CAPE YORK SUBSTANCE ABUSE STRATEGY

1. CAPE YORK SUBSTANCE ABUSE STRATEGY

2. AGENDA • The Facts • A Comprehensive Strategy • Alcohol Management Plans Issues for Success

3. WE HAVE A SUBSTANCE ABUSE EPIDEMIC Nationally, Indigenous persons more likely to use drugs(1) In Queensland, Aborigines over-present in substance abuse clinics(2) % % 98% 87% Indigenous 57% Non-Indigenous 37% 32% 17% 2% 13% • From Australian Bureau of Statistics, The Health and Welfare of Australia’s ATSI Peoples, 2003. Data from 2001 • Cape York Justice Study (Fitzgerald), 2001

4. ALCOHOL IS A LARGE PART OF THIS EPIDEMIC Illustrative Distribution of Drinking Behavior Across Cape York Indigenous and QLD Non-Indigenous Persons % 20 40 Non-drinker 10 60 Moderate (social) drinker Excessive drinking 2.5x(1) 50 20 Illustrative of the missing “moderate” drinking class and the dominance of alcoholism in Cape York (1) From Justice Study report. Base is undefined Note: Illustrative distribution of lack of moderate drinking class Source: Cape York Justice Study (Fitzgerald) 2001; Cape York Institute Estimates

5. SUBSTANCE ABUSE IS THE MAIN CAUSE OF ABORIGINAL SOCIETY’S PROBLEMS Substance Abuse Violence Poor health Criminal over-representation Cultural erosion Key point Defense Grog abuse is the main cause of all types of Aboriginal violence and violence-related injury There are certainly other causes of violence. However, effectively attacking grog abuse will also mean attacking violence Self-denial and family denial of addiction exacerbates violence Substance abuse is the key factor in poor health through in Aboriginal communities Poor diet and exercise, lack of services, and poor environment are also causes. However, epidemic grog and drug abuse prevents the lifestyle changes necessary to address these other factors. Substance abuse is the main cause of Aboriginal over-representation in the criminal justice system There are certainly other causes, but the majority of Aboriginal criminal cases—especially those of violent crimes and homicides—involve substance abuse. Substance abuse is hindering the transmission of cultural knowledge across generations Certainly there are other challenges to preserving language and culture. Tackling these challenges is difficult enough sober. It is virtually impossible for a people addicted.

6. CAPE YORK STATISTICS ILLUSTRATE THIS NEGATIVE IMPACT • Mortality rates in Cape York are 2x-3x than those in Queensland overall • Median age at death is at least 20 years younger for Indigenous Queenslanders • Alcohol-related death rates are 21x the overall Queensland average • Alcohol-related violence and homicide 18x the overall Queensland average Source: Queensland Government brochure: Alcohol Restrictions in Indigenous communities

7. SLIDE INTO ADDICTION STARTS WITH EXPERIMENTATIONAlcoholics Anonymous Feelings Chart “Feelings Chart” Phases of Addiction Explanation Bad OK Good Normally we hover around the “okay” mark, with some good and bad moments in life For a number of reasons, we may be tempted to try a drug, and discover a pleasurable effect With recognition that the drug’s pleasurable effect relieved stress or anxiety, we seek its effect again As seeking becomes habitual, the “good” phase of the drug becomes shorter. Without the drug, the “feeling” starting point moves from OK to Bad. The drug is necessary just to briefly relieve our Bad state Normal state Base state Experimental phase Seeking phase Dependency or addiction Why addictions become epidemic and how addiction should be handled oft a subject of debate

8. WE REJECT PRIOR EXPLANATIONS OF AND PROPOSED SOLUTIONS TO THE EPIDEMIC Prior explanations or solution Description Rationale Basis for rejection “Symptom theory” Voluntary rehabilitation “Normalization” or “responsible drinking “Harm minimization” Addiction epidemics are a “symptom” caused by underlying social and economic problems a society faces Addict will eventually seek help for their addiction Programs aimed at changing concept of drinking, promoting moderation Deal with the consequences of substance abuse so as to minimize harm to self and others Less stressful environments and mutual understanding are first steps in solving substance abuse and addiction Things will eventually become so bad that rehabilitation will seem the only option Responsible behavior will be practiced if the “be responsible” message is repeated Substance abuse has become entrenched and therefore endemic. The best approach is education, safer venues, and increased law enforcement Addiction (maintained through denial) is a condition in its own right. It can be addressed without first righting the “social, historical and economic wrongs” Damage is already done. Directly, the addict has modeled abuse and recruited new addicts. Indirectly, he/she has caused chaos in community Alcoholics (and the abuse epidemic they make up) cannot abstain, by definition. Moreover, “moderate” drinkers are the recruiting example, not drunks Rather than deal with the consequences of abuse, we should not tolerate it to begin with. “Harm minimization” essentially accepts abuse as a given.     Our core principle is intolerance of abuse

