News

QNADA submission to the Inquiry into Australia’s illicit drug problem: challenges and opportunities for law enforcement

Late last year QNADA developed a submission for the Commonwealth Inquiry into Australia’s illicit drug problem: challenges and opportunities for law enforcement. The submission identified 5 key areas of improvement to the existing Australian approach to illicit drug law enforcement:

1. The removal of criminal penalties for possession (decriminalisation) as a prudent strategy to reduce the investment required over time to process people through the criminal justice system and increase opportunities for people to access treatment when they need it.
2. A review of current approaches across law enforcement, treatment and harm reduction to ensure an appropriate balance across the three pillars of the National Drug Strategy in future investment.
3. Focused awareness-raising and training for police and other law enforcement entities on the impact of stigma and discrimination for people who use drugs.
4. The establishment of a new national governance framework to support effective coordination of the National Drug Strategic Framework, which includes representation from NGO AOD peak bodies.
5. A reinforced and sustained commitment by law enforcement agencies to support the implementation of evidence based harm reduction strategies such as drug checking services, safe injecting facilities, expanded diversion initiatives and improved access to naloxone.

QNADA’s submission to the Inquiry into Australia’s illicit drug problem: challenges and opportunities for law enforcement is available at https://www.aph.gov.au/Parliamentary_Business/Committees/Joint/Law_Enforcement/IllicitDrugs/Submissions

QNADA Submission to the Women’s Safety and Justice Taskforce

Response To Discussion Paper 3: Women and girls’ experiences across the criminal justice system

In April 2022 QNADA provided a submission to the third discussion paper of the Women’s Safety and Justice Taskforce – Women and girls experiences across the criminal justice system. The submission focused on specific questions within the discussion paper, and called for:

• responses that focus on addressing the broader social, cultural, and structural determinants of health, and prioritise alternatives to imprisonment – particularly for low-harm drug offences;
• greater clarity around the main drivers of increased drug related imprisonment and recidivism among women and girls, namely increased law enforcement activity by police, rather than any marked change in community behaviour or attitudes;
• meaningful, transparent consideration to be given to decriminalising low-harm drugs in Queensland, in partnership with peaks and other relevant non-government organisations;
• increased investment in, and provision of, alcohol and other drug treatment and harm reduction services for women and children in contact with the criminal justice system across Queensland;
• the expansion of police diversion to all illicit substances, including the removal of the current requirement to admit to an offence prior to accessing diversion, the removal of limits on the number of times a person can access diversion, and reconsideration of the purpose, delivery and type of interventions provided to people diverted from the criminal justice system;
• recognition that, even in the context of increased investment by the Queensland Government, there remains gaps in the treatment system and, although most people who use alcohol and other drugs never require treatment or help, for every dollar invested in treatment and harm reduction there is a seven dollar return^[1];
• people deprived of their liberty for drug related offending to be provided voluntary and evidence-based health services, including harm reduction and drug treatment services, as well as essential medicines, including HIV and Hepatitis C services, at a standard that is equivalent to that in the community in accordance with the International Guidelines on Human Rights and Drug Policy^[2].

The submission also highlights significant and ongoing concerns with the recent introduction of section 229BC of the Criminal Code (Failure to report sexual offending against a child to police) in Queensland. Although the need to ensure adults are appropriately protecting children and young people from sexual abuse is beyond question, the amendments have significant implications for the support provided by non-government AOD services to people who have experienced child sexual abuse. These implications are inherently problematic as:

• a significant proportion of those who access AOD services have complex histories of abuse and trauma (including child sexual abuse), poor experiences with police and other statutory bodies and a general distrust in services (particularly for those who use illicit drugs);
• it is key for victim-survivors to have access to services they trust and can safely to disclose to, and section 229BC inhibits disclosure for those who do not wish to engage with police – this correspondingly impacts treatment outcomes, impedes future service engagement and increases the likelihood of future harm;
• the reality is conviction rates are low and many victim-survivors do not want to engage in often confusing, invasive, lengthy and traumatic criminal justice proceedings;
• although the amendments respond to findings of the Royal Commission into Institutional Responses to Child Sexual Abuse, they are not consistent with the Royal Commission’s findings in relation to the challenges faced by victim-survivors in disclosing such abuse.

The submission calls for urgent review of the provisions, seeking to repeal the amendments or include clear exclusions to ensure Queenslanders who have experienced child sexual abuse can safely disclose that abuse in therapeutic settings and receive effective support for the well-known physical and psychological impacts of trauma.

[1] Alison Ritter et al., “New Horizons: The Review of Alcohol and Other Drug Treatment Services in Australia,” in Final Report (Sydney: University of New South Wales, 2014).

[2] https://www.undp.org/library/international-guidelines-human-rights-and-drug-policy

QNADA’s Submission to the draft National Tobacco Strategy 2022-2030

In March QNADA submitted a response to the call for feedback on the draft National Tobacco Strategy 2022-2030 (the Strategy). The QNADA submission wholly supports the priority areas for the Strategy and commends it for seeking to directly address tobacco industry interference in public health and tobacco control policy. QNADA argues this approach sets an example for other drug policy areas, such as alcohol, where industry influence and involvement continues to stifle good public health policy. QNADA agrees with the Strategy position that government action alone cannot reduce the prevalence of tobacco use, and that a strength of Australia’s tobacco control measures to date has been partnerships between governments, NGOs, health professionals, research groups and community groups. To this end, QNADA identified four areas we believe the strategy should further address. We’ve provided an abridged version of what we included in our submission below.

1. Future proof the strategy by clarifying how all priority areas and actions could be applied to new and emerging nicotine products.

