14 April 2015

Australian 'Drug' Use

The United Nations estimates that around 243 million people worldwide use illicit drugs each year, or 5.2% of people aged between 15 and 64. About 42% of Australians say they have used illicit drugs at some time in their life and almost 15% said they used illicit drugs in the past year. But in terms of lives lost, legal drugs such as tobacco and alcohol present major problems to society by killing more people than illegal drugs. Tobacco (smoking cigarettes etc) kills more people than any other drug. Illegal drugs including heroin, cannabis, ecstasy and amphetamines can have unknown or dangerous ingredients. Mixing drugs, especially with alcohol, can be fatal.

By far the most commonly used illicit 'drug' (it's actually a herb) in Australia is cannabis with 10.2% of Australians reporting using it in the past year. 35% of Australians say they have used it at some time in their life. But the number of people who report recent cannabis use has fallen from a high of 17.9% in 1998. The next most popular illicit drug in Australia is ecstasy, well behind cannabis with 2.5% of Australians saying they have used it in the past year. A further 2.1% of Australians say they have used cocaine in the past year and the same number have used methamphetamines.

Despite increasingly restrictive anti-smoking laws and aggressive public health measures such as plain packaging, nicotine (in tobacco) remains one of the most commonly used drugs in Australia. 16.1% of Australians over the age of 18 smoke tobacco daily. But the rate is declining. In 2001, 22.4% of Australians over 16 smoked and in 2007-2008 that number was down to 18.9%. Even though the number of Australians smoking is dropping, 15,000 Australians still die each year as a result of tobacco-related illnesses. Long-term smokers are at a higher risk of developing a range of potentially deadly diseases including:

**Cancer of the lungs, mouth, nose, throat, oesophagus, pancreas, kidney, liver, bladder, bowel, ovary, cervix, bone marrow, and stomach.
**Lung diseases such as Chronic Obstructive Pulmonary Disease (COPD) which includes chronic bronchitis and emphysema.
**Heart disease, heart attack and stroke (Australia's biggest killer).
**Poor blood circulation in feet and hands, which can lead to pain and, in severe cases, gangrene and amputation.

31% of Australians say they used to smoke, but managed to quit, 51.1% say they never smoked and 1.8% smoke less than daily. In November 2014, the Australian Institute of Health and Welfare (AIHW)’s National Drug Strategy Household Survey report 2013 was released showing that there has been a significant decrease in daily smokers aged 14 years or older in Australia, falling from 16.6% in 2007, 15.1% in 2010 to 12.8% in 2013. Australia’s low smoking rate is the result of sustained, concerted and comprehensive public policy efforts from all levels of government and action from public health organisations.

1973 – health warnings first mandated on all cigarette packs in Australia
1976 – bans on all cigarette advertising on radio and television in Australia
1986 to 2006 – phased in bans on smoking in workplaces and public places
1990 – bans on advertising tobacco products in newspapers and magazines published in Australia
1992 – increase in the tobacco excise
1993 – Tobacco Advertising Prohibition Act 1992 prohibited broadcasting/publication of tobacco advertisements
1994 to 2003 – bans on smoking in restaurants
1995 – nationally consistent text-only health warnings required
1998 to 2006 – bans on point-of-sale tobacco advertising across Australia
2006 – graphic health warnings required on packaging of most tobacco products
2010 – 25% increase in the tobacco excise
2011 – first complete State or Territory ban on point-of-sale tobacco product displays
2012 – introduction of tobacco plain packaging, updated, expanded graphic health warnings
2013 – changes to the bi-annual indexation of tobacco excise and a 12.5% excise increase in December
2014 - second of four 12.5% excise increases on 1 September 2013
2015 to 2016 – remaining 12.5% excise increases on 1 September each year

Figures from the Australian Bureau of Statistics (ABS) show that total consumption of tobacco and cigarettes in early 2014 was the lowest ever recorded estimated expenditure on tobacco products; $3.508 billion in December 2012, $3.405 billion in March 2014. The Commonwealth Treasury advised that tobacco clearances (including excise and customs duty) fell by 3.4% in 2013 relative to 2012 when tobacco plain packaging was introduced. In April 2013, the CEO of a major tobacco company noted a decline in tobacco product sales: As I'm looking at Asia Pacific, I should also mention Australia, we've had the first six months of the plain pack environment in Australia. We've seen the market decline roughly 2% to 3%, so maybe not as bad as we might have anticipated.

Many Australians like a drink. Around one in three will have an alcoholic beverage on a given day. 13% have had wine, 11% have had beer and 2.1% have had spirits. Australians drink on average the equivalent of 9.9 litres of pure alcohol each year which sounds like a lot, but is less than the 13.1 litres consumed in the mid 1970's. While Australians are drinking less, tastes have also changed. In the 1960's beer was the drink of choice, with 75% of alcohol consumed being beer. That's dropped to 41%. Maybe because while wine was only responsible for 12% of alcohol consumption in the 1960's, it now makes up 37%.

