SUBSTANCE ABUSE & HARM MINIMISATION

The use of both legal and illegal drugs may harm individual users, their families and the community. Tobacco smoking is the single largest cause of preventable death and disease in Australia. Risky alcohol use is second only to tobacco as a preventable cause of death and hospitalisation and plays a significant role in a wide range of social problems including road crashes, crime and violence. Alcohol use does not just affect the individual drinker – many people are affected by another’s use and of course we all pay for the high costs to the police and health services.

The Greens (WA) believe in an approach that is evidence-based and seeks to prevent and minimise harm as the most effective way to manage these issues, irrespective of whether the drugs are legal or illegal. This approach should accord with the recommendations of the Global Commission on Drugs Policy and robust scientific evidence.

Aims
The Greens (WA) want:

  • to prevent and reduce harmful drug use and drug-related deaths, disease, crime and corruption
  • a national whole of government approach to prevention, early intervention, treatment and regulation informed by evidence, subject to continuous research and evaluation
  • an approach that recognises the range of factors that can contribute to drug use (i.e. social disadvantage, poor connection to school/communities, mental health problems) and includes a multifaceted response that addresses the social determinants of health
  • to improve the efficacy of all management, treatment, regulatory and judicial responses to drug use and related harm in the community, focussing resources on  reducing demand, reducing supply and reducing harm for individuals and the whole community
  • increased investment in analysis and evaluation of the effect of different policies and programs on drug use, especially through deriving better metrics, indicators and goals to assess progress
  • a regulatory scheme that has as its principal goal the prevention and reduction of alcohol and tobacco related harm where public health is not secondary to commercial aspirations
  • Government consideration of models of legal regulation of drugs other than alcohol and tobacco that reduce the influence of organised crime while improving the health and security of the public
  • comprehensive approaches to significantly reduce hazardous and harmful alcohol consumption combining fiscal measures, controls on the number, hours of sale and nature of alcohol outlets, controls on alcohol promotion, road safety measures and well resourced, evidence-based and enduring community education
  • increased resources being made available for education programs about low risk alcohol, prescription and non-prescription medication use
  • the first line response for possession of amounts of illicit drugs for personal use to be a public health one, including provision of education and, where indicated, referral to treatment. Criminal sanctions should be reserved for drug manufacture, distribution and supply
  • increased resources being made available for prevention, withdrawal management, drug treatment (including a range of treatments such as evidence based pharmacotherapies, outpatient counselling and inpatient rehabilitation programs) and harm minimisation programs
  • continued support for programs that have proven to be effective in reducing drug related harm to individuals and communities such as needle and syringe exchange programs and substitution therapies
  • consideration given to whether policies will assist or hinder efforts to control the transmission of blood borne viruses such as HIV, hepatitis C and hepatitis B through injecting drug use prior to policy implementation
  • significantly expanded programs for people experiencing mental health issues along with co-existing alcohol or drug abuse problems (see also The Greens (WA) Mental Health policy)
  • rapid responses to solvent and substance inhalation, including approaches that address underlying issues and education and treatment options
  • increased attention given to legal and illegal drug use among Indigenous Australians and other marginalised or disadvantaged populations with programs developed by the communities affected and supported by national/state funding (see also The Greens (WA) Aboriginal & Torres Strait Islander policy)
  • recognition of the significant proportion of incarceration that is contributed by Alcohol and Other Drugs (AOD) especially for Aboriginal Australians, indicating the need for effective prevention, investing in AOD programs within the justice system and ensuring pre-release/back to community programs (see also The Greens (WA) Justice policy)
  • to ensure that all drug treatment and harm minimisation programs are equally available across the community including in correctional facilities, for young and elderly people and for people with a disability.

