The Australasian Professional Society on Alcohol and Other Drugs: from a cottage industry to a regional player
FOUNDING OF THE SOCIETY
The Society grew from initial discussions with a relatively small group of medical colleagues. This led to the establishment in 1981 of what was initially called the Australian Medical Society on Alcohol and other Drug Problems (AMSAD). The First Annual Meeting of the Society was held at the Australian National University, Canberra, on 31 July and 1 August 1981.
The founders of the Society agreed that the Society should:
- • be primarily a medically orientated organization established to meet the needs of medical scientists and practitioners; and
- • endeavour to attract a broad medical membership from individuals who had a scientific or professional interest in the prevention, diagnosis and treatment of alcohol and drug-related problems.
AN EVOLVING FOCUS
In the early years of the Society's existence, attention was directed exclusively toward the alcohol and other drugs (AOD) professional needs and interests of medical practitioners. In this sense, the focus of the Society was narrow and specifically targeted. However, a major change in focus occurred during the first 10 years of the Society's existence as it became increasingly apparent that the AOD field involved multi-disciplinary teamwork, and that the Society was increasingly reliant on the input of colleagues from disciplines beyond medicine.
In the late 1980s, this more multi-disciplinary and integrated team approach was reflected in the acceptance of non-medical professionals as full members of the Society, thus recognizing that contributions from scientists and practitioners from other disciplines would enhance and strengthen the Society. The Society's name was duly changed to the Australian Medical and Professional Society on Alcohol and Other Drugs (AMPSAD) and again in 1993 to the Australian Professional Society on Alcohol and Other Drugs (APSAD), with the specific reference to ‘medical’ deleted as redundant.
In 2004 the Society changed its name yet again to the Australasian Professional Society on Alcohol and other Drugs (APSAD) reflecting a shift in focus to the Australasian region including New Zealand and the Asia-Pacific basin. This latter shift in focus is also reflected in the inclusion of a specific Asia-Pacific section within the Society's journal, Drug and Alcohol Review (see below).
The evolution of APSAD is not dissimilar to the developmental pathway experienced by its British-based counterpart, the Society for the Study of Addiction (SSA), albeit over a longer period of time. Like the SSA, APSAD's genesis commenced with an impetus from medical political interests and then grew to encompass a broader disciplinary base, reflecting the expansion of interest in addiction from biological, psychological and social science into nursing, social work and criminal justice work and the voluntary sector .
Today, APSAD is a mature, independent body. It is a truly multi-disciplinary organization representing the full spectrum of professionals involved in the drug and alcohol field in the region. It is Australasia's leading multi-disciplinary organization for professionals involved in the AOD field. APSAD is dedicated to increasing the profile of issues related to the use of alcohol and other drugs through the dissemination of information from the wide range of professions involved in this field. In addition, it strives to promote improved standards in clinical practice and in research into AOD issues and allied subjects.
The role and functions of the Society have been very much influenced by external, societal and epidemiological factors. These factors have included the changing patterns of alcohol and other drug use, comorbidity issues, increasing levels of service demand, the concomitant increase in the international AOD knowledge base and associated changes in intervention and treatment protocols.
The growing complexity and scope of drug- and alcohol-related problems further highlights the need for professional support for the workers in this field. The Society has recognized that for continuous improvement in AOD service quality, efficiency and effectiveness it is essential to be able to respond to change. The ability to attract, support and train a diverse work-force with the requisite knowledge, skills and abilities is also essential. However, the challenges involved in achieving this are not inconsiderable, particularly with regard to attracting and supporting qualified staff to keep pace with the increasing demand for evidence-based prevention and treatment services.
OVERALL AIMS OF THE SOCIETY
APSAD is dedicated to:
- • promoting evidence-based improvements in the treatment and prevention of drug and alcohol-related problems;
- • raising awareness about the problems related to the use of alcohol and other drugs;
- • promoting best standards in research in the drug and alcohol field; and
- • providing development and support to professionals working in the drug and alcohol fields.
APSAD is governed by a Council elected by the Society's membership. Council membership is structured to ensure jurisdictional representativeness. This is especially important in a large country such as Australia, with its relatively small population base. Council members come from a variety of different disciplines. The term of the President is 2 years. It is noted that of the 12 Presidents to date (one of whom held two terms), three have been non-medical members of the Society. An informal arrangement now exists whereby the Presidency alternates between a medical and non-medical member.
