It’s now been a few weeks since the tax hike on cigarettes – I’m interested whether anyone in the field is seeing an increase in people deciding to quit? I know there’s evidence on the link between price and use, but I’m guessing it takes more than a few weeks for that to kick in for most people?
The Federal Health Minister has launched an Illicit Drug Campign to go along with its Tobacco and Alcohol campaigns. It’s a campaign that involves lots of information around the dangers of illicit drug use, that aims to “decrease motivation” of young people to commence use.
I’m all for education and knowledge, but I just get the feel this is just more of the same. There doesn’t seem to be any real differentiation from the decades of previous information and it just doesn’t seem that engaging. Again, campaigns like this probably do help but I’m interested in your thoughts: if you had the same budget, what would you do to ensure an effective and engaging campaign for young people and illicit drugs?
Here’s the text of the full press release:
Ad Campaign launched to confront Illicit Drug Use
The Rudd Government today launched the next stage of its hard-hitting $17 million advertising campaign to combat illicit drug use in Australia.
The campaign presents the ugly facts of illicit substance use including confronting and graphic images of young people addicted to drugs and the reality of underground production
This campaign aims to tackle drug use by presenting the physical and psychological impacts of illicit drug use.
It urges young people to decide against drug use and directs users to support, counselling and treatment services.
This campaign is about young people understanding the consequences of illicit drug use, asking them to ‘face facts’ and emphasising the damaging effects drugs have.
Too many young Australians don’t understand the very real and dangerous impacts of taking or using illegal drugs.
Ecstasy is made in filthy, makeshift labs, using toxic ingredients like battery acid and bleach. The toxicity of each pill varies and the potential for overdose is in every single pill.
There is no ‘quality control’ over the manufacture of drugs such as ecstasy.
In 2007 more than one third of the people aged over 14 had used an illicit drug at least once in their lifetime.
The proportion of recent regular ecstasy users who use weekly or more often has risen from 0.8 per cent in 1998 to 17.3 per cent in 2007. There is also a disturbing trend in the
increased ecstasy use by young females aged between 14-19 which is up from 4.7 per cent in 2004 to 6 per cent in 2007.
The campaign features print, outdoor, radio and in-venue advertisements depict real-life situations.
The advertisements, which will appear from this Sunday, were developed with the advice of clinicians, law enforcement officers and young people.
Further information, fact sheets and advice is available at www.australia.gov.au/drugs or by calling the free national hotline: 1800 250 015.
Saw this message from the NSW Department of Justice and Attorney General:
The Bureau of Crime Statistics and Research in collaboration with the Drug Policy Modelling Program, National Drug and Alcohol Research Centre has today released the following report:
How do methamphetamine users respond to changes in methamphetamine price?
One of the core objectives of supply-side drug law enforcement is to reduce drug use by raising the cost of buying drugs.
The effectiveness of this strategy depends on how illicit drug users respond to the rise in costs. The aim of the current study was to estimate how methamphetamine users would respond to changes in the price of methamphetamine and heroin
using a scenario-based research design.
It’s been a substantive week for the ATOD sector from a government policy viewpoint, with the release of the Return on investment 2: evaluating the cost-effectiveness of needle and syringe programs in Australia 2009 report by the Commonwealth Department of Health and Aging and the steady progress towards realisation of a nationwide Preventative Health Agency.
For those working at the NSEP coalface the Commonwealth report doesn’t contain any great surprises: the program has saved hundreds of millions of dollars overs its lifetime (Alex Wodak has a спалниnice piece over at Crikey on the report). The challenge now falls to both the Commonwealth and State governments to follow-through and further entrench the validity of NSEP. Hell, they could even expand its reach. There’s a chance for some governmental innovation.
The Health Minister Nicola Roxon is enthused by the passage of the legislation supporting the formation of a preventative health agency. Not surprisingly, the pressure is already being applied to Senators in regards to its passage through that chamber. The press release in full:
Australia’s first ever Preventive Health Agency will soon be established following the passage of important legislation in the House of Representatives today. The Agency is a key part of the Rudd Government’s decision to invest more in preventative health measures than any other government in Australia’s history.
