DRUGS AND HARM MINIMISATION

This address was given to The 'City of Melbourne - Community Forum on
Illegal Drugs' at the Melbourne Town Hall on Monday 30 March, 1998

I congratulate Melbourne City Council for this Drug Forum initiative. If
there was a simple solution it would have popped up somewhere in the world
by now so we do not come with unrealistic expectations. Although none of us
have the solution to the drug crisis we do have a common commitment to keep
talking and cooperating because this is our problem. When nearly as many
people died in Victoria from drug related causes as road deaths and the
cost to our economy of heroin, cannabis and cocaine turnover is 0.5% of GDP
it is truly our problem and not just confined to a few miserable addicts.
Each day I come to work and see disused needles. At least once a week I see
someone openly injecting. Sometimes they are embarrassed and try to hide
from my gaze. Mostly they don't even blink. Of the 20-30 young people we
feed each day 70% regularly use heroin.

I fully support the notion of harm minimisation. This suggests that drug
use isn't to be primarily approached in moral categories of good and bad.
Nor does it work on the disease theory that addicts need to be sought out
and then treated because of a pathology. Rather, harm minimisation is a
public health approach that focuses on the patterns of drug use in the
community that includes all of us, namely our drinking, smoking,
self-medicating and our search for chemical pleasure. Between those who
abstain at one end and those who use heavily at the other most of us lie
somewhere in the middle. This helpfully shifts the focus away from
alcoholics and addicts toward a public conversation about alcohol and drug
related problems that affect all of us.

Whilst I wish to retain aspects of the law enforcement and therefore, the
prohibitionist model, it is clear that charging, sentencing and imprisoning
those with drug problems is not adequately addressing this social problem.
Police resources have to focus on traffickers rather than those possesing
for personal use.

Whilst there are many types of drug use from those who are gainfully
employed and smoke marijuana or use heroin as a recreational drug to those
who are tragically addicted in a life threatening way, I believe the extent
of the growth in drug abuse reflects a fragmenting community. Many of the
young people that we work with at Collins Street Baptist Church simply do
not believe in this whole enterprise that we call society. They are neither
motivated by its promises of reward nor involved in its public discussions.
They have literally checked out of this society which by and large has
promised them no jobs or future. Tragically, many are checking out of life
itself. Drug abuse becomes an obvious out growth of such a culture of
rejection and pain. Curiously for others their trafficking is reaping huge
rewards and makes them some of Victoria's most successful businessmen and
women.

It is my belief that we need to find a middle road between deterrence and
support. It should include full harm minimisation strategies that offer
counselling, education and literature to those injecting in needle
exchanges and safe houses sometimes called a shooting gallery. Just as the
Police agree not to track and prosecute those frequenting needle exchanges
these safe house would be also immune. But they need to be tightly and
professionally managed. Elsewhere, however street and private use would
still be illegal.

This intentionally acknowledges that though illegal many will still shoot
up and their safety is paramount. Effectively we have defacto shooting
galleries already without the proper opportunities for the educational
imperatives. Harm minimisation must include vigorous educational
initiatives such as the Premier's recently funded Youth Substance Abuse
Service. That scheme, which is to be based in households aims to avoid
sending young people to institutions where they may be treated alongside
alcoholics or other drug abusers many years older than themselves is
welcome. Likewise, the proposed School Drug programs are extremely
important.

However, the law enforcement model still has a role. The power of the TAC
advertisements and educational programs lies not just in its persuasion.
The visible presence of booze buses and the regular charging of people for
drink driving, is a heavy handed sanction that also deters irresponsible
drink drivers. Likewise to avoid tobacco companies and others agressive
marketing decriminalised or legalised drugs like marijuana the legal
boundaries need to be clear. When they are shifted the market simply moves
to the next illicit substance and ruthlessly exploits it. Hence, some legal
sanctions are still very important.

In my view it is not an argument to say that many of our marijuana laws are
disobeyed to some degree and therefore should be replaced. All laws are
disobeyed to some degree. Most Victorians obey the marijuana laws most of
the time. For our young people, the law still plays an important role and
it still reflects our community belief that drug abuse is unacceptable. At
the end of the day, we will become a bankrupt society if we tell our young
that it is permissible for them to be stoned on drugs as long as they don't
steal our video recorders. Somewhere along the line we have to say no as a
society and the law does play an educational role even if it is simply
heard to say we prefer you don't use and here is why.

Decriminalistion may break the nexus between dope and harder drugs but it
will almost certainly lead to an increase in drug use just as the removal
of alcohol prohibition in the U.S did. For most parents this defies
commonsense as their one remaining lever to say to their children is this
is against the law. Try talking to the average parent who is struggling to
relate to their pot smoking adolescent. They will tell you of the obvious
disintegration in their children and how the lack of self-insight means
they are greeted with hostility and denial that marijuana is in fact the
cause of their decline. Pity the teachers who will inevitably face stoned
students ignorantly telling them dope is legal (forget the subtle legal
differences ) once decriminalised.

Whilst prohibition of alcohol did spawn crime. It is often not related that
during this period of prohibition in the U.S. there was less alcoholism,
far fewer alcohol related deaths, less marital violence, lower
hospitalisation rates and costs, fewer mental hospital cases. The accepted
convention in introducing therapeutic drugs is to demand careful trialling
before permitting release onto the market. The evidence suggests that it is
a myth to say marijuana use is safe and the law must still convey that
there are dangers associated with its use.

Australians are commonsense enough to accept contradictory aims. They will
understand that shooting galleries don't make sense when something is still
illegal but they will prefer to save lives and live with the apparent
contradiction whereby the law declares this unacceptable with a social
sanction attached.

In conclusion we must think laterally. We should encourage drug abusers to
undertake treatment by offering expungement of drug related criminal
records if they pursue rehabilitation. We must avoid the hypocrisy of
lecturing our kids about illicit drugs while drinking ourselves into
oblivion. We must own the fragmentation of a culture that rewards winners
and punishes losers thus intensifying hopelessness and the refuge of
analgesics.