Question:

Describe about the Indigenous and Substance Abuse.

Answer:

Introduction

Substance abuse can harm the users, the community, and the society. Most indigenous people in Australia have been affected by the high levels of substance abuse as compared to the non- indigenous people, which is contributing to the increased cases of health and social risks among this group. The most affected group is the Aboriginal and Torres Strait Islander. The substances most used are cannabis, which is being used among individuals from all the age groups. The use of illicit drugs is associated with the social harm that is affecting the indigenous people. Some of the harm caused by substance abuse includes a high risk of contracting HIV and hepatitis C from sharing needles during the injections of the drugs, increased chances of psychological suffering and high risks of suicidal. In addition, substance abuse is linked to social problems like harm to family, crime, violence, and incarceration cases.

Literature Review

The Impact of being an Indigenous Person and Substance Abuse

1. Health Impact

Substance abuse is responsible for over 3.4 % of the disease burden among most of the indigenous people leading to 2.65 of the deaths. Cannabis is the most common abused drug between the Aboriginal and the Torres Strait Islanders, which is linked to the increased cases of anxiety, psychosis, and depression while the injection of the drug increases the risk of HIV and hepatitis C infections. In 2015, substance abuse led to the hospitalization of most indigenous people due to drug poisoning, behavioral, and mental disorders. Further, substance abuse has been noted as the major contributor to suicidal cases among the indigenous people, especially the Aboriginal and the Torres Strait Islanders.

2. Social Impact

Substance abuse is the leading cause of harm to children and families. According to a research conducted by Roxburgh and Burns (2011)  suggest that the indigenous people aged 14 years and older who have been victims of substance abuse are likely to be victims of victims than the non- indigenous people who had not used any substances.

Context of Substance Abuse among the Indigenous People

Substance abuse amongst the indigenous people contributes to disease burden and disease costs in Australia. In addition, substance abuse contributes to injuries, ill- health, violence, crime, and social disruption. According to a research conducted by Roxburgh and Burns  (2011) found out that, 20% of indigenous people aged 15 years and older have abused drugs in the last one year, and about 46 % have used some form of drugs at least once, in their lifetime, these statistics are alarming which calls for immediate intervention. Substance abuse contributes to most of the problems amongst the indigenous people, which affects the health, and well-being of this people. For instance, in 2015, there were over 50, 000 cases of hospitalization where the patients were diagnosed with the use of drug and substance abuse, this is about 44% of all hospitalizations during this period. Further, substance abuse is the major contributor to deaths in Australia, especially among the indigenous people.

A research conducted by the Australian Institute of Health and Welfare (2013) indicates that 1.4 % of all the deaths in Australia related to substance abuse. For instance, in 2013, 1300 case of deaths was related to drug and substance abuse, this excludes tobacco, and alcohol and most of those deaths were among the people aged between 14 and 55 years. Substance abuse contributes significantly to the economic costs. The total cost associated with drug and substance abuse in 2015 was about $55 billion of which $ 9 billion (15%) was from drug and substance abuse. $ 3.7 billion of this was from law- enforcement costs while $ 1.8 related to lost productivity due to drug and substance abuse (Australian Institute of Health and Welfare, 2013).

Contributing Factors to Substance Abuse among the Indigenous People

1. Historical Context

High cases of drug and substance abuse are among the Aboriginal and Torres Strait Islander people who are the indigenous groups in Australia as compared to the non- indigenous people. The problem of substance abuse among the indigenous groups can be understood in the historical context of dispossession and colonization. The European colonization on this group of people led to the loss of tradition and custom of the indigenous people, which resulted in years of economic and social exclusion and dispossession. The socioeconomic withdrawal is associated with substance abuse among the indigenous people, the continuous feeling of hurt and exclusion has facilitated the progress of this behavior among the indigenous people (Loxley et al 2015).

