Public Health Essay: Addressing Substance Abuse in Aboriginal Youth

This essay addresses the critical public health issue of substance abuse among Aboriginal youth aged 13-24 in Australia, highlighting its significant impact on their health and wellbeing. The introduction outlines the developmental challenges faced by this population group, including increased freedom and risk-taking behaviors, which contribute to substance use. The essay delves into the impact of alcoholism and illicit drug use, citing statistics on early onset of substance abuse, higher rates of drug use compared to non-Indigenous counterparts, and the associated health risks, including mental health issues, accidents, and risky behaviors. It explores the complex causes of substance abuse, including the lasting impacts of colonization, socioeconomic factors like poor access to healthcare, racism, unemployment, family conflict, and peer influence. Furthermore, the essay examines the role of public health workers and services, discussing various intervention approaches, such as community-based programs, workforce development, and cognitive behavioral interventions like Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT). The essay concludes with recommendations for addressing the issue, including increased funding for community programs, taxation on alcohol, and the importance of cultural appropriateness and family support. The paper references relevant studies and reports to support its claims and provides a comprehensive overview of the issue and potential solutions.

Running head: PUBLIC HEALTH
PUBLIC HEALTH
Name of the student
Name of the university
Author note

1
PUBLIC HEALTH
Introduction
Adolescents or young adulthood is the main developmental period, which is typically
characterized by a sequence of life transitions, like going through and leaving the compulsory
education system, making new peers, entering employment. Younger people experience greater
freedom and less control than they normally experience during the childhood (Snijder et al.,
2018). This appears to be one of the particular issue related to drug and alcohol abuse among the
aboriginal male aged between 13 to 24 years. The consumption of alcohol and drugs is one of the
main cause of preventable disease and illness in Australia. , including the main trends in the
availability, harm, consumption and treatment for the vulnerable population (Snijder et al.,
2018).
The report aims to discuss about a current health issue like drug and alcohol abuse among
the aboriginal youths aged 13 to 14 years. In order to do so, the report will critically interpret the
methods for the building up of the community constituencies and collaborations directed to an
advancing youth health within the local primary health care settings. Furthermore, this report
will also provide with some sets of recommendations of how the public health care workers can
support this groups of population to prevent, minimize and alleviate the health condition.
Impact of alcoholism and illicit drug use
Indigenous people have the oldest culture in the world. One of the common experience
among the indigenous people is the lasting impact of colonization that continues to impact the
health and the wellbeing of many indigenous people nowadays. Additionally with the lower
outcomes in many social determinants of health like education, poor access to the health care
services, racism, housing and unemployment increases the susceptibility of the drug and alcohol

2
PUBLIC HEALTH
abuse. Hence, the prevention of the substance use among the adolescents has been identified as
one of the key areas to improve the health of the indigenous people. Substance use and
alcoholism has been evident in the lower age. In Australia, the substance use among the
aboriginals is reported to be 2-6 years earlier than the national average (Snijder et al., 2018). The
Aboriginal and the Torres Strait Islanders are 4 times more likely to report about injecting drugs.
In Australia, the indigenous adolescents aged between 14-15 years are five times more likely to
report about the use of the cannabis and are more than twice to report about excessive use of the
alcohol when compared to the non0indegenius counterparts (Snijder et al., 2018). The early onset
of the substance abuse has been found to be identified as one of the risk factors for the
problematic substance abuse later in the life.
Alcoholism and drug abuse have well documented effect on the substance users. The
prolonged use of the drugs and the alcohol not only deteriorates the health of a person, but also
impairs the mental health and also damages the spirit of the person (Doyle et al., 2018).
Alcoholism and drug abuse impacts both the users and the society, from the health risk of the
users to the increased risk of early pregnancy, financial cost, accidents and the productivity cost.
The three main causes of death due to alcoholism and drug abuse has been found to be motor
vehicle accidents, suicide and homicide (Geia, Broadfield, Grainger, Day & Watkin‐Lui, 2018).
Adolescent people have stated that in the last two weeks they have either driven under the
influence of alcohol or drugs. Recent data has shown that the aboriginal adolescents who indulge
in binge drinking are more likely to engage in risky behavior, such as keeping a large number of
sexual partners and inconsistent use of sexual protection. 25% of the females who had been
treated for substance abuse have reported pregnancies (Wand et al., 2016). A significant amount
of hospitalizations and do tor’s visits are attributable to illicit use of drugs and alcohol. As per

