Drug Policy and Reform News - January 2019

Hi all,

Welcome to the first edition of the Drug Policy and Reform newsletter for 2019.

2018 was another busy year with a lot of amazing work happening in our creative, skilful and hard-working sector. In this e-news, we highlight some of this great work, along with the exciting new work ahead for 2019. Keep an eye out for the news on our new consumer resources, new service providers, the developments in SafeScript, and current innovative sector support being delivered through our partner, Turning Point.

The departmental team looks forward to continuing to work with you all in 2019 and, as always, we welcome your feedback on this bulletin, including on any topics you would like to see included in future editions. Comments can be provided by emailing aod.enquiries@dhhs.vic.gov.au.

Hope everyone manages a relaxing break over the holiday season and in the summer months too.

Drug Policy and Reform unit

Department of Health and Human Services

New resources to support consumer choice of quality drug treatment

New resources to support consumers to choose high quality alcohol and other drug treatment services are now available online.

These resources are for people seeking treatment, their support people as well as for people referring others to treatment.

The resources include:

• a factsheet about 'how treatment services work and where to get help'
• a factsheet about 'how to make a complaint'
• a poster encouraging 'key questions to ask when choosing a treatment service'.

You can download, print and share the resources - visit health.vic's Alcohol and other drug client charter and resources section.

Medically supervised injecting room

The medically supervised injecting room (MSIR) is continuing to reduce harms associated with injecting drug use in North Richmond.

Since the MSIR opened on 30 June 2018, more than 1,500 people have registered to use the service and staff have safely responded to more than 300 overdoses, many of which may otherwise have been fatal.

The MSIR is also providing clients with access to a range of health and support services, including general health care, oral health, drug treatment services and legal services.

Construction of the purpose-built facility has commenced and is expected to be completed in mid-2019.

The purpose-built facility will provide more capacity and ensure people who inject drugs have access to the full range of treatment and support services they need to reduce harm from their drug use.

Service providers for new residential rehabilitation facilities

After a competitive tender process, we are pleased to announce the successful service providers who will operate the new residential rehabilitation facilities in Corio and Wangaratta.

Gateway Health and Odyssey House will partner together to deliver the services at Wangaratta's new facility, while Windana has been appointed as the successful tenderer for the new facility in Corio. Both new facilities are projected to commence operation in 2020-21.

These are just two of the new residential rehabilitation facilities the government has supported, with a new adult residential rehabilitation facility to also be built in Bairnsdale, the new youth facility to be built in the Latrobe Valley as well as the new Grampians service which commenced operating in late 2018.

Since 2014-15, the Government will have more than doubled the number of drug residential rehabilitation beds in Victoria once all new facilities are operational, with more than half of the new beds based in regional Victoria.

Announcement of new youth residential rehabilitation service

In late September, the government announced that a new 20 bed youth residential rehabilitation facility will be built in the Latrobe Valley, providing an opportunity for young people to address their substance use issues, and develop important skills that will help them to re-enter the community.

We are currently working to identify an appropriate parcel of land for the new facility, with a location to be announced in the coming months.

Consistent with previous practice, in early 2019 we will release a call for submissions to seek an operator of the new service through Buying for Victoria (formerly Tenders Vic tenders.vic.gov.au).

Community Ice Action Grant recipients

Over the past four years the Victorian Government has provided 52 Ice Action Grants totalling over $500,000 to passionate and engaged community groups across the state.

In 2018 the following organisations have been funded up to $10,000 to tackle the drug ice in their local communities.

• The Australian Red Cross Society
• Ballarat and District Aboriginal Co-operative
• Break the Ice Australia
• Frankston Mornington Peninsula Primary Care Partnership
• Kirrae Health Service
• Latrobe Community Health Services
• Mitchell Shire Council
• Mungabareena Aboriginal Organisation
• Sports Focus: Loddon Campaspe Sports Assembly
• Stepping Up Consortium: through Taskforce Community Agency
• Sudanese Mothers Coalition in Victoria
• Taskforce Community Agency
• Thorne Harbour Health (formerly Victorian Aids Council)
• Wodonga Council.

Residential services - transition to activity-based funding

On 1 July 2019 residential services will change to activity-based funding. At present, there are two funding models within the system, which leads to complications in a range of areas including performance management and reporting.