9. WE MAINTAIN THAT THE CAUSES OF SUBSTANCE ABUSE ARE STRAIGHTFORWARDFive Factors Underpin Current Epidemic Availability of drug Money to acquire the drug Time to use drug Neighbors who use the drug Society/Ideology that permits use 1 2 4 5 3 • How easily obtained is the drug or grog? • Cost • Distribution channels • Is there money available (disposable or misappropriated) to purchase the drug? • Cost • Timing • Is there enough time to use the drug to an addictive level? • Supervision (youth) • Employment (adults) • Involvement in outside activities • Are there immediate examples in the community of those who misuse drugs? • Parents • Friends • Other role models • Television • Is there a social standard and cultural ideology that is permissive of the drug’s use? • Soft consequences • Disorganization • Sense of defeat Substance Abuse = Addiction Moreover, once established, addiction becomes a cause in its own right

10. AGENDA • The Facts • A Comprehensive Strategy • Alcohol Management Plans Issues for Success

11. SUBSTANCE ABUSE MUST BE TACKLED FROM MULTIPLE ANGLESSix-Pronged Approach Required Rebuild intolerance Control supply Manage money Manage time Treatment and rehabilitation Fix up home and community 1 2 3 4 5 6 Reason Action • Must confront the evil in our midst, not deny it. A community-led resurgence of pride claiming that dysfunction is not endemic to indigenous society • Bestow Community Justice Groups with power to rebuild/reinforce Aboriginal Law • Establish a regional CJG • Create new methods of policing • Have zero tolerance of abuse • Consumption is not possible without supply, and unfettered supply is disastrous. But, controlling supply is not the magic bullet • Prohibit takeaways from canteens • Prohibit importation of alcohol in communities where there are canteens • Develop community-specific Alcohol Management Plans developed by CJGs • Lack of financial institutions and poor family income management skills create a cash economy that fuels substance abuse • Implement assisted family income management programs • Establish credit union or other fiduciary presence • Make income management compulsory for abusers • Boredom is the consequence of passive welfare, addictions, and social dysfunction—not the other way around • Build jobs • Develop volunteerism • Digitally preserve cultural knowledge • Increase sport and recreation opportunities • Provide 4WD transport to help get to country • Increase travel • Current primary health care system treats Aboriginal patients in isolation from family health and family circumstances • Provide for mandatory and voluntary rehabilitation • At family request • In and upon leaving detention • Increased screening and doctor intervention • Employ a AA counseling methodology • Aboriginal communities are in squalor, reflecting low levels of social and cultural capital and no responsibility for our environment • Maintain physical environment • Responsi-bility of local gov’t • Develop bylaws with standards of maintenance • Reform CDEP to support community improvements • Work towards home ownership

12. CAPE YORK HAS A COMPREHENSIVE STRATEGY TO END SUBSTANCE ABUSE Accept causes Availability of drug Money to acquire the drug Time to use drug Neighbors who use the drug Society/Ideology that permits use 1 2 4 5 3 Substance Abuse = Increased violence, crime, poor health, cultural erosion Recognize impact Implement strategy Rebuild intolerance Control supply Manage money Manage time Treatment and rehabilitation Fix up home and community 1 2 3 4 5 6 • Empower community justice groups • Limit alcohol available in communities • Enable income management through banking, FIM • Employment as well as volunteerism, sport, and travel • Screening, intervention, rehab, AA, compulsory attendance • Address squalor through better maintenance and fostering pride in appearance Focus of this document is supply control

13. AGENDA • The Facts • A Comprehensive Strategy • Alcohol Management Plans • Inception • Policy implications • How it works Issues for Success

14. ALCOHOL MANAGEMENT PLANS BASED ON FOUR PRINCIPLES • Reduce the volume of alcohol available • Restrict the kinds of alcohol available • Restrict the venues where alcohol may be consumed • Restrict the time of day alcohol is available Actual establishment took many years

