i thought people might be interested in reading my article from Whack (magazine of Victorian User group), March 2001, also carried in a slightly different form in Green Left Weekly
www.greenleft.org.au
apologies for the length of the post. a lot of the article does use heroin as the basis for the debate, but i try and lay the argument for across-the-board legalisation
Options for drug law reform
BY MICHAEL ARNOLD
Over recent years the “drug problem” has been regularly discussed in the corporate media. In the midst of this discussion, more than 1000 Australian heroin users have died as a result of overdoses between 1996 and 2000.
While drug forums and community consultations have been held in many
localities across Australia, the federal and state governments refuse to
consider alternatives to drug prohibition. This is despite the arguments of
many doctors, law enforcement officers, health professionals, and drug users
that this approach has resulted in an explosion of property crime, a crisis in
public health and the systematic persecution of a large section of the
population.
The federal government’s National Drug Strategy enshrines a policy of “harm
minimisation”. Harm minimisation contains three pillars:
l<~>Demand reduction — education aimed at stopping people from using
drugs; as well as counselling or job-creation that may reduce the impetus for
some people to use drugs.
l<~>Harm reduction — programs that seek to reduce direct harm to users,
e.g., needle syringe provision and disposal services, methadone programs,
etc.
l<~>Supply reduction — programs that boost police and customs resources
and seek to stop the flow of drugs into the country or a particular suburb.
Most government resources are allocated to supply reduction. But supply
reduction measures often negate harm reduction work. With less of the drug
available, users often substitute another drug, causing damage to their
health. As the price is driven up, petty property crime increases as users look
for a way to obtain the money needed to purchase the amount of the drug
that their body has become accustomed to.
This is what has happened in Australia during the last seven months, as the
supply of heroin has dried up, partly as a result of police measures.
It is evident to many people that the current laws and policies surrounding
drug use are bankrupt and need to be changed. What form change should
take is a matter of heated debate.
There are three main options canvassed in the drug reform debate:
medicalisation, decriminalisation and legalisation.
Medicalisation
Medicalisation refers to making currently-prohibited drugs available through
prescription by a medical professional. This system was trialed for heroin in
Switzerland between 1996 and 2000, and is now a feature of Swiss medical
practice for provision of both heroin and, in a more limited way, cocaine.
During the Swiss heroin trials, which involved around 1500 participants,
participation in violent crime dropped to one-seventh of its pre-trial rate, with
only one participant in every 100 committing violent acts.
Prior to participation in the trial around one user in every four suffered from
symptoms of depression, schizophrenia and other forms of mental illness.
After one year on prescription diacetylmorphine (heroin), only 5% were
affected by these conditions. Drug user participation in property crime
dropped by half and dealing dropped to one-third of its pre-trial rate.
Over the last five years a range of new pharmacotherapies (drugs used in
the maintenance of or withdrawal from an opiate dependence) have been
trialed in Australian capital cities. The most trialed, buprenorphine, will now
be available through GPs.
When the pharmacotherapie trials were originally conceived, a
diacetylmorphine provision trial was to have been included (known commonly
as the “ACT heroin trial”, although it would also have involved Melbourne,
Sydney and Adelaide users). This was ultimately blocked by the Howard
government, which refused to alter federal laws to allow for the importation or
production of diacetylmorphine.
Supporters of medicalisation argue that it allows users of drugs that
potentially have damaging effects to the body and/or mind access to
continuous medical care. They argue that the process of obtaining a
prescription may discourage young people from starting to use these
substances, particularly in an ongoing way that could lead to dependence.
And of course those users who are able to access prescriptions will receive
affordable, medical-grade gear.
But under these programs, drugs users are reliant on medical practitioners
for their drug supply. This has the potential to significantly reduce users'
liberty. Methadone maintenance programs (MMP) are an example of the way
in which medicalisation of a drug can be used as a form of social control.
Methadone is a synthetic opiate which prevents a user from feeling heroin
withdrawal symptoms. Taking methadone regularly allows me to work without
the daily stress and financial pressures associated with a heroin
dependency. However, as a participant in a MMP I must report to my
pharmacist five days a week. Having been a “very good boy” for five years,
and having a constructive relationship with a very good doctor, I have the
“luxury” of two take-away doses a week. I also have the more unusual
privilege of being able to get dosed at another chemist while I am working in
the city during the week.
However, in order to go away for work, pleasure, or protest I must apply
weeks in advance for take-away doses or to use a different chemist. And I am
not allowed to be away from a chemist for seven days. Users without good
relationships with their doctor or chemist, who return “dirty” urine tests or who
are hit by financial difficulties, stand to lose take-away privileges — denying
them freedom of movement — or may lose access to methadone altogether.
This can mean that they must satisfy a massive opiate dependence — often
paid for by crime — or face a withdrawal potentially far worse than that
associated with heroin use.
Participants in the Swiss program must attend three times a day to be dosed.
This often causes massive lifestyle disruption and severe restrictions on
travel.
So medicalisation can either benefit or control users’ lives, depending on the
conditions of the programs.
