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2.17 Drug and other substance use including inhalants

Why is it important?

Drug and other substance use is a contributing factor to illness and disease, accident and injury, violence and crime, family and social disruption and workplace problems (SCRGSP 2014a). Estimates of the burden of disease and injury in Aboriginal and Torres Strait Islander peoples attribute 3.4% of the total burden to illicit drug use (Vos et al. 2007).

Substance use is often associated with mental health problems (Catto et al. 2008) and has been found to be a factor in suicides (Robinson et al. 2011). The use of drugs or other substances including inhalants is linked to various medical conditions. Injecting drug users, for example, have an increased risk of contracting blood-borne viruses such as hepatitis or HIV (Kratzmann et al. 2011) and around half of heroin and opioid users report overdosing (Catto et al. 2008).

For communities, there is increased potential for social disruption, such as that caused by domestic violence, crime and assaults. Research has identified relationships with loss of control and abusive behaviour, ranging from physical to emotional violence (Franks 2006). Alcohol and substance use has been found to be a factor in assault (Mitchell 2011; Mouzos et al. 2004). Drugs and other substance use play a significant role in Aboriginal and Torres Strait Islander peoples' involvement in the criminal justice system (see measure 2.11).

Glue sniffing, petrol sniffing, inhalant abuse and solvent abuse are difficult to control because the active substances are found in many common products that have legitimate uses. People who use these products as inhalants risk long-term health problems or sudden death. Continued use can also lead to the social alienation of sniffers, violence and reduced self-esteem (Karam et al. 2014; Midford et al. 2011). There is also reported high use of kava in some Arnhem Land communities (Clough et al. 2002).

Findings

The latest data on substance use rates for Aboriginal and Torres Strait Islander peoples comes from the 2012–13 Health Survey. In 2012–13, half (53%) of Indigenous Australians aged 15 years and over reported never having used drugs and other substances, 23% reported using substances in the last 12 months and a further 23% reported having used substances but not in the last 12 months. Time-series data between 2002 and 2012–13 is limited to non-remote areas only. Between 2002 and 2012–13, there was a decline in recent users (from 26% to 24%); however, there was an increase in Indigenous Australians who had used substances at least once in their lifetime (from 44% to 49%) in non-remote areas. Between 2008 and 2012–13, there was a small significant increase in the proportion of the Indigenous population who had used marijuana in the last 12 months in remote areas (14% to 17%) and non-remote areas (18% to 20%).

Comparisons with non-Indigenous Australians are available from the National Drug Strategy Household Survey, which included a small sample of Indigenous Australians. According to this survey, in 2013 Indigenous Australians aged 14 years and over were 1.5 times as likely to report using substances in the last 12 months compared with non-Indigenous Australians (around 23% and 15% respectively) (AIHW 2014v). In 2001, 37.4% of non-Indigenous Australians reported they had ever used substances compared with 41.4% in 2013. Over this period there was no clear trend in recent users.

In 2012–13, substance use was more prevalent among Indigenous males, of whom 53% had tried drugs compared with 40% of Indigenous females. Indigenous males also had higher rates for recent use in the last 12 months (28%) compared with Indigenous females (18%). Rates of substance use reported by Indigenous Australians aged 15 years and over in the last 12 months were lower in remote areas (19%) than non-remote areas (24%).

Cannabis was the most common illicit substance used in the last 12 months for Aboriginal and Torres Strait Islander peoples (19%), followed by pain-killers or analgesics for non-medical use (3%) and amphetamines/speed/ice (2%). Approximately 18% of Indigenous Australians reported having used one substance in the last 12 months and 5% two or more substances. The study of burden of disease in Aboriginal and Torres Strait Islander peoples estimated that heroin or poly-drug dependence was responsible for 37% of the burden due to illicit drugs (Vos et al. 2007).

In 2012–13, 18% of Indigenous Australians aged 15 years and over reported alcohol or drug-related problems as a family stressor during the last 12 months with rates higher for females (21%) than males (15%). Indigenous Australians reported alcohol or drug-related problems at 3.6 times the rate of non-Indigenous Australians.

A 2008 survey of school students showed that around 23% of Indigenous students aged 12–15 years had used an illicit substance in their lifetime, compared with 11% of all 12–15 year old students. The most common illegal substance used by Indigenous students was cannabis (used by 20%), followed by amphetamines (8%), ecstasy (6%), hallucinogens (5%), cocaine (5%) and opiates (5%). In addition, 24% of Indigenous students had used inhalants (glue, paint, petrol), with 13% in the past month (compared with 8% in the past month for total students) (White et al. 2009).

