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Substance abuse needs mature policy approach

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The AMA has called on the Federal Government to treat substance abuse and other behavioural addiction problems within the community as a high-level priority to address.

Substance dependence and behavioural addictions are chronic brain diseases and people affected by them should be treated like any other patient with a serious illness.

AMA President Dr Michael Gannon said while the Government responded quickly to concerns about crystal methamphetamine use, with the National Ice Action Strategy, broader drug policy appears to be a lower priority.

“I don’t think we need to underestimate the cancer in our society that methamphetamine causes. It’s destroying lives, it’s destroying communities, it’s destroying families,” Dr Gannon said.

“But we can acknowledge that and at the same time reflect on the carnage that legal drugs still cause.

“Twelve per cent of Australians are still smoking. It’s the only habit that kills over half of its regular users and certainly impairs the health of the remainder.

“And alcohol; it’s a difficult conversation. So many of us enjoy a drink. Not many of us would think that we are problem drinkers. But if you look at how deeply inculcated in our society drinking alcohol is, you start to get an idea about the potential harm it causes.”

Given the consequences of substance dependence and behavioural addictions, the AMA believes it is time for a mature and open discussion about policies and responses that reduce consumption, and that also prevent and reduce the harms associated with drug use and control.

“Services for people with substance dependence and behavioural addiction are severely under-resourced. Being able to access treatment at the right time is vital, yet the demand for services outweighs availability in most instances,” Dr Gannon said.

“Waiting for extended periods of time to access treatment can reduce an individual’s motivation to engage in treatment.”

Substance abuse is widespread in Australia. Almost one in seven Australians over the age of 14 have used an illicit substance in the past 12 months, and about the same number report drinking 11 or more standard alcoholic drinks in a single session.

Substance use does not inevitably lead to dependence or addiction. A patient’s progression can be influenced by many things, such as genetic and biological factors, the age at which the use first started, psychological history, family and peer dynamics, stress, and access to support.

The AMA recently released its Harmful Substance Use, Dependence, and Behavioural Addiction (Addiction) 2017 Position Statement, pointing outthat dependence and addiction often led to death or disability in patients, yet support and treatment services were severely under-resourced.

The costs of untreated dependence and addictions are staggering. Alcohol-related harm alone is estimated to cost $36 billion a year.

Those affected by dependence and addictions are more likely to have physical and mental health concerns, and their finances, careers, education, and personal relationships can be severely disrupted.

Left unaddressed, the broader community impacts include reduced employment and productivity, increased health care costs, reliance on social welfare, increased criminal activity, and higher rates of incarceration.

About one in 10 people in Australian jails is there because of a drug-related crime.

Dr Gannon said the Government’s updated National Drug Strategy was disappointing because no additional funding had been allocated to it, meaning that measures requiring funding support were unlikely to occur in the short to medium term.

“The recently-released National Drug Strategy 2017-2026 again lists methamphetamine as the highest priority substance for Australia, despite the Strategy noting that only 1.4 per cent of Australians over the age of 14 had ever tried the drug,” he said.

“The Strategy also notes that alcohol is associated with 5,000 deaths and more than 150,000 hospitalisations each year, yet the Strategy puts it as a lower priority than ice.”

Dr Gannon called on the Government to focus on the dependencies and addictions that cause the greatest harm, including alcohol, regardless of whether some substances are more socially acceptable than others.

“General practitioners are a highly trusted source of advice, and they play an important role in the prevention, detection, and management of substance dependence and behavioural addictions,” he said.

“Unfortunately, limited access to suitable treatment can undermine GPs’ efforts in these areas.”

Behavioural addictions also include pathological gambling, compulsive buying, and being addicted to exercise or the internet.

Like substance dependence, they are recognised as chronic diseases of the brain’s reward, motivation, memory, and related circuitry.

Go to:  position-statement/harmful-substance-use-dependence-and-behavioural-addiction-addiction-2017 to read the full Position Statement.