Substance-Use Nursing & Primary Health Care: Victoria, Australia Essay

This essay provides a detailed analysis of substance-use nursing and its role within primary health care in Victoria, Australia. It begins by defining the attributes of substance-use nurses, highlighting their independence, patient-facing approach, multifaceted skills, and structured care methods. The essay then establishes substance-use nursing as a crucial component of primary health care, emphasizing its focus on addressing the personal healthcare needs of individuals and families affected by substance abuse, within the context of the community. The study examines the specific clientele served by substance-use nurses in Victoria, including those requiring psychological counseling, withdrawal services, and pharmacotherapy, with a particular focus on the needs of vulnerable populations such as the youth and the Aboriginal community. The essay identifies the need for culturally competent substance-use interventions for Aboriginal Australians, which is addressed by several initiatives, including Aboriginal Community Controlled Organizations and the Bunjilwarra Koori Youth Alcohol and Drug Healing Service. It concludes by outlining two key responses a primary healthcare nurse can initiate to ensure culturally appropriate substance-use nursing care: creating a culturally safe environment and conducting health education programs for patients and the public.

Running Head: SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA
AUSTRALIA
Substance-use Nursing & Primary Health Care: Victoria Australia
Name:
Institutions and Affiliation:
Instructor:
Date:

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
Substance-use Nursing & Primary Health Care: Victoria Australia
A substance-use nurse has different attributes. They are independent, engage in
multifaceted activities, patient-facing and have a structured approach to the provision of drug-
and-substance treatment services (Johnston, 2017). In regard to independence, these nurses can
independently provide pain management services and also single-handedly regulate the treatment
process of individuals addicted to drugs and substances. Secondly, substance-use nurses are
patient-facing as they focus on directly engaging each individual patient in one-on-one teachings
on the dangerous effects of drug use and addiction. They thus provide patient-centred care that is
tailor-made for the patients and those at risk, knowing well that treatment options vary among
persons (Wilkinson et al, 2015). Thirdly, these nurses are multifaceted and therefore able to
manage different interacting factors that influence care for substance and drug use addicts. They
can work as social workers, handle mental health problems and also effectively administer
medical treatment of cases. Partly as a social worker, a Substance Abuse Nurse plays a role in
supporting individuals that have little else than addiction in their lives. Further, a substance-use
nurse plays a structured role and thus has a well-planned approach to the treatment of their
patients (Roden & Jarvis, 2012). Through their structured care, they are able to administer and
regulate treatment, teach the public, patients and their families on dangers of drug and substance
abuse. Their structured care enables them provide the appropriate physical and/or emotional
support to these groups.
Primary healthcare involves providing integrated and accessible healthcare services
particularly by clinicians that are accountable in addressing numerous personal healthcare needs,
creation of sustainable partnership with their patients and further, practicing within the context of
both family and the community. Substance abuse nursing meets the threshold to be a role of

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
primary health care as it involves effective treatment of patient's substance use problem and
therefore addressing their "personal health care need" as envisaged in primary healthcare
requirements (Roden & Jarvis, 2012). In line with their attributes, substance-use nurses works
within the context of family and the community. This therefore indicates that substance abuse
nursing is a role in primary healthcare.
A substance-use nurse provides primary healthcare services to individuals, families and
the community which are mainly aimed at preventing, managing and controlling drug and
substance abuse (Thomas & Staiger, 2012). Their clientele’s main characteristics include;
persons requiring drug-use related psychological counselling; individuals seeking substance use
withdrawal and rehabilitation services and further, those that require pharmacotherapy to manage
their drug and substance addiction. A case of Victoria state in Australia, a substance abuse nurse
serves a clientele of about 40, 000 people annually who are under the state’s specialist drug,
alcohol and other substance use treatment programs(Wilkinson et al, 2015). The nurse can
provide these services within the community-based treatment centres. In Victoria the clientele
include; the youth-a population that is most vulnerable to dug and substance use; the aboriginal
population, whose health outcomes are worse than those of non-indigenous Australians; all
citizens within Victoria that need these services as directed by the Victorian Severe Substance
Dependence Treatment Act of 2010 (Thomas, & Staiger,2012). According to the Act the state’s
specialist drug, alcohol and other substance use treatment centres should offer compulsory
treatment to residents with severe substance dependence. Further, the clientele would include
groups and persons that require family and peer support services to aid their peers in the
treatment process.

