About AODCCC

Our aim is to empower the voices of consumers, their families and supports, ensuring the health and wellbeing of our community. 

About AODCCC

Beyond Stigma

We aim to create a safe space for diverse views to be shared, along with taking courageous steps towards what is needed in the community, which in this case, is to look beyond stigma.

Beyond Stigma

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Alcohol in WA...

Alcohol is estimated to cost the Australian community nearly $67 billion a year in health, workplace and other costs.1

WA Emergency Departments see almost 10,000 alcohol related presentations per year.1

Challenging Stigma Through Education

Alcohol related Emergency Department presentations to Royal Perth Hospital, cost the WA community $7.5 million per year.1

Within the whole of Australia, country WA had the highest proportion of lifetime risky drinkers (24%), as of 2019? 2

Challenging Stigma Through Education

Fetal Alcohol Spectrum Disorder (FASD)
‘The Invisible Disability’ is caused by alcohol exposure during pregnancy.3

WA Department of Justice records show 21 per cent of youth detainees and 1 per cent of adult prisoners in WA had been diagnosed with FASD as of February 2023.5

These statistics are most likely incorrect as reports show inadequate screening processes for identifying disability and cognitive impairments.

As of February 2023, less than half of WA prisons have provided screening for “functional impairment”.5

Almost 90% of people with FASD do not have the commonly recognised characteristic facial features, which often means FASD goes undetected, whether it be overlooked or ignored.3

Common characteristics and behaviours of someone with FASD can include:

  • Memory issues- often resulting in telling lies.
  • Impulsivity and risk taking.
  • Learning difficulties.
  • Difficulty recognising appropriate public and private behaviours- will often not follow rules.
  • Low self-esteem and lack of social skills.
  • Isolation- often resulting in truanting from commitments, criminal behaviours, alcohol and drug use and separation from family.3

In 2018, WA had the highest prevalence of FASD in the youth justice setting worldwide (36%).4

Addiction in Australia...

Around 1 in 20 Australians disclose having an addiction or substance use challenge.8

In 2021, the cost of addiction to Australia was estimated at just over $80 billion.

The value of lost life due to addiction was estimated at just over $48 billion (retrospective) or $173.8 billion (future-focused).9

Challenging Stigma Through Education

These costs closely align to Australia’s single largest spending program in history
– JobKeeper, which cost an estimated $90 billion in 2021.9

Drugs in the Australian Healthcare System...

Challenging Stigma Through Education

In 2020-21, among all drug related hospitalisations, 15,100 presentations were for Amphetamines and other stimulants, with 82% of these for Methamphetamine (12 400 hospitalisations).6

Mental and behavioural disorders due to psychoactive substance use accounted for 26.7% of all mental health presentations to Australian public Emergency Departments in 2020-21.6

Mental Health and Alcohol and Other Drugs...

The Illicit Drug Reporting System found that in 2022, 46% of Drug Trends survey participants, who were all current injecting drug users, had experienced mental health challenges in the previous 6 months. The three most common occurrences were depression, anxiety and PTSD.10

Challenging Stigma Through Education

Alcohol and other drug use can directly affect a person’s mental health and a person’s mental health can directly affect their alcohol and other drug use.11

It is estimated that within the Australian population, more than one-third of people seeking treatment for alcohol and other drug use, have at least one co-occurring mental health issue.12

People with substance use challenges are often considered to be more responsible for their circumstances compared to people going through mental health challenges.

The belief that a substance user’s ill health or life circumstances is a result of the person’s own behaviour in isolation from mental health, can reinforce stigma and impact attitudes towards the value and appropriateness of alcohol and other drug treatment and services.13

Drug use in WA...

In 2019, Australian Institute of Health and Welfare (AIHW) data uncovered Perth people’s perceptions and attitudes towards illicit drug use.

If given $100 to spend on reducing the harms of illicit drug use, the data shows majority of people surveyed would spend $36 on education, $34 on law enforcement and $30 on treatment options.

Within this same cohort, 61% of people supported pill testing being introduced into the Perth community14

In 2020-2021, Western Australian, publicly funded alcohol and other drug treatment agencies provided treatment to 17,200 individuals, with a total of 22,245 treatment occasions.

94% of these individuals were receiving treatment for their own alcohol and other drug use, the rest were seeking treatment for someone else’s use.

Majority of individuals identified as male (64%), and 22% of individuals identified as Indigenous.

Methamphetamine was reported as the principal drug of concern (92% of all treatment episodes).15

Challenging Stigma Through Education

In Perth, Methamphetamine use has increased over the past few years, with 78% of participants in the National Drug Research Institute (NDRI) 2022 Drug Trends survey, reporting recent use. There is a continued increased trend in Crystal Methamphetamine use in Perth (77% in 2022).10

Drugs and the Law...

