PUBH6001 Health Policy and Advocacy- The National Drug Strategy

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 PUBH6001 Health Policy and Advocacy- The National Drug Strategy

Introduction

Public health forms an integral part of the healthcare system; for it to achieve the

mandated roles, the government, through various organizations such as the Department of Health

and Aged Care, promotes policy implementation tailored to address different health concerns in

the country. While policymakers play a crucial role in the policymaking process, other

stakeholders, such as the federal and state health organizations, health institutions, learning

institutions, communities, and non-governmental agencies, collaboratively contribute to the

success of various policies (RACP, 2024). This report, therefore, provides an analysis of The

National Drug Strategy (NDS) 2017–2026, one of the key public health policies adopted since

2017 to address the problem of substance abuse. According to the Australian Institute of Health

and Welfare, (2023a), illicit drug use is one of the major public health issues, and this manifests

through the high burden of diseases, rising mortality rates, and social impacts like increased

crime rates and violence. In addition, the use of alcohol, tobacco, and other drugs has been

identified as the major preventable illness in the country; statistics indicate that Cannabis

accounted for 52% proportion of the national illegal drugs between 2020 and 2021; additionally,

3.3% of the Australian population (age 16-85) reports symptoms of drug abuse annually

(Australian Institute of Health and Welfare, 2023b). This data indicates the severity of the

problem, thus becoming the most exciting subject to explore from a policy perspective. NDS is a

vital policy framework the government has established to involve several stakeholders in a bid to

minimize the uptake of Alcohol, Tobacco, and other drugs. It outlines the government's

collaborative commitment to addressing the problem.

Policy Definition
 Policy, as defined by the core course readings, refers to a framework developed to

provide a solution, a chance, or an opportunity to address an issue and promote change and plan

(Stoneham et al., 2019). Technically, the policy is a plan outlining a course of action and a guide

to inform institutions, government agencies, or people on how something can be implemented

and the anticipated outcomes. Stoneham et al. (2019) further explain that policies can be

developed by a government or instantiations for specific purposes in an industry, government, or

community. In this sense, NDS is a policy developed by the government for public health

purposes, i.e., to address drug abuse-related problems in the country. In a work setting, policies

are used to define the workplace environment and set rules; this can involve health-related

policies around the workplace, such as a smoke-free policy (Government of South Australia,

2020).

Search Strategy and Policy Selection Criteria

I performed a comprehensive search for the relevant public health policies; this involved

searching the official websites of both the federal and state governments, explicitly emphasizing

public health issues about substance abuse. The National Drug Strategy 2017–2026 selection

criteria were informed by its relevance to the chosen subject, its role in contemporary society,

and its significance in addressing public health challenges. The Department of Health and Aged

Care website can access the policies. The selection of the policy was mainly based on relevance

to drug abuse and time of initiation. Recent policies such as NDS provide insights into the

contemporary policy landscape and issues around a given problem(Australian Government

Department of Health, 2019). The challenges faced through the search process include the

complexity of navigating government websites and finding the latest policy because the sites

contain vast information and outdated policies that do not meet search criteria.
 Key Policy Elements and Application of Kingdon's Multiple Streams Theory

Ministerial forward: The Ministerial forward in the NDS sets out the government's

commitment and multidimensional focus on drug-related issues nationwide. NDS forward states

that Australia is committed to reducing the harm caused by drug-related problems by considering

social, economic, and health consequences; the commitment is achieved through three pillars,

i.e., reducing the demand, supply, and harm associated with drugs and alcohol (Australian

Government Department of Health, 2019).

Vision statement: The vision of the NDS is to ensure safe, healthy, and resilient Australian

communities by reducing the harms related to alcohol, tobacco, and abuse of other drugs.

Goals and Objectives: The NDS delineates four fundamental goals and objectives:

 Preventing and delaying the uptake or use of alcoholic, tobacco, and other drugs

 Mitigating the deleterious consequences associated with substance and alcoholic

consumption.