The legislation is now with the Senate for consideration. It is essential that this Bill be passed without delay so that the agency can commence work on 1 January 2010.
The creation of this agency responds to calls from health professionals for Australia to establish – as many other countries have done – a dedicated agency to focus exclusively on driving the prevention agenda and combat the complex challenges of preventable chronic disease.
The agency will guide health ministers in their task of curbing the growth of lifestyle risks driving chronic disease. It is a role requiring national leadership, capacity to work across sectors and portfolios, and an oversight role for surveillance and monitoring.
The agency will bring together the best expertise in the country and play a key role in gathering, analysing and disseminating the best available evidence and evidence-based programs.
Its prevention activities will engage all Australian governments as well as employers, businesses and other sectors, to benefit every community in the nation.
The new preventive health agency will concentrate on reducing the burden that preventable health problems are already placing on the workforce, and ensure Australia’s productive capacity is maintained.
The agency will receive $133 million over four years, from the Government’s record $872 million COAG Prevention Partnership funding.
Strong support for the agency has been expressed by key players in the preventive health field such as the Public Health Association of Australia, and this is important in ensuring the agency’s success in forging cohesiveness in national preventive health efforts.
The preventative health agency legislation holds some promise and it’ll be interesting to see how much ideology enters the debate. You can expect the AMA to go in hard on the issue of medical funding not beign sacrificed on the altar of prevention. There may also be some argy bargy over the taskforce being another incremental step toward Commonwealth takeover of health. Beyond that, it’s really hard to see any Senator taking a strong stand unless it’s to claim the model is wrong or that there’s not enough funding for it to work effectively.
Over to you: are you encouraged by the NSEP report and the taskforce legislation? Do you see it as a positive step toward better health services delivery?
I noticed this letter from Tony Trimingham yesterday, which sums up perfectly the other side of politics: the part that actually makes a difference:
Whatever you think of Della Boscas personal indescretions I want to record my thanks and appreciation for all the good work he did as Special Minister of State and then Health Minister especially in regard to the problems of drugs and alcohol. Here was a man who took a deep personal interest in these issues and who was always open to listen to the concerns of those affected. No other Minister in this portfolio showed the same interest and concern as he did over his years involved. ‘He also made real and effectective changes. This is a loss that all my colleagues in the sector are now feeling. I also feel that at the moment he must be feeling friendless and isolated and just want him to know that many in the field are feeling sadness at his going in this way.
I tend to agree with the line former premier Bob Carr and many others took this week: a minister’s personal issues aren’t necessarily a hanging offence from a ministerial or policy perspective. That said, the NSW Labor government is so past its use-by date that nothing surprises anymore. Unless they parachute Barrie Unsworth into the premiership – then I’d be truly gobsmacked.
It’s unlikely you missed it, but this week saw thr Senate pass the legislation related to raising taxes on pre-mixed alcoholic beverages, commonly called ‘alcopops’ (I bet alcohol industry marketing people still lose sleep over what a double-edged sword that term has become). It’s hard to disagree with ADCA’s viewpoint :
Alcopop Tax – The first step to reforming harmful drinking
The Alcohol and other Drugs Council of Australia (ADCA) congratulates the Senate for passing the alcopop taxation legislation, but is calling for taxation reform to go even further.
“This issue has been delayed too long. There is no doubt that targeting these pre-mixed high-alcohol sweetened drinks is an important part of addressing issues of national binge drinking, ” ADCA’s Chief Executive Officer, Mr David Templeman, said today.
“We appreciate the Rudd Government continuing to fight for this tax, given the evidence from the Australian Taxation Office showed since the new tax rate for Ready-To-Drink spirits (alcopops) has been in effect, total spirits consumed decreased by 8 per cent.” he added.
ADCA believes that the tax will discourage underage drinking and delay the onset of drinking by some young people. This is imperative given the 2007 National Drug Strategy Household Survey showed more than 20% of 14-19 year olds consume alcohol on a weekly basis and the risk of accidents, injuries, violence and self-harm are high among drinkers aged under 18.