15. GRASSROOTS EFFORTS PROMPTED GOVERNMENT ACTION Grassroots momentum Government consideration and legislation Community-empowered development of rules/regulations Prior 2000 2001 2002 2003 2004 Future Momentum for change building Community elders and Justice Groups frustrated by continued decline of order and values Apunipima(1) and Cape York Partnerships formed working group, focused on practical strategy Grog and Drugs Strategy Noel Pearson, in cooperation with Apunipima and Cape York Partnerships, outlined the causes of and remedies for the abuse epidemic Finalization of strategy completed in 2002 Cape York Justice Study Queensland government sponsored study on the extent of social problems in Cape York Recommended many activities including need for community-based Alcohol Management Meeting Challenges, Making Choices Queensland government response to Justice Study Provided policy direction on the amendment to legislation(2) to enable CJGs to regulate alcohol possession and consumption Aurukun first to implement Alcohol Management takes hold Napranum, Wujal Wujal, Kowanyama, Lockhart River, and Pormpuraaw implement alcohol management plans Alcohol Management spreads further Hope Vale, Northern Peninsula Area (Bamaga. Seisa, Injinoo, New Mapoon, Umagico), Mapoon, and Yarrabah implement alcohol management plans Development of Regional Justice Group Consistency of Alcohol Management Plans across communities Community Justice Groups responsible for plan development (1) Cape-based health advocacy organization (2) Community Services Legislation Amendment Act of 2002

16. IN DEVELOPING THESE PLANS, COMMUNITY JUSTICE GROUPS MUST CONSIDER MANY QUESTIONS • Should the community be dry? • Should drinking happen only in the canteen? • How much and what type of alcohol can be brought into the community? • When should the canteen be open? • How many takeaways should be allowed? • How can sly grogging be stopped? • What should be the consequences for non-compliance?

17. PROCESS OF PLAN DEVELOMENT IS A PARTNERSHIP BETWEEN COMMUNITY LEADERS AND GOVERMENT • Develops Alcohol Management Plan with recommendations • to the Community Liquor License Board • about community alcohol limits • Deals with behavior Community Justice Groups • When a dispute between two, refer to Executive Director of the Liquor Licensing Division Community Liquor License Board • Minister appoints members • Holds canteen license • Sets license conditions in consultation with CJG • Appoints/manages canteen manager Community Canteen • Managed as a business in accordance with license conditions • Manager of canteen in non-voting member of Liquor License Board • Profits go to Community council Council • Profits from canteen operations listed separately on council books • Apply profits to socially responsible initiatives

18. AGENDA • The Facts • A Comprehensive Strategy • Alcohol Management Plans • Inception • Policy implications • How it works Issues for Success

19. OUR ALCOHOL MANAGEMENT PLANS HAVE SIGNIFICANT POLICY IMPLICATIONS Implication Rationale Reject notion of majority rule Reject top-down alcohol laws Moderate drinker loses rights In communities where alcoholism is epidemic, the alcoholic is dominant in both physical number and coercive behavior. To develop plans via majority rule would be to allow the alcoholic to govern (or not govern) his consumption. Hence the minority must rule with regard to plan development While seductively simple and uniform, state and federal level alcohol laws do not sufficiently control supply for the Aboriginal context. Moreover, they do not allow any flexibility for the unique situation in each community. Community-led plans are best For the average non-indigenous, this is difficult to understand. First, there is a fine line between responsible and irresponsible drinking and that line is not absolute but varies by individual. Hence a rule of thumb is difficult to employ. Second, historically, indigenous drinkers do not manage moderation—quickly slipping into addiction. Finally, and most importantly, they play a strong if indirect role in recruitment of new experimenters. The alcoholic is not the poster of fun, the moderate drinker is. Alcohol management plans ask the moderate drinker to sacrifice for the good of all Biggest pill to swallow is the sacrifice of moderate drinker

20. AGENDA • The Facts • A Comprehensive Strategy • Alcohol Management Plans • Inception • Policy implications • How it works Issues for Success

21. TOWNSHIPS DO NOT HAVE ALCOHOL MANAGEMENT PLANS Aboriginal Community Township City Communities vary in how they address alcohol

22. THREE MAIN MODELS OF ALCOHOL MANAGEMENT CURRENTLY EMPLOYED ON THE CAPE No-canteen community Canteen community with zero limit carriage Canteen community with limited carriage • e.g. Hope Vale • Can bring in limited amount and type • e.g. Aurukun • Cannot bring in alcohol • No takeaways from canteen • e.g. Northern Peninsula Area • Can bring in limited amount and type • Can takeaway from canteen Canteen Canteen   Imagination is key—More models can exist!

