DRUGS: by Colliss ParrettNews Weekly
Latest push to promote needle/syringe programs
, March 19, 2011
Today there is continuing discussion at both the national and local level on illegal drugs and their use. It is gratifying that New South Wales, Victoria and Western Australia have rejected the idea of establishing medically-supervised injecting centres (MSICs) in their jurisdictions.
However, drug liberalisers are pushing strongly to make needles and syringes available in prisons. The flashpoint is the Australian Capital Territory where the government is wavering on its moral obligation to prevent the supply and use of drugs, and on its publicly declared commitment to have inmates come out of jail drug-free.
The liberalisers are trying to use the fear of the spread of hepatitis C infection as a justification for allowing needles and syringes in prison.
Corrective services officers are emphatically against the proposal because needles will be used as weapons, and their role is one of correction, not of acting as health carers!
If the needle proposal is adopted in the ACT's prison (the Alexander Maconochie Centre), the 60 other prisons around Australia may fall like dominoes, and 27,000 prisoners could have ready access to needles and syringes - and still be at risk of contracting hepatitis C.
To gain a proper perspective on the drug issue, it is essential to understand the principles of public health. There are three levels of prevention:
- applying measures to prevent a disorder from occurring, such as vaccinating people against tetanus or promoting health education.
- instituting measures to diagnose and treat a disorder in its early stages and then preventing any further relapse.
- management of a case at a later stage in order to slow progression.
Drug use is symptomatic of a wide range of underlying problems - most of which are too numerous to discuss in detail here, but which are well known to government and the community.
In my view, nearly all can be traced back to flaws endemic in our drug strategy. There has been far too little emphasis on primary prevention over the past decades. This has swollen the incidence of drug dependency, thereby throwing a heavier burden onto secondary and tertiary prevention (that is, after
the event). An epidemic cannot be contained or reduced if effective measures to do so are not adopted.
The philosophical argument for permitting illicit drug use is that in a free society adults should be allowed to do whatever they please, provided they accept the consequences of their own choices and cause no direct harm to others.
In reality, addiction does not affect the user alone. It affects family and friends, road-users, paramedics, doctors, hospital and rehabilitation staff and the funding taxpayer.
No culture that makes publicly sanctioned self-indulgence its highest good can long avoid a radical egotism in which any limitations on personal behaviour are regarded as infringements of basic rights.
The practical argument for permitting illicit drug use includes the assertion that prohibition is the cause of criminality surrounding drug distribution.
Similarly, it could be argued, it is prohibition against domestic violence, car-theft, arson, rape, fraud and burglary which creates offenders in these categories. Thus it could be held that the ultimate cause of all criminality is the law. As far as I know, no one has ever suggested that the law should therefore be abandoned.
Ethan Nadelman, who founded the Lindesmith Centre in the USA in 1994 - a drug policy institute created with financial assistance from Hungarian-American financier George Soros - and who recently visited Australia, assumes that the number of potential addicts would not soar under substantially more liberal drug laws.
I myself can't muster such Panglossian optimism. The problem of reducing the amount of crime committed by individual addicts is emphatically not the same as the problem of reducing the amount of crime committed by addicts as a whole.
By way of analogy, it is claimed that prison does not work because many prisoners are recidivists, who by definition, have failed to be deterred from further crime by their last prison sentence. But does any sensible person believe that the abolition of prisons would reduce the number of law-breakers?
Those who say the war on drugs is lost must also ask whether medicine has lost the war on death. Few, if any, wars on our major social breaches are winnable. So, to make drugs a special exception is illogical.
The cardinal objective of our public health policy must be to reduce the incidence and prevalence of illegal drug use. If you do not reduce the number of drug-users, the problem will escalate.
By way of example, the incidence of hepatitis C infections in Australia has increased nearly five-fold in the past 25 years to over 200,000 sufferers.
Another example is how cannabis dependency has escalated to 220,000 addicts, which is nearly six times higher than the total of persons addicted/dependent on all drugs in Sweden.Colliss Parrett is a former director of the Drugs of Dependence unit in the Commonwealth Department of Health. He is currently a fellow in Drug Free Australia.