Alcohol and other drug use and treatment for Aboriginal Australians involved in the criminal justice system

Background: Globally almost all Indigenous people who no longer have sovereignty over their lands are socioeconomically disadvantaged, and for multiple complex interrelated reasons, some overuse alcohol and other drugs (AoD). Many Indigenous peoples, including Aboriginal Australians are imprisoned at higher rates than other citizens, with AoD use being implicated as a major contributing factor to this over imprisonment in Australia.

In this presentation by an Aboriginal academic, differences in patterns of AoD use by Aboriginal and non-Aboriginal Australians at entry to prison will be outlined. The implications for treatment and support needs in prison, and an overview of what Aboriginal prison inmates think are the best approaches to delivering AoD treatment will be discussed. It is hoped the learnings from Australia could be useful for other countries with disadvantaged Indigenous citizens

Methods: Quantitative and qualitative methods were used in this research. Comparative analysis was conducted by Aboriginality of 2018-19 state of New South Wales prison intake health screening data for AoD. The Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) was used to assess drinking. A thematic analysis of in-depth interviews with 14 Aboriginal men in prison about AoD treatment.

Results: A higher proportion of Aboriginal than non-Aboriginal people had an AUDIT-C score of 4+; also a higher proportion of Aboriginal people used cannabis daily/almost daily before prison. Aboriginal cultural connections and past bad experiences of non-Aboriginal people mean short-term AoD programs are best delivered to an Aboriginal-only group whereas these issues can be overcome in longer-term programs.

Conclusions: Specific support programs for alcohol relapse prevention for Aboriginal people in prison and leaving prison are needed to help them reduce or abstain from AoD use. This also could reduce likelihood of return to prison.