Cost benefit analysis of Opal fuel substitution

OPAL COST BENEFIT
ANALYSIS

REPORT BY
ACCESS ECONOMICS PTY LIMITED

FOR

THE OPAL ALLIANCE

23 FEBRUARY 2006

Opal cost benefit analysis

TABLE OF CONTENTS

Acknowledgements and disclaimer ....................................................................................4
Glossary of terms and acronyms........................................................................................5
Executive summary...............................................................................................................i
Introduction ..........................................................................................................................1
1. Petrol sniffing ..............................................................................................................2
1.1 Definitions and symptoms.......................................................................................................2
1.2 Impacts ...................................................................................................................................2
1.2.1 Physical impacts and health service utilisation ..............................................................2
1.2.2 Criminal behaviour and justice system impacts .............................................................4
1.2.3 School and employment performance ...........................................................................6
1.3 Causes ....................................................................................................................................7
1.3.1 Cultural disruption and erosion of traditional values ......................................................7
1.3.2 Trans-generational dysfunction, mental illness, isolation ..............................................8
1.3.3 Socioeconomic: low employment, education and economic structures ........................9
1.4 Interventions .........................................................................................................................10
1.4.1 Awareness and harm minimisation health strategies...................................................11
1.4.2 Youth and recreational programs.................................................................................13
1.4.3 Employment, education and training services .............................................................13
1.4.4 Outstations ...................................................................................................................14
1.4.5 Deterrence (legal sanctions, police presence).............................................................16
1.4.6 Community action programs ........................................................................................19
1.4.7 Supply reduction strategies..........................................................................................19
2. Fuel substitution policies .........................................................................................20
2.1 Unleaded petrol (ULP) ..........................................................................................................20
2.2 The Comgas Scheme and Avgas .........................................................................................20
2.2.1 Comgas Scheme..........................................................................................................20
2.2.2 Avgas ...........................................................................................................................21
2.3 Opal.......................................................................................................................................22
2.3.1 Background ..................................................................................................................22
2.3.2 Proposed Rollout Region .............................................................................................24
2.3.3 Estimation of supply volumes.......................................................................................25
2.3.4 Subsidy rates by volume ..............................................................................................26
2.3.5 Implementation challenges ..........................................................................................27
3. Prevalence and regional demographics ..................................................................29
3.1 Population analysis ...............................................................................................................29
3.2 Prevalence ............................................................................................................................31
3.3 Comorbidity and mortality .....................................................................................................36
3.3.1 Other drug abuse .........................................................................................................36
3.3.2 All cause mortality ........................................................................................................36
3.4 Prevalence approach to cost measurement .........................................................................37
4. Costs of sniffing........................................................................................................38
4.1 Health system costs..............................................................................................................38


4.1.1 Sniffing-related hospitalisations....................................................................................38
4.1.2 Other sniffing-related health system costs ...................................................................40
4.2 Burden of disease .................................................................................................................42
4.2.1 Methodology .................................................................................................................42
4.2.2 Estimation of DALYs and the value of healthy life lost.................................................47
4.3 Crime and justice system costs ............................................................................................49
4.3.1 Police, legal costs and incarceration ............................................................................49
4.3.2 Vandalism and property damage .................................................................................53
4.4 Other costs of sniffing ...........................................................................................................55
4.4.1 Production losses .........................................................................................................55
4.4.2 Accommodation and community care ..........................................................................57
4.4.3 Counselling and rehabilitation ......................................................................................58
4.4.4 Deadweight losses .......................................................................................................59
4.4.5 Second generation and other impacts..........................................................................60
4.5 Summary of the costs of petrol sniffing.................................................................................61
5. Evaluation of costs and benefits..............................................................................63
5.1 Cost of adjunctive policies.....................................................................................................63
5.1.1 Package of policies.......................................................................................................63
5.1.2 Estimated cost of a four-government program .............................................................64
5.2 Cost benefit and effectiveness analyses...............................................................................66
5.2.1 Results..........................................................................................................................66
REFERENCES.....................................................................................................................68

FIGURES
Figure 2-1: Proposed Rollout Region, by SLA 25
Figure 3-1: Prevalence and incidence approaches to cost measurement 37
Figure 4-1: Distribution of health costs, by type, all drug abuse 41
Figure 4-2: Petrol sniffing, healthy life lost, % share by cause, 2005 49
Figure 4-3: Ratio of indigenous to non-indigenous age-standardised rates of
imprisonment(a), 2004 51
Figure 4-4: Average cost per criminal incident, 2003 ($) 54
Figure 4-5: Costs of petrol sniffing, 2005, % share 62

TABLES
Table 1-1: Attributable fraction of crime, three case studies 5
Table 1-2: Levels of intervention and associated strategies 11
Table 2-1: Derivation of petrol volumes, Rollout Region, 2005 26
Table 3-1: Population, Rollout Region, by State/Territory, age, gender & ethnicity,
2005* 29


Table 3-2: Employment, Rollout Region, by State/Territory, age, gender &
ethnicity, 2005* 30
Table 3-3: Attendance at an educational institution by State/Territory, 2005* (%) 31
Table 3-4: Prevalence estimates, inhalation, various studies 32
Table 3-5: Prevalence rates of petrol sniffing by State/Territory (%), Rollout
Region, by age and chronicity, 2005 34
Table 3-6: Prevalence of petrol sniffing by State/Territory (number of people),
Rollout Region, by age and chronicity, 2005 35
Table 3-7: Mortality from sniffing, 1998-2003, by cause of death and region 36
Table 4-1: Petrol sniffing related health costs by type, Rollout Region, 2005 ($) 42
Table 4-2: International estimates of VSL, various years 46
Table 4-3: YLL, YLD and DALYs lost from sniffing, Rollout Region, 2005 48
Table 4-4: Total police costs due to sniffing, by State/Territory, 2005 ($) 50
Table 4-5: Estimated cost of property damage, based on Mutitjulu 55
Table 4-6: Lost earnings & tax revenue due to sniffing, Rollout Region, 2005 56
Table 4-7: Sniffers requiring long term care 57
Table 4-8: Deadweight losses due to petrol sniffing ($m), 2005 60
Table 4-9: Petrol sniffing cost summry, 2005 ($m) 61
Table 5-1: Summary costing of adjunctive policies 65
Table 5-2: Cost benefit and cost effectiveness analyses, Opal ($m) 67


ACKNOWLEDGEMENTS AND DISCLAIMER
This report was prepared by Access Economics for the Opal Alliance. The Opal
Alliance consists of the GPT Group, the Ngaanyatjarra Pitjantjatjara Yankunytjatjara
(NPY) Women’s Council and the Central Australian Youth Link-up Service (CAYLUS).
The GPT Group, owners of the Ayers Rock Resort in Central Australia, has joined
forces with Aboriginal community organisations to lobby the Federal Government to
expand its existing subsidy of Opal to combat the practice of petrol sniffing in Central
Australia. Access Economics provides independent, high quality economic advice and
analysis and does not form part of this lobbying effort.

Access Economics would like to acknowledge with appreciation the comments, prior
research and expert input from the following members of the Opal Alliance:

Vicki Gillick
NPY Women’s Council

Blair McFarland and Tristan Ray
CAYLUS

Bruce Morris
GPT Group

Access Economics would also like to acknowledgement inputs from:

Greg Andrews
Mutitjulu Working Together Project

Julia Mitchell
Flinders University

Gillian Shaw
Consultant, Bowchung Pty Ltd

While every effort has been made to ensure the accuracy of this document, the
uncertain nature of economic data, forecasting and analysis means that Access
Economics Pty Limited is unable to make any warranties in relation to the information
contained herein. Access Economics Pty Limited, its employees and agents disclaim
liability for any loss or damage which may arise as a consequence of any person
relying on the information contained in this document.


GLOSSARY OF TERMS AND ACRONYMS
ABS Australian Bureau of Statistics
AIHW Australian Institute for Health and Welfare
ALOS average length of stay
Anangu Pitjantjatjara word for ‘Aboriginal person’
APY Anangu Pitjantjatjara Yankunytjatjara1
BP British Petroleum
CAYLUS Central Australian Youth Link Up Service
CBA cost benefit analysis
CEA cost effectiveness analysis
DALY disability adjusted life year
DHA Department of Health and Ageing (Commonwealth)
GPT GPT Group
NPY Ngaanyatjarra Pitjantjatjara Yankunytjatjara
MWTP Mutitjulu Working Together Project
NT Northern Territory
QALY quality adjusted life year
SA South Australia
ULP unleaded petrol
YLD years of healthy life lost due to disability
YLL years of life lost due to premature mortality
VSM volatile substance misuse
WA Western Australia

1
Formerly AP Lands – name officially changed to the APY Lands (Anangu Pitjantjatjara Yankunytjatjara)
since amendments to the Pitjantjatjara land Rights Act in late 2005.


EXECUTIVE SUMMARY
This report presents a cost benefit analysis for the subsidised supply of British
Petroleum’s (BP’s) Opal Unleaded Petrol (ULP), hereafter called ‘Opal’, throughout a
large Rollout Region of Central Australia comprising the statistical areas of Tennant
Creek and Central NT in the Northern Territory, the Far North area of South Australia,
and Laverton, Ngaanyatjarraku, Halls Creek, plus the communities of Kiwirrkurra and
Kunawarritji in Western Australia. Opal is presently available or approved for rollout in
part of this region.

