Transcript The case for developing more effective approaches to

The case for developing more
effective approaches to alcohol
and drug problems
Probation and Community Corrections Officers
Conference
Dr Alex Wodak AM
St. Vincent’s Hospital
[email protected]
27 October 2011
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Topics:
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Scale current problems
Current policy settings
Barriers to improvement
Forces for change
Overcoming barriers
Conclusions
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Scale current problems:
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Almost every family experience
Sense despair, hopelessness
Often identified as major problem
High health, social, economic costs
Major impact alcohol, tobacco on ‘the gap’
Consumption alcohol rising ?
Increasing binge drinking among young
Prescription opioids
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Scale current problems:
• 37 murders Victoria linked meth
• Major official corruption
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Current policy settings:
• Tobacco
– Big recent drop smoking rates
– More action recently: price, packaging
– But now ‘islands’ 1960s prevalence
– Ban smoking prisons?
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Current policy settings:
• Alcohol
– Tax chaos
– Very liberal availability
– Restrictions undermined competition
– Advertising, marketing unregulated
– Drinks industry omnipotent, gets its way 100%
– Parties intimidated
– Community powerless
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Current policy settings:
• Prescription drugs
– Increasing consumption SR opioids 20 years
– Following US, Canadian trends
– US serious harms from 2000
– Mainly chronic non-cancer pain
– Also benzodiazepines – insidious
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Current policy settings:
• Illicit drugs
– Framed as criminal justice problem
– Rhetoric, funding follows
– Ineffective, counterproductive, expensive
– Difficult identify benefits
– Works well politically
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Barriers to improvement:
• Tobacco
– Major progress over long time
– Shows progress is possible
– Tobacco industry tamed
– Decrease smoking disadvantaged
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Barriers to improvement:
• Alcohol
– Drinks industry too powerful
– Newspapers afraid
– Excessive concentration newspaper owner
– TV, radio lives off newspapers
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Barriers to improvement:
• Prescription drugs
– Messy – DoHA, states, territories
– Whose responsible?
– Multiple interventions needed
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Barriers to improvement:
• Illicits
• What works isn’t popular, what’s popular
doesn’t work
• Fear vs evidence
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Forces for change:
• Alcohol
– Rising community concern alcohol
– NAAA
– Global action – WHO
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Forces for change:
• Illicit drugs
– Growing recognition failure War on Drugs
– Global Commission Drug Policy
– UN Commission HIV, Law
– Sovereign debt crisis USA, W Europe
– New models e.g. Portugal
– Crisis prisons USA
– Mexico
– Changing community attitudes, internet
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Overcoming barriers:
• Funding flowing to drug law reform
• New drug law reform organisations
• LEAP
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Conclusions:
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Exciting time
Change starting drug law reform
Pressure building effective response alcohol
Also action SR opioids
Benzodiazepines
Harm reduction debate over
Drug law reform debate following
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