Measures
The Greens (WA) will initiate and support State legislation and actions that:

Education

  • commit substantial resources to enduring and evidence based public and community education on tobacco use and alcohol, illegal drug and pharmaceutical drug misuse
  • ensure alcohol-related interventions and programs for Aboriginal communities recognise the particular social and structural factors connected to alcohol related problems (see also The Greens (WA) Aboriginal & Torres Strait Islander policy)
  • support community based advocacy groups such as Local Drug Action Groups (LDAG) financially and with infrastructure and access to expertise/personnel (independent of government) to deliver locally relevant messages and participate in local decision making such as liquor licensing
  • ensure that all local communities have drug education information kits in their public libraries and community centres that deal with associated harm from drug use and prescription drug misuse, and harm minimisation
  • support special initiatives for young people as a particularly vulnerable group to prevent and delay onset of substance use
  • ensure drug and alcohol education becomes a mandatory part of the curriculum in all schools, and that schools are encouraged to engage with the School Drug Education and Road Aware (SDERA) program (see also The Greens (WA) Education policy)
  • resource ongoing comprehensive education campaigns to ensure parents are aware of the dangers of supplying their children with alcohol, and the provisions and penalties within the Liquor Control Act 1988 as it applies to the purchase and supply of alcohol to minors
  • ensure mandatory labelling and verbal advice by doctors as to the effects and potential for dependence on prescribed drugs
  • develop more social education and other programs on the dangers of drugs of concern such as GBH, Rohypnol and the so-called “date-rape” drugs

Treatment and Rehabilitation

  • increase the accessibility of Quitline services, culturally secure tobacco cessation programs and nicotine replacement therapy for all those whom it is clinically appropriate
  • ensure adequate tobacco cessation support for those affected by smoke-free policies in state-funded services and facilities
  • increase government funding to provide easily accessible and sensitive counselling and treatment programs with adequate follow-up for drug users and affected family members
  • ensure a broad range of opportunities exist for screening, referral and treatment in primary health care and explore role of new technologies to deliver interventions to broad range of lower risk individuals (see also The Greens (WA) Health policy)
  • provide adequate support for families of people undergoing drug treatment and/or rehabilitation
  • ensure provision of drug and alcohol rehabilitation centres, and associated services, according to evidence based research of the needs or requirements of  each WA Country Health Service region
  • ensure ready access to evidence based and approved pharmacotherapies across the community, with intensive psychosocial support, to people who are drug dependent
  • ensure that adequate treatment resources are applied to alcohol related crime, including treatment in prison, community based corrections and extending services available through the alcohol and drug sector (see also The Greens (WA) Justice Policy)
  • improve access to diversion, rehabilitation and treatment programs as a sentencing alternative for substance-dependent people convicted of non-violent drug-related crimes
  • increase funding for programs for drug dependent persons released from prison, to assist their wellbeing and re-integration into society

Harm Reduction

  • encourage manufacturers to produce lower alcohol content beverages
  • continue support for the comprehensive roll out of non-sniffable fuel, or conversion of entire communities to diesel vehicles only, throughout regions in Western Australia where petrol sniffing and trafficking is a problem, with associated diversionary and rehabilitation programs
  • expand availability of needle exchange and safe disposal programs to all regional areas and prisons
  • introduce medically supervised injecting centres in suitable locations in metropolitan and regional centres
  • support methadone maintenance programs
  • support “depenalisation” of minor cannabis offences

Regulation

  • ban donations from alcohol, tobacco, gambling and pharmaceutical industries to all levels of government (see also The Greens (WA) Open & Honest Government Policy)
  • maintain regulatory measures to ensure all people are protected from exposure to tobacco smoke in all public and work environments (see also The Greens (WA) Workplace Relations policy)
  • address exposure to tobacco smoke in other outdoor places where people gather or move in close proximity such as in multi-unit developments and are not currently covered by legislation
  • maintain bans on advertising and promotion of tobacco products so that the bans are complete and comprehensive, including at point-of-sale
  • support local governments to develop public health plans that include alcohol and planning mechanisms that prevent problems associated with alcohol in the community (see also The Greens (WA) Local Government Policy)
  • adequately fund an independent regulator of liquor licensing and alcohol sales
  • ensure that outlet density planning regulations are based on a combination of alcohol consumption or sales per capita figures for that area, the number and types of outlets currently in existence, and the harms associated with these different outlets, in order to support smaller venues and those with additional attractions such as live music (see also The Greens (WA) Sustainable Settlements policy)
  • enhance the capacity of local communities to have input to liquor licensing decisions with simpler legislation that gives priority to public health/social impact; (see also The Greens (WA) Public Participation  policy)
  • improve enforcement of server and licensed venue responsibility legislation, including meaningful and rapid implementation of penalties for licensees who allow staff to continue serving intoxicated patrons
  • introduce as a condition of liquor licences that drinking glasses are to include an indication of the number of standard drinks they contain
  • introduce a minimum floor price to prevent the excessive consumption of very low priced alcohol that contributes to significant harm in the community
  • ensure greater restrictions on availability and promotion of alcohol products including outside and inside liquor outlets, printed material distributed in letter boxes, outdoor advertisements, inside sporting venues, and newspapers and other publications printed and distributed in Western Australia
  • phase out the sponsorship of sporting bodies by alcohol companies and provide additional funds to organisations such as Healthway to provide alternative sponsorship opportunities
  • continue the testing of blood alcohol concentrations in drivers, with strong penalties for driving over the limit
  • introduce car alcohol ignition interlock devices to stop people with a high blood alcohol concentration from driving
  • more effectively regulate the exposure of children to alcohol promotions and advertising
    • engage with Aboriginal communities wanting to address alcohol problems in their communities on initiatives such as
    • levies on cheap take-away alcohol and encouragement, by pricing, the sale of low alcohol beers;
    • take-away free days;
    • reducing the number of take-away alcohol outlets; and
    • increased funding and support for rehabilitation.
  • remove personal use and possession of illegal drugs and associated implements from the criminal code while retaining strict penalties for selling, supplying or trafficking these drugs
  • allow currently illegal drugs to be regulated and prescribed for medicinal purposes based only on their therapeutic and palliative effects
  • trial a regulatory regime for new psychoactive substances (‘legal highs’) which will require distributors of psychoactive substances to establish the safety of their products before they may be legally sold
  • support a review of prescribing and regulatory processes to ensure  the potential for oversupply and abuse of prescription medication is minimised