The average age of a first drink is around 15 and-a-half. While 72.3% of those 12 to 17-years-old haven't had a drink in the past year, 17% of teens aged 15 to 18 say they had sex when drunk and later regretted it. Friends or acquaintances supply the alcohol for 45.4% of those 12 to 17-years-old who are drinking, while 29.3% get it from their parents. We hear a lot about the problem of young drinkers, but in fact the largest number of drinkers in any age group is men aged 51 to 70, 45.4% of whom had a drink on a given day. 31.5% of women of the same age had a drink. Men aged 55 to 64 are the most likely to have more than the recommended limit of two drinks a day. As for men in other age groups, 6.5% of those 14 to 19-years-old, 29.1% of those 19 to 30-years-old, 39.6% of those 31 to 50-years-old and 43.5% of those over 70 say they had a drink in the past day.

Drinking is more dangerous than driving. More than 5,500 Australians are killed by alcohol each year; twice as many as die as a result of road accidents. An astonishing 157,132 Australians are hospitalised each year as a result of alcohol consumption. But we are trying to drink less. 49% of drinkers said they had cut down, mostly for health reasons. Around 18% of Australians exceed their 'lifetime risk' of no more than two drinks a day; that gives them a greater than 1% chance of dying from alcohol-related causes.

Caffeine is the 'drug of choice' for many Australians. 46% drink coffee, compared with 38% who drink tea. It's estimated around two thirds of the 16.3 million daily cups of coffee are made from instant coffee powder, the other third from ground coffee beans. According to one estimate, Australians over the age of 14 spend on average $8.60 a week or $447 per year on coffee bought away from home. Coffee drinkers have an average of 330 ml of coffee per day, while tea drinkers have 400 ml of tea. The biggest coffee drinkers are aged 31-50, while the biggest tea drinkers are 51 and over. Caffeine is used in a number of different products. The amount of caffeine in these products can vary dramatically, so it’s always best to check the label.

In Australia between 2004 and 2010, there were 297 calls to the New South Wales (NSW) Poisons Information Line concerning toxicity from caffeinated energy drinks. The most commonly reported symptoms included palpitations/tachycardia, tremors, shaking, agitation and restlessness.

Misuse of prescription drugs is a big problem. Around 4.7% of the population misuse pharmaceutical drugs, most of those, around 3.3%, misuse pain killers. In the last few years prescriptions of opioids for chronic pain have skyrocketed creating a new wave of possible drug addicts. There's little evidence to support their long term use but doctors are facilitating addictions that can last for years. Prescriptions of oxycodone (active ingredient in Oxycontin) have trebled in the past decade, according to Medicare records. It is not known how many of those prescriptions result in addictions: most, it is believed, do not. NDARC, the National Drug and Alcohol Research Centre, has begun a large study of opioid patients that should shed further light. But with prescription rates rising, there is growing concern that a cultural attachment to opioids is inevitably leading to increased addiction and other forms of abuse, such as overdose and black market trading. And that Australia, if it doesn't act quickly, could emulate the US epidemic of opioid abuse. In Western Australia in April 2015, Professor Eric Visser, heading an Australia-first project to improve the medical care of patients, says one in five Australians have chronic pain but the condition is still under-recognised. He said many of them found themselves with drug and alcohol problems. Many people who abused prescription and over-the-counter painkillers had started using the drugs to manage chronic pain. Others had turned to cannabis to seek relief.

"Chronic pain is a big problem and many people will seek health care because of their pain, yet in most medical school curricula it doesn't get much of a look-in" Professor Visser said. " ... it's still a very under-recognised health problem, even though it's up there with depression, heart disease and cancer." He said managing chronic pain was complex and because people found it hard to get timely treatment, many resorted to self-medicating and some ended up with dependency issues. "Cannabis is often used and over-the-counter medicines have become a big problem too," he said. "We need to develop best practice for doctors on how to manage pain, but also provide good information to the community about realistic expectations, even though it mightn't be a cure." Murdoch University would be the first in Australia to teach chronic pain medicine as a core part of a student's degree and research would be done to help improve the quality of life for 3.5 million Australians with conditions such as joint and back pain.

The Australian Federal Government has growing concerns about the use of the drug known as ice or crystalline methamphetamine. According to a survey by the Australian Institute of Health and Welfare, around 2.1% of Australians say they used methamphetamine or amphetamine drugs including ice, speed, base and prescription amphetamines in the past year. Overall use of methamphetamines has actually fallen from a peak of 3.7% of the population in 1998. But the proportion of users taking the more potent ice has increased dramatically in recent years. In 2013, 50.4% of users said the main form of the drug they used was ice, up from 22% in 2010. Meanwhile the proportion using 'speed' had fallen from around 51% to 29%.

Expanded from ABC Fact Check

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