The cost benefit analysis aims to assess the potential economic impact of the use of
Opal throughout the defined Rollout Region.

Opal, which was introduced to the market in February 2005, is a fuel produced by BP
to combat petrol sniffing in Aboriginal communities. Opal lacks the aromatic
hydrocarbons and tetraethyl lead that induce a ‘high’ when sniffed and is therefore
considered to be an important tool in reducing the incidence of petrol sniffing.

Petrol sniffing is a particularly harmful form of volatile substance misuse that is
prevalent among Aboriginal communities in Central and other parts of Australia, with
substantial associated health and social impacts and costs.

i


The Comgas Scheme (now the Petrol Sniffing Prevention Program)

Opal has been available so far mainly in those communities that qualify for participation
within the Federal Government’s Comgas (also known as the Aviation fuel or Avgas)
Scheme. Prior to the introduction of Opal, the Comgas Scheme utilised Avgas as a
“non-sniffable” fuel substitute. Avgas, however is high in lead and, unlike Opal, was
not suitable for some types of engines.

The Comgas Scheme has operated in a number of remote Aboriginal communities in
the Northern Territory, South Australia and Western Australia since 1998. As Opal and
Avgas cost approximately 33 cents per litre more than regular unleaded petrol, the
Comgas Scheme has provided a subsidy equal to the fuel price differential, thereby
making these fuel substitutes the same price for consumers as regular unleaded petrol.

The November 2004 evaluation of the effectiveness of the Comgas Scheme,
conducted for the Australian Department of Health and Ageing, provides evidence that
fuel substitution and/or supply reduction contributes to a lower prevalence of petrol
sniffing in Central Australian Aboriginal communities, with similar findings in other
regions (eg, Arnhem Land). Proximity to supplies of regular unleaded fuel, however,
has limited the effectiveness of Avgas and more recently Opal in communities that are
relatively close to alternative sources, such as roadhouses. This study’s proposed
Rollout Region is thus geographically large and includes major towns in order to reduce
access to alternative sources of fuel and mitigate this historically limiting factor.

Methodology

The cost benefit analysis of the wider introduction of Opal as described in this report
compares the benefit from reducing the costly impacts of sniffing and the cost of
effectively extending the supply of Opal through a package of policies including the
subsidy.

Benefit of lower petrol sniffing costs – Cost of Opal rollout = Net benefit

Petrol sniffing costs include the lost value of healthy life (‘disease burden’), health
system expenditure, crime and justice system costs, production losses, community and
informal care of sick or disabled sniffers, rehabilitation costs and the deadweight losses
that arise from lower taxation revenues and higher welfare payments. These costs are
ameliorated to some extent if the prevalence of sniffing is reduced, yielding benefits
relative to the absence of Opal.

The cost of the Opal rollout includes the larger Government subsidy required for an
increased volume of Opal supplied, and the cost of supporting programs (eg, for youth,
employment, education, training, prevention, rehabilitation, deterrence and so on)
designed to optimise the positive impacts of Opal. Due to the difficulty in obtaining
accurate estimates of petrol usage in the region, low, base and high options were used
to show a range of potential fuel subsidy costs.

Findings

The total cost of petrol sniffing in 2005 in the Rollout Region was estimated as
$78.9 million, of which:

ii


$38.1 million (49%) was the net cost of the disease burden (after reducing the
gross cost by the individual’s share of health and productivity costs);
$16.2 million (20%) was the crime and justice system impact;
$8.3 million (11%) was the productivity loss;
the health, long term care and rehabilitation impacts were each about 5% of the
total ($4.1 million, $4.2 million and $3.7 million respectively);
informal care provided by families and significant others was valued at
$2.3 million (3%); and
deadweight losses from raising additional taxation revenue to fund transfers was
estimated at $1.9 million (2%).
The full $78.9 million cost of sniffing in 2005 would not be saved because Opal would
not totally eradicate all the impacts of sniffing; some costs of sniffing in 2005 would
continue to be incurred and, as noted above, a small amount of sniffing may continue
to be prevalent, so varying prevalence scenarios were modelled. In the base case
scenario, prevalence is assumed to be reduced by 75%, with sensitivity analysis at
100% (eradication, best case) and 50% (worst case). These scenarios are derived
from evidence from communities where Avgas was formerly substituted along with
demand reduction policies. All costs would reduce proportionately except that
residential and long-term care costs would be expected to continue, while rehabilitation
costs may reduce more gradually than other costs as some of the neurological and
cognitive impairment from chronic petrol sniffing ameliorates and to help avoid
addiction swapping, varying from 50% in the base case, with worst case at 100% and
best case at 0% (no more rehabilitation required).
The total benefit of lower petrol sniffing costs in the Rollout Region is estimated
in the base case as $53.7 million. Other scenario results are shown in the table
below.

Prevalence Total Benefit Net Wellbeing Total Financial
Scenario ($m) Benefit ($m) Benefit* ($m)
Best (100%) 73.5 38.1 35.3
Base (75%) 53.7 28.6 25.1
Worse (50%) 34.9 19.1 15.8
* Note: Total Benefit minus Net Wellbeing Benefit equals Total Financial Benefit..

The total cost of the Opal rollout package is estimated in the base case as
$26.6 million, comprising two components:
The cost of the subsidy is estimated to be between $11.8 million (low or best
case) and $19.7 million (high or worst case) in 2005, with a base case of
$15.8 million, assuming a subsidy rate of 27 cents per litre and no other
significant associated supply costs.

Usage Scenario Litres (million) Cost ($m)
High (worst) case 73.1 19.7
Base case 58.5 15.8
Low (best) case 43.9 11.8

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The cost of a package of strategies to address petrol sniffing is estimated to be
$10.8 million per annum shared by the NT, SA, WA and Commonwealth
Governments. Well-implemented supplementary demand reduction policies are
essential to accompany supply substitution and would include:
awareness and harm minimisation health strategies;
youth and recreational programs;
employment, education and training services;
preventive and rehabilitative outstation programs;
deterrence (legal sanctions, police presence); and
community action programs.

Cost Benefit Analysis

The results of the cost benefit analysis show base case petrol sniffing benefits of
$53.7 million per annum and base case Opal rollout costs of $26.6 million,
producing a net gain of $27.1 million. Scenario results range from a net gain of
$4.3 million in the worst case to a net gain of $50.8 million in the best case. These
extreme upper and lower amounts, however, are considered to represent less likely
outcomes.

TOTAL COST BENEFIT ANALYSIS ($ MILLION)

Best

Base

Net
Benefits
Worst
Costs

-40 -20 - 20 40 60 80

If the value of the healthy life gained is excluded from the above results and only
financial benefits are considered, the results of the cost benefit analysis show base
case petrol sniffing benefits of $25.1 million and base case Opal rollout costs of
$26.6 million, producing a net loss of $1.5 million. Scenario results range from a net
loss of $14.8 million in the worst case to a net gain of $12.7 million in the best case.
These extreme upper and lower amounts, however, are considered to represent less
likely outcomes.

iv


FINANCIAL COST BENEFIT ANALYSIS ($ MILLION)

Net
Benefits Best
Costs

Base

Worst

-40 -20 - 20 40

Even in the worst case scenario, the net financial loss is small and represents a cost-
effective purchase of the 140 Quality Adjusted Life Years (QALYs) gained, at $105,656
per QALY. QALYs are a measure of the healthy life gained from reducing morbidity
and premature death. The Australian government already funds therapies in this
range, and the World Health Organisation recommends funding health initiatives that
cost up to three times Gross Domestic Product per capita per QALY (ie up to
$120,000/QALY for Australia).
In the base case and best case, the rollout is cost-saving, which means that it not
just saves financial costs, but gains the extra years of healthy life as well.
Moreover, the results do not take account of the benefits that may flow from any
additional strategies, such as a more stable youth population, socio-economic
benefits, reductions in other addictions (eg, alcohol, marijuana) and therefore
better health, and improved general social, family and community cohesion.

Access Economics
February 2006

v


INTRODUCTION
The Opal Alliance commissioned Access Economics in July 2005 to provide a cost
benefit analysis of a rollout of Opal across central Australia. The Opal Alliance
comprises:
Vicki Gillick, NPY Women’s Council
Blair McFarland, CAYLUS
Bruce Morris, GPT Group
Tristan Ray, CAYLUS

Project methodology has been developed in consultation with the Opal Alliance;
members also provided comments on the draft report. A broad range of stakeholders
were consulted in the research stage. This report presents our findings.

Chapter 1 defines petrol sniffing and its symptoms, traces its impacts and causes, and
outlines complementary interventions that can help address sniffing and their likely
effectiveness given past lessons. Establishing an evidence basis for impacts is
particularly important in analysing the costs of petrol sniffing.

Chapter 2 traces historical fuel substitution policies including substitution with unleaded
petrol, Avgas and the Comgas Scheme. The emphasis however, is on the nature of
Opal, the proposed Rollout Region, estimation of supply volumes and subsidy rates for
those volumes given economies of scale in supply, and implementation challenges.

