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Aboriginal substance abuse

One of the most provocative papers at the recent APSAD (Australian Professional Society on Alcohol and Other Drugs) Conference was given by Don Weatherburn, director of the NSW Bureau of Crime Statistics and Research. In it he argued that the high arrest rates of Australian aboriginals were not due to their social disadvantage but primarily directly to substance abuse. Most aboriginal arrests are for drunkenness.

Weatherburn argued particularly for the need to control alcohol intake not by denying the blackfella access to booze but by encouraging local communities who sought to control supply. The paper was obviously influenced by Noel Pearson’s thinking on this issue – Pearson has written a broadly favourable response here.

A couple of points about substance abuse among aboriginals: While there are rising levels of illicit drug consumption (mainly marijuana but also heroin and amphetamines) there are very significant problems with licit drug abuse. Cigarette smoking and alcohol consumption are responsible for much higher mortality than among non-aboriginal populations. Many aboriginals, particularly women, do not drink at all but those who do drink tend to consume at hazardous levels. Rates of cigarette smoking among aboriginals are about twice those of non-aboriginals.

Volumetric tax reforms on alcohol that target alcohol content rather than product value are likely to fall heavily on poor aboriginals for whom cheap cask wine is a major source of alcohol. They may also create incentives to switch toward the use of more damaging illicit drug substitutes such as solvents. This limits the usefulness of general tax measures.

That alcohol is a neurotoxin and that it poses serious health risks might be a difficult message to sell to people who have lost their lands and have been left in an extremely difficult situation. But the effort needs to be made.

Health workers have often stated that cigarette smoking is a relatively minor concern in aboriginal communities given other pressing concerns but this isn’t true. Cigarettes are an expensive habit that impoverishes poor people on a daily basis. But more importantly it reduces life span and this is an important consideration given the persistent major health inequalities that exist between indigenous populations and the non-indigenous – aborigines born after 1996 are expected to live about 20 years less. Reducing smoking to even non-indigenous levels would make inroads into this disparity.

Some form of community-generated restrictions on consumption of licit drugs like nicotine and alcohol are one of the most direct ways of improving aboriginal health. They might have greater impact than targeting more nebulous issues of social disadvantage. Of course, in addition, the full range of legal and other policies for controlling consumption of illicit drugs makes sense. Its an issue I’ll try to look into further.

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