 Enhancing the availability of support and treatment services.

 Assisting in the recovery of those impacted by substance abuse and alcoholism.

Strategies: NDS provides a mix of strategies tailored to promote preventative efforts; these

include the following:

 Harm reduction

 Demand and supply reduction involves preventing the availability and access to illicit

drugs

 Formation of partnerships

 Coordination & collaboration

 Evidence-informed Responses
  National direction, jurisdictional implementation

 Providing recovery interventions and social support

The emphasis is on prevention, while other initiatives focus on secondary approaches, which

include providing access to treatment and social support for the affected individuals (Pereira et

al., 2020). In a bid to implement these strategies, the policy incorporates peer-based community

support, primary care services, and specialists in drug abuse-related issues. NDS consists of

various strategic principles and components to ensure success (Australian Institute of Health and

Welfare, 2019). It is crafted under three pillars to ensure a balanced approach: demanding

reduction, supply reduction, and harm reduction. This approach is extensive and touches on

different areas that promote the abuse of drugs. Demand reduction focused on averting the

uptake of these drugs to delay or stop the use of their usage. Supply reduction emphasizes

measures to disrupt the production and distribution supply of the drugs in the market. Lastly is

harm reduction, which involves methods set to manage the socioeconomic effects of the use of

these drugs. The three pillars are the major concepts that informed the formation of the policy.

Policy formation involves consideration of multiple factors.

To understand the process of policymaking and policy elements, Kingdon's multiple

streams theory explains it from three streams. Kingdon identifies problem, policy, and political

stream as the key elements that operate independently but should be combined in order to offer

the best solution to an issue (Hoefer, 2022). The theory suggests that to ensure effective policy

change, their elements must converge at a certain point to provide an opportunity for action.

Ideally, the theory promotes multiple approach concepts in policy formation and implementation

and affirms the vital role of combining efforts from different stakeholders to facilitate policy

change.
 To begin with, the problem stream involves identifying a problem that requires policy

mitigation measures(Shephard et al., 2020). A problem could arise from a crisis, research

findings in a particular matter, or public outcry over political, social, or economic challenges

(Camilla Bakken Øvald, 2023). In the case of NDS, the issue here is the impact of drug abuse,

the burden it presses on the public, and the effects on the communities and research data

significantly identifies it as a severe public health issue that requires policy formulation to

address every aspect (Littleton et al., 2021). Stakeholders involved within this stream include

policymakers, the affected communities, public health advocates, and researchers. The

development of NDS involved a series of consultations in 2015; the processes involved online

surveys, interviews, and forums to collect data about the problem (Australian Government

Department of Health, 2019). Major issues identified included the rising drug addiction and

social impacts such as increased health conditions associated with alcohol, tobacco, and other

drugs.

Second is the policy stream, which involves establishing solutions to address the

identified problems. It involves proposing alternative solutions; the main actors at this stage are

government agencies and implementors. Therefore, through Kingdon's theory lenses, NDS

provides a wide range of solutions, including partnerships, treatment, social support for the

affected individuals, and evidence-based response (Australian Government Department of

Health, 2019). These are the strategic principles developed to address the matter

comprehensively. Lastly is the political stream; this dimension emphasizes the role of political

actors; policymakers and the government in decision-making to create an opportunity for a

course of action—the responsible actors at this level work to achieve the delegated agendas

within the policy implementation process (Smith, 2023). In general, NDS policy can best be
illustrated using the theory in detail. The theory proposes that policy change happens through a

combination of the three streams to provide an opportunity for action.

Evidence-Based Recommendations for Future Policy Development

NDS is a well-crafted policy framework that addresses the issue of drug abuse from

different dimensions. A lot has been achieved since its initiation. The Ministerial forward and

vision statement align well with the strategies outlined in the policy. The strategy strongly

emphasizes the government's commitment to addressing the challenge of ensuring a safe and

healthy population. However, a few gaps need to be addressed for improvement and future

policy development around this subject. The following highlights gaps and the recommendations

developed from the gaps identified in NDS.

