THE GREAT SIDESTEP ON HEROIN

For politicians to continue insisting that certain drugs remain illegal when
alcohol and tobacco are not defies logic, GEOFF PAGE argues.

WITH illicit drug use now at the top of John Howard's agenda for Friday's
premiers conference we can be pretty certain of one question that our
leaders are not going to be asking why are drugs such as heroin illegal in
the first place?

They haven't always been so, and there may well be a strong argument for
returning to that situation. Does one need to remind people of the
relatively innocuous presence of heroin in cough mixtures in Australia in
the 1940s? Or that the AMA opposed heroin's being made illegal? Or that
there were no fatal heroin overdoses in the 10 years before its banning?

The standard argument for banning these drugs is that they are highly
addictive, heroin in particular, and therefore potential users of the
relevant substance have to be "saved from themselves" by not being given the
chance to sample them and so become hooked.

This argument has a number of problems, the most obvious being that we
already have two major addictive drugs, alcohol and nicotine, which are not
banned and which it would be quite impractical to ban. We need only recall
the prohibition era in the United States to remind ourselves of these
impracticalities. It may seem strange then, in this context, to recall that
tobacco and alcohol cause many more deaths and more extensive human misery
than all of the illicit drugs put together 18,124 deaths in Australia in
1995 directly attributable to tobacco, for a start.

Of course, some argue that if we'd had a ban on tobacco and alcohol we would
have saved many lives. It seems obvious to almost everyone, however, that a
ban on two such well-entrenched substances would cause massive problems of
compliance, destroy important industries, deprive the country's governments
of much-needed revenue and cause massive corruption in law-enforcement
agencies. On balance then, the banning of tobacco and alcohol doesn't seem a
good idea even to those who "never touch the stuff" themselves.

And it's here that we arrive at the aspect that our premiers are most likely
to ignore. In a secular democratic society, what right does anyone have to
ban a substance and/or behaviour which gives pleasure to the user or
participant and causes no direct harm to anyone else? Thus, while we do not
ban tobacco, we have the reasonable insistence that people smoke outside
rather than in unventilated public enclosures. Analogously, we have the
relegation of previously illegal brothels, unused by most people, to
non-residential areas.

The argument that cigarette smoking is not in our fellow citizens' best
interest is, morally speaking, irrelevant to the case. The adult citizen has
a right to information about a particular drug (eg, the clear statistical
connection between tobacco smoking and heart disease) but it is hard to see
why, in a democratic society, he or she should be forcibly prevented from
using it. In such a society the greatest right we have is to warn not to
legislate.

In a democratic society we regulate to ensure (or try to ensure) that
alcohol and nicotine are available only to those who are old enough to make
up their own minds about the risks involved. Both substances can cause
life-threatening addictions and are destroying many lives. But again we
don't ban them. That's the kind of thing you see in theocracies and other
forms of "we know better than you" totalitarianism.

It is hard, then, to see that most illicit drugs are any different in kind
from alcohol and nicotine. They may, in some cases, be more addictive. They
may cause some strange behaviours but when this is significantly anti-social
it can be dealt with just as the anti-social consequences of alcohol and
nicotine are dealt with. If people using a certain drug threaten serious
injury to others they can be dealt with in ways analagous to the way that
random breath testing addresses drink-driving.

This is not to argue that currently illicit drugs such as heroin, cocaine,
ecstasy, amphetamines and cannabis are harmless. That would be extremely
naive given the scientific literature and what many of us know from personal
experience. The statistical implication of heavy marijuana smoking as a
trigger for onset among those predisposed to schizophrenia is just one
example.

The facts are that currently illicit drugs tend to damage consumers only
(which is not to say that their family and friends don't suffer as they do
with tobacco or alcohol). However, the presumptuous banning by the majority
of substances which a minority uses for its own pleasure is bound to be, as
history suggests, resoundingly unsuccessful and corrosive of the society as
a whole, if only through the inevitable, and widely observable, corruption
of law enforcement in such matters.

It will not take long for Mr Howard and others to muster the usual
objections that this "opening of the floodgates" calls up. Many more people,
they say, will try these drugs and become addicted than was the case when
they were illegal. The state will have to pay much more for rehabilitation.
The "security fence" of banning drugs should be put at the top of the cliff
rather than having the "ambulance" of rehabilitation at the bottom. The
costs, they assert, of an education campaign about the real effects and side
effects of the newly legalised drugs would be prohibitive.

