Objective
To respond to an anticipated reduction in the NSW drug and alcohol medical workforce.

Methods
NSW anticipates that, as a number of the current D&A specialists are approaching retirement and there are very few new graduates entering the field, there will be a shortage of Addiction Medicine specialists.
NSW Health consulted with key stakeholders to identify contributing factors and opportunities for response. Factors identified included lack of training for GPs, lack of consistent approaches to drug and alcohol in medical curricula, the low status of drug and alcohol in the spectrum of medical practice, and poor links between private and public sector medical practitioners.

Results
In response, NSW Health has initiated a suite of capacity building initiatives including: funding the Australasian Chapter of Addiction Medicine to establish specialist training programs associated with the recognition of Addiction Medicine as a Medical Speciality, funding GP Network NSW to develop training to enhance GPs ability to manage difficult patients with co morbidity, and funding Sydney University to produce publicly available drug and alcohol medicine lectures and to work with other NSW Universities on common key learning objectives for undergraduate medical training. Other initiatives relate to workshops at Conferences, additional medical specialists in rural areas, and extra postgraduate training positions.

Conclusions
The suite of strategies being implemented in NSW in response to complex workforce issues is showing small gains but the real outcomes are hoped to be seen long term. Their ability to secure medical workforce capacity for the provision of drug and alcohol specialty care will be limited until Addiction Medicine is approved as a valid medical speciality.