Geographic trends
Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.
Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) (ABS 2016) (Table S3.3).
Health and harms
Almost 1 in 2 Indigenous Australians with a mental health condition were daily smokers (46%) and about 2 in 5 (39%) have used substances in the last 12 months. This was higher than for Indigenous Australians with other long-term health conditions (33% and 24%, respectively) or those with no long-term health condition (39% and 29% respectively) (ABS 2016) (Table S3.11).
The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively (AIHW 2016b) (Table S3.12).
The Penington Institute’s annual overdose report highlights that in 2017 the rate per capita of unintentional drug-related deaths per 100,000 population was 3 times higher for Indigenous Australians than non-Indigenous Australians (19.2 compared with 6.2). The rates for Indigenous Australians were higher than those for non-Indigenous Australians across all drug types. There has been an increase between 2009 and 2017 in the rate of unintentional drug-induced deaths for Indigenous Australians (from 10.3 to 19.2 unintentional drug-related deaths per 100,000). However, it should be noted that:
- rate calculations can be volatile due to smaller numbers of Indigenous deaths.
- these data are reported for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory only, which are considered to have adequate levels of Indigenous identification in the mortality data (Penington Institute 2019).
Refer to Box IMPACT1 for different data sources on drug deaths.
Treatment
In 2017–18, the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) showed that 16.1% of clients were Indigenous Australians aged 10 and over (AIHW 2019a). Indigenous Australians (3,597 per 100,000 population) were 7 times as likely to receive AOD treatment services than non-Indigenous Australians (495 per 100,000 population) (Table S3.13). Specifically, where the principal drug of concern was:
- amphetamines—952 per 100,000 population for Indigenous Australians compared with 131 per 100,000 population for non-Indigenous Australians.
- heroin—164 per 100,000 population for Indigenous Australians compared with 27 per 100,000 population for non-Indigenous Australians.
- cannabis—970 per 100,000 population for Indigenous Australians compared with 122 per 100,000 population for non-Indigenous Australians.
- alcohol—1,303 per 100,000 population for Indigenous Australians compared with 165 per 100,000 population for non-Indigenous Australians (AIHW 2019a) (Table S3.14).
In 2016–17, Indigenous clients travelled 1 hour or longer to their treatment service in about 1 in 4 (26%) closed treatment episodes. About 1 in 8 (13%) closed treatment episodes for non-Indigenous clients had a travel time of 1 hour or longer (AIHW 2019b).
Indigenous clients who sought treatment in Regional and remote areas travelled 1 hour or longer to the treatment service in 37% of closed treatment episodes, compared with 13% of closed treatment episodes for Indigenous clients in Major cities (AIHW 2019b).
It should be noted that as remoteness areas increase (become more remote), the accuracy of time travel/distance estimates decrease, due to the larger size of remote areas (AIHW 2019b).
Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2018:
- Indigenous Australians were almost 3 times as likely (76 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (27 clients per 10,000 population) (AIHW 2019c) (Table S3.15).
Data from the OSR show that in 2016–17, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 39,400 Aboriginal and Torres Strait Islander clients (AIHW 2018a). The OSR data also shows that:
- All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (95%) and amphetamines (80%)
- Treatment episodes were more likely to occur in non-residential settings (89%)
- One quarter of all treatment episodes were in Very remote areas (24%) and the highest proportion of clients were located in Major cities (37%).
Policy context
The Aboriginal and Torres Strait Islander Health Performance Framework 2017
The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services (DoH 2017b).
National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019
The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities (IGCD 2014).
References
ABS (Australian Bureau of Statistics) 2013. Australian Aboriginal and Torres Strait Islander health survey: first results, Australia, 2012–13. ABS cat. no. 4727.0.55.001. Canberra: ABS. Viewed 19 January 2018.
ABS 2016. National Aboriginal and Torres Strait Islander social survey, 2014–15. ABS cat. no. 4714.0. Canberra: ABS. Viewed 14 December 2017.
ABS 2017a. Australian Demographic Statistics, March 2017. ABS cat no. 3101.0. Canberra: ABS. Viewed 30 May 2018.
ABS 2017b. Aboriginal and Torres Strait Islander Peoples: smoking trends, Australia, 1994 to 2014–15. ABS cat. no. 4737.0. Canberra: ABS. Viewed 25 October 2017.
AIHW (Australian Institute of Health and Welfare) 2016a. Australian Burden of Disease Study: Impact and causes of illness and death in Aboriginal and Torres Strait Islander People. Australian Burden of Disease Study series no. 6. Cat. no. BOD 7. Canberra: AIHW. Viewed 11 October 2017.
AIHW 2016b. Australian burden of disease study: Impact and causes of illness and death in Australia 2011. Australian Burden of Disease series no. 3. Cat. no. BOD 4. Canberra: AIHW. Viewed 18 October 2017.
AIHW 2017. National drug strategy household survey 2016: detailed findings. Drug statistics series no. 31. Cat. no. PHE 214. Canberra: AIHW. Viewed 14 December 2017.
AIHW 2018. Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018. Cat. no. IHW 202. Canberra: AIHW.
AIHW 2019a. Alcohol and other drug treatment services in Australia 2017–18. Drug treatment series no. 33. Cat. no. HSE 230. Canberra: AIHW. Viewed 25 July 2019.
AIHW 2019b. Alcohol and other drug use in regional and remote Australia: consumption, harms and access to treatment, 2016–17. Cat. no. HSE 212. Canberra: AIHW. Viewed 15 March 2019.
AIHW 2019c. National opioid pharmacotherapy statistics (NOPSAD) 2018. Web Report. Viewed 3 April 2019.
AIHW 2019d. Australia’s mothers and babies 2017—in brief. Perinatal statistics series no. 35. Cat. no. PER 100. Canberra: AIHW. Viewed 27 June 2019.
AIHW 2019e. Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2017–18. Online web report. Canberra: AIHW. Viewed 7 August 2019.
DoH (Department of Health) 2017a. National Drug Strategy 2017–2026. Canberra: DoH. Viewed 12 January 2018.
DoH 2017b. Aboriginal and Torres Strait Islander Health Performance Framework. Canberra: DoH. Viewed 25 January 2018.
IGCD (Intergovernmental Committee on Drugs) 2014. National Aboriginal and Torres Strait Islander Peoples Drug Strategy 2014–2019. Viewed 14 December 2017.
Penington Institute 2019. Australia’s annual overdose report 2019. Melbourne: Penington Institute.