2. Social Factors

First, the level of education determines the employment opportunities, which in turn affects the living standards of an individual. Most of the indigenous people have a low educational achievement, low levels of education, dropping out of school at a young age, and low retention rates. There is a direct relationship between the level of education and substance abuse, thus, the low level of education between the Aboriginal and Torres Strait Islanders is the major contributor to the increased cases of drug and substance abuse among this people. Second, unemployment affects an individual’s quality of life directly. Unemployment can trigger substance abuse, which also the ability to seek and maintain employment. Third, the income of individuals directly contributes to drug and substance abuse. A research conducted by the Australian Institute of Health and Welfare (2013)  indicates a direct relationship between health and income with the low-income earners experiencing a high rate of bad health. Finally, peers play a considerable role in substance abuse. Peers influence decision-making, which increases the chances of individual using drugs. A bigger percentage of indigenous youths confirmed that peer pressure to be the influencing factor towards substance abuse; this is as compared to non- indigenous youths. Thus, substance abuse is prevalent in indigenous people as compared to non- indigenous people.

Discussion

Health Impact of Substance Abuse among Indigenous People

Some of the health impact of substance among the indigenous people results in death and hospitalization, which contribute to the increased disease burden among the indigenous people as compared to the non- indigenous people. Discussed below are some of the health impacts of substance abuse on the indigenous people.

1. Harms Relating to the Use of Cannabis

The use of cannabis has been linked to the mental health common between the Aboriginal and Torres Strait Islanders. The mental harm associated with the use of cannabis includes anxiety, lack of motivation, mood swings, psychosis, ad depressions. In this case, the more an individual uses the drug, the higher the chances of developing mental problems.

2. Risks relating to Injection of the Substances

Numerous health problems arise from injecting the substances. The common health problems being HIV and hepatitis C, these infections are on the increase between the Aboriginal and Torres Strait Islanders. Most of the indigenous people share the needles used in injecting the drugs because they feel discriminated which prevents them from accessing new equipment from the NSPs. A research conducted by Collins and Lapsley (2008) indicate that around 90% of hepatitis C new infections in Australia happen as a result of sharing the equipment used to inject the substances. Cases of hepatitis C were higher among the indigenous people as compared to the non- indigenous people. Hepatitis C has no treatment; this exposes the indigenous people to more serious health complications like increased cases of HIV. New infections of HIV are common among the indigenous people. Clough et al 2016 note that new HIV cases among the Aboriginal and Torres Strait Islanders were attributed to the sharing of needles used for drug injections as compared to the non-indigenous people. Further, drug injections can lead to overdose, which can lead to death and other severe health complications. Heroin is the most common overdosed drug with the highest number of deaths among the indigenous people as compared to the non- indigenous people (The Kirby Institute, 2014).

3. Emotional Health of the Indigenous People

Substance abuse contributes to the negative outcome on the emotional health in the indigenous people. A research conducted by The Kirby Institute (2014) indicates that 11% of young people aged below 15 in the Aboriginal and Strait Islanders have experienced some form of stressor in their life. Most of these stressors are associated with substance abuse. The use of various substances like tobacco, alcohol, inhalants, and cannabis result to cases of anxiety and depression among these people. The use of cannabis by the indigenous people has been linked to the increased cases of psychosis, depression, depression, and anxiety. In addition, injection of substances contributed to mental health problems, which include mood swings, sleeping disorders, and less enjoyment.

Social Impact of Substance Abuse among the Indigenous People

In addition to the health impact, substance abuse is associated with social effects, which include crime, assaults, and violence. Discussed below is some of the social impacts of substance abuse on the indigenous communities

1. Family

Substance abuse affects families negatively. In families, children are the most affected. Drug and substance abuse is the contributing factor to child neglect and abuse, which creates a harmful and unsafe environment for children. Those parents who are involved in substance abuse cannot undertake their domestic tasks or meet the needs of the children due to the feelings of withdrawal or intoxication because of using drugs. Further, the use of drugs can lead to financial constraints, which means that parents will opt to buy drugs to provide basics like food, shelter, and clothing to their children. Finally, children whose parents abuse drugs are more likely to experience violence as compared to those parents who do not.

2. Community Violence

Drug and substance abuse can negatively affect the community. Violence and harm including homicides and assaults are connected to substance abuse. Violence and crime are prevalent in the Aboriginal and Torres Strait Islander’s neighborhood as compared to the non-indigenous neighborhood, this is because of the high usage of drugs among this communities (Lee, Clough, Jaragba, Conigrave, Patton, 2008).

