GOOD NEWS ON DRUGS, SO WHERE ARE THE SMILES?

Far from being thrilled, experts have greeted with suspicion statistics
showing a drop in heroin deaths, writes Paola Totaro.

NEWS that the number of heroin deaths has dropped in NSW this year provoked
a reaction of disbelief so unexpected that it requires further analysis.
What sparked such a response? Why the scepticism?

To all intents and purposes, the drop - from 491 in 1998-99 to 296 in
1999-2000 - should be great news for a State that has been plagued by
nearly a decade of skyrocketing heroin use patterns and an ever-rising
death toll. Indeed, a cynic might have imagined at least one or two State
or Federal politicians cock-a-hoop about the figures and taking credit for
the fall.

Instead, the news was greeted with a resounding silence in the political
sphere, while conspiracy theories abounded behind the scenes in the drug
and alcohol field. Drug politics, it seems, is as prone to paranoia as its
parliamentary cousin.

"Is this an attempt to broadcast some good news before we hear the
disastrous national figures for 1999?" asked one widely respected drug
law-reform advocate.

"Are you sure Della Bosca [the NSW minister responsible for drug policy]
isn't using this to kybosh the injecting room?" asked another.

"Nobody believes those figures. Nobody," said one senior health department
bureaucrat who, out of the blue, offered a personal critique.

The numbers buck every trend. Nothing similar has happened in Victoria,
where every indication suggests that they are on target to equal, or
possibly even exceed, the 360 deaths registered in 1999.

So fears of data collection glitches are understandable, a little healthy
cynicism even welcome.

But downright disbelief?

Here, according to Professor Wayne Hall, executive director of the National
Drug and Alcohol Research Centre, are the facts for those who question the
methodology.

The NSW statistics for the financial year 1999-2000 are based on what are
called "suspected heroin overdose deaths" and are those used by coroners to
determine cause of death. Basically, they include individuals who tested
positive for recent heroin use by showing the presence of morphine in the
blood or urine. Often they can include deaths from another cause where the
person had recently used heroin, sometimes leading to an overestimation in
the number of heroin overdoses, not the opposite.

State-by-State coronial data is then used by the Australian Bureau of
Statistics (ABS) to compile national data on overdose deaths. But because
figures are systematically coded into cause of death and classified
according to international specifications, this takes time, and publication
is delayed often by 12 months or more. As a result, the latest national
data we have is for 1998 and, chances are, when 1999 numbers are finally
released they will still show the upward trend. Indeed, most experts
predict up to 1,000 deaths nationwide and, because NSW usually represents
just under half that, 1999 figures for NSW are expected to be up, too.

So if statistics released by the ABS in the next few weeks appear to
contradict the fall, don't panic - there has been no change in the way
these deaths are defined or classified. The same laboratory and staff
analysed the deaths and there has been no change in the way information is
collected. Still, when the time comes, NSW data will of course be checked
with coronial data systems and the ABS just to be sure.

So, setting aside any methodological hiccups, what else could have caused
the drop? Could fewer people be using the drug? Is it harder to get? Not
according to the most recent Illicit Drug Reporting System (IDRS), the only
national snapshot of the drug market. Indeed, the 2000 results of the IDRS
show that price has dropped yet again in NSW while there has been no change
in purity and no shortages of the drug reported by informants.

Could more users have managed to enter government-funded treatment? Experts
argue that this is a possibility, but the number of beds simply has not
expanded rapidly enough in NSW to explain the dimensions of the drop.

What about changes in drug-use patterns? After all, NSW has funded many
recent public campaigns designed to teach users about the risks of
overdose, including the dangers of poly-drug use, injecting alone and
returning to heroin after a period of abstinence. More awareness and public
and media discussion about the drug problem is another possibility, as is
the effect of changed police protocols on overdose response. These days,
users and bystanders are more likely to call an ambulance when someone
overdoses simply because police are not required to attend and ask
questions as a matter of course.

Truth is, both sides of the drug debate could happily exploit the good news
and perhaps it is this which best explains the odd reaction.
Anti-harm-minimisation advocates could argue that education and treatment,
not radical experiments such as a medically supervised injecting room, are
enough to save lives, while those who support the injecting room trial may
fear that the drop could be used to justify abandonment of the trial or,
worse still, cuts in government funding for drug and alcohol work.

In the end, stats mean little in the short term and we need to wait and see
what trends emerge in coming years before we get too excited. But it's a
sad day indeed when the first glimmer of hope in this tragic area is
greeted with anything less than optimism and enthusiasm.