In more than 20 years of working in the alcohol, drug and mental health fields, I have never forgotten the first principle I learnt when I began work at the Australian Drug Foundation: there is no such thing as a drug problem, there are only people problems.
We are all drug users. We grow up in a drug-using culture. We quickly learn that drugs are good for us. In every household in Australia there are dispensing policies, ways of using prescribed drugs, over-the-counter drugs and recreational drugs including tea, coffee and alcohol.
Drugs enable many of us to live longer lives, to manage symptoms of disease; to cope with temporary emotional or physical pain; to relax, have fun and maintain our lives. Even the supposedly evil illicit drugs often have real benefits if used in exact doses to address specific symptoms. Heroin was historically used as a painkiller in childbirth in Australia.
Knowing drugs are generally good for us does not mean we shouldn't tackle the harm that comes from drug abuse, whether it is the harm from short-term excess such as binge drinking and amphetamine-related violence, or the physical and emotional harm from longer-term dependence. What is important to remember is that, if we focus solely on the drugs without focusing on the people using the drugs, any success will be limited.
As a former CEO of Odyssey House, I know that getting people to give up drugs is not the biggest challenge in drug treatment. Ensuring that people have meaning and value in their lives, good physical and mental health, stable housing, employment or training options, a realistic income, positive relationships, a sense of being valued and belonging, opportunities for enjoyable expression and recreation: these are the big challenges for people who have drug problems.
The recent debate about youth binge drinking, alcopops tax and the harm associated with alcohol is a very important one. Substantive Australian and international research literature spanning several decades already exists, highlighting what works and what doesn't. I live in hope that this broader evidence base informs policy decisions, but I also know the realities of vested economic interests and politics, where evidence alone is rarely enough for real change.
Binge drinking by young women has been a concern for over a decade. In the mid-1990s, young women not only caught up to, but passed, young men in the binge-drinking stakes. In many ways this should not have surprised us. Young women had already gained the lead in smoking rates. Concerns had also emerged about the mental health of young women, including levels of self-abuse and body image problems.
The danger in recent debates is that we are ignoring young women and their needs, and focusing solely on one measure for one form of one drug. As a community, we need to lift our gaze and begin to ask the more important questions: why have young women overtaken young men as binge drinkers and smokers, why are surveys indicating high levels of mental health problems among young men and women, why is the burden of mental illness falling more heavily on our young people, why do we have increasing concerns about obesity and sexually transmitted diseases among our young people, what is the role of young people in our society, given longer lifespans and delayed parenting?
Our young people are experiencing life quite differently to previous generations. They face a range of challenges and complex life options. Within this context, we need to think about their health and wellbeing in different ways.
I am often dismayed by our tendency to focus attention only on the problems of young people. In some ways this reinforces problem-atic behaviour by distorting what is normal.
My experience is that the current generation of young people are remarkably resilient and adaptable, highly intelligent, confident, concerned about their environment and seeking positive roles in their communities. These are positive attributes that we should embrace, promote and build on. Of course there are many young people who are overly commoditised; some are clearly disenchanted; some are lost or disconnected from the broader community. I am not sure that we have made a serious attempt to re-engage these young people.
Youth binge drinking is a real concern. It is hurting many of our young people. We need to respond to this problem. We need to draw upon the best available evidence about what works.
This must include addressing the hypocritical role models and images we provide to young people about adult binge drinking. It must also include addressing underlying mental health and wellbeing issues.
At the same time we also need to be brave enough to consider that youth binge drinking is not just about a single product or a single drug. There is a danger that we succeed in reducing binge drinking only to see an increase in other risky behaviour, possibly illicit drug use.
Binge drinking is part of the bigger picture of how some of our young people seek meaning in their lives. If we are serious about addressing binge drinking, it is worthwhile to remember the first principle there are no drug problems, only people problems.
The Health Minister has talked about not only wanting to address the very serious problems associated with youth binge drinking, but also about the need for an increased emphasis on prevention.
If we are to achieve a more physically and mentally healthy community, a good place to start is by focusing the new prevention agenda clearly on adolescents and young adults.
Young people should be prioritised, not just because some have a tendency to binge drink, but because we know the value of prevention and early intervention. More important, we understand the benefits of actively including young people in our community.
Now is the time to develop a major prevention strategy that reaches out to young people and addresses issues far beyond their patterns of drinking.
David Crosbie is chief executive of the Mental Health Council of Australia.