Indigenous residential treatment programs for drug and alcohol problems: Current status and options for improvement

Commonwealth-funded residential rehabilitation programs for Indigenous problem drinkers or drug users were established in the 1970s as community-controlled organisations that were separate from Aboriginal Medical Services and independent of State drug and alcohol units. Structural and political factors during their development and growth have meant that many such programs are now poorly networked with sources of professional advice and other types of therapeutic community. They remain wedded to a single treatment regime and are insulated from change. On the other hand, some offer a range of vocational and skills-based activities as well as providing referrals for effective counselling. Trends in Indigenous drug and alcohol misuse are changing, with a decline in alcohol use and an increase in opiate use as the principal drug problem for those receiving services. Residential programs need to be informed and competent in order to respond to these changes. Fruitful avenues to pursue in order to improve their knowledge base and perspectives include providing better training for board members as well as facilitating exchanges with other, non-Indigenous therapeutic communities. Collaboration in quality improvement reviews, closer partnerships with local State drug and alcohol services and non-government organisation networks, and mandatory participation in the many available in-service training programs would contribute to achieving these goals