Bridie O'Reilly

The public health and safety benefits of the Northern Territory's Living with Alcohol programme

An evaluation is presented of the impact of a comprehensive population-based alcohol harmreduction programme in the Northern Territory funded by a levy of 5 cents per standard drink which took effect from April 1992. The proceeds of the levy supported increased treatment, public education and other prevention activities. Towards the end of the study period (the first 4 years) other positive initiatives were introduced: the lowering of the legal limit for drivers to 0.05 mg/ml and a special levy on cask wine. Indicators of alcohol-related harm were tracked from 1980 to June 30 1996 and developed from hospital, mortality and road crash data. In each case appropriate control data from the same source was employed to control for other possible confounding effects. Alcohol aetiological fractions for major alcohol-related causes of death were estimated taking account of the level of high-risk alcohol use in the Northern Territory. Multiple linear regression and time-series analyses were employed to test for any...

Measuring Exposure to Cannabis use and other Substance use in Remote Aboriginal Populations in Northern Australia: Evaluation of A ‘Community Epidemiology’ Approach using Proxy Respondents

We evaluate a method to describe changing substance use patterns in northern Australias remote Aboriginal communities (Arnhem Land, Northern Territory). Substance use was assessed in random samples in two communities A (n = 194) and B (n = 176). Five Aboriginal health workers made assessments independently of each other in community A. A different group of three health workers made independent assessments in community B. Sub-samples were opportunistically recruited for interview (community A, n = 77; community B, n = 55). In community C, 101 people were interviewed and were also assessed by four local health workers working together. Proportional agreements (kappa-κ statistic) among health workers for a history of substance use and current use, varied from κ = 0.207 for petrol sniffing (P = 0.006) up to κ = 0.749 for cannabis use (P<0.001), all better than would be expected by chance. In communities A and B, agreement between health workers’ consensus and self-reported substance use was weaker (0.103<κ<0.482) probably because of under-reporting in interviews. In community C, where interviews were conducted in a confidential clinic setting, agreement between health workers’ concensus and self-report varied from κ = 0.273 for petrol sniffing (P<0.001) up to 0.819 for tobacco use (P<0.001). Aboriginal health worker consensus classification clarified equivocal self-report data.

Cannabis and other drug use by tertiary students in Darwin, Northern Territory, Australia

Cannabis has been reported to be associated with impaired educational attainment in adolescents, reduced school performance and the potential for underperformance in adults engaged in occupations requiring high-level cognitive skills. The current study examined the extent and patterns of cannabis and other drug use among 386 tertiary students in Darwin, Northern Territory, Australia. The sample was mainly female (72%), half were aged under 25 years and 52% were in the first year of tertiary study. Cannabis use was prevalent among students, with 68.3% ever using it, 32.4% in the last year and 22.4% with recent use (last six months). The current pattern of cannabis use was significantly associated with age and gender. The most common reasons for using cannabis were to unwind (45.6%) or become stoned (33.7%). Close to half (52.3%) of recent users were not at all concerned about their cannabis use and 63.2% did not think they needed to reduce consumption. In the last six months, 84.5% of students had used alcohol, 12.1% amphetamine, 8.4% ecstasy, 6.8% nonmedical use of benzodiazepines, 4.6% hallucinogens, 1.6% inhalants and 1.1% opiates. A quarter (23.6%) of students had used alcohol and cannabis on the same occasion. The results are discussed in relation to the utility of traditional awareness programs and the desirability of appropriate and credible intervention strategies. ____________________

Client satisfaction and outcomes at Darwin Detoxification Unit

This study investigated detoxification completion rates and client feedback at Darwin Detoxification Unit from February to August 1999. Through client exit questionnaires, 140 clients recorded reason for leaving and rated satisfaction with staff, daily routine/activities, medication and facilities. Half of all admissions completed detoxification. Alcohol admissions were more than twice as likely as other drug admissions to complete detoxification (p < 0.05). Satisfaction levels were high for both alcohol and other drug admissions and no significant association was found between satisfaction with the Unit and completion of detoxification. The study highlights the challenges in retaining other drug admissions and the need to identify additional strategies to encourage detoxification completion.

The Illicit Drug Reporting System (IDRS) 1999: Northern Territory drug patterns and trends

The national Illicit Drug Reporting System acts as an early warning system to detect and track amphetamine, heroin, cannabis, and cocaine use patterns and emerging trends. In the Northern Territory, structured interviews of 28 key informants and analysis of other drug indicator data, demonstrated that there was were diverse groups of amphetamine, opiate, and cannabis users in Darwin. There were reports of increasing use by Aborigines and youth. Amphetamines and morphine were usually injected and there had been a 338% increase in needle and syringe distribution in the 4 years to 1998/99. MS Contin 100mg was the usual opiate used, and the consumption of this Schedule 8 morphine narcotic had increased 1,100% from 1996 to 1998. Opiate overdoses were rare. The purity of amphetamines was low, but cannabis potency was high. All three drugs were considered to be easy to obtain. The policy and research implications of the results are discussed.