Drug Policy In Australia Research Articles

\u2018Worth the test?\u2019 Pragmatism, pill testing and drug policy in Australia

BackgroundRecent deaths of young Australian music festival attendees from ‘party-drug’ overdoses have sparked debate about the effectiveness of drug policies. Australia is widely lauded for its harm minimisation approach to drugs, and yet, over the last 30 years, it can be argued its policies have been fragmented, sometimes inconsistent and contradictory. The present article examines the root of this inconsistency, using it as a foundation to advocate for drug policy reform. In keeping with the goals of the National Drug Strategy to promote policy innovation, there is an opportunity to learn from international studies which have shown promising findings in the reduction of party-drug use and its harms through application of pill testing.MethodThis paper evaluates Australia’s National Drug Strategy and pill testing through a lens of pragmatism, to determine whether there is space for testing practices in contemporary policy. Specifically, the paper analyses current drug policy literature and research studies, examining a range of key drug use indicators, social and political debate and research evidence.ResultsThe need for policy reform, attitudinal and cultural shifts and development of stronger cross-sectoral partnerships is highlighted, to ensure a rational and logical approach that genuinely tackles drug policy-making and strategy from a broad public health perspective.ConclusionsUsing a theoretical frame of pragmatism and drawing from national and international research evidence, this paper recommends the integration of pill testing into Australia’s harm minimisation strategy.

Governing drug use through partnerships: Towards a genealogy of government/non-government relations in drug policy

Drug policy in Australia is underpinned by the idea of partnerships wherein the non-government sector is one important partner in both delivering services and contributing to policy and decision-making processes. This article presents a genealogy of the concept of government/non-government ‘partnerships’, tracing its emergence and development within drug policy discourse in Australia. We find that the rise of neo-liberal policies since the 1980s has been a key factor facilitating the emergence of government/non-government ‘partnerships’ rhetoric in drug policy. Since the 1980s, the role of non-government organisations (NGOs) in drug policy has been articulated in relation to ‘community’ responsibilisation in contrast to the welfarist reliance on expert intervention. We link the rise of this rhetoric with the neo-liberal turn to governing through community and the individualisation of social problems. Furthermore, although we find that governments on the whole have encouraged the service delivery and policy work of NGOs at least in policy rhetoric, the actions of the state have at times limited the ability of NGOs to perform advocacy work and contribute to policy. Constraints on NGO drug policy work could potentially compromise the responsiveness of drug policy systems by limiting opportunities for innovative policy-making and service delivery.

Examining the opinions of people who use drugs towards drug policy in Australia

Aims: This study aimed to investigate whether there is heterogeneity of opinion about drug policies amongst people with different experiences of drug use, so as to stimulate discussion about how the diverse perspectives of people who use drugs can be meaningfully included in policy deliberation.Methods: The views of people who inject drugs were compared with the views of people who regularly use 3,4-methylendioxymethamphetamine (MDMA), using data obtained from two Australian surveys (the Ecstasy and Related Drugs Reporting System and the Illicit Drug Reporting System). Support for drug-related policies (including treatment, harm reduction and drug legalisation) was examined using questions from the National Drug Strategy Household Survey. The extent to which demographic variables and/or drug use experience accounted for differences of opinion amongst the two samples was also explored.Findings: There were significant differences between the views of IDRS and EDRS participants, about legalisation, and a range of harm reduction and treatment interventions. The heterogeneity in support for the legalisation of different drugs could be accounted for by recent experience of use, over and above demographic differences between people who inject drugs and people who regularly use MDMA.Conclusions: These findings speak to the diversity of attitudes and experiences amongst people who use drugs, and reinforce the need to better represent a diversity of opinion in drug policy deliberation and challenge stereotypical perceptions which stigmatise people who use drugs.

Public opinion and drug policy in Australia: Engaging the ‘affected community’

Policy should be informed by the people it directly affects; however, the voices of people who use illicit drugs have been marginalised from drug policy debate. In Australia, the majority of survey data regarding attitudes to drug policy are collected at the population level and the opinions of people who inject drugs remain underexplored. This study aimed to investigate how people who inject drugs perceive drug policy in Australia and whether these opinions differ from those of the broader general population. Drug-related policy questions were drawn from the National Drug Strategy Household Survey (NDSHS) and added to the 2011 Illicit Drug Reporting System (IDRS) Survey (n = 868). The results were analysed for the full IDRS sample and by recent drug use. IDRS responses were compared with the general population using the 2010 NDSHS. There was a high level of support among IDRS participants for measures to reduce the problems associated with heroin, but heterogeneity in levels of support for legalisation and penalties for sale/supply across different drug types. Differences between the opinions of the IDRS sample and the NDSHS sample were identified regarding support for harm reduction, treatment, legalisation and penalties for sale/supply. These findings provide a springboard for further investigation of the attitudes of people who use illicit drugs towards drug policy in Australia, and challenge us to conceptualise how the opinions of this community should be solicited, heard and balanced in drug policy processes.

