AER_newsletter-oct07 by liwenting


									                               Changing the way we drink
                               Newsletter of the Alcohol Education and Rehabilitation Foundation Ltd

                               V O L U M E      1     I S S U E    3                                         S P R I N G   2 0 0 7

  ABN 91 096 854 385
In this issue
Alcohol: Our Favourite
                              From the CEO                                                       New NHMRC
  Drug—ABCTV          p2    Alcohol is no ordinary            Reverend Bill Crews' Exodus
Try the Online Alcohol
  Assessment          p3
                            commodity, to borrow
                            a phrase from the
                                                              Foundation when they pre-
                                                              sented a petition calling for     News Flashdraft
                                                                                                The NHMRC is seeking public
                                                                                                consultation on the
                                                              labelling of alcohol products     25 June '07
                                                                                                 revised Australian alcohol
“Be Real, Be In Control”    World Health Organi-                                                National Awards
                                                              to the Hon. Brendan Nelson         guidelines for low-risk
  South Burnett CTC p4      sation.                           MP and Mr John Murphy MP,          drinking.
“Learning For Liberation”   It can be a toxic sub-            the Federal Member for
                                                              Lowe.                              They are intended to give
  Dublin, June ‘07    p5    stance, both in health                                               Australians clear guidelines on
Mutitjulu Holiday           and social terms when it          This group really have first-      how to avoid, or minimise, the
  Program             p6    is abused.                        hand experience of what            harmful consequences of drinking
                                                              alcohol abuse can do to your       alcohol — both the immediate
Walungurru Holiday          As we emerge from the foot-       health, your relationships
                            ball season and enter                                                effects of each drinking occasion,
  Program             p7                                      and to the people you love.
                            schoolies time, we are see-                                          and the longer-term effects of
ATCA Executive Officer                                        Don Weatherburn reported           regular drinking.
                            ing, once again, the 'mad
  visits Slovenia     p8    Mondays' and the shocking         recently that alcohol-related      When finalised the guidelines will
Perry A Go-Go         p9    Schoolies.                        violence and crimes costs          provide a valuable resource for a
                                                              the NSW Police $50 million a       wide range of groups and
A Political Agenda    p9    Footballers, cans in hand,        year in salary costs alone.        individuals including health
                            greeting their fans in front of   And yet we have demands
Calendar                    the television cameras and                                           professionals, community groups,
                                                              from the hotels lobby for still    professional and educational
                            the trailer loads of grog at      more trading hours, and the
4th Australasian Drug                                                                            organisations, policy makers, the
                            schoolie events.                  Lord Mayors of Sydney and
Strategy Conference                                                                              general public and those
                            What sort of message is this      Newcastle wanting 'a wine          businesses responsible for
Gold Coast
                            sending to our young peo-         bar on every corner'.              providing alcohol.
22-25 October               ple.                              This is despite the evidence       You are invited to comment on
APSAD / Cutting Edge        There is some evidence that       that increased availability        the draft. See the NHMRC website
Conference                  the message is getting            and longer trading leads to        for details at:
Auckland, NZ,               through. Jeff McMullen's          greater consumption and an
                            "Difference of Opinion" on        increase in social and health
4-7 November                                                  harms
                            ABC TV was a good slant                                              The closing date for submissions
ATCA Conference             and complemented the work         Finally, AER has been taking       is TUESDAY 11 DECEMBER 2007
Melbourne                   of the SBS Insight program.       our own message to politi-
                            Dr Norman Swan's Health           cians of all persuasions –
14-16 November              Report on Radio National on
                            drugs and the Teenage brain
                                                              we need to change the              Some recent
ACOSS National                                                way we drink.
Annual Conference           was a studied and serious
                            exposure of the issue.
22-23 November              I was privileged to be with       Daryl Smeaton
                            the wonderful people from         CEO                               There have recently been
                                                                                                several national radio and TV
                                                                                                broadcasts of interest to the
• AER is reviewing its
  grant application
                            Research funded by AER                                              AOD sector.
                                                                                                Difference of Opinion - ABCTV
                            Changes in intoxication levels and experience of                    with Jeff McMullen
  will be advertised on     responsible service practice. BOCSAR                       p2       6 September                 p2
  our website.              Substance use and mental health problems in                         Alcohol: Our Favourite Drug
                            young Australians. UNSW, School of Psychology              p2
                                                                                                Insight - SBS
                            Stability and change in women's alcohol consumption.
                                                                                                with Jenny Brockie
                            Turning Point Alcohol and Drug Centre                      p3
                                                                                                15 May 2007                     p9
                            Reducing morbidity of licit substance users: a record               Are we making booze too
                            linkage assessment of a BI in an ED. Uni. if WA            p3       readily available
                            The relationship between income distribution and
                            alcohol-related harm. Monash Uni.                          p6       ABC Radio National:
                                                                                                The Health Report
                            Evaluation of opportunistic screening & brief
                            intervention program in St Vincent’s ED                    p7
                                                                                                with Norman Swan
                                                                                                8 October 2007                  p10
                            Treatment Multiplier - estimation of need                           Alcohol, drugs and the
                            Turning Point Alcohol & Drug Centre                        p11
                                                                                                teenage brain
                            Modelling GP behaviours in regard to screening for
                            at-risk drinking. NDARC                                    p10
                                                     Alcohol Education and Rehabilitation Foundation Ltd