“One of the recently revised alcohol guidelines specifically targets children and young people under 18 years of age – advising that NOT drinking alcohol is the safest option. We know that these alcopops are particularly attractive to young people, and so raising the tax level is part of addressing that problem,” he added.
Such a move also fits with the announcement in October 2008 by the National Preventative Health Taskforce Paper Australia: The Healthiest Country by 2020 setting a target to reduce the prevalence of harmful drinking for all Australians by 30%.
“The annual cost to the Australian community from harmful drinking is estimated to be almost $15.3 billion, and we have recognised there is a national health issue at stake here,” Mr Templeman said. “We must be prepared to legislate in order to create healthier communities and to give our young people every incentive not to get involved in harmful drinking patterns.”
ADCA as the national peak non-government (NGO) body representing the AOD sector, will continue to strive to engage with Government to deliver the National Binge Drinking Strategy and Preventative Health Taskforce priorities aimed at creating a healthier Australia. This will require significant investment in prevention and treatment.
“ADCA looks forward to seeing additional Government funding directed to short and long-term prevention measures in order to significantly reduce alcohol-related harm. This includes management of responsible drinking, product branding, outlet density, marketing and advertising, opening hours, alcohol awareness projects for communities, and most importantly, investment in standardised and consistent data collection to plan for the future.”
Mr Templeman said that statistical data supplied by the alcohol industry must be consistent across all States/ Territories. Accurate data collection had now been confirmed by the Senate Standing Committee on Community Affairs as a crucial element to properly understand and address alcohol-related harm.
The point raised over data collection is incredibly valid – the only excuse left for inferior data collection is a lack of will and funding across the government and non-government sectors to tackle the issue.
After a little over a year of running a public campaign around binge drinking, and with the ‘Alco Pops’ legislation still bogged down in the Senate, Health Minister Nicola Roxon has announced the upcoming illicits campaign:
THE HON NICOLA ROXON MP – MINISTER FOR HEALTH AND AGEING
MEDIA RELEASE – 19 APRIL 2009
NATIONAL CAMPAIGN TARGETS ILLICIT DRUGS
Hard-hitting ads targeting ice, ecstasy and marijuana will be rolled out from today, as part of an $18 million national campaign.
The ads confront young people with the dangers posed by these harmful drugs, and will include print, television, cinema, outdoor advertising and internet ads.
The risks associated with these drugs include:
• Ice users are at risk of drug-induced psychosis which may lead to aggressive and violent behaviour. They also suffer physical problems including damaged teeth, gums and skin lesions, and are at greater risk of stroke, panic attacks, anxiety, and severe depression.
• Ecstasy users are at risk of chronic sleep problems, cracked teeth through grinding, high blood pressure, dehydration, anxiety, nervousness, hallucinations, severe depression, thermal meltdown and death from heart failure.
• Marijuana users are at risk of psychosis (particularly the earlier marijuana use is initiated), increased risk of depression, risky sexual behaviours and chronic respiratory conditions.
The rates of drug use in society are still too high. In 2007, of Australians aged over 14 years, 38.1 per cent had used an illicit drug and one in three had used marijuana. Of Australians aged 20-29 years, 23.9 per cent reported using ecstasy and 16 per cent had used methamphetamines such as ice at least once in their lifetime.
This campaign particularly targets young methamphetamine users by portraying in stark and confronting terms the real harms and risks associated with drugs like ice and ecstasy.
The ads use slightly revised versions of earlier ads, in order to reinforce the message that these drugs are dangerous.
The television commercial Don’t Let Ice Destroy You, was produced under the guidance of expert clinicians, and law enforcement officers were also consulted.
The campaign also directs drug users to important points of support, counselling and treatment services that are available in communities throughout the country.
This campaign is one part of more than $800 million the Government is investing over five years in tackling the scourge of drug abuse.
Further information about the Government’s National Drugs Campaign is available from www.australia.gov.au/drugs or by calling the free national hotline 1800 250 015
Comprehensive strategies can be worthy, but am I alone in worrying whether a broad, mainstream campaign is the best way to target illicit drug users?
