Should drug and alcohol residential rehabilitation facilities be established in places like Albury? It’s a question the NSW government must be asking, according to a recent parliamentary inquiry.
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Twelve recommendations were handed down by an Upper House committee last week, including that the NSW government “significantly increase funding to drug and alcohol-related health services” and develop a population-based planning tool to ascertain where the need lies.
A gap in the kind of services where people can stay for a week or more and take part in withdrawal and counselling is evident on the Border, according to local health worker Angie McQuire.
The nurse manager of drug and alcohol services at Albury Community Health, an arm of Albury Wodonga Health, oversees services utilised by patients as far as Henty and Urana.
“The closest rehabilitation facilities we have are Calvary in Wagga, which is withdrawal and rehab, or the Circuit Breaker near Benalla, which is just rehab,” Ms McQuire said.
“They’re far away and there can be a waiting list.
“The report mentions there’s 800 (residential rehabilitation beds in NSW) and they’ve worked out we need 1700.”
This 900-bed shortfall was estimated by the Network of Alcohol and other Drugs Agencies, whose members revealed half of all treatments in 2016 occurred in regional NSW, despite almost 62 per cent of the state’s population living in Greater Sydney.
Data collected by NADA showed 69 per cent of regional clients identified either methamphetamine or alcohol as their principal drug of concern.
While there is not an “ice epidemic” in NSW, the state’s health department’s drug and alcohol service director David Reid told the inquiry, he noted “it is a serious problem”.
Ms McQuire has seen an increase in methamphetamine use in the past 13 years in the Border region.
“It’s becoming cheaper and is more readily available,” she said.
“But while we emphasize methamphetamine, we tend to forget about the other drugs; in the time I have been here, the opioid treatment program has grown from about 40 people to 80 people and it keeps expanding.
“I don’t really care what the drug is – if you have an issue with it, let’s work through that.
“Addiction is a chronic condition like any other, and we have to get rid of the stigma around it.
“We talk about cardiac disease or diabetes, but with drugs and alcohol it becomes a tangible thing, and someone becomes a bad person because they use it.”
Albury Community Health provides counselling, opioid programs, and withdrawal – where case workers and a GP assist with a detox from a particular drug at a patient’s home.
Due to the nature of addiction and likelihood of relapse, Ms McGuire said it was important a range of treatments, and not just rehabilitation, be available.
“Residential rehab is not the be-all and end-all, but it’s about giving a set of options,” she said.
“One person may come in and just need information, but for others they will be in and out of the service for a long period of time.
“We need to get the story behind what they are using, how long for, their relationship with the drug and what they want to do about it.
“Withdrawal means you’re going to stop using a drug for five to seven days, but what will they do after that?
“It’s really important for people to look at their long-term goals.”
A new rehabilitation facility being built by the Victorian government in Wangaratta will be the closest for people on the Border.
What that facility will look like and the range of services on offer will become clearer within the next year, with information sessions to be held for the community.
There will also be opportunities for Wangaratta residents to provide input through the planning process led by local government, Victorian Mental Health Minister Martin Foley said.
“Wangaratta is the best location for the facility, based on community demand and proximity to other health and support services, so we can get people in the North East the best possible healthcare and support, as soon as they need it,” he said.
“We know the damage alcohol and drug issues cause to families and communities in regional Victoria – that’s why we’re building a new residential rehabilitation facility in the North East, as well as more than doubling our rehabilitation beds across the state.”
Across the Border, the NSW government has also ramped up funding in recent years, committing $225 million towards alcohol and other drug services in the 2018-2019 budget and rolling out new programs in Southern NSW.
Funding also supports a partnership between the Murrumbidgee local health district and Albury Wodonga Health, with the mental health and drug and alcohol directors meeting monthly to discuss immediate and long-term delivery of services.
Despite the numerous programs working in this space, there is no central register or publicly available resource in NSW which lists information about what’s available, and Ms McGuire agreed with the inquiry's finding that needed to change.
“Part of the recommendations is there should be a statewide information register – I really liked that,” she said.
“Then everybody would have access to it, and know which facilities do what.
“If we were able to have everything how we wanted it, rehab would be brilliant.”
While the inquiry did not visit Albury, it floated expanding government services, including the Koori Youth Court and the MERIT program, where they are currently absent.
The MERIT program operates in 62 of the 150 NSW local courts, but not Albury, and “is a voluntary pre-plea, intensive three-month case management program for adult defendants that aims to address health and social welfare issues and break the drug-crime cycle”.
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