Note: The Democrats are one of the smaller parties in Australia, but are
soon to hold the balance of power in the Federal Senate.

BREAKING THE CYCLE

Thirty-four heroin users have died in South Australia this year. SA
Democrats leader MIKE ELLIOTT looked for a solution on a study tour.

WHY spend my time on heroin addicts? Because drug users are
somebodies. Somebody's son, daughter, sister, brother, father, mother.
They come from all sectors of society. They are ordinary people with
an extraordinary problem. In Australia, we introduced drug laws to
protect people but these laws have ended up killing the people they
were meant to help.

South Australia has an eight times greater rate of drug deaths than
the Dutch and about twice the Swiss rate. SA's laws also cost our
community dearly. We all share the cost of crime.

After spending two weeks studying the drug policies of those two
countries, and their implementation, I've come back convinced that
there is not one simple solution but a suite of approaches which offer
some hope and are certainly an improvement on our present situation.
We need law enforcement, which is focused on the pushers and a health
and social approach adopted towards users.

I witnessed the programs, spoke with the health professionals,
politicians, police and drug users.

The Dutch experience

The Netherlands reported 65 drug deaths from a population of 15.4
million people in 1995, compared to SA's 34 so far this year (from a
population of 1.3 million people). The United Kingdom, with a
population of 58 million and similar drug policies to Australia,
experienced 1778 deaths in that same year.

The most important action taken in the Netherlands has been the
separation of the market for cannabis from the markets of other more
dangerous drugs such as heroin, cocaine and amphetamines.

Although there has been no legalisatlon of cannabis, the country has
allowed cannabis to be sold through "coffee shops" so long as a number
of rules are abided by, including:

o It cannot be sold to under-18s.

o There is a limit on the amount of cannabis which can be held in the
premises at one time.

o There is a limit on the amount which can be sold to one
individual.

O No other illegal drug can be sold or used on the
premises.

What this has done is to establish a place where cannabis can be sold
without other drugs being offered.

It is worth noting that the consumption of cannabis in the Netherlands
is about on par with neighboring European nations and about half that
of the United States. There has been no explosion in use.

The evidence tends to suggest that the number of young Dutch people
using heroin has decreased rather markedly in recent years.

The low recruitment into problematic use of heroin in Holland suggests
that if there is a link between cannabis and harder drugs, it is that
they are often sold through the same networks, not that using cannabis
leads to the use of harder drugs.

The Dutch are also running vigorous education programs based on
honesty and realism, within the community and through schools.

If you are not honest about cannabis, you won't be believed about the
harder drugs such as cocaine or heroin.

For me, the most powerful and personally distressing experience of the
tour was the "consumer rooms" which the Dutch and Swiss have
established with the encouragement of police and the Government. What
we know as "shooting galleries" in Australia, the rooms offer a safe
haven for drug users to inject or inhale heroin.

The reality of witnessing people injecting themselves in arms, legs
and even eyebrows was distressing. I am convinced, however, that
consumer rooms are a crucial component of tackling the drug users'

problems.

The most dangerous aspect of heroin use is the potential to overdose.
Since the consumer rooms were established over the past four years,
there have been few, if any, deaths in the rooms, due to the first-aid
assistance which is always on hand.

These rooms also supply clean needles and syringes and maintain a
level of hygiene, which limits the spread of infectious disease.

Close to 50 per cent of problematic users were previously not in
contact with potential help. User rooms bring many of these people
in.

I was surprised that their locations made minimal impact on the
neighborhoods in which they were situated.

The Dutch have just started a heroin prescription trial similar to
that operated by the Swiss and one proposed for Australia.

Heroin addiction is one that is not easily broken. It can only happen
when the "addict" is ready.

The Swiss heroin prescription program

In Switzerland, about 30,000 of its population of eight million people
are hard drug users. Drug-related deaths through overdose decreased
from 419 in 1992 to 241 in 1997.

In 1994, the Swiss began a heroin prescription program with 1000
patients. Prescription is about keeping people alive. It is about
allowing a level of normality to return. It resolves the preoccupation
about where the net fix will come from, where the money will come
from. The user can now think about life, where to live, establishing
relationships, employment and, hopefully, getting off heroin.

At the first government-sponsored Swiss trials, program entrants had
to be addicted for at least two years (but more usually five or more
years), they had to have failed in at least two previous trials such
as methadone or abstinence programs, and they had to give up their
drivers licence.

Heroin clinics open for two hours, three times a day, seven days a
week. Clients are given heroin in a syringe and return it after use.
Their health and social welfare are closely monitored and they are
provided with other assistance as needed.

By 1998, 120 clients were in abstinence programs and 200 were in
methadone programs - excellent results considering these were the
"tough cases". No patient had died from overdose.

Before entering the program, 70 per cent of the participants bad
resorted to crime to pay for their addiction. Today, this had been
reduced to 10 per cent. Those involved in prostitution were virtually
zero.

As a result of this trial, the Government estimates it saves an
average of close to $A50 per patient day - principally policing and
court costs.

But more than the money - the program has offered a lifeline to those
caught up in the drug cycle.

I spoke at length with two patients, one a 20-year addict, and the
other who had been addicted for 15 years. Both were vehement in their
support for the program. I sensed it had created for them the first
glimmer of hope in all their years of drug use.

This success has the overwhelming support of the Swiss public. A
referendum held last year to close the heroin prescription trial was
defeated 71 percent to 29 percent. The program is now expected to be
extended to up to 3000 at which time there is expected to be no other
suitable clients. (Health professionals say the program is only
appropriate for about 10 per cent of problematic users.) In
Switzerland, there has also been a rapid expansion of consumer rooms
with the support of police and politicians.

The combined efforts in these areas have reduced the plethora of
syringes left in parks and other public spaces. The chances of people
being robbed, mugged, or burgled has decreased. We must remember that
drug users are ordinary people with an extraordinary problem. To
protect them, we made drug use a criminal offence.

Laws designed to protect have had the opposite effect. Rather than
protect, it kills many of them. Uncertain doses and purity are killing
people.

Many others are pushed to crime and prostitution. The programs we
offer simply don't work for many people.

The "bad guys" are the pushers and, in the present regime, they

continue to prosper. Let's continue to hunt down the pushers, but we
must stop punishing the users. The challenge for us - a community is
to make decisions that may be against our own prejudice. But the
decisions should not be hard ones to make. They are decisions of
compassion, of humanity to others.

The Dutch and the Swiss have shown us another way.

We must separate the cannabis market from the market for heroin,
cocaine and amphetamines. I advocate sale through pharmacies, with a
number of safeguards. We must boost our education programs. The
proposed heroin prescription trial must go ahead.

The toughest call is on consumer rooms. But I am convinced that they,
too, save lives and offer hope when otherwise there is little.

Alternatively, we watch more of our loved ones suffer and die. No
family is immune. We must act.

Checked-by: Rich O'Grady