Knowledge guides

LG 20: Substance use and addiction disorders in Aboriginal and Torres Strait Islander people and Māori

History and context

Trainees should be able to describe the factors that contribute to current disparities.

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Epidemiology and public health

Trainees should be able to describe the underlying rationale, the strengths and weaknesses of different datasets, and the implications for service planning across sectors.

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Responses at service level

Advanced Trainees should be able to describe the various strategies to improve service responses for Aboriginal and Torres Strait Islander people and Māori.

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Responses at policy level

Advanced Trainees will be able to describe the various policy responses, and their strengths and weaknesses.

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Important specific issues

Advanced Trainees will identify important specialty-specific issues and the impact of these on diagnosis, management, and outcomes.

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  • Contemporary colonisation manifested as systemic and internalised racism, including negative stereotyping
  • Equity
  • The effect of colonisation on the Aboriginal and Torres Strait Islander and Māori communities
  • The role of intergenerational trauma and epigenetics in addictions
  • The role of social determinants of health, including self-determination and Indigenous rights
  • Disproportionate prevalence of substance use disorders and other addictions in Aboriginal and Torres Strait Islander people and Māori
  • Fetal alcohol spectrum disorder (FASD) and Aboriginal and Torres Strait Islander people – public health and clinical aspects
  • Metro / regional / remote differences and challenges for Aboriginal and Torres Strait Islander people and Māori
  • Sources of information and data
  • An understanding of the difference between cultural competence and cultural safety, and responding in ways that are culturally safe
  • Assessing substance use and harms in Aboriginal and Torres Strait Islander and Māori contexts
  • Institutional and systematic racism – understanding service avoidance and mistrust
  • Strategies for engaging Aboriginal and Torres Strait Islander people and Māori in mainstream services
  • The essential role of cultural approaches to treatment
  • The importance of service development by Indigenous peoples for Indigenous peoples
  • The relevance of language
  • The roles of Aboriginal and Torres Strait Islander people and Māori working in medical nursing and allied health
  • Alcohol and drug policies – significant harms for Aboriginal and Torres Strait Islander people and Māori associated with current drug policies
  • Culturally appropriate clinical outcome measures
  • Harm reduction in the context of Indigenous peoples, such as mobile assistance patrols and sobering-up services
  • Indigenous health strategies
  • Reducing inequities and the role of addiction medicine in achieving these outcomes
  • Social determinants of health
  • Substance use, disorders, and addictions and impacts of colonisation on Indigenous peoples