QNADA News

New policy position paper

This Systemic Responses: Criminal Justice position paper is the next iteration of the initial Systemic Responses position paper endorsed by the QNADA board in 2019. Our work on the Responsive Systems project since then has developed our position to be able to separately address issues in the criminal justice system, youth justice system, and child safety system as each has unique intersections with our sector and impacts people who use drugs differently. We want to do a deep dive into each of these systems and suggest how they could improve their responses to better align with evidence on what works to improve the wellbeing of individuals and communities.

Please click on the image below to read and download the full paper.

Submission on the Corrective Services (Emerging Technologies and Security) and Other Legislation Amendment Bill 2022

QNADA prepared this submission on the Corrective Services (Emerging Technologies and Security) and Other Legislation Amendment Bill 2022 by considering aspects most relevant to our work and our members. Many of our member services support people who have previously been in, or are in, correctional centres or youth detention facilities which provides us with a clear understanding of how any proposed legislative amendments may be implemented or operationalised across Queensland. In the submission we discussed the following points in detail:

• Modernising the emergency response framework
• Criminalising evolving behaviours putting corrective services facilities and youth detention centres at risk and the use of x-ray body scanners and other emerging technologies
• Enhancing information sharing

Please click here to read the full submission.

Submission to the Tobacco and Other Smoking Products Amendment Bill 2023

QNADA recently made a submission to the Tobacco and Other Smoking Products Amendment Bill 2023. We have concerns over an increased regulatory response to further reduce smoking rate in Queensland. We think the provision of evidence-based tobacco prevention and cessation programs as part of routine care across all health and community services and in correctional settings, including within alcohol and other drug treatment and harm reduction services, is more beneficial in helping people to reduce their use.

Please refer to the full submission here.

Submission to the Inspector of Detention Services Bill 2021

QNADA welcomes the opportunity to provide feedback on the Inspector of Detention Services Bill 2021. We commend the intent of the Bill and recognise the important role that the Inspector of Detention Services will have in ensuring accountability and oversight of detention in Queensland with a view to promoting and upholding the humane treatment and conditions of the people detained.

QNADA members provide a diverse range of alcohol and other drug treatment and harm reduction services to people with alcohol and other drug issues in detention facilities. Our feedback is primarily related to the provisions around the interactions between the Inspector of Detention Services and alcohol and other drug treatment and harm reduction services delivered in detention facilities, as well as those delivered to people exiting detention facilities or engaged with community corrections.

Please read the full submission here.

Submission to the Strengthening Community Safety Bill 2023

QNADA’s member services work at the intersection of multiple different systems and provide support to young people and their families who are in contact with, or are at risk of having contact with, the youth justice system. This makes us uniquely positioned to comment on the proposed amendments, which are:

• contradictory to what we know works when responding to youth crime;
• out of step with other Australian jurisdictions; and
• inconsistent with recent commitments by the Queensland Government to reduce demand within the criminal justice system, address the overrepresentation of First Nations people within the youth justice and criminal justice systems and achieve health equity by 2030.

For these reasons, QNADA does not support this Bill, including the supposition that its incompatibility with the Human Rights Act 2019 and international standards is justified ‘to respond to the small cohort of serious repeat young offenders who engage in persistent and serious offending, in particular, offending which occurs while on bail.’ The amendments will have significant implications for all young people on bail and, as with other strategies that aim to increase police presence and enforcement, will only serve to increase the number of young people detected, arrested and incarcerated in Queensland.

Please read the full submission here.

Submission to the Police Powers and Responsibilities and Other Legislation Amendment Bill 2023

QNADA welcomes the opportunity to provide feedback on the Police Powers and Responsibilities and Other Legislation Amendment Bill 2023, and recognises the proposed expansion of the Police Drug Diversion Program (PDDP) as an important step toward reducing the potential for harms associated with AOD use in Queensland. This submission focuses on:

• the significant individual, social and economic harms caused by the criminalisation of people who use drugs;
• shortcomings in the operation of the current PDDP to effectively divert people who use drugs who would otherwise not come to the attention of police away from the criminal justice system;
  the importance of practice change within the Queensland Police Service (QPS) that takes into account the experiences of people who use drugs and their interactions with police, and seeks to address the impact of stigma and discrimination embedded in policing practices;
• issues with the Bill, including with respect to the potential for inequity in the response to children and young people;
• opportunities to learn from the implementation challenges identified with the current approach to improve quality assurance processes and establish a strong, independent monitoring and evaluation framework; and
• other opportunities to further reduce the harms associated with the current policy approach to drug use, including the increasing shift towards decriminalisation across multiple jurisdictions.