The Council's executive at present includes:
President: Ingrid van Beek
President Elect: Alison Ritter
Immediate Past President: Ann Roche
Treasurer: Anthony Jackson
Secretary: Sharon Dawe
In 2005 there was a total of 382 members of APSAD located in every state and territory of Australia (351 members) and in New Zealand (19 members), as well as elsewhere in the world, including Singapore, United States, United Kingdom, Israel and Switzerland (12 members). This is a comparatively large membership when contrasted with similar bodies in other countries. It is also consistent with the comparatively high level of AOD research and policy development that emanates from Australia in relation to its size.
The professional disciplines represented by the membership include educators, counsellors, medical researchers, general practitioners, addiction medicine and public health physicians, psychiatrists, pharmacists, nurses, policy advisers, psychologists and social/behavioural researchers. APSAD's membership list is not currently available publicly.
BENEFITS OF MEMBERSHIP
APSAD offers various forms of professional development to support the varied interests of its members. These include: complimentary subscription to APSAD's scientific journal Drug and Alcohol Review; discounted registration to the annual APSAD Conference and subscription to the quarterly APSAD Newsletter.
ANNUAL MEMBERSHIP FEES
Membership fees are very modest and have been kept deliberately at a level that makes the Society accessible to a wide range of professional groups, regardless of income level. The individual membership rate is AU$ 190 (equivalent to about US$ 145), with concessions available at AU$ 150 for those with a gross income less than AU$ 45 K per annum.
In addition to individual membership, the Council also considers applications for institutional membership. The primary aim of granting institutional membership is to ensure equitable access to APSAD's services and journal for groups (usually working within an agency or organization) that may be disadvantaged by distance, funding and number of staff eligible for membership. Small institutions (up to five staff members) are charged at AU$ 420, and larger institutions (six or more professional staff) at AU$ 825.
FINANCIAL MANAGEMENT AND VIABILITY
APSAD's sources of income derive primarily from annual membership subscriptions and any surpluses from hosting its annual conference, including a capitation payment applied to the registration fees of all APSAD members who attend. APSAD also currently receives a grant from the Australian Government Department of Health and Ageing to assist in producing Drug and Alcohol Review, along with royalty and support payments from its publishers, Taylor & Francis.
The survival of the Society has hinged on its ability to remain financially viable. This has been achieved through judicious use of the Society's funds, applying for grants that reflect the Society's core business, seeking competitive tenders for all expenditures (including publication of the journal), wise investments and very careful monitoring of the Society's overall financial status.
RELATIONSHIPS WITH OTHER RELEVANT ORGANIZATIONS
In parallel with the evolution of the Society, as outlined above, a number of other important developments have occurred in the AOD field in Australia. One of the more important of these was the establishment of the Australasian Chapter of Addiction Medicine within the Adult Medicine Division of the Royal Australasian College of Physicians (RACP) in 2001; APSAD worked with the RACP towards this. This new Chapter will provide specialist medical training in addiction medicine and will represent the interests of medical specialists in the field. There is a formal link between the Chapter and APSAD through the Chapter being represented on APSAD Council.
APSAD also encourages a relationship with the Drug and Alcohol Nurses of Australia (DANA), and to this end also has a DANA representative on the APSAD Council.
ACTIVITIES OF APSAD
Over the years since APSAD was established it has been involved in a diverse array of professional development activities and has often provided the lead for activities that later became mainstream. For instance, APSAD developed the initial methadone maintenance training programmes for medical practitioners in Australia in the late 1980s and early 1990s. Such pharmacotherapy training programmes are now provided routinely by all major jurisdictions in the country and form the basis of the required accreditation to become a pharmacotherapy prescriber.
Today the Society focuses its effort on two major forms of professional development for health professionals: the Annual Drug and Alcohol Conference and the Society's scientific journal, Drug and Alcohol Review, which are detailed below.
The Society has become increasingly aware of the need to provide support for AOD workers and ensure high quality training and professional development. Research indicates that AOD worker stress and higher levels of exhaustion are linked to lower levels of work-place support and lower levels of self-confidence concerning work-related skills . Farmer  found that the major stressors for British workers in drug treatment clinics were organizational and client-related factors. In particular, high work-loads, staff shortages, unsupportive work relations, poor physical work conditions and difficult patients featured as the main sources of stress. Similarly, a recent Australian study found that AOD workers derived most job satisfaction from positive client outcomes and performing work of value to society . Other common sources of job satisfaction identified by AOD treatment staff are personal growth, interactions with clients, collegial co-worker relationships and a commitment to treatment .
Maintaining good levels of job satisfaction have been shown to relate to higher standards of performance and worker retention [6,7]. APSAD has therefore attempted to support and reinforce this through its range of professional development strategies. The Society has made a conscientious effort to undertake strategies that will reduce AOD workers' stress and improve their job satisfaction.
