n8876282

Name: Madeline Honey Student Number: n8876282 Tutor: Abbey Diaz

Illicit Drug Use in Australia

//Present your artefact// media type="custom" key="24288442" This video is part of an anti-drug campaign in Australia aimed at preventing drug use. This campaign targeted many drugs including, ice, heroin, marijuana, speed and ecstasy, all of them depicting very dangerous and scary situations directly linked to the use of these drugs. The ads focused on extreme short and long-term effects that these drugs can have and enforced that you cannot know what will happen when you take drugs. In all of these advertisements, drugs were labelled bad and dangerous, and the people taking them as ignorant and just doing it for fun, or to try something new.

//Name the public health issue central to your analysis (100 words)// The public health issue central to this analysis is illicit drug use within Australia, and looking at the topics addiction, treatment and criminality. People tend to look at drugs in a negative way, and a lot of anti-drug advertisements seen are usually trying to stop the problem without addressing the cause. Therefore in this paper the main focuses will be, what leads to addition and who is addicted; is harm minimisation better than abstinence and why; and whether criminality or treatment is the best way to approach drug related crimes.

//Literature review// Drug use has many direct and indirect impacts on a person’s health and wellbeing, the importance of this topic being displayed in the countless forms of literature bringing to light the causes and best treatments for addiction. Reasons for drug addiction have been studied endlessly to try and determine exactly what leads to a person abusing, having dependence, or being addicted to drugs. Part of drug addiction can be explained by genetics. As seen in Contributions of Basic Science to Understanding Addiction (Kuhar, 2010), effects of drugs on receptors have shown how drugs can change the biochemical makeup of the brain, these drug induced changes are long lasting, which Kuhar suggests can explain why drug addiction is a chronic and relapsing disease. Further research has also had similar conclusions, as seen in The Genetics of Addiction (Volkow & Muenke, 2012), where studies have looked at neurotransmitters that drugs affect and how the architecture of genes may affect a persons changes of undergoing epigenetic modification, which is crucial for understanding how chronic drug exposure is connected to long lasting changes in neurotransmitters. Volkow and Muenke also enforced that the risk of drug addiction is strongly influenced by a complex combination of genes, developmental processes and environmental factors, including drug exposure. Much literature on the topic of drug addiction and its health detriments has focused on social determinants and socioeconomic characteristics. As suggested by Galea and Vlahov (2002), social and economic factors shape the risk behaviour and the health of drug users; affecting health indirectly by shaping an individuals drug-use behaviour, and directly by affecting the availability of resources, access to social welfare systems, marginalisation, and compliance with medication. They go on to inform of features of the social environment such as income distribution, workplace control, housing, education, cultural norms, social networks and discrimination all affect a persons health and wellbeing, concluding that the health and behaviours of drug users and drug use risk is inexplicably bound to their social environment and social processes. This notion is enforced by Thomas, Richardson and Cheung (2008), in Geography and Drug Addiction, showing many characteristics contribute to increased drug abuse and prevalence, including residential segregation and income inequality, race and ethnicity, risk of unemployment and education level. Thomas et al. also suggests that physical structures of communities and neighbourhoods are operational factors in accessibility and human activity and wellbeing, as emerging studies link drug use behaviours to built environments. Australia’s current approach to drug use is the National Drug Strategy, which looks at harm minimisation (Ministerial Council on Drug Strategy, 2011). Australia’s National Drug Strategy focuses on three pillars: demand reduction, supply reduction, and harm reduction. Harm reduction models have become widespread, with many treatment professional operating treatment programs where the reduction of drug use, criminal involvement, unemployment, and other negative consequences are the standards for successful recovery (Fisher & Roget, 2009). This model is opposed to that of abstinence, in which complete sobriety is undertaken. Harm reduction appears to be the best option when looking at drug problems, when reflecting on previous literature showing that drug addiction is a relapsing disease (Kuhar, 2010) and has shown to cause, with continued use, cognitive deficits that exacerbate the difficulty of establishing sustained abstinence (Gould, 2010). There are multiple harm minimisation interventions currently in place within the Australian public health system, including drug courts and needle exchange programs. Drug courts in Australia operate in New South Wales, Queensland, South Australia, Victoria and Western Australia, each varying in formation, process and procedures (Australian Institute of Criminology, 2010). The main aim of these courts is to divert illicit drug users from incarceration into treatment programs for their addiction. In an evaluation of the New South Wales and Queensland pilot drug courts by Freiberg (2004), good results were found for those who completed the treatment programs. On the evaluations it was found that many people who entered the drug court program, with 46% in NSW, were terminated. However, re-offenses compared with control groups, those who were terminated and those who received custodial sentences, were lower, as was the time it took to re-offend. Evaluators also found significant decreases in drug use during the supervision period and that the health and wellbeing of participants in the program were significantly improved. Needle and Syringe programs are intended to reduce the spread of infections such as HIV and hepatitis C among injecting drug users (Australian Government: Department of Health and Ageing, 2005). They provide a range of services, including provision of sterile equipment, education on reducing drug use, health information, and referral to drug treatment. This program has shown to be affective in reducing the re-use of injecting equipment, with sharing going down from almost 100% in 1986, to just 13% in 2001, and partaking in drug treatment, as a survey showed an increase in participation from 68% in 2000, to 76% in 2004 (Australian Government: Department of Health and Ageing, 2005). Although the results of needle and syringe programs are positive, there are limitations to them as well. In a study by Peterson, Northeast, Jackson and Fitzmaurice (2007) surveying health professionals in rural and remote Australia, it was found that slightly less than half the surveyed professionals felt that illicit drug use was increasing in their area. They also found that the majority of doctors felt that harm minimisation facilities were inadequate, and that lack of access to harm minimisation strategies is potentially exacerbated by a shortage of health care facilities and health care professionals in rural areas. When looking at treatment and criminalisation, they both have very different affects on a person’s health and wellbeing; therefore it needs to be investigated what these effects are, if and how treatment is more effective and for what cases it would be appropriate for. In the Encyclopaedia for Substance Abuse Prevention, Treatment, and Recovery, (Fisher & Roget, 2009), it was stated that client variables that may impact treatment effectiveness include age, gender, duration of substance use, type of substance, life problems experienced, voluntary or involuntary admission to treatment, prior treatment, client health, psychological problems, criminal activity, level of education and income. They also state that treatment does appear to have a beneficial, long-term effect on a variety of client behaviours, including drug use. Criminalisation he extent of criminalisation varies according to the drug type, although the policies have been widely criticised as being counterproductive. Those who favour decriminalisation aim to reduce negative social consequences related to drug use without explicitly permitting that use (Fisher & Roget, 2009). Similar criticisms of criminalisation are present in The Impact of Cannabis Decriminalisation in Australia and the United States (Single, Christie & Ali, 2009). In their report, it is brought to attention that arrests and prosecutions have little or no effect on rates of cannabis use or cannabis related harm, the presumed benefit of criminalisation being deterrence of cannabis use. The only effect criminalisation being adverse social consequences for users, such as negative impacts on employment and family discord.

