UnitingCare ReGen CEO Laurence Alvis participated in the recent Prevention and Treatment roundtable sessions of the National Ice Taskforce hearings in Sydney. With Taskforce public consultations having now closed, the following provides a summary of his notes on the key issues raised by roundtable participants. Overall, the roundtable participants stressed the need for comprehensive, long-term and evidence-based interventions that addressed the broad issues affecting people who use ice, including in areas such as housing, employment and mental health. These recommendations contrast with the findings from the Senate Estimates Committee hearing this week of a further $8 million cut to drug and alcohol programs (discussed in more detail below).
The key messages emerging from the ‘prevention’ and ‘treatment’ roundtable sessions were:
- The Government’s response must be based on evidence, not populist appeal;
- Treatment services need to be adequately funded if they are to provide timely responses to people in crisis; &
- Ice-related harm is one aspect of a complex set of issues. A holistic, long-term approach is needed.
However, Monday’s Senate estimates proceedings (which confirmed a further $8 million in funding cuts to existing alcohol and other drug treatment programs) raise serious concerns about the Federal Government’s commitment to a comprehensive, national response to the impacts of methamphetamine use. While the Government has been keen to heighten community fears about people who use methamphetamine, it is showing little sign of providing any meaningful supports to affected individuals, families and communities around Australia.
The roundtable sessions highlighted both the community impacts the need for policy makers to listen to the evidence in developing a national response. Key topics of discussion included:
Family members feeling helpless. They are the front line in reducing harm and supporting change, but currently lack adequate information or supports.
Currently, there are not enough treatment options available – waiting lists for services are too long and are a barrier to people seeking support for themselves or a loved one. People in crisis are unable to receive timely support.
Impacts are not solely due to methamphetamine use, there are complex issues affecting people using ice – it’s a symptom, as well as a cause, of related harms.
There is no simple solution. AOD treatment (in isolation) will not solve the problem. We need a holistic response to complex individual needs and systemic issues affecting local communities – mental health, housing, employment.
Current services are not aimed at already vulnerable communities that are known to be particularly affected e.g. Aboriginal and LGBTI communities. We need different approaches/messages for different communities.
Evidence based policy
The current ‘Ice is destroying lives’ TV campaign is not relevant to the 85% of people who use ice but do not experience psychotic behaviour. The National Ice Action Strategy must be based on evidence, not populist appeal.
Education campaigns need greater input from consumers to ensure messages are relevant to target groups. There is also a need to recognise ice use as a health issue – prevention needs to be linked to social determinants of health.
It is important to stick to the evidence when framing public debate to inform communities and avoid further stigmatising already vulnerable people. Don’t waste $9 million on ineffective (and potentially damaging) ad campaigns.
Current treatment models
There are good outcomes from specific projects – reductions in use, criminal behaviour and suicide – so use the evidence on effective programs and allow resources for evaluation of models and treatment outcomes.
Stimulant-based pharmacotherapy is required – more work still to be done in this area.
The Victorian Drug Court model which includes the family drug court should be expanded to other states and territories – treatment is more effective when participation is voluntary but justice system can provide effective entry point.
Primary Health networks can be better used to provide some interventions and stronger pathways into treatment from services such as EDs, GPs and courts and greater post-treatment (including release from prison) supports to prevent relapse and support recovery.
There is also a need increased flexibility in established treatment models to cater for different drug types, including methamphetamine and whatever substances come next.
Funding needs to be considered for adequate periods: one-year extensions make it difficult to attract or retain quality staff. Services spend much of their resources writing ongoing funding submissions, rather than on providing treatment services.
Long waiting lists for services and ongoing loss of experienced staff are signs of a sector in crisis.
Current funding streams for prevention and early intervention are not aligned. Sector needs greater consistency to be able to provide early interventions that prevent escalation of harms.
Recovery from drug dependence is a long-term process. We need a long-term approach to service planning, funding and delivery.
Taskforce chief Ken Lay has already flagged the need for long-term, appropriately funded policy response. Its recommendations are due to be delivered to the Prime Minster by the end of the month. The Government’s response to these recommendations (National Ice Action Strategy to be release by end of 2015) will provide the final test of whether its actions match its rhetoric.
ReGen’s submission to the Taskforce is available on its website.