Annual APSAD Conference
The annual APSAD Drug and Alcohol Conference plays an important role in the life of the Society. The APSAD Conference is acknowledged as the premier AOD conference offered each year in Australia. It has been running now for more than 20 years and each year it has grown in size, strength, rigour and quality. The conference provides an important venue for APSAD to promote the use of best practice approaches in the prevention, early intervention and treatment of alcohol and other drug problems. It marries research and skill development with an equal emphasis on each. The 3-day meeting is usually combined with a wide array of satellite meetings. This ensures that diverse areas of professional interest can be catered for, that skills-orientated training can always be provided at reasonably intensive levels, and that maximum stimulation and challenge can be offered to participants.
The Conference encourages participation from APSAD members, others and organizations representing affected communities. Each year the conference organizers provide support for specific high-needs groups. This has included travelling fellowships for rural and remote workers, special Indigenous worker support strategies and subsidized conference places for members of consumer organizations.
In 2006 the APSAD conference will be held in Cairns, Queensland. The 2007 Annual APSAD Conference will be in Auckland, New Zealand and will be a joint conference with Cutting Edge, its national drug and alcohol conference organization, further strengthening APSAD's ties to the Asia-Pacific region.
As indicated, a principal role of the Society is to support workers in the AOD field, a field which is often hampered in its efforts because of stigma and lack of understanding and recognition of the work and achievements made. The importance of recognition is highlighted as a particularly important strategy [4,8], but one that is often largely overlooked. In an effort to redress this to some small extent, in 2004 APSAD established the Annual APSAD Awards for Excellence in Science and Research.
The Early Career Award is for excellence in research and practice relative to career opportunities; the Senior Scientist Award is for a scientist who has made an outstanding contribution to the field of substance use and misuse. These Awards are presented to the successful applicants at the Annual APSAD Conference.
The Society's Journal: Drug and Alcohol Review
Drug and Alcohol Review is the official journal of the Australasian Professional Society on Alcohol and Other Drugs (APSAD), and is currently in its 25th year of publication.
The Review is an international scientific journal, which aims to publish the best of contemporary research and critical analysis and review into the field. It publishes papers describing original research findings and reviews and commentaries on clinical, educational, psychological, biomedical and sociological aspects of alcohol, tobacco and other drug use.
The Review is distributed to members of APSAD and is available to personal subscribers and drug and alcohol agencies throughout Australasia. Increasingly, it has become an international journal in its scope and receives papers and has readers from nearly 60 countries world-wide. The Review is therefore a key mechanism for continuing education in the drug and alcohol field within Australasia, and contributing to the dissemination and update of best practice approaches throughout the region.
History of Drug and Alcohol Review
Drug and Alcohol Review was established as the journal of the Australian Medical Society on Alcohol and other Drugs in 1981. It has remained an integral part of the Society ever since. The Foundation Editor was Les Drew from 1981 to 1983, who then approached John Saunders to take over the editorship in 1984; he continues in the role of Editor-in-Chief of the Journal to the present day.
During the first 4 years of its publication, the Review was essentially a place where non-reviewed conference proceedings were published. From 1985 to 1989 several changes to the Review were instituted, as the Society recognized the absence of a national drug and alcohol journal in Australia. In 1985 there was a shift from the publication of conference proceedings to publication of original papers and critical review articles, and a panel of independent reviewers was developed. In 1986 publication of the Review increased to four times a year, and was expanded to 360 pages.
Under John Saunders' leadership, the journal was revised and set on an international standing through the association of the Society with Carfax as publisher of the Journal in 1990. It adopted its present name of Drug and Alcohol Review and increased its volume size to 448 pages. In recognition of the fact that many countries were adopting a harm reduction approach to respond to substance misuse, the Review encouraged submission of papers from this perspective.
In 2001 there was a further increase in volume size to 480 pages, and from the beginning of 2005 the Review became a bi-monthly publication with a total volume size of 720 pages. A European editorial office was established under the charge of Peter Anderson. In 2006 a regional office for the Americas will be established.
Together, these international positions will strengthen the Review's international reputation and local relevance and allow for better receipt of papers from both Europe and North America.
By providing an international forum for the presentation and discussion of original research and reviews, Drug and Alcohol Review aims to make available the best of contemporary knowledge and opinion to all those engaged in the investigation, prevention and treatment of alcohol, tobacco and drug problems.