Decriminalisation
The second option is decriminalisation. This involves the removal of criminal penalties from the use
of illicit drugs.
Where drugs have been decriminalised, possession, and production of these
drugs for personal use, is often dealt with like a traffic law infringement. The
obvious benefit from decriminalisation is that users do not receive a criminal
record or face the threat of jail time if found with drugs.
However, in most decriminalised systems the state maintains the right to
enter your premises or search your person, seize your stash, and you cop a
fine for your troubles.
In South Australia and the ACT, possession and growth of small amounts of
marijuana have been decriminalised. But the hassles associated with growing
your own dope means that most users still rely on the black market.
It is unclear how decriminalisation of fully-synthetic drugs such as speed or
ecstasy would work. They need to be produced by trained chemists, not in
backyard laboratories. The amount of poppy required for making heroin, and
the skill needed to turn opium into diacetylmorphine indicates that production
and distribution of opiates is unlikely to be carried out by amateurs.
Decriminalisation supporters proceed from the premise that citizens need to
be protected from currently-illicit drugs, but that drug use is primarily a
medical issue, not a legal one.
In my opinion, it remains a part of the prohibitionist arsenal, and is s unlikely to lead to a fundamental change in the treatment
and well-being of drug users, as the black market will retain control of
production, and the police will continue to engage in supply control
measures.
Legalisation
My preferred option for drug law reform is full legalisation. This means the
removal of all legal restrictions on access to drugs, with the possible
exception of age limits (which are already applied to legal drugs).At the same time as laws on the use of drugs are lifted, a range of new laws may need to come into place governing production and distribution of drugs.. The most likely form of
distribution under a legalised system would be over the counter at
pharmacies, or through pubs or cafes.
Legalisation recognises the basic human right to control our own bodies and
minds. Laws should be used to protect users’ consumer and medical rights,
not as instruments of social control.
There are yet to be many working examples of full legalisation of an illicit
drug in the developed world. The International Narcotics Control Board
usually acts quickly to stomp on any reform agenda. However, legal advice
provided to the Swiss and to Australian policy reformers suggests that the
Convention on Narcotics Control does allow nation-states the right to
determine their policy on legality if they feel changes will benefit the health
and well-being of their citizens.
I, and the majority of drug-user activists I know, support the full legalisation of
illicit drugs used for recreation or self-medication. However, for speed,
cocaine and heroin in particular, medically supervised trials that provide the
drug to dependent people is likely to be a vital first step.
A current issue for the movement is the recent reports that marijuana reform activists in Nimbin have actively opposed reform options for users of other drugs in a campaign that is being waged in Northern NSW in response to police arrests. It is certainly not a new phenomena. This “pot-purism” is slowing the development of a united movement for law reform.
All drugs, including pot, can be used in ways that are harmful, or in ways that
are of personal benefit — social, emotional, or physical. This is likely to be
true regardless of the legal system controlling the use of drugs. Until legal
barriers are removed, we will not know which harms are caused by
prohibition. Thus we do not really know how to target harm reduction and
other health messages for users.
Divide and rule is the oldest strategy in the book. Its employed to keep oppressed groups on the fringes. Users across the country are understandably desperate to pressure policy makers into implementing law reform. But selling users of other drugs down the river in order to cut a deal for your subculture is not the way to do it. Building a united mass movement of drug users and our supporters is.
A significant number of pot smokers (I don’t have exact stats although its probably not quite a majority) also use other drugs. Until we have across-the-board reform these users will continue to face the threat of arrest and incarceration.
Safe injecting rooms
One of the main topics of public debate in recent years, particularly in Melbourne, Sydney and
Canberra, has been safe injecting rooms, labelled ‘shooting galleries’ by the tabloids. These facilities, now being referred to as Medically Supervised Injecting Facilities, offer users a safe, sterile environment in
which to use the drugs they have purchased.
Research, including extensive interviews with users conducted by VIVAIDS as part of the Drug Policy ExpertCommittee consultative process, suggests that injecting facilities will only ever cater for a very particular group of users — generally dependent, and often homeless, users or those who use away from their home.
For these users, facilities like the one recently established in Kings Cross
(which have functioned in Europe for 10 years) offer a great opportunity to
inject somewhere where the risk of virus transmission is minimal, where you
can receive attention if you overdose, and access other services if needed.
These centres, however, would not be necessary if users could access
controlled, regular and affordable doses of their drug of choice. Overdoses
— one of the main harms the centres overcome — affect a majority of lone
users taking drugs in their own home. They can be caused by a sudden rise
in drug-purity or, more often, the combination of the drug with sleeping pills
and/or alcohol (taken to reduce withdrawal symptoms or to supplement the
effects of poor quality heroin). Users often use alone due to fear of prosecution, or concerns about the reactions of family and friends.
Affordable heroin would free users from the poverty traps that result in
homelessness, and allow users to take their drugs in a safe way in their
preferred environment. Safe injecting rooms are an important step, but
hopefully the need for them will be short-lived.
[ 23 October 2002: Message edited by: mibrane ]
