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Thursday 12 August 1999

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Drugs: the right advice

By DAVID PENINGTON

MORE than three years ago the Premier faced up to the serious problem of open sales of heroin on our streets and the rising death toll from drug overdose. His advisory council was established to explore what needed to be done. After extensive consultations in the community, with experts around Australia and internationally, the council made more than 70 recommendations, every one of them unanimous.

After intensive lobbying by people strongly opposed to decriminalising possession and use of marijuana, judged by the council to be critical to stopping recruitment of young Victorians to heroin, this aspect was dropped. However, the Government conscientiously adopted almost all the other recommendations and committed new resources.

Since then, what has happened?

The annual death toll from drug overdose has continued its inexorable rise. Those who die come from every section of society, although some groups are particularly at risk. A national survey of age of initiation into heroin use has shown younger and younger children experimenting with heroin. Deaths from drug overdose occur most commonly 6 to 12 years after initiation. We face, therefore, years of increasing deaths from drug overdose and increasing recruitment of young people to heroin use unless we successfully tackle the problem of initiation, as well as continuing with every effort to retrieve those already heroin dependent.

Why is Australia particularly at risk from heroin?

The International Narcotics Control Board of the United Nations reports that world production of opium is at an all-time high. The bulk of production is in South-East Asia and South Asia. There is a huge glut of opium products and Australia is the nearest ``wealthy'' market. It is acknowledged that only 10 to 15per cent, at best, can be seized, despite every effort of police and customs - hence the ``flooding'' of our markets, with falling prices and increasing purity. The illicit drug industry is estimated at $7billion by Access Economics for Australia in 1996. It can buy its way through all manner of obstacles.

Marijuana users represent a ready market for heroin traffickers to access. A recent national survey of schools showed that 55per cent of 17-year-olds admit to having at least experimented with marijuana. In 1998, 2.7million Australians admitted to having used marijuana within the past year. A cap of heroin now costs less than a ``reefer'', so marijuana users are the population at greatest risk, and the great majority are young people. They have already contravened the law to use cannabis, so trying heroin is no ``big deal''.

Why is there such opposition to changing failed policies?

Opposition comes from a number of sources. For some it is simply a moral issue - drugs are ``evil'' and should not be touched. Such people do not want to look at any evidence that challenges their view. In respect of the ``moral'' stance, I remind them of the parable of the Good Samaritan. The Levites passing by on the other side were not seen as the moral individuals!

Others fear that any change to the law would be interpreted as ``sending the wrong message''. My concern is that we are sending no message relevant to marijuana users. Young people, sensitive to hypocrisy, are well aware that alcohol causes many more deaths in our society than marijuana. In 1997, 3700 deaths were attributed to hazardous and harmful alcohol consumption in Australia. Just one was thought to be connected to use of cannabis.

We are told by those most vehemently against marijuana that it is just as dangerous as any ``hard'' drug. However, the INCB, the world's expert body, does not agree. It ranks the relative harmfulness of drugs at one overall, with opiates ranking 2.79 and cannabis 0.47. There is no doubt that marijuana abuse causes social and mental problems, including ``drop-out'' from education and employment, exacerbation of any tendency to schizophrenia and other psychiatric problems. This is a health issue that needs to be tackled appropriately.

The problems with marijuana are from frequent and regular use by a minority. Yet we send no selective message about these dangers, and the overall ``message'' from the law is clearly ignored. We need a vigorous, health-based campaign against marijuana abuse, just as we have mounted, with some success, programs against alcohol abuse by car drivers.

VicHealth would be the right vehicle. To make it credible, a period of suspension of prosecutions for possession and use, and for growing a small number of plants, would help, while retaining a financial penalty for use of cannabis in public or in schools. Trafficking, especially to children, should continue to incur severe penalties.

In those states or territories where possession and use has been decriminalised, use is no greater than in those where this remains criminal. Italy decriminalised possession and use of all illicit drugs in 1993, but now has a substantially lower death rate from drug overdose than does the UK, Sweden, the US or Australia.

What do we do about dependent heroin users?

Most dependent users commit crime, prostitution or trafficking to earn money to support their addiction. They choose not to come into contact with treatment or counselling services. In many cities in Germany, Holland and Switzerland, safe injecting houses have been operating for up to 10 years. Death rates have fallen by five to 10-fold in these cities. In most facilities, there has not been a single overdose death. Users come into contact with professional services and some, in time, choose treatment.

The Swiss nation held a referendum on 12June this year. They decided, by a large majority, to make heroin available on medical prescription to dependent users with the expressed intention of taking the trade out of the hands of criminals and freeing society from the associated crime.

Although we are not yet ready to take that step, provision of safe injecting facilities for dependent users under appropriate medical supervision is a very necessary first step.

Dr David Penington was chairman of the Premier's Drug Advisory Council. E-mail:opinion@theage.fairfax.com.au

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