//Cultural and social analysis// When looking at the issue of illicit drug use within Australia and the health and wellbeing of drug users, adopting social theory is important to obtain a more critical and insightful view of the problems. Therefore, when inspecting illicit drug use, it is imperative to observe society, people’s behaviours and noticing patterns that occur. It has been observed through the literature review, that certain groups of people are more prone to addiction both genetically and by the strong influences of their environments (Kuhar, 2012; Volkow & Muenke, 2012; Galea & Vlahov, 2002; Thomas et al., 2008). Social contexts and characteristics largely influence and can either highly increase or decrease a person’s risk of drug use and the health affects both directly and indirectly related to it. Considering social constructs when trying to understand this issue betters our understanding of how society affects the risk of drug use for us to adequately provide helpful services that are adapted to the context of the people needing the help. The National Drug Strategy is aimed at improving the health, social and economic outcomes for Australians by preventing the uptake of harmful drug use and reducing the effects of licit and illicit drugs in our society (Ministerial Council on Drug Strategy, 2011). Australia’s National Drug Campaign similarly, aims at helping young people and their parents understand the harmful effects and consequences of drug use. The campaign aims to increase knowledge about potential negative consequences in a simpler way for the younger generation. On the home page of their website, they provide to the point information about a variety of drugs, as well as links for an iPhone app, free resources and seeking help (Australian Government: Department of Health, 2011). Although these organisations do influence drug use in a positive way, in the media drug use is portrayed differently. An example of this can be seen in the cultural artefact, casting a completely negative view of drugs and the people who use them, this portrayal could lead to moral panic (Weidner, 2009). In a moral panic, a condition, episode, person or group of persons becomes defined as a threat to societal values and interests, and the social contextual circumstances that underpin individual’s drug use are often disregarded. The cultural and social groups most at risk for drug use are males aged 20-29 (Australian Institute of Health and Welfare, 2010). For recent use of cannabis, the people most likely to be affected are those who are unemployed, those who reported speaking English at home, those who identify as homosexual or bisexual, those who have never been married, and those who identify as Aboriginal or Torres Strait Islander. The risk for drugs other than cannabis are for the same people, with the addition of being more likely to live in a remote, or very remote area.
 * |||||||||||| ** Use of Illicit Drugs, by Age and Sex (per cent) **  ||
 * |||||| ** Ever used **  ||||||  ** Recent use **  ||
 * ** Age Group ** || ** Males **  ||  ** Females **  ||  ** Persons **  ||  ** Males **  ||  ** Females **  ||  ** Persons **  ||
 * 14-19 || 25.3  ||  24.9  ||  25.1  ||  18.1  ||  18.2  ||  18.2  ||
 * 20-29 || 52  ||  50.5  ||  51.3  ||  ** 30.5 **  ||  24.3  ||  27.5  ||
 * 30-39 || 62  ||  56.5  ||  59.3  ||  22.6  ||  15  ||  18.8  ||
 * 40-49 || 56.8  ||  47  ||  51.9  ||  16.6  ||  9  ||  12.8  ||
 * 50-59 || 43.3  ||  32.1  ||  37.6  ||  10.5  ||  7.1  ||  8.8  ||
 * 60+ || 17.4  ||  10.9  ||  14  ||  5.5  ||  4.9  ||  5.2  ||
 * ** 14+ ** || ** 43.2 **  ||  ** 36.5 **  ||  ** 39.8 **  ||  ** 17 **  ||  ** 12.3 **  ||  ** 14.7 **  ||