                        CHANGING THE WAY WE DRINK                                                                           PAGE        2

                               Responsible Service - BOCSAR
                                                                      The study showed that between         tives designed to encourage more
       The likelihood of an   A study by the NSW Bu-
                                                                      2002 and 2006 there was a mod-        responsible service in the wake of
                              reau of Crime Statistics &              est improvement with respect to       the NSW Alcohol Summit.
   intoxicated young adult    Research repeated a sur-                the more overtly intoxicated pa-      It would also seem prudent to
          receiving an RSA    vey originally conducted in             trons in the responsible service of   begin evaluating individual initia-
    intervention improved     2002.                                   alcohol on licensed premises.         tives so we can obtain a better
from one in ten in 2002, to   Since then the NSW Government           The results are consistent with       understanding of what works in
                              had instituted a range of initiatives   other evidence suggesting that it     encouraging the responsible ser-
       one in four in 2006.   to encourage responsible service        is possible to encourage more         vice of alcohol.
                              of alcohol (RSA) on licensed prem-      responsible service of alcohol.       See story:
                              ises.                                   There is, however, clearly scope
 This represents a modest
                              It was important to check whether       for further improvement. It would     page155.asp
improvement with respect      these initiatives had led to an         be prudent to continue with and       Adrian Hobbs
       to the more overtly    improvement.                            perhaps expand the policy initia-     Project Co-ordinator
   intoxicated persons.

                          Alcohol: Our Favourite Drug
                          Difference of Opinion—ABCTV, 6 September
                          Alcohol is deeply embedded in Austra-                       Policy Research at Turning Point Alcohol and
                          lian culture. It’s part of the way we                       Drug Centre (AER grantee)
                          socialise, relax and celebrate. It em-                      Dr Tanya Chikritzhs, Senior Research Fellow
                          ploys 36,000 people in an industry                          and Statistical Advisor at the National Drug Re-
                          worth $18.3 billion.                                        search Institute, Curtin University of Technology
                                                                                      (AER grantee)
                          83% of Australians drink alcohol to some ex-
  So, do we have a        tent. It’s perfectly legal but it causes more               Natalie Toohey, Head of Communications at
                          death and injury than all illicit drugs together.           Foster's Group
  national drinking
                          The program’s panel included:                               Bill Healey, Director, National Affairs for the
  problem? or is it
                                                                                      Australian Hotels Association
   just a case of a       Professor Robin Room, Chair of social re-
                          search in alcohol at the School of Population               Read the transcript, see the video, listen to the
                          Health, and Director of the Centre for Alcohol              podcast.
   few too many?


                              Change in Women’s alcohol consumption
                              Younger women are least likely to abstain                    In the case of 18-23 year olds, cessation or
                              from alcohol consumption and older                           significant reduction in risky drinking was
                              women more likely to do so.                                  predicted by a change in mental health status
Recommendation 1:             Younger women consume alcohol at the highest                 from "depressed" to "not depressed", a change
 the feasibility of a         quantities, while older women consume at the                 in Body Mass Index, becoming married, and
 longitudinal study           highest frequencies.                                         birth of a first child.
 devoted to alcohol use       These are some of the results from a Turning                 Non-smokers and those who had stopped
 be investigated              Point Alcohol & Drug Centre study which also                 smoking, and those having a partner loose their
                              found less than 6% of women were drinking at                 job were also more likely to stop short-term
                              levels associated with risk in the long-term;                risky drinking.
Recommendation 2:
                              although it also found alcohol consumption at                Factors reducing the likelihood of stopping were
 alcohol research             short-term risky levels was exhibited by a large             illicit drug use in the previous year, becoming
 be included as a             proportion of respondents in the youngest and                employed or staying employed, and starting a
 primary component of         mid-aged groups.                                             new close personal relationship. Social support
 the proposed Australian      The study considered factors affecting women's               or a family history of alcohol were not
 Longitudinal Study of        alcohol consumption including educational                    significant in this analysis.
 Older People                 status, marital status or divorce, having                    See the story at
                              children, age, depression, social support,         
                              employment status, financial status, ethnicity,              Adrian Hobbs
                              and socio-demographic factors.                               Project Co-ordinator
                              Data was taken from the Australian Longitudinal
                              Study on Women's Health, which examines the
                              health and wellbeing of more than 40,000
                                                       Alcohol Education and Rehabilitation Foundation Ltd

                             CHANGING THE WAY WE DRINK                                                               PAGE      3

   Substance use and mental health problems
   A study by the School of           Externalising of problems wasFurther, this predictive rela-
   Psychology, UNSW focused           associated with increased    tionship works largely via
   on reasons that mental             usage, to the extent that thesocial mechanisms such that
   health and substance-use           adolescent was in a social   adolescents with behaviour
   problems develop and co-           environment that facilitated problems are likely to show
                                      drug use.                    increased substance use if                Which people will be
   occur in Australian youth.
                                   An internalising disposition    they inhabit a world in which             at greatest risk for
   It was found that:              acts to protect against the use substance use is facilitated.             using licit and illicit
   ∗ Alcohol, cigarette, and       of alcohol, marijuana and       The implications are that early           substances?
      marijuana use was signifi-   tobacco over time, during       intervention efforts should be
                                                                                                             Why are they so vul-
      cantly associated with men- adolescence.                     directed toward the remedia-
                                                                                                             nerable to psycho-
      tal health problems in the   No evidence that social skills, tion of externalised behav-
                                                                   ioural problems, and provid-              logical or psychiatric
      form of outward aggression, emotion regulation, or the
      anti-social behaviour, and                                   ing protective mechanisms                 illnesses?
                                   motives reported for sub-
      impulsiveness.               stance use, had roles in medi- that buffer the negative ef-               How does this vul-
   ∗ Anxiety and depression        ating the relationship between fects of parental and peer                 nerability develop
                                   mental health and substance     influences on substance use.
      were not associated with                                                                               over time?
      substance use once their     use.                            See story:
      shared variance with exter- Higher externalising of prob-                   What are the factors
      nalising problems was con- lems in the context of a facili- pages/page156.asp                          that determine use?
      trolled.                     tative social environment is                                              Can we successfully
   ∗ The relationship of external- predictive of an increase in    Adrian Hobbs                              intervene?
                                   substance use over time.        Project Co-ordinator
      ising problems to substance
      use was largely mediated     The results showed that be-
      by the attitudes of the ado- havioural problems in early
      lescent’s parents and peers. adolescence are predictive of
                                   substance-use problems over

