Enter Stage Right: TONY ABBOTT *dripping hypocrisy*

"I'd probably be too much of a grog-monster for you fellas"

[news.com.au, 25 January 2013]

www.gettyimages.com.au

The Age, 26 August 2017:

Former prime minister Tony Abbott has defended himself for being drunk and incapacitated on the job in 2009, while slamming welfare recipients for blowing taxpayers' money on booze.

Mr Abbott, who admitted to passing out in his office and missing key votes following a rowdy dinner while in opposition, said his drinking binge paled in comparison to Labor's profligate spending…..

In the same 2UE interview on Saturday, Mr Abbott argued for the rollout of cashless welfare cards for all working age Australians receiving benefits from the government, to help combat binge drinking…..

"The whips tried to rouse him to get him down into the chamber to vote, but they were unable to move him," Mr Turnbull recounted on Friday.

"I can't remember anyone else missing a vote because they were too drunk to get in the chamber, but the fact is Tony Abbott has 'fessed up to it." [my highlighting]

SEIN KAMPF: how many in Germany see Donald John Trump post-Charlottesville

“HIS STRUGGLE

Neonazis, Klu-Klux-Klan,

Racism:

How Donald Trump fuelled hatred in America”

[Stern news magazine, 23 August 2017]

Legality of Same-Sex Marriage voluntary postal survey to be decided by High Court of Australia on 5 September 2017

On the question of whether the law should be changed to allow same-sex couples to marry…..

On 8 August 2017 the Turnbull Government announced it would proceed with a voluntary postal plebiscite if the Senate again refused to pass the Bill for a compulsory attendance plebiscite.

On 9 August the Finance Minister announced that the Australian Bureau of Statistics would conduct a voluntary postal survey of citizens registered to vote.

On 10 August proceedings were commenced in the High Court challenging the minister’s power to expend monies to conduct this survey.

High Court of Australia, August 2017:

Wilkie & Ors v The Commonwealth of Australia & Ors

Documents*

10/08/2017 Application for an order to show cause

10/08/2017 Notice of constitutional matter (Plaintiffs)

11/08/2017 Hearing (Single Justice, Sydney v/ link Melbourne)

14/08/2017 Amended Application for an order to show cause

16/08/2017 Appearance (Defendant 4, Submitting)

17/08/2017 Hearing (Single Justice, Brisbane v/link Melbourne & Sydney)

23/08/2017 Written submissions (Plaintiffs)

23/08/2017 Chronology

30/08/2017 Written submissions (Defendants)

01/09/2017 Reply

05/09/2017 Hearing (Full Court, Melbourne)

*The due dates shown for documents on this page are indicative only. 

Related matter:

M106/2017 – Australian Marriage Equality Ltd & Anor v. Minister for Finance Mathias Cormann & Anor

  Documents*

10/08/2017 Writ of summons

10/08/2017 Statement of claim

10/08/2017 Notice of constitutional matter (Plaintiffs)

11/08/2017 Hearing (Single Justice, Sydney v/link Melbourne)

14/08/2017 Amended Statement of claim

16/08/2017 Defence (First Defendant)

16/08/2017 Submitting Appearance (Second Defendant)

17/08/2017 Hearing (Single Justice, Brisbane v/link Melbourne & Sydney)

21/08/2017 Special case

23/08/2017 Written submissions (Plaintiffs)

23/08/2017 Chronology

30/08/2017 Written submissions (First Defendant)

01/09/2017 Reply

05/09/2017 Hearing (Full Court, Melbourne)

*The due dates shown for documents on this page are indicative only. 

