Drug Use Among Aboriginal And Torres Strait Islander
Drug use among Aboriginal andTorres Strait Islander peoplesAn assessment of data sources
The Australian Institute of Health and Welfare is Australia’s national health and welfarestatistics and information agency. The Institute’s mission is better health and wellbeing forAustralians through better health and welfare statistics and information.Please note that as with all statistical reports there is the potential for minor revisions ofdata in Drug use among Aboriginal and Torres Strait Islander peoples: an assessment of datasources. Please refer to the online version at www.aihw.gov.au .
DRUG STATISTICS SERIESNumber 17Drug use among Aboriginaland Torres Strait IslanderpeoplesAn assessment of data sourcesOctober 2006Australian Institute of Health and WelfareCanberraAIHW cat. no. PHE 76
Australian Institute of Health and Welfare 2006This work is copyright. Apart from any use as permitted under the Copyright Act 1968, nopart may be reproduced without prior written permission from the Australian Institute ofHealth and Welfare. Requests and enquiries concerning reproduction and rights should bedirected to the Head, Business Promotion and Media Unit, Australian Institute of Health andWelfare, GPO Box 570, Canberra ACT 2601.This publication is part of the Australian Institute of Health and Welfare’s Drug StatisticsSeries. A complete list of the Institute’s publications is available from the Business Promotionand Media Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT2601, or via the Institute’s website http://www.aihw.gov.au .ISSN 1442–7230ISBN 1 74024 608 XSuggested citationAustralian Institute of Health and Welfare 2006. Drug use among Aboriginal and TorresStrait Islander peoples: an assessment of data sources. Drug statistics series no. 17. Cat. no.PHE 76. Canberra: AIHW.Australian Institute of Health and WelfareBoard ChairHon. Peter Collins, AM, QCDirectorPenny AllbonAny enquiries about or comments on this publication should be directed to:Louise YorkAustralian Institute of Health and WelfareGPO Box 570Canberra ACT 2601Phone: (02) 6244 1271Published by Australian Institute of Health and WelfarePrinted by Pirion, Canberra
ContentsAcknowledgments . viiAbbreviations.viiiSummary .11234Introduction .51.1Purpose of the project .51.2Project methodology, analytical framework and report structure .6Background: summary of literature review .92.1Tobacco, alcohol and other drug use .92.2Associated harms.102.3Context and influences .102.4Intervention and treatment services .112.5Resources .122.6National drug strategies .13Stakeholder workshop.143.1Workshop background .143.2Workshop discussion and proposals.14What are the priority information areas? .204.156What are the key questions? .20What information is already available? .225.1Key data sources .225.2Describing key data sources .255.3Comparability of key data sources in terms of methodology: scope, coverage,timing and collection counts.285.4Comparability of key data sources in terms of data items .32To what extent can existing data sources answer key questions? .536.1Introduction.536.2Tobacco, alcohol and other drug use and associated risk behaviours.556.3Context and influences .606.4Associated harms and health status .666.5Intervention and treatment services .686.6Resources .696.7Summary.70v
7What are the information gaps and how do we fill them? .737.1Introduction.737.2Priority information needs and the main information gaps .747.3Options for improvement and better use of existing sources .77Appendix 1: Literature review and policy context.85Appendix 2: Stakeholder workshop.124Appendix 3: Comparative analysis of key data sources .135References.163List of tables .172vi
AcknowledgmentsThe authors of this report were Louise York, Chrysanthe Psychogios, Samantha Bricknell,and Ros Madden from the Australian Institute of Health and Welfare (AIHW). Fatima GhaniGonzalo from the AIHW provided invaluable assistance in preparing and completing thedata source summaries. Ros Madden (then Head, Functioning and Disability Unit) alsoprovided leadership and advice on the report content and directions. Louise York andChrysanthe Psychogios managed the project.Other members of the AIHW project team providing input were Fadwa Al-Yaman (Head,Aboriginal and Torres Strait Islander Health and Welfare Unit), Mark Cooper-Stanbury(Head, Population Health Data and Information Services Unit), Ken Tallis (Acting DeputyDirector) and Paul Magnus (Acting Head, Health and Functioning Group).Special thanks to those providing additional expert advice throughout the project and tothose who attended and participated in the project workshop (listed in Appendix 2).We appreciate the efforts of all data custodians who provided input into the data sourcessummaries.Thanks also to the Australian Government Department of Health and Ageing which fundedthe project on behalf of the Ministerial Council on Drug Strategy.vii
DRS–PDIIDUIGCDKHLSLDSLSACAustralian Bureau of StatisticsAustralian Institute of CriminologyAustralian Institute of Health and WelfareAustralian Longitudinal Study on Women’s HealthAlcohol and Other Drug Treatment Services National MinimumData SetAustralian Standard Geographic ClassificationAustralian Schools Students Alcohol and other Drug SurveyBettering the Evaluation and Care of Health survey of generalpractice activityBrief Treatment Outcome Measure–ConciseComputer-assisted telephone interviewCentral Australian Youth Link-Up Service Inhalant Substance MisuseDatabaseCommonwealth–State/Territory Disability Agreement NationalMinimum Data SetDrug and Alcohol Services Report—annual data collected fromAustralian Government funded Aboriginal and Torres Strait Islandersubstance use specific servicesAustralian Government Department of Health and AgeingDrug Use Careers of OffendersAustralian Government Department of Veterans’ AffairsDrug Use Monitoring in AustraliaAustralian Government Department of Families,Community Services and Indigenous AffairsGeneral Customer SurveyGeneral practitionerGeneral Social SurveyHepatitis B VirusHepatitis C VirusHousehold, Income and Labour Dynamics in AustraliaHuman immunodeficiency virusIndigenous Drug Injectors Study (South Australia)Illicit Drug Data ReportIllicit Drugs Reporting System–Injecting Drug UsersIllicit Drugs Reporting System–Party Drug InitiativeInjecting Drug UserIntergovernmental Committee on DrugsKids Help Line StatisticsLongitudinal Data Set 1% SampleLongitudinal Study of Australian Childrenviii