Chapter 3 provides a demographic review of the Rollout Region, investigating age,
gender and ethnicity of the population and employment rates from ABS Census data.
This analysis edifies an estimation of the prevalence of chronic and occasional sniffing
in the Rollout Region. Comorbidity and all cause mortality are also assessed, and the
prevalence approach to cost measurement is outlined.

Chapter 4 then estimates the annual costs of sniffing in 2005 including: health system
costs; “burden of disease” (the cost of morbidity and premature death in human life
terms); crime and justice system costs; production losses; the cost of informal care for
people disabled due to sniffing; accommodation, counselling and rehabilitation
interventions; and, as far as possible second generation impacts and other costs.

Chapter 5 outlines the nature of adjunctive preventive policies that would need to
accompany a rollout of Opal for maximum effectiveness. The annual cost of an
integrated four government program is then estimated. The final section provides the
cost benefit analysis – with the fuel subsidy and implementation program forming the
costs, and the benefits being the reduction in many of the numerous costs associated
with petrol sniffing, based on estimated prevalence reductions. Cost effectiveness
analysis is also presented.

1


1. PETROL SNIFFING
1.1 DEFINITIONS AND SYMPTOMS
Petrol sniffing is a particularly harmful form of volatile substance misuse (VSM) or
inhalant substance abuse)2, which is practised primarily by young Aboriginal people.
Petrol fumes can be inhaled directly from a bag, saturated rag or small container, either
through the nose (“sniffing”) or through the mouth (“huffing” or “bagging”). Petrol
contains neurotoxic substances including aromatic hydrocarbons (such as toluene,
xylene, benzene and n-hexane) and leaded petrol also contains tetraethyl lead. When
inhaled, petrol produces immediate effects that may be perceived as positive (the
‘high’) of euphoria, relaxation, excitement and hallucination that can last for up to six
hours (Cairney et al, 2002 and 2005). Symptoms range from mild neurocognitive
dysfunction to severe irreversible encephalopathy that can be fatal, with the
permanence of brain changes related to the length and severity of the person’s sniffing
history.

1.2 IMPACTS
This section reviews the evidence for linkages between sniffing and various economic
and other impacts. Economic impacts are ones that use real resources, which could
otherwise be put to alternative productive use. In addition, less tangible impacts are
identified and, where possible, evidence is presented for quantifying these impacts,
which provides the groundwork for estimating the costs of sniffing in Section 4.

“In communities where petrol sniffing is endemic, there is a high incidence
of property damage, vandalism, social disruption, poor educational
performance, sexual promiscuity, sexually transmitted diseases, juvenile
crime and an excessive demand on health resources. Consequently, the
lives of family and community members can be disrupted substantially.
The additional burden to public health is sizeable with morbidity and
mortality rates related to petrol sniffing increasing consistently since the
1980s.” Cairney et al (2002:83).

1.2.1 PHYSICAL IMPACTS AND HEALTH SERVICE UTILISATION
Negative physical impacts of sniffing are as follows.
Short term direct impacts of petrol sniffing result from 15-20 inhalations (larger
doses are more likely to cause more harm) and include intoxication, dizziness,
auditory and visual hallucination, slurred speech, staggered gait, hunger,
irrationality, aggression, impulsiveness/disinhibition, increased libido, confusion,
lack of coordination, headaches, poor memory, vomiting, delirium,
unconsciousness, seizures, coma and, rarely, sudden death.
Longer tem direct impacts include psychological addiction and, for chronic
sniffers, cerebellar ataxia, grand mal epilepsy, encephalopathy, low body weight
and nutrient deficiency, progressive decline in cognitive ability and chronic

2
Other inhalants include glue, aerosols, nitrites and liquid solvents.

2


disability including mental impairment, acquired brain injury (ABI), central nervous
system damage, dementia, persistent psychosis and death from heart failure or
lead poisoning.

“The number of young people disabled by petrol sniffing, from these
figures, represents 58% of the total number of disabled clients identified,
and 73% of all adult disabilities. These figures also show that the results of
widespread and unchecked petrol sniffing on AP Lands has caused 88% of
the incidents of Acquired Brain Injury across the AP Lands. Petrol sniffing
would appear to be the single biggest cause of disability amongst the
Pitjantjatjara and Yankunytjatjara people.” Tregenza (2002:19).

“If nothing is done, 120 sniffers in the NT alone could acquire brain injury
over the next few years, with 500 regular sniffers in the broader region at
risk of brain injury or death.” MWTP (2005d). “Around 20 regular sniffers in
Mutitjulu are at risk of ABI. Two died in 2004. Many are in wheelchairs.”
Andrews (2005c).
Physical secondary complications of sniffing include burns, infections and
pneumonia, increased incidence of STDs, accidents especially asphyxia, injury
from violence, homicide, self-harm and suicide. In addition, there can be effects
on the unborn children of female sniffers caused by sniffing during pregnancy,
including birth deformities, low birth-weight and miscarriage.

Health service utilisation due to sniffing tends to be concentrated on acute
hospitalisations, often together with aerial medical evacuation, and the longer term
impacts of sniffing and its secondary impacts, which include limited rehabilitative or
residential care for the disabled.
Short term health impacts: Aerial medical evacuations have been found to
occur at the rate of around 6 per annum per 800 population in sniffing
communities (Brady, 1989) or around 4% of all evacuations (Brady, 1992), with
an average length of stay (ALOS) in hospital of 25 days (range 4 to 65 days),
based on an Arnhem Land study (Chambers, 1989) although longer in a later
study – median length of stay 28 days (range 5 to 118 (Cairney et al, 2004)
suggesting ALOS of 46 days if the distribution is the same). The average of
these two estimates is an ALOS of 36 days. Hospital treatment can include
emergency department, intensive care unit admission, other (longer) inpatient
treatment, intubation, sedation, brain imaging, saccade (eye movement) and
blood testing, and chelation therapy if leaded petrol has been used (costing $700
for medication alone, in 1989) which reduces lead levels by mobilising inorganic
lead in the blood. As a result of cranial nerve damage, some petrol sniffers may
lose reflexes during therapy that may cause them to ‘inhale’ food and drink, in
which case additional paramedical staff become involved in treatment – a
dietician, a speech therapist, a physiotherapist and an occupational therapist.
Allied health services are also part of standard treatment for sniffers who are
hospitalised, with a view to rehabilitation. Outpatient visits in a Canadian study
were at the rate of 0.83 visits per sniffer per annum to manage their petrol abuse
(Tenenbein, 1997). AIHW cost and burden of disease data by ICD-10 code can
be used with these volume parameters to derive health costs in Sections 4.1 and
4.2.
Longer term health impacts include the loss of healthy life from disability
and premature death due also to the secondary impacts of sniffing – mortality
from various causes, long term injuries or infections such as STDs, the

3


generational impact of low birth weight, the many health impacts of violence
(Access Economics, 2004, identifies increased health risks from smoking,
alcohol, polydrug use, depression, anxiety disorders and other impacts), as well
as the financial costs of care for people suffering these impacts and disability
from sniffing. Three quarters (73%) of adult disabilities on the APY Lands were
found to be due to sniffing (Tregenza, 2002:19). While some people with
disabilities are able to access residential care services in the formal sector, the
majority are looked after by informal carers (see Section 4.4.2). In Central
Australia, the number of people with severe brain damage as a result of petrol
sniffing is expected to rise to 60, with an annual cost of care of around $9m
(Legislative Assembly of the NT, 2004a), implying an average cost of residential
care per person of $150,000. This estimate accords with McFarland (1999:19)
report of the cost of care (to Territory Health Services) for a profoundly disabled
young sniffer of over $160,000 per annum in the late 1990s. Andrews (2005c)
estimates less conservatively that the number of disabled sniffers in the NT will
rise to around 120 in the next few years, with health costs of maintaining an ex-
sniffer with ABI between $150,000 and $300,000 per annum, potentially reaching
$750,000 for more serious cases (MWTP, 2005d). Andrews (2005c) concludes
that: “The total costs of caring for disabled sniffers in the NT alone could be $36
million per annum. If WA and SA are also included, the figure could be
considerably higher - up to $80 million per annum. Capacity for such care is
currently very limited and governments will at some stage have to face this issue,
including the question of capital costs.” The right-tail skew in care costs is
conservatively treated in this report (Sections 4.1 and 4.2) by utilising the official
NT estimates of $150,000 per annum and a prevalence of 60 sniffers
requiring lifetime care in 2005.

In addition, the long term health impacts of conditions secondary to sniffing are
included in the costing in Sections 4.1 and 4.2. Findings from the literature search
relevant for these impacts follow.
STD prevalence (two third of females and one third of male sniffers3 are
infected) is higher than in the general population and the excess can be
attributed to sniffing.
Deaths from accidents and injuries (intentional and unintentional) can be
derived from the mortality distribution (Section 3.3.2), with relative morbidity from
these conditions and for low birth weight derived from AIHW data, and with the
health system costs mapping the distribution of the disability burden of disease.

1.2.2 CRIMINAL BEHAVIOUR AND JUSTICE SYSTEM IMPACTS
“In addition to medical costs, delinquency is common among petrol sniffers
and is the cause of considerable cost to the community. Petrol sniffing may
promote delinquent behaviour due to its intoxicating effects that include a
hunger for stimulation, proneness to violent outbursts and a need to release
tension. Petrol sniffers have caused substantial damage to property and …
interact heavily with the juvenile justice system, particularly in association
with vandalism, violence, robbery, rape and sexual promiscuity.” Cairney et
al (2002), p83, 85.

