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Managing legal and medical complexities in caring for people with drug and alcohol problems: a call for change

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How can we respond more effectively?

The current “ice (crystal methamphetamine) epidemic” has thrown into relief long-standing dilemmas for front-line practitioners dealing with the burden of care associated with drug and alcohol misuse in the face of legal complexity and insufficient support from the health system and other government agencies. Despite increasing investment in border protection and law enforcement, the Australian Crime Commission has been reporting growth in the importation, manufacture and supply of crystalline methamphetamine of increasing purity, leading to the establishment of the National Ice Taskforce.1 Concurrently, medical and public health bodies (including the Australian Medical Association, Public Health Association of Australia, and South Australian Network of Drug and Alcohol Services) are reporting under-resourcing of measures to reduce drug demand and to provide early intervention, treatment and rehabilitation in the community.2 The issues for clinicians are not new, and the views of the medical profession need to be strongly heard, so as to achieve rational, health-based policies in response to the ice epidemic and other drug problems, and to manage the problems associated with drug and alcohol misuse, particularly mental health issues.

Historically, in the first half of the 20th century, the predominant concern in…