Harm Minimization: Substance Abuse in Australia

This paper discusses the prevalence and impact of substance abuse in Australia, as well as the harm minimization strategies implemented to reduce its adverse effects. It explores the incidence and rationale behind substance abuse, the psychological impact on individuals, families, and communities, and the national and international policies and trends in harm minimization. The three pillars of harm minimization - harm reduction, supply reduction, and demand reduction - are discussed, along with their effectiveness in reducing the negative consequences of substance abuse. The paper concludes by emphasizing the importance of these strategies in improving health behavior and strengthening the connection between community and society.

Running head: HARM MINIMIZATION
HARM MINIMIZATION
Name of the student:
Name of the university:
Author note

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Introduction:
With the high prevalence of the chronic disease, the harms from alcohol, tobacco and
other substance influence all Australian communities, families as well as individuals. The
excessive substance use is termed as a substance use disorder which further impact quality of
life. Approximately, 1 in 20 Australians has the habit of substance abuse which further
manifestoed as a psychological disorder (Fry, Fry & Castanelli, 2015). It further induces long-
term damage to the brain such as poor decision making, memory, and attention along with the
development of the chronic disease. Substance abuse is a major cause of mental illness
(Degenhardt et al., 2016). The most commonly abused substances in Australia are tobacco and
alcohol. Australia’s National Drug Strategy has been underpinned by Australian Institute of
Health and Welfare where three pillars of harm minimization have been used to change the
health behavior of the individuals with the habit of taking psychoactive drugs and reduction of
premature death (Sutherland et al., 201. This paper aimed to provide the incidence and
prevalence of substance abuse, the psychological impact of the substance abuse and national
along with international policy and treads to the minimization of the substance abuse in the
following paragraphs.
Discussion:
Prevalence and incidence of the substance abuse and rationale behind it :
The consumption of tobacco alcohol and other illegal drugs is a major contributing factor
behind the preventable disease and high mortality of premature death in Australia. Smoking is
the most preventable cause of premature death (Leske et al., 2016). Approximately, 13% of
Australians of 14 years or more developed a habit of smoking every day which further

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contributed to 8% of the disease (Health direct, 2019). On the other hand, 1 in 6 Australians
drinks at risky levels which further induces violence, injuries, and accidents (Health direct,
2019). Considering the illegal drug consumption, approximately 35% of the Australian consume
illegal drugs such as cannabis, cocaine, and ecstasy which further impacted their life. According
to a survey of Australian Institute of Health and Welfare, compared to non- indigenous
Australians, aboriginal Australians are more likely to develop a habit of substance abuse
(Australian Institute of Health and Welfare, 2018). Rontziokos and Deane (2018), highlighted
that in the non-indigenous population, the Australians of aged 14 years or more than 14 years are
more likely to use substance due to peer pressure. In adults, the environmental factors such as
attitude, exposure, personal and cultural beliefs, lack of employment and other stress factors are
acting as contributing factors behind the development of substance abuse. On a different note,
considering the geographic trends, aboriginal individuals are more likely to develop the habit of
consumption of tobacco, alcohol or illicit drugs such due to social determinants of health such as
lack of employment, lack of proper housing and educational opportunity along with lack of
access to the health care (Ridani et al., 2016). Consequently, the rate of substance abuse is 1.8
times higher in Aboriginal Individuals compared to non-Indigenous Australians (Wilson et al.,
2016). According to Connolly (2017), social Bandura’s social cognitive theory, knowledge
acquisition of individuals can be directly related to observing others within the context of social
interactions, which means individuals develop values and health behavior based on their social
interaction and observation. Hence, in this current context, the poor social interactions and
development of values lead to the development of substance abuse such tobacco, alcohol, and
other illicit drugs.

