Drug use is a health issue, and should not be treated as a crime

By Zeb Holmes and Ugur Nedim

The authors of an article published in the Medical Journal of Australia have joined the chorus of health experts calling for an emphasis on harm reduction measures and government regulation when it comes to drug use, rather than trying to arrest our way out of the problem.

The peer-reviewed article, titled ‘Beyond ice: rethinking Australia’s approach to illicit drugs’, argues that drug use should be classified as a health issue, rather than a criminal law problem which is dealt with through greater investment in law enforcement and harsher penalties.

Easy access despite punitive measures

The article’s authors, Matthew Frei and Alex Wodak, cite figures which suggest that the demand for ‘ice’ has continued to rise despite the implementation of punitive measures.

The report’s findings are consistent with what many have been saying for years – that the ‘war against drugs’ has been lost.

Surveys suggest that between 2009 and 2014, the percentage of drug users who found it “easy” or “very easy” to obtain ice increased from 65% to 91%. This is despite a concerted effort by law enforcement to stop the manufacture and importation of drugs, which has contributed to drug seizures rising from 160 kg in 2011–12 to almost 1500 kg in 2012–13.

The 2014 Illicit Drug Reporting System found that the mean age for ice users is 40 years, that they are more likely than the general population to be unemployed, and that they generally engage in multiple or polydrug use. This suggests there is a strong demand for the drug amongst seasoned users.

Failure of punitive approach

The focus of the 2016 National Ice Taskforce Report was to evaluate preventative and diversionary initiatives and make recommendations, rather than criminalisation strategies.

Former Victorian Police Commissioner Ken Lay acknowledged during the taskforce’s deliberations that “we can’t arrest our way out of the problem”.

“Over the past two decades in Australia we have devoted increased resources to drug law enforcement, we have increased the penalties for drug trafficking and we have accepted increasing inroads on our civil liberties as part of the battle to curb the drug trade”, he stated.

“All the evidence shows, however, not only that our law enforcement agencies have not succeeded in preventing the supply of illegal drugs to Australian markets but that it is unrealistic to expect them to do so.”

Skewed priorities

In an attempt to address the issue of drugs, Australian governments have allocated two-thirds of spending on law enforcement, and only 21% on treatment programs, 9% on preventative programs and 2% to harm reduction measures. And importantly, these figures do not take into account the enormous amount of money spent on keeping drug offenders behind bars.

Professor Nicole Lee, from the National Drug Research Institute, told MJA InSight that “while we focus on the use of drugs, we will continue to implement ineffective strategies, such as arresting people for use and possession”, adding, “if we focus on harms, we start to implement effective strategies, including prevention, harm reduction and treatment.”

Prison populations have continued to increase as the war on drugs continues, surging by 16% over the past two years, with the rise primarily attributed to more arrests, tougher bail laws and longer sentences.

And sadly, prison has proven to be an ineffective means of breaking the cycle of crime – with 48% of NSW inmates returning to prison within just two years of release, according to 2014–15 Productivity Commission data.

The way forward

The MJA article calls upon governments to regulate drugs, citing Australia’s success in reducing tobacco consumption through regulatory measures.

Matt Noffs, CEO of the Noffs Foundation, agrees with this approach.

“We banned tobacco advertising, and we’ve done this better than any other country. We made it harder to get and harder to smoke, we made it more expensive, and all of these measures have led to a decrease in smoking and, therefore, a decrease in people being harmed by it”, he remarked.

Dr Wodak believes an important first step is to view drug use as a health and social problem, rather than something we need to punish. “People who need help don’t just need health assistance; they need social help with housing and training in employment,” he said.

Harm reduction

While conservative politicians gawk at a regulatory framework, measures such as methadone programs and injecting rooms have proven to be extremely successful in reducing the harm associated with the use of heroin.

As observed by Professor Lee, “[h]arm reduction strategies such as pill testing, needle syringe programs, early closing for venues selling alcohol and safe injecting facilities significantly reduce harms to people who use alcohol and other drugs and the community”.

The MJA article’s authors note that, “British politician Denis Healey was fond of saying ‘if you find yourself in a hole, stop digging’. It’s time Australia took his advice when responding to illicit drugs.”

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