Please click here to read the full submission.

Please feel free to watch our appearance at the the public hearing for the Inquiry into Police Powers and Responsibilities and Other Legislation Amendment Bill 2023 here (QNADA appeared from 5:09:45).

Refreshed Policy Position Papers

The following three policy position papers were recently reviewed and updated, please click on the image below to read the full version:

Decriminalisation (drug law reform)

Effective responses to drug use

Stigma and discrimination

Western Queensland Primary Healthcare AOD Capacity Development

From May 2021 to December 2022 QNADA embarked on a project supported by WQPHN and QNADA to facilitate AOD capacity development within primary healthcare services in Western Queensland. It goes without saying, Western Queensland is vast and sparsely populated, meaning there are unique challenges to health service access and delivery across this region. Western Queensland has a predominantly generalist health workforce and a limited availability of alcohol and other drugs (AOD) specialist services[1].

Primary healthcare services in the region have the potential to serve as an initial point of contact for people who use alcohol and other drugs and for those who have concerns with their use, by playing a critical role in facilitating appropriate care and follow up, particularly at an early stage[2]^,[3],[4]. The role of primary healthcare services can include informal conversations about a person’s relationship with substances through to formalised AOD screening and brief intervention, supporting referrals to specialist AOD services, and contributing to enhanced continuity of care[5]^,[6]. However, primary healthcare services often report a lack of confidence and skills to provide adequate AOD care, which is compounded by barriers such as stigma and discrimination and workforce shortage[7],[8].

QNADA, in partnership with external stakeholders, delivered and facilitated a range of activities throughout the project, including:

• providing individual primary healthcare practice support
• establishing regional service level network meetings
• coordinating the delivery of ASSIST (Alcohol, Smoking and Substance Involvement Screening Test) training
• reviewing alcohol and other drugs related HealthPathways
• delivering an AOD in primary healthcare toolbox talk
• drafting an easy to use information resource for primary healthcare practitioners responding to AOD issues
• promoting existing resources (eg Adis 24/7, ADCAS, Insight).

The project had a small number of participants however key findings from the project evaluation indicated an overall positive impact. For example, an increased level of confidence was found in using alcohol and other drug specific screening and assessment tools (e.g. ASSIST), delivering brief intervention to patients, and matching referrals to patient needs. An increased level of knowledge was also found in some key alcohol and other drug concepts (eg harmful drug use, alcohol and other drug dependence), and in alcohol and other drug information services (eg HealthPathways, Alcohol and Drug Clinical Advisory Service). In addition, several enablers for primary healthcare services to deliver good practice AOD responses in Western Queensland were identified. At the service level, these included having accurate and informed knowledge around patterns of alcohol and other drug use, the range of AOD treatment types, and local referral options, and maintaining collaborative relationships between key workers among services. At the system level, having face to face engagement and networking opportunities (eg network meetings) for workers, and a stable and engaged workforce (eg consistent staffing within a practice) is also likely to contribute to better provision of alcohol and other drug care.

However, at a systems level, the lack of alcohol and other drug specific MBS item numbers, high workforce turnover, and excessive distance between services all contribute to challenges for primary healthcare services in providing AOD support. These issues will continue to inform QNADA’s advocacy into the future as part of our ongoing work with other state and territory partners and the national AOD peak, Australian Alcohol and other Drug Council (AADC).

