2012 INREVIEWOur Vision:A society in whichall individuals andcommunities enjoy goodhealth and wellbeing, freefrom drug-related harm

Drug markets have neverbeen more diverse, fluid ortransformative. In 2012 Anexcontinued its leadership andadvocacy role in harm reductionwith significant contributionsto improving understandingof drug and alcohol use andminimising their harmfulimpacts.

Anex now co-ordinates theAugust 31 InternationalOverdose Awareness Daywhich is gaining recognitionaround the world. Overdosedeaths continue to increasein Australia, fuelled to a largeextent by prescription drugs.Anex received numerousreports from concerned NSWhealth workers that manyclients were injecting fentanyl.It appeared to be aregional/rural phenomena.We held a roundtable fact-finding seminar at Wodongawhere it became clear thaturgent action was required toreduce overdoses from fentanyl.

Following an official Anexnotification of reported over-prescription of fentanylin regional NSW, the state’sPharmaceutical Services Unitlaunched an investigation thatis on-going.

Anex has continued to advocatefor programs to reduce opioid-related fatalities throughthe provision of the overdosereversal drug naloxone. Wesought the Australian MedicalAssociation’s backing fornaloxone distribution programsand it subsequently fullyendorsed Anex’s platformof proposals.

It is therefore pleasing thatin 2012 concrete steps weretaken. The Australian CapitalTerritory, South Australia andnow Victoria have openlyendorsed these programs,which most importantly,sends a signal that all livesare valued. There are alsotwo small programs inoperation in NSW.

The ACT Government wentto an election with acommitment to implementin-prison needle exchange.Chief Minister Hon. KatyGallagher recognised Anex’sleadership in public educationconcerning such a program, butnoted that consultations withunions were still needed.Interestingly, opinion pollingconducted for the CanberraTimes in the lead-up to the ACTelection did not detect publicconcern regarding the proposedneedle exchange.

The year was also markedby tensions concerning theemergence of ‘recovery-oriented’ approaches to drugpolicy. After researching thediscussion paper on ‘recovery’,we then worked closelywith Victorian policy-makerstoward the resultant wholeof government alcohol and drugstrategy, which has maintainedstrong commitments to harmreduction.

We extend our utmost thanksto the numerous supporters,colleagues and collaboratorswho assist and advise us. Weespecially thank the AustralianGovernment Department ofHealth and Ageing and theVictorian Department ofHealth. We also thank Mr IanSanders for his hard work asan Anex Board member, whoresigned in 2012 after eightyears on the Board. Wewelcome Professor Ian Gust AOto the Board.

Professor Steve WesselinghChair

John RyanChief Executive Officer

Chair and CEO’s Message

ANEX PATRONS

Chief PatronEmeritus Professor Sir Gustav Nossal AC CBE

PatronsProfessor Margaret Hamilton AOHon. Justice Michael Kirby AC CMGEmeritus Professor David Penington AC

ANEX BOARD OF DIRECTORS

ChairProfessor Steve Wesselingh

DirectorsProfessor Ian Gust AOThe Hon Robert Knowles AOMs Amanda MilledgeMr Ian Sanders (part)Mr Terry ScanlonDr Ingrid van Beek AMThe Hon David WhiteMr Scott Wilson

Professor Steve WesselinghChair John Ryan

Chief Executive Officer

Anex Goal One:A highly capable,recognised andresourced sector Building staff skills: training

to deliver better outcomes

In the ever-changing world ofdrug use it is vital that frontlinestaff are afforded theopportunity to remain up-to-date with emerging trendsthrough training and education.

With the high staff turnover inmost organisations, there is aconstant need for newcomers tolearn basic skills and approachesthat seasoned alcohol and otherdrug workers have long beenexpert in. Our Anex Bulletin,NSPForum and a wide range oftraining sessions and seminarsdo just this.

Workforce DevelopmentTraining

As a Registered TrainingOrganisation with combineddecades of field experience, Anexis constantly reminded that thebest form of learning a Needleand Syringe Program (NSP)worker can have is directface-to-face interaction withcolleagues and other peers.

In 2012, our training engagedalmost 350 differentorganisations, including:employment services, maternaland child health services,community health servicesand hospitals as well as privatesector agencies. More than 1500people were directly trained witha flow-on effect to thousandsmore in the community.

Seminar topics were as variedas fetal alcohol syndrome,fentanyl misuse, legal highsand ice, for which interest hasbeen intense.

NSPforum: encouragingsupport and service deliveryexcellence

More than 800 posts wereexchanged through the Forum,which provides frontline workerswith a critical informationexchange, networkingopportunities and updates.

The use of fentanyl patches byinjectors attracted a lengthydiscussion, as did safe syringedisposal, police activity nearsome NSPs, and back-to-basicsmatters such as safe injectingtraining.

