Developments on National Drug Policy in AUSTRALIA
by Dr. Alex Wodak, Director of Drug & Alcohol Services at St. Vincents Hospital N.S.W. Australia
The drugs policy debate is becoming increasingly lively in Austalia. Although the Green Paper on AIDS ("AIDS A Time to care: A Time to Act') released in December 19* contained very little consideration of the role of changing drugs policy in the containment of HIV infection, it is understood that the forthcoming White Paper, which will be completed by June 1st, will address the issue. Following the release of the Green Paper, the Commonwealth Department of Community Services and Health organised a number of panels travelling around the national capitals and major cities, collecting evidence on the response to the Government's Green Paper. It is significant that the person chosen to chair the panel on Intravenous Drug Use (IVDU) was Senator Peter Baune who is known as a firm and unequivocal advocate for major drugs policy reform. The only other parliamentarian on the committee was Dr. Rick Charlesworth better known outside Australia as the Captain of the medal winning national hockey team, but an equally clear advocate of major drugs policy reform. The Commonwealth Department of Community Services and Health recently nominated Mr. Justice Michael Kirby, President of the Supreme Court of Appeal, New South Wales, to the International Advisory Council of the WHO Global Programme on AIDS. Mr. Kirby is a very well known and Senior Judge in Australia. Although his position does not permit unfettered ventilation of his view in public, it is understood that Mr. Kirby is also a supporter of drugs policy reform.
The major impediment to serious consideration of drugs policy reform in Australia at present is lack of credible alternatives. The Australian Medical and Professional Society on Alcohol and Drugs (AMSAD) held a workshop near Canberra on 13th -15th April, 1989 on "AIDS and Drugs Policies for the Early 1990's". The workshop was attended by over thirty participants coming from all states and the Australian Capital Territory. A number of general principles were agreed upon and a plan for further action arising from the workshop will be submitted to the Commonwealth Government. During the workshop, consideration was given to the development of credible alternatives to existing policy including consideration of different options within the framework of decriminalisation and legalisation.
In the opening session of the workshop, Mr. Desmond Manderson provided an overview of the development of Australian Policies on Illicit Drugs in the 20th Century. As in the United States, one of the major factors which determined Australian Policies on opium and related compounds in the Early 20th Century was hatred of the Chinese living in the country. Australia was increasingly influenced during the 20th Century by the drug policies pursued by the United States of America and generally, tightening of policy in the US was followed by similar developments in Australia.
Participants of the Workshop supported the notion that harm minimization for individuals and society should be accepted as the primary goal for policies relating to illicit drug use. In this sense, limitation of drug use was recognized as one means of achieving this objective. It was noted that when considering alternative harm minimization strategies, the adoption of the "least worst option" will be necessary.
The workshop was strongly influenced by the need to contain HIV infection among intravenous drug users. However, participants also recognized the need to balance all advantages and disadvantages of existing and alternative drug policies. Participants recognized that if currently illegal drugs are to be supplied through a legal system of supply, then:
1) Procedures will need to be designed such that impulsive use and use by the young is minimized.
2) Every effort will need to be made to discourage recruitment to drug use and to discourage heavy use.
3) The heterogeneity of consumers will require that a variety of outlets will be necessary for the optimal supply of substances.
4) The control (or preferably elimination) of advertising or promotion of drugs that have a potential to result in harm will be necessary.
5) It will be necessary to maintain legislation prohibiting supply of drugs, other than by legal outlets, with the possible exception of cannabis.
6) The system of supply should be under strict Government control with minimization of the profit motive. A Government monopoly was favoured when practicable.
Supply control policies were not completely discounted. Participants agreed that supply control policies should be retained as a harm minimization strategy when the policies are feasible, effective and capable of implementation with reasonable costs. However, it was recognized that supply control policies are ineffective as the major means of dealing with drug problems.
On the opening night of the workshop, a panel discussion followed presentation of papers arguing for drugs policy reform presented by representatives of the three major political parties in Australia.
A Foundation For Drug Policy has recently been announced with an interim committee consisting of Mr. Simon Davies, Dr. Robert Marks, Dr. Steven SIugford and Dr. Grand Wardlaw. This is a voluntary, non profit organisation which is attempting to stimulate debate on the wide range of issues related to drug policy. It is also seen as a body capable of presenting a coherent and well founded critique of existing policies as well as presenting sensible and constructive alternatives to current strategies. (Further details are available from Dr. Steven Mugford, C/- Department of Sociology, Faculty of Arts, Australian National University, P.O. Box 4, ACT, 2601, Australia). A complete report of the AMSAD Workshop is available from the convenor: Dr. LRH. Drew, Queanbeyan Hospital, P.O. Box 729, Queanbeyan, NSW, 2620, Australia.
At present, a number of major issues are occurring in the drugs policy reform debate in Australia. Firstly, legislation relating to drugs paraphenalia has been retained in several states and needle and syringe exchange. The paraphenalia legislation enables the possession of used needles and syringes by an intravenous drug user to be used as evidence of self ad ministration. The effect of retention of such legislation has been an increase in the disposal of used needles and syringes in public areas including streets, parks and beaches. This has resulted in considerable public outcry threatening the expansion of needle and syringe exchange and to some extent, even the survival of this strategy. Repeal of this legislation is likely to proceed in a number of jurisdictions. Secondly, police activity directed against cannabis has resulted in a spectacular increase in price and decrease in availability.
This has resulted in the apparent cross substitution from cannabis to injectable substances including heroin by intravenous drug users. This development is seen as alarming by health professionals concerned at the potential for spread of HIV infection in Australian intravenous drug users. The third issue concerns the regulated supply of currently illicit substances themselves. These drugs include heroin, methadone, cocaine and amphetamines. A surprisingly high degree of support for drugs policy reforms in this area has been demonstrated in public opinion polls. A trial is anticipated to commence in the second ha]f of 1989 in Sydney evaluating the regulated supply of intravenous methadone and possibly intravenous morphine to intravenous drug users. Although the background to the development of this trial owes much to the debate on containment of HIV infection, other broader issues have also influenced the planning for this study.
It is likely that the debate on drugs policy reform in Australia will be intensified when the report of the Joint Parliamentary Committee on the National Crime Authority is released later this year. The Australian National Council on AIDS has organised a workshop in Canberra on May 1st and 2nd, 1989 to discuss obstacles in the implementation of HIV containment strategies in intravenous drug users. This conference will be attended by over seventy participants representing all jurisdictions within the country. More than likely, drugs policy reform will be seen as a major issue in this workshop.
Two or three years ago, the debate on drugs policy in Australia was of little interest and received minimal support from eminent members of the community. Within a short period, this is now not only a respectable issue, but it is very much an "idea whose time has come". Support is received for reform from distinguished pillars of the community and the subject is rarely out of the media's attention. Australia could play an important role internationally in this area as other countries currently supporting reform of drug policy may be constrained by political considerations from spearheading an international review of drugs policy.