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The Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities

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The Harmful Use of Alcohol in Aboriginal and Torres Strait Islander Communities House of Representative Standing Committee on Indigenous Affairs Inquiry into the harmful use of alcohol in Aboriginal and Torres Strait Islander communities Queensland Government submission May 2014 Contents SUMMARY ................................................................................................................................................. 3 BACKGROUND ......................................................................................................................................... 4 Queensland’s Aboriginal and Torres Strait Islander Peoples ................................................. 4 Harmful use of alcohol in Queensland ................................................................................... 4 Alcohol Management Plans In Queensland ........................................................................... 4 The AMP Review ................................................................................................................... 5 RESPONSE TO THE INQUIRY TERMS OF REFERENCE .............................................................. 6 1. Patterns of supply of, and demand for alcohol in different Aboriginal and Torres Strait Islander communities, age groups and genders ................................................................ 6 2. The social and economic determinants of harmful alcohol use across Aboriginal and Torres Strait Islander communities .................................................................................... 7 3. Trends and prevalence of alcohol related harm, including alcohol-fuelled violence and impacts on newborns, e.g. Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders. ......................................................................................................................... 8 4. The implications of Foetal Alcohol Syndrome and Foetal Alcohol Spectrum Disorders being declared a disability………………………………………………………………………..9 5. Best practice treatments and support for minimising alcohol misuse and alcohol-related harm ............................................................................................................................... 10 6. Best practice strategies to minimise alcohol misuse and alcohol-related harm .................... 7. Best practice identification to include international and domestic comparisons ................... ANNEXURE 1: History of alcohol management in Aboriginal and Torres Strait Islander communities ............................................................................................................................................. 11 ANNEXURE 2: Alcohol Management Plans in Queensland ............................................................ 15 ANNEXURE 3: The Review of Alcohol Management Plans ............................................................. 23 REFERENCE LIST ................................................................................................................................. 26 Page 2 of 26 SUMMARY Many Aboriginal and Torres Strait Islander people abstain from drinking alcohol. Despite this fact, it has been reported that just over half (51 per cent) of the Aboriginal and Torres Strait Islander adult population in Queensland could be drinking alcohol at a risky/high-risk level (Australian Health Ministers’ Advisory Council, 2012). Harmful use of alcohol in Aboriginal and Torres Strait Islander communities is both a cause and a symptom of the low socio-economic circumstances faced by many Aboriginal and Torres Strait Islander people. Addressing alcohol misuse and harm in Aboriginal and Torres Strait Islander communities is complex with many inter-related issues. In 2002 Alcohol Management Plans (AMPs) were introduced by the Queensland Government to reduce alcohol-related violence in discrete Indigenous communities (see Annexure 2 for list), particularly against women and children. AMPs were progressively rolled-out to 19 discrete Indigenous communities covering 15 Local Government Areas. Despite decreasing trends for reported offences against the person, and for hospital admissions for assault-related conditions in some communities, the rate of hospitalisation for assault-related conditions in 2012–13 was at least five times the Queensland rate of 1.3 per 1,000 persons. In all communities, (except the Northern Peninsula Area), the overall rate of reported offences against the person was at least six times the Queensland rate of 6.7 per 1,000 persons (Department of Aboriginal and Torres Strait Islander and Multicultural Affairs, 2013a). Supply reduction interventions are achieved through regulation and enforcement, while demand reduction interventions require more effort and take more time to yield results. Additionally, effective demand reduction interventions rely on addressing the vexed issue of entrenched socio-economic disadvantage and its link to harmful use of alcohol. A holistic approach is required to address many complex and inter-related issues confronting Indigenous people. Efforts are required to: • improve school attendance and educational attainment • improve parenting skills and effective supervision of teenagers • increase employment and economic participation • improve the effectiveness and number of health and rehabilitation centres • enable focussed and collaborative community leadership and government effort. One of the most significant learnings from our experience to date with AMPs is that community generated and community “owned” proposals can be more effective than government imposed “solutions”. The Queensland Government is working with Aboriginal and Torres Strait Islander communities to review AMPs to encourage communities as a whole to identify their preferred way of reducing alcohol misuse and related harm in their communities. Page 3 of 26 BACKGROUND Queensland’s Aboriginal and Torres Strait Islander Peoples Queensland’s Aboriginal and Torres Strait Islander population is growing. The majority of Aboriginal and Torres Strait Islander peoples live in regional and urban Queensland. One fifth of Queensland’s Indigenous population live in remote communities. This submission focuses on issues confronting Aboriginal and Torres Strait Islander people living in remote communities. However, this submission does acknowledge that Aboriginal and Torres Strait Islander peoples living in urban and regional Queensland also experience high levels of disadvantage compared to non-Indigenous Queenslanders, including alcohol and substance misuse issues. Harmful use of alcohol in Queensland Many Aboriginal and Torres Strait Islander people abstain from drinking alcohol. A survey conducted by the Australian Bureau of Statistics in 2004–05 found that in Queensland, Aboriginal and Torres Strait Islander adults (28 per cent) were more likely than non-Indigenous adults (13 per cent) to report having abstained from alcohol consumption in the previous 12 months (Australian Health Ministers’ Advisory Council, 2012). However, the survey also revealed that risky alcohol consumption is prevalent among Aboriginal and Torres Strait Islander peoples. One estimate is that in Queensland, just over half (51 per cent) of Aboriginal and Torres Strait Islander adults could be drinking alcohol at risky/high-risk levels over a 12 month period1. This was higher than the identified proportion for non-Indigenous persons in Queensland (42 per cent) and for Indigenous persons nationally (47 per cent). Alcohol Management Plans In Queensland AMPs were introduced in Queensland to reduce alcohol-related violence in the communities, particularly against women and children. They were progressively rolled-out by the Queensland Government to 19 discrete Indigenous communities covering 15 Local Government Areas, from 2002. AMPs were introduced following the public release of the then Queensland Government’s Aboriginal and Torres Strait Islander Women’s Task Force on Violence Report (Queensland Government. 1999) and the 2001 Cape York Justice Study (Fitzgerald, 2001). • In the period 2003–2006, Alcohol Management Reviews were conducted for each of the discrete Indigenous communities. These reviews examined the impact of the alcohol restrictions on the community, presented the views of stakeholders within the community as well as provided the future directions and actions sought by the community in reducing violence and harm and increasing community safety and well-being. AMPs in Queensland include specific strategies to reduce: • the supply of alcohol through law enforcement (e.g. through alcohol restrictions, licence conditions, enforcement activities, bans on homebrew and homebrew equipment, dry place declarations and liquor accords). • the demand for alcohol through service delivery, including those provided under the Alcohol Management Reform (AMR) Program (for example, through rehabilitation services, detoxification services, and sport and recreation services), education and use of the media. 1Definitions of risky/high risk drinking levels are based on the guidelines set by the National Health and Medical Research Council. Page 4 of 26 The AMP Review The Queensland Government review of the AMPs (the Review) examines current AMPs and enables communities as a whole to identify their preferred way of reducing alcohol misuse and related harm. The Review will assess the effectiveness of AMPs to reduce alcohol misuse and related harm. Similar to the Inquiry, It will assess supply and demand reduction strategies and alcohol related harm and violence. The Review is community
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