3
D’Abbs and MacLean (2000), p28.

4


As a result of sniffing, 80% of sniffers and ex-sniffers had been involved with the law
(Burns et al, 1995). Stojanovski (1999) reports that attempts to stop petrol sniffing tend
to be met with violence from gangs of sniffers. In some communities, people leave
bowls of petrol on the bonnets of their cars to prevent the cars from being damaged by
sniffers stealing petrol. He also reports speaking to a petrol sniffer who witnessed one
of two homicides that occurred within a few months in Central Australia where the
perpetrator was sniffing petrol at the time and was hallucinating when he killed the
other boy.

As observed by Burns et al (1995) in Maningrida, 100% eradication of petrol sniffing led
to reduction of crime to 42% of original levels. The attributable fraction of criminal
activity can be estimated from this evidence as 58%; in other words, 58% of crime in
Maningrida was committed as a result of petrol sniffing.

D’Abbs and MacLean (2000) also summarise two other examples of crime costs – one
in the Pitjantjatjara Lands of South Australia, where 40 of 103 cases before the courts
involved sniffing, and an earlier Manangrida study where 32 of 71 offences in one year
were described as “petrol sniffing was involved”. There was no significant difference
between chronic and occasional sniffing. Table 1-1 summarises the case studies.

TABLE 1-1: ATTRIBUTABLE FRACTION OF CRIME, THREE CASE STUDIES

Sniffing Total AF
Manangrida, 1988, offences 32 71 45%
Pitjantjatjara Lands, 1979-80, court cases 40 103 39%
1
Manangrida, 1987-90 to 1991-1994 , annual court files 85 147 58%
Total, three case studies 157 321 49%
1
A ‘before’ and ‘after’ comparison in relation to crime and sniffing.

The average attributable fraction of 49% from the three case studies is used to
estimate criminal costs in Section 4.3.

Andrews (2005b) notes that two very visible impacts of property crime in central
Australia relate to car dumping and the state of housing.

Family violence and abuse, assault (physical and sexual), rape and murder can
also be consequences of sniffing (McFarland, 1999).

“In a child sexual assault case that occurred at Amata in 1995, a four-year-
old girl was sexually assaulted. She had to be evacuated to Alice Springs
hospital for surgery. No offender was identified. The child's mother and
her defacto were at the time (and continue to be) chronic petrol sniffers.
The child's maternal aunt and uncle were also chronic petrol sniffers. Up to
six or more petrol sniffers would stay in the household where this child was
living. No charges were laid.

Six months after the child was raped her mother was the victim of a serious
assault and rape. Alcohol was the main substance featured in this incident.
Her husband was in such an inebriated state that he was unaware that
another man was raping his wife. When she complained to the husband
that she had been raped his response was to punch her about the body
and cause her to fall out of a moving vehicle. She was also evacuated to

5


the Alice Springs hospital and remained in the intensive care unit for a
number of days due to respiratory failure as a result of chronic sniffing.
She would not make a complaint to the police for fear of her husband being
gaoled. She had already experienced the shame of having her petrol
addiction publicly aired in a contested Family Court matter several years
before.” Affidavit of NPY Women’s Council Domestic Violence Service
Manager Jane Lloyd, to SA Coroner Wayne Chivell in the matter of Hunt,
Ken and Thompson (deceased), May-June 2002, Umuwa, quoted in
Coroner’s findings (para 6.26).

While the health impacts of these behaviours are measurable both in financial terms
and in terms of the loss of healthy life (as outlined in the previous section), the social
and cultural impacts are considered too intangible to adequately measure, while
recognising their importance. The criminal justice costs are measured in terms of
attributing a fraction (49% described above) of total policing, legal and detention costs.
Policing costs are able to be estimated based on the police resources in the
Rollout Region.
Incarceration costs are able to estimated on the basis of trial cases proceeding
to a guilty verdict, and interim detention measures. The cost of secure
accommodation for a violent ex-sniffer in the Northern Territory cost $750,000
per year (Hudson, not dated:6) reported that the detention of young people with a
history of petrol sniffing cost Correctional Services as much as $3 million in 1994.
Legal costs are of two main types:
the cost of prosecution and defence, although there was no literature
evident on the average costs of cases proceeding to trial; and
the cost of coronial inquests, which can be reviewed case by case.

1.2.3 SCHOOL AND EMPLOYMENT PERFORMANCE
“Further behavioural and social problems are caused by irregular school
attendance among petrol sniffers.” Cairney et al (2002), p83.

Data from the Australian Bureau of Statistics (ABS) quantify the lower rates of
employment and education among Aboriginal people across the Rollout Region
(Section 3.1). However, it is important to note that lower employment and education
are both a cause and effect of petrol sniffing (Section 1.2.3) and that, over time, lower
educational levels result in reduced likelihood of employment and are a predictor of
future lower earnings. That said, d’Abbs and MacLean (2000:29) conclude that:

“Sniffing has been associated with poor school attendance and school
performance, with the latter described as a result rather than a cause of
petrol sniffing”.

At Yuendumu, Stojanovski (1999) reported that, prior to the introduction of
interventions, teachers in the local school were unable to teach their students properly
due to constant disturbances from petrol sniffers. Many children stopped going to
school and sniffed petrol in the day time instead, designing halters so that they could
sniff non-stop while walking around. Other sniffers still attended school but were
unable to study due to the physiological effects of petrol, falling asleep on the
classroom floor hung over. For the students who did not sniff petrol, their schooling
was interrupted by the visits of kids who are high on petrol dropping into classrooms,

6


clowning around, and trying to recruit other students to sniff petrol with them.
Research from South Australia gives evidence of this sort of behaviour severely
disrupting classes, in some cases students and teachers were barricaded in the
classroom while petrol sniffers pelt the windows and doors of the classroom with
stones (Folds, 1987, pp56 -73).

In Mutitjulu, census data indicate that 86% of the population has no educational
qualifications at all (Smith, 2001).

Burns et al (1995) observed in the Maningrida community in NT that eradication of
petrol sniffing led to substantially increased school attendance, suggesting that the
second generation costs of sniffing may be very high (Section 4.4.5).

Petrol sniffing can lead to reduced work participation, effects on morale and higher job
turnover (see the employment differential in Section 1.4.3). Differences in
employment rates, standardised by age and gender, are considered and quantified in
Section 3.1, with the productivity costs of sniffing then calculated in Section 4.4.1.

1.3 CAUSES
Causes of sniffing are complex and inter-related. A long history of conflict,
dispossession and acculturation has resulted in trans-generational dysfunctionality,
particularly manifest in substance abuse. At a personal level, many young Aboriginal
people cite boredom, social acceptability and peer group pressure as reasons for
sniffing, which represents a perceived escape into excitement, risk-taking, danger and
access to a ‘different world’; this is more similar to reasons cite by young drug users in
urban Western culture. However, in many Aboriginal communities petrol sniffing has
grown to epidemic proportions, and the reasons for this growth warrant careful
investigation if interventions are to be successful. Addressing addiction issues is
considered by many Aboriginal people to be central to improving the quality of life in
their communities.

“If we get rid of the addiction problems everything else will fall into place.
But if these problems aren’t overcome, nothing else will be successful”.
Mr Wilson, Chairman of Mutitjulu Community Council, December 2004.

1.3.1 CULTURAL DISRUPTION AND EROSION OF TRADITIONAL VALUES
Occupied Territory Syndrome is a phenomenon of societies enduring on-going
occupation of their land, manifesting a range of behaviours reflecting frustration with
lack of sovereignty and control eg, Palestinian youth expressing anger and
powerlessness through violence. Occupation over generations leads to a societal
sense of hopelessness where violence against the occupying force turns inwards into
violence against the self and the community; behaviours consistent with Occupied
Territory Syndrome include substance abuse, family violence, suicide, vandalism, child
abuse, neglect and malicious damage of infrastructure. International experience has
shown that Occupied Territory Syndrome can be addressed by promoting community
ownership and control, helping communities to develop and share an honest history of
their colonisation, and promoting the notion that people can change if they want
(Andrews, 2005d).

The forced removal of children during the Stolen Generations era has had a significant
and proven influence on parenting skills and culture.

7


A well documented aspect of Aboriginal culture is the right to personal autonomy and
unwillingness to impose one’s will on another, particularly in relation to adhering to the
right for others to do with their own bodies what they choose (eg, Brady, 1992, pp72-
75). This can make it hard for parents to stop teenage children from sniffing, especially
males who have been initiated as ‘men’. Sanctions used by non-Aboriginal parents
such as grounding or curfews are considered foreign and inappropriate in Aboriginal
child rearing. Moreover, young people exploit their right to self autonomy, refusing
parental requests for intervention and sometimes threatening them with weapons. In
such cases, police intervention (removal, court bonds and bail) may be requested by
parents: “That kid won’t listen to us, get the police.” (Stojanovski, 1999), since young
people recognise that the police have authority over them that their parents do not.

