The Development of Indigenous Substance Misuse Services in Australia: Beliefs, Conflicts and Change

Abstract

The aim of this paper is to overview earlier and recent issues in the field of Indigenous substance misuse intervention from its beginning to more recent developments. The overview will specifically analyse developments, advancements and change in the area of tertiary intervention or 'rehabilitation' as it is commonly referred to by Indigenous people. First, the paper will focus on Indigenous historical and theoretical constructs that have impacted on the development of Indigenous notions of 'rehabilitation' or intervention. Indigenous interpretations of the disease model of alcoholism, particularly the Alcoholics Anonymous philosophy, is analysed as well as the socio-cultural beliefs associated with those models. Second, conflicts with the mainstream management of substance misuse intervention are overviewed. Third, the paper highlights the complexity of more recent evolution of the services and discusses possible options for change. Attention is also devoted to Indigenous alternative interpretations of intervention and their relevance to the area of secondary intervention. Recent developments in the area of primary health care and their potential towards further improvement is also considered as well as obstacles to those changes.