Theme: Alcohol and Other Drugs
Attendees - 19.
Mark Haynes: AOD Youth Outreach Worker at Ballarat Community Health
Chair & Acknowledgement of Country
Kelly Ashmore: Administration Officer at Highlands LLEN
Note Taker
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Pauline Molloy: Manager of the Pharmacotherapy – Harm Minimisation Team at Ballarat Community Health.
Pauline presented on harm minimisation and the work that BCH are currently doing in this space. Ballarat Community Health are running a month-long promotion around harm minimisation which refers to a set of frameworks and policies that the government supports as part of our national drugs strategy that seeks to lessen the harmful effects of alcohol and other drugs on individuals and the community.
Pauline discussed three programs that are being run by Ballarat Community Health to promote harm minimisation.
Naloxone Provision
Overdose deaths in Australia continue to rise with more than 1700 people dying as a result of accidental drug overdose in 2016 (this is more than the road toll). The State Government provide funding to BCH to increase the access to and uptake of Naloxone across the community. BCH’s project around Naloxone involved visiting and training prescribers and pharmacists in the Community Overdose Prevention Education Protocol (COPE) who would in turn train patients to use the drug effectively in the event of an overdose. BCH currently has a Masters of Public Health Student who will be undertaking an evaluation of the project over 5 weeks to gauge its success and current barriers.
Medication Assisted Treatment of Opioid Dependence (MATOD)
This treatment involved substituting opioids with other long acting opioid drugs such as methadone, the aim being to assist people to manage physical dependence, craving and compulsive drug use. Outcomes involved improving health for patients enabling them to live a more stable life style. The substitution drugs are chosen as they are orally active (do not need to be injected) and are only required to be taken once a day.
This treatment is also known as ORT or OST. BCH are very busy in this space and are anticipating a potential increase in the number of people identifying as having dependency issues as the Safe Script program rolls out this year. Safe Script is a real time prescription monitoring program which involves tracking of ‘monitored’ medicines every time they are prescribed or dispensed to patients.
Needle and Syringe Program (NSP)
There are many NSP’s across Ballarat including local pharmacies, all the Ballarat Community Health sites as well as at Uniting.
NSP’s Provide:
- Sterile injecting equipment
- Sexual health products
- Sharps disposal facilities
- Health information
- Referrals to other services.
There is no evidence to suggest that NSP’s encourage drug use but there is very strong evidence of their role in harm reduction in the AOD space. It is extremely cost effective with every dollar being invested in NSP’s resulting in a $27 return in cost savings.
Pauline handed over to Philippa Cane to discuss the Secure Dispensing Unit.
Secure Dispensing Unit
A Secure Dispensing Unit is basically a vending machine for sterile injecting equipment. There are a variety of packs that the machine dispenses including steroid packs and 10 x 1ml packets of syringes. It is open 24 hours. It specifically allows cohorts of people who wish to escape the stigma of attending an NSP to access these products. It is located across the road from Eureka Medical Centre which was a key aim of the program. BCH have about eight volunteers who come in fortnightly to pack the machine, they are integral to the success of the program. The SDU has been running for just over a year and is steadily increasing in number of products being dispensed.
How do people access it?
They press the button, select the product and it will be dispensed just like any vending machine. There is a child safety button on the machine to stop any unsafe access.
Is there any anxiety from clients as the SDU is so close to the police station?
The police have been very supportive, we haven’t had any targeting or incidents with the SDU.
Have you noticed a change over the past 5 years in terms of the people using these services?
Not necessarily. The cohort of people using NSP’s is not what people might expect with 1% of users under 20, 5% under 25 and 1/5 over 50. The cohort being treated using MATOD are also aging with users growing older.
What were people’s reactions when you offered them the Naloxone?
People often didn’t want to identify as using opioids, instead they were happy to say they were using amphetamines. A lot of new people are coming in to get access to the drug, and some of them are travelling a long way to receive Naloxone. It’s worth noting that Naloxone isn’t just used for illicit drugs, a lot of prescription drugs are causing overdoses as well.