Workforce Development, Research and Evaluation

  • index funding to the health sector for substance use prevention and treatment programs, so that funding levels keep pace with the increased cost of services and need
  • increase access to suitable training for health professionals to increase their understanding of social and cultural determinants of Indigenous health and substance use
  • increase flexible specialist services and professional development programs for community and health sector workers, to ensure such services accommodate the diversity of people who have drug related problems
  • facilitate training for all health practitioners on the effectiveness and implementation of brief interventions to decrease alcohol consumption for those drinking above National Health and Medical Research Council (NHMRC) recommended guidelines
  • support universities to develop a more comprehensive undergraduate and postgraduate teacher training curriculum in alcohol and drug issues
  • increase funding for national drug research centres to enable them to better undertake and disseminate research, evaluation and the development of best-practice drug policy
  • increase funding and support for research programs monitoring drug-use trends and the availability of new substances
  • support rigorous scientific trials, to be carried out by accredited medical professionals, of new replacement treatments for substance dependence and to reduce the likelihood of relapse
  • continue to research the use of cannabis for relief of chronic pain and other conditions

The Greens (WA) will support and advocate for Federal legislation and actions that:

  • maintain an adherence to the established national approach towards harm minimisation which should be reviewed regularly to address changing patterns of use and other emerging issues (see also the Australian Greens Drugs, Substance Abuse and Addiction policy)
  • ensure regular and substantial increases to the taxation on tobacco products and include guarantees of a specific percentage of this tax to be used to fund specific tobacco control and health promotion activities
  • prohibit the importation and sale of any new tobacco or alternative tobacco products, other than therapeutic goods
  • support the development of regulatory mechanisms for addressing tobacco promotion on the Internet and through social media
  • increase excises and other taxes on alcohol in proportion to the alcohol content of beverages (a tiered volumetric tax), with resulting revenue to fund alcohol-related primary health care and health promotion programs
  • phase out alcohol promotions from times and placements with high exposure to young people up to 25 years of age
  • ensure mandatory labelling of all alcoholic drinks with research-based health warnings and the number of standard drinks contained
  • subject alcohol products to the same nutritional labelling/information provision as all other food and beverage products
  • require the Federal government to cover accredited drug and alcohol treatment and rehabilitation programs with Medicare
  • make drug substitution treatments available under the pharmaceutical benefits scheme, and compensate pharmacists for costs of dispensing treatment
  • replace the current policy of mostly investing in a law enforcement approach and invest more resources in evidence based prevention
  • review drugs policies in a comprehensive manner, involving families, schools, public health specialists, development practitioners and community leaders in partnership with law enforcement agencies and other relevant government bodies
Authorised by Lynn MacLaren © 2017

Hon Lynn MacLaren MLC - Member for South Metropolitan Region (2009-2017)
Legislative Council, Parliament of Western Australia