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
From the clientele characteristics, the most outstanding health issue of concern is the
need for culturally appropriate substance-use interventions for the aboriginal Australians.
Understanding that culturally competent health care is paramount in reducing gap between the
healthcare disparities between the aboriginal and non-indigenous Australians, I determined that
cultural competence in substance use nursing for aboriginal communities in Victoria is
imperative. A nurse should thus ensure that their services are appropriate and culturally
acceptable to the aboriginal community (D'Abbs & Chenhall, 2013). Their community and
residential based drug-and-substance treatment services must meet the specific healthcare needs
of the aboriginal Australians across Victoria. There are several justifications as to why the nurses
must take action to ensure that the substance use nursing services provided are culturally
appropriate. First, primary healthcare emphasizes that healthcare providers should effectively
deliver services which meet cultural, linguistic and social needs of their patients (D'Abbs &
Chenhall, 2013). Secondly, culturally competent health providers can ensure that there is
improvement in the health outcomes and the quality of care of patients within their catchment.
Further, culturally competent system of health can also contribute effectively on eliminating
racial and/or ethnic disparities in health.
Several initiatives are in place within victoria to ensure that the aboriginal communities
receive culturally competent substance-use nursing care. The first initiative is aimed at
promoting access to alcohol and other substances treatment services for aboriginal residents. The
Victoria state government through the Aboriginal Community Controlled Organizations offers
accessible aboriginal-specific substance use nursing services (Campbell et al, 2017). These
organizations accept referrals which come from in-take services within the catchment areas to
enrol them on alcohol and substance treatment services. They also accept direct referrals from

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
different treatment centres to boost accessibility. Aboriginal people also have a choice of
utilizing the mainstream services via the existing intake services in different catchments in
Victoria. Further, health facilities give first priority to the Aboriginal people in the provision of
treatment services for alcohol and other drugs in the state; ensuring that this group finds
maximum access to the services (Johnston, 2017). Accessibility to primary healthcare as
promoted in these initiatives agrees with the Ottawa Charter’s strategies including the one on the
need to build healthy public policies. It is evident that the policies guiding the Aboriginal
Community Controlled Organizations in Victoria are healthy as they are tailor-made to ensure
equity in healthcare for all Australians disregarding their demographic status (Campbell et al,
2017). The initiative also creates a supportive environment for Aboriginal Australians to develop
good self-health-seeking behaviour, as envisaged in the second action plan of the Ottawa Charter
(Tilford, 2017). This is consideration that they take up these services and own the initiatives
under implementation in their areas.
The second initiative includes the Bunjilwarra Koori Youth Alcohol and Drug Healing
Service. This service is state-wide and it comprises of 12-bed residential rehabilitation and/or
healing services specifically meant for young people of age 16-25 years from the Aboriginal
communities in Victoria (D'Abbs & Chenhall, 2013). The service is conducted by the Victorian
Health Service and the Youth Support and Advocacy Service. These services are however
supported by the state Aboriginal and non-indigenous health services. Further, the Aboriginal
Metropolitan Ice Partnerships, an initiative under Victoria's Ice Action Plan is currently being
implemented in four metropolitan parts of the state. It is aimed at helping Aboriginal people in
the areas to have improved access to substance use nursing services for those affected by ice and
other drugs(Campbell et al, 2017). This is carried out via partnerships of different Aboriginal