Record linkage and brief interventions.
The School of Psychiatry and           The study concluded that Brief        Recommendations:
Clinical Neurosciences, Univer-        Intervention within the ED            The inclusion of a question on
sity of Western Australia              reaches a larger proportion of the    past hospital events involving
evaluated the viability of Brief       target population, especially those   alcohol and drug-use as part of a
Investigations in the hospital         who may never present at a spe-       screening questionnaire for ado-
Emergency Department.                  cialist facility.                     lescents.
Therapeutic options available in       The main predictor of readmission     Adolescents with a history of AOD
tackling addictive substance use       with alcohol or other drug event      events (available from the WALD)
are usually intensive, costly, and     was having had a previous event.      should be targeted for more inten-
reach only a small proportion of       Another predictor was the use of      sive intervention when they pre-
those being targeted.                  other licit-substances such as in-    sent at hospital EDs.
The study validated a new section      halants or prescription medicines.    Those presenting after the use of
of the WA Department of Health’s       Adolescents presenting with this      inhalants and prescription medi-
Linked Database (WALD) against         type of substance use may also        cines should also be considered
paper hospital records for this        benefit from more intensive treat-    for more intensive treatment.
study.                                 ment.
                                                                             See the story at
It demonstrated the utility of this    There were no gender differences,
approach to data collection for        in particular between users of        page158.asp
future research, thus minimising       alcohol alone and those who used
costs.                                 alcohol with other substances of
                                                                             Adrian Hobbs
Follow-up data was obtained on         concern.
                                                                             Project Co-ordinator
100% of participants, using the
WALD; whereas in an earlier
study, follow-up details could only
be obtained for 69% at 6 months,
53% at 12 months, and 46% at
18 months
                                                  Alcohol Education and Rehabilitation Foundation Ltd

                       CHANGING THE WAY WE DRINK                                                                     PAGE           4

            “Be Real, Be In Control” South Burnett CTC Youth Services
        South Burnett CTC Youth Services (CTC)
        used AER funding to provide diversionary
        activities and education about the dangers
        and risks of alcohol, inhalants, and other licit
        substances to 10-18yo young people.
        The “Be Real, Be In Control” project has
        successfully provided a range of diversionary
        activities for young people in the South Burnett
        area of south east Queensland.
        Specifically, the target clients were young people
        at risk, geographically isolated youth, and
        Indigenous youth across nine small towns in the
        South Burnett region.
        Activities and programs were developed for each
        of the three target groups, including the
        establishment of youth groups and meetings,
        pool parties, game nights, karaoke parties,
        discos, day trips, bowling, a touch football
        competition, the establishment of the “Cherbourg
        Games”, and Duke of Edinburgh training.
        CTC also used AER funding to develop a
        purpose-built trailer with audio visual equipment,
                                                                                                        South Burnett youth group
        which was used extensively for project activities, and which
        can still be used for community events.
        A key determinant to the success of this program was the          Strong community involvement continued throughout the
        input and collaboration by local community organisations.         project in most of the towns included in the project. A number
        The dedicated staff of CTC Youth Services established             of strategic networks and partnerships were formed as a
        voluntary steering committees for each of the target groups.      result, and these will continue to be maintained and developed
        The steering committees involved input from representatives       further for current and future community initiatives.
        of local welfare associations, police, schools, other community   Kirsten Firman, manager of CTC Youth Services, reported that
        members and CTC staff.                                            the primary change resulting from the program occurred on a
                                                                          community level, as all programs created a sense of
                                                                          community togetherness. In particular, the towns that hosted
South Burnett touch football team
                                                                                                      the Youth Groups gave the young
                                                                                                      people a safe, alcohol-free, and
                                                                                                      fun space to meet with their
                                                                                                     This gave adults the chance to
                                                                                                     see young people in a positive
                                                                                                     light and generated a greater
                                                                                                     understanding of the issues facing
                                                                                                     youth in remote towns.
                                                                                                     For more information about the
                                                                                                     “Be Real, Be in Control” project,
                                                                                                     please contact:
                                                                                                     Kirsten Firman at South Burnett
                                                                                                     CTC Youth Services on (07) 4162
                                                                                                     7788 or visit their website

                                                                                                     Eleanor Sharp
                                                                                                     Project Co-ordinator
                                                                Alcohol Education and Rehabilitation Foundation Ltd

                                   CHANGING THE WAY WE DRINK                                                                      PAGE   5

“Learning For Liberation” Dublin, June 2007
Helen Shilton attended the               They have also published an             Helen asked the audience to write
11th International European              anthology of writing inside the         down their thoughts about the
Prison Educators Association             prison.                                 sessions.                                   “There is a
Conference ‘Learning for                 Helen spoke about the creative          A number of students helped with
                                         writing class being the first chance    the preparation of the presentation
Liberation’ in Dublin, Ireland
                                         these men have had as adults to         and Helen provided them with            improvement in
on 13-17th June 2007.
                                         express themselves in the words         feedback about the session and            their English
While there, Helen (Lecturer,            they want to use.                       shared comments with them.
Literacy and Creative Writing at                                                                                           literacy skills
                                         There is a substantial improvement      This has helped them feel involved in
the Alice Springs Correctional           in their English literacy skills and    the process. There was great interest           and
Centre) presented a seminar on           comprehension as they write what is     shown from everyone she spoke to        comprehension
the use of creative writing in           in their hearts.                        at the conference about her work
                                                                                 with Aboriginal people, especially in     as they write
prisons in Alice Springs.                Most of the authors are indigenous
                                         people with a background of drug        regard to language, culture, poor        what is in their
Her seminar inspired many                                                        health, education and alcohol abuse.
participants with this concept for use   and alcohol abuse. For many, this                                                    hearts.”
in their own prison systems in many      abuse has been a major factor           Helen’s paper was well received and
other (mainly European) countries.       leading to their time in prison.        we have included copies of two of
                                         Through writing about substance         the poems by Simon Smith and Hans
Over the past two years, students                                                Katakarinja.
from the creative writing class at       abuse, they can acknowledge their
Alice Springs Correctional Centre        addiction and recognise the need for
have put their stories, poems and        change. Creative writing has assisted   Joanne Weir
radio plays in the public domain.        individuals to make the necessary       Project Co-ordinator
Their work is published in magazines     paradigm shift in their consciousness
and anthologies, and has been            to make a difference in their life
recorded professionally for              beyond prison.