Over 65,000 people go through the Australian prison system each year.16

Challenging Stigma Through Education

The Australian Institute of Health and Welfare states that people who spend time in prison experience elevated levels of vulnerability and disadvantage, along with higher rates of tobacco smoking, high- risk alcohol consumption, and illicit drug use, than the general population.16

The laws surrounding illegal drugs affect all of us – people who use drugs, people who have family members or friends using drugs, health professionals seeing people for drug- related challenges, ambulance and police officers in the front line of drug harms, and all of us who live with the ongoing and large societal consequences of drug-related crime.

Drug-related offences also take up the majority of the work of police, courts and prisons.17

Drugs and the WA Justice System...

WA Department of Justice and Corrective services data shows drug use in WA prisons decreased almost 75% during the Covid-19 pandemic, when social visits were suspended. Of more than 1000 random tests carried out in May 2020, 9 results came back positive for drug use, compared to 35 positive results in February the same year.18

Challenging Stigma Through Education

The Department is required to assess prisoners for addiction treatment options within 28 days of admission into prison.

The 2017 audit shows only 11.6% of prisoners were assessed during this time, with the majority having to wait 70 to 100 days.

This delays treatment and often results in prisoners being released before a placement becomes available to complete the therapeutic program.

The audit concluded: “Opportunities to help prisoners reduce the harm from dangerous practices are being missed.” 21

In 2019-2020, Australian Federal Police data revealed almost 9000 cannabis related arrests were made and 1538 Cannabis Intervention Requirements were issued, in WA Drug-related offences also take up the majority of the work of police, courts and prisons.19

Challenging Stigma Through Education

‘Illicit drugs’ is the biggest category for sentencing among WA adult prisoners, with almost 1000 adults sentenced every year between 2017-2020 under this category20

A government led audit of the Department of Justice in 2017, found that since 2010, the number of programs available to address addiction-based offending has decreased from 4 to 1.

This single therapeutic program is unlikely to meet the cultural, educational, and gender specific needs of all prisoners, leading to poorer outcomes21

In 88.5% of parole cases, failure to complete a treatment program due to inadequate assessment processes, was a contributing reason for being denied parole. Denial of parole leads to additional prison time and increased costs to the State.21

Failure to address alcohol and substance use challenges whilst in prison, can lead to reoffending.21

Opioid Dependence...

Studies suggest that of the 2.2 million Australians who undergo surgery every year, more than 13,000 of them may become persistent opioid users.22

Challenging Stigma Through Education

Opioid prescriptions given after surgery lead to long term use of opioids in a relatively small percentage of that population. However, given the large number of surgical procedures that occur, this means that a large number of people in the population are affected22

The availability of opioids for analgesic and surgical reasons, varies substantially across the globe. Countries that have much higher prescribing rates for opioids have greater ratesof non-medical use and opioid overdose deaths.

Australia is one of these countries23

The most frequently prescribed opioids post-discharge from surgery is Oxycodone, followed by Codeine with Paracetamol, Tramadol, and Oxycodone with Naloxone24

Prescription drug dependence in Australia, is increasing25

The type of drugs in focus changes over time depending on availability.

Legislative changes by governments and marketing decisions by pharmaceutical companies are the two factors that can alter availability and perceptions about particular drugs27

Challenging Stigma Through Education

This is where scheduling of particular drugs becomes important- for example, Schedule 4 medications are classified as prescription only,
whereas a Schedule 8 drug is classified as a controlled drug, meaning it is more difficult to be prescribed and has been shown to result in a decrease of use28

In 2023, Psilocybin and
MDMA (substance commonly used in Ecstasy), were re-scheduled from Schedule 9 (prohibited substances) to Schedule 8 (controlled drugs), enabling therapeutic use in a controlled medical setting30

In 2018, all products containing Codeine were up-scheduled from over- the-counter drugs to become prescription only (Schedule 4) medicines29

Alcohol and Other Drugs among Aboriginal and Torres Strait Islander People

2019 Australia wide statistics show more than one-quarter (28%) of Aboriginal and Torres Strait Islander people aged 15 years and over had used substances for non-medical purposes over the past year.

This was near consistent between remote (27%) and non-remote (29%) areas and was higher among young people aged 15-29 years (33%) and 30 – 44 years (31%) compared to those aged 45 and over (21%) 31.

In 2018, illicit drug use was the fourth highest contributor (6.9%) to the total burden of disease among Aboriginal and Torres Strait Islander people.

Among illicit drug use risk factors, the largest contributors to the burden of disease were Opioid use, Amphetamine use and Cannabis use, respectively 6.