For those outside of NSW who are unaware, the current Labor government has been in power since 1995 and to put it politely, is well and truly showing signs of disrepair. The current NSW Opposition has managed to stay disciplined since the 2007 election and under Barry O’Farrell has mad a much needed move to the centre-right.
NADA has put out a press release applauding the NSW Opposition for its call to improve funding for treatment services rather than the ever-expanding rollout of prison beds. Kudos to NADA for being vocal on this, and here’s to a lot more of that by ATOD peak bodies.
I’m far from a Liberal Party supporter but it shows how bizarre things have become where a Labor government are promising more and more prisons whilst the so-called conservatives are wanting an increased focus on treatment.
For those living in NSW, have you noticed whether things have deteriorated in regards to the government’s grasp of health issues? Post a comment below – feel free to use a psuedonym and fake email address if you’re worried about protecting your privacy. There’s not enough open discussion about the impact of politics on health and the current NSW situation is as good a place as any.
The NADA press release:
NADA applauds calls for the expansion of drug crime diversion programs
The Network of Alcohol and Drug Agencies (NADA) welcomes the NSW Opposition’s justice spokesperson’s call to end simplistic “tough on crime” approaches to deal with offenders with severe drug and alcohol and mental health issues. NADA CEO Larry Pierce thinks the NSW Opposition got it right in identifying that more funding for drug and alcohol rehabilitation programs are more effective than building more prisons. “There is strong evidence for the effectiveness of drug crime diversion programs like Drug Courts and magistrates referral to treatment in NSW and across the country” .
“it would be good to see real political bi-partisanship on this issue” says Mr Pierce. NADA also calls on the State and Australian government to further strengthen their current commitment to drug crime diversion and rehabilitation programs.
I’ll append the extensive snippets below from the COAG Communique kindly provided by Gino Vumbaca on the ADCA list. First though, some thoughts on the details. My initial reaction is that for the ATOD sector, there’s not a significant gain except in the indigenous health area. The proposed social marketing campaign may include alcohol, tobacco and possibly some illicit drugs – hopefully it’s not just a continuation of current approaches. I’d like to see some real investment and research into Web 2.0 and preventing ATOD issues amongst particular age groups.
Onto the actual communique, and wold love to hear your thoughts below as well.
Indigenous Reform COAG has previously agreed to six ambitious targets for closing the gap between Indigenous and non-Indigenous Australians across urban, rural and remote areas:
to close the gap in life expectancy within a generation;
to halve the gap in mortality rates for Indigenous children under five within a decade;
to ensure all Indigenous four years olds in remote communities have access to early childhood education within five years;
to halve the gap in reading, writing and numeracy achievements for Indigenous children within a decade;
to halve the gap for Indigenous students in year 12 attainment or equivalent attainment rates by 2020; and
to halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade.
Since the targets were agreed in December 2007 and March 2008, all governments have been working together to develop fundamental reforms to address these targets. Governments have also acknowledged that this is an extremely significant undertaking that will require substantial investment. COAG has agreed this year to initiatives for Indigenous Australians of $4.6 billion across early childhood development, health, housing, economic development and remote service delivery.
In giving effect to this commitment to closing the gap on Indigenous disadvantage, COAG agreed to the first ever NP agreement in October 2008. This agreement comprises $564 million of joint funding over six years to address the needs of Indigenous children in their early years. As part of the initiative, 35 Children and Family Centres are to be established across Australia in areas of high Indigenous population and disadvantage to deliver integrated services that offer early learning, child care and family support programs. The funding will also increase access to ante-natal care, teenage reproductive and sexual health services, and child and maternal health services.
This NP is now joined by a new National Agreement on Indigenous reform and two new NPs which cover the areas of Economic Participation ($228.8 million – $172.7 million Commonwealth funding and $56.2 million State funding over five years) and Remote Service Delivery ($291.2 million over six years). Taken together with the Indigenous Health NP and the Remote Indigenous Housing NP, these new agreements represent a fundamental response to COAG’s commitment to closing the gap. Sustained improvement in outcomes for Indigenous people can only be achieved by systemic change. Through these agreements, all governments will be held publicly accountable for their performance in improving outcomes in these key areas.