If it were purely a financial issue there would have to be some delicate
accounting to be done. On the one side would be the dollar cost of current
law enforcement (and its corruption), court costs relating to drug offences,
prison costs, tax non-compliance by dealers, losses suffered by individuals
and businesses being robbed to sustain existing heroin habits which now cost
much more to support than if the substance were legally available. On the
other is the huge amount the current war against drugs is costing.

And certainly there would be human costs in legalisation or, more
accurately, regulation. It's hard to calculate how many people might become
occasional users or addicts if prohibition were lifted. Certainly some would
and these would involve extra costs for rehabilitation facilities for those
who wished to end their addiction. It would also obviously cost money to
administer and regulate the supply, irrespective of what form the market
eventually took. Experience with the partial decriminalisation of cannabis
in the ACT and South Australia indicates that usage in those places has
stayed at much the same levels.

Thus, though the costs of regulation would be significant we also have the
principle of not letting citizens die in the streets from diseases traceable
to their own misguided behaviour (lung cancer and emphysema, to name just
two) is well established. Assisting future addicts wishing to address their
medical problem would be simply an extension of the existing principle. So
too would harm-minimisation measures which help to manage addictions until
such a time as the addict is ready to come off the drug. In some cases,
certainly, this might never occur as is the case with some alcoholics.

We do not, however, diminish the status of alcoholics as independent adult
human beings by wagging our forefinger at them and telling them that we
know, from our lordly omniscience, that alcohol will be bad for them and
therefore they will have to buy it at a sly grog shop (which will almost
certainly not sell true quality, will not pay taxes and will have had to pay
off the local police). Nor do we wave a similar finger at those already
obese people in fast food outlets who are almost certainly hastening their
own death by over-consumption of fats.

It should be emphasised that we are talking about adults here. The argument
against allowing minors who are not yet in a position to make an informed
decision about drug taking is much stronger. Those who sell drugs to minors
(whether it be heroin, cigarettes or alcohol) are in effect exploiting their
ignorance and inexperience and must obviously be deterred. Admittedly this
is not going to be a lot easier than enforcing the current general
prohibition but at least it would be being attempted for logical and morally
worthwhile reasons.

It might be easier, too, if our law-enforcement resources were concentrated
on this important, but finite, sector of the problem. As far as education is
concerned much would need to be done to counteract the "cool effect" where
illegal behaviour is seen by the user's peer group as daringly romantic. If
the substance being used was not illegal after age 18 some of this glamour
factor may be removed but not all of it, obviously. The inclusion of young
ex-addicts in such education programs would again be an obvious advantage in
rendering the whole issue of illegal drug-taking less romantic. As far as
adults are concerned, however, it is hardly logical, or morally justifiable,
to be telling someone who is fully qualified to vote that we forbid him or
her from embarking on any activity which may prove, in our superior opinion,
to be self-destructive.

CLEARLY, there are no simple solutions to what both sides of the debate are,
not inaccurately, calling the "drug scourge". Those who have tried
unsuccessfully many times to give up tobacco will not be surprised to learn
that giving up heroin is not something achieved over just a few days of
"strong-mindedness" or even through six months in a sympathetic
rehabilitation facility. All are agreed that the lifestyle involved in
sustaining a significant illegal heroin habit does no-one any good.

Advocates of "zero tolerance" and "abstinence" treatment methods continue to
clash with "harm minimisers" who argue that a functioning human being who
has an ongoing but managed habit is better than one dead from an overdose.
Most of these "harm minimisers" recognise that no single approach is going
to work for every addict and that a range of different strategies needs to
be employed.

Underlying all this, however, is still the issue of whether any drug used
for pleasure should be illegal in the first place. In the short term, the
consequences of regulating for adult consumption all of these drugs might
seem apocalyptic and would obviously have some negative consequences. Even
so, there seems to be no logical or moral reason why those of us who don't
use illegal drugs should continue to ban them on the grounds that we know
better than our fellow Australians what is good for them. We have long
recognised the limits of our interdictive powers in relation to alcohol and
cigarettes (and fast food). Why is it taking us so long to attempt the next
rational step?