Thetop15thingsinAODin2017(youwontbelieveNo.7!)

JeffBuckley–InsightRebeccaLang–QNADAWednesday8thMarch2017

Weacknowledgethetradi1onalcustodiansofthelandonwhichwemeettodayandpayrespecttoElderspast,presentandemerging.WealsoextendthatrespecttootherAboriginaland/orTorresStraitIslanderswhoarejoiningusheretoday.

DavidRHorton,creator,©AboriginalStudiesPress,AIATSISandAuslig/Sinclair,Knight,Merz,1996.Viewaninterac1veversionoftheAIATSISmapwww.abc.net.au/indigenous/map/HeaderArtworkproducedforQueenslandHealthbyGilimbaa

ValeJeffCheverton

Tothe51%ofyou…

 #BeBoldForChange

TODAY’S PRESENTATION  GlobalContext

 AustralianContext

 QueenslandContext

 UpcomingEvents

THEGLOBALCONTEXT

1

q Approx1in20adultsusedatleastonedrugin2014(stabledespitegrowingglobalpopula1on)

q Approx43.5drug-relateddeathspermillionpeoplein2014(ratealsostable).

q Overdosedeathscontributeroughly1/3–1/2halfofalldrug-relateddeaths,mostlytoopioids.

q Cannabisremainsthemostcommonlyusedillicitdrugatthegloballevel,followedbyamphetamine.Bothratesarestable.

q Approx33millionusersofopiates/prescrip1onopioids-sharpincreaseinheroinuseintheUS

q Cocaineusealsoontherise,par1cularlyinSthAmerica.

(14%)

Global PWID HIV rates §  Australia = 2.1%

§  North America = 9.1%

§  Western and Central Europe = 11.2%

§  Asia = 12.5%

§  Africa = 13.6%

§  Eastern and SE Europe = 22.9%

AGEq Youngpeopletendtoseektreatmentforcannabis

andamphetamineuseq Peopleintreatmentforopioidorcocaine-related

disordersaretypicallyintheirthir1es…

GENDERq Overall,men3xmorelikelythanwomentouse

cannabis,cocaineoramphetamines,whereaswomenmorelikelythanmentoengageinnon-medicaluseofopioidsandtranquilizers.

q Thisgenderdivideindruguseisnarroweramongyoungpeoplethanamongadults.

 AnnualsurveyconductedbyDrAdamWinstockintheUKbetweenNovemberandDecember

 Independent,withabigfocusonharmreduc1on

 2017resultsdueoutinMay/June

 www.globaldrugsurvey.com

2

Highlights from the 2016 GDS (n = 100,000):

q  Increasedshoppingonthedarknet

q Morepeopleusingecstasyandexperiencingharm,mainlyduetohigh-doseMDMApillsonthemarket

q Alsoincreaseincocaineandnitrousoxideuseamongclubbers

q Synthe1ccannabinoidsaremostlikelytoleadtoemergencymedicaltreatment=“mostdangerousdrugsintheworld”

q Amongalcoholusers,drinkingspiritscausingmostharm.https://www.globaldrugsurvey.com/wp-content/uploads/2016/06/GDS2016-Press-Release-1.pdf

THEAUSTRALIANCONTEXT

NaUonalAODpolicystructure

q AustralianNa1onalAdvisoryCouncilonAlcoholandDrugs(ANACAD)

q SeniorOfficialsreplacementforIGCD

q MinisterialDrugandAlcoholForum(MDAF)asreplacementforMinisterialCouncilonDrugStrategy

3

NewNaUonalDrugStrategy2016-2025

S1llindralform,beingreconsideredinlightonnewNa1onalIceAc1onStrategy

Maintains3pillarsofharm-minimisa1on

 Nomajorchanges,althoughbuildsinextraconsulta1vemechanismswithstakeholders

 www.na1onaldrugstrategy.gov.au

4 2017–2025Expectedreleaseinfirsthalfof2017followingendorsementbytheMDAF

 Sub-strategyoftheNa1onalDrugStrategy

 HarmminimisaUonPLUS…

1. AboriginalandTorresStraitIslanderownershipofsolu1ons

2. Holis1capproachesthatareculturallysafe,competentandrespecmul

3. Whole-of-governmenteffortandpartnerships

4. Resourcingonthebasisofneedwww.na1onaldrugstrategy.gov.au

AboriginalAndTorresStraitIslanderPeoples’DrugStrategy2014-2019(*ComplementaryAc1onPlan)