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Impact of substance abuse in population:
According to stress vulnerability model, human always carries genetic as well as other
predispositions of mental illness, which further highlighted that due to personal experience and
biological factors, some individuals are generally more vulnerable to the psychological disorders
compared to others. Eventually, when individuals experience stressors, they tend to use alcohol
and smoking which trigger or facilitate psychological distress inpatient. Connolly (2017),
highlighted that, individuals with a habit of substance abuse, tend to exhibit poor health behavior
and social harm such as violence, aggression, and anger. The use of alcohol or other illicit
increases the risk of depression and anxiety and other mental illnesses in some people.
Individuals with mental illness tend to experience substance-induced psychosis such as auditory
hallucination or delusions. Individuals with mental illness are more likely to develop the habit of
consuming tobacco and alcohol which further increase these symptoms (Gasior, Bond &
Malamut, 2016). Hence, substance abuse and mood disorders are interconnected. Alcohol
reduces the impact of antidepressants in the patient with mental illness such as depression and
anxiety. Consequently, alcohol and other consumption facilitate health harm such as suicidal
behavior, road trauma, lack of empathy, chronic disease development and violence in individuals
which further impacted the lives of individuals, families, and communities (Bei, B., Wiley, Allen
& Trinder, 2015). The economic harm, in this case, includes decreased productivity, increased
criminal activity, and increased health care cost.
Harm minimization as the strategy to reduce adverse impact:
Australian Institute of Health and Welfare (2018), designed a national framework for building
safe, healthy and resilient Australian communities through preventing as well as minimizing
alcohol, tobacco, and other drug-related health, social and economic harms among individuals,

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families, and communities. The National Drug Strategy 2017–2026 is one such policy which use
harm minimization as the approach to prevent the adverse social, economic and health of
Australian communities. Midford et al. (2016), Harm minimization is defined as a holistic
approach which aims to address the issues associated with substance use by reducing the harmful
effects of alcohol and other drugs on individuals and society. There are three pillars of the harm
minimization such as harm reduction, supply reduction and demand reduction which based on
the assumption that while the use of the illicit drug cannot be minimized, and the associated
harm can be reduced with a range of support that can be provided to individuals, families, and
communities. Considering the reduction of harm, effective reduction in harmful behavior in
adolescents and in adults such as frequent use, way of using can reduce the negative impact on
communities, families (Australian Institute of Health and Welfare, 2018). The treatment options
and support services such as detoxification of alcohol through anxiolytics, sedatives, and
vitamins, simple counseling’s, lifestyle modification along with referring to the rehabilitation are
an effective approach in the territory and local level. These services provide a wide range of
peer-based community support by involving family as well as the community in the treatment
and providing literacy to each of them. Creating an environment such as sober transport
increased health promotions, smoking-free areas are effective in reducing reckless behavior in
individuals (Gainsbury, Jakob & Aro, 2018). Effective drink driving policies can reduce poor
health behavior in patients (Gainsbury, Jakob & Aro, 2018). These services allow an individual
to connect with the services that change the health behavior of the individuals. The impact of
these services on the Australian community is that these services facilitate collaboration between
health professionals and the community, reduce the behavior of substance abuse, improve access
to the health care and enhance the connection between society and family (Gainsbury, Jakob &

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Aro, 2018). Considering the second pillar such as supply reduction, supply reduction strategize
aims to limit the availability and access to the tobacco, alcohol and other drugs for preventing
poor health behavior. Preventing illicit supply can reduce availability and associated harm in
individuals which include includes dismantling or disruption of distribution networks as well as
manufacturing and cultivation of the illicit drugs (Australian Institute of Health and Welfare,
2018). Gainsbury, Jakob and Aro (2018) argued that effective supply reduction strategy induce
regulation of retail and wholesale, age restriction, border control, regulation of distribution and
implementation of real-time monitoring of the drugs that were prescribed to prevent illegal
supply. Consequently, the individuals, especially adolescents failed to gain access to the illicit
drugs, tobacco, and alcohol which will further reduce the harm associated with illicit drug use
and unhealthy inpatient. Midford et al. (2016), argued that Smoking prevention for Student with
the assistance of Year Program of Integrated Harm Minimization School can reduce the poor
habit of smoking. A strong partnership between health and law enforcement has been a key
strength of Australia’s national drug strategies (Australian Institute of Health and Welfare,
2018). Considering the demand of reduction, Moore et al. (2016), argued that substance use is s
a multi-determined behavior, influenced by a range of biological, psychosocial and
environmental factors which enhance the desire for consuming alcohol and smoking. In this
case, Moore et al. (2016), argued that smoking of e- cigarettes can reduce the habit of smoking
tobacco. On the other hand, Wong and Manning (2017) an effective approach is to the
prevention of uptake through the involvement of family members, peers, and community and
providing counseling for a healthy life. Midford et al. (2017), also argued that the delay in first
use and proper education can lead to improved health and social outcomes. The impact of these
strategies reduction of personal, family and community harm along with adherence to the healthy