Dreamtime                                                           The Pain Rains
                                                                    My soul wails loud for her comfort
I see time as it affects
                                                                        like a lonely dingo calling for company.
   all things as well as living flesh.                              Leaving her the wound scars my heart
I've seen things struggle to survive                                    like the road cutting through Mparntwe.
   before my eyes.                                                                          The pain rains
Flowers come to bloom                                               Without her I am eaten from the inside
   just to wither and die.                                             I am alone like a hollow log
Trees drop their leaves,                                               in the middle of the desert
                                                                                           The pain rains
   I've seen them eaten from inside.
I have been given a personality,                                    Theories intertwine with my thoughts
                                                                        like the titree bush’s twisting branch tips.
   a name,
                                                                    The sweet truth was buried deep underneath
                        I am alive.                                     like the rich honey of the honey ant
                                                                        that lays beneath the problems of the earth.
I still hear the echoes                                             It was then that memories of what I really missed took shape.
   of music, of singing.                                            Stretched over the distance of my past
Passed down from the elders                                              like a rainbow hovering in a cloud of mist
   to the children.                                                 Untouchable yet beautiful to see.
I am more than any can remember,                                    Slowly but surely like the late dawn of sunrise
I have secrets, I have many songs,                                       delayed by the heights of the MacDonell Ranges
                                                                    It took the breaking of my heart to understand its pain.
   I am the dancer,
                                                                    The whirling mass of dark clouds gather about
I am the paintings on the rocks,                                         collecting the things that matter most
   I am every dot, every line,                                      Building up from fragments of th einner body’s past.
I am the Devils Marbles, I am Uluru,                                Irresistible, the feeling of this country flows through me.
                      I am forever,                                 Foaming with rage like the Todd River after a rain
                I am the Dreamtime.                                 Only now do I realize my soul is crying for my country
                                                                                               Not company
                                         Simon Smith
                                                                                              The pain rains
                                                                                                      Hans Katakarinja
                                                     Alcohol Education and Rehabilitation Foundation Ltd

                      CHANGING THE WAY WE DRINK                                                                          PAGE        6

Kids learned to repair
and maintain their
                               Mutitjulu Holiday Program
                                                                      A major difficulty in organizing a
They competed in a             The Mutitjulu Community
                                                                      program lay in undertaking any
series of bike races,          provided a School Holiday              physical activity due to high
and developed skills in        Program in the community               temperatures in summer.
snooker, basketball,           at Uluru.                              Recommendations included:
football and gymnas-           The project addressed serious          • childcare (for the under-5s that
                               substance abuse problems caused          attended)
tics.                          partly by the ready supply of
                                                                      • a caseworker and case
There was a Blue Light         petrol, alcohol and cannabis.
                                                                        management strategies
disco, hip-hop work-           Mutitjulu's freer access to these
                                                                      • community bus for excursions
                               substances was acting as a
shops, movies and                                                     • greater involvement of parents
                               magnet to people with substance
excursions to outlying         abuse problems from the wider            and caregivers
areas.                         region.                                • alternative venues

                               A varied program was provided          • forming partnerships with
Craft and jewellery                                                     Sydney and NSW Central Coast
                               for all participants, which included
making, and hair-              bicycle repair and maintenance, a        groups to facilitate exchanges
dressing workshops             youth holiday recreation program,        and more volunteers
were popular on the            and hairdressing. The overall          • purchase of

                               emphasis was on leading a                more durable
hottest days.
                               healthy lifestyle.                       bikes
                                                                      • upgrading the

                                                                        BMX track
                                                                      • a cover for the

                                                                        basketball courts
                                                                      •   establishment of
                                                                      Overall the
                                                                      participants were
                                                                      enthusiastic and
                                                                      actively involved
                                                                      in the program.

                                                                      Adrian Hobbs
                                                                      Project Coordinator

                             Income distribution and alcohol-related harm
                         This project by Monash University con-                       It was found that income inequality was sig-
                         tributes to an understanding of geo-                         nificantly and strongly associated with:
A first attempt to       graphic patterns in the extent and nature                    •   hospitalisation caused by acute drinking
develop a Gini           of alcohol-caused harm, and how this re-
                         lates to social and contextual factors evi-                  •   hospitalisation caused by chronic drinking
coefficient, based
                         dent at the level of the local government                    •   deaths caused by chronic drinking
on income
                         area.                                                        There was no significant association found
distribution alone,
                         The study used:                                              between income inequality and death either
for use at a local
                             hospitalisation data obtained from the Na-               wholly or partially caused by acute alcohol use.
area level in            •
                                                                                      This may be attributable to the relatively small
Australia.                   tional Hospital Morbidity Database,
                                                                                      numbers of these deaths evident at a local-
                         •   deaths from the ABS Mortality Datafile,                  area level.
Income inequality
                         •   Local Government Area (LGA) income and                   In general the results showed that increasing
has been shown to            socio-demographic data from the ’01 census.              local-area-level income inequality was
be associated with
                         The project team:                                            associated with increasing rates of alco-
rates of all-cause                                                                    hol caused harm.
mortality, violent       •   developed measures of income disparity for
                             all local areas;
crime, and life
expectancy.              •   developed measures of the rates of key alco-             See the story:
                             hol-related harms; and                         