 “…aim to improve the reporting of AOD issues through putting the spotlight on stories that contain misinformation, perpetuate unnecessary moral panic and stigma.”

 www.aodmediawatch.com.au

5

6 Increaseddrugoverdoses/deaths.Renewedcallondrug-checking

q GoldCoast-October-death25y.omale+16hospitalised•  25C-NBOMe,MDMAand4-FA(para-fluoroamphetamine)-notFlakka!

q MountLindesayRave-NYE-death26y.o.male•  SuspectedNBOMe(“demonicallypossessed”)

q Melbourne“ChapelSt”-mid-January-3deaths,20+hospitalised•  25C-NBOMe,MDMAand4-FA

q RainbowSerpentFesUval-late-January–death22y.o.male• Drankamyl-nitrate(poppers)

q ElectricParadeFesUval-Melbourne-February-22hospitalised• GHB(gamma-hydroxybutyrate)

Increaseddrugoverdoses/deaths.Renewedcallondrug-checking

q PinkCaps“UltraAlert”releasedviaACTINOSlastmonth

• Lab-testresultsindicate4-FAand25C-NBOMe

• SuspectedsamebatchtoGCandMelbdeaths,

plusrecentoverdosesinPerthandCanberra

• MelbournearrestsinDecemberandFebruary

q CarfentanyldetecUon• Sydney(Dec)andBrisbane(Feb)MailCentres

• NoevidencemixedwithMDMAinAustraliaasreported

 So everyone wants to know what number 7 is right?

 You won’t believe it…

Kaleabis! 7

http://www.newyorker.com/magazine/2017/02/27/why-facts-dont-change-our-minds

 We assure you that everything from here on in is real…

 OK?

CodeinechangetoSchedule4in2018

§ TGAannouncedinDecemberthatpainkillerscontainingcodeinewillnolongerbeavailableOTCfromFebruary2018

§ Stated"liuleevidence"low-dosecodeinemedicineswere"anymoreeffec1veforpainrelieforcoughthansimilarmedicineswithoutcodeine"

§ WillbringAustraliaintolinewithothercountrieswhereOTCcodeineisnotavailable(e.g.US,mostofEurope,Japanetc)

§ Concernsre:displacementeffect+increaseddemandfortreatment

8

NewNaUonalAODNGOTreatmentFundingArrangements

§  Exis1ngCommonwealthinvestmentpostJune2017announced3rdMarch§ $75millionp.a.§ Exis1ngtreatmentprovidersextendedby2yearsto30June2019§ $42millionp.atransferredtoPHNs,remainingfundswillremainCommonwealthadministered(mostlylargeproviderswhooperateovermul1plePHN)

§ Thisisaddi1onto$241.5millionannouncedinFebruary2016forPrimaryHealthNetworks(PHNs)tocommissionmoredrugandalcoholtreatmentservicesundertheNa1onalIceStrategy.

9

THEQUEENSLANDCONTEXT

q BrisbaneNorth•  LivesLivedWellatRedcliffe,Caboolture,Decep1onBayandStrathpine•  Ins1tuteofUrbanIndigenousHealth(IUIH)servicesforAboriginaland/orTorresStraitIslandersin5newloca1ons

q BrisbaneSouth•  LivesLivedWellatBeenleigh,•  QueenslandInjectorsHealthNetwork(QuIHN)inRedlandsandBayIslands•  IUIHservicesforAboriginaland/orTorresStraitIslanders

q GoldCoast•  LivesLivedWellatNerang,•  QuIHNbyoutreachacrossnorthernGC•  KrurungalAboriginalandTorresStraitIslanderCorpora1on

q SunshineCoast,WideBay,CentralQld•  WeHelpOurselves(WHOS)formild/moderatedetox•  IndigenousWellbeingCentre(IWC)•  FamilyDrugSupport(FDS)•  QuIHN

QldPHNinvestmentto-date 10

q NorthernQld• Gindaja•  Atcontrac1ngstageforservicesinMackay

q DarlingDowns/WestMoreton•  SunriseWay(DarlingDowns)•  TeenChallengein(DarlingDowns)•  EACH(WestMoreton)

q WesternQld•  Interimservicesbeingcommissionedwhilechallengeresustainabilityofspecialistservicesisinves1gated

q Workforce/SectorDevelopment•  QNADAforBrisbaneNorthandBrisbaneSouthPHNs

QldPHNinvestmentto-date

ConnecUngCaretoRecovery2016-2021

 ReleasedNovember2016

 Fivepriorityareas:

