How climate change already impacts people who use alcohol and other drugs: Australian service staff perspectives

Increased prevalence and intensity of extreme weather events, as well as more gradual climatic shifts, have disproportionate impacts for people who experience poverty and stigmatisation. This includes many who engage with alcohol and other drug (AoD) services. The aim of this paper is to identify a broad range of already-occurring climate change impacts on Australian AoD service users, as observed by service staff. This is an interpretive qualitative study. Climate change impacts are conceptualised as 'contextual vulnerabilities' emerging through interacting socioeconomic, institutional and local climatic circumstances. We conducted online individual and focus group semi-structured interviews with 30 staff from AoD agencies across all Australian states and territories. Participants worked in metropolitan, regional and remote settings, and held a range of roles. Our analysis generated three themes: that climate change: 1) compounds material and 2) affective harms for people who use AoD services, and 3) erodes their capacity to limit substance use and manage associated risks, for example by accessing harm reduction resources.Extreme weather events and longer-term shifts occurring as the climate warms, appear in many interviewee accounts to be associated with increased AoD use. Problems and harms reported for people who use AoD services vary according to interacting vulnerabilities: substance consumption patterns, age and ongoing impacts of colonisation and dispossession experienced by First Nations communities. These are compounded by institutional settings governing service and housing availability including stigmatisation, and by local climatic risks to which people are exposed. Together, these place people at risk of worsened socioeconomic disadvantage, intensified negative affect or reduced capacity to protect their health and wellbeing. Equitable service responses can moderate this. By documenting diverse impacts of climate change in Australia for people who use AoD services, as identified by staff, we demonstrate the need for further research here and in other countries. Planning and resourcing must be designed to address specific contextual vulnerabilities that operate within local communities. Without coordinated, equity-focused policy action, climate change is likely to intensify existing material, affective and adaptation capacity inequalities for people who use AoD services, increasing both preventable harm and demand on already stretched agencies.