                         •   analysed and mapped the relationship be-
                             tween income inequality and the rate of alco-            Adrian Hobbs
                             hol-caused harms at an LGA level.                        Project Co-ordinator
                                                                    Alcohol Education and Rehabilitation Foundation Ltd

                                         CHANGING THE WAY WE DRINK                                                                    PAGE       7

Alcohol screening & brief intervention in an ED
St Vincent’s Hospital (Melb)                 ∗   Results:                                  staff training and motivation,
                                                                                           provision of adequate staff time      Alcohol has been
evaluated opportunistic alco-
                                             ∗   149 brief interventions were              and resources, and adequate           attributed to
hol screening and brief inter-
                                                 provided by 40 emergency clini-           privacy;
ventions in their Emergency                                                                                                      more than 3,500
Department.                                                                            ∗   judging the timing of screening       deaths and
It was expected the ED itself would          ∗   only 10% of the 149 participants          during an ED visit needs refine-      96,000 hospital
provide a window of opportunity for              randomised to motivational in-            ment;                                 attendances in
identification, referral, or brief inter-        tervention attended appoint-
vention (BI) for high-risk drinking.             ments                                 ∗   there needs to be an acceptance       Australia
                                                                                           that unless there are specific        annually.
34 doctors and 67 nurses were                ∗   the remainder received standard           staff for screening, many pa-
given BI training by Turning Point               care - no counselling                     tients will not be screened.
Alcohol and Drug Centre, maximis-                                                                                                Alcohol use is the
ing the probability that at least one        Brief Intervention:-                      Alcohol screening and BIs are fea-
                                                                                                                                 most common
                                                                                       sible in terms of actual time spent
BI-trained staff member would be             ∗   consideration could be given to       per task; but the perception of           reason for repeat
present on each shift.                           offering all emergency clinicians     time required for these activities        ambulance and
All attendees to this adult emer-                training in Brief Intervention;       was a barrier to staff participation,     emergency
gency department were eligible for               however                               especially the time taken for re-         department
screening for high-risk alcohol use                                                    cruiting and consenting of patients
with the Paddington Alcohol Test.            ∗   ED attendance with alcohol                                                      attendance.
                                                 screening appears to decrease         for research.
Over the 12 months of the                        high-risk alcohol use, regardless     This is an important consideration
study:                                                                                 for future ED-based alcohol inter-        Yet few studies
                                                 of the type of intervention.
∗   32,965 patients presented                                                          ventions.                                 have examined
                                             ∗   emergency clinicians trained to                                                 the effectiveness
∗   10,274 of these were screened                deliver BIs may be no more effi-
                                                                                       See the story:
                                                                                                                                 of ED clinician-
    by 183 emergency clinicians                  cacious than standard care, or
                                                 referral for off-site motivational
∗   1,046 screened positive for high-
    risk alcohol use                             interview.
                                             Screening:-                               Adrian Hobbs
∗   471 consented to enrolment in
                                                                                       Project Co-ordinator
    the study                                ∗   issues that need to be addressed
∗   females were less likely than                when introducing screening for
    males to consent                             high-risk alcohol use include

Walungurru Holiday Program
The Walungurru Community                    including music workshops, lantern
Council Aboriginal                          making and painting
Corporation provided a                      Hairdressing workshops (also
School Holiday Program for                  popular with the mothers) covered
the remote community of                     washing and cleaning, treatment for
                                            head lice and scabies, hair cutting,
Kintore, 530km west of
                                            styling and colouring.
Alice Springs.
                                            There was a very high rate of
Isolation and boredom were major                                                     This was a holistic approach with an
                                            attendance at all activities, with
factors, with petrol sniffing and                                                    emphasis on healthy eating and            "Kids with smiling
                                            many parents getting involved as         exercise.
suicide on the increase and                 well.
                                                                                                                               faces and laughing
difficulty undertaking much physical                                                                                           are usually a good
activity due to high temperatures.          Many new skills were taught and
                                                                                     Joanne Weir                               indication if a
                                            are still apparent in the community:
The Holiday program included:               young girls continue to do each          Project Co-ordinator                      program is running
∗   a workshop teaching the kids to         others' hairdressing, and the boys
                                            continue to use the BMX track daily                                                Walungurru had
    repair and maintain bikes
                                            and maintain their bikes.                                                          plenty of both
∗   a mini-BMX track constructed
                                                                                                                               throughout this
∗   a series of evening races using                                                                                            program.
    the new track and repaired bikes                                                                                           High participation
∗   skills development in cricket,                                                                                             and attendance
    cycling, softball, volley ball and                                                                                         numbers are also
    gymnastics                                                                                                                 another way to
∗   Blue Light Disco, photo-sessions                                                                                           gauge the success of
    and movies                                                                                                                 these programs.