Linking NSP workforcenationally through theAnex Bulletin

Six editions of the Anex Bulletinwere produced last year withcontinued support from theAustralian GovernmentDepartment of Health andAgeing. The Bulletin is theonly workforce developmentpublication produced specificallyfor the tens of thousands ofpeople working throughout NSPnetworks. The Bulletin aims toprovide concise and practicalinformation that frontline staffcan apply in their daily andvaried interactions with injectingdrug users as well as their lovedones.

A number of Bulletin stories lastyear examined mental health

and NSP clients. A special issuefor International OverdoseAwareness Day featured detailedoverdose prevention andresponse information, witha key message of ‘unusualsnoring can mean OD risk’.

Fentanyl on the nationalagenda

Anex put fentanyl pain-reliefpatch misuse and related fataloverdoses on the nationalagenda in 2012 by organisinga special seminar in Wodongaand an official Notification tothe Australian HealthPractitioner Regulation Agency.Acting upon concerns raised bya number of frontline healthprofessionals, Anex alertedNew South Wales, Victorianand Australian Governmentauthorities that sharp rises inprescription of fentanyl - anextremely powerful opioid -appeared associated withworrying rises in fatal overdosesin New South Wales and Victoriain particular.

The Notification led to theNSW Pharmaceutical ServicesAgency launching an ongoinginvestigation into some doctors’fentanyl prescription procedures.The IntergovernmentalCommittee on Drugs hasalso identified fentanyl as animportant item of discussion.

“Fentanyl misuse, including overdoses, has been broughtto the attention of NSW Police in a number of areasacross the State, particularly in Southern and WesternNSW. NSW Police Force has and continues to workwith the NSW Health Ministry to address this issue.”

- NSW Police Force, Drug and Alcohol Coordination.

Fetal Alcohol SpectrumDisorder

Problems associated with fetalalcohol exposure linger throughlife, with thousands of adultsacross Australia affected by arange of disorders. Anex’s FetalAlcohol Spectrum Disorderseminar focused on the longterm problems associated withthis disorder as well as providingpractical strategies for workingwith affected people.

Strong demand for Anexcrystal methampetaminestraining

Drug and alcohol services, NSPs,police, and hospital emergencydepartments in regional Victoriawere startled in mid-to-late2012 by an upsurge inmethamphetamineconsumption.

Methamphetamine productiontechniques continue to evolve,with reports that the highlyportable ‘shake and bake’method in which ‘ice’ can bemanufactured by large numbersof people on smaller scales thantraditional ‘labs’, has emerged inparts of southern Australia.

Anex responded to urgentcapacity building requestsfrom a broad cross section offrontline workers with a trainingprogram that has been in highdemand. Highly experienceddrug and alcohol workers whoare cautious about beingalarmist are reporting that it“seems more like an epidemicthan what was being reportedin the media a few years ago”.Methamphetamine use is beingreported by the majority ofclients in treatment services(including youth and familyservices).

Trans-generational impactof problematic drug use

Health and welfare servicesincreasingly have to offersupport to grandparents whocare for their grandchildrenbecause of their adult child’sdrug use. With the supportof a grant from the TheAndrews Foundation, Anexconvened a seminar on thetransgenerational impact ofproblematic drug and alcoholuse in Gippsland. Speakerswere from the Women’s Alcoholand Drug Service (The RoyalWomen’s Hospital), ChildProtection Services and theMirabel Foundation.

Anex Goal Two:An informed and engaged community thatunderstands and supports harm preventionand reductionapproaches todrug issues

Anex advocacy: shaping policyenvironment

Much of Anex’s advocacy workis unfunded, yet has importantcommunity-wide healthimplications. We are dedicatedto the acknowledgement,promotion and provision ofevidence-based practice toreduce the harms associatedwith drug use.

Gains in movement towardfirst in-prison needle exchange

The Harm Minimisation inPrisons Committee convenedby Anex has for many yearsencouraged the ACTGovernment to move forwardwith its long-stated wish toimplement Australia’s first in-prison pilot needle exchange.ACT Chief Minister Hon. KatyGallagher recognised this publiceducation program by Anexas she announced in July acommitment to proceed withinthe Alexander MaconochieCentre.

Anex has led a public educationprogram in the ACT, stronglysupported by eminentAustralians and peak bodiessuch as the Australian MedicalAssociation.

Big gains in promotion ofoverdose prevention throughnaloxone provision

Naloxone has been used inmedical settings for decades toreverse the effects of opioids.Anex firmly believes that allAustralian governments shouldsupport programs that allowpotential overdose witnessesto administer naloxone in anemergency. We continued todiscuss this with governmentsacross Australia, and are hopefulthat several other jurisdictionswill soon join South Australia,the Australian Capital Territoryand New South Wales in havingthe first-generation pilotprograms that we know willsave lives.

