title: 'Individual' harms, Community 'harms': reconciling Indigenous values with drug harm minimisation policy.
abstract: This paper uses data on the social context of drug-related harms in the Melbourne Aboriginal Community to inform an alternative model of harm minimisation, and discusses its potential application in programme development. The paper involves a secondary analysis of interviews and focus group discussions with 62 Community members who participated in a qualitative injecting drug use study conducted at the Victorian Aboriginal Health Service in Melbourne. Individuals and families within the Melbourne Aboriginal Community experience significant levels of harm associated with injecting drug use, and face restricted access to appropriate service options. This experience of drug use contributes to a broad range of values within the Community around harm minimisation approaches to programme delivery. We propose a fundamentally distinct harm minimisation model which explicitly acknowledges this range of conflicting values, and reflects the need for a breadth of services and programmes that address these tensions. Policies and funding must support Aboriginal Communities to negotiate through these conflicting Community values to actively create spaces in the service system for both using and non-using Community members. This includes the development of regional approaches which articulate an appropriate mix of services and the roles of Aboriginal and mainstream services in their delivery.
authors.affiliation: Victorian Aboriginal Health Service, Australia.
authors.forename: Anke E
authors.initials: AE
authors.lastname: van der Sterren
authors.forename: Ian P
authors.initials: IP
authors.lastname: Anderson
authors.forename: Lisa G
authors.initials: LG
authors.lastname: Thorpe
mesh_terms: D017144:Focus Groups; D005544:Forecasting; D040261:Harm Reduction; D006297:Health Services Accessibility / Q000639:trends; D006301:Health Services Needs and Demand / Q000639:trends; D006303:Health Services, Indigenous / Q000639:trends; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D007406:Interview, Psychological; D016730:Program Development; D012940:Social Problems / Q000208:ethnology* / Q000517:prevention & control; D012944:Social Support; D012945:Social Values / Q000208:ethnology*; D015819:Substance Abuse, Intravenous / Q000208:ethnology* / Q000517:prevention & control / Q000534:rehabilitation; D014739:Victoria
chemical_list: D013287:Illicit Drugs