Retirement, bereavement, change in home situation, infrequent contact with family and friends, and social isolation leading to an increase in alcohol consumption by older people

British Medical Journal, Substance misuse in older people, 22 August 2017:

Baby boomers are the population at highest risk

Developed countries have seen substantial increases in longevity over the past 20 years, contributing to a global demographic shift. The number of older people (aged over 50) experiencing problems from substance misuse is also growing rapidly, with the numbers receiving treatment expected to treble in the United States and double in Europe by 2020.1

In both the UK and Australia, risky drinking is declining, except among people aged 50 years and older.23 There is also a strong upward trend for episodic heavy drinking in this age group. This generational trend is not restricted to alcohol. In Australia, the largest percentage increase in drug misuse between 2013 and 2016 was among people aged 60 and over, with this age group mainly misusing prescription drugs. However, people over 50 also have higher rates than younger age groups for both past year and lifetime illicit drug misuse (notably cannabis).4

Of additional concern is the increasing proportion of women drinking in later life, particularly those whose alcohol consumption is triggered by life events such as retirement, bereavement, change in home situation, infrequent contact with family and friends, and social isolation. The rise of alcohol misuse in "baby boomers" (people born between 1946 and 1964) has also been noted in Asian countries.5

Older people with substance misuse show different characteristics but most fall into one of three groups: maintainers (unchanged lifetime patterns), survivors (long term problem users), and reactors (later uptake or increased patterns). The distinction is important because each requires different assessment, intervention, and treatment regimens.6

With alcohol being the most common substance of misuse among older people, underdetection of alcohol problems is of immediate concern. Alcohol misuse in the older population may increase further as baby boomers get older because of their more liberal views towards, and higher use of, alcohol. A lack of sound alcohol screening to detect risky drinking may result in a greater need for treatment, longer duration of treatment, heavier use of ambulance services, and higher rates of hospital admission.

Two systematic reviews of both descriptive and analytical trials found that treatment programmes adapted for older people with substance misuse were associated with better outcomes than programmes aimed at all age groups.78 Age adapted programmes resulted in less severe addiction, higher rates of abstinence, improved health status, and better aftercare. Assessment, treatment, and recovery plans require careful consideration of age specific clinical needs. Professionals need to consider the possibility of coexisting mental disorders such as cognitive impairment and depression (dual diagnosis), as well as complex physical presentations that may include the presence of pain, insomnia, or the non-medical use of prescription drugs. Older people with dual diagnosis use both inpatient and outpatient services more frequently than those with substance misuse alone.9 The management of substance use in older people can also be influenced by mental capacity, which may change with the onset of cognitive impairment.

Future healthcare for older people with substance misuse will continue to present challenges for service delivery, particularly with the growing influence of baby boomers. Some of the recommendations from the 2011 Royal College of Psychiatrists' report on substance misuse in older people (Our Invisible Addicts),10 such as examining safe drinking limits for older people, developing age specific skills in the assessment and treatment of substance misuse, and adapting services have been incorporated into an information guide for clinical practice.11 In the United States, the importance of better education for clinicians has already been noted.12 In the UK, a revision of Our Invisible Addicts is under way.

The baby boomer population also brings challenges to the diagnostic process, given the complexity of clinical presentations. Clinicians will need improved knowledge and skills in assessing and treating older people at risk of misuse of opiate prescription drugs, cannabis, and, increasingly, gabapentinoid drugs used to treat neuropathic pain and anxiety.13

Guidance for service commissioners has begun to acknowledge the needs of older people with substance misuse, particularly in the context of dual diagnosis.14 The Drink Wise Age Well project in the UK has also started to evaluate interventions for alcohol misuse in older people.15 But there remains an urgent need for better drug treatments for older people with substance misuse, more widespread training, and above all a stronger evidence base for both prevention and treatment.

The clinical complexity of older adults with substance misuse demands new solutions to a rapidly growing problem. So far, there has been little sign of a coordinated international approach to integrated care.

References

1.     ↵

Wu LT, Blazer DG. Substance use disorders and psychiatric comorbidity in mid and later life: a review. Int J Epidemiol2014;358:304-17. doi:10.1093/ije/dyt173 pmid:24163278.