∗   excursions to outlying areas
                                                                                                                               Walungurru also
                                                                                                                               experienced these
Arts and crafts were introduced                                                                                                throughout the
                                                       Alcohol Education and Rehabilitation Foundation Ltd

                       CHANGING THE WAY WE DRINK                                                                        PAGE        8

                             ATCA Executive Officer visits Slovenia
                             Janice Jones, Executive Officer of the                   The ATC has been operating since the 1960s as a
                             Australasian Therapeutic Communities                     supportive organisation for professionals who work
                             Association, travelled to Slovenia to                    in TCs. It acts as a focus for information, debate,
                                                                                      and training in support of its 53 member agencies
                             attend the European Federation of                        and 21 individual members. ATC member agencies
                             Therapeutic Communities (EFTC)                           provide programs for a variety of client groups
                             Conference in June 2007.                                 including drug and alcohol recovery, personality
                             Janice also visited the Association of Therapeutic       disorders, child protection, homelessness, mental
                             Communities in the United Kingdom to research and        health, and sexual abuse perpetrators.
                             analyse governance structures for use at ATCA.           RADIO PROGRAM
                             THE EUROPEAN FEDERATION                                  The UK ATC in collaboration with the EFTC facilitates
                                                                                      a web-based radio program
                             The European Federation of Therapeutic
                                                                                      which includes interviews with well known luminaries
                             Communities has been in operation for 29 years.
The Mayor of Skofia Loka                                                              from the sector as well as interviews with managers,
                             Its membership is spread over 15 countries and           staff and researchers.
 Mr. Igor Draksler (left),   represents more than 40 treatment centres. The
     Janice Jones and                                                                 Incorporated in the Royal College of Psychiatrists
                             Federation operates out of a “Virtual Office”. It has
the Secretary of the EFTC                                                             Centre for Quality Improvement, the Community of
                             no paid staff and is managed by the Executive
                                                                                      Communities is a standards-based quality
 Dirk Vandevelde (right),    Committee comprising seven members from six
                                                                                      improvement network which brings together TCs in
                             European countries.
                                                                                      the UK and internationally. It facilitates an annual
                                          Janice was invited to attend their AGM      cycle of self and peer reviews which promotes
                                          and was impressed to see so many            improvement in quality TC practice.
                                          countries represented. This creates an
                                                                                      SITE VISITS
                                          interesting mix of nationalities and
                                          cultural norms to coordinate.               During her stay, Janice also visited 3 therapeutic
                                                                                      communities in the UK.
                                          THE CONFERENCE
                                                                                      MAIN HOUSE personality disorder service providing
                                          The EFTC and drug rehabilitation            assessment and treatment for men and women aged
                                          programs of Slovenia welcomed               18 upwards with long-standing and severe
                                          delegates to the 11th EFTC European         emotional, behavioural and interpersonal difficulties.
                                          Conference on Rehabilitation and Drug       They run a 12 month program under a democratic
                                          Policy in Slovenia.                         model for the day-to-day running of the house.
                                         The overarching theme of the conference      Resident's progress is regularly reviewed and after 9
                                         was that of working together with clients,   months the residents attend a "moving on" group.
                                         carers, service providers and                GLEBE HOUSE, near Cambridge, provides a relapse
                                         governments to ensure a network of           prevention program to young men with behaviour
                                         treatment services which work for the        that causes significant concern and/or have
                                         needs of the client. Within this             perpetuated sexual abuse. The service offers
A sumptuous feast            movement the Therapeutic Community movement              residents a 52 week program followed by a 2 or 3
prepared by the residents,   plays an effective and creative part.                    year follow up support network situated in carefully
their families and people    The Conference explored four themes:                     managed exit houses. Glebe House is staffed by 8
from the local village.                                                               clinical practitioners and 15 therapists including
                              •   Working with the Criminal Justice System
                                                                                      forensic scientists plus admin and support staff.
                              •   Not Just Addiction
                                                                                      THE LEY COMMUNITY was established in Oxford in
                              •   Families and Communities; and                       1971 by two local psychiatrists working with drug
                              •   Contributors to Change                              dependent people in treatment at Littlemore
                                                                                      Hospital. There are now 25 staff working within a
                                                  SERVICE VISIT                       community of up to 64 residents. Half the staff have
                                                  The co-host of the Conference       been through a drug rehab programme themselves.
                                                  Društvo “Projekt Clovek”            OUTCOMES
                                                  (Association Project Manager)
                                                                                      An understanding of the broad range of services
                                                  invited all the delegates from
                                                                                      using the TC model as a treatment process for
                                                  the conference to visit their
                                                                                      various issues.
                                                  Therapeutic Community in Skofia
                                                  Loka, 30 minutes drive from the     ATCA has negotiated with the ATC to host a 3-day
                                                  city of Ljubljana.                  Living and Learning Workshop as an adjunct to
                                                                                      ATCA's annual conference
                                                  This was an exciting event as the
                                                  local community, parents of the     Radio TC International now has an interview with the
                                                  residents and the residents         Executive Officer of ATCA discussing Therapeutic
                                                  themselves had all contributed to   Communities in Australia included in its program.
                                                  the preparation of a fantastic      Community of Communities will present their
                                                  meal served in a marquee in the     standards and workshop the peer review process at
                                                  grounds of the TC.                  ATCA's Annual Conference
                                                 Delegates were welcomed by the       Its governance and management practices compare
      Newly completed        Mayor of Skofia Loka and the Manager, staff and          favourably with the UK
 accommodation for final     residents who had prepared a musical greeting for
       stage residents.                                                               A pen pal program is in the process of being
                             us. The TC is set in a valley surrounded by pine
                                                                                      established with the Ley communities in Australia
                             covered mountains.
                                                                                      and New Zealand with ATCA playing a leading role.
                             THE UK ASSOCIATION                                       Craig Fees has reported that Janice's visit has had
                             Janice met with Craig Fees, the Secretary of the         good repercussions: "What you're achieving with
                             Association of Therapeutic Communities (ATC) and         ATCA is feeding into discussions about the future
                             the Director of the Therapeutic Community Archive        direction of ATC and the Planned Environment
                             Office.                                                  Therapy Trust”.
                                                                                      Janice Jones
                                                               Alcohol Education and Rehabilitation Foundation Ltd