National Indigenous Reform Agreement COAG agreed to the National Indigenous Reform Agreement (NIRA) which captures the objectives, outcomes, outputs, performance measures and benchmarks that all governments have committed to achieving through their various National Agreements and NPs in order to close the gap in Indigenous disadvantage. The NIRA provides an overarching summary of action being taken against the closing the gap targets as well as the operation of the mainstream national agreements in health, schools, VET, disability services and housing and several NPs. The NIRA will be a living document, refined over time based on the effectiveness of reforms in closing the gap on Indigenous disadvantage.
Closing the Gap COAG Meeting in 2009 In October 2008, COAG agreed to convene a dedicated meeting in 2009 on closing the gap on Indigenous disadvantage. COAG has asked for advice on how the NPs and National Agreements will collectively lead to a closing of the gap and what further reforms are needed. In addition to this, COAG has asked for a Regional and Urban Strategy to coordinate the delivery of services to Indigenous Australians and examine the role that private and community sector initiatives in education, employment, health and housing can make to the success of the overall strategy. COAG noted that the it will work to develop a further reform proposal, including benchmarks and indicators for improvements in services and related outputs relevant to family and community safety, for consideration at the Closing the Gap COAG meeting to be held in 2009.
Revised Framework of the Overcoming Indigenous Disadvantage Report In April 2002, COAG commissioned the Productivity Commission’s Steering Committee for the Review of Commonwealth/State Service Provision to produce a regular report against key indicators of Indigenous disadvantage, with a focus on areas where governments can make a difference. The resulting Overcoming Indigenous Disadvantage (OID) Report has been published every two years since 2003. COAG agreed to a new framework for the OID Report that is aligned with the closing the gap targets.
HEALTH AND AGEING COAG agreed today to a landmark deal providing $64.4 billion over five years, including an additional $8.6 billion over current forward estimates. This includes $60.5 billion over five years for the National Healthcare Agreement, which reverses the cuts of the previous Agreement and provides $4.8 billion in additional base funding. In the fifth year of this Agreement, the base will increase by $1.5 billion. This means that States are, on average, better off by nearly $1 billion each year over the five years. As part of this deal, the Commonwealth is offering a $500 million recurrent boost in base funding from 2008-09, increasing the starting point for the National Healthcare Agreement from $9.96 billion to $10.46 billion. The Commonwealth is also delivering a more generous indexation formula, which currently delivers indexation of 7.3 per cent per annum to put public hospital funding on a more sustainable footing.
Shared Accountability and Better Performance Reporting The Commonwealth and the States have also agreed to the following objectives and outcomes for the health and hospital system. These are:
children are born and remain healthy;
Australians manage the key risk factors that contribute to ill health;
Australians have access to the support, care and education they need to make healthy choices;
the primary health care needs of all Australians are met effectively through timely and quality care in the community;
people with complex care needs can access comprehensive, integrated and coordinated services;
Australians receive high-quality hospital and hospital related care;
older Australians receive high-quality, affordable health and aged care services that are appropriate to their needs and enable choice and seamless, timely transitions within and across sectors;
patient experience: Australians have positive health and aged care experiences which take account of individual circumstances and care needs;
social inclusion and Indigenous health: Australia’s health system promotes social inclusion and reduces disadvantage, especially for Indigenous Australians; and
sustainability: Australians have a sustainable health system.
The Commonwealth and the States have also agreed to report against a number of performance measures to address these outcomes including: preventable disease and injuries; timely access to GPs, dental and other primary health care professionals; life expectancy, including the gap between Indigenous and non-Indigenous Australians; waiting times for services; and net growth in the health workforce. The COAG Reform Council will report progress against these performance measures annually, commencing in 2009-10. In addition, the COAG Reform Council will report performance against a range of measures, including:
reduced incidence and prevalence of sexually-transmitted infections and sentinel blood borne viruses (for example, Hepatitis C, HIV) for Indigenous and non-Indigenous Australians;
increased immunisation rates for vaccines in the national schedule;
reduced waiting times for selected public hospital services;
a reduction in selected adverse events in acute and sub-acute care settings compared to 2008-09 levels;
a reduction in unplanned/unexpected readmissions within 28 days of selected surgical admissions compared to 2008-09 levels;
increased rates of services provided by public hospitals per 1,000 weighted population by patient-type compared to 2008-09 levels;
timely access to GPs, dental and primary health care professionals; and
a reduction in selected potentially avoidable GP type presentations to emergency departments.
