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Dr. Alex Wodak's presentation at the Probation and Community Corrections Officers Conference focused on the current scale, policies, barriers, forces for change, and strategies to overcome obstacles in addressing alcohol and drug problems. Key issues include rising alcohol consumption, prescription opioid use, illicit drug challenges, and the need for impactful policy changes in public health.
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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 • Barriers to improvement • Forces for change • Overcoming barriers • Conclusions
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
Scale current problems: • 37 murders Victoria linked meth • Major official corruption
Current policy settings: • Tobacco • Big recent drop smoking rates • More action recently: price, packaging • But now ‘islands’ 1960s prevalence • Ban smoking prisons?
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
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
Current policy settings: • Illicit drugs • Framed as criminal justice problem • Rhetoric, funding follows • Ineffective, counterproductive, expensive • Difficult identify benefits • Works well politically
Barriers to improvement: • Tobacco • Major progress over long time • Shows progress is possible • Tobacco industry tamed • Decrease smoking disadvantaged
Barriers to improvement: • Alcohol • Drinks industry too powerful • Newspapers afraid • Excessive concentration newspaper owner • TV, radio lives off newspapers
Barriers to improvement: • Prescription drugs • Messy – DoHA, states, territories • Whose responsible? • Multiple interventions needed
Barriers to improvement: • Illicits • What works isn’t popular, what’s popular doesn’t work • Fear vs evidence
Forces for change: • Alcohol • Rising community concern alcohol • NAAA • Global action – WHO
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
Overcoming barriers: • Funding flowing to drug law reform • New drug law reform organisations • LEAP
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