LSICMCDSNACCHONAGATSIHDLongitudinal Study of Indigenous ChildrenMinisterial Council on Drug StrategyNational Aboriginal Community Controlled Health OrganisationNational Advisory Group on Aboriginal and Torres Strait IslanderHealth DataNAPEDCDNational Non-admitted Patient Emergency Department Care DatabaseNATSIHSNational Aboriginal and Torres Strait Islander Health SurveyNATSISNational Aboriginal and Torres Strait Islander SurveyNATSISSNational Aboriginal and Torres Strait Islander Social SurveyNCISNational Coroners Information SystemNCMHCDNational Community Mental Health Care DatabaseNCSDDNational Community Services Data DictionaryNDSHSNational Drug Strategy Household SurveyNHDDNational Health Data DictionaryNHMDNational Hospital Morbidity DatabaseNHSNational Health SurveyNIDACNational Indigenous Data and Alcohol CommitteeNMDNational Mortality DatabaseNMDSNational Minimum Data SetNOPSADNational Opioid Pharmacotherapy Statistics Annual Data collectionNPCNational Prisoner CensusNPCSNational Police Custody SurveyNPDCNational Perinatal Data CollectionNPEBVSNational Prison Entrants’ Bloodborne Virus SurveyNRMHCDNational Residential Mental Health Care DatabaseNSMHW (C & A)National Survey of Mental Health and Wellbeing(children and adolescents)NSMHW (psychotic) National Survey of Mental Health and Wellbeing(low prevalence (psychotic) disorders)NSPAustralian Needle and Syringe Program SurveyNSW MDS-DATSNew South Wales Minimum Data Set for Drug and Alcohol TreatmentServicesNSW–IHSNew South Wales Inmate Health SurveyNSW–PHSNew South Wales Population Health SurveyNT PDSDBNorthern Territory Police Drug Seizure Data BaseOATSIHOffice for Aboriginal and Torres Strait Islander HealthPDUParty drug usersQLD–WPHSQueensland Women Prisoners’ Health SurveySAAP–NDCSupported Accommodation Assistance Program NationalData CollectionSARService Activity Reporting—annual data collection from AustralianGovernment funded Aboriginal and Torres Strait Islander primaryhealth care servicesSCATSIHStanding Committee on Aboriginal and Torres Strait Islander Healthix
SDACSLASOMIHVIC-PHSWAACHSYACRYPiCHSSurvey(s) of Disability, Ageing and CarersStatistical Local AreaState Owned and Managed Indigenous HousingVictorian Prisoner Health StudyWestern Australian Aboriginal Child Health SurveyYouth Alcohol Consumption Research, formerly the National AlcoholCampaign tracking researchYoung People in Custody Health Surveyx
SummaryBackground and project methodologyThe Australian Institute of Health and Welfare was commissioned by the AustralianGovernment Department of Health and Ageing, on behalf of the Ministerial Council on DrugStrategy, to identify and report on the current state of data collections relating to substanceuse issues for Aboriginal and Torres Strait Islander peoples in Australia, and set out optionsfor improving these data. The report achieves this by reviewing relevant data sources,highlighting inconsistencies between them and identifying data gaps. Data sources areassessed in terms of their capacity to answer a series of key questions, highlighted both bystakeholders through a workshop and by a literature review. While options are suggested fornew analyses of existing data sources, this project does not involve analysing the datasources to answer these key questions.An analytical framework is used throughout the report to organise the contextualinformation relating to Indigenous substance use. The five domains of the framework areintended to capture: contemporary patterns and trends in the use of tobacco, alcohol and other drugs the contextual factors associated with substance use and non-use, including exposure topreventive initiatives recognised harms associated with tobacco, alcohol and other drug use intervention and treatment services currently operating to assist Aboriginal and TorresStrait Islander peoples with substance use problems estimated expenditure on preventive, intervention and treatment programs andassociated services, including health and long-term care.Throughout this report, the term ‘substance use’ is used to refer to the use of tobacco, alcoholor other drugs. ‘Other drugs’ may include both illicit drugs and other drugs used illicitly.Chapters 2 and 3 contain an overview of the literature review and the stakeholder workshopundertaken to guide the assessment of data sources relating to Indigenous substance use.More comprehensive information on these aspects of the project is included in Appendixes 1and 2 respectively.Key questionsThe work on the literature review (Chapter 2) and discussions at the workshop (Chapter 3)revealed consistent themes in the types of information required about Indigenous substanceuse and its associated harms. Drawing on both of these sources, the key questions for thefield appear to be about: the nature or patterns of substance use among Indigenous substance users (for example,prevalence of substance use, type of substance used, frequency of use, age at first use,geographic variation, risk behaviours) the characteristics of Indigenous substance users and their context, including their socialcontext; social participation; influence of and exposure to family functioning andresilience, and family stressors and disruption; and exposure to substance use in thecommunity1
mortality, morbidity and disability among Indigenous substance users other associated harms, such as violence, crime, detention, imprisonment andhomelessness the affordability, accessibility and appropriateness of current approaches for interventionand treatment of substance use in Indigenous peoples what is working well in terms of intervention, treatment and prevention, why it isworking and what extra measures or initiatives could make a difference expenditure relating to treatment and other interventions.Three main information needs (agreed at the stakeholder workshop) cut across the keyquestions, namely the need for: community-level and individual information whole-of-government and cross-sectoral information timely information on emerging trends and patterns.Information currently availableThere are difficulties in collecting reliable information about substance use amongAustralians, particularly in relation to the use of illicit substances, and these complexitiesand sensitivities are amplified when collecting such information about Aboriginal andTorres Strait Islander peoples, particularly those living in small communities.Nevertheless, Australia has a relatively large number of data sources that could be furtherdeveloped and used in combination to provide better understanding of substance use, andcontributing contextual factors, among Indigenous people. A total of 44 data sources werereviewed for this project and compared in terms of their methodology and data items (as perthe information framework). In brief, the current information landscape includes: Indigenous-specific population surveys conducted by the Australian Bureau of Statistics(the National Aboriginal and Torres Strait Islander Social Survey and the NationalAboriginal and Torres Strait Islander Health Survey) that collect information aboutsubstance use as well as a range of contextual information a drug-specific population survey on drug use behaviours and perceptions (the NationalDrug Strategy Household Survey) administrative data collections which describe the characteristics of people accessingmainstream alcohol and other drug treatment services, Indigenous-specific substance usetreatment services and a range of other health services (for example, hospitals andgeneral practitioners) and community services interventions (for example, the SupportedAccommodation Assistance Program), as well as providing information about the typesof services these people receive the Western Australian Aboriginal Child Health Survey, which describes the health andsocial context of Indigenous children, and the Longitudinal Study of IndigenousChildren (currently under development) other surveys relating to substance use (for example, the Illicit Drug Reporting System–Injecting Drug Users and the Indigenous Drug Injectors Survey, which are surveys ofinjecting drug users, and the Youth Alcohol Consumption Research, which tracksawareness of the National Alcohol Campaign among young people)2
a range of surveys about the health and substance use patterns of people in custody(for example, Drug Use Careers of Offenders, Drug Use Monitoring in Australia, NewSouth Wales Inmate Health Survey) a number of data sources about drug-related arrests and drug seizures (for example, theNorthern Territory Police Drug Seizure Data Base and the Illicit Drug Data Reportcollection).Extent to which available information answers key questionsEach of the reviewed data sources was developed with a specific purpose, which is reflectedin their methodology (including scope and counting rules) and selection of data items. It isnot realistic to expect each of these data sources in isolation to meet all of the informationneeds relating to Indigenous substance use and its associated contextual factors. Rather, it isdesirable that, overall, they provide a national picture with, for example, sufficient coverageof relevant population subgroups and geography. Equally important are the comparabilityof data items and availability of information over time, so that the reviewed data sources canbe used as a set to paint a picture of the current situation, trends and emerging issues.The set of reviewed data sources was assessed in terms of its capacity to answer the keyquestions identified in Chapter 4. Information gaps were highlighted and then prioritised tothose that are considered essential, practical, least burdensome to sur
DASR Drug and Alcohol Services Report—annual data collected from Australian Government funded Aboriginal and Torres Strait Islander substance use specific services DoHA Australian Government Department of Health and Ageing DUCO Drug Use Careers of Offenders
Aboriginal / Aboriginal Peoples – ‘Aboriginal’ is a general term used in the Canada Constitution (1982) to describe the Inuit, Métis Nation and First Nations and as such is still used in some official government documents but is falling out of use. Aboriginal Peoples is more acceptable than Aboriginal.
Aboriginal women and reducing rates of potentially preventable hospitalisations among Aboriginal people. More broadly, it emphasises the impact that system-wide quality improvement efforts can have on Aboriginal people's health. Patient Perspectives: Hospital care for Aboriginal people does not consider the question of whether the gap is closing.
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marriage, children, work, travel, wages, housing and land, and access to health care and education. . Tasmania Tasmanian Aboriginal Centre 1994 Western Australia Yorganop Child Care Aboriginal Corp 1992-93 . and add a place name, or in the print version look under 'Aboriginal and Torres .
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