Challenging Stigma Through Education

The most commonly used drug among the Indigenous population in 2018-19, was Cannabis, with 24% of Aboriginal and Torres Strait Islander people having reported using the substance over the previous year 31.

It is estimated that the burden of disease associated with alcohol misuse among Indigenous people is almost double that of the non-Indigenous population 2.

Alcohol related death rates were between 5 to 19 times higher for Indigenous people than for non Indigenous people, in Western Australia 32.

In 2022, over 40% of WA prisoners identified as Aboriginal and Torres Strait Islander.

This is the highest percentage since 2013, with majority of prisoners in this group aged between 25-34 years 33.

In 2022, Western Australia had the third largest amount of illicit drug offences (60) among Aboriginal and Torres Strait Islander prisoners out of the whole of Australia 33.

References

1) WA’s hidden crisis: Harm from alcohol. Cancer Council Western Australia, WA Network of Alcohol and other Drug Agencies, Alcohol and Drug Foundation and Telethon Kids Institute; Perth, WA. May 2022. Available at: https://cancerwa.asn.au/wp-content/uploads/2022/08/2022-06-WAs-Hidden-Crisis-Harm-from-alcohol-FINAL.pdf

2) The Australian Institute of Health and Welfare (AIHW) 2019, National Drug Strategy Household Survey. Available at: https://www.aihw.gov.au/getmedia/5de2b48f-a738-4fbc-8634-1b49eb926ab8/aihw-phe-270-Chapter7-Geographic.pdf.aspx.

3) Anon, (n.d.). FASD FAQs – Fetal Alcohol Spectrum Disorder FAQs. Available at: https://www.nofasd.org.au/fasd-faq/

4) Bower, C., Watkins, R.E., Mutch, R.C., Marriott, R., Freeman, J., Kippin, N.R., Safe, B., Pestell, C., Cheung, C.S.C., Shield, H., Tarratt, L., Springall, A., Taylor, J., Walker, N., Argiro, E., Leitão, S., Hamilton, S., Condon, C., Passmore, H.M. and Giglia, R. (2018). Fetal alcohol spectrum disorder and youth justice: a prevalence study among young people sentenced to detention in Western Australia. BMJ Open, 8(2), p.e019605. doi: https://doi.org/10.1136/bmjopen-2017-019605

5) She raised three kids on her own because her husband was in prison. A diagnosis changed that. (2023). ABC News. 25 Feb. Available at: https://www.abc.net.au/news/2023-02-26/prison-fasd-disability-screening-banksia-hill-geoffrey-taylor/101999476

6) Australian Institute of Health and Welfare (AIHW) 2023, Alcohol, tobacco & other drugs in Australia. Available at: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia

7) Australian Institute of Health and Welfare (AIHW) 2023, Mental Health. Available at: https://www.aihw.gov.au/mental-health/topic-areas/emergency-departments#data-source

8) Health direct (2019). Substance abuse. Available at: https://www.healthdirect.gov.au/substance-abuse

9) Rethink Addiction and KPMG, Understanding the Cost of Addiction in Australia (2022). Rethink Addiction, Richmond, Victoria. Available at https://indd.adobe.com/view/publication/c8bdf583-cb36-4c16-bf79-e8730aa04a1c/qkli/publication-web-resources/pdf/Cost_of_addiction_design.pdf

10) Agramunt, S. and Lenton, S. (2022). Western Australian Drug Trends 2022: Key Findings from the Illicit Drug Reporting System (IDRS) Interviews. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney. DOI: 10.26190/tz6s-je20. Available at: https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/WA_IDRS_2022_Report_0.pdf

11) World Mental Health Day: The impact of alcohol and other drugs – Alcohol and Drug Foundation. (2020). Available at: https://adf.org.au/insights/world-mental-health-day/

12) Comorbidity Guidelines (n.d.). Management of co-occurring, or comorbid, AOD and mental health. Available at: https://comorbidityguidelines.org.au/in-a-nutshell

13) Ending Discrimination Against People with Mental and Substance Use Disorders: The Evidence for Stigma Change (2016). Available at: https://nap.nationalacademies.org/read/23442/chapter/4

14) Australian Institute of Health and Welfare (AIHW) 2022, Australia’s attitudes and perceptions towards drugs by region. Available at: https://www.aihw.gov.au/reports/illicit-use-of-drugs/australias-attitudes-and-perceptions-towards-drugs/contents/interactive-data-map

15) Australian Institute of Health and Welfare (AIHW) 2022, Alcohol and other drug treatment services in Australia annual report. Available at: https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia/contents/state-and-territory-summaries/western-australia

16) Australian Institute of Health and Welfare (AIHW) 2022, Health of Prisoners. Available at: https://www.aihw.gov.au/reports/australias-health/health-of-prisoners