Awareness if this issue is important, as people need to be aware of what is happening and why it is happening, rather than just having a media reflected view. People are not equally affected by this issue, as can be seen in the statistics above, SES and social determinants hugely impact on a persons risk of drug use and the adverse health affects that follow. The issue of illicit drug use within Australia needs to be discussed and criticised from many different angles and points of view, as there is currently a very negative stigma the goes along with drug use, the cultural artefact given being an example. Public experts should continue focusing on the marginalised people who are not in control of the environments that are facilitating and enhancing their risk of drug use.
 * |||||||||| ** Use of Illicit Drugs in Australia (per cent) **  ||
 * ** Column1 ** || ** Any illicit drug (exc. Cannabis) ** || ** Ecstasy ** || ** Meth/amphetamine ** || ** Cocaine ** || ** Cannabis ** ||
 * ** All persons (aged 14+) ** || 8.3  ||  3  ||  2.1  ||  2.1  ||  10.3  ||
 * ** Aboriginal/Torres Strait Islander ** ||  ||  3  ||  3.6  ||   ||  15.5  ||
 * ** Labour force status ** ||  ||   ||   ||   ||   ||
 * Currently employed || 8.9  ||  3.8  ||  2.6  ||  3  ||  11.5  ||
 * Student || 9.5  ||  5.1  ||  1.5  ||  2.3  ||  16.1  ||
 * Unemployed || ** 13.2 **  ||  4.1  ||  4.8  ||  2.2  ||  ** 20.1 **  ||
 * Engaged in home duties || 5.5  ||  1  ||  1  ||  0.6  ||  6.2  ||
 * Retired or on a pension || 4.5  ||  0.1  ||  0.2  ||  0.1  ||  1.8  ||
 * Volunteer/charity work || 5.3  ||   ||  0.3  ||   ||  5.8  ||
 * Unable to work || 11  ||  1.7  ||  3.8  ||  0.8  ||  14  ||
 * Other || 11  ||  2.4  ||  2.4  ||  1.8  ||  9.7  ||
 * ** Main language spoken at home ** ||  ||   ||   ||   ||   ||
 * English || ** 8.5 **  ||  3.2  ||  2.2  ||  2.3  ||  ** 10.8 **  ||
 * Other || 5.1  ||  1  ||  0.5  ||  0.4  ||  3.6  ||
 * ** Geography ** ||  ||   ||   ||   ||   ||
 * Major cities || 8.6  ||  3.3  ||  2  ||  2.6  ||   ||
 * Inner regional || 7.2  ||  2  ||  2  ||  1  ||   ||
 * Outer regional || 7.4  ||  2.2  ||  1.5  ||  0.9  ||   ||
 * Remote and Very remote || ** 11.1 **  ||  4.1  ||  4  ||  2  ||   ||
 * ** Marital status ** ||  ||   ||   ||   ||   ||
 * Never married || ** 13.5 **  ||  6.9  ||  3.8  ||  4.5  ||  ** 19.9 **  ||
 * Divorced/separated/widowed || 7.1  ||  1.1  ||  1.4  ||  0.9  ||  7.5  ||
 * Married/de facto || 6  ||  1.6  ||  1.3  ||  1.3  ||  6.5  ||
 * ** Sexual orientation ** ||  ||   ||   ||   ||   ||
 * Heterosexual || 7.7  ||  2.8  ||  2.9  ||  2.1  ||  10  ||
 * Homosexual/bisexual || ** 23.9 **  ||  10.8  ||  7.1  ||  4.4  ||  ** 26 **  ||
 * Not sure/other || 12.1  ||  4.7  ||  2.4  ||  2.4  ||  7.5  ||
 * ** Sexual orientation ** ||  ||   ||   ||   ||   ||
 * Heterosexual || 7.7  ||  2.8  ||  2.9  ||  2.1  ||  10  ||
 * Homosexual/bisexual || ** 23.9 **  ||  10.8  ||  7.1  ||  4.4  ||  ** 26 **  ||
 * Not sure/other || 12.1  ||  4.7  ||  2.4  ||  2.4  ||  7.5  ||
 * Not sure/other || 12.1  ||  4.7  ||  2.4  ||  2.4  ||  7.5  ||

