Can Australia respond to drugs more effectively and safely? | REPORT | SMART Recovery Australia

A report on whether Australia could develop safer and more effective policy in relation to illicit drugs has been released by independent public policy-focused think tank, Australia21. The report is the result of a full-day roundtable conducted at the University of Sydney that comprised of 17 law enforcement experts — retired judges, prosecutors, senior police, prison and parole administrators, drug law researchers, and advocates, including Alex Wodak, who was responsible for bringing SMART Recovery to Australia.

[The views and opinions of authors expressed herein do not necessarily state or reflect those of SMART Recovery Australia.]

The Report’s thirteen recommendations for illicit drug law reform

1. