Legal and Social Issues Committee

MELINA BATH (Eastern Victoria) (16:58): I am pleased to rise to put my name in association with Mr Limbrick’s motion 27 on the notice paper. In particular my interest lies around an inquiry into and consideration of the drug harm reduction policies, opioid substitution therapy service delivery – how is that going? – the establishment of a drug checking service, the safe consumption sites, a prescription hydromorphone program and also nicotine harm reduction, including e-cigarettes and their role in smoking cessation. We have had debates on that in past parliaments – and also any other related matters. Now the ‘any other related matters’ that I would like to see included in that is also to include people who have been drug affected and alcohol affected as well, because alcohol certainly places a significant burden on human lives. Those that become addicted can devastate their family, devastate themselves and really impact very heavily on not only the fabric of society but also the economics of our towns and communities.

The other day I was pleased to have with the shadow minister in this space Emma Kealy a briefing with the Victorian Alcohol and Drug Association, and I was very pleased to gain some understanding and insight from their in-depth knowledge of this topic. They are really, as we call it, at the coalface of support. They are down in the pit with people, working out those strategies, working out harm minimisation treatments and doing a most amazing role. And I thank all those people who work in this area because, let us be honest, it is a very challenging space for people to operate in. It is often very highly committed people – they may not always be, but sometimes they can be reformed drug users and alcoholics – but it is still a very, very important area, and we thank all of those people who work in this space.

One of the things that was impressed upon me – and I would like to just put on record some of the learnings that I took out of that briefing – was that substances which are licit, so prescription drugs and things that come across from doctors who write them out and those sorts of things, can heavily impact on people’s lives and health as well as illicit substance abuse. Again they went into the detail around harm minimisation frameworks, which can include the physical – certainly if someone comes in and they are addicted, they have a physical addiction to whatever that drug may be, but their psychological state is altered. They are working in an impaired state. They may be functioning in the community at some stage, but the back end of their life is often falling apart. Their emotional state is heightened, reduced or bouncing all over the place. But it is also that wider ripple effect that they have on their families and on their communities, whether they become then a danger of violence within their family unit – whatever that looks like – or within the local street that they live in, or whether there is that crime ripple effect that then can occur if you are talking about illicit substance abuse and the need to have access and the need to keep those funds flowing through. One of the things that made sense – it totally hit the mark from the people I see coming into my electorate office and families who are highly distressed – is that 35 per cent of all suicides in Victoria have alcohol or drug (AOD) related dependencies. So one-third of everyone who commits suicide has already got this propulsion due to abuse of either alcohol or drugs.

The other point is that with those fatalities – and this is not something I enjoy reading, but I think it is important to say – it is not only in the city; it certainly happens in rural and regional Victoria and in our larger regional centres. Let me read you the very sad lists of fatalities from alcohol and drugs through the LGAs and who is topping those charts. From alcohol, pharmacological drugs as well as illicit drugs, the highest deaths have occurred – and this is fairly consistent too; this is a nine-year cycle here, and unfortunately Geelong has a very high quota. Bendigo has also got 12 per year roughly. The Hume LGA and then unfortunately the Latrobe local government area also have around probably 10 to 11 fatalities annually through drugs and alcohol. And they were saying these are direct responses. These are not people crashing their car being high or the like; these are direct fatalities due to an overdose. So there are some startling statistics that I wanted to put on record about the need to look into regional Victoria as well when we look into this inquiry. I hope this motion gets up, and then I hope we can travel out into the regions – where it is warranted – to come out and listen to responses.

The other thing that I found quite alarming – and these statistics are off – was ambulance attendances in regional Victoria.

They highlighted three separate locations. One was Latrobe, and again this was alcohol-related ambulance attendances. Between 2021 and 2022 they were 68 per 10,000 head of population – that is, double the state average. Horsham had 125 per 10,000 head of population, and Ballarat, looking in terms of pharmaceutical-related ambulance attendances, was 70 per cent higher than the state average. So that is saying that there is certainly something going on there. Interestingly, when they looked at Mildura for AOD treatment, Mildura had illicit drug treatment at twice the state average, but pharmaceutical and AOD treatments were 20 times the state average. Certain pockets have certain issues that are really prevalent, and I think it is quite important for this committee to be region specific, to drill down and to see what is going on.

The other thing that I felt really saddened to understand was in terms of rehabilitation centres. Victoria unfortunately has a ratio of only 0.74 beds per 10,000 head of population, and we lag far behind Queensland, New South Wales, Western Australia, Tasmania and the ACT. So you have to ask why that is not serving these statistics that I have read out. I know my shadow minister Emma Kealy had a very important policy going into the election which was around an increase of 180 detox and residential rehab beds across the state and they were in pockets, some of which I have described today. It is important that when people are ready to get treatment there is that treatment available, there is funding towards that treatment but also there are beds.

There are many mechanisms and different ways to have treatment, and that was outlined. They can be in the home and attached to a hospital, but sometimes it is very important to actually get people into a residential detox and then rehabilitation centre. We want to see outcomes and we do not want to see families crushed by this.

The other thing – and I think Mr Limbrick actually brought it up – that was really quite shocking and there needs to be new models to look at, was that very few GPs actually prescribe that pharmacotherapy. There are a few of those GPs carrying a huge burden to write those scripts out and get people on alternative treatments to get them off those hard drugs – heroin et cetera. They also were talking about alternative models such as a nurse-prescribed way of presenting those. Certainly it has to be monitored well and prescribed and followed up, but I think that is also another area to look at in this inquiry.