0 + 0 WILL COME TO NOTHING

I have spent the past decade studying the social effects of drug-related
harm. I learnt my trade in New York City, cutting my teeth in impoverished
black and Hispanic neighbourhoods that bore the brunt of "zero tolerance"
drug policies.

Faced with a spiralling body count, I became committed to harm reduction as
the best course and engaged in civil disobedience in order to distribute
clean needles and syringes.

I returned to Australia in 1992, thrilled at the concept of needle exchange
without the prospect of arrest, and I was determined to conduct research
which made a difference.

Cabramatta was a natural choice for a field site and in 1995 we started the
first Australian study of heroin-user lifestyles and economic behaviour.

We charted the evolution of a street-based injecting culture and recorded
the harm associated with it, including overdoses, blood-borne viral
transmission, and the collateral damage suffered by local communities.

Late last year, we interviewed and tested 110 Indo-Chinese injecting drug
users. Sixty per cent were hepatitis C positive. The median age of the
sample was 22 years. An alarming 35 per cent reported reusing someone else's
syringe in the past month.

Over the next three years many of our participants will contract hepatitis C
and a minority will be diagnosed HIV positive. Some of these young people
will also become overdose statistics.

I have seen a lot over the past five years. I've watched "Long", a shy
13-year-old, become a seasoned injector and brazen street dealer. I've seen
"Lilly" drift from private schoolgirl to prostitute. I interviewed "Kim"
hours before she died and held "Linh" as the Department of Community
Services removed her newborn infant.

I was with "Vu" when his brother was shot and with "Jenny" when she learned
she had HIV. I hugged "Suzie's" mum as she buried her only daughter.

I've watched countless beautiful young women fade into emaciated skeletons
and seen sweet young men turn into hardened criminals.

I've spent nights in abandoned houses littered with discarded syringes,
performed countless resuscitations, and been in and out of police stations,
courts and prisons.

Last Wednesday night I cried as I observed "Sara", a young Vietnamese woman,
dig desperately for a vein into which to inject a few lines of cocaine.

Evidence-based drug policies require systematic research, but to work they
also require tolerance and compassion. As an American colleague put it, zero
tolerance plus zero compassion equals zero.

In the lead-up to this week's drug summit there has been much polarisation
between "experts" and those directly affected.

Pitting "science" against "experience" is divisive and counterproductive.
The model of the clinical, detached and "objective" researcher has been
challenged in the wake of the HIV/AIDS epidemic.

Like most risky behaviour, the non-medical use of psycho-active drugs such
as heroin and cocaine is unlikely to be eliminated. The community needs to
be made aware of the social and individual harm that results and encouraged
to support a wide range of interventions.

These include primary medical care, substance-abuse treatment, disease
prevention and health-promotion initiatives, programs designed to reduce the
number of those who begin using drugs, and strategies to enable existing
users to switch to safer forms of drug use.

Politicians must be convinced of the need to evaluate our drug policies on
the basis of evidence and not on whether they send the right, wrong or mixed
messages.

Finally, we need to remind ourselves that drug users are part of the
community. Protecting community health and well-being requires protecting
the health and wellbeing of drug users. To do this we need to integrate them
in the community rather than alienate them.