Addressing indigenous substance misuse and related harms

Substance misuse and its consequences among indigenous minority populations in countries such as Australia, New Zealand/Aotearoa, Canada and the United States is a major health and social problem. In Australia among Indigenous peoples, the proportion of tobacco smokers is twice that in the non-Indigenous population; there is a higher proportion of people who consume alcohol at harmful and hazardous levels; there are higher rates of illicit drug use, including injection of illicit drugs; and there are higher rates of volatile substance misuse, including petrol fume inhalation. These higher rates of substance misuse are accompanied by commensurately higher rates of alcohol- and other drug-related morbidity and mortality and rates of violence and other forms of social disruption [1]. Although there is some variation in the specific rates of use and their consequences, the patterns of substance misuse among indigenous minority peoples in New Zealand/Aotearoa, Canada and the United States are broadly similar to those found in Australia [1 – 4]. That these peoples are ethnically and culturally diverse highlights the role of their common histories of dispossession and continuing economic and social marginalisation in the aetiology of substance misuse and related problems.