On December 1 the FederalCouncil of the Australian MedicalAssociation adopted Anex’srecommendations as its officialpolicy:

� Australian governmentsshould take necessarysteps to facilitate theestablishment of new pilotprograms directed towardsopioid overdose treatmentwith naloxone;

� Australian governments[should] support theeducation of health careworkers and potentialoverdose witnesses about theuse of naloxone in preventingopioid overdose-relatedmortality and morbidity; and

� the effectiveness of naloxoneprograms should beadequately evaluated.

Anex has been in closeconsultation with the VictorianGovernment concerning naloxoneprovision. It was extremelyheartening to see that the StateGovernment gave strong in-principle support for establishinga pilot program when it recentlyreleased its new whole ofgovernment drug and alcoholstrategy - ‘Reducing the alcoholand drug toll - Victoria’s plan2013 - 2017’.

Leading discussions on theemergent ‘recovery’ approach

Anex produced a ground-breaking discussion paper onthe emergence of ‘recovery-oriented systems of care’ withindrug treatment. Anex did this toprompt debate and stress thatAustralia’s outstanding andworld leading gains in bloodborne virus prevention throughprinciples of harm reductionshould not be put at risk.

As a consequence of raisingthe matter in a forthright, butevidence-based manner, theVictorian Government set animportant precedent by releasingnew policy directions thatembrace aspects of therecovery-oriented approachwhile maintaining strongsupport for all manner of harmreduction interventions, includingpharmacotherapy and NSPs.

“We recognise that Anex has been active in raising publicand professional awareness of naloxone distribution asa potentially effective harm-reduction measure.”

- Australian Medical Association President,Dr Steve Hambleton.

Famous Australians supportingLucid

Lucid is a new social enterpriseestablished by Anex to helpprotect individuals, organisationsand communities from thedetrimental effects of alcoholand other drugs. Lucid heldthe 30 Portraits 30 Daysexhibition to highlight thereal issues around how alcoholand other drugs affect thecommunity. The Hon Bob HawkeAC, Sir Gustav Nossal AC CBE,Baz Luhrmann, Kimbra andMatt Moran were among the30 inspirational Australianswhose images were displayedin conjunction with theNational Gallery of Victoria.See all the portraits atwww.lucid.org.au/3030

The Lucid at Work Programprovides preventative andremedial solutions to theproblem of alcohol and otherdrug misuse in the Australianworkforce, and is designed tohelp both employees andemployers better tackle thisproblem. Anex piloted theLucid at Work Program in2012 and we will continue tobuild on this successful program.

International OverdoseAwareness Day

Anex took the lead in organisingInternational OverdoseAwareness Day on August 31.

A dedicated websitewww.overdoseday.com wasbuilt where health services,groups and individuals fromaround the world could registerevents, order badges anddownload event materials andinformation. Demand for thesilver badge was unprecedented,with orders for almost 60,000badges received.

A confronting communityservice announcement wasproduced to highlight thatunusual snoring was often asign of overdose occurring.A moving documentary wasalso produced, and wasscreened at Federation Square.

International OverdoseAwareness Day 2012 waslaunched in Australia with aspecial forum in Wodonga onthe Victoria-New South Walesborder on the emerging andserious problem of fentanylpatch misuse, which is causingsharp rises in related fataloverdoses.

Lucid Drink Driver Program

Each year tens of thousands ofpeople lose their driver’s licencebecause of alcohol-relatedoffences. Lucid’s highly qualifiedand engaging trainers heldaccredited courses to helpdrivers get back on the roadsafely.

“Quentin was only a junior in high school. I didn’t even know him very well,just seen him around school. It was New Years Eve and he overdosed and diedtoday because of it. No one thinks it’ll happen to them and they’ll be lucky, but it canliterally happen to ANYONE who takes too much of too many different things.Be safe.”

- Tribute from International Overdose Awareness Day website.

International Overdose Awareness Daybanners.Chair

Portrait of former QLD Chief MagistrateDi Fingleton.

Portrait of Anex Chief Patron EmeritusProfessor Sir Gustav Nossal AC CBE.

Anex Goal Three:A highly capable and sustainable organisationwith fruitful strategic relationships

Fundraising Committee:securing Anex’s future

The Anex Fundraising Committeewas instrumental in stagingnumerous activities, includingthe Lucid 30 Portraits 30 Daysexhibition. Committee membersare Amanda Milledge (Chair),James Ball, Russell Barrett,Terry Scanlon, Clive Scott andLinda Wachtel. The Committeesought to generate financialsupport for InternationalOverdose Awareness Day.

Patrons and Board:new members

The Board of Directors advisesAnex on complex strategy issuesand ensures that Anex operatestransparently and complieswith the highest standardsof corporate governance.

