JUST SAY NO TO AMERICA

Australia Is Taking The Correct Approach To Tackling The Drug Problem, Writes Ernest Drucker.

AS AN an American public health professional who has worked for more
than 30 years in the treatment of drug addiction and, more recently,
in research on AIDS prevention (these days on sabbatical leave here in
Australia), I have followed the twists and turns of your national
debate on the establishment of safe injecting rooms and heroin trials
with more than casual interest.

In my own country, command centre of the global "war on drugs", even
such a debate would be impossible and the actual implementation of
such programs still unthinkable.

The US Government effectively dominates local and State drug policies
and has banned Federal funding for all harm minimisation activities as
"sending the wrong message", claiming they are thin covers for "drug
legalisation". This, even as 10,000-15,000 Americans die from drug
overdoses each year and more than 20,000 new HIV infections occur
among the nation's one million to two million drug injectors (about
200,000 of whom already carry the AIDS virus). Some localities
continue to prosecute their own citizen activists who (defying the
laws) continue to distribute clean injecting equipment, and 11 States
still ban methadone treatment altogether - despite the fact that
research has clearly demonstrated that both approaches slow the spread
of AIDS.

What we do instead, and with a vengeance (literally), is incarcerate
drug users. And we do so at a fearsome rate - having last week placed
the two millionth American behind bars, an American who most probably
is a drug user. Today, the US imprisonment rate is about four times
that of Australia and has increased 100 per cent in the past decade
alone. Most of this increase is associated with harsh mandatory
sentences for drug use.

But the US is not content to impose this insanely self-destructive
approach upon its own citizens alone. We insist that other nations do
likewise and toe the line of "zero tolerance". The US has done
everything in its power to influence the Commonwealth to desist from
the very innovations that have already saved so many Australian lives
(such as needle exchange and the involvement of drug users'
organisations) and objects strenuously to others that can save more
lives if implemented - ie, the heroin trial, and most recently, the
safe injecting rooms.

But great powers like the US have other ways to make their feelings
known. Last week, the United Nations International Narcotics Control
Board (or INCB), which the US also dominates (even though it continues
to be delinquent in its UN dues), issued a press release in which it
accused Australia of violating international narcotic treaties if it
went ahead with plans for safe injecting rooms.

The INCB claimed that such programs are "not in line with
international conventions" and that the "explicit or tacit approval of
so-called drug injection rooms - or 'shooting galleries'- are seen as
a step in the direction of drug legalisation". Sound familiar?

Most experts on international law, who understand the actual power and
mandate of the INCB, dismissed its assertions as a hollow threat. But
the INCB will visit Australia in April - just as the first injecting
rooms are getting set to open in Sydney. No doubt it will repeat its
view that these facilities not only promote "tolerance towards illegal
drug use and trafficking but also [run] counter to the provisions of
the international drug control treaties", asserting that "any
national, State or local authority that permits the establishment and
operation of such drug injection rooms also facilitates illicit drug
trafficking".

This refrain echoes similar statements made a few years ago about the
meticulously planned heroin trial that was then set to begin in the
ACT. In that case a series of calls and visits from Washington and
Vienna (home of the INCB) and open threats against your Tasmanian
opium industry carried the day and the heroin trial was stopped by the
Federal Government - despite its prior approval by your State health
ministers. Such heroin programs have since been successfully
implemented in Switzerland (with more than 1,000 patients) and the
Netherlands, will soon begin in Germany and are planned for Spain and
Italy.

And, of course, this approach echoes US policy at its most retrograde,
characterising even sound scientific trials of new approaches and
other public health measures of proven effectiveness as devious routes
towards drug legalisation.

Why would a country, normally so generous of spirit and so famously
open to innovation, adopt a posture so lethal to its own citizens? And
more to the point here in Australia today, why would the US complain
so bitterly about another distant country's choice of a more pragmatic
and humane path? Why would we attempt to impose our own clearly failed
approach on others?

A partial answer can be drawn from the work of the Australian critic
Robert Hughes, who has lived in America for more than 20 years. Hughes
likes America. He readily speaks of his "visceral attachment" to it
("next to Australia, America is a place I know and love best") and has
become unusually perceptive about its people and culture.

In a series of lectures given at the New York Public Library in 1992,
Hughes spoke of the "fraying of America" by the success of "populist
demagoguery", and "a distrust of formal politics; sceptical of
authority and prey to superstition; its language corroded by fake pity
and euphemism".

How else can we comprehend sentencing tens of thousands to long prison
sentence because they have a problem with drugs? He speaks of a
"culture of complaint" that is overtaking American thought and
threatens to "unravel that sense of collectivity and mutual respect
[and] has broken the traditional American genius for consensus, for
getting along by making up practical compromise to meet real social
needs".

Thus, while many American politicians tell us in private that the war
on drugs is a fiasco, there is no public debate about any of it in any
actual political forum - the sceptics silenced by well-grounded fears
of political retribution, fears of being called "soft on drugs" by
demagogic opponents. The appalling casualty rate our citizens continue
to pay for this mishandling of our own huge drug problem is the price
we pay for this hypocritical lapse in moral judgment.

The stunning success of your approach to AIDS (Australia having
averted an epidemic among its drug users) is one of the things that
has drawn me back here - to learn from your fine public health
professionals and emulate their programs wherever possible in the US.
And while hepatitis and overdose remain massive problems here - as
everywhere else in a world awash in illicit drugs - you have the
foundations of intent and a willingness to examine outcomes that are
the prerequisite to effective policies.

So now that the nation's first injecting room is soon to open in Kings
Cross (with others to follow in Victoria and elsewhere), I am once
again filled with admiration for Australia's compassionate pragmatism
in drug matters. And its courage to do the right thing - even in the
face of strong outside pressures to abstain from the sort of
harm-minimisation strategies that have already saved thousands of
Australians lives.

Good on you!