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lifestyle (Australian Institute of Health and Welfare, 2018). On a different note, Butterfield et
al. (2016) suggested drug checking is one of the minimization strategy which can reduce the
engagement with substance abuse. Consequently, impact of minimization strategy include
reduction of social harm such as violence, aggression, and anger, reduction of health harm such
as improvement of health and adherence to the healthy lifestyle and reduction of economic harm
such as hospital stays and health care cost.
Conclusion:
Thus it can be concluded, the harms from alcohol, tobacco, and other substance impacted
more than thousand Australian communities, families as well as individuals. A significant
number of Australians are subjected to high substance use due to lack of employment, lack of
education, subjected to negative life events. The rate of consumption is higher in aboriginal
Australians compared to non-indigenous Australians. Three pillars of harm minimization and
national drug strategy 2017–2026 are effective strategies to reduce these harm, improve health
behavior and improve the connection between community and society.

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References:
Australian Institute of Health and Welfare (2018). Alcohol, Tobacco and other drugs in
Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-
other-drugs-australia/contents/priority-populations/people-who-inject-drugs
Australian Institute of Health and Welfare (2018). Alcohol, Tobacco and other drugs in
Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-
other-drugs-australia/contents/priority-populations/people-who-inject-drugs
Bei, B., Wiley, J. F., Allen, N. B., & Trinder, J. (2015). A cognitive vulnerability model of sleep
and mood in adolescents under naturalistically restricted and extended sleep
opportunities. Sleep, 38(3), 453-461.
https://academic.oup.com/sleep/article/38/3/453/2416967
Butterfield, R., Barratt, M., Ezard, N. & Day, R., 2016. Drug checking to improve monitoring of
new psychoactive substances in Australia. Medical Journal of Australia, 204(4), pp.144-
145.
https://espace.curtin.edu.au/bitstream/handle/20.500.11937/29714/239611_239611.pdf?
sequence=2
Connolly, G. J. (2017). Applying social cognitive theory in coaching athletes: The power of
positive role models. Strategies, 30(3), 23-29.
https://www.shapeamerica.org/uploads/pdfs/2018/publications/strategies/Applying-
Social-Cognitive-Theory-in-Coaching-Athletes-The-Power-of-Positive%20Role-
Models.pdf

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Degenhardt, L., Larney, S., Chan, G., Dobbins, T., Weier, M., Roxburgh, A., ... & McKetin, R.
(2016). Estimating the number of regular and dependent methamphetamine users in
Australia, 2002–2014. Medical journal of Australia, 204(4), 153-153.
https://espace.curtin.edu.au/bitstream/handle/20.500.11937/16079/239814_239814.pdf?
sequence=2&isAllowed=y
Fry, R. A., Fry, L. E., & Castanelli, D. J. (2015). A retrospective survey of substance abuse in
anaesthetists in Australia and New Zealand from 2004 to 2013. Anaesthesia and
intensive care, 43(1), 111-117.
https://journals.sagepub.com/doi/pdf/10.1177/0310057X1504300117
Gainsbury, S. M., Jakob, L., & Aro, D. (2018). Understanding end-user perspectives to enhance
perceived value uptake of harm-minimization tools: considering gambler’s views of a
pre-commitment system. International Gambling Studies, 18(1), 22-
38.https://www.researchgate.net/profile/Sally_Gainsbury/publication/
319898424_Understanding_end-
user_perspectives_to_enhance_perceived_value_uptake_of_harm-
minimization_tools_considering_gambler%27s_views_of_a_pre-commitment_system/
links/59c49615aca272c71bb1b8de/Understanding-end-user-perspectives-to-enhance-
perceived-value-uptake-of-harm-minimization-tools-considering-gamblers-views-of-a-
pre-commitment-system.pdf
Gasior, M., Bond, M., & Malamut, R. (2016). Routes of abuse of prescription opioid analgesics:
a review and assessment of the potential impact of abuse-deterrent
formulations. Postgraduate Medicine, 128(1), 85-96.
https://www.tandfonline.com/doi/full/10.1080/00325481.2016.1120642