The Board is chaired byProfessor Steve Wesselinghwho is Executive Director ofthe South Australian Healthand Medical Research Institute(SAHMRI). Mr Ian Sandersstepped down from the Boardin December 2012.

Distinguished scientist ProfessorIan Gust AO has agreed to jointhe Anex Board. World renowned,including for his groundbreakingresearch into hepatitis A andhuman papillomavirus vaccines,Professor Gust was instrumentalin having hepatitis B incorporatedinto routine vaccine programs inAustralia.

Audit, Risk Management andCompliance Committee

The Anex Audit Committeeassists the Board to overseethe reliability and integrity offinancial management,accounting policies, assetmanagement and financialreporting and disclosurepractices.

It also regularly reviews Anex’srisk management plan and makesrecommendations to improve theeffectiveness of internal controland risk management processes.The Committee was chaired byMr Ian Sanders during 2012.

Anex proposed an Australian definition of recovery as “a voluntary self-determinedprocess toward minimisation or cessation of drug-related harms. This involvesfostering healthy supported connections, such as with self, family, peers andcommunity, and is premised upon fair access to pre-requisites for wellbeing.”

Anex works towards a society in which all individuals and communitiesenjoy good health and wellbeing, free from drug-related harm.

You too can help make a real difference and be a part of this vision.

Make a donationBy making a donation to Anex, you are helping strengthen the nationalnetwork of organisations and individuals working to prevent and reducedrug-related harm in our community.

Your help will enable Anex to provide:� advocacy to reduce drug-related harms;� evidence-based advice to governments and health organisations;� network facilitation and support;� training and professional development;� community education; and� research policy development.

To make your donation, please call 03 9650 0699.Donations over $2 are tax deductible.

SupportersAnex extends particular thanks to our major supporters:Australian Government Department of Health and AgeingVictorian Department of HealthThe Dyson Bequest

We also appreciate the support of:The Andrews FoundationAustralian Medical AssociationBell Charitable FundChurchill TrustCity of MelbourneFAREPharmacy Guild of AustraliaThe RE Ross TrustRussell Barrett Architects

Lucid SupportersMaddocksNGV3 Sided SquareTyrell’s WinesMs Anjali RaoMs Alexandra FloodMr Sebastian KrumenMr Chris Tass ParkerMr Angus Castran

Lucid Donors $10,000Milledge FamilyThe Pratt Foundation

Lucid Donors $5,000Mr Brian Watson & Ms Edwina Le Maistre

Lucid Friends $1,000Mr Malcolm BroomheadProfessor Edward Byrne AOMai Ho FoundationMs Ruth Oakden Rockman FoundationMr & Mrs Edward YenckenDr David Young

Lucid Donors < $1,000Ms Elizabeth BalderstoneMr Roger BrownMr & Mrs Andrew & Geraldine BuxtonDr Simon CrowleyMr Brendan DardisMr Bruno DimasiMrs Andrea EvansMs Rose GilderMr & Mrs Jamie & Rebecca GrayMs Suzanne GriffithsMr & Mrs Phil & Rosie HarknessMr & Mrs Carl & Lorraine HoltMr Trevor HughesMs Barb InglisMr & Mrs Tony LewisMs Marita LillieMs Sally LindsayMrs Jan MacleodMr Alex MacmillanMr David MartinMr Don MartinMr Rupert Myer AM & Mrs Annabelle MyerMr & Mrs Jamie & Kerrie NasserMr Bruce Parncutt & Ms Robin CampbellMr & Mrs Peter & Angie ScanlonMs Deborah StahleMr & Mrs Tony & Alyssia Stewart-GuzzozziMr Peter TimmsMr Frank Van HaandelMs Pamela WarrenderMr Ivan Wingreen

Lucid 3030 Portrait SubjectsMs Laura AndersonMr Roger AntochiMr Ron Barassi AMMs Layne BeachleyMr John BorghettiProf Edward Byrne AOMr George CalombarisMr Li CunxinMs Elizabeth DebickiMr Joel & Nash EdgertonMs Di FingletonThe Hon Bob Hawke ACMr Geoff HuegillMs Kimbra JohnsonMs Asher KeddieMs Tan LeMs Frances LindsayMr Baz LurhmannMr Matt MoranEmer Prof Sir Gustav Nossal AC CBEMr Harry O’BrienMs Fiona O’LoughlinEmer Prof David Penington ACMs Heloise PrattMr Ben QuiltyProf Brian Schmidt ACMr Les Twentyman AOMr David WalshMs Pamela Myer Warrender

International OverdoseAwareness DayFederation SquareMs Marianne LathamSalvation Army Crisis Centre SceneOnMs Rachel Shankland

95 Drummond Street,Carlton VIC 3053Australia

Telephone: +61 3 9650 0699Facsimile: +61 3 9650 1600Email: info@anex.org.auWebsite: www.anex.org.au

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