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15. A multicultural approach to drug and alcohol-related issues and problems

The cultural diversity of the Australian population has received little emphasis in the establishment of drug and alcohol services in this country. Relatively little consideration has been given to the values and heritage that predominate among different cultural communities, with the majority of drug and alcohol services available reflecting broader Australian community values. Therefore, when consulting with people of non-English-speaking background or Aboriginal or Torres Strait Islander peoples regarding drug- and alcohol-related problems, a number of issues need to be considered.


The greatest barrier for people of non-English speaking backgrounds is language. The information available is often insensitive to language, levels of education and cultural differences, and therefore may be an ineffective education tool. Often the printed information given is distributed to people according to their country of birth rather than by preferred language, and therefore may be irrelevant or inadequate. As a result, many people from non-English speaking backgrounds are largely uninformed about drugs and their effects, the problems that can be experienced, or the drug and alcohol support services available, and thus are oblivious to telltale signs of problems arising from intoxication and dependency. Language barriers, and the insensitivity of mainstream drug and alcohol services to cultural differences, may discourage people from non-English speaking backgrounds from accessing available services.


While many people from non-English speaking backgrounds would prefer to consult a professional or knowledgable member in their own community about a drug- or alcohol-related problem, in many cases this may not be an option. These people are therefore faced with the prospect of accessing the mainstream agencies, often with little understanding of the services, where they exist, or the concepts upon which they are modelled.

As a general practitioner or health worker, there are a number of issues you may like to consider when consulting people from non-English speaking backgrounds.


There is evidence to suggest that people from some cultural backgrounds may be at greater risk of developing a drug- or alcohol-related problem:



Since the 1980s, use of kava, a traditional intoxicating drink used by South Pacific Islanders made from the root of the plant Piper methysticum, has been seen as an adjunct to or substitute for alcohol use in some Aboriginal and Torres Strait Islander communities.

Clinical effects

Kava possesses psychotropic qualities, producing a mild narcotic-like effect associated with muscle relaxation. The use of kava may lead to:

Kava is an introduced drug to Aboriginal and Torres Strait Islander communities. The high quantities sometimes consumed are a cause for concern. Many serious toxic physical effects can result from renal and hepatic damage.

Heavy kava users may present with the following symptoms:

Long term kava use has also been directly or indirectly associated with:


Kava use, like alcohol use and petrol sniffing in other Aboriginal and Torres Strait Islander communities, has many complex social factors associated with its use. While there is concern regarding its use, consideration must also be given to the role of kava in these particular communities, particularly where kava is used as an alternative to alcohol.

Heavy kava users should be monitored and advised to stop using. In order to reduce the harmful effects of kava, health care workers should encourage users to reduce kava consumption, provide dietary information to reduce effects of malnutrition and work with indigenous communities to encourage their own reforms which address the physical and social effects of kava.

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