9
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Health direct (2019). Substance abuse. [online] Healthdirect.gov.au. Available at:
https://www.healthdirect.gov.au/substance-abuse [Accessed 9 Sep. 2019].
Leske, S., Harris, M. G., Charlson, F. J., Ferrari, A. J., Baxter, A. J., Logan, J. M., ... &
Whiteford, H. (2016). Systematic review of interventions for Indigenous adults with
mental and substance use disorders in Australia, Canada, New Zealand and the United
States. Australian & New Zealand Journal of Psychiatry, 50(11), 1040-1054.
https://journals.sagepub.com/doi/pdf/10.1177/0004867416662150
Midford, R., Cahill, H., Lester, L., Foxcroft, D. R., Ramsden, R., & Venning, L. (2016).
Smoking prevention for students: findings from a three-year program of integrated harm
minimization school drug education. Substance use & misuse, 51(3), 395-407.
https://www.researchgate.net/profile/Richard_Midford/publication/294917973_Smoking
_Prevention_for_Students_Findings_From_a_Three-
Year_Program_of_Integrated_Harm_Minimization_School_Drug_Education/links/
5c301299458515a4c70d30c1/Smoking-Prevention-for-Students-Findings-From-a-Three-
Year-Program-of-Integrated-Harm-Minimization-School-Drug-Education.pdf
Midford, R., Cahill, H., Lester, L., Foxcroft, D. R., Ramsden, R., & Venning, L. (2016).
Smoking prevention for students: findings from a three-year program of integrated harm
minimization school drug education. Substance use & misuse, 51(3), 395-407.
https://www.researchgate.net/profile/Richard_Midford/publication/294917973_Smoking
_Prevention_for_Students_Findings_From_a_Three-
Year_Program_of_Integrated_Harm_Minimization_School_Drug_Education/links/
5c301299458515a4c70d30c1/Smoking-Prevention-for-Students-Findings-From-a-Three-
Year-Program-of-Integrated-Harm-Minimization-School-Drug-Education.pdf

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Midford, R., Lester, L., Williams, T. and White, V., 2018. The relationship between Australian
harm minimisation alcohol education and student uptake, consumption and
harm. International Journal of Drug Policy, 52, pp.25-31.
https://www.sciencedirect.com/science/article/abs/pii/S0955395917303523
Moore, M., McKee, M. and Daube, M., 2016. Harm reduction and e-cigarettes: distorting the
approach. Journal of public health policy, 37(4), pp.403-410.
https://link.springer.com/article/10.1057/s41271-016-0031-2
Ridani, R., Shand, F. L., Christensen, H., McKay, K., Tighe, J., Burns, J., & Hunter, E. (2015).
Suicide prevention in Australian Aboriginal communities: a review of past and present
programs. Suicide and Life‐Threatening Behavior, 45(1), 111-140.
https://www.researchgate.net/profile/Joe_Tighe2/publication/265689911_Suicide_Preven
tion_in_Australian_Aboriginal_Communities_A_Review_of_Past_and_Present_Program
s/links/59e56851458515250246fe6d/Suicide-Prevention-in-Australian-Aboriginal-
Communities-A-Review-of-Past-and-Present-Programs.pdf
Rontziokos, H., & Deane, F. (2018). Systematic Review of Suicidal Behaviour in Individuals
Who Have Attended Substance Abuse Treatment. International Journal of Mental
Health and Addiction, 1-19. https://link.springer.com/article/10.1007/s11469-018-9994-5
Sutherland, R., Bruno, R., Peacock, A., Lenton, S., Matthews, A., Salom, C., ... & Barratt, M. J.
(2017). Motivations for new psychoactive substance use among regular psychostimulant
users in Australia. International Journal of Drug Policy, 43, 23-32.
https://www.sciencedirect.com/science/article/abs/pii/S0955395917300026

11
HARM MINIMIZATION
Wilson, M., Jones, J., Butler, T., Simpson, P., Gilles, M., Baldry, E., ... & Sullivan, E. (2017).
Violence in the lives of incarcerated Aboriginal mothers in Western Australia. Sage
open, 7(1), 2158244016686814.
https://journals.sagepub.com/doi/pdf/10.1177/2158244016686814
Wong, G.T. and Manning, M., 2017. Adolescent illicit drug use and policy options in Australia:
A multicriteria decision analysis. Journal of Drug Issues, 47(4), pp.638-664.
https://journals.sagepub.com/doi/abs/10.1177/0022042617719444