Substance Abuse in Remote Australia

“Smooth runs the water where the brook is deep”. Henry VI, Part 2

Earlier this week the Federal Indigenous Affairs Minister, Senator Nigel Scullion, released a report commissioned by the Department of Health four years ago into issues related to petrol sniffing in remote communities and regions. The Minister’s media release emphasises the significant reductions in the incidence of petrol sniffing in remote Australia over the eight years since Low Aromatic Fuel (LAF) began to be rolled out in remote Australia. NACCHO’s response was similarly positive.

The report itself, authored by Professor Peter d’Abbs and Gillian Shaw of the Menzies Research School in Darwin and Bowchung Consulting in Canberra respectively, is a text book study in how detailed and robust research and analysis can shine an analytical light onto what are very opaque and confusing real world trends. At around 40 pages, plus appendices, replete with clear tables and analysis, the report is a reasonably easy read and repays closer attention than I give it here.

Apart from the detailed findings, the report provides substantive support and confirmation for an extremely positive narrative, namely, that government policy can make a difference if backed up with persistence, policy leadership, and dare I say multi-party support. But smooth waters run deep.

The Australian Government began to focus on the issue in the mid-1980s when the Senate produced a report on Volatile Substance Abuse. In 2005, BP began to produce OPAL fuel, Commonwealth introduced its Petrol Sniffing Prevention Program (PSPP), and the then NT Government introduced NT legislation on substance abuse. Over the subsequent years, there was a focus on persuading fuel retailers to voluntarily shift to low aromatic fuel in remote regions. Baseline research on the extent of the problem in remote communities was commissioned. The latest report is merely the latest in that line of commissioned policy research.

In 2013, the Parliament enacted the Low Aromatic Fuel Act 2013 to promote the take up of LAF and to control the sale of non-LAF in prescribed areas.

The Bill was initiated by Greens Senator Rachel Siewert, and like much legislation, was the subject of a complex and quite tortured gestation, with more than a few twists and turns along the way. The Bills Digest prepared by the Parliamentary Library (Low Aromatic Fuel Bill 2012, Bills Digest 68:2012-13) provides an excellent summary of the policy lead up to the Bill, the Bill’s structure and framework, and outlines the positions of the various parties and stakeholders.

A Senate Committee report outlined broad multi-party support for addressing the issue, but recommended against the Greens Bill. To give a flavour of the complicated politics underlying the Bill’s development and passage, Senator Scullion’s speech on the second reading in November 2012 laments and criticises a change of tack by Labor away from bipartisan Labor/Coalition opposition to the Bill (on the rationale that uniform national legislation by the states and territories was required) and to a position supporting the Greens’ Bill. Senator Scullion suggested that there must have been some ‘deal’ between Labor and the Greens relating to some other issue, and perhaps he was right. The link above to the page on Parliamentary website dealing with the Bill takes you to an informative webpage with links to the various stages of the Bill’s progress through the Parliament, including the Second Reading debate.

Having initially opposed the legislation, Minister Scullion has become a convert, utilising his Ministerial powers to ban the supply of Regular Unleaded Petrol (RULP) in areas around Tennant Creek, Katherine and Palm Island in Queensland.

The Australian Government operates a web site dedicated to low aromatic fuel policy and information. The link is here.

The Australian Health Ministers’ Advisory Council  Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report provides a comprehensive snapshot of the broad array of health issues facing Indigenous Australians. At pages 114-5, it outlines the issues and some key literature on substance abuse including petrol sniffing.

The release of the most recent report, and the short background outlined above provides an opportunity to provide some commentary on the policy issues involved.

The thirty year process of policy development provides further demonstration, if any is needed, of just how hard it is to drive policy change in the Indigenous policy domain. And this in an area where virtually everyone accepts that there has been a major problem. While the numbers of sniffers documented in the report are comparatively low, when a thirty year view is taken, the numbers of lives irretrievably affected, and the consequential life opportunities foregone, amounts to a terrible cost for thousands of Indigenous citizens.

A second and related observation is to note the substantial inertia evident in the policy stances of the major parties, evident in their initial support for state based uniform national legislation, an outcome which might easily have taken a further thirty years to achieve had the Greens Bill not been enacted.

Third, having said that, both major parties were very supportive in funding the Petrol Sniffing Prevention Strategy, presumably because this did not risk antagonising the states and territories, who have primary responsibility for regulating the sale of fuel and similar substances in their jurisdictions.

The clear success of the PSPP over the past decade is certainly an achievement worth celebrating. It has not come without considerable cost to taxpayers in the form of subsidies to oil companies to underpin the production and distribution of LAF, but no serious stakeholders appear to question that the outcomes justify the costs.

As an aside, there is not much transparency in the Government’s published information in relation to these costs. I haven’t searched the Budget Papers, but there is no real information on the PMC website on LAF about the financial arrangements between the Government and the oil companies.

The enactment of the Low Aromatic Fuel Act is a further achievement worth celebrating as it provides a mechanism for the Commonwealth to step in and take action when persuasion and voluntary measures don’t work. It backs up and reinforces the Commonwealth’s influence in shaping productive policy outcomes in this area. The legislation is demonstrable evidence of the value of the potential of minor parties to influence policy if they set their minds to it.

The risk, as with all such Commonwealth legislation, is that it provides an incentive for the states and territories to step away from the hard decisions which they ought to be taking. Every instance of Commonwealth action under the legislation is arguably evidence of policy failure by the state or territory concerned.

The legislation is not perfect, and provides a number of mechanisms which potentially allow a Minister to create exclusions from the mandated policy within a region. Moreover, there appears to be limited parliamentary oversight of the exercise of any such exclusions. Like any policy framework, the devil is in the detail, and there is a need for ongoing vigilance to ensure that the headline policy is in fact being implemented on the ground. While one would hope that relevant Indigenous advocacy groups (such as NACCHO and the National Congress) build and maintain the capacity to monitor the operation of the legislation, it is a fact of life that the policy analysis capacity of the community sector in Indigenous affairs is quite thin. There is nothing in the LAF policy framework which guarantees sustained bureaucratic and ministerial focus, nor is there a guarantee of positive outcomes on an ongoing basis.

My major critique of the policy framework relates to the risks of adopting a too narrow or segmented frame of analysis. The D’Abbs/Shaw report in fact hints at this. If one takes the situation on the ground, community by community, or region by region, as the frame of analysis, and looks at substance abuse more broadly, it becomes apparent that the gains in reducing petrol sniffing may be offset in large measure by increasing abuse of alternative substances, in particular, alcohol, cannabis, and other harmful substances.

D’Abbs and Shaw comment directly on this issue (page 48):

While declines in petrol sniffing associated with LAF have been accompanied by high levels of alcohol and cannabis use in some communities, we found no evidence of a simple causal relationship between declining petrol sniffing and increasing alcohol and/or cannabis use. In many communities, the growth of cannabis use pre-dates the introduction of LAF and, in any case, use of these and other drugs is driven by a complex mix of supply and demand factors, rather than by any single cause. Both alcohol and cannabis are widely seen as now posing more serious problems than petrol sniffing.

So while there is no evidence of a ‘’substitution effect, there is an ‘offset ‘ problem, namely the gains made in reducing sniffing are potentially outweighed by the social and health costs of other substance abuse. The authors also comment on the serious challenges arising from the patchy and inconsistent provision of youth sport and recreation services in remote communities which potentially act as a counter-weight to the emergence and continuation of harmful substance abuse behaviours.

These observations are not arguments against the policy approach adopted on LAF, but rather implicitly raise the question can governments, and in particular the Commonwealth Government, do more to address the broader substance abuse issues destroying lives in remote communities. Indeed, does the success to date in addressing petrol sniffing provide us with lessons or pathways for successfully addressing other equally destructive substance abuse epidemics in remote Australia?

Options might include expanding the scope of the Low Aromatic Fuel Act to give the Commonwealth Minister powers to intervene in particular regions in relation to alcohol misuse (the federal minister already has significant powers in the NT), and even perhaps to address issues relating to illegal access to cannabis (bearing in mind that cannabis is technically illegal whereas fuel and alcohol are legally available substances).

Perhaps more usefully, there might be scope for the Commonwealth to take a sustained interest in the financing, and implementation of sport and recreation programs remote communities. My own experience tells me that this is an area best characterised as a ‘mish mash’ of projects, programs, activities, without any overarching coherence, without quality standards applicable to program delivery, and with extremely variable outcomes. My intuition tells me that there is scope for substantial improvements in outcomes just from improving the overall quality of these sorts of programs across the board in remote Australia.

Of course, a broader lesson which we might draw from this research is that addressing narrow slices of a problematic policy domain, while worthwhile in itself, can never be a substitute for a more comprehensive, coherent policy approach with legitimacy in the eyes of Indigenous stakeholders and citizens, and which will inevitably need to be place or regionally based to at least some extent. This is the glaring gap in remote Indigenous policy frameworks at present, one that governments of all persuasions have struggled with since the demise of ATSIC.

In releasing the most recent LAF Report, the Minister understandably and correctly pointed to the substantial policy successes achieved to date in reducing petrol sniffing incidence in remote regions. Smooth waters. However, his reticence in highlighting the report’s comments on the ongoing challenges in relation to substance abuse more generally, and in the shortfall in preventive youth services in communities (where the population under age 25 is usually in the majority) is less commendable. Many of these challenges can be traced back to shortfalls in state and territory policy action on substance abuse and Indigenous disadvantage more generally, matters which ought to be front and centre of the Minister’s policy agenda.

Finally there is an issue about transparency which needs to be mentioned. The taxpayer funded report was dated February 2016, and has taken six months to be released. Given the serious issues involved in addressing substance abuse, it is time that all sides of politics committed to releasing such reports expeditiously upon receipt. Six months is five months too long.