DRUGS: by Dr Joe SantamariaNews Weekly
Drug policy criticised by international board
, March 10, 2001
Dr Joe Santamaria explains why the International Narcotics Control Board is less than impressed with Australia's harm reduction policies.
In the Annual Report of the International Narcotics Control Board for the year 2000, the comment about Australia's Drug Strategy reads as follows:
"Harm Reduction continues to be a major element of the strategy on drug abuse in both Australia and New Zealand. While such an approach may help reduce the incidence of communicable disease, the Board stresses that harm reduction should not become a goal in itself and that such a strategy should not be adopted at the expense of a strong commitment to reduce both the supply of and the demand for illicit drugs. Moreover all such measures must be in conformity with the provisions of the international drug control treaties."
The chief executive officer of the Australian Drug Foundation took some umbrage at these comments (The Australian, February 23, 2001) stating that any "responsible policy includes supply reduction, demand reduction and harm reduction ... although sometimes funds are less than balanced".
He then outlined some of the measures introduced under the umbrella of harm reduction, "like needle and syringe exchanges, supervised injecting facilities or prescribed heroin ...".
These comments are typical of the harm reduction strategists. It is interesting to read the statement "Our Philosophy" on the Drug Foundation's web site:
"The Australian Drug Foundation (ADF) is concerned with the consequences of drug use rather than with drug use per se. We do not view drug use from a moral stance but from the perspective of the harm it causes. The concept of harm reduction underpins everything the ADF stands for. This means accepting the fact that we live in a drug-taking society and working to minimise alcohol and drug-related harms."
Such a position was adopted also by the Drugs and Crime Prevention Committee of the Victorian Government in their Occasional Paper No.1 on Harm Minimisation. They used the term "use tolerance".
The message is obvious. The use of mind-altering drugs is OK if you use them safely and responsibly and keep clear of becoming addicted.
But if you do become addicted, we will introduce measures to save you from dying and make the drugs affordable so that you are not hassled to break the law to support your addiction.
Moreover, we will make the needles and syringes available to you so that you do not contract a communicable disease.
What happened in Australia?
Demand reduction flew out the window and the numbers using the illicit drugs escalated. The population of intravenous drug users doubled over the last 10 years. The epidemic of Hepatitis C has proliferated as it has in other parts of the world which have focused their strategies on the suggested measures of harm reduction.
The heroin deaths have paralleled the escalating distribution of needles and syringes.
Between 30-40 per cent of intravenous drug users share their equipment. The recent fall in the number of heroin deaths in Victoria and New South Wales was not due to the harm reduction strategies but to the efforts of those concerned with cutting off the supply of cheap heroin. This outcome resulted in an increasing number of heroin addicts deciding to seek detoxification programmes.
The harm minimisation strategists are fond of labelling those who favour sanctions on illicit drug use as being moralistic, that their stand is based on a moral premise. But it is a basic tenet of public health medicine that you must control the incidence rate of an epidemic i.e., the number of new cases of a disorder which threatens the common good of the community.
That principle extends to reducing the number of people who have or who indulge in the disorder (the prevalence rate). Public health has frequently required that we impose sanctions on certain types of behaviour. The classic examples are drinking and driving, regulations about the handling of foodstuffs, underage drinking, smoking in public places, the wearing of seat belts and crash helmets.
The object of such laws is to protect the community generally and to avoid the normalisation of dangerous behaviours.
There is considerable truth in the statement that governments have underfunded treatment programmes. But governments have also continued to fund programmes that should be critically evaluated in the light of their outcomes, such as the needle and syringe distribution centres, the methadone maintenance programmes, the legalised possession of cannabis, and the drug education programmes.
There is now considerable scientific evidence which suggests that the philosophy of the harm reduction model is misfiring.
Those who do not have a vested interest in the status quo should closely study the evidence that supports the statement of the International Narcotics Control Board about the situation in Australia.