                                      CHANGING THE WAY WE DRINK                                                            PAGE      9

Perry A Go-Go
Perry Shire Council (west of            gers of alcohol and other drugs on     Anecdotal evidence is that these      “The idea of ‘drug-
Bundaberg) in conjunction with          their health and wellbeing,            events were very successful and       proofing’ the kids
surrounding shires purchased a          Attracting an average attendance of    well received throughout the com-
trailer equipped with a large                                                  munity. The organising committee      before they enter
                                        24 young people (about 80% of the
sound system together with CDs          target audience) as well as some       planned to continue with a pro-        high school was
and DVDs.                               parents, the discos were also popu-    gramme of events, and the facility
                                                                                                                    identified previously
This formed the basis for seven         lar with older members of the com-     continued to be in heavy demand.
discos staged in Mt Perry in con-       munity welcoming a venue with no       In summary, a small grant making a
                                                                                                                      by parents and
junction with other events such as      smoking or alcohol.                    large impact of ongoing value in a   teachers of Mt Perry
the local agricultural show, rodeo,                                            small community.
                                        The steering committee consisted of                                            State School.”
etc., as well other events in           local police, parents, local nursing
neighbouring shires.                    director, student and Shire Youth      Adrian Hobbs
The project aimed to educate young      Group representatives, and the         Project Co-ordinator
people at upper-primary school          Shire's Community Development
level (years 5 to 7) about the dan-     Officer.

Putting binge drinking on the political agenda
Rev. Crews and a group of reformed                    Recent figures released by the Economist
alcoholics travelled to Canberra to                   magazine show Australia ranks first for                              “We need to
deliver a petition calling on                         take-away alcohol sales.                                       develop an honest
government to force brewers to put                                                                                     approach to the
alcohol health warnings on their                                                                                       risks associated
products.                                             Sam Hunt                                                         with alcohol use
                                                      Public Affairs Officer, AER                                          and abuse”,
With 61% of all alcohol consumed by
                                                                                                                     Murray McFadyen.
Australians drunk at levels considered risky
to high risk, Rev. Crews believes
consumers have the right to know exactly
how it will affect their health.
“Binge and unhealthy drinking should be an
election issue. Both major parties need to
look at ways of curbing and minimising its
affects”, says Rev. Crews.

                                                                                                                    “Research on
                             The petition was presented                                                             labelling shows that
                             to Dr. Brendan Nelson                                                                  if the messages are
                             by reformed alcoholic
                             Mr Murray McFadyen.
                                                                                                                    short, specific, and
                                                                                                                    large enough, they
                                                                                                                    can have an effect,”
                                        For more information see the Exodus Foundation website at:                  Daryl Smeaton, CEO
                                                      of AER.
                                                                                                                    “Other countries
                                                                                                                    such as the USA,
                                                                                                                    Canada and some
                                                                                                                    members of the EU
                                                                                                                    label alcohol. AER
                                                                                                                    believes that
                                                                                                                    consumers are
                                                                                                                    entitled to similar

                                                                                                                    And another
     SBS Insight 15 May 2007                                                                                        transcript that
     “With more and more 24-hour licences being issued, there's increasing concern we may be                        makes interesting
      making booze too readily available.”                                                                          reading
       Read the transcript at
                                               Alcohol Education and Rehabilitation Foundation Ltd

                    CHANGING THE WAY WE DRINK                                                                        PAGE        10

                        Grants in Australia - CPA Australia, June 2007
                        CPA Australia has released its latest version of          The booklet can be downloaded as a PDF file
                        “Grants in Australia: management and                      for reading on-line or printing from the CPA
                        accountability made easy for not-for-profit               Australia website at
                        organisations” dated June 2007
                        This is straightforward guide for not-for-profit
                        bodies is aimed at helping them manage                    xchg/SID-3F57FECA-2111CC5D/cpa/
                        grants and satisfy accountability                         hs.xsl/990_23011_ENA_HTML.htm

                                                  Update your contact details
                                       IF YOU MANAGE A GRANT WITH AER—ARE YOU
                         Changing jobs?                                                          Moving?
                                                    Going on long term leave?
                                                                       Starting to manage an AER Grant?
Please, help us          If you answered YES to any of these questions, then please give AER a
keep in contact          call on (02) 6122 8600 or shoot your friendly Project Co-ordinator an email.
   with you.             This will help us keep our database up-to-date, and help us keep in touch.
                         Thank you
                         Gail, Eleanor, Joanne, Adrian

                             Modelling GP behaviours
                         Early screening and brief intervention                   •   Targeted payments showed a cost per standard
                         (GPs are in a unique position to do this)                    drink avoided of $691. This is the financial
                         potentially has significant benefits in the                  incentive, fee-for-service system, generally
                                                                                      adopted in Australia.
                         prevention of alcohol-related health and
                         social problems.                                         The study concluded that:

                         This NDARC study at the University of NSW re-            •   there is little empirical evidence for the principle
                         analysed existing studies, using Australian data             that financial reward is an effective incentive for
                         wherever possible. A simple measure, "cost per               a GP to modify their practice in defined ways.
                         standard drink avoided" was developed to facilitate          This needs further examination.
                         comparison.                                              •   there is scope for future research to explore the
                         Four strategies were identified and modelled in              economic impact of combining methods.
                         detail:                                                  •   other methods of screening patients and
                         •   Academic detailing showed a cost per standard            providing brief interventions need to be
                             drink avoided of $50. Educational activity focused       investigated.
                             on individual GPs within their practice.             •   the workload on GPs of providing preventive
                         •   Interactive continuing medical education                 services needs to be examined.
                             workshops showed a cost per standard drink           See the story at
                             avoided of $86. Education sessions conducted
                         •   Computerised reminder systems showed a               Adrian Hobbs
                             cost per standard drink avoided of $91.              Project Co-ordinator

  Are you a risky
                         Try the Online Alcohol Assessment
     drinker?            at Turning Point Alcohol and Drug Centre’s website
Try this online test.              Are you a risky drinker?                       There are 10 questions to complete before
                                                                                  you are presented with an assessment of
                                                                                  your drinking levels and suggested actions
 Privacy assured.        The online assessment can help you work out              you may consider taking.
                         if your drinking levels are posing a risk to
                         your health.                                             Your privacy and confidentiality is assured.