Over time, traditional social structures and relationships that govern Aboriginal society
have been undermined, and traditional cultural values of responsibility and reciprocity
(ngapartji ngapartji)4 have been distorted.

1.3.2 TRANS-GENERATIONAL DYSFUNCTION, MENTAL ILLNESS,
ISOLATION

A family history of mental illness and addiction (particularly alcoholism in parents) is
common among petrol sniffers. 80% of sniffers in Mutitjulu come from families
characterised by social and cultural breakdown associate with alcohol misuse
(Andrews, 2005c). In relation to the investigation of the death of one Aboriginal youth,
his mother said:

“Before he started sniffing, Kunmanara Coulthard said to his father: ‘If you
don’t stop drinking grog, we [my brothers and I] are going to start sniffing
petrol’”. (Andrews, 2005d).

There is greater comorbidity of mental illness with substance abuse. Many sniffers
have complex psychological needs that require adjunctive treatment with the abuse.

“Children and sniffers have become bosses over their parents. They are
running the agenda by their behaviour. They are out of control and people
have to react to the behaviour of sniffers rather than keeping to the law and
keeping to the culture. Sniffers break their mother’s arms. There is
violence against families. Sniffers threaten their parents that they will
commit further acts of self-harm. They swear at their parents. They breach
traditional secrets by speaking out of turn. They throw rocks at their
parents. When I talk about these things I am talking about sniffers
generally…” Punch (Kawaki) Thompson, father of the deceased sniffer
Kunmanara Thompson, in evidence to SA Coroner Wayne Chivell in the
matter of Hunt, Ken and Thompson (deceased), May-June 2002, Umuwa.

“A reality of the Young People’s project operating on the AP(Y) lands is
that despite the best efforts of the staff to restrict their work to 12 to 25 year
olds and concentrate on preventative initiatives, we are constantly asked to
assist the many individuals over 25 years of age who are sniffing petrol.

4
Ngapartji ngapartji is a Pitjantjatjara expression meaning “mutual reciprocity” – a two-way social system
of sharing by demand rather than unsolicited giving that Anangu traditionally apply to their social
relationships.

8


They are often persons in their 30s and 40s who are ‘chronic’ sniffers and
many have serious mental and physical disabilities as a result of the
sniffing.” Affidavit of Vicki Gillick, NPY Women’s Council Co-ordinator, in
the matter of Ward, Ken, Ryan and Cooper (deceased), SA Coronial
inquest, Coroner Wayne Chivell, Umuwa November 2004.

Stojanovski (1999, p9) reflects that the most chronic sniffers “are kids who are often the
abandoned children or the street kids… these kids carry with them a lot of personal
hurt and have significant members of their families and role models (often their
parents) who live lives of chronic substance abuse”. Neglect, hunger, loneliness,
sadness and experimentation are other reasons cited by Stojanovski for sniffing.

1.3.3 SOCIOECONOMIC: LOW EMPLOYMENT, EDUCATION AND
ECONOMIC STRUCTURES

Petrol sniffing most frequently occurs in Australia among Aboriginal adolescents who
are from low-income, isolated communities, since petrol is relatively cheap, readily
available and there is limited access to other drugs (eg, heroin) that are favoured by
similar groups in the wider community (Cairney et al, 2002).

Section 1.2.3 notes that low education and employment are both a cause and impact in
the vicious circle of petrol sniffing, quantified through ABS data for the Rollout Region
in Section 3.1. There is less motivation for children to learn at school or study hard to
get a job if there is little expectation of future reliance on employment for income.

Andrews (2005b) describes “four economies” in many remote Aboriginal communities.
The welfare economy: a range of Centrelink payments together with free or
subsidised provision of goods and services eg, rent, electricity, water.
The market economy: commercial markets for labour, products and services.
The customary economy: wild resource harvesting (hunting and gathering).
The grey economy: income earned from illicit activities eg petrol trafficking, drug
or contraband alcohol sales, often at very high prices eg, $50 for a 750ml bottle
of petrol (MWTP, 2005d), prostitution.

The value of the customary economy to an Aboriginal Community in NSW has been
estimated at around 5% of total income (Gray et al, 2005). Employment in the market
economy also represents a relatively small proportion of total income (estimated as
one-third of total income in the Mutitjulu area in Andrews, 2005b). In contrast, the
same source estimates that the majority of income (60-70%) is derived passively from:
welfare payments (nearly half of passively derived income);
trust royalties and gate monies5 (20%); and

5
Royalties include rent and other disbursements from trust fund earnings such as the Ininti Trust. “Gate
monies” refer to entrance fees paid by visitors to the National Parks that comprise many tribal lands, for
example, the Uluru Kata Tjuta National Park (UKNP). Royalties, in particular, vary from year to year and
represent compensation for foregone rights to land under lease agreements. They are not taxed as
personal income and do not reduce recipients’ entitlements to Centrelink payments. However, these
resources are often not directed to community development activities but rather, diverted to individual
purposes.

9


subsidised services and utilities (32%).

These income shares do not include the unknown (overall) size of the grey economy.
However, some members of the community earn significant monetary income from this
grey-market activity. Others are reported to exchange petrol or other addictive
substances for sex or other barter transactions.

Many Aboriginal people agree that “if we are to survive… we have to get rid of the
passive welfare mentality that has taken over our people” (Pearson, 2000).

“In my Grandfather’s day we were strong… we ate bush tucker and were
not dependent on sit-down money, marijuana or grog”. Elsie Malbunka, 18
February 2005. “We need to stop relying on sit-down money, the young
fellas need to work rather than humbugging the old people”…“Lack of
money is not the problem, if anything there is too much of it”. Community
elders, September 2004. “Sit-down money is killing our young people.
When the welfare money come in it really killed the work. Now young ones
don’t know work, they welfare trained. No more sit-down money. Cut it out.
Level-im up, everyone gotta work.” (Smith, 2001).

The resources of the passive welfare economy are susceptible to irrational
appropriation and expenditure, resulting in what Noel Pearson has called the human
right to “misery, mass incarceration and early death” (Pearson, 2001). Andrews
(2005d) makes the important point that Aboriginal people naturally have every right to
enjoy economic returns from their assets (royalties and gate monies) but the issue is
one of informed choice about allocation of those returns and greater equity in their
distribution.

1.4 INTERVENTIONS
Over the years, a number of interventions have been trialled in attempts to address
petrol sniffing.

“Research indicates that responses to petrol sniffing and other inhalant
substance abuse lie in a coordinated and sustained effort by government
departments and community agencies in partnership with affected
communities… Notably, a small number of communities have eliminated
petrol sniffing over the past two years through a concerted community
approach to prevention.” NT Department of Health and Community
Services (2002).

“Now listen, I know some of you have heard about petrol sniffing, but
where I come from every single family has a family member affected by
petrol sniffing, and we now have a terrible problem on our hands. When our
young people sniff petrol they develop all sorts of health problems, such as
mental health problems, heart and lung problems and acquired brain
injuries. Petrol sniffers sniff all night and do not rest and this affects the
whole family. Anangu families are exhausted. These petrol sniffers are our
own flesh and blood, yet we have lost them all to petrol... Of course we
know that some petrol sniffers cannot be helped. They will live their lives in
wheelchairs with acquired brain injuries. But for the new recruits…well we
are hoping that with Opal there will be no new recruits to petrol sniffing.”
Janet Inyika, NPY Women’s Council staff member, former Executive
member and resident of Amata community SA, launching Opal fuel with

10


Health Minister Tony Abbott, Adelaide, February 2005. Translation by Linda
Rive, NPY Women’s Council.

D’Abbs and MacLean (2000:Table 2) suggest a structure for thinking of interventions to
address petrol sniffing (reproduced below). A brief discussion of some interventions is
presented in the following sections.

TABLE 1-2: LEVELS OF INTERVENTION AND ASSOCIATED STRATEGIES

Level of intervention Strategies
Primary intervention Focusing attention and resources on young people
or primary prevention: actions to Recreational programs
prevent the emergence of a School and training opportunities
problem, and/or to prevent it
Employment
from spreading to new areas or
groups (eg supply reduction, Information and education about petrol sniffing
education) Substitution of petrol with Avgas/Comgas
Use of unleaded petrol
Locking up petrol supplies
Adding deterrents to petrol
Movement to outstations/homeland centres
Secondary intervention Using Aboriginal culture and symbolism
(also known as secondary Individual and family counselling and care
prevention or early Counselling and community development: the HALT
intervention): actions targeted model*
towards a population either
Petrol Link-up
deemed to be at risk, or already
in the early stages of exhibiting Community action
a problem, designed to halt Initiation and other ceremonies
further progress of the problem Community-based sanctions
(eg, community meetings,
individual and family Community wardens, night patrols and police aides
counselling) Jail, treatment orders and other statutory sanctions
Outstation programs
Harm reduction and minimisation
Diversionary activities such as sport or discos
Tertiary intervention Town-based rehabilitation and respite
or treatment: actions targeted Hospital treatment
towards persons already
misusing drugs, designed to
halt further drug misuse or
mitigate illness and disability
(eg, hospitalisation)

Source: d’Abbs and MacLean (2000), Table 2. * Note: HALT – Healthy Awareness Lifestyle Team.