The Commonwealth and the States have also agreed to provide a basis for more efficient use of taxpayer funding of hospitals, and for increased transparency in the use of those funds through the introduction of Activity Based Funding. It will also allow comparisons of efficiency across public hospitals.
Health Prevention NP The Commonwealth and the States have agreed to a Health Prevention NP, with the Commonwealth providing funding of $448.1 million over four years, and $872.1 million over six years starting from 2009-10 to improve the health of all Australians. This funding could support the following elements:
increased access to services for children to increase physical activity and improve nutrition;
provision of incentives for workplaces and local communities to provide physical activity and other risk modification and healthy living programs;
increased public awareness of the risks associated with lifestyle behaviour and its links to chronic disease;
a national social marketing campaign; and
enabling infrastructure, including a national preventative health agency, surveillance program, workforce audit, eating disorders collaboration, partnerships with industry and a preventative health research fund, leading to better oversight and research into prevention, leading to improved outcomes.
This funding will lead to reductions in the proportion of people who smoke, are at unhealthy bodyweight, and/or do not meet national guidelines for physical activity and healthy eating. Specifically, governments commit to:
increase the proportion of adults and children with healthy body weight, reduce rates of obesity and avert new cases of diabetes in adults each year;
increase the proportion of children and adults meeting national guidelines for physical activity and healthy eating; and
reduce the proportion of adults smoking daily, averting premature deaths and ameliorating costs.
Indigenous Health NP The Commonwealth and the States have agreed to an Indigenous Health NP worth $1.6 billion over four years, with the Commonwealth contributing $806 million and the States $772 million. This proposal will contribute to addressing the COAG-agreed closing the gap targets for Indigenous Australians, closing the life expectancy gap within a generation and halving the mortality gap for children under five within a decade. The proposal includes expanded primary health care and targeted prevention activities to reduce the burden of chronic disease. This NP is a down payment on the significant investment needed by both levels of government to close the unacceptable gap in health and other outcomes between Indigenous and non-Indigenous Australians. The NP will lead to:
reduced smoking rate among Aboriginal and Torres Strait Islander peoples;
reduced burden of diseases for Aboriginal and Torres Strait Islander communities;
increased uptake of Medicare Benefits Schedule-funded primary care services to Indigenous people with half of the adult population (15-65 years) receiving two adult health checks over the next four years;
significantly improved coordination of care across the care continuum; and
over time, a reduction in average length of hospital stay and reduction in readmissions.
This means that over a five-year period, around 55 per cent of the adult Indigenous population (around 155,000 people) will receive a health check with about 600,000 chronic disease services delivered. More than 90,000 Indigenous people with a chronic disease will be provided with a self-management program, while around 74,500 Indigenous people will receive financial assistance to improve access to Pharmaceutical Benefits Scheme medicines.
“NSW Health has recently released the preliminary evaluation of the Stimulant Treatment Program, which is now available on the NSW Health publications website.
The Stimulant Treatment Program (STP) commenced in New South Wales in 2006 with a trial of two standalone stimulant treatment clinics based in Darlinghurst, St Vincent*s Hospital and Newcastle, Hunter New England Area Health Service. The clinics provide treatment for stimulant users, primarily methamphetamine users including brief interventions, CBT and case management for people with mental health and substance use problems, using a stepped care approach to treatment.
NSW Health recently conducted a preliminary evaluation of the STP. The aim of the evaluation was to measure the effectiveness of the model of clinical intervention for stimulant users and identify key issues relating to service delivery, and to examine the feasibility of conducting the STP at the two clinics.
The preliminary evaluation was able to demonstrate that the STP has been successful in attracting and retaining people who need treatment but are often reluctant to present at mainstream drug and alcohol services.
The report can be found at: