On 7 April, Prime Minister Tony Abbott announced the establishment of a new Task Force to identify more effective responses to the drug crystal methamphetamine, commonly referred to as “ice”.
In response former Victorian Chief Police Commissioner Ken Lay who has been appointed to chair the task force said that Australia – and I quote, can't "arrest its way" out of the ice epidemic, a sentiment echoed by a number of retired and serving police chiefs.
Yet on the weekend the Prime Minister responded by announcing a $1 million “dob in a dealer” hotline while at the same time cutting substance misuse funding by $8.2 million. That’s funding for prevention and services. And nothing could more starkly highlight the failure of Australia’s drugs policy. We’re not alone in dealing with this problem and there is a lot we can learn from overseas. So last month I took the opportunity to visit Portugal, a country which has removed criminal penalties for the possession of all drugs and for personal drug use in 2001.
So in Portugal, serious criminal penalties apply for drug dealers but it’s no longer a criminal offence to possess drugs for personal use. Instead personal drug use is considered to be an administrative violation and penalties are decided by regional panels made up of legal, health and social work processionals. People with drug dependence are encouraged to seek treatment, though they are rarely punished if they choose not to. The ambition is to make sure that treatment is accessible when people seek help.
In 2001, Portugal had more than 100,000 heroin addicts – that was one in 100 of the population addicted to heroin. In the years leading up to reform, the number of drug-related deaths had soared, and rates of HIV, AIDS, Tuberculosis, and Hepatitis B and C among people who inject drugs was rapidly increasing. There was a growing consensus from law enforcement and health officials that the criminalisation and marginalisation of people who use drugs was contributing to this problem, and that under a new, more humane, legal framework it could be better managed.
So Portugal decided to remove criminal penalties for personal use and it allocated 90% of its anti-drug funding into expanding and improving prevention, treatment, harm reduction and social reintegration programmes with 10% allocated to policing and punishment.
So from this, what have we learned?
- Levels of Portugal’s drug use are below the European average;
- We know drug use has declined among those aged 15-24, the population most at risk of initiating drug use;
- Lifetime drug use among the general population has increased slightly, in line with trends in comparable nearby countries;
- Rates of past-year and past-month drug use among the general population – which are seen as the best indicators of evolving drug use trends – have decreased;
- We know that between 2000 and 2005 (the most recent years for which data are available) rates of problematic drug use and injecting drug use decreased;
- Drug use among adolescents decreased for several years following decriminalisation, but has since risen to around 2003 levels;
- And we know that the rates of people who continue to use drugs has also decreased.
And it’s a policy that fits in with what I learned as a doctor working in a drug and alcohol clinic. The people I saw as patients had a lot in common. They struggled with physical drug dependence and with the other things that anchor us in our lives like family, friends, relationships, a job and a rofo over our heads – they struggled to manage all of those things.
They often had mental illness – anxiety, depression or psychosis. Sometimes these illnesses were triggered by their drug use, sometimes they preceded it. All of these things combined in a single patient means we have huge challenges as medical professionals to get people well and keep people well, and help them get their lives back on track. But when a patient is ready for help and seeks it out, they can and do recover, but only when the services they need are available to them.
One thing that definitely doesn’t help them is getting caught up in the criminal justice system. For someone struggling just to get off drugs and keep a roof over their head, an encounter with the law is almost guaranteed to erase any progress they had made. We wouldn’t arrest people for developing diabetes, but other patients struggling with a serious health issue could easily find themselves under arrest and facing charges. We actively intervene to minimise any chance they have of recovery. And even if they do recover, they still have the obstacle of a criminal record which can severely limit any prospects of future employment. Now I have personally seen the impact of drug use and drug dependence has on people’s lives – it breaks up families and has a devastating impact on young kids. So I don’t come at this from some sort of libertarian perspective that everybody should be able to do what they want, when they want regardless of the consequences.
But what I do know is this: our current policy doesn’t deter people from using drugs and it actively creates harm rather than preventing it.
Most heavy drug users go through a cycle of addiction and eventually stop using, either thanks to treatment or simply because they come to accept the harmful consequences of their use. Our challenge is to keep people healthy during this time which means ensuring that people who inject drugs use clean needles to avoid potentially fatal viruses and it means implementing overdose prevention strategies and so on. And as a nation, Australia will never make advances with its drug problems until people with severe problems who seek help can obtain effective care quickly, easily and affordably.
But in many parts of the country, six month waiting lists for drug treatment are common and treatment options are often too narrow. What we see is that it’s not just those individuals who bear the cost but society as a whole. Depriving drug treatment facilities of funds is a classic false economy.
The National Drug and Alcohol Research Centre report that Australian governments spent approximately $1.7 billion in 2009/10 on illicit drugs. This included programs to prevent or delay the commencement of drug use in young people, drug treatment services including counselling and pharmacotherapy maintenance, harm reduction programs such as the needle syringe program, police detection and arrest in relation to drug crimes and policing the borders of Australia for illegal importation of drugs and their precursors. The $1.7 billion amount equates to 0.13% of GDP, and 0.8% of all government spending and yet we don’t spend time in this chamber debating whether what we’re doing is effective or working. 66% of this went on law enforcement; 21% on treatment; 9% on prevention and 2% on harm reduction.
One thing I do agree with the Prime Minister on is when he said that the ‘[war on drugs is] not a war we will ever finally win. The war on drugs is a war you can lose’. I believe in evidence based policy. You don’t have to look far to find the evidence to support this assertion. Around the globe we have been at it for nearly a century, doubling down repeatedly on harsher penalties and more sophisticated enforcement of drug laws. But by any measure you care to name, the policy has been a failure. Drugs are as cheap and easily available as they have ever been. In fact the price of street heroin and cocaine is cheaper than it’s ever been. All we have to show for it is a broken treatment system, people in jail only to be replaced by a new user or a new dealer as soon as they have been locked away.
I think it is time to acknowledge this reality and find a new way forward. I’m pleased to be working with members of the Liberal and Labor Party as the Convenor of The Parliamentary Group for Drug Policy and Law Reform. We need to call this for what it is, drug use is a health issue, not a criminal issue. We have tried that approach and it’s an approach that has failed.
Of course stopping drug traffickers will always play a role, but it will be more effective if we reduce demand. We have to fund evidence based treatment. We have to put more money into treatments that we know work like methadone, ‘substitution’ programs for drugs like ice and education programs. But let’s be clear, education programs need to be realistic and need to accord with the experiences of drug users. If not, it will be ineffective or even work can drive drug use up.
We once lead the world on this. We were on the verge of implementing a heroin trial to address the issue of heroin use. It has been more than a decade since this issue has been discussed in this Parliaent. We are seeing changes right around the world and they show us if we look at this issue objectively, in a more measured light, reallocate money to those areas where we know the evidence is clear and above all when we start to accept that drug use will always be with us and it is a health issue, then we’ll finally start to make progress.