1.4.1 AWARENESS AND HARM MINIMISATION HEALTH STRATEGIES
Education aimed towards sniffers is best directed towards effects of sniffing that are
likely to be of concern to young people (eg, impaired coordination preventing
participation in sport), with emphasis on harm minimisation (eg, preventing
asphyxiation through warnings about not lying down with a petrol can on the face) and
early intervention before chronic habits are established. Educational activities are also

11


usefully targeted at select groups within the community such as parents or professional
staff to promote caring capacities, such as by discussing other communities’ successes
and fostering linkages with them, eg, Petrol Link Up, who developed the Three Ways
model combining (1) supply reduction; (2) outstation rehabilitation and respite, with
(3) diversionary youth programs. Education of non-sniffing juveniles is sensitive, as in
some cases it may precipitate experimental sniffing (Roper and Shaw, 1996:15).

Educational materials have taken the form of workshops, films, videos, story-telling and
pamphlets in appropriate languages or using Aboriginal culture or symbolism (eg, Brain
Story, by Petrol Link Up). However, the research on educational responses to inhalant
abuse indicates they are of limited value. The evidence for this position is summarised
in the following quote from d’Abbs and Maclean (2000:49, Section 8.5 “Information and
education about petrol sniffing”):

“Smith (1986, 5), on the basis of a review of petrol sniffing literature,
advances two pessimistic conclusions about educational strategies: first,
too little is known about the causes and nature of petrol sniffing to enable
soundly based educational programs to be designed; and second, few of
the programs that have been implemented have been subjected to rigorous
evaluations, with a result that little is known about the factors making for
success or failure.

While the former may no longer be the case, the latter has certainly not
changed. The Senate Select Committee on Volatile Substance Fumes
(Commonwealth of Australia 1985, 217–18) was a little more hopeful,
sounding both a warning and some positive guidelines. There was general
agreement, the Senate Committee reported, that juvenile sniffers were well
aware of the dangers of petrol sniffing, and that providing information on
the dangers of sniffing was not only likely to be ineffective, but might prove
counter-productive. This was especially the case, the Senate Committee
suggested, with information in the form of scare tactics.”

Later in the same section is the following information (d’Abbs and Maclean (2000:50).

“Hayward and Kickett’s (1988) findings add weight to the Senate
Committee’s conclusions. Hayward and Kickett interviewed 103 school
children from seven Western Desert communities. They found that 72 per
cent of petrol sniffers considered petrol sniffing to be harmful, and 77 per
cent agreed that ‘petrol sniffing can kill you’ (1988, 27). Sandover et al
(1997, 122) found that Aboriginal petrol sniffers interviewed in prison knew
of the dangers of petrol sniffing but felt powerless to cease the practice.
McFarland points out that young Aboriginal people’s lives are full of danger
and risk and in this context petrol sniffing does not appear to be particularly
hazardous (1999, 5).”

Saturation activities (eg, juveniles visiting hospitals, care facilities of prisons where the
impacts of sniffing are evident), have had mixed success (d’Abbs and MacLean,
2000:50). Programs that incorporate life and work skills as well as knowledge about
how to get help in relation to substance abuse offer scope for further development.
Funding for substance abuse case workers is another approach which CAYLUS has
trailed and found to be very effective.

12


1.4.2 YOUTH AND RECREATIONAL PROGRAMS
Youth programs and/or the employment of a youth worker have been used in some
communities to provide diversionary activities including for those exiting treatment
programs and to foster community youth engagement – for example, sports and
recreation, literacy and numeracy, excursions, bush trips and camps, learning
traditional culture with elders (eg, hunting, bush medicine, stories), discos/dance,
catering, clean-up days, music, film, photography, multi-media, community radio
stations (useful in disseminating information in cultural settings were language is not
traditionally written; MWTP, 2005a), driver training, drink driving avoidance and other
health awareness training.

The timing of activities is also important – after school, on weekends and during
holidays, and particularly during ‘crime time’ (6pm to midnight). Staff need to
understand the issues, provide activities that are exciting and purposeful (eg breaking
in horses), include sniffers without being preferential, and provide activities (and/or
women workers) specifically for females.

“In all the AP communities I have observed young people to be very ready
to get involved in youth activities, even simple things like swimming and
using band equipment. If there is no youth worker there is nothing for young
people to do after school and nothing for those who have left school. These
12 to 25 year olds are growing up without the opportunities available to
youth elsewhere. This limits their opportunities for social interaction, inter-
generational mentoring and for the development of self-esteem, knowledge
and skills.” Richard Farrell, NPY Women’s Council Youth Development
worker, Affidavit to SA Coroner Wayne Chivell, in the matter of Ward, Ken,
Ryan and Cooper (deceased), SA Coronial inquest, Umuwa November
2004.

1.4.3 EMPLOYMENT, EDUCATION AND TRAINING SERVICES
Education strategies are required to enhance participation in primary and secondary
schooling. In some communities, when appropriate educational facilities have been
provided on site, sniffers have begun attending (Mosey, 1997:22). Two effective past
programs include the Detour Project in Alice Springs, run by Tangentyere Council, and
an innovative NT Education Department program in Yirrkala (d’Abbs and MacLean,
2000:48). More recently the Yarrenyty-Arltere Learning Centre based in Larapinta
Town camp in Alice Springs has been integral in a whole community strategy that has
reduced prevalence of inhalant abuse in the community.

As Coroner Wayne Chivell noted in his September 2002 findings in the matter of Ward,
Ken, Ryan and Cooper (deceased) young people on the AP(Y) Lands are
disadvantaged in the area of education:

“Education levels on the Anangu Pitjantjatjara Lands are appallingly low
when compared with the rest of Australia. Mr Tregenza pointed out that
there had been no employment training on the Anangu Pitjantjatjara Lands
for the last 5 years, and that the Department of Technical and Further
Education (TAFE) has only returned this year to resume its operations,
although it has not been determined what courses they propose to run. He
said: ‘In my view this, along with basically a failed primary education
system, means that all of the people leaving school – and particularly the

13


boys – they are, in my view, functionally illiterate as they leave school,
which leaves the opportunity for them to gain work in the community fairly
limited. And, as there is no tertiary education in the communities, their
opportunities of training are limited.'” Chivell, 2002, para 7.4.

Job ready networks/skills training are also essential in complementing a roll-out of
Opal to comprehensively address sniffing problems. Burns (1996:247) concluded that
employment and skills training programs, together with the introduction of Avgas, was
critical to success at Maningrida in eradicating sniffing. When 27 sniffers from
Maningrida were interviewed in 1992 only 7% were employed; by 1994 this had risen to
63% (chi squared=11.53, df=1); the difference in employment as a result of the
eradication of sniffing, given employment opportunities, was thus 56%.

A number of observers have pointed to lower incidence of sniffing in communities
associated with the cattle industry or where the youth can be occupied working with
camels or in the tourism sector. An example is the promotion of employment
opportunities for Aboriginal people across Central Australia by the (indigenous)
Employment Coordinator at Ayers Rock Resort working with local communities and
Ngaanyatjarra Aboriginal College.

1.4.4 OUTSTATIONS
There is divided opinion on whether outstation programs (sometimes called ‘homeland
centres’) should be used as detoxification/rehabilitation centres or if their focus should
be development and diversion for sniffers and young people at risk, or a combination of
both. Some community decisions are simply that sniffers “be taken to a safe place to
detoxify”. However, such actions should not simply be the unsupported removal of
sniffers to provide respite for themselves and their communities but, rather,
appropriately resourced programs offering assessment, support and referral in the
event of complex physical or psychological rehabilitation needs. The absence of
support at an outstation resulted in the death of an Aboriginal boy who bled to death
after smashing a window, due to isolation and lack of communications, leading to a
coronial inquiry.

The Mount Theo Petrol Sniffer Program has been a joint effort of senior Warlpiri
community members from Yuendumu and extremely dedicated non-Aboriginal workers.
Mount Theo has operated since 1994, with the support of the local school, Tanami
Network and the local Community Government Council and working closely with the
local Yuendumu Police and the Northern Territory Correctional Services Office in Alice
Springs.

Mount Theo has been heralded as a model of care and has succeeded in reducing
sniffing and its impacts in Yuendumu through a two-pronged strategy of:
prevention – a pro-active youth and recreation program in Yuendumu; and
rehabilitation – the petrol sniffer outstation program at remote Mount Theo.

Mount Theo provides a safe but basic, and by some standards harsh, environment out
bush where chronic petrol sniffers and young sniffers are looked after by tribal elders
until they are ready to rejoin their community. Some are bonded by the courts to live at
Mount Theo and take part in the program. While living at the outstation, the young
people’s bodies can detoxify with a healthy diet, work and exercise, ‘ring-leaders’ are
removed from trouble-making and recruiting in town, and are instead involved in

14


gardening, bushwalking, outdoor and educational programs and traditional activities
such as making artefacts and hunting.

The number of sniffers had permanently decreased from 67 young people to 20 in the
four years to 1998, most of the 70% decline occurring in the early years. Currently,
Mount Theo reports there are no chronic sniffers in Yuendumu, and occasional small
outbreaks in the community are dealt with swiftly and effectively.

Removal to the outstation (50 kilometres away from the nearest main road and
approximately 130 kilometres fro Yuendumu, so the young people do not run away, but
with a telephone for safety) is considered an important aspect of the program to
prevent a culture of petrol sniffing from becoming entrenched amongst the young
people of Yuendumu.

