S.TRUEMAN PhD THESIS 2016

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levels of use deemed by health authorities as safe, negatively affects the general health of individuals, but also exacerbates and contributes to the development and treatment resistance of serious mental illness (Hartz et al., 2014). For these reasons, excessive levels of consumption of illicit drugs and alcohol increase workloads and complexity of work for remote nurses. Table 2.1 Drug Usage in People Aged 14 Years or Older, by Remoteness (as Percentage of Total Population According to Remoteness Classification Index), 2010 (Source: AIHW, 2014)

Major Cities

Inner Regional Outer Regional

Remote/ Very Remote

Illicit drugs Cannabis Ecstasy (MDMA) Cocaine

14.8 64.8

13.9 65.5

15.0 64.2

17.2 55.2

3.3

2.0

2.2

4.1

2.6

1.0

0.9

2.0

MDMA: methylenedioxy-methamphetamine

Rates of use of illicit drugs (see above), which include heroin, methadone, morphine and ecstasy, are higher as a percentage of population in remote locations than other areas; the one exception is cocaine usage, for which remote areas have the second highest rate of usage (see Table 2.1) (AIHW, 2014). There exists a strong association between excessive use and increased mental illness (both incidence and severity of symptoms) concerning the four drug classifications identified in Table 2.1. Excessive use of cannabis can contribute to the development of psychosis and affective disorders (Caspi et al., 2005; Di Forti et al., 2012; Moore et al., 2007; Radhakrishnan, Wilkinson & D’Souza, 2014). Excessive ecstasy (MDMA) use