Do you think people aren’t seeing prescription drugs as a risk?
I think this is very much the case.
Are there any pharmacotherapy treatments for methamphetamines that you know of?
There are trials being run at the moment.
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Mark Haynes: AOD Youth Outreach Worker at Ballarat Community Health
Mark presented on The SSMART ASSK Program and the changes they have made recently to increase engagement in the program. The SSMART ASSK Program is centred around harm minimisation and is run for all Year 9 students across the region including Bacchus Marsh and Beaufort. The students enter and work their way around four different stations on various topics including Alcohol and its Effects, Party First Aid and Drug Use. Then there is a skit performed that simulates a party scenario exploring the issues young people may face at parties around drug use and sexual assault.
We utilise a computer program where the students can use their phones to ask questions anonymously, this has been implemented to avoid any embarrassment over questions asked and encourage a better discussion and this method has been working very well.
There continues to be a lot of questions asked by students around sexual assault, questions about consent, where to go to get help, how to respond etc. Very useful to see these questions and be able to gauge what is happening across schools in our community and respond effectively. Different themes come from different schools, some display better knowledge on various issues, and some have more awareness or practical exposure.
AOD Station
Wanting to bring more information about new drugs and synthetics so that the students are aware of the effects and dangers we introduced some elements to the Other Drugs station.
There is a police representative on the SSMART ASSK panel who provides information and insight into the legal issues surrounding these questions.
Mark discussed his clients and their reporting had been focused on Ecstasy use for young people in the age group (18 – 24) which arises often from a natural curiosity, its easy availability and the perceived safety around this particular drug. They are wanting to bring the issue of Ecstasy use into the program and how the students can engage with the information.
This study examined the different ingredients they found in various pills in five countries.
The program now includes asking students to use simple kitchen ingredients to prepare a ‘batch’ of Ecstasy to identify where specific ingredients come from and understand the variations of each ingredient that can be found in different pills.
Are you seeing an increase in people taking Ketamine?
Yes absolutely, it’s becoming a lot more common. We explore this drug with the students to get them thinking about the risks of using it.
The program is seeing different trends for young people and we are trying to adapt the program to these changes.
Do we measure whether the messages have stuck down the track for the students?
We have tried to measure the impact of SSMART ASSK, it has been very difficult. We hope that we can adapt an accurate measure of the success of the information getting through. We capture the information in a survey the students do at the end. In the past some of the messaging has not been as effective as we would have liked and this came from follow up surveys to students a year or two later. This was one of the main drivers of revisiting the SSMART ASSK program and trying to condense the message down to 3 key points that will hopefully prove to be more memorable.
Does anything go out to parents about the program to teach them about harm minimisation?
I will take that back and find out what information is sent out to families, I’m not sure how much is sent home for parents to learn as well as the students. The students do complete work in class at their various schools prior to coming to SA and anecdotally it has been observed that their general knowledge about drugs and their effects has improved over the last year or two.
Check out the YSAS website http://www.workingitoutwithyodaa.org.au/ for fact sheets and info on AOD.
Could parents at home be ignorant to the fact that prescription medications at home could be just as dangerous as illicit drugs and should schools be doing more on this?
Yes I think this is a big issue that needs to be addressed a lot more and not looked over by people. We know that the majority of overdoses both deliberate and accidental is due to the misuse of prescription medications rather than illicit substances.
Was there an impact to moving the program to Wendouree Performing Arts Centre?
The program used to be run at the Element Nightclub to simulate the environment for the students. It has a good impact by providing a window into what clubs look like in the daylight, but it wasn’t as conducive as the performing arts centre for delivery.
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Resources and Further Information
Young Entrepreneur's Day
Youth Priority Access Dental Clinic
Girl Space
Multicultural DV Alert Training
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Thank you to BGT Jobs + Training for providing BYSN with a home at Barkly Square
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Next Meeting:
Theme: Working with LGBTQI+ Young People
Tuesday, 15 October 2019
Barkly Square
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