17) Ritter, A. (2019). Decriminalisation or legalisation: injecting evidence in the drug law reform debate. National Drug and Alcohol Research Centre. UNSW. Sydney. Available at: https://ndarc.med.unsw.edu.au/blog/decriminalisation-or-legalisation-injecting-evidence-drug-law-reform-debate

18) Drug use at WA prisons declines after suspension of social visits during COVID-19. (2020). ABC News. 25 Jun. Available at: https://www.abc.net.au/news/2020-06-25/illicit-drug-use-in-wa-prisons-drops-during-covid/12393100?utm_campaign=abc_news_web&utm_content=link&utm_medium=content_shared&utm_source=abc_news_web

19) Illicit Drug Data Report 2019-20. (2021). Australia: Australian Criminal Intelligence Commission (ACIC). Available at: https://www.acic.gov.au/sites/default/files/2021-10/IDDR%202019-20_271021_Full_0.pdf

20) Quarterly Statistics – Custodial (Adult Prisoner) 2020 – Quarter 4. (2021). Australia: Government of Western Australia Department of Justice and Corrective Services. Available at: https://www.wa.gov.au/system/files/2021-12/2020-quarter4-adult-custodial.pdf

21) Minimising Drugs and Alcohol in Prisons. (2017). Western Australia: Office of the Auditor General. Available at: https://audit.wa.gov.au/reports-and-publications/reports/minimising-drugs-alcohol-prisons/key-findings/addiction-treatment-needs-not-met-harm-reduction-program-not-delivered/

22) Roughead EE, Lim R, Ramsay E, et al. Persistence with opioids post discharge from hospitalisation for surgery in Australian adults: a retrospective cohort studyBMJ Open 2019;9:e023990. doi: 10.1136/bmjopen-2018-023990. Available at: https://bmjopen.bmj.com/content/9/4/e023990.info

23) Nilsson, U., Amirpour, A. (2023). That’s How We Like to Do it–The Over Prescription of Narcotic Pain Medication After Discharge. Journal of Perianesthesia Nursing. Available at: https://doi.org/10.1016/j.jopan.2022.10.005

24) Dery, M. (2019). Study reveals risk of opioid dependence following surgery. Australian Pharmacist. Available at: https://www.australianpharmacist.com.au/

25) Australian Institute of Health and Welfare (AIHW) 2023, Illicit Drug Use. Available at: https://www.aihw.gov.au/reports/illicit-use-of-drugs/illicit-drug-use

26) Ree, E. (2018). The Benzodiazepine Toolkit. Victoria: Reconnexion. Available at: https://uploads-ssl.webflow.com/5aced27ea8e8388044acab17/5ca5aa7876bfccbcc79cba1d_Benzo%20Toolkit%20Booklet%20web4.pdf

27) Monheit, B., Pietrzak, D. and Hocking, S. (2016). Prescription drug abuse – A timely update Patterns of abuse. FOCUS 862 REPRINTED FROM AFP, [online] 45(12). Available at: https://www.racgp.org.au/getattachment/ff54476c-040c-4b46-a1ac-554bea955e66/Prescription-drug-abuse-A-timely-update.aspx

28) Therapeutic Goods Administration (TGA). (2022). Scheduling basics of medicines and chemicals in Australia. Available at: https://www.tga.gov.au/scheduling-basics-medicines-and-chemicals-australia

29) Therapeutic Goods Administration (TGA). (2018). Codeine information hub. Available at https://www.tga.gov.au/news/news/codeine-information-hub

30) Therapeutic Goods Administration (TGA). (2023). Change to classification of psilocybin and MDMA to enable prescribing by authorised psychiatrists. Available at https://www.tga.gov.au/news/media-releases/change-classification-psilocybin-and-mdma-enable-prescribing-authorised-psychiatrists

31) National Aboriginal and Torres Strait Islander Health Survey, 2018-19. (2019). Australian Bureau of Statistics. Available at: https://www.abs.gov.au/statistics/people/aboriginal-and-torres-strait-islander-peoples/national-aboriginal-and-torres-strait-islander-health-survey/latest-release#substance-use

32) Wilson M, Stearne A, Gray D, Sherry S. (2010). The harmful use of alcohol amongst Indigenous Australians. Australian Indigenous HealthInfoNet. Available at https://espace.curtin.edu.au/bitstream/handle/20.500.11937/34089/159785_26126_WilsonHarmfulUseAIHIN.pdf?sequence=2

33) Prisoners in Australia, 2019. (2021). Australian Bureau of Statistics. Available at: https://www.abs.gov.au/statistics/people/crime-and-justice/prisoners-australia/latest-release

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