Alcohol and other drugs

In April 2015, the Australian Government established a National Ice Taskforce to advise on the development of a National Ice Action Strategy, which was delivered in December of that year. There was $298.2 million was invested over four years to strengthen drug education, prevention, treatment, support and community engagement.

South Western Sydney Primary Health Network (SWSPHN) has been tasked with commissioning drug and alcohol treatment services, based on the needs of the local community. SWSPHN has worked with the local drug and alcohol sector and the community to co-design new services that will build on the existing local services to better meet the unique needs within south western Sydney.

       South Western Sydney Drug and Alcohol Service Directory 

 

Why do we need to act?

Excessive alcohol intake is a major risk factor for morbidity and mortality. Long term adverse health effects of high consumption of alcohol include cardiovascular disease, some cancers, nutrition-related conditions, risk to unborn babies, cirrhosis of the liver, mental health conditions, tolerance and dependence, long term cognitive impairment and self-harm.

22.1 per cent of residents in South Western Sydney aged 16 years and over, consumed alcohol at a level posing long term risk to health compared to 25.9 per cent in NSW.

Drug misuse includes use of illicit substances, misuse of pharmaceutical medication (ie prescription, or over the counter medications), as well as the misuse of household substance. Drug misuse impacts on both mental and physical health.

42 per cent of Australians aged 14 years or older reported previous illicit drug use, including misuse of pharmaceuticals. There has been an increase in those misusing pharmaceuticals, particularly in men aged 30-39 years and women aged 40-49 years.

The use of crystal methamphetamine more than double between 2010 and 2013. Methamphetamine use has also been identified as a growing issue within the Aboriginal communities. This increase use has seen more than a 5-fold increase in methamphetamine related hospitalisations across Australian. Since 2013, South Western Sydney Local Health District has had the second highest rate of hospitalisations across metropolitan Sydney.

People who misuse substances are more likely to experience a mental health problem than the general community.

SWSPHN has completed an extensive consultation with the relevant stakeholders has identified local priorities. As a result of this consultation, the following action plan has been developed:

  1. Support the increase in primary health care capacity to manage drug and alcohol related health issues by:
    • Developing support through a professional network
    • Improved integration with LHD services through GP Liaison support
    • GP registrar training to increase knowledge skills and confidence in addiction medicine
    • Development of treatment protocols, decision support tools and referral pathways
  2. Development of treatment services prioritising higher need groups including youth, homeless, parents with children, people exiting the justice system and other at risk groups. 
    • Psychological counselling
    • Withdrawal management
    • Rehabilitation (non-residential)
    • Aftercare
    • Indigenous specific Alcohol and other drug (AOD) services
  3. Increase the cultural competency of mainstream drug treatment services when treating Indigenous populations

 

Commissioned services

On Friday 9 June 2017 SWSPHN officially launched the newly commissioned services that will work with clients, their families and with GPs to provide withdrawal management, rehabilitation, aftercare and psychosocial counselling. These services include:

  • ACON: Founded in 1985, ACON is a NSW based health promotion organisation providing specialised information and services supporting the needs of lesbian, gay, bisexual, transgender and intersex (LGBTI) people and people with HIV. ACON will be expanding their flexible, individualised psychosocial counselling service for the LGBTI community with AOD needs into South Western Sydney. ACON will also be providing training to GPs. See the ACON website for more information, http://www.acon.org.au/ or see the attached flyer.
    • Services can be accessed by invidivuals or health professionals by calling the intake officer Ph: 9206 2000 (call back within 48 hours) or via the website www.acon.org.au/substance-support
       
  • Headfyrst: The Salvation Army is working with headspace centres in South Western Sydney to provide their counselling and support services to young people aged 12-25 years who have co-morbid mental health and AOD health needs. Outreach services will be co-located at the headspace sites in Liverpool (Ph: 8785 3200), Campbelltown (Ph:4627 9089) and Bankstown (Ph: 9393 9669). For more information email headfyrstsouth@aue.salvationarmy.org visit their website or see the attached Headfyrst Brochure

 

  • Odyssey House: Providing psychosocial counselling, care coordination, after care and case management services for adult clients with co-occurring AOD and mental services are available in Campbelltown with outreach in Tahmoor, Bowral and Bankstown.  Odyssey house has commenced an innovative model of care to work with general practices providing skilled staff to support clients to continue withdrawal management with their own GP.
  • St Vincent de Paul: Expansion of their six-week non-residential rehabilitation day program in Campbelltown to support services including before and after care, psychosocial counselling, case management, psychosocial education groups and support groups for adults with AOD dependency. Services will be available in Liverpool, Fairfield and Warwick Farm, as well as working with the local Aboriginal communities in SWS to deliver culturally appropriate AOD services. More details can be found on the website www.vinies.org.au/findhelp or see the attached Rendu House brochure.

    See Forms and Templates for referral templates suitable for practice software.

 

Supporting General Practice

There is evidence that Australian GPs may not be identifying up to 70 per cent of risky/high-risk drinkers. To support early intervention, SWSPHN is supporting GPs to utilise the 5A’s framework, which encourages screening assessment and brief intervention, and has been proven an effective approach.

 

The 5A’s framework

The framework provides health professionals with an evidence based approach to identifying and supporting high risk behaviours. The 5As consist of:

  • Ask: systematic identification of risk factors
  • Assess: multiple risk, readiness to change, health literacy
  • Advise/Agree: tailored information, motivational interviewing, goal setting
  • Assist: referral to intensive intervention
  • Arrange: follow up, maintenance

Drug and Alcohol localised HealthPathways are being developed to help guide health professionals in providing appropriate care through clinical referral pathways and support servcies. The service directory of local drug and alcohol support services can also help support GPs with the implementation of the 5As framework.

Tools for implementing 5As

 

SWSPHN has a long history of supporting general practice implementing the 5As framework within a quality improvement model. See here for more information on how to be involved.

Learning opportunities

SWSPHN is working with the local drug and alcohol sector to tailor suitable learning opportunities to support general practice to increase their skills knowledge and confidence in managing patients with substance abuse issues.  See the SWSPHN website for more information on CPD events.

The Opioid Treatment program requires medical practitioners to be come accredited OTP prescribers, by completing the Opioid Treatment Accreditation Course (OTAC).

All patients must be initiated and stabilised on the OTP by an accredited prescriber before they can be transferred to the care of a non-accredited provider. A non-accredited provider may be authorised by the Ministry of Health to prescribe methadone or buprenorphine for up to 5 patients. Forms to apply for authorisation can be found here.

Health professional resources

Other useful resources