Mr Stojanovski explained his view of the importance of the Outstation:

“In my opinion, if we didn’t have an Outstation we would not have solved
petrol sniffing in Yuendumu. The reason is that you need a deterrent, you
need a consequence. Even if there were lots of different fun things to do in
Yuendumu and lots of education and anyone could get a job if they really
wanted to, it’s a hallucinogenic drug, it’s fun … so because of that, having
that Outstation has been really essential in removing the peer group
pressure on kids to sniff petrol … I think if we ran that Outstation and did
not have those other things happening in Yuendumu it wouldn’t work, but I
think that if we didn’t have that Outstation we would still have heaps of
petrol sniffing.” From evidence of Stojanovski to SA Coroner Wayne
Chivell, Umuwa May-June 2002, Chivell (2002), para 10.42.

Mount Theo has worked cooperatively with local police and with courts to ensure bond
and bail conditions for petrol sniffers include clauses like: “Not to sniff petrol, and to
reside at Mount Theo or elsewhere at the direction of the Outstation Manager.”
Sniffers are often relieved to go to Mount Theo instead of gaol, which they see as the
alternative. The wording of the clause allows legal flexibility and discretion to
rehabilitate the sniffers and re-introduce them to Yuendumu to observe their behaviour
and monitor relapses as appropriate. However, there are challenges with removal
because it has strictly been only possible only once crimes are committed, as sniffing
itself is not an offence in the NT and it would be better to intervene early and prevent
offending. While police can encourage non-sniffers to go to Mount Theo, forced
removal is a grey area of the law even with written parental direction. This is reported
as the biggest gap in the program by its coordinators, who would like to ‘nip petrol
sniffing in the bud… to prevent the young person from developing a pattern of crime
and violence that is so often associated with petrol sniffing.” (Stojanovski, 1999, p19).

“There was one young man who began sniffing in 1997, and who had
previously not been involved in crime and violence. His parents wanted to
send him to Mount Theo but the young man refused to go. Instead he got
deeper and deeper into petrol sniffing. He began to hallucinate and see
devils. He started walking around at night with a knife and an axe, sniffing
petrol and threatening people. He recruited other young people to sniff
petrol. Twelve months later he was in prison, serving time for numerous
assaults, including stabbing, punching a nurse, escaping from custody, and
throwing petrol on a police officer. If we had been able to take him to
Mount Theo when he first began sniffing maybe he would never had started
this trouble.” Stojanovski, 1999, p19.

15


1.4.5 DETERRENCE (LEGAL SANCTIONS, POLICE PRESENCE)
Domestic and international experience has proven the critical importance of law and
order as a foundation for sustained community development (MWTP, 2005a). In
general, broad-based and integrated law and order strategies need to be developed by,
for and in each community.

“Coming from a deeply sad place in their heart and their spirit for their sons
and daughters, Women’s Council women are asking the police to live in the
community so that they can help us. The police in the Northern Territory
and Western Australia have responded really well, they have taken on our
thinking about the three states, they built that place, that police station at
Kintore, but in South Australia they are not listening.” Nura Ward, NPY
Women’s Council Executive member, Affidavit to SA Coroner Wayne
Chivell, in the matter of Ward, Ken, Ryan and Cooper (deceased), SA
Coronial inquest, Umuwa November 2004. Translation by Suzanne Bryce,
NPY Women’s Council.

The impact on sniffing of legislative change among the Ngaanyatjarra people in WA is
evident in relation to the November 1996 removal by the WA Government of custodial
sentences below six months, therefore altering the available penalties for sniffing petrol
from a fine or a prison term, to a fine only. This change led to a perceived resurgence
in sniffing and sniffing related problems in the Ngaanyatjarra communities (Peter
Rapkins, Ngaanyatjarra Council, personal communication, 1997, cited in Stojanovski,
1999, p20).

A police presence is considered an important element of any law and order reform,
together with more active policing in communities.

“I think it was difficult for police to enforce things that, I guess – that we
would have liked enforced. And I think also for the community constables
in Fregon, they were compromised as well with their policing, especially
given that their own sons were sniffing … I would say that it’s very
important, police – formal police support in terms of law and order within
the communities and I think without that stability of law and order, the
violence and things that happen during the day, it’s not just the petrol
sniffing, but I guess the violence during the day and what children are
growing up with and the trauma that they go through, seeing things on a
day to day basis, I think without sort of dealing with those issues, it’s very
difficult for services to operate.” John Harvey, then NPY Women’s Council
Youth Development worker, in evidence to SA Coroner Wayne Chivell in
the matter of Hunt, Ken and Thompson (deceased), May-June 2002,
Umuwa.
Moran (2003) reports that a Queensland Police Service internal survey of
selected officers throughout that state found that 73% of police respondents
identified VSM as a problem in their area. Workshops conducted in ten locations
provided an overview of the who, where, what and why of VSM usage in each
area. Although this study was outside the proposed Rollout Region, it is relevant
in terms of potential policy solutions – Queensland Police Service is using a
Problem Oriented and Partnership Policing approach to work towards identifying
local strategies to address the problem in each area.

16


In Mutitjulu, increased policing was identified by community members and
Working Together project partners as critical for securing a safer and more
harmonious environment. The Australian government is funding the capital costs
of a police post (around $2 million), while the NT government will fund recurrent
costs, recruit two Aboriginal Community Police Officers, provide housing for the
ACPOs, and maintain adequate policing support from Yulara (MWTP, 2005a).
An important issue that has been raised in this context is the possibility for
increased incarceration that may (or may not6) be associated with increased
policing, as well as the need for complementary community justice programs and
decisions about appropriate punishment. Appropriate facilities and associated
services (eg suicide prevention) are also paramount.
Police presence can have a significant and badly needed deterrent effect.

“Mr Stojanovski said that a constant police presence at Yuendumu (a
sergeant, two constables and an Aboriginal community police officer) is
‘really important’ for dealing with sniffing, in that the police will stand behind
him during negotiations to take a child to Mount Theo as a deterrent from
acting. He said that if the court makes attendance at Mount Theo a
condition of a bond or a condition of bail, this gives them even further
support in convincing the child to come.” SA Coroner, Wayne Chivell,
findings in the matter of Hunt, Ken and Thompson (deceased), September
2002, para 11.8.

Definition of property rights is also an important aspect of ensuring responsibility for
careless of malicious damage, for example: rent payments and tenancy agreements;
“user pays” for utilities (payment options could potentially include Centrelink deductions
or Smart Cards); conditionality from funding bodies on repairs to criminal damage so
that damaged assets are not repaired or replaced by communities (if at all), but by
individual community members; retrieving and fining illegal dumping of vehicles rather
than leaving them to degrade.

Legal sanctions and bylaws: Stojanovski (1999) emphasises the desire of the
Yuendumu Community Government Council (reflecting other communities calls also) to
pass a by-law to make petrol sniffing illegal in the community, so that early intervention
and removal of sniffers can have the official back-up of police. In response to critics of
criminal sanctions, he notes that there are important differences between petrol sniffing
and other drugs (where there is a climate of decriminalisation), namely that:

“Most crime associated with petrol sniffing occurs as a result of its
psychological effects, and there is little crime involved in obtaining and
distributing petrol, as it is a cheap legal substance. Thus there is little to
suggest that making petrol sniffing illegal would result in the creation of a
black market of petrol dealers, or in a change in the purity of petrol used.
While concerns about the black market and drug purity are valid in
considering the criminalisation of other drugs such as heroin, they have
little relevance to the efforts of a small Aboriginal community trying to stop
its children from sniffing petrol.”

6
The deterrent effect of a permanent police presence may in fact over time result in a lower rate of
incarceration.

17


That said, in practice by-laws have had mixed results. In contrast to the WA example
cited above, in the APY Lands in SA, where possession or supply for the purposes of
sniffing has been illegal since 1981, the benefits are not established. This is in large
part because enforcement options are limited to the imposition of fines or a Community
Service Order, or a treatment or rehabilitation order. The latter is not in fact an option,
due to the lack of any such alternatives thus far being available.

NT Volatile Substance Abuse Prevention Act

The NT Volatile Substance Abuse (VSA) Prevention Act, due to come into effect in
early 2006, has the potential to make a significant contribution to addressing petrol
sniffing, as an adjunctive policy to the rollout of Opal in the Central Deserts.
Accompanied by an increase in resources to address sniffing, the Act will:
give police and ‘authorised persons’ the powers to search and seize volatile
substances;
help to keep petrol sniffers safe by giving police or other authorised persons the
power to remove petrol and take sniffers to a safe place;
assist with the longer-term issue of treatment by giving Magistrates the power to
issue treatment orders to sniffers;
allow communities to control the sale, supply and use of petrol by developing
community management plans; and
strengthen provisions as they relate to illegal supply.