In 2012–13, a higher proportion of Indigenous Australians aged 15 years and over who were recent substance users reported they were current smokers (69%) and drank at risky/high-risk levels (76%) than Indigenous persons who had never used illicit substances (33% and 44% respectively). Approximately 5% of mothers with a child aged 0–3 years reported having used substances during pregnancy in 2008.

A 2013 study of 41 Aboriginal communities in the NT, WA and SA found 276 people were current sniffers (d'Abbs et al. 2013). Nearly 80% of sniffers were male and over half were aged 15–24 years. There was a significant reduction in the prevalence of petrol sniffing in 15 communities with time-series data following the introduction of low aromatic fuel in those communities. Across the sample there were 546 petrol sniffers in 2005–07, dropping to 160 in 2008, and 97 in 2011–12, an 82% decrease in the number of people sniffing between baseline and the current survey. The report indicates that sniffing levels have dropped in regions where there has been an uptake of low aromatic fuel and that the regions with the highest levels of sniffing are those where regular unleaded petrol is still available. Between 2008 and 2011–12 there was a continued decline from 2005–07 in the number of sniffers aged 5–9 years and 10–14 years and a slight increase in the 15–24 year age group. While the number of occasional sniffers declined, the numbers of heavy sniffers in 14 communities rose from 18 in 2008 to 32 in 2011–12.

For the period July 2011 to June 2013, there were 6,926 hospitalisations of Indigenous Australians related to substance use. Indigenous Australians were hospitalised for conditions related to substance use at rates 2.5 times as high as non-Indigenous Australians.

The Drugs Use Monitoring in Australia programme run by the Australian Institute of Criminology reports on drug use among police detainees at 8 police stations in metropolitan areas in SA, NSW, Qld, WA and the NT. In 2012, the proportion of detainees that tested positive for drugs was higher for Indigenous detainees than for non-Indigenous detainees in all police stations surveyed. Cannabis was the most frequently detected drug.

Implications

In 2012–13, around 1 in 5 Aboriginal and Torres Strait Islander peoples aged 15 years and over had used substances in the last 12 months. Higher rates of drug use are related to poorer health status and higher levels of psychological distress.

The National Drug Strategy 2010–2015 (NDS) provides the framework for an integrated and coordinated approach across all levels of government which aims to reduce the prevalence of drug-related harm and drug use in Australia. Under the strategy, a specific National Aboriginal and Torres Strait Islander peoples Drug Strategy (NATSIPDS) is being developed. The NATSIPDS will act as a guide for governments, communities, service providers and individuals to identify key issues and priority areas for action relating to the harmful use of alcohol and other drugs. The overarching goal of the 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 on individuals, families, and their communities. The strategy builds on the national framework provided by the NDS, and has been informed by extensive community and stakeholder consultations.

The Indigenous Advancement Strategy—Safety and Wellbeing programme provides funding for strategies known to enhance community safety, including combatting alcohol and other substance misuse. The Petrol Sniffing Strategy, launched in 2005, is a comprehensive regional approach to addressing the problem of petrol sniffing in regional and remote areas of Australia. The strategy aims to reduce the incidence of petrol sniffing and improve the health and social wellbeing of Indigenous youth. In 2014–15, the Petrol Sniffing Strategy became part of the Government's Indigenous Advancement Strategy under the Safety and Wellbeing Programme managed through the Department of the Prime Minister and Cabinet.

Table 2.17-1 Aboriginal and Torres Strait Islander peoples aged 15 years and over, substance use by remoteness and sex, 2012–13
Non remote areas Remote areas Males Females Persons
Used substances
Used substances in last 12 months
Marijuana, Hashish or Cannabis Resin 19.6% 17.2% 24.2% 14.2% 19.1%
Pain-killers or analgesics for non-medical use 3.2% 1.5%† 2.6% 2.9% 2.8%
Tranquilisers or sleeping pills for non-medical use 2.3% 0.9%† 2.2% 1.8% 2.0%
Amphetamines or speed 2.8% 0.8%† 3.0% 1.8% 2.4%
Kava 1.2%† 1.8%† 2.1% 0.6%† 1.3%
Other 2.9% 0.8%† 3.4% 1.5% 2.5%
Total used substances in last 12 months 23.8% 19.0% 27.6% 18.1% 22.7%
Used substances but not in last 12 months 24.8% 17.1% 25.1% 21.3% 23.1%
Total ever used substances 49.1% 36.2% 53.3% 39.6% 46.3%
Never used substances 49.7% 63.6% 45.7% 59.4% 52.7%
Total 100% 100% 100% 100% 100%
Persons who accepted form ('000) 291 81 181 192 372
Persons 15 years and over ('000) 318 91 201 208 409

Note: Comprehensive significance testing results are published in the Detailed Analyses

† Estimate has a relative standard error between 25% and 50% and should be used with caution.

Source: ABS & AIHW analysis of 2012–13 AATSIHS