3
PUBLIC HEALTH
the report in 2018, 78666, emergency rooms visits by the adolescents in Australia have been
found due to the illicit use of drugs and alcohol. Some of the most common drugs used in
Australia are Cocaine, marijuana, methamphetamine (Wand et al., 2016). Higher rates of
marijuana has been associated with increasing number of school dropouts. As per the findings,
adolescents are more susceptible to the chronic effects of marijuana on the cognition of the
adolescent population.
Some of the common psychiatric disorders associated with the use of alcohol are
depression, anxiety disorder, bipolar disorder. More cases of suicide attempt has also found to be
associated with the illicit use of drugs (Kennedy et al., 2015). ADHD among the adolescents has
been found to be associated with substance abuse. As it has been already stated, that adolescents
aboriginals who consume alcohol or drugs are often associated with antisocial behavior and risky
behavior such as unprotected sex, increasing the transmittance of sexually transmitted disease.
An elevated risk of HIV has been found among the Aboriginal and the Torres Strait Islander
adolescents, this is due to the illicit use of injectable drug use among the adolescent population.
Again according to the study by Webster (2012) there had been an elevated rate of prescription
drug use among the Australian aboriginal adolescent Individuals.
The reason behind the current pattern of substance abuse among the aboriginal and the
Torres Strait Islanders are complex. Many scientist are of the opinion that alcohol and drug abuse
are consequences of the effects of dispossession and colonization and the separation from the
cultural practices (Bryant et al., 2016). However, most of the literary sources have focused on the
impact of the contemporary realities of poor living standards, unemployment, family conflict and
welfare dependence, lack of boredom. Racism and discrimination in the field of health care,
education and unemployment have also been identified as some of the factors for alcoholism and

4
PUBLIC HEALTH
drug abuse (Gutierrez & Sher, 2015). The effect of familial environment is another factors
influencing substance abuse and abstinence, particularly for the Indigenous Australians, where
association to the immediate and the extended family are strong and are expected culturally. In
communities where illicit use of drugs or alcoholism in common or for the individuals who are
regular users, family instability is found to be one of the common predisposing factor (Gutierrez &
Sher, 2015). Some of the other issues that has been noticed related to alcohol or drug use are,
parental absenteeism, drug use, home based use of alcohol and drug use. Peer groups can be
greatly influential as acknowledged by young Aboriginal Australians involved in the sniffing of
petrol and intravenous use of drugs.
Role of the public health workers and services and interventions
Efforts for preventing alcoholism and reducing the use of drugs includes a wide range of
interventional approaches that target primary interventions, addressing the needs of the users and
the community. A number of services can be provided by health care workers with the aim of
delaying the use of adolescent substance abuse and prevention of the associated adverse effects.
In order to benefit the mainstream population, health care workers can collaborate with the
educators and can conduct school based prevention programs for reducing the onset and the
escalation of the substance use. Calabria, Clifford, Rose and Shakeshaft, (2014) have stated that
family based and community based strategies can be helpful. Gutierrez and Sher, (2015) have
argued, mass media campaigns had not been very effective in reducing drug abuse and
alcoholism. In fact the Calabria, Clifford, Rose and Shakeshaft, (2014) have argued that mass media
campaigns can to some extent contribute to this practice. This can be explained by the fact that
younger generation might consider it to be cool enough to try out some thin that is banned or is
related to something risky.

5
PUBLIC HEALTH
Recognizing the community threat of alcohol and drugs an interdisciplinary team model
can be used to prevent the use of drugs in the communities (Broyles, Conley, Harding & Gordon,
2013). The model combines the participation of the communities, students, health care
professionals and the teachers. It is necessary to develop the workforce. In order to make that
possible it necessary to provide sufficient training to the health care workers and the social
workers for enhancing the educational competencies for providing the basic services like alcohol
screening, brief intervention and referral to treatment, prevention programs for children of the
parents with substance abuse disorder, implementation of the evidence based community
programs (Cunningham & Paradies, 2012). Stakeholders like the pharmacist, physicians,
assistants, nurse practitioners, social workers, dentists, psychologists and occupational therapists
can be involved in the community based programs.
According to Broyles, Conley, Harding Jr and Gordon, (2013), community Reinforcement
Approach (CRA) is an evidence bases cognitive behavioral intervention for the adolescent
population suffering from alcohol and drug abuse. CRA reduces the consumption of alcohol and
drug abuse by the use of a social, recreational , family and the vocational reinforces for
motivating people towards making their non-drinking and non-drug using life style more
rewarding than alcoholism or the consumption of drugs (Broyles, Conley, Harding Jr and Gordon,
2013). Community Reinforcement and Family Training (CRAFT) is a cognitive behavioral
intervention in collaboration with targeted aboriginal and the Torres Strait Islander community
for the delivery of health care in an aboriginal-specific health care setting. The interventions
would provide systematic and personalized training and support to the family members of a
problem drinker (Broyles, Conley, Harding Jr and Gordon, 2013). It would also take in to account,
the social and the emotional wellbeing of the family members.

6
PUBLIC HEALTH
Substance abuse and alcoholism is a public threat and hence the nurses and health care
professionals play an important role in patient advocacy. They can provide referrals to important
services like special helpline number, rehabilitation centers for drug abuse. Nurses can teach or
counsel the patients to develop resilience in order to cope up with both the positive and negative
emotions and disruptive behavior related to drinking and drug abuse (Alim et al., 2012).
Resilience allows an individual to adapt themselves to stressful or traumatic events associated
with substance abuse (Calabria, Clifford, Rose & Shakeshaft, 2014).
Conclusions and recommendations
Although, the government had introduced several reforms in order to control the rampant
alcoholism and drug abuse among the aboriginal adolescent, but one of the flaw is the common
assumption of Aboriginal to be a homogenous population with the some common interventions.
Better approaches are required to address the diversity of the population as well as facilitating
cultural appropriateness, encouraging the training of the staffs for offering a broader range of the
intervention approaches that even include support for the families.
It is recommended to find out the protective factors that can prevent the indiscriminate
use of drugs and alcohol among the adolescent youth. These are- strong bonding with the
families, experience of parental surveillance with transparent rules of conduct within the family
unit and the involvement of the parents in the lives of the children, bond with prosocial
institutions like school , family or religious organizations can also have positive impact on the
adolescents. The government should increase the funding to set up more community based
programs for abstaining the adolescents from alcohol. Some of the other recommendations
includes, increasing the tax over alcohol. No alcohol outlets should be present within the close
proximity of schools and universities.

