In Australia, Aboriginal and Torres Strait Islander community controlled health services have been established since 1971 to provide accessible, quality and culturally-appropriate primary healthcare. The first of these services, the Aboriginal Medical Service Cooperative Redfern (‘the AMS’), created its own Drug and Alcohol Unit (‘the Unit’) in 1999. The Unit initially prescribed opioid substitution treatment (OST) and its coordinator, Bradley Freeburn, a Bundjalung man, provided counselling. Soon afterwards, the Unit started dispensing OST. It now cares for around 150 individuals, each of whom is understood in the context of family, community and culture. The Unit is on the same site as the AMS's primary care service, specialised medical and mental health clinics, and dental clinic. This allows for integrated physical and mental health care. The Unit contributes to drug and alcohol workforce development for other AMS staff, state-wide and nationally. Several Aboriginal and Torres Strait Islander community controlled health services around Australia now offer OST prescription, and a small number administer slow-release buprenorphine. We are not aware of others that dispense Suboxone. In the USA and Canada, over the last 10 years, First Nations communities have also responded to lack of treatment access, by creating standalone OST clinics. We were not able to find examples of Māori-controlled OST clinics in Aotearoa, New Zealand. The feasibility of this model of readily accessible OST, situated within a holistic, culturally-grounded primary health-care service recommends it for consideration and evaluation, for Indigenous or non-Indigenous communities.

中文翻译：

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成年：在土著社区控制的初级卫生服务中提供阿片类药物替代治疗 21 年

在澳大利亚，自 1971 年以来，原住民和托雷斯海峡岛民社区控制的卫生服务已经建立，以提供可及、优质和文化相适应的初级卫生保健。这些服务中的第一个，原住民医疗服务合作社 Redfern（“AMS”）于 1999 年创建了自己的药物和酒精部门（“该部门”）。该部门最初规定了阿片类药物替代治疗（OST）及其协调员布拉德利Bundjalung 男子 Freeburn 提供咨询服务。不久之后，该单位开始分发 OST。它现在关心大约 150 个人，每个人都在家庭、社区和文化的背景下被理解。该单位与 AMS 的初级保健服务、专门的医疗和心理健康诊所以及牙科诊所位于同一地点。这允许综合身心保健。该部门为全州和全国其他 AMS 工作人员的毒品和酒精劳动力发展做出了贡献。澳大利亚各地的一些原住民和托雷斯海峡岛民社区控制的医疗服务机构现在提供 OST 处方，少数人使用缓释丁丙诺啡。我们不知道有其他人分发 Suboxone。在过去 10 年中，在美国和加拿大，原住民社区也通过创建独立的 OST 诊所来应对缺乏治疗机会的问题。我们无法在新西兰奥特阿罗找到毛利人控制的 OST 诊所的例子。这种易于获取的 OST 模型的可行性，位于一个整体的、以文化为基础的初级卫生保健服务中，建议将其用于土著或非土著社区的考虑和评估。