Community Health Workers and the Drug Problem

Denial about the habitual misuse of substances is a standard feature of addictive behaviour. Denial by a collective of addicts when they form a sufficient proportion can then become a societal norm. This societal denial is a major factor in the conspiracy of silence. Breaching denial is a necessary first step for addicted people seeking change. The community response to addictive behaviour must contain the essential steps as defined in the structured intervention technique (“Alconfrontation”) for the individual. They are: (i) definition and acceptance of the nature of the problem; (ii) education about addictive behaviour and the substances concerned, within a relevant perspective; (iii) clarification of the options and objectives; and (iv) contract making. It is possible for communities to achieve collective change if enough significant catalytic individuals and agencies strive to do so. In relation to drink driving and analgesic abuse there have already been significant advances. Cigarette smoking has declined rapidly and this wind of change can be fanned. Armidale in New South wales has a Bicentennial objective to be visibly free of cigarette smoking with its theme “Armidale Leads the Smoke‐Free World”. Innumerable surveys have confirmed that the major factor in society's problems is substance abuse. What is needed now is a core of catalysts to provoke change by increasing awareness, by appropriate education, by exploring tactics for change and by pushing for commitment and contract for change.