1. Focus on Socioeconomic determinants of drug abuse

While NDS gives priority to the most vulnerable population to drug abuse and involves a

series of preventative strategies, there is a need first to address the root cause of the problem

rather than the secondary aspects. The current interventions outlined in the strategy are effective,

but the policy could have achieved more by addressing social determinants. A study conducted

in 2019 indicated that the majority of the people reported having abused opioids across 17 states

in the United States were from low-income families with high rates of poverty and

unemployment (Grinspoon, (2021). In addition, other studies affirm that poverty is one high-risk

factor leading to drug abuse or overdose. Alcoholism is one of the most abused substances in

Australia; while the country is one of the most developed nations, minority groups such as the

Aboriginal and Torres Strait Islanders are exposed to a socioeconomic disparity leading to high

rates of poverty and alcohol abuse (Holland et al., 2023). The enduring impacts of

discrimination, unequal employment opportunities, and low quality of life among these
populations have significantly exacerbated the use of alcohol and other drugs. In this sense, it is

evident that poverty and other forms of economic inequalities can have a significant effect on

substance abuse. It is, therefore, important to address this gap in NDS or incorporate

socioeconomic determinists' viewpoint in developing future policies.

2. Lack of Policy Advocacy

Policy advocacy should be an integral part of policymaking and the implementation

process. NDS lacked adequate advocacy to enlighten civil society about the policy, its role, and

the demand for its nationwide adoption by stakeholders. According to Chiu et al. (2021), policy

advocacy is important in defining the responsibilities, obligations, and accountabilities of the

organizations, institutions, and individuals involved in policy processes. In contemporary

society, digital media can serve a crucial role in promoting policy advocacy and creating

awareness about the critical elements of policy and the roles of various stakeholders (Jurns,

2019). Social media platforms like Facebook and Instagram can be used to increase engagement

around the subject and policy process to establish relationships with stakeholders and the general

population (Nguyen, 2021). This approach could also help policymakers and public health

promoters promote key policy aspects and increase engagement.

3. Funding and Resource Allocation

The strategy mainly focuses on the ideas and plans to promote collaboration and

prevention toward achieving policy goals and objectives. However, funding and resource

distributions are not adequately addressed. Research conducted in South Africa indicated that

one of the key barriers to implementing substance abuse-related policies is the need for more

adequate resources and a proper resource allocation plan (Nyashanu & Visser, 2022). While one

of the NDS's strategies is to provide treatment and priorities for the most vulnerable group, little
information discusses funding streams and resource allocation to focus on the underlying

populations (Ananthapavan et al., 2022). Therefore, It is crucial to incorporate funding and

resource allocation elements in policy formulation to ensure that all stakeholders involved in

funding are held accountable and perform as expected.

Conclusions

Conclusively, the National Drug Strategy 2017-2026 establishes a comprehensive

framework for managing issues related to alcohol, tobacco, and other abuse of other drugs in

Australia. The strategy has been designed to serve for about a decade since its inception.

Kingdon's multiple stream theory best explains the formulation and elements of the policy,

which encompasses all the three streams proposed by Kingdon for a successful policy process.

Preventative approaches are the main focus of the policy. Harm reduction, demand, and Supply

reduction pillars form an integral part of the policy and inform the general idea driving the

policy. In addition, secondary approaches, such as providing treatment and support to the

affected communities of individuals, are remarkable. The mission forward, the policy's vision,

goals, and objectives are aligned and outlined for the strategy in every aspect. Despite the

strengths identified with NDS, a few gaps must be addressed in future policy development. The

main gap is a lack of focus on socioeconomic determinants of substance abuse, which, according

to research, is one of the risk factors. Overall, the NDS is a crucial step in addressing Australia's

drug abuse and related issues in public health.

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