Content and contributors
Contributors to Drug and Alcohol Review examine and report on alcohol, tobacco and drug problems from a wide range of clinical, psychological, biomedical and sociological perspectives. The Journal features articles including the following categories: Original Research; Reviews; Brief Communications; Seminars in Practical Management; For Debate; Reviews and Commentaries; Letters to the Editor; News and Views; Harm Reduction Digest; Asia Pacific Column and Book Reviews.
The scientific quality and professional standards of Drug and Alcohol Review are guaranteed by the editorial team and a panel of expert peer reviewers.
The Journal is now available online to its subscribers and APSAD members and is included in Medline, the premier bibliographic database. Portals such as Taylor & Francis's own ‘Addiction Arena’ and SARA provide a convenient way of accessing summary information and document delivery services. This ensures a level of public and professional awareness and accessibility of the Review that is higher than ever before.
Drug and Alcohol Review aims to have approximately one-third of its content as critical reviews of the research literature, contributions to clinical practice and current awareness columns. To this end, it established the ‘Harm Reduction Digest’ in 1994, which is edited by Simon Lenton. The ‘Asia-Pacific Column’, edited by Robert Ali, was launched in 2004. It provides summaries and updates on developments in drug and alcohol policies and programmes in the region.
The Review's impact factor in the addictions social science category is currently 1.62 which, along with the immediacy factor of 0.56, places it in the top five substance use journals internationally.
APSAD'S PUBLIC INFLUENCE
APSAD is frequently called upon to submit position papers, make presentations to parliamentary enquiries on drugs and provide supporting documentation to various enquiries and reviews related to alcohol and other drug matters. A recent example of this is its submission to the Australian Medical Council in support of addiction medicine gaining recognition as a medical speciality.
APSAD is currently developing a general set of guiding principles on social policy issues on alcohol- and drug-related matters to which new members might sign off. Development of such a set of principles could help to establish the Society's general stance on issues of social policy when they arise.
FUTURE DEVELOPMENTS AND CHALLENGES
The overall strategic direction of the Society had previously been determined by the Council at its regular bi-monthly meetings and through informal consultation with membership and the field at large. However in 2005, APSAD undertook its first comprehensive strategic planning exercise; APSAD's future development will be guided by its 2006–08 strategic plan, which is the first such plan for APSAD.
Over the next 3 years APSAD will concentrate its efforts in the following four priority areas.
- 1APSAD membership—APSAD will seek to increase its membership base further, particularly among currently under-represented groups, including young and Aboriginal drug and alcohol health professionals. Its membership criteria will also be reviewed and student, graduate and undergraduate membership categories established. The feasibility of an Asian Pacific membership category and cross-membership with other Associations will also be examined. Services for existing members will also be improved.
- 2Work-force development—as well as supporting work-force development through the maintenance of the high academic standards of its annual conferences and scientific journal, APSAD plans to develop a range of on-line resources for drug and alcohol professionals. This will include the establishment of a resource clearing house with links to other relevant resources and the publication of mentoring tools on its website.
- 3Partnerships—APSAD will review its existing partnerships and encourage the development of others, particularly with relevant professional associations in the Asia-Pacific Region and thereby hoping to increase the membership from these countries.
- 4Systems and governance structures—to enable its full potential to be realised APSAD now needs to expand and restructure its various administrative arrangements. To achieve this, APSAD will be relocated to larger premises and additional personnel with high-level office management and organizational skills will be employed. All the editorial processes for Drug and Alcohol Review will also be brought fully on-line this year, improving the efficiency of this publication. APSAD looks forward to meeting these future challenges.
THE LONG VIEW
The emergence of the Australasian Professional Society on Alcohol and Other Dugs into its current manifestation as a mature, vibrant, multi-disciplinary organization has been a challenging process. The challenges facing the Society continue to the present day and will continue into the future. What started as a small organization with an appropriately (for that time period) narrow focus has grown and expanded in a way that the original founders would not probably have envisaged. The Society's growth, development and maturation over the past 25 years also parallels the development of the AOD field at large. It has indeed been stimulating to attempt to keep pace with the expanding knowledge and evidence base that forms the working platform for all our work. It has also been challenging to survive political sea changes and controversies, and to respond appropriately to other external exigencies. APSAD has aimed to provide a church that is broad and inclusive enough to ensure a professional umbrella that could accommodate the diversity of views, perspectives and disciplines while also maintaining high levels of scientific rigour. The Society has also grown as a ‘business’. Good governance and sound business practice are now more essential to the Society's functioning and survival than ever before.
On all these fronts, APSAD has not only survived but has thrived, particularly in the last 5–6 years. As the AOD field has grown in sophistication, so too has the Society. We believe it is now well placed to hold its leadership role and continue to make significant contributions to the field well into the future.