Adult community services already use an activity-based funding model, and therefore this change will increase consistency across the system. After the change, residential services will have 'drug treatment activity unit' targets with consistent pricing across activity types.

The department held two series of workshops with service providers to discuss the changes and identify opportunities for simplifying and improving the system. These were well attended by service providers and were an invaluable opportunity to test the model and underlying assumptions.

The department is now finalising the modelling, in particular for youth residential services, and will continue engaging with service providers during the process. In the future, the department will also seek to transition youth and Aboriginal community-based services so that all drug and alcohol services use the same funding model.

Activity- based funding targets for residential services will come into effect from 1 July 2019.

SafeScript - supporting the safer supply of high-risk medicines

SafeScript is a new system, providing doctors, nurse practitioners and pharmacists with a comprehensive history of high-risk medicines supplied to patients in their care.

SafeScript assists in facilitating the early identification, treatment and support of patients who are developing signs of dependence on high-risk prescription medicines.

SafeScript is more than an IT system and includes initiatives to support both clinicians and patients.

• SafeScript training is encouraging the safe supply of high-risk medicines by enhancing the communication skills and confidence of prescribers and pharmacists in discussing medicine dependence. More information is available at the Victorian and Tasmanian PHN Alliance website.
• SafeScript Pharmaceutical Helpline (1800 737 233) offers free and confidential advice to people that are concerned about their use of prescription medicines and risk of dependency. The helpline is available 24 hours a day, seven days a week.
• SafeScript GP Clinical Advisors are now available (1800 812 804) to provide peer-to-peer support to GPs in Western Victoria in responding to the needs of patients using high-risk prescription medicines.
• Drug and Alcohol Clinical Advisory Service (DACAS) (also available on 1800 812 804) offers telephone consultancy to assist health professionals in responding effectively to the needs of people with substance use issues. This service is available state-wide and staffed by addiction medicine specialists.
• Reconnexion (1300 273 266) not only provides support services to people experiencing benzodiazepine dependency, but also offers secondary consultations to upskill GPs in benzodiazepine dependence. More information is available at the Reconnexion website.

See health.vic's SafeScript section or follow @SafeScript on Twitter for the latest SafeScript updates.

Current Turning Point sector support activity

The department funds Turning Point to deliver priority projects, practical tools, guidelines and resources to support the AOD sector in the delivery of evidence-based care and activities improving the efficiency and effectiveness of the AOD treatment system.

In 2017-18, Turning Point reviewed scientific literature and worked with existing working groups, clinicians and consumers to inform the development of refreshed AOD withdrawal guidelines and new methamphetamine treatment guidelines for clinicians, as well as a new series of booklets on withdrawal for clients.

In response to feedback, the following products and activities for 2018-19 are currently underway:

• Online search portal for peer support/mutual aid groups held throughout Victoria to be hosted on the DirectLine. This service finder function will enable consumers, family members, AOD treatment providers and other health care professionals etc. to search for meetings based on preferences such as location, meeting type, and special focus/interest groups. This will facilitate access to peer support groups that are matched to peoples preferences.
• Guidelines for managing cognitive problems and acquired brain injury (ABI) in AOD treatment. This user-friendly guide will help clinicians:
• identify, screen, respond to and manage cognitive problems
• identify when a referral to neuropsychological assessment is needed
• by providing tips and strategies for addressing cognitive difficulties and drawing on cognitive strengths to optimise treatment engagement.
• Discharge Planning and Aftercare tool. Turning Point previously worked closely with the sector to refresh the intake and assessment tools, which identified a need for a discharge planning tool, summarising a clients' goals, non-AOD service engagement, need for further support and aftercare on completion of their episode of formal AOD treatment.
• Reducing 'did not attend' (DNA) rates: a pilot study. Non-attendance is a major cause of healthcare inefficiency worldwide. DNAs at AOD services are notoriously high, and contribute to increased wait times, as well as adverse treatment outcomes, treatment drop-out and relapse to substance use. In collaboration with BehaviourWorks Australia, as well as several AOD treatment services, Turning Point is conducting a multi-site study testing the impact of including a behaviour change "nudge" SMS added to appointment reminders, to determine whether this simple, low-cost intervention can change non-attendance rates among AOD outpatients.