DECLARATION UNDER SUBSECTION 196B(9)
OF THE VETERANS’ ENTITLEMENTS ACT 1986
The Repatriation Medical Authority (the Authority), under subsection 196B(9) of the Veterans’ Entitlements Act 1986 (the Act), makes the following declaration in respect of the review of the contents of the Statements of Principles in force under the Act concerning substance use disorder, Instrument Nos. 3 and 4 of 2009.
The investigation related to "a threatening, hostile, hazardous and/or menacing situation and/or environment". The Notice of Investigation was published in the Government Notices Gazette of 26 March 2014.
The Authority declares that it does not propose to amend Statements of Principles, Instrument Nos. 3 and 4 of 2009, concerning substance use disorder for the reason that the new sound medical-scientific evidence available is not sufficient to justify an amendment to the Statements of Principles already determined in respect of substance use disorder.
A cross-sectional Vietnam veteran study reported some significant associations between drug dependence and drug abuse and malevolent environment and perceived threat. The cross-sectional Australian Gulf War Veterans' Health Study reported a non-significant increased risk for drug dependence and drug abuse in the previous 12 months for veterans of the conflict when compared to a group of veterans who were not deployed to the Gulf War. A retrospective database study of veterans of the recent Afghanistan and Iraq conflicts reported that greater perceived threat during deployment was not significantly associated with substance use disorder. Likewise, no significant association between perceived threat and substance use disorder was reported in a cross-sectional study of Afghanistan and Iraq veterans.
Overall, the evidence was inconsistent and the studies were limited in quality and quantity. An association was demonstrated in one of the older studies, but this study was limited by its cross-sectional design, retrospective data collection, lack of independent validation of some measures and possible confounding by other lifestyle factors and pre-deployment factors. Two newer studies did not find significant associations between perceived threat and substance use disorders.
The Authority concluded that the sound medical-scientific evidence available is inadequate to raise a reasonable hypothesis concerning a causal relationship between exposure to a threatening, hostile, hazardous and/or menacing situation and/or environment and substance use disorder.
The Common Seal of the )
Repatriation Medical Authority )
was affixed at the direction of: )
PROFESSOR NICHOLAS SAUNDERS AO
CHAIRPERSON 17 / 10 /2014