In 2004 the Australian National Council on Drugs (ANCD) the principal advisory body to the Australian Government on alcohol, tobacco and other drugs policy, recognized harmful Indigenous alcohol, tobacco and other drug use as a priority, and established an Indigenous Stakeholders Group to look at the best means to address Indigenous alcohol, tobacco and other drug problems. The formation of the National Indigenous Alcohol and Drug Committee (NIDAC) was officially announced by the ANCD in December 2004 to assist the ANCD in providing advice to government on a range of issues that impact on Indigenous communities and ways of addressing the serious alcohol, tobacco and other drug problems that exist for Indigenous Australians, whilst ensuring these issues remain a priority to government. An important component of NIDAC’s work is to contribute to the development of policy relevant to Indigenous alcohol, tobacco and other drug problems taking into account the National Drug Strategy 2010 – 2015 and the National Drug Strategy Aboriginal and Torres Strait Islander People’s Complementary Action Plan.
Patterns of alcohol, tobacco and other drug use among Indigenous Australians have been shaped by history. With the effects of dispossession, alienation, trauma and loss recognized as contributing factors to the lower health and socio- economic status that Indigenous Australians continue to experience today, the use of alcohol, tobacco and other drugs have consequently become the cause and effect of much suffering in Indigenous communities.
The NIDAC Strategic Plan for 2012-2014 identifies priority areas of focus and provides direction for NIDAC through the broad objectives and activities identified in the plan. The Committee recognises that the complexities of alcohol, tobacco and other drug use among Aboriginal and Torres Strait Islander people demands a holistic and flexible approach and that the priorities listed are not intended to cover all challenges. Rather, they represent priority areas of concern to which the Committee can make contributions, and assist the ANCD in supporting the Australian Government’s 2010 – 2015 National Drug Strategy and National Drug Strategy Aboriginal and Torres Strait Islander People’s Complementary Action Plan. NIDAC also maintains the flexibility to respond to emerging alcohol, tobacco and other drug issues as they arise.
The priority areas of focus are:
Fetal and infant health
NIDAC is concerned about the impact of fetal alcohol spectrum disorder (FASD) on Australian children, youth and adults. Currently, FASD is not well known or understood in Australia, with most research and work in this field undertaken overseas. Internationally, estimates of FASD range from 1–3 per 1000 live births in the general population to as many as 9.1 per 1000 live births among high-risk populations, making FASD a substantial global concern (Stratton, K., Howe, C. and Battaglia, F.C 1996). While this information is helpful in guiding an understanding of FASD generally, it does not equip us with an understanding of the condition and its effects or of what is required to address it in Australia. Also given that the 2010 National Drug Strategy Household Survey indicates that Aboriginal and Torres Strait Islander people are 1.5 times more likely to drink alcohol at risky levels for both single occasion and lifetime harm, FASD is a particular concern among Aboriginal and Torres Strait Islander communities. Providing direction on how this can be addressed in Australia is therefore important.
NIDAC recognizes the importance of focusing on youth. The Indigenous population profile is younger than that of the general Australian population, so focusing on the behaviour and health status of youth is an opportunity to lower overall rates of tobacco, alcohol and drug problems more generally. In addition, a focus on young people provides a way to ‘break the cycle’ where unhealthy or risky patterns of use are transmitted to children from parents or other carers. Indigenous offenders are more likely to begin offending younger ages than non-Indigenous offenders (Joudo 2008). 54% of people aged 10–17 years in juvenile corrective institutions in 2008 were Indigenous (Australian Institute of Criminology 2011). Young people are also particularly vulnerable to some of the adverse effects of their own and others’ alcohol, tobacco and other drug use.
People in the justice system
Prisoner health is an important priority for NIDAC. Time spent in prisons is fraught with many risks to prisoner’s health and wellbeing. Offenders have disproportionately higher rates of serious mental illness (Ogloff et al 2007) and drug use. While in prison, they are at increased risk of blood borne virus transmission, physical violence, sexual assault and isolation. All of these risks have particular relevance to the grossly over represented population of Aboriginal and Torres Strait Islander people who make up over one-quarter of Australia’s prison population. In the past 20 years, Aboriginal and Torres Strait Islander people have continued to fill our country’s prisons at alarmingly disproportionate rates. The strong links between alcohol, tobacco and other drug use and Indigenous incarceration highlight an urgent need for action.
Adequate and secure funding to build the capacity of Aboriginal and Torres Strait Islander community controlled health organisations and other culturally secure services to respond to alcohol, tobacco and other drug use
In the context of self-determination it is critically important that there is a diverse range of responses to facilitate self-determination in health care. Aboriginal and Torres Strait Islander people should have access to a range of services and be able to make informed decisions about which services to use. This includes ensuring access to Aboriginal and Torres Strait Islander community controlled services as well as other relevant organisations that provide services to Aboriginal and Torres Strait Islander people that are well resourced and maintained to deliver effective alcohol, tobacco and other drug services.
NIDAC recognizes that Aboriginal and Torres Strait Islander community controlled health organisations and other culturally secure services along with adequate and secure funding is essential to the definition of Aboriginal holistic health and allows Aboriginal communities choice in determining their own affairs, protocols and procedures.
Workforce and organisational development
NIDAC recognizes the vital importance of providing ongoing support for workforce and organisational capacity development to ensure the sustainability effective responses of the Aboriginal and Torres Strait Islander community controlled sector as well as other culturally secure services.
For Aboriginal and Torres Strait Islander community controlled health organisations and other culturally secure services to provide adequate alcohol, tobacco and other drug services they need to have the capacity both to effectively provide the services for which they were established and to meet changing needs and increasing demand as well as provide employment opportunities, broader social and economic development, and the capacity to address a wider range of social issues (Gray et al 2010).