SA Regulated Substance Amendment Bill

In mid-2004, the SA Government introduced an amendment to the Pitjantjatjara Land
Rights Act to apply to the APY Lands. The Regulated Substance Amendment Bill has
yet to be passed. If and when it becomes law, there will be increased police powers of
search and seizure, and increased penalties for the supply of ‘regulated substances’,
which now includes petrol. At present, there is only a small fine for those convicted of
‘possession for the purpose of inhalation’. It is rarely paid and often converted to a
Community Service Order, which is often not performed. The other available penalty
for possession, an order for treatment or rehabilitation (AP Land Rights Act Regulation
43(10)) has to date been of little or no use, in the absence of any treatment or
rehabilitation services.

As SA Coroner Wayne Chivell noted in his findings in the matter of Hunt, Ken and
Thompson (deceased), September 2002:

“Senior Sergeant Wilson (OIC Marla SA Police) said that 20 to 30 bonds
are imposed on the Anangu Pitjantjatjara Lands in each court circuit. The
circuits occur every two months. The bonds carry a condition to be of good
behaviour, but the Magistrate does not make treatment orders or other
orders directed at rehabilitation because there are no such facilities
available.

“This is particularly significant since the maximum penalty for possessing
petrol for the purpose of inhalation is only a $100 fine, and the usual
penalty imposed in the Magistrates Court is that the complaint is dismissed
without conviction, or the defendant is convicted without penalty. I am sure

18


that more creative and positive opportunities for rehabilitation would be
used if they were available.” (Paras 10.51 and 10.52.)

1.4.6 COMMUNITY ACTION PROGRAMS
The 1985 Commonwealth Senate Select Committee on Volatile Substance Fumes, the
first comprehensive enquiry into VSM in Australia, formed the guiding principles of
policy thereafter, recommending that “all actions in response to petrol sniffing should
originate from and be controlled by the Aboriginal people in each community affected”.
However, the admirable commitment to self-determination unfortunately legitimised a
stance where perhaps governments did too little, too sporadically, with little evaluation
or continuity in responses (d’Abbs, 2005). There was little sharing of information and
no dataset for monitoring prevalence or deaths. This has changed with the coronial
inquests beginning in 1998, although there is still a long way to go in achieving the right
balance between sustained ‘external’ support and the integrity of self-deterministic
family and community-based networks.

Subsidiarity, capacity building and peer support are essential elements to
successful implementation of any initiative targeted at reducing sniffing. For example,
the Mount Theo project has an active Youth Committee (many of whom are former
clients) called Jaru Pirrjirdi, which means “strong voices” in the Warlpiri language. It
meets weekly to discuss such issues as new members, purchasing furniture for the
youth room, night school program and how to utilise funds generated from discos and
other fundraising activities. These meetings recognise and understand youth culture
and can help tailor some of the activities to address particular needs and give
ownership to the youth. The Jaru Pirrjirdi Youth Committee assists young Warlpiri
people in addressing issues underlying substance misuse and trying to create positive
futures for both the individuals and their communities.

1.4.7 SUPPLY REDUCTION STRATEGIES
Supply reduction strategies have included the following.
Locking up petrol supplies, which has been described as having ‘been tried in
just about every place where sniffing became a problem – with just about
universal lack of success” (Commonwealth of Australia, 1985:2003);
Adding deterrents to petrol, notably ethyl mercaptan or ‘skunk juice’, which has
an offensive smell and induces nausea, vomiting and diarrhoea. The main
limitation of this is that the additive can be removed through evaporation (leaving
it out in the open) and the strategy has now been abandoned.
Substitution of leaded petrol with unleaded petrol (see Section 2.1) and
substitution of petrol with Avgas or Comgas (see Section 2.2). These policies
have engendered more extensive success.
Opal substitution is a supply reduction strategy, although to be effective, supply
reduction strategies are best accompanied with demand reduction strategies.

Supply reduction policies, when carefully targeted, can be effective in limiting access to
sniffable fuel and thus reducing prevalence and costs, as described in the next
sections.

19


2. FUEL SUBSTITUTION POLICIES
2.1 UNLEADED PETROL (ULP)
Both leaded and unleaded petrol (ULP) contain a mixture of aliphatic and aromatic
hydrocarbons, naphthalenes, paraffins and alkenes. In addition, leaded petrol contains
tetraethyl lead, an organic hydrocarbon with a lead component which has physical,
pharmacological and toxicological characteristics that are more typical of hydrocarbons
than of inorganic lead. Tetraethyl lead is present in leaded petrol at concentrations of
0.15-0.4 grams per litre in Australia, while ULP must not contain more than 0.013
grams per litre. The neurotoxicity associated with petrol sniffing is caused by the lead
additives and hydrocarbon components, both independently and in combination, with
the acute impacts attributable to the actions of the volatile hydrocarbons. The half-life
of hydrocarbons in the body is less than 24 hours, whereas lead components can
remain in the body for many years.7 An approximate estimate of the aromatic content
is 30% for leaded petrol and 70% for ULP (Cairney et al, 2002).

Leaded petrol has been shown to result in more severe encephalopathy than unleaded
petrol, greater psychotic symptoms and more frequent seizures, although other effects
are similar. In regions where leaded petrol has been phased out completely, there
have been no hospital admissions with lead encephalopathy and medical evacuations
also appear lower overall (Cairney et al, 2005). However, petrol sniffing and its many
other costs still occurs in communities when only ULP is available, although leaded
petrol is reportedly preferred for the effects of inhalation (Fortenberry, 1985; Galzigna
et al, 1973). Thus while switching from leaded to ULP may cause fewer short term
health impacts, in the medium term there is likely to be limited difference in either the
prevalence or costs of petrol sniffing.

2.2 THE COMGAS SCHEME AND AVGAS

2.2.1 COMGAS SCHEME
The Comgas Scheme is a Federal Government funded and operated initiative to
subsidise “non-sniffable fuel” in remote Aboriginal communities in the Northern
Territory, South Australia and Western Australia. The Scheme’s main objective is to
reduce the supply of sniffable petrol and therefore, along with other measures, assist to
combat the harmful impacts of petrol sniffing. A subsidy is required as Opal and the
previously used aviation gas (Avgas) are both significantly more expensive than regular
petrol. The current Opal subsidy is approximately 33 cents per litre. This subsidy
equalises the price of regular and Opal/Avgas and underpins the commercial
acceptance of these substitute fuels.

The Comgas Scheme has operated in a limited way since 1998 and was available to
36 small communities by the end of 2004. The Federal Government announced an

7
Tetraethyl lead in leaded petrol is absorbed easily by the body and, because it has a half-life in brain
tissue of more than 500 days and in bone of more than 10 years, it can continue to be re-released into the
bloodstream even years after the cessation of petrol sniffing. The specific neurological detrimental effects
of lead have, however, so far not been separated from those of the toxic hydrocarbons (Cairney et al,
2005).

20


expansion of its geographic coverage of the Scheme within Central Australia in late
2005, but excluding Alice Springs and other regional centres.

For communities to participate in the Scheme, they must be Government approved and
meet certain criteria including being more than 50 kilometres from the closest source of
petrol. These criteria are under review based on the recent initiative by the
Government to expand the Scheme’s coverage and change its name – see Section
2.3.1.

2.2.2 AVGAS
As mentioned above, Avgas was used as a petrol substitute under Comgas Scheme up
until 2005 when Opal was introduced.

Avgas contains less of the hydrocarbons used in petrol and thus produces little
euphoric effect; moreover it is high in tetraethyl lead so can cause severe headaches
and stomach cramps that substantially inhibit sniffing. It was first introduced in 1992 in
Arnhem Land. Evaluation suggests that in general, across communities, it has induced
a decline in sniffing and precipitated a change to more episodic rather than ongoing
regular sniffing. Moreover, those sniffers who continued tended to be older, more
chronic sniffers with fewer younger people starting to sniff (Roper and Shaw, 1996). It
functions thus as a supply reduction and harm minimisation strategy.

However, substitution of petrol with Avgas has had mixed success, depending on the
community. In Maningrida, Burns found that its use was critical in eradicating sniffing
within four months of its introduction in 1993, while noting other key factors in the
success story – notably community resolve and support and employment and skills
training programs.

In other communities where Avgas has been less successful, such as in the APY
Lands, the main obstacle to success has been proximity to alternative access sources,
either due to location of the community (eg near a main highway) or the presence of
dealers. Another expressed concern in relation to Avgas is the potential damage to
catalytic converters and oxygen sensors in cars, which may cause reduced fuel
efficiency and rough running (BP Australia, 1999). A final concern is a perception that
Avgas may now be becoming more commonly sniffed, possibly due to higher levels of
toluene over time (content varies between suppliers), and sniffers mixing Avgas with
petrol, where the high lead content of Avgas is a particular problem.

The Commonwealth’s 2004 Review of the Comgas Scheme summarises its origins as
follows.

“The level of excise on Avgas when it is used for non-aviation purposes is
45.2 cents per litre, making it more expensive than ULP. Several
communities successfully petitioned the Australian Government for relief
from the excise, and the Comgas Scheme was launched in 1998. At least
36 communities have introduced Avgas for varying periods of time and 33
have participated in the Comgas Scheme since that time.” (Department of
Health and Ageing, 2004:11)

The Review, based on six case studies, found Avgas to be safe, effective, popular in
reducing sniffing and with “some positive impact in every situation”. Its effectiveness
was found to depend on (1) distance to the nearest outlet for ULP; (2) length of time
that it had been used; and (3) types of other complementary anti-sniffing interventions.

21

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