//Analysis of the artefact and your own learning reflections// The artefact shows the angle of the Australian Government when trying to deal with illicit drug control. The advertisement represents drugs users as ignorant to the consequences, and gives a general, overall bad vibe about anything drug related. While these media advertisements may intend to scare young teens into not using drugs, it does not account for the pressures and influences of SES and cultural differences that are not in control. This advertisement makes for a good case to the issue as it displays the negative stigmas that can lead to moral panics, as previously mentioned, resulting in people only having a superficial view, only looking on the outside. The advertisement also not accounting for reasons behind why people use drugs and how help should be given is also relevant to the issue for looking into the causes and influences on drug addicted people. To me personally, I agree with the reasons and aims behind anti-drug campaigns, but do not entirely agree with how they go about it, portraying drug users to all be bad and dirty. As a result of this assessment I have learnt that social and cultural influences, as well as genetics, play a large part in the risk a person has of trying and becoming addicted to illicit drugs, and that although there are government organisations aimed at helping drug affected people, this is not as widely known as the media portrayal of illicit drug users. I believe that this will affect my future learning and thinking processes as I will now not just assume that any one view is a correct portrayal of a situation, and will try to investigate further to widen my views.

//Learning engagement and reflection task// http://healthcultureandsociety2013.wikispaces.com/share/view/64687310 http://healthcultureandsociety2013.wikispaces.com/share/view/64688210

References

Kuhar, M. (2010). “Contributions to basic science to understanding addiction”, //BioSocieties, 5//(1). 25-35. doi: 10.1064/biosoc.2009.10

Volkow, N.D., & Muenke, M. (2012). “The genetics of addiction”, //Human Genetics 2012//(131). 773-777. doi: 10.1007/s00439-012-1173-3

Galea, S., & Vlahov, D. (2002). Social determinants and the health of drug users: Socioeconomic status, homelessness, and incarceration. //Public Health Reports, 117//(1), 135-145.

Thomas, Y.F., Richardson, D., & Cheung, I. (2008). //Geography and drug addiction// [EBL]. Washington, D.C: Springer

Fisher, G. L., & Roget, N. A. (Eds). (2009). //Encyclopedia of substance abuse prevention, treatment, & recovery//. Thousand Oaks, CA: SAGE Publications, INC. doi: []

Gould, T.J. (2010). “Addiction and cognition”, //Addiction Science and Clinical Practice 2010//. 4-14.

Australian Institute of Criminology. (2010). Australian Responses to Illicit Drugs: Drug Courts. Retrieved from []

Freiberg, A. (2004, January). Australia’s drug courts. //Of Substance: the National Magazine on Alcohol, Tobacco and other drugs//, 2, 12-15.

Australian Government: Department of Health and Ageing. (2005). Needle and Syringe Programs: a review of the evidence. Retrieved from []

Single, E., Christie, P., & Ali, R. (1999). The impact of cannabis decriminalisation in Australia and the United States. Retrieved from []

Peterson, G. M., Northeast, S., Jackson, S. L., & Fitzmaurice, K. D. (2007). Harm minimisation strategies: opinions of heath professional in rural and remote Australia. //Journal of Clinical Pharmacy and Therapeutics, 32//(5), 497-504.

Ministerial Council on Drug Strategy. (2011). National Drug Strategy 2010-2015. Retrieved from []

Australian Government: Department of Health. (2011). National Drugs Campaign. Retrieved from []

Weidner, R. R. (2009). Methamphetamine in three small Midwestern cities: Evidence of a moral panic. //Psychoactive Drugs, 41//(3), 227-239.

Australian Institute of Health and Welfare (AIHW). (2010). Drugs in Australia 2010: tobacco, alcohol and other drugs. //Drug Statistics Series, 27//.