While QNADA recognises the emphasis on preventing and reducing harms from new and emerging products (including e-cigarettes) in priority area 9 of the draft strategy, we believe these issues are relevant across the entire strategy and need to be outlined more widely. As novel nicotine products become more widely used and available, and the evidence around potential harm and therapeutic use continues to evolve, all priority areas and actions of the strategy will become increasingly relevant to novel products. QNADA supports strengthened regulations for new and emerging products, however we do not support legislative approaches that focus on individuals who are using these products as opposed to organisations selling and promoting them.

2. Closely monitor trends related to excise.

Excise increases have been resoundingly successful in reducing smoking prevalence at a population level. However, we note the relatively small gains excise measures have furnished in disadvantaged populations. We suggest that while price increases have been – and may continue to be – an effective mechanism to reduce tobacco use, we may be approaching a threshold, where prohibitive pricing begins pushing vulnerable populations to illicit tobacco in the absence of other nicotine replacements and support. While we acknowledge the ATO’s Tax Gap Analysis findings of a reduced net illicit tobacco market in spite of rising licit tobacco prices, we suggest targeted research be undertaken to quantify the extent of illicit tobacco use amongst disadvantaged groups and to better inform countermeasures to illicit tobacco use.

3. Prioritise support and resourcing for community controlled organisations and ensure meaningful partnerships.

We are pleased to see the strategy acknowledges the social and cultural determinants of health as influencing tobacco use and the broader importance of tobacco cessation efforts to closing the gap. We support the intent to bring culturally safe tobacco cessation interventions to mainstream health services, however resourcing and support for community controlled organisations should be a priority, and the upskilling of mainstream organisations should not be at the expense of community controlled organisations.

4. Appropriately resource organisations to deliver interventions and increase access to NRT

QNADA strongly agrees that evidence-based tobacco prevention and cessation programs should be part of routine care across all health (including AOD treatment and harm reduction services), social care and custodial settings. However, we do not support mandating tobacco interventions as a condition of government funding. In our view this makes little sense in the context of existing governance mechanisms that facilitate good clinical practice. We suggest instead working across systems to ensure that relevant frameworks, strategies, and guidelines address tobacco and other nicotine products where relevant, achievable, and necessary. Further, such an approach risks adding an unnecessary layer of reporting to already underfunded and overburdened services.

QNADA’s Submission to the Inquiry into the opportunities to improve mental health outcomes for Queenslanders

Tom Ogwang

In February QNADA submitted a response to the Mental Health Select Committee Inquiry into the opportunities to improve mental health outcomes for Queenslanders (the Inquiry). The submission addressed the Terms of Reference for the Inquiry in three distinct, but inter-related parts: Services (part A), Policy (part B) and Systems (part C). We’ve provided a very brief overview of highlights from our submission below. If you’d like to read it in full, you can download it here – https://documents.parliament.qld.gov.au/com/MHSC-1B43/IQ-5DEF/submissions/00000048.pdf.

Part A: Services

Developing a shared understanding of when and how the services system should respond to AOD related issues is key to improving AOD responses on the whole. Our shared understanding should recognise that only a small proportion of people who use AOD require treatment, however there are still insufficient specialist services available to meet demand. These challenges are compounded by critical specialist AOD workforce shortages.

Part A highlights that in order for the services system to become better coordinated or ‘integrated’, all systems of care should be informed by both AOD scientific evidence and lived experience in all aspects of program and policy development. In short, policy should be responsive to need and informed by the people it most directly affects. However, people who use drugs have traditionally been marginalised from policy debate and from receiving appropriate care.

Two case studies (Daisy’s Story and Jane’s Story) exemplify how QNADA member services and clients navigate system complexity, and how external system responses impact on client outcomes and opportunities.

Part B: Policy

The absence of a clear whole of government endorsed public AOD plan since 2017 has stifled leadership and prioritisation for AOD system reform outside the health system. It impacts agency understandings of their roles and responsibilities to deliver or support agreed state and national priorities and commitments. This absence means that there is no overarching mechanism drive action across systems such as criminal justice, domestic and family violence, youth justice, child protection, education, and communities.

Part B explores the reforms required to reduce costs and harms associated with criminalising illicit drug use. We note that the approach of criminalisation has proven largely ineffective at significantly reducing the consumption of illicit drugs and has not achieved a sustained reduction in supply. For example, the Queensland Productivity Commission’s makes a compelling economic argument for decriminalisation for low harm drugs within its 2020 Inquiry into Imprisonment and Recidivism and found that:

• Illicit drugs policy has failed to reduce supply or harm and was found to be a key contributor to rising imprisonment rates, with drug offences contributing to 32% of the increase since 2012
• Current illicit drugs policy results in significant unintended harms, through supporting a large criminal market and incentivising the introduction of more harmful drugs
• Evidence suggests legalising lower harm drugs and decriminalising others is unlikely to increase drug use and is likely to provide net benefits to Queensland of at least $2.8 billion by 2025
• Targeted community-level interventions and greater use of diversionary approaches are feasible alternatives to the criminal justice system which are significantly less expensive.

Part C: Systems

For the significant majority of people who use AOD, the risk of harm to both themselves and the community is increased primarily as a result of the social, policy and legislative responses to their use, rather than the substance itself.

Part C discusses opportunities for whole of system collaboration and partnerships across the criminal justice, child protection and youth justice systems. Queensland’s Mental Health, Alcohol and Other Drugs Strategic Plan 2018-23 (Shifting Minds) highlights the importance of collective leadership and responsibility across all policy, funding, program development and service delivery to achieve common outcomes and benefits. There is currently no entity in Queensland who has primary responsibility for, and a dedicated focus on, effectively influencing, driving and coordinating this change within the context of AOD policy and planning.

In early 2021 QNADA launched the self-funded Responsive Systems project to improve cross-agency collaboration and partnerships and support more effective system responses outside the health sector.