Address to the 5th National Indigenous Drug and Alcohol Conference
6 November 2018
Good morning. In West Australian Noongar language I say “kaya wangju” – hello and welcome.
I acknowledge the traditional custodians of the land on which we’re meeting, the Kaurna people, and pay my respects to Elders past and present.
The 5th National Indigenous Drug and Alcohol Conference is a positive opportunity to make progress on a difficult issue.
The conference theme is Responding to Complexity – and there certainly is no one-size-fits-all solution to the challenges our people face.
This is why we have to attack the scourge of drug and alcohol dependency and abuse on multiple fronts.
To form new partnerships.
To speak and to listen, with open minds and hearts.
All of us want to see better health for First Nations Australians.
We know that the excessive consumption of drugs and alcohol is associated with health problems in all societies.
It has been linked to chronic conditions such as cancer and liver disease, the spread of hepatitis and HIV, injuries and deaths from motor vehicle accidents and assaults, increased encounters with the law, deaths in custody, suicides and family breakdown.
The reasons why First Nations’ people engage in high risk drug and alcohol consumption are indeed, complex.
Working together, we are making progress, reducing binge drinking rates among our people from 38 per cent to 31 per cent between 2008 and 2014–15.
But there is still much work to be done.
As we see in the Aboriginal and Torres Strait Islander Health Performance Framework report, social determinants are estimated to make up 34 per cent of the gap in health outcomes between First Nations’ people and other Australians.
Together, with behavioural risk factors, such as alcohol, drug and tobacco use, they account for 53.2 per cent of the health gap.
Alcohol and drug abuse has a broad and insidious impact.
We have a moral and social imperative to work together to put an end to violence and dysfunction and the drug- and alcohol-driven neglect of children in our communities.
Our Government is committed to working with families and individuals to address substance misuse and to break the cycle of disadvantage that prevents children from attending school, and adults from going to work.
Particularly for the protection of children, we have invested over $10 million to provide better diagnosis and management, develop best practice interventions and services to support high-risk women.
A 10-year FASD Strategic Action Plan is in the final stage of development.
Just as important, we see outstanding examples of local warriors for health – like June Oscar and her team in Fitzroy Crossing – who have tackled alcohol in their communities, with life-changing results for children and families.
We must try harder to understand and address the underlying causes of alcohol and drug misuse.
The percentage of First Nations’ people who drink is no greater than for other Australians – in fact, there are many of our people who do not drink at all.
Equally, the impacts of trauma on the health of our communities cannot be ignored, because they add to the complexity of the challenge.
Trauma is no excuse for substance abuse, violence or neglect – but understanding its history can help us reduce its impact.
It reaches across generations of Aboriginal and Torres Strait Islander people, and must be acknowledged and addressed.
Significant health impacts have resulted from displacement from family and country, institutionalisation, racism, abuse and neglect.
This has led to increasingly high rates of incarceration and juvenile detention, suicide, family violence, children being taken into care, and poorer physical and mental health.
63 per cent of First Nations’ prisoners are incarcerated as a result of violent crimes and offences that cause harm.
First Nations’ offenders are also more likely to be under the influence of alcohol when they offend.
It’s a sad fact, that alcohol was involved in 80 per cent of cases of domestic homicide, where both the offender and the victim were First Nations’ people.
That’s more than three times the level of domestic homicides involving other Australians.
It’s also known that First Nations people who engage in alcohol-related crime are themselves more likely to be the victims of such offences.
The question is, how do we reduce high-risk levels of alcohol consumption?
Harm reduction programs can minimise the immediate danger posed by alcohol misuse; but our broader aim should be to reduce alcohol intake.
Our Government is investing in a series of activities which have been shown to be effective.
These range from alcohol restrictions to treatment and rehabilitation.
Under the Indigenous Advancement Strategy, the Government has committed around $70 million in 2017–18 to support over 80 Indigenous alcohol and other drug treatment services.
They are located in places with high First Nations’ populations, in capital cities and regional centres as well as outer regional and remote areas.
Alcohol is a particular problem in the Northern Territory.
Our Government recognises this and is providing more than $91 million over seven years for targeted local action to reduce alcohol related harm.
A significant part of our national support to reduce risk also includes primary healthcare and population health programs addressing smoking and alcohol, in urban, regional and remote locations across Australia.
Poor mental health as a result of drug and alcohol problems is a huge issue and one which I am pleased will be addressed during this important conference.
It is equally high on our Government’s agenda.
The Australian Health Ministers’ Advisory Council recently endorsed the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023.
The council has prioritised development of a national Indigenous Health and Medical Workforce Plan, which aims to increase the number of Aboriginal doctors, nurses and health workers on country and in our towns and cities.
Primary Health Networks across Australia also have mental health and Aboriginal and Torres Strait Islander health among their priorities.
I am very keen to ensure Primary Health Networks provide a strong platform for culturally comfortable drug, alcohol and mental health services.
To that end, we have targeted more than $85 million to improve access for integrated, culturally appropriate and safe mental health services for First Nations people.
Our Primary Health Networks are also currently investing a further $79 million on the provision of alcohol and other drug services specifically designed to meet the needs of First Nations people, at the local level.
While the effects of alcohol and drugs can be dire, the insidious damage caused by tobacco is significant.
Statistics show that smoking is responsible for 23 per cent of the gap in health outcomes between First Nations’ people and other Australians.
That is why reducing smoking rates among Aboriginal and Torres Strait Islander people is central to our efforts to close the gap.
By supporting locally linked projects within a national campaign, we are seeing some success.
The daily smoking rate for First Nations’ people aged 15 years and over has declined from 49 per cent in 2002 to 39 per cent in 2014–15, with most of this since 2008, when targeted measures commenced.
However, the daily smoking rate in remote areas is still 47 per cent, and worryingly, the number of First Nations’ women smoking while pregnant remains far too high, at 46 per cent.
To continue supporting change for the better - through funding certainty and proven programs - we have gone to a four-year, $300 million funding commitment for the successful Tackling Indigenous Smoking program.
We are supporting Aboriginal and Torres Strait Islander specific education programs, as part of the National Tobacco Campaign.
“Don’t Make Smokes Your Story” targets First Nations’ smokers aged 15 years and over.
Since its third phase concluded at the end of June, evaluation has shown its effectiveness.
86 per cent of First Nations smokers were aware of the campaign.
7 per cent had quit and 26 per cent said they had reduced the amount they smoke.
If we can maintain this sort of momentum, I am we will see significant improvements in health in future.
We have also had significant success in reducing petrol sniffing, which can cause brain damage and even death.
Independent research undertaken since 2005 indicates that in communities with low aromatic fuel, petrol sniffing has dropped by 88 per cent.
Low aromatic fuel, subsidised by the Government, has now replaced regular unleaded in around 175 outlets in the Northern Territory, Queensland, Western Australia and South Australia.
There were special factors related to petrol sniffing which make it impractical to apply the same approach to alcohol and drug misuse.
But there is one big lesson from that success.
When families, communities, local organisations and governments join hands, we are powerful together.
Alcohol and other drugs, tobacco, lifestyle risk factors and social determinants represent more than half of the quest for health and life equality.
It’s now been 10 years since the launch of the Closing the Gap initiative.
The agenda is being refreshed and it’s time to refresh our approach – including by acknowledging the complexity of the drug and alcohol challenge and making even greater efforts to address it.
This conference will be an important part of that solution - and I look forward to hearing the outcomes.