                         Do the test online at:
                                                          Alcohol Education and Rehabilitation Foundation Ltd

                               CHANGING THE WAY WE DRINK                                                             PAGE       11

Graduate Diploma in Psychology
The AER Foundation congratu-       when attempting to address
lates Alison Maynard for com-      disadvantaged young people’s                                               Alison with her
pleting her Graduate Diploma in    substance use issues and the                                               Graduate Diploma in
Psychology.                        course I have completed has
                                                                                                              Psychology from
Alison is part of the Youth Out-   added to my ability to work in
                                   this sector more effectively.”                                             Deakin University.
reach Team at Drug and Alcohol
Services West (DASWest) in         Alison.
“As the drug and alcohol sector    Joanne weir
and the mental health sector       Project Co-ordinator
are becoming more connected

Treatment Multiplier - estimation of need
Turning Point Alcohol and Drug Centre                alcohol use. Those in crisis or with immediate
studied specialised alcohol and drug                 physical needs, or were acutely intoxicated were
treatment in Victoria: using telephone               ineligible.
services to determine the prevalence of              Routinely collected demographic information was
problematic alcohol use and treatment                used to determine whether the study population
utilisation.                                         differed from those not included. The treatment
It is clear that excessive licit and illicit drug    multiplier was calculated as the proportion of
consumption is responsible for considerable          callers that had received government-funded              This study
harm in society. The planning and provision of       alcohol treatment in Victoria in the previous 12         demonstrated the
alcohol and drug treatment endeavours to             months.                                                  feasibility of using
reduce these harms to the individual and the         Results from this study were compared with               data from a
wider community.                                     estimates from other studies and is in broad             telephone
Systematic planning of substance-abuse               agreement in predicting between 34,900 and               counselling and
treatment services is essential. In the past,        47,000 individuals expected to receive treatment         referral service to
treatment systems have developed in response         through government-funded agencies.                      develop a treatment
to political pressure, personal philosophy,                                                                   multiplier.
                                                     The study concluded that:
advocacy for a particular group and funds                                                                     Application of a
availability. A clear and systematic planning        •   Data collected from a telephone service can be
                                                         used to form a treatment multiplier to               multiplier method
process is generally absent.                                                                                  indicate that the
                                                         calculate the number of clients that require
Use of prevalence estimation of service demand           intensive treatment for alcohol use annually.        Victorian
is supported, but this is especially difficult for                                                            government-funded
hard-to-reach populations. This study aimed to       •   In Victoria, it estimated that the government-       treatment sector
use a multiplier method to determine the                 funded treatment sector should expand                may need the
number of individuals with problematic alcohol           treatment for alcohol by 300%.                       capacity to serve up
consumption.                                         •   The potential for research data collection on        to 40,200 clients per
The group studied was those callers to the               hard-to-reach populations via a telephone            year.
DirectLine drug and alcohol counselling and              counselling and referral service is feasible.
                                                         Special consideration due to the unique service      This is a 300%
referral service who requested help for their own                                                             increase from
alcohol use. Those in crisis, with immediate             delivery type should be given, especially in
                                                         areas such as training for data collection, caller   current treatment
physical needs, or who were acutely intoxicated                                                               utilisation for alcohol
were omitted.                                            recruitment and the diverse range of caller
                                                         presentations.                                       clients.
Questions covered the caller’s use of alcohol and
drug treatment services. The data was analysed       See the story at
to provide standard epidemiological rates of
treatment utilisation which was then compared
to other prevalence rates of alcohol consumption
determined using a variety of other methods.         Adrian Hobbs
The validity of the ‘DirectLine’ method was then     Project Co-ordinator
Data were generated by anonymous
questionnaire from an alcohol and drug
telephone counselling and referral service
between July ‘04 and December ’04. Eligible
callers were those requesting help for their own
Alcohol Education and Rehabilitation                  AER was established as an independent public company
Foundation Ltd                                        in October 2001 with a $115 million grant from the
PO Box 19                                             Australian Government to address prevention, treatment,
Deakin West ACT 2600                                  research and rehabilitation for the misuse of alcohol as
Australia                                             well as paint, petrol and glue sniffing.
Level 1, Suite 8                                      AER strives to:
Arralumna House
8 Phipps Close                                        •    prevent alcohol and other licit substance misuse, including
Deakin ACT 2600                                            petrol sniffing, particularly among vulnerable population
                                                           groups such as Indigenous Australians and youth;
Phone:      (02) 6122 8600
                                                      •    support evidence-based alcohol and other licit substance
Fax:        (02) 6232 4400                                 misuse treatment, rehabilitation, research and prevention
E-mail:                               programs;

Website:                              •    promote community education encouraging responsible
                                                           consumption of alcohol and highlighting the dangers of licit
                                                           substance misuse;
                                                      •    promote public awareness of the work of the AER and raise
                                                           funds from the private sector for the ongoing work of the AER;
            We’re on the Web:
                             •    provide funding grants to organisations with appropriate
                                                           community linkages to deliver these services.
                                                      Commitment to these objectives drives the work we do each day.

Alcohol, drugs and AER’S TRAVEL POLICY                                                                       Subscription
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Disclaimer: The ideas and views expressed in this newsletter are those of the AER Foundation except for those credited to individuals or other
organisations. Any comments should be made via letters to the Editor that can be published, or directed to the authors themselves. If you wish to
provide a contribution, that would be welcome, but there is no guarantee of publication. No anonymous contributions accepted.
                                                                                                                                   PAGE       12

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