2.     ↵

Office for National Statistics. Adult drinking habits in Great Britain: 2005 to 2016. 2017.https://www.ons.gov.uk/releases/adultdrinkinghabitsingreatbritain2015

3.     ↵

Australian Institute of Health and Welfare. National Drug Strategy Household Survey (NDSHS) 2016: key findings. 2017.http://www.aihw.gov.au/alcohol-and-other-drugs/data-sources/ndshs-2016/key-findings

4.    ↵

Kostadinov V, Roche A. Bongs and baby boomers: Trends in cannabis use among older Australians. Australas J Ageing2017;358:56-9.. doi:10.1111/ajag.12357 pmid:27730759.

5.     ↵

Nadkarni A, Murthy P, Crome IB, Rao R. Alcohol use and alcohol-use disorders among older adults in India: a literature review. Aging Ment Health2013;358:979-91.. doi:10.1080/13607863.2013.793653 pmid:23659339.

6.     <![endif]>↵

Nicholas R, Roche AM. Grey matters. Preventing and responding to alcohol and other drug problems among older Australians. Information Sheet 3. The silver tsunami: the impact of Australia's ageing population.National Centre for Education and Training on Addiction, Flinders University, 2014, http://nceta.flinders.edu.au/files/7014/1679/1083/EN559.pdf.

7.     <![endif]>↵

Moy I, Crome P, Crome I, Fisher M. Systematic and narrative review of treatment for older people with substance problems. Eur Geriatr Med2011;358:212-36. doi:10.1016/j.eurger.2011.06.004.

8.     <![endif]>↵

Bhatia U, Nadkarni A, Murthy P, et al. Recent advances in treatment for older people with substance use problems: An updated systematic and narrative review. Eur Geriatr Med2015;358:580-6. doi:10.1016/j.eurger.2015.07.001.

9.     ↵

Bartels SJ, Coakley EH, Zubritsky C, et al. PRISM-E Investigators. Improving access to geriatric mental health services: a randomized trial comparing treatment engagement with integrated versus enhanced referral care for depression, anxiety, and at-risk alcohol use. Am J Psychiatry2004;358:1455-62. https://doi.org/10.1176/appi.ajp.161.8.1455.doi:10.1176/appi.ajp.161.8.1455 pmid:15285973.

10.   ↵

Royal College of Psychiatrists. Our invisible addicts: first report of the older persons' substance misuse working group of the Royal College of Psychiatrists. 2011. http://www.rcpsych.ac.uk/files/pdfversion/cr165.pdf

11.   ↵

Rao RT, Crome I, Crome P. Substance Misuse in Older People: an Information Guide. Cross Faculty Report FR/OA/A)/01.The Royal College of Psychiatrists, 2015,https://www.rcpsych.ac.uk/pdf/Substance%20misuse%20in%20Older%20People_an%20information%20guide.pdf

12.   ↵

De Jong CAJ, Goodair C, Crome I, et al. Substance misuse education for physicians: why older people are important. Yale J Biol Med2016;358:97-103. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797843pmid:27505022.

13.   ↵

Evoy KE, Morrison MD, Saklad SR. Abuse and misuse of pregabalin and gabapentin. Drugs2017;358:403-26.doi:10.1007/s40265-017-0700-x pmid:28144823.

14.   ↵

Public Health England. Better care for people with co-occurring mental health, and alcohol and drug use conditions. 2017.https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/625809/Co-occurring_mental_health_and_alcohol_drug_use_conditions.pdf

15.   ↵

Drink Wise Age Well. Impact report. 2016. http://www.drinkwiseagewell.org.uk/wp-content/uploads/2016/11/DWAW_AR16-LoResSpreads2.pdf

The question of marriage equality needs to be resolved

Over a two week period from 12 September 2017 an Australian Marriage Law Survey Form will be sent by post to every Australian registered to vote. It will be sent to the address given on the Commonwealth Electoral Roll.

This voluntary survey form needs to be returned before 6pm on 27 October 2017. If it is received by the Australian Bureau of Statistics after the deadline it will not be counted.

The survey form asks one straightforward question: “Should the law be changed to allow same-sex couples to marry?”

Trump the Demagogue

US President Donald J. Trump holds a rally at the Phoenix Convention Center in Phoenix, AZ, on 22 August 2017

Political meme of the Week

@MissBaileyWoof