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The case for developing more effective approaches to alcohol and drug problems

The case for developing more effective approaches to alcohol and drug problems. Probation and Community Corrections Officers Conference Dr Alex Wodak AM St. Vincent’s Hospital awodak@stvincents.com.au 27 October 2011. Topics:. Scale current problems Current policy settings

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The case for developing more effective approaches to alcohol and drug problems

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  1. The case for developing more effective approaches to alcohol and drug problems Probation and Community Corrections Officers Conference Dr Alex Wodak AM St. Vincent’s Hospital awodak@stvincents.com.au 27 October 2011

  2. Topics: • Scale current problems • Current policy settings • Barriers to improvement • Forces for change • Overcoming barriers • Conclusions

  3. Scale current problems: • Almost every family experience • Sense despair, hopelessness • Often identified as major problem • High health, social, economic costs • Major impact alcohol, tobacco on ‘the gap’ • Consumption alcohol rising ? • Increasing binge drinking among young • Prescription opioids

  4. Scale current problems: • 37 murders Victoria linked meth • Major official corruption

  5. Current policy settings: • Tobacco • Big recent drop smoking rates • More action recently: price, packaging • But now ‘islands’ 1960s prevalence • Ban smoking prisons?

  6. Current policy settings: • Alcohol • Tax chaos • Very liberal availability • Restrictions undermined competition • Advertising, marketing unregulated • Drinks industry omnipotent, gets its way 100% • Parties intimidated • Community powerless

  7. Current policy settings: • Prescription drugs • Increasing consumption SR opioids 20 years • Following US, Canadian trends • US serious harms from 2000 • Mainly chronic non-cancer pain • Also benzodiazepines – insidious

  8. Current policy settings: • Illicit drugs • Framed as criminal justice problem • Rhetoric, funding follows • Ineffective, counterproductive, expensive • Difficult identify benefits • Works well politically

  9. Barriers to improvement: • Tobacco • Major progress over long time • Shows progress is possible • Tobacco industry tamed • Decrease smoking disadvantaged

  10. Barriers to improvement: • Alcohol • Drinks industry too powerful • Newspapers afraid • Excessive concentration newspaper owner • TV, radio lives off newspapers

  11. Barriers to improvement: • Prescription drugs • Messy – DoHA, states, territories • Whose responsible? • Multiple interventions needed

  12. Barriers to improvement: • Illicits • What works isn’t popular, what’s popular doesn’t work • Fear vs evidence

  13. Forces for change: • Alcohol • Rising community concern alcohol • NAAA • Global action – WHO

  14. Forces for change: • Illicit drugs • Growing recognition failure War on Drugs • Global Commission Drug Policy • UN Commission HIV, Law • Sovereign debt crisis USA, W Europe • New models e.g. Portugal • Crisis prisons USA • Mexico • Changing community attitudes, internet

  15. Overcoming barriers: • Funding flowing to drug law reform • New drug law reform organisations • LEAP

  16. Conclusions: • Exciting time • Change starting drug law reform • Pressure building effective response alcohol • Also action SR opioids • Benzodiazepines • Harm reduction debate over • Drug law reform debate following

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