Drug and Alcohol Review (March 2004), 23, 133 – 134
Asia Pacific Column Announcement of column on capacity building in the Asia Pacific region Welcome to Drug and Alcohol Review’s first Asia Pacific Column, which is intended to be a timely communication for researchers, health professionals, policy makers and key stakeholders about substance use issues in the Asia Pacific region. The column aims to keep readers informed about news and events occurring within the Asia Pacific region that are pertinent to the drug and alcohol field. Of focus will be research projects, policy changes and implementation of drug and alcohol programmes within the region, and also of collaborations between Australia and the other nations of the Asia Pacific. The definition of which countries actually comprise the Asia Pacific region varies between disciplines. Rather than be prescriptive, a pragmatic definition probably is the best for these purposes, that is, those countries in close proximity to Australia which may have substance use problems or established routes for illicit drug trafficking. Of particular interest is South East Asia, but does include (although is not restricted to); Australia, Bangladesh, Bhutan, Brunei, Cambodia, China, Fiji, India, Indonesia and East Timor, Japan, North and South Korea, Laos, Malaysia, Mongolia, Myanmar, Nepal, New Caledonia, New Zealand, Papua New Guinea, Pakistan, Philippines, Singapore, Solomon Islands and Nauru, Thailand, Vanuatu and Vietnam. Capacity building and strengthening our regional relationships with our near neighbouring countries is an important part of creating positive change in the Asia Pacific. Several important events have occurred within recent months that certainly show there is interest and change occurring within the Asia Pacific region and particularly in relation to Australia. In October 2003 the Australian Prime Minister, Mr John Howard, announced that the Australian National Council on Drugs (ANCD) would be taking on a broader role by advising the Federal Government on drug issues affecting the Asia Pacific region. Mr Howard said that the role of the ANCD will be to ‘advise the Australian Government on the most appropriate ways to work with our regional neighbours to share the knowledge and understanding we have developed from our successful strategies to reduce demand for illicit drugs, particularly our work with the community sector, as well as learn from their experiences.’ The committee involved in the Asia Pacific drug issues initiative will be cross-sectoral, and as well as
ANCD members, will include delegates from Australia’s leading law enforcement agencies, national drug centres, drug- and alcohol-related centres engaging in regional work, and appropriate government, foreign affairs and aid organizations. In this capacity one of the first roles of ANCD will be to prepare a comprehensive and culturally relevant report to the Federal Government identifying potential models and roles for Australia in the Asia Pacific region on drug issues. In very simple terms this means a search of what is already occurring in the Asia Pacific with regards to substance use programmes, policy and research, where these events are occurring, and who (organization-wise) is involved. In addition a model which can be used to effectively gather, manage, process and disseminate this information will be developed. Obviously some of these events will be occurring outside the jurisdiction of the drug and alcohol area per se, which is why the ANCD will maintain a multi-sectoral focus. The committee will also be expected to address and advise on issues including: . . . .
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the development of a more integrated approach to addressing drug issues in the Asia-Pacific region; finding ways that Australia can promote a greater level of co-operation with regional and international organizations; identification of potential structures and processes for addressing new and emerging issues in the region; finding ways to increase Australia’s contribution to the capacity of the region in addressing drug issues and assisting in regional reductions in the level of blood borne viral infections and communicable diseases associated with drug use; increasing Australia’s understanding on the impact and influence of regional factors on Australia’s drug policies and outcomes; increasing Australia’s influence on regional drug policy and programs; the promotion of a greater international awareness and understanding of Australia’s expertise in drug policy programme development and implementation and evaluation; increasing Australia’s opportunities to respond quickly and decisively to any changes in drug use trends and patterns; and finally, to increase the likelihood of opportunities to interact with countries in the region and to learn to better address cultural drug issues within Australia.