Provision of opioid substitution therapy services in Australian pharmacies

Opioid dependence, despite being the subject of significant public funding, remains a costly burden to Australian society in human and economic terms. The most cost-effective public health strategy for managing opioid dependence is opioid substitution therapy (OST), primarily through the use of methadone or buprenorphine. Supervised dispensing of OST from specialist clinics and community pharmacies plays a crucial role in enhancing compliance, monitoring treatment and reducing diversion. Australia, compared with other countries in the world, ranks very high in illicit opioid use; hence there is a great demand for OST.The utilisation of community pharmacies for stable patients has many advantages. For public clinics, patient transfer to community pharmacies relieves workload and costs, and increases capacity for new OST patients. From a patient's perspective, dosing at a pharmacy is more flexible and generally more preferable. Pharmacists stand to gain clientele, profit and receive small incentives from state governments in Australia, for their services. Yet, many "unmet needs" exist and there is a high demand for more involvement in OST service provision in community pharmacy in Australia.In the UK there has been a steady increase in community pharmacy provision of OST, and pharmacists appear ready to provide further healthcare services to these patients.The role of pharmacy in some countries in Europe, such as Germany, is less prominent due to their approach to harm minimisation and the complex, variable nature of OST provision across the European Union (EU). The provision of OST by pharmacists in the USA on the other hand is of lesser frequency as the healthcare system in the USA encourages detoxification clinics to handle cases of illicit drug addiction.At a time when harm minimisation strategies constitute a topic of considerable political and public interest, it is important to understand the scope and variability of pharmacy involvement in drug policy in Australia. Hence, this review highlights the role of pharmacists in OST and explores the scope for expanding this role in the future.

Training in Addiction Medicine in Australia

ABSTRACT Barriers to entering addiction medicine (AM) have led to a persisting workforce shortage. To address this problem, the Chapter of Addiction Medicine (AChAM) was formed in 2001 as a subdivision of the Royal Australasian College of Physicians (RACP). Through consultation, AChAM has identified the scope of practice and offered fellowship to suitable established practitioners. The Chapter successfully applied to the Australian Government for recognition of AM as a medical specialty, which was finalized in November 2009. Specialist reimbursement item numbers were incorporated into that decision process and commence operating in November 2010. AChAM has designed and implemented a training scheme using a model similar to that of the RACP internal medicine training program. This comprises 3 years of basic general medical training post internship followed by 3 years of discipline-specific supervised training. The training is broadly based, with experience in both ambulatory care and inpatient care, and including physical health as well as mental health. Assessment is continuous and competency based. There is no exit examination. The overriding clinical approach rests upon the harm minimization framework consistent with long-established national drug policy in Australia and favors evidence-based treatment.

The size and mix of government spending on illicit drug policy in Australia

To estimate how much governments in Australia spend on reducing and dealing with illicit drug problems. Government documents and supplementary information sources were used to estimate drug-related expenditure for the financial year 2002-03, in Australian dollars. Public sector expenditure on reducing drug problems ('proactive expenditure') was classified into four policy functions: prevention, treatment, harm reduction and enforcement. Expenditure related to the consequences of drug use ('reactive expenditure') was included as a separate category. Spending by Australian governments in financial year 2002-03 on all drug-related activities was estimated to be $3.2 billion. Proactive expenditure was estimated to be $1.3 billion, comprising 55% on enforcement, 23% on prevention, 17% on treatment, 3% on harm reduction and 1% on activities that span several of these functions. Expenditure on dealing with the consequences of drug use was estimated to be $1.9 billion, with the majority the result of crime-related consequences. Several insights result from estimating these expenditures. First, law enforcement is the largest drug policy component, with Australian governments also spending significant amounts on treatment and prevention programmes. Secondly, apart from the prevention component, Australia's drug policy mix is strikingly similar to recent international estimates. Finally, expenditures associated with dealing with the consequences of illicit drugs are large and important for assessing drug-related public sector expenditure.

Newspaper coverage of drug policy: an analysis of pre‐election reporting of the Greens' drug policy in Australia

With the headline 'Ecstasy Over The Counter' in a popular daily newspaper, the debate on drug policy officially entered the arena of the 2003 New South Wales (Australia) State Election. The debate resurfaced in the lead-up to the 2004 Australian Federal Election. This paper analyses the pre-election coverage of drug policy issues in four Australian newspapers. Four high-circulation daily newspapers were monitored for a one-month period prior to both elections and analysed for their coverage of drug policy, particularly with respect to the policy of the Greens. The newspapers took different perspectives on drug policy issues, with two framing it in emotive terms as a moral debate and two framing it as political manoeuvring. The newspapers focused upon emotive and sensationalist factors. They did not provide their readers with information or a rationale for the formulation of drug policy, be this from a harm minimisation or zero tolerance perspective.

Generic drug policy in Australia: a community pharmacy perspective

This article provides a commentary, from a community pharmacy perspective, on the policy environment for the pharmacy sector in Australia, with a particular focus on present challenges arising from proposals to achieve substantial PBS cost savings from an anticipated surge of new generic drugs. Some $2 billion of medicines currently on the PBS will come off patent in the next 4 years. This growth comes from a low base where generics currently account for only 15% of the total PBS budget. Remuneration for PBS dispensing is fixed through five year agreements with the government, so trading terms on generics are important for the cross-subsidy of other dispensing activities and professional services. These trading terms (discounts provided by generics suppliers) have become part of the overall cost and revenue structure of pharmacies. Despite these arrangements, generic substitution rates in Australia are lower than in most comparable countries, which the government views as an opportunity to promote generic use. The future of generic drug supply via the PBS is important to allow consumers access to medications at the lowest possible price and to provide space for PBS listing of new and expensive drugs. But considerations of PBS reform need to take account of the role and viability of community pharmacy sector as provider of pharmaceuticals in a timely and efficient manner to Australian residents.

Conflict over drug policy in Australia.

Conflict over drug policy in Australia.