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  1. 1

    Christian Smyth

    Some further thoughts on changing the conversation on addiction…
    There’s a lot of talk about harm reduction at the moment, with many debating how we can do it better. It’s a tough balancing act trying to implement programs that the community feel comfortable with, that will also genuinely help people struggling with alcohol, drug or gambling problems.

    The opportunity to reduce harm can extend beyond clinical practices and programs of addiction treatment. We can reduce harm to people being affected by addiction, by changing the conversation, reducing stigma and letting people know what support is available to them.
    To be clear we are not calling for people or organisations to glamorise addictive behaviours, but for the discussion to be more mindful and compassionate of people who are vulnerable.

    The imagery and language long associated with addiction has reinforced a stereotype, focusing on the criminal or degenerate image of addiction. People are portrayed as dark and dangerous and there is usually an emphasis on the moral failing of those addicted, regardless of what they are addicted to.

    This stereotype is harmful as for some it may prevent people from accessing help, a 2016 study from the University of Western Australia found that ‘the biggest barriers to methamphetamine users seeking treatment are embarrassment or stigma, belief that help is not needed, preferring to withdraw without help and privacy concerns”.

    If we can reduce stigma and make people aware of the confidential service available to them, hopefully we can reduce the harm.

    Even when there is reporting or promotional health messages that are focused on prevention, they still seem to follow the degenerate rhetoric, rather than focusing on services available or the opportunity to turn lives around.

    When creating these messages or articles it would be helpful to give some consideration to how it may affect people in recovery. People who are working hard to change their lives can be particularly vulnerable to triggers especially when including photos of something they are trying to stay away from.

    Rapper 360 last year spoke about the government’s anti-ice ads in the SMH. As someone who has openly spoken about being in recovery, he was particularly critical of the government including images of drug paraphernalia in the ads saying “they have zero idea that simply showing a picture of a pipe will have every addict itching”.

    Addiction is affecting people beyond the fringes of society, it is touching people in every region and community across this country.

    A further difficulty of negative portrayal of addiction is that it not only affects the individual themselves, it also affects the community around them. Family and friends of those struggling with addiction often express that they also feel heavily stigmatised and responsible for the addictive behaviour.

    At Turning Point we are seeing increasing numbers of concerned families and friends accessing our services, and there are many more communities we could help, if they knew about the services available to them and felt that they could reach out for help.

    In 2016 our Breakthrough program, for family and friends being affected by ice addiction, delivered assistance to over 1500 concerned family members across Victoria, through more than 80 sessions in multiple locations around the state. This is a program that covers one state, for one drug and is really just getting started, if more people were aware of the programs available to them the whole community could be better served..

    Talking about life beyond addiction is critical to supporting those seeking treatment and their families and there are examples out there such as that show how to provide support for people who consider themselves to have an alcohol or other drug addiction and helps them deal with stigma.

    Mental health used to be a heavily stigmatised topic, often with overtly negative representation. Reporting and public health messaging relating to mental health is now handled with much more sensitivity. Trigger warnings, signposting to services, expert advice and accurate and respectful language are a normal part of the conversation now. We should do the same with addiction and we could start by adding signposting to, a national support service for anyone concerned about alcohol or other drugs, at the end of all alcohol advertising.

    There are lots of different views about next steps in harm reduction and we understand that this is a complex policy area, but while we debate the merits of needle and syringe programs, supervised injecting centres or pill testing we know people and their families are experiencing real trauma and need help now. If one thing we can do is reduce harm to people being affected by addiction by changing the conversation, reducing stigma and letting people know what support is available to them, surely this is something we can all agree on?

    If you or someone you care about is concerned about their alcohol, drug use or gambling, confidential help is available 24/7 at:

    Christian Smyth and Cassandra Jovic, Monash University and Turning Point

  2. 2

    Ben Harris

    Many people rely on prescription drugs for pain management. We’ve done a qual study ‘Attitudes Towards Opioids Among Patients Prescribed Medication in Victoria’ (at ) which examines the attitudes of patients on opioids long term. This was part funded by the Victorian Government, to get a better handle on the patient side of prescription drugs before implementing the real time monitoring system.

    There are clearly too many opioids prescribed in Australia, with the second highest rate of increase in the developed world (we’ve done a handy infographic at )

    As pointed out by Lubman and Smyth, prescription drug use and misuse is highly damaging, and we need better access to pain management services, as well as addiction services. Self management resources are key for living well with pain.

    The New York experience is sobering. We will step up our efforts making sure patients are better informed of their options when the prescription monitoring system is introduced.

    Ben Harris
    MOVE muscle, bone & joint health


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