1. Access to appropriate services as close to home as practicable and at the optimal time

2. Workforce development and optimisation of skills and scope

3. Better use of ICT to enhance clinical practice, information sharing and performance reporting

4. Early identification and intervention in response to suicide risk

5. Strengthening patients’ rights in accordance with the Mental Health Act 2016

 Addi1onal$43millionoverfiveyearsforNGOAODTxservices($3M15/16,then$10m/year)

 DeloiueEconomicsdralingcomplementaryMHAODWorkforceDevelopmentFramework

11

RequestForOffer§  RequestforOffer(RFO)announcedlastweekforNGOstodeliveralcoholand

otherdrugpsychosocialinterven1ons(outclient)services.§  $4.25Mavailableperannumforperiod1July2017to30June2021(withan

op1onalextensionperiodof12monthsto30June2022)§  NB:Newfunding–exis1ngQHfundedTxprovidersremaininplace§  Targetsprioritypopula1ongroupsexperiencingalcoholandotherdrugrelated

problemsinspecificHospitalandHealthServiceareas

§  RFOclosesMonday27March2017.

Priority Population Geographic Locations - HHS

Adult (18 years +) Mackay, South-West, West Moreton, Wide Bay

Aboriginal and/or Torres Strait Islanders (18 yrs +)

Primary: South West, Central Qld, Wide Bay Secondary: Cairns + Hinterland, Townsville

Young people (up to 25 years, including Indigenous YP)

Primary: Cairns + Hinterland, Townsville, Mackay, South West, West Moreton Secondary: Gold Coast, Metro North, Metro South, Sunshine Coast

AcUonOnIce

 DralIceAc1onPlan"Ac1ononIce"releasedbytheQldGovtinFebruary.

 Outlinescurrentac1vi1esacrossallgovernmentagenciestoaddresstheharmscausedbyiceuseinQueensland.

 TheyareseekingfeedbackonthisdralplanbyCOBFriday31March2017.

12

QMHCReviewofStrategicPlan

 ForumsscheduledacrossQld:

• Rockhampton—13&14March• MountIsa—23&24March• Ipswich—28&29March• Logan—4&5April• Brisbane—10&11April• Townsville—8&9May• Cairns—10&11May• Toowoomba—1&2June

 hups://www.qmhc.qld.gov.au/queenslanders-urged-take-part-renewal-mental-health-drug-alcohol-strategic-plan/

13

QldAODModelsofService

Yepwe’vedoneit.Seriesofvisualpostersoutlining:q StatewideAODtreatmentservicedeliveryframeworkq StatewideHHSModelofServiceq DABITMOSdueoutshortly

q Availablefordownloadhere:hup://insightqld.org/resources/

14

QldOutcomeMeasurementFramework  Underway!

 5cross-government/non-government/privatesectorreferencegroupsmetinFebruary

q Residen1altreatmentq Psychosocialinterven1onsq Harmreduc1onq Withdrawalmanagementq Medica1onassistedtreatment

   Dralindicatorsbeingdevelopedacrossthefollowingdomains:

q Clientindicators(direct/poten1alsecondaryimpact)q Processindicatorsq Systemindicators

15

UPCOMINGEVENTS

OTHERAODCONFERENCES+EVENTS

 WalkontheWide(WOWS)OnedaySymposiumonsubstanceuseandsociety

 RBWHBrisbane–12May|hups://www.health.qld.gov.au/metronorth/events/wows

 AustralianandNewZealandAddicUonConference2017  GoldCoast-15-17May|addic1onaustralia.org.au

 TheAustralasianProfessionalSocietyonAlcohol&otherDrugs(APSAD)Conference2017  Melbourne–12–15November|

 hups://www.apsad.org.au/apsad-conference/current-conference

QUESTIONS?

CONTACTUS  JeffBuckley  Director–StatewideClinicalSupportServices,MetroNorthMentalHealth–AlcoholandDrugService.

 Ph:(07)38375800,jeff.buckley@health.qld.gov.au

 www.insightqld.org

 RebeccaLang  CEO–QueenslandNetworkofAlcoholandotherDrugAgencies  Ph:(07)30235050,rebecca.lang@qnada.org.au

 www.qnada.org.au

 SpecialthankstoLindaHipper,CameronFrancisandBenDougherty