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
community Controlled organizations and the mainstream substance and drug treatment service
providers. The organizations carry out assertive outreach and/or treatment services and help in
streamlining accessibility to even more intensive services when necessary. This approach agrees
with the Ottawa Charter strategy on the need to re-orient primary healthcare towards illness
prevention and promote health (Fry & Zask, 2016). By partnering with different institutions, it is
clear that this program plays a major role in preventing drug and substance-use negative effects
and at the same time promotes the available health care services for Aboriginal Australians to
access.
A primary healthcare nurse can initiate two responses in order to address the need for a
culturally appropriate substance-use nursing for aboriginal Australians. First, a nurse must
effectively create a culturally appropriate environment within their areas of jurisdiction as an
authority, which will attract Aboriginal people in Victoria to approach him/her for drugs-and-
substance-use treatments (Johnston, 2017). The goal of this initiative will be to offer a culturally
safe, welcoming and friendly service to the Aboriginal people in different catchment areas in
Victoria. The objective of this initiative mainly includes the intention to promote access of
treatment services for those at risk and already engaging in substance abuse from the aboriginal
communities. This is in regard to the understanding that primary healthcare must meet the health
needs of each social group to effectively prevent and control adverse health conditions. Among
the strategies to create a culturally safe, friendly and welcoming environment, nurses should be
willing to accept any drug-and-substance user referral cases including self-referrals, direct
referrals especially from other facilities and those from intake services in catchment areas
(Wilkinson et al, 2015). This will make them Aboriginal people feel accepted and prioritized in
regard to the efforts towards improving their health.

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
Another initiative includes carrying out health education of the patients, relatives and the
public on drug-and-substance adverse effects. This agrees with the Ottawa Charter strategy on
inculcating skills among the people to prevent and/or ameliorate disease conditions (Fry & Zask,
2016). The main goal of this strategy will be to ensure that by the end of the teachings, individual
aboriginal people visiting the primary healthcare facility will be aware of the dangers of
substance use and the approaches to prevent them. The main objective thus includes ensuring
that all patients enrolled on substance use treatment therapy are fully informed of their likely
health deterioration if they persist on the use of substances (Zimmermann et al, 2012). This will
also improve their compliance levels to rehabilitation services and even make them share out the
information to other community members. The strategies as borrowed from Strobbe (2013) will
include holding brief learning sessions, providing learning materials like brochures, and
engaging in focus groups to teach visiting aboriginal patients and those at risk from the
catchment areas on the dangers and the importance of quitting drugs-and-substance use.

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
References
Campbell, M., Hunt, J., Scrimgeour, D., Davey, M., & Jones, V. (2017). Contribution of
Aboriginal Community-Controlled Health Services to improving Aboriginal health: an
evidence review. Australian Health Review.
d'Abbs, P., & Chenhall, R. (2013). Spirituality and Religion in Response to Substance Misuse
Among Indigenous Australians. Substance Use & Misuse, 48(12), 1114-1129.
Fry, D., & Zask, A. (2016). Applying the Ottawa Charter to inform health promotion programme
design. Health Promotion International, daw022.
Johnston, D. (2017). Cultural Competence Training In Sydney Local Health District
Australia. Primary Health Care Open Access, 07(02).
Kovitwanichkanont, T., & Day, C. (2017). Prescription Opioid Misuse and Public Health
Approach in Australia. Substance Use & Misuse, 1-6.
Patouris, E., Scaife, V., & Nobes, G. (2016). A behavioral approach to adolescent cannabis use:
Accounting for nondeliberative, developmental, and temperamental factors. Journal Of
Substance Use, 21(5), 506-514.
Roden, J., & Jarvis, L. (2012). Evaluation of the health promotion activities of Paediatric Nurses:
Is the Ottawa Charter for Health Promotion a Useful Framework?. Contemporary Nurse,
365-403.
Strobbe, S. (2013). Addressing substance use in primary care. The Nurse Practitioner, 38(10),
45-53.
Thomas, A., & Staiger, P. (2012). Introducing mental health and substance use screening into a
community-based health service in Australia: usefulness and implications for service
change. Health & Social Care In The Community, 20(6), 635-644.

SUBSTANCE-USE NURSING & PRIMARY HEALTH CARE: VICTORIA AUSTRALIA
Tilford, S. (2017). From the Ottawa Charter 1986 to the Vienna Declaration 2016. International
Journal Of Health Promotion And Education, 55(3), 173-174.
Wilkinson, C., Allsop, S., & Dare, J. (2015). Alcohol, ageing and Australia. Drug And Alcohol
Review, 35(2), 232-235.
Zimmermann, A., Lubman, D., & Cox, M. (2012). Tobacco, caffeine, alcohol and illicit
substance use among consumers of a national community managed mental health
service. Mental Health And Substance Use, 5(4), 287-302.