In the short to medium term, there are opportunities to address a range of barriers identified in the evaluation including:

• further strengthening linkages between primary healthcare services and their locally available specialist alcohol and other drug treatment services
• continuing to address stigma that is associated with illicit drug use and negative connotations around seeking alcohol and other drug treatment, which created challenges for both providing and seeking support
• addressing concerns around lack of anonymity in small towns in order to increase help seeking
• responding to specific concerns around the normalisation of high quantity and frequency alcohol use.

In future QNADA hopes to continue our activities supporting primary healthcare services in the Western Queensland region by:

1. continuing to facilitate local workforce linkage across the Western Queensland region through AOD focused service level networks.
2. continuing individual practice engagement to enhance alcohol and other drug responses in primary healthcare services.
3. facilitating and supporting ongoing alcohol and other drug related professional development and upskilling opportunities for primary healthcare services, with a focus on staff most likely to provide an AOD response (eg practice nurses).

While QNADA is pleased with the progress we’ve made in this space, this represents a first step to enhancing AOD responses in primary healthcare settings.  We’d like to thank WQPHN for their support in funding this project and all the service providers and project partners who participated. Thank you!

————————————————–

[1] Western Queensland Primary Health Network, “A Five-Year Plan (2021-2026) to Improve Mental Health, Suicide Prevention and Alcohol and Other Drug Treatment Services in Western Queensland,” (2021).

[2] Queensland Mental Health Commission, “Achieving Balance 2022-2027: The Queensland Alcohol and Other Drugs Plan,” (2022).

[3] Queensland Health, “Better Care Together: A Plan for Queensland’s State-Funded Mental Health, Alcohol and Other Drug Services to 2027,” (2022).

[4] Michala Kowalski and Liz  Barrett, “Engaging General Practice and General Practitioners in Alcohol and Other Drug Treatment,” in Drug Policy Modelling Program Monograph (University of New South Wales, 2020).

[5] Ibid.

[6] Queensland Health, “Better Care Together: A Plan for Queensland’s State-Funded Mental Health, Alcohol and Other Drug Services to 2027.”

[7] Western Queensland Primary Health Network, “A Five-Year Plan (2021-2026) to Improve Mental Health, Suicide Prevention and Alcohol and Other Drug Treatment Services in Western Queensland.”

[8] Kowalski and Barrett, “Engaging General Practice and General Practitioners in Alcohol and Other Drug Treatment.”

Submission to the Queensland Women’s Health Strategy Consultation Paper

QNADA welcomes the opportunity to provide feedback on the Queensland Women’s Health Strategy Consultation Paper. We commend the intent of the development of the Queensland Women’s Health Strategy and recognise the importance of working to achieve gender equality and health equity in Queensland by advancing the rights and interests of women and girls, including those who use alcohol and other drugs (AOD).

While the majority of people who use AOD do not experience problems with their use, a proportion (11-12%) are likely to require specialist treatment. In Australia, women represent approximately 40% of the proportion of people accessing AOD treatment services. They continue to face a range of treatment access barriers due to issues such as:

• continuing treatment and harm reduction supply issues in the face of increasing demand
• fear of legal and social repercussions of service engagement
• employment and family responsibilities
• implications relating to parenting, pregnancy, and childbirth (e.g. potential for child protection involvement resulting reduced willingness to approach services for assistance).

Despite welcome increased investment into the AOD system in recent years, as well as recognition of these barriers, women remain underrepresented in treatment and strategies are required to increase accessibility.

A range of strategies and initiatives have the potential to make it easier for women to access AOD treatment when they need it. These include:

• offering free child care to women accessing AOD treatment
• expanding existing day rehabilitation program options to enable increased treatment availability during school hours
• establishing/funding dedicated programs for women
• expansion of programs that support families to stay together while a parent is undergoing residential rehabilitation (e.g. family units)
• other initiatives to reduce stigma and discrimination of woman who use AOD.

Please click here to read the full submission.

Queensland Government Commended for Drug Law Leadership

We commend the Palaszczuk Government for taking an important first step in prioritising health based responses to illicit substance use, for introducing legislation to expand the Police Drug Diversion Program for cannabis to include other drugs. Here is our joint media release with Alcohol and Drug Foundation and AMA Queensland. 

Please click on the image to view the full document.

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