7
PUBLIC HEALTH

8
PUBLIC HEALTH
References
Alim, T. N., Lawson, W. B., Feder, A., Iacoviello, B. M., Saxena, S., Bailey, C. R., …
Neumeister, A. (2012). Resilience to meet the challenge of addiction: psychobiology and
clinical considerations. Alcohol research : current reviews, 34(4), 506–515.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860393/
Australian Institute of Health and Welfare, (2017).Alcohol, tobacco & other drugs in Australia.
Access date: 12.3.2019. Retrieved from:
https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/
contents/priority-populations/aboriginal-and-torres-strait-islander-people
Broyles, L. M., Conley, J. W., Harding Jr, J. D., & Gordon, A. J. (2013). A scoping review of
interdisciplinary collaboration in addictions education and training. Journal of addictions
nursing, 24(1), 29-36. DOI: 10.1097/JAN.0b013e318282751e
Bryant, J., Ward, J., Wand, H., Byron, K., Bamblett, A., Waples‐Crowe, P., ... & Kaldor, J.
(2016). Illicit and injecting drug use among I ndigenous young people in urban, regional
and remote A ustralia. Drug and alcohol review, 35(4), 447-455. doi: 10.1111/dar.12320
Calabria, B., Clifford, A., Rose, M., & Shakeshaft, A. P. (2014). Tailoring a family-based
alcohol intervention for Aboriginal Australians, and the experiences and perceptions of
health care providers trained in its delivery. BMC Public Health, 14(1), 322.
https://doi.org/10.1186/1471-2458-14-322

9
PUBLIC HEALTH
Calabria, B., Clifford, A., Rose, M., & Shakeshaft, A. P. (2014). Aboriginal Australians, and the
experiences and perceptions of health care providers trained in its delivery. BMC Public
Health, 14(1).
Cunningham, J., & Paradies, Y. C. (2012). Socio-demographic factors and psychological distress
in Indigenous and non-Indigenous Australian adults aged 18-64 years: analysis of
national survey data. BMC public health, 12(1), 95. https://doi.org/10.1186/1471-2458-
12-95
Doyle, M. F., Butler, T. G., Shakeshaft, A., Guthrie, J., Reekie, J., & Schofield, P. W. (2015).
Alcohol and other drug use among Aboriginal and Torres Strait Islander and non-
Aboriginal and Torres Strait Islander men entering prison in New South Wales. Health &
Justice, 3, 15. doi:10.1186/s40352-015-0027-1
Geia, L., Broadfield, K., Grainger, D., Day, A., & Watkin‐Lui, F. (2018). Adolescent and young
adult substance use in Australian Indigenous communities: a systematic review of
demand control program outcomes. Australian and New Zealand journal of public
health, 42(3), 254-261. https://doi.org/10.1111/1753-6405.12789
Gutierrez, A., & Sher, L. (2015). Alcohol and drug use among adolescents: an educational
overview. International journal of adolescent medicine and health, 27(2), 207-212. DOI
10.1515/ijamh-2015-5013
Kennedy, M. C., Marshall, B. D., Hayashi, K., Nguyen, P., Wood, E., & Kerr, T. (2015). Heavy
alcohol use and suicidal behavior among people who use illicit drugs: A cohort
study. Drug and alcohol dependence, 151, 272-277.
https://doi.org/10.1016/j.drugalcdep.2015.03.006

10
PUBLIC HEALTH
Snijder, M., Stapinski, L., Lees, B., Newton, N., Champion, K., Chapman, C., … Teesson, M.
(2018). Substance Use Prevention Programs for Indigenous Adolescents in the United
States of America, Canada, Australia and New Zealand: Protocol for a Systematic
Review. JMIR research protocols, 7(2), e38. doi:10.2196/resprot.9012
Wand, H., Ward, J., Bryant, J., Delaney-Thiele, D., Worth, H., Pitts, M., & Kaldor, J. M. (2016).
Individual and population level impacts of illicit drug use, sexual risk behaviours on
sexually transmitted infections among young Aboriginal and Torres Strait Islander
people: results from the GOANNA survey. BMC public health, 16(1), 600.
https://doi.org/10.1186/s12889-016-3195-6
Webster P. C. (2012). Prescription drug abuse rising among Aboriginal youths. CMAJ :
Canadian Medical Association journal = journal de l'Association medicale canadienne,
184(12), E647–E648. doi:10.1503/cmaj.109-4258