The Royal Australian College of General Practitioners has called on the federal government to help GPs and practice teams help more people with alcohol and other drug issues including opiate abuse.
The RACGP call to action followed the release of the National Drug Strategy Household Survey 2022-2023 which found 1 per cent of people drank alcohol in ways which risked their health, 47 pc of people had used an illicit drug and while cigarette smoking had declined from 11 pc to 8.3 pc the use of e-cigarettes and vapes nearly tripled from 2. 5 pc to 7 pc.
RACGP vice-president and national rural chair Dr Michael Clements said an added challenge people living in remote and rural locations faced over the tyranny of distance was often a dearth of local healthcare professionals.
Based in Townsville, Dr Clements said he regularly travelled to remote areas including the Gulf of Carpentaria to operate clinics to communities who otherwise would have to drive for days to access healthcare services.
"As well as operating clinics in Townsville I visit Karumba and the lower Gulf every week or two," he said.
"I pilot my own plane, a Cirrus SR-22 which can carry four people so I can fly out registrars, obstetricians for women's health and specialists to run clinics as they are needed,
"Flying from Townsville to Karumba is the equivalent of going from London to Zurich, I think many health industry professionals don't appreciate the distances people would otherwise have to travel to access healthcare."
Dr Clements also regulatory visits two very different patient demographics on islands with similar population sizes in the Townsville region.
"Magnetic Island has an older population of 2000 with masticated health issues while Palm Island has a mostly Indigenous population with a lot of chronic disease," he said.
But Dr Clements said alcohol abuse was across all strata of society no matter the location and support for GPs crucial to help people with this and all drug issues.
"Alcohol is one of the most readily available drugs which can cause harm," he said.
"It's such a normal part of normal Australian culture and remains a stubborn problem and must be a priority for government, GPs and practice teams."
He said in his experience too many patients self-medicated with alcohol to escape from their day-to-day stresses.
"Some people use opiates and painkillers but not for the pain relief," he said.
Dr Clements said more strategies needed to be considered to encourage a greater number of GPs to consider the benefits of working outside the urban fringe and making a genuinely positive difference to those living in rural and remote communities.
RACGP Alcohol and Other Drug spokesperson Dr Hester Wilson, said she welcomed the release of the survey results and called for greater support for GPs saving lives at risk.
"We must ensure all people can get the help and support they need for alcohol and other drug issues, including from their GP," she said.
"Non-medical use of pain-revilers and opioids, such as codeine or oxycodone, declined from 2.7 per cent in 2019 to 2.2 per cent in 2022-23.
"This is very welcome, so let's harness this momentum to drive down harmful non-medical opioid use even further.
"Following last year's budget, the college applauded the federal government's decision to add lifesaving opioid dependence treatment medicines, such as methadone and buprenorphine, to the Pharmaceutical Benefits Scheme, saving patients valuable dollars.
However, Dr Wilson said these changes will have unintended consequences for a small group of vulnerable patients experiencing additional challenges such as homelessness for whom the new access arrangements will be unnecessarily onerous.
"Late last year, the government heeded our calls and delayed the implementation of these changes until June 30 this year," she said.
Dr Wilson said the RACGP continued to "engage productively" with the Department of Health and Aged Care to ensure they could find a long-term solution that allows direct access to medicines, including long-acting buprenorphine.
"These treatments save lives, so let's ensure GPs aren't held back in helping patients at risk," she said.
"On the illicit drug front, the survey finds that cocaine use is much higher in Australia compared to other countries, and ketamine use increased meaning that in 2022-2023 around 300,000 people had used the substance in the previous 12 months.
"These are harmful drugs, and I encourage all GPs to be proactive and initiate discussions with patients about these substances. Some people may not be aware they are putting themselves at extreme risk."
Dr Wilson said alcohol abuse continued to be regarded by GPs as an ongoing challenge.
"Alcohol is the most destructive drug in Australia," she said.
"The proportion of people drinking alcohol above guideline recommendations has fallen slightly from 33 per cent in 2016 to 31 per cent in 2022-2023, but we have a long way to go."
Dr Wilson said the survey also revealed fewer males consumed alcohol at risky levels but in young women it had increased.
"This mirrors increases in other risky behaviours including illicit drug use," she said.
"It is vital that GPs keep having conversations with patients about alcohol consumption and how to have a healthier relationship with this drug or leave it behind altogether, especially young women (as) I see a concerning number of women drinking alcohol before they are aware they are pregnant.
"The good news is that proportion of people drinking alcohol at risky levels is continuing to gradually decline over time.
"We are far from out of the woods yet, but I think more and more people, especially younger people, are waking up to the impact of alcohol on the health of themselves and their community."
Dr Wilson said she believed what she termed "Big Alcohol" will hopefully find it more challenging to target younger demographics and "glamorise booze".
"Increasingly people are viewing this drug as the new cigarettes," she said.
"Their eyes are wide open."
Dr Wilson said that Australia must also fight complacency on nicotine use.
"There is no 'safe' or relatively 'risk-free' level of smoking, or vaping. Full stop," she said.
"The survey reveals that between 2019 and 2022-2023, the national tobacco smoking rate has dropped from 11 pc to 8.3 pc, which is positive news.
"However, use of electronic cigarettes and nicotine vaping products has increased substantially.
"The survey was conducted prior to recent regulations coming into effect, so there is hope we can arrest this trend."
Dr Wilson said anyone considering taking up vaping her message was straightforward.
"Don't start, because you may well have a lot of difficulty stopping," she said.
"It is not a safe alternative, and we don't fully know the long-term health consequences of vaping. If you're vaping and finding it hard to stop, there are good treatments available and your GP can help you."
Last year, the RACGP urged the federal government to view alcohol and other drug use through a health lens and end what it called the pointless 'war against drugs' mentality.
Know more about this issue? Contact Alison Paterson on 0437 861 082.
