THE SADNESS EPIDEMIC

There is no single solution to the heroin problem. But there are
things we can do. The first is to realise that addiction is about
wounded people. And causing them more damage, as the Prime Minister's
"war on drugs" involves, is counterproductive. A war on drugs is a war
on drug users, that is, our children. It springs from diplomacy,
rather than any knowledge of drug addiction.

Up to 50 years ago, addicts could get heroin from doctors. It worked
well enough to suit the New South Wales director-general of health,
and the predecessor to the Australian Medical Association, which
argued against "curtailment of availability". But the
prohibition-conscious US was unhappy and pressured the federal
Government, through international treaties, for an import ban, which
was achieved in 1953.

The irony is that methadone, the drug used to wean addicts off heroin,
is essentially the same thing. The difference being, as the Turning
Point Alcohol and Drug Centre's director of research, Dr Alison
Ritter, notes, methadone removes the high. What is withheld is the
buzz; a step that seems to owe more to Calvinism than common sense.

Methadone is disliked by many addicts for its side-effects, and its
cost. But there are no alternatives. This is not because options don't
exist, but because the best ones are not available in Australia.

Few doubt that Buprenorphine, a drug that blocks heroin and provides
an opiate effect, and LAAN, a long-lasting type of methadone, are
efficacious. The question for the multinational drug firms that make
them, and upon whom we depend for availability, is: "Are they
profitable to provide in Australia?"

Turning Point is testing the two drugs, partly, as Ritter explains, to
convince drug firms that they have a "good product" and it should be
produced locally.

What this means, of course, is that commercial considerations, not
health issues, control whether addicts can get a helpful drug. And
even if the trials are successful, and the companies can be persuaded
to make them available in Australia's tiny - 50,000 to 100,000 addicts
- - market, finances will again intervene against the user. This is
because the Federal Government is unlikely to subsidise a drug such as
LAAN, which mimics an existing drug, that is, methadone. The fact that
LAAN works for twice as long as methadone, and therefore makes life
much easier for addicts, is not considered - nor is the way heroin is
used to sidestep underlying issues such as family trauma,
homelessness, unemployment and depression.

These are the sicknesses in our society. Heroin is the symptom. What
we have, as youth worker Bernie Geary points out, is a sadness
epidemic as much as a heroin one. It is a genuine crisis. And while a
remedy to the most fundamental problems of alienation and inequality
are not in the offing, some remedial measures are. The most
controversial is heroin trials, that is, making the drug available on
prescription to addicts. Such a step won't erase the black market, but
it is likely to reduce it, along with crime and fatal overdoses. But
it requires political guts.

What is clear is that enforcement alone will not work, and as a result
funds need to be spread more equally between law and order on the one
hand and treatment and support on the other. Policing, particularly of
heroin importing, is necessary, but the notion that Customs and the
police will kill the menace is ridiculous.

The demon, you see, is in ourselves, as much as the murky world of
dealing. And this is probably the most critical and difficult lesson.
Damaged children are fodder for drug dealers. Every addict I spoke to
for last week's series of reports in The Age had a history of abuse or
trauma. Every one, even the well-to-do types who went to private
schools, and, in the case of one middle-aged man, held down an
executive job.

This does not mean they are blameless. But it does mean that, to get
better, they have to feel better about themselves. The more we label
them "dirty junkies", the more they will use drugs to escape.

Counselling and therapy, then, are as central as pharmaceuticals and
punishment. This is beginning to be recognised in prisons, where
psychologists are now working alongside jailers. But not nearly enough
to make a real difference. You only have to look at the shambles that
passes for a rehabilitation process. The "detoxes", where addicts go
to get clean, and the "rehabs", where they are meant to recover, are
inadequate, and in short supply.

Addicts must phone every day, often waiting up to an hour to get
through, to hold their place in a detoxification program. This can go
on for three or four weeks. That is an eternity in the life of a user
who, in any case, rarely has the focus to meet rules designed to suit
bureaucrats. The same is true of back-up when they get out. Because
there are not enough halfway houses, users clean after a spell in
detoxification are thrown into the heroin bonanza of emergency
accommodation. It gets even worse when looking for a rehabilitation
centre, that is, a supportive place to spend months re-building your
life.

It means that workers in the field must lie about addicts' ages and
addresses to find a refuge.

Users are dying because they mix heroin with tranquillisers and
alcohol, and because they shoot up alone or with those who are either
ignorant of overdose or afraid of its consequences. This is where the
supervised injecting centre comes in. Such places are neither the
answer nor the evil their proponents suppose. A place where street
kids "whack up" under the eyes of a nurse is a safety measure, like
putting on a seatbelt before driving.

It won't stop the carnage, but it will help lessen it, at least for
the hard-ups who shoot up in city laneways, and do not understand the
lethal nature of poly-drug use. To eulogise or demonise such a step,
as some have done, is to misrepresent what is happening on the street.
And that is, sadly, all too common in heroin's dirty war.