ISSN 0959-5236 print/ISSN 1465-3362 online/04/010133–02 # Australian Professional Society on Alcohol and Other Drugs DOI: 10.1080/09595230410001658840
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While not a primary outcome of the Asia Pacific drug issues initiative, it could be anticipated that these outcomes may eventuate a greater level of trust and co-operation with governments and agencies in the region, leading to increased access to intelligence on the supply of illicit drugs and potentially other areas of national security and border protection interests. It may also lead to a greater willingness of the region to increase dealings with other sectors within Australia such as trade and technical support. In order to support the new role of the ANCD, the Federal Government has provided four hundred thousand dollars from the existing ‘Tough on Drugs’ initiative. These monies were presented to the Chair of the ANCD, Major Brian Watters, by the Parliamentary Secretary to the Minister for Health, the Honourable Trish Worth, at the APSAD conference in November 2003. It is noteworthy that the presentation occurred at the Australian Professional Society on Alcohol & other Drugs conference, given the strong presence of delegates from South East Asia including Malaysia, Singapore and Thailand. Indeed, this conference hosted the first ever APSAD Asia Pacific Regional Symposium. This forum explored recent trends in substance use in the Asia Pacific region and key researchers from Australia and South East Asia presented the findings of current prevention and treatment initiatives in the region, with a particular emphasis on methamphetamine use and regional efforts in supply and demand reduction. In Adelaide, the Drug and Alcohol Services Council was designated as an official World Health Organization Collaborating Centre for Research into the Treatment of Drug and Alcohol Problems under the auspices of the University of Adelaide’s Faculty of Health Sciences. The centre was opened by South Australia’s Minister for Health, the Honourable Lea Stevens in November 2003, and will undertake and coordinate major research activities throughout the world, but particularly in the Asia-Pacific region. The centre will play a vital role in the development of quality evidence-based treatment options, training and enhance demand reduction strategies within the Asia Pacific. The centre will also develop research-based collaborations with countries in the Asia Pacific who have an interest in evidence-based treatment. Treatment guidelines developed in Australia will be used as a benchmark. This will increase the capacity of other nations to treat drug problems effectively, and may also reduce the impact of harmful drug use across the region, given that patterns of drug use transcend national borders. The centre already has several projects underway including: (1) the development and testing of the Alcohol, Smoking and Substance Involvement Screen-
ing Test (ASSIST) questionnaire which is a brief and simple method of screening for risky substance use. This project is occurring in several countries including Australia, India and Thailand. The ASSIST questionnaire is designed for use by primary care workers and will be linked to a brief intervention to help substance users reduce their drug use and thereby avoid harmful consequences; (2) an evaluation of the efficacy of maintenance treatment programmes for opioid dependence and in the prevention of HIV and Hepatitis in developing and transitional countries including China, Indonesia and Thailand. Evidence-based guidelines for maintenance therapies developed in Australia will serve as a benchmark for these countries; (3) an assessment of tincture of opium in the treatment of opiate dependence in Asian people will also be undertaken. The initial stage of the project will provide basic information on the pharmacological action of tincture of opium, the composition of tincture of opium as used in the Asia-Pacific region, and the potential acceptability of tincture of opium to the Asian community in Australia; (4) involvement in a multi-site study on methamphetamine-induced psychosis, being undertaken in four high prevalence countries in the AsiaPacific region (Japan, Philippines, Thailand, Australia). The study aims to explore the nature of psychotic symptoms associated with methamphetamine use, map current clinical approaches to psychosis, and identify primary prevention opportunities. In closing, a brief look at drug policies in neighbouring Asian countries strongly suggests that regional building between Australia and the Asia Pacific, using a ‘hearts and minds’ approach is required to reduce harms from substance use, and save lives. A workshop held in Hanoi, Vietnam, in November 2003 on the ‘Management of methamphetamine users and opioid dependence in Asia’ brought together delegates from all over Asia. Reports from the delegates on drug policies within their countries demonstrated a generally punitive approach to drug use, with an emphasis on supply reduction. At a bare minimum ‘treatment’ consists of detoxification, although incarceration and the death penalty are the status quo in many countries. Some nations reported progression in their drug policies including the implementation of demand reduction strategies and maintenance substitution treatment for opioid dependence. However, the idea of harm reduction policies including needle exchange remains largely controversial in the majority of these Asian nations. RACHEL HUMENIUK & ROBERT ALI WHO Collaborating Centre, C/- 161 Greenhill Road, Parkside, SA 5063, Australia E-mail:
[email protected]
