RACGP: Action needed on NSW alcohol and other drug reform

Royal Australian College of GPs

The Royal Australian College of General Practitioners (RACGP) has today called on the NSW Government to act decisively and deliver on alcohol and other drug policy reform.

More than two-and-a-half-years ago, Commissioner Dan Howard handed the report of the Special Commission of Inquiry into crystal methamphetamine and other amphetamine type stimulants to the NSW Government. It contains 109 recommendations, none of which have been acted on. This is despite a joint statement from the RACGP, the Royal Australasian College of Physicians (RACP) and its Australasian Chapter of Addiction Medicine, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the Australian Medical Association (AMA) NSW in October last year calling on the Government to stop delaying its response to the inquiry.

RACGP President Adj. Professor Karen Price said that action was needed.

“Enough is enough, the NSW Government must act now,” she said.

“The report was handed down more than two-and-a-half-years ago and none of the recommendations have been acted on. Disappointingly there was no funding included in the NSW budget handed down just last week – this is a missed opportunity.

“Although this was a special inquiry into crystal methamphetamine, commonly known as ‘ice’, the report contained detailed recommendations on how to tackle alcohol and other drug use in communities across the state more broadly. Alcohol and other drug use is, first and foremost, a health issue that should be managed by health professionals, including GPs.

“There is no point continuing with the status quo and hoping that a ‘war on drugs’ approach will get us anywhere. Almost all of us know a person in our lives who has a problematic relationship with alcohol or other drugs. This isn’t something that affects ‘other’ people, it cuts across all demographics and all segments of society. The NSW Government should heed the recommendations of the report and put in place practical solutions.”

RACGP NSW and ACT Chair and Sydney GP A/Professor Charlotte Hespe said that the report contained many promising recommendations.

“The report’s recommendation could, if acted on, make a positive difference in the lives of many people in my home state of NSW,” she said.

“Several of the recommendations speak specifically to the vital role GPs play in helping people with alcohol and other drug issues. The report recommends that NSW Health promote and facilitate increased access to ambulatory withdrawal for amphetamine-type stimulants in clinically appropriate circumstances including appropriate support for GPs delivering care in nonacute settings. This is important because helping people withdrawing from these stimulants is challenging in the best of circumstances.

“The report also outlines that NSW Health should, in areas of need, enhance models of alcohol and other drug nurse in-reach services to GP clinics. Primary health networks in NSW should also continue to enhance and fund the development of training for GPs to support them to effectively screen for amphetamine-type stimulant use and refer into treatment as required. This would complement the RACGP’s successful AOD GP Education Program.

“Also, the report specifies that primary health networks in NSW continue to enhance, fund, and deliver capability building programs for GPs to support them in utilising mental health and chronic disease care plans for alcohol and other drug use. Another vital recommendation is that NSW Health work with the Government and advocate for the inclusion of additional alcohol and other drug-specific items in the Medicare Benefits Schedule. This would make a real difference and better enable responses to alcohol and other drug use in communities across Australia.

“We have the road map in front of us. Now is the time for the NSW Government to dust off the report and act because these problems will not go away.”

Chair of the RACGP’s Specific Interests Addiction Medicine network and Sydney GP Dr Hester Wilson said that action was sorely needed on multiple fronts.

“The Government should respond to the recommendations and develop an evidence-based whole-of-government alcohol and other drugs policy as well as a Drug Action Plan, as recommended in the report,” she said.

“This should be done in consultation with experts in addiction medicine, GPs, and other health practitioners. The Government should significantly increase funding for evidence-based alcohol and other drugs services so that everyone seeking treatment can get it when they need it. They should also ensure personal addiction issues are treated as health and social issues, not as criminal ones.”

Dr Wilson said that there has never been a more important time to act on the report’s findings.

“We saw during the pandemic that more people turned to drugs and alcohol when faced with lockdowns that isolated them from loved ones and activities they enjoy. It was a way of coping with a very stressful and lonely situation and the fallout from the pandemic will be felt for quite some time,” she said.

“These people need help. Punishing people with alcohol and other drug problems does not work. It is counterproductive and can make their situation a lot worse in the long run, instead they need help and compassion. We need to carefully look at the underlying causes of alcohol and other drug use. As a GP that is something that I do almost every day, I take the time to try and get a solid understanding of the factors that lead to this behaviour and what kind of help my patients need.

“As I have said many times before, people don’t just get out of bed in the morning and decide to ruin their life through drug and alcohol use. It is far more complex than that, yet a law enforcement-first approach assumes otherwise. We need to change course and responding to this report handed down more than two-and-a-half-years ago is long overdue.”

The RACGP’s submission on the National Alcohol and Other Drug Workforce Development Strategy highlights the key role of general practice in helping patients with drug and alcohol problems.

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