well as online support and educational platforms

 

 

  • an evidence-based communications strategy targeting public awareness, particularly for vulnerable groups (LGBTI, Indigenous, rural and remote, young people), using a mixture of methods including social media and peer-to-peer

 

 

  • urgent implementation of Addiction Medicine MBS items recommended in August 2013

 

 

  • improved education for medical professionals

 

 

  • action on staff shortages in the drug and alcohol treatment sector

 

 

    You can read the full taskforce report here. The report and government’s funding announcement were cautiously welcomed by groups in the health and drug and alcohol sector. “By funding treatment as a main focus of the government’s response to the issue of ice there is a much greater likelihood of a reduction in harm associated with the use of this drug,” said Michael Moore, CEO of the Public Health Association of Australia. “For too long Australia has paid lip-service to harm reduction while focussing most of the funding and effort on just the supply reduction aspect. “This announcement marks the first steps in a sensible return to re-align funding, focus and efforts into moving away from a largely prohibitionist approach to the much more effective approach of harm minimisation.” Moore congratulated the government for distributing funds for treatment through PHNs, noting that they “have the ability to ensure that the funding is directed appropriately, to deal with overlap of other drug dependency and to see comorbidities are dealt with in the most effective manner.” Lynne Magor-Blatch from the Australasian Therapeutic Communities Association was less convinced, questioning whether PHNs were yet fully capable. Frank Quinlan, CEO of Mental Health Australia, said the taskforce report “provides our community with a pathway towards addressing what is a significant social problem, with clear linkages to mental health and wellbeing.” Some questioned whether the political focus on ice was distracting from more pressing issues such as prescription opioid overdose deaths, while others described it as “a return to an old and failed response to drugs,” with scant reference to harm minimisation — for decades one of the central tenets of Australia’s drug policy. Wrote Bill O’Loughlin, head of Harm Reduction Victoria:

It is the old mantra: “Don’t take drugs and, if you do, then stop. The report reframes and reinterprets harm reduction by focusing on the harms created by ice and uses this as evidence for the need for treatment services. This is a serious and dangerous reinterpretation of government policy, and of what is accepted by specialists in the field. It raises the question of why the report placed more emphasis on the opinions of concerned people in the community and not on the advice from those who know what they are talking about. Many ordinary Australians are deeply concerned about ice but that does not make them experts in what to do about it.

Nicole Lee, an associate professor at Curtin University’s National Drug Research Institute, said the report and government response “mark a shift in focus towards support for better health responses,” though she refuted political descriptions of an ice “epidemic”.

The proof of the pudding will be in the eating, especially as it looks as though the bulk of the funding will go through the Primary Health Networks tied to mental health delivery, rather than the specialist alcohol and drug treatment system. In the past, linking mental health and alcohol and drug treatment services has not been advantageous to the drug treatment sector. Good implementation is going to be key.

 

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