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
Overview
The Veterans’ Entitlements Act 1986 was enacted to provide various benefits and entitlements to veterans, their families, and dependants. In 2014, the Repatriation Medical Authority, under the authority granted by subsection 196B(9) of the Act, made a declaration concerning the review of the Statements of Principles in force regarding substance use disorder. This declaration followed an investigation into whether a threatening, hostile, hazardous, and/or menacing situation or environment could be linked to substance use disorders in veterans. After examining available medical-scientific evidence, the Authority concluded that there was insufficient new evidence to warrant an amendment to the existing Statements of Principles. The decision was based on the inconsistency and limited quality and quantity of the studies examined, which did not sufficiently support a causal relationship between such environments and substance use disorders.
Scope and Application
The Veterans' Entitlements Act 1986 applies to Australian Defence Force (ADF) veterans and their families, regulating their entitlements to various benefits and services. This Act governs the provision of medical, psychological, and financial support, encompassing a broad range of individuals and entities associated with veterans' affairs. The legislation extends its reach across the Commonwealth of Australia, ensuring that veterans and their families nationwide are eligible for support under the Act's provisions. The Repatriation Medical Authority, operating under this Act, has the authority to review and amend Statements of Principles concerning various health conditions, including substance use disorders, as demonstrated in the declaration regarding Instruments Nos. 3 and 4 of 2009. The Authority’s decision not to amend the Statements of Principles on substance use disorder is based on the assessment that the available medical-scientific evidence is insufficient to justify changes. This decision reflects the Act's requirement to base such amendments on robust and sound evidence, ensuring that the benefits and services provided are both justified and necessary.
Key Provisions
The Repatriation Medical Authority (the Authority), under subsection 196B(9) of the Veterans’ Entitlements Act 1986, has made a declaration concerning the review of Statements of Principles related to substance use disorder, specifically Instruments Nos. 3 and 4 of 2009. This declaration comes after an investigation into whether there is a link between exposure to a threatening, hostile, hazardous and/or menacing situation and/or environment and substance use disorder among veterans. The Notice of Investigation was published on 26 March 2014 in the Government Notices Gazette. The Authority has decided not to amend the existing Statements of Principles because the new medical-scientific evidence does not support such a change.
The obligations placed on the Authority by this declaration include a thorough review of the available evidence. The Authority examined a cross-sectional Vietnam veteran study, which indicated some associations between drug dependence and drug abuse and a malevolent environment and perceived threat. However, other studies, such as the cross-sectional Australian Gulf War Veterans' Health Study and a retrospective database study of veterans from the Afghanistan and Iraq conflicts, did not find significant associations between perceived threat and substance use disorder. The Authority concluded that the evidence was inconsistent and not sufficient to justify amending the Statements of Principles.
The declaration highlights that the evidence available is inadequate to establish a causal relationship between exposure to a threatening, hostile, hazardous and/or menacing situation and/or environment and substance use disorder. The Authority considered the quality and quantity of the studies, and while one older study showed an association, it was limited by its design and other factors. Two newer studies did not support the idea of such a link. As a result, the Authority concluded that the current Statements of Principles remain appropriate.
Breaching the requirements outlined in the Veterans’ Entitlements Act 1986 could result in legal consequences. The Act may impose civil or criminal penalties for non-compliance, although specific penalties are not detailed in the declaration. Generally, under Australian law, breaches of legislative provisions can lead to fines, imprisonment, or both, depending on the severity of the offence. In this context, failure to adhere to the Authority's determinations or the legislative requirements could result in legal action against the parties or entities involved.