23. Backup Canteen/Tavern CAPE YORK COMMUNITIES (AMP DETAILS) Community Date Enacted Carriage Exists? Hours per week Type served Limit Takeaway? Exceptions NPA (Bamaga, Injinoo, Seaisa Umagico, New Mapoon) Aurukun Hope Vale Kowanyama Lockhart River Mapoon Napranum Prompurraw Wujal Wujal Yarrubah 14/4/2004 30/12/2002 14/4/2004 5/12/2003 3/10/2003 14/4/2004 30/5/2003 5/12/2003 3/10/2003 6/2/2004 9L light/mid beer AND 2L non-fortified wine Zero 9L L/M beer AND 2L wine Zero Zero 9L L/M beer AND 2L wine Zero 4.5L Heavy OR 9L L/M beer Zero 9L L/M beer OR 9L premixed OR 9L combination Yes (Bamaga & Injinoo) Yes No Yes Yes No Yes Yes No Yes ? ? n/a ? ? n/a ? ? n/a ? ? L/M beer, pre-mixed spirits with meal n/a L/M beer ? n/a L/M beer, premixed spirits ? n/a L/M beer, premixed spirits ? ? n/a ? ? n/a ? ? n/a ? Yes, up to carriage limit No n/a No No n/a No Yes, to carriage limit n/a Yes, to carriage limit None None Isabella Crk Rd Barret Crk Rd Cameron Crk Rd None Portland and Frenchman Rds None Peninsula Dev. RdRine River Bay Albatross Bay None Bloomfield Falls and Track None

24. STATISTICS SHOW PLANS ARE WORKING(1) • Overall(2): • 48% reduction in alcohol-related injuries • 54% reduction in presentations for assault • Kowanyama(3): • 65% drop in alcohol-related offenders • 68% reduction in offences against the person • Aurukun: • 73% drop in alcohol-related health clinic presentations • Lockhart River: • 67% drop in alcohol-related presentations • 82% drop in assault presentations • Data from the Premier’s press release. Additional data not yet publicly available • Results for six communities across QLD: 4 in Cape York include Aurukun, Lockhart River, Pormpuraaw, and Wujal Wujal. • Mornington Island and Doomadgee also included • (3) Press release cites Kawanyama but does not indicate its figures are included in the Overall statistics • Source: Queensland Premier’s office: Press Release 6/7/04

25. AGENDA • The Facts • Comprehensive Strategy • Alcohol Management Plans Issues for Success

26. DESPITE INITIAL SUCCESS, OBSTACLES DO STILL EXIST • Roadhouses and canteens outside the community are most often not under restriction • Drunks can still be present in the community • Sly-grogging, or illegally bringing drinks into the community, is difficult to stop • Roadhouse takeaways • Boats • Flights • Cars • Police are under-resourced and often inconsistent in their monitoring • Cross-community inconsistency of policy breeds some resentment A regional, macro-level approach appears necessary

27. REGIONAL APPROACH COULD START WITH A REGIONAL JUSTICE GROUP • Membership comprised of the “best of” members of Community Justice Groups • Jurisdiction over cross-community issues • Support role for local justice groups • Interface for CJGs and senior Government officials Specifics of Regional Approach still under development

28. THE MAIN THING TO REMEMBER: ALCOHOL MANAGEMENT IS ONLY ONE PIECE OF THE PUZZLE Accept causes Availability of drug Money to acquire the drug Time to use drug Neighbors who use the drug Society/Ideology that permits use 1 2 4 5 3 Substance Abuse = Increased violence, crime, poor health, cultural erosion Recognize impact Implement strategy Rebuild intolerance Control supply Manage money Manage time Treatment and rehabilitation Fix up home and community 1 2 3 4 5 6 • Empower community justice groups • Limit alcohol available in communities • Enable income management through banking, FIM • Employment as well as volunteerism, sport, and travel • Screening, intervention, rehab, AA, compulsory attendance • Address squalor through better maintenance and fostering pride in appearance