Alcohol and other drugs
In April 2015, the Australian Government established a National Ice Taskforce to advise on the development of a National Ice Action Strategy, which was delivered in December of that year. There was $298.2 million was invested over four years to strengthen drug education, prevention, treatment, support and community engagement.
South Western Sydney Primary Health Network (SWSPHN) has been tasked with commissioning drug and alcohol treatment services, based on the needs of the local community. SWSPHN has worked with the local drug and alcohol sector and the community to co-design new services that will build on the existing local services to better meet the unique needs within south western Sydney.
Why do we need to act?
Excessive alcohol intake is a major risk factor for morbidity and mortality. Long term adverse health effects of high consumption of alcohol include cardiovascular disease, some cancers, nutrition-related conditions, risk to unborn babies, cirrhosis of the liver, mental health conditions, tolerance and dependence, long term cognitive impairment and self-harm.
22.1 per cent of residents in South Western Sydney aged 16 years and over, consumed alcohol at a level posing long term risk to health compared to 25.9 per cent in NSW.
Drug misuse includes use of illicit substances, misuse of pharmaceutical medication (ie prescription, or over the counter medications), as well as the misuse of household substance. Drug misuse impacts on both mental and physical health.
42 per cent of Australians aged 14 years or older reported previous illicit drug use, including misuse of pharmaceuticals. There has been an increase in those misusing pharmaceuticals, particularly in men aged 30-39 years and women aged 40-49 years.
The use of crystal methamphetamine more than double between 2010 and 2013. Methamphetamine use has also been identified as a growing issue within the Aboriginal communities. This increase use has seen more than a 5-fold increase in methamphetamine related hospitalisations across Australian. Since 2013, South Western Sydney Local Health District has had the second highest rate of hospitalisations across metropolitan Sydney.
People who misuse substances are more likely to experience a mental health problem than the general community.
- Support the increase in primary health care capacity to manage drug and alcohol related health issues by:
- Developing support through a professional network
- Improved integration with LHD services through GP Liaison support
- GP registrar training to increase knowledge skills and confidence in addiction medicine
- Development of treatment protocols, decision support tools and referral pathways
- Development of treatment services prioritising higher need groups including youth, homeless, parents with children, people exiting the justice system and other at risk groups utilising the following treatment models. See link for more information on commissioned servcies.
- Psychological counselling
- Withdrawal management
- Rehabilitation (non-residential)
- Indigenous specific Alcohol and other drug (AOD) services.
- Increase the cultural competency of mainstream drug treatment services when treating Indigenous populations
Supporting General Practice
SWSPHN is working with South Western Sydney Local Health District to provide support to GPs providing care to patients with AOD and associated health issues through a phone help line. This service includes:
- Direct realtime access to local Drug Health clinicians. Further input can be sought from medical specialists as required.
Advice on clinical issues, from screening through to management and referral pathways
Available 9am-5pm weekdays (excluding public holidays)
HELPLINE PHONE: 0455 079 436
The 5A’s framework
There is evidence that Australian GPs may not be identifying up to 70 per cent of risky/high-risk drinkers. To support early intervention, SWSPHN is supporting GPs to utilise the 5A’s framework, which encourages screening assessment and brief intervention, and has been proven an effective approach.
The framework provides health professionals with an evidence based approach to identifying and supporting high risk behaviours. The 5As consist of:
- Ask: systematic identification of risk factors
- Assess: multiple risk, readiness to change, health literacy
- Advise/Agree: tailored information, motivational interviewing, goal setting
- Assist: referral to intensive intervention
- Arrange: follow up, maintenance
Drug and Alcohol localised HealthPathways are being developed to help guide health professionals in providing appropriate care through clinical referral pathways and support servcies. The service directory of local drug and alcohol support services can also help support GPs with the implementation of the 5As framework.
Tools for implementing 5As
- South Western Sydney Drug and Alcohol Services Directory
SWSPHN has a long history of supporting general practice implementing the 5As framework within a quality improvement model. See here for more information on how to be involved.
SWSPHN is working with the local drug and alcohol sector to tailor suitable learning opportunities to support general practice to increase their skills knowledge and confidence in managing patients with substance abuse issues. See the SWSPHN website for more information on CPD events.
The Opioid Treatment program requires medical practitioners to be come accredited OTP prescribers, by completing the Opioid Treatment Accreditation Course (OTAC).
All patients must be initiated and stabilised on the OTP by an accredited prescriber before they can be transferred to the care of a non-accredited provider. A non-accredited provider may be authorised by the Ministry of Health to prescribe methadone or buprenorphine for up to 5 patients. Forms to apply for authorisation can be found here.
Health professional resources
- NSW Opioid Treatment Program
- Brief intervention for substance abuse (WHO)
- Alcohol Screening and brief interventions in primary care (RACGP)
- Managing Co-occuring Alcohol and Other Drugs and Mental Health Conditions Guidelines (DoH)
Other useful resources
- Learning resources for teachers, parents and students https://positivechoices.org.au/
- Alcohol and drug foundation http://adf.org.au/