3. Incarceration

The imprisonment rate, especially in the Aboriginal and Strait Islanders, is considerably high as compared to the non- indigenous. The connection between incarceration, crime, and substance abuse among these communities is complex. For instance, a 2014 survey indicate that 70% of the indigenous prison entrance indicate substance abuse in the preceding 12 months, a comparable percentage of non-indigenous prison entrants of 64% (Clough, d’Abbs, Cairney, Gray, Maruff, Parker, O’reilly, 2004). In the Aboriginal and Torres Strait Islander, entrants reported cannabis to be the drug commonly abused at 54%, amphetamine at 20%, and analgesics at 16%. On the other hand, the non- indigenous entrants were less likely to use drugs (Bohanna and Clough, 2012).

Further, the 2016 “Pharmacy syringe and needle survey” indicated that a considerable proportion of the indigenous as compared to the non- indigenous people had been incarcerated and the health of inmates was affected by the substance abuse. A research conducted by Loxley et al 2014 indicated that most of the inmates were using some form of drugs, which include injections, this led to a widespread of infections like hepatitis C and HIV. Overall, alcohol was the major cause of violence and drugs like amphetamines and heroin were connected to drug and property offenses.

Summary and Conclusion

While the majority of the indigenous people do not abuse drugs, drug and substance abuse is considerably higher among the indigenous people as compared to the non- indigenous people in Australia. The use of a specific drug is consistent in the Aboriginal and Torres Strait Islander people. Cannabis use is high in the remote areas of the Aboriginal and Torres communities. The impact of substance abuse among the indigenous people is substantially higher than in the non- indigenous people. Factors contributing to the rise in substance among the indigenous people are complex. The high use of drugs and substances is directly related to the social determinants of health, which are the economic and social disadvantages that have contributed to the harmful substance abuse among the indigenous people. Therefore, it is important for the government to work with the indigenous people in order to address the issue of substance abuse. The government should formulate policies that address the issue of drugs in order to provide a long- term solution to the problem. For instance, the Australian drug policy should formulate strategies to minimize substance abuse especially among the Aboriginal and Torres Strait Islander people.

Reference

Australian Institute of Health and Welfare (2013) Alcohol and other drug treatment services in Australia 2011-12. (AIHW Catalogue no HSE 139) Canberra: Australian Institute of Health and Welfare

Begg S, Vos T, Barker B, Stevenson C, Stanley L, Lopez A (2007) The burden of disease and injury in Australia 2003. (AIHW cat. no. PHE 82) Canberra: Australian Institute of Health and Welfare

Bohanna I, Clough AR (2012) Cannabis use in Cape York Indigenous communities: high prevalence, mental health impacts and the desire to quit. Drug and Alcohol Review;31(4):580–584

Clough A, d’Abbs P, Cairney S, Gray D, Maruff P, Parker R, O’reilly B (2004) Emerging patterns of cannabis and other substance use in Aboriginal communities in Arnhem Land, Northern Territory: a study of two communities.Drug and Alcohol Review;23(4):381-390

Clough AR, Lee KSL, Cairney S, Maruff P, O’Reilly B, d’Abbs P, Conigrave KM (2016) Changes in cannabis use and its consequences over 3 years in a remote Indigenous population in northern Australia. Addiction;101(5):696-705

Collins DJ, Lapsley HM (2008) The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05. Canberra: Department of Health and Ageing

Degenhardt L, Hall W (2012) Extent of illicit drug use and dependence, and their contribution to the global burden of disease. The Lancet;379(9810):55-70

Lee KSK, Clough AR, Jaragba MJ, Conigrave KM, Patton GC (2008) Heavy cannabis use and depressive symptoms in three Aboriginal communities in Arnhem Land, Northern Territory. Medical Journal of Australia;188(10):605-608

Loxley W, Toumbourou JW, Stockwell T, Haines B, Scott K, Godfrey C, Waters E, Patton G, Fordham R, Gray D, Marshall J, Ryder D, Saggers S, Sanci L, Williams J (2004) The prevention of substance use, risk and harm in Australia: a review of the evidence. Canberra: Department of Health and Ageing

The Kirby Institute (2014) Bloodborne viral and sexually transmitted infections in Aboriginal and Torres Strait Islander people: surveillance and evaluation report 2014. Sydney: University of New South Wales

Select Committee on Youth Suicides in the NT (2012) Gone too soon: a report into youth suicide in the Northern Territory: committee report. Darwin: Legislative Assembly of the Northern Territory

Roxburgh A, Burns L (2011) Drug-induced deaths in Australia 2007. Sydney: National Drug and Alcohol Research Centre, UNSW