Matters of Interest

Drug and Alcohol Treatment Services

The Hon. D.G.E. HOOD (15:20): Alcohol and drug use have major health implications for Australians, and South Australians of course, and are associated with many physical and social harms, including mental illness, injury, addiction, chronic disease and premature death. People living in rural areas—approximately 28 per cent of our population—often have worse outcomes, unfortunately, compared with people living in metropolitan areas. This can be due to several factors, including educational achievement, higher unemployment and less access to sufficient health services, a significant concern for this government.

The federal government's Australian Institute of Health and Welfare recently examined evidence indicating that people living in rural and remote areas were more likely than those living in urban environments to have used illicit drugs and to have consumed alcohol at what are deemed unsafe levels. Problematic alcohol and drug use often results in people requiring treatment. However, for people living in rural Australia, access to alcohol and other drug treatment agencies is more difficult than it is for those dwelling in urban areas, with only 7 per cent of existing services located within rural and remote areas, despite those areas having some 28 per cent of our population.

The Australian government's 2017-2026 National Drug Strategy recognises this as a significant issue, identifying the need to provide access to effective and affordable treatment and support services for the whole population. The National Drug Strategy has also identified Indigenous Australians as a priority population, due to the level of harm suffered from alcohol and drug use.

It is important to identify trends in alcohol and other drug use, in particular illicit drugs, in regional and remote Australia, as I am attempting to do today, because this enables better planning, with a primary focus on treatment and variation in treatment types and recovery rates. Available geographic data reflecting consumptions and harms highlights the disparity of consumption patterns, impacts and treatment services in major cities compared to regional areas for alcohol and other drugs.

Whilst recent data indicates the consumption of illicit drugs, such as cocaine and ecstasy, is similar in urban and regional areas, the incidence of cannabis use is highest in the more remote parts of Australia. Data from the National Wastewater Drug Monitoring Program also shows a higher prevalence of opioids, such as oxycodone and fentanyl, in regional areas as well.

Alcohol remains the most common cause of hospitalisations, and is the highest for people residing in rural and remote areas—not surprising, given that it is the most commonly used. Regardless of where a person resides, the rate of alcohol-related hospitalisations is significantly higher than for other drugs, such as methamphetamines, opioids, cannabis and other sedatives and hypnotics—again not surprising, given the prevalence of its use.

Consumption of illicit drugs in general is significantly higher in rural regions compared to major cities. In particular, for any illicit drug it is 25 per cent compared with 15 per cent, and for cannabis it is 17 per cent compared with 10 per cent. Alarmingly, over the past decade, the rate of drug-induced deaths has increased at a faster rate in regional Australia, up 41 per cent since 2008, compared with just 16 per cent—I say just, but still—in major cities. That is 41 per cent compared with 16 per cent.

There has been a stark increase in the rate of deaths involving opioids in regional and remote areas as well. The rate of drug-induced death for any opioid, excluding heroin, is significantly higher in regional and remote areas—four deaths per 100,000 population—than in urban areas, where the figure is 3.3 deaths per 100,000 population.

Overall, illicit drug use is estimated to cost the Australian economy some $8 billion annually through healthcare costs, productivity losses and associated crime. It is also responsible for some 2 per cent of the burden of disease and injury in Australia—not insignificant. Nationally in 2016-17, agencies in remote areas had the highest rates of clients who sought or required treatment, almost 1,300 clients per 100,000 population.

The Australian Institute of Health and Welfare 2016-17 data indicated that clients who sought services in regional and remote areas were more likely than those in major cities to travel one hour or longer to reach these services, creating somewhat of a disincentive. Of course, differences in travel times and distances partly reflect the availability of services in regional Australia, and this pattern is the same across the most common principal drugs of concern and the main treatment types.

The key point from all of this—and I have much more data to give, which I will give in future contributions—is that our regions are under-serviced with respect to services for dealing with addictions, particularly with illicit substances. We are not well served in the City of Adelaide as a general rule for such treatment services, but our friends in rural and regional areas fare even worse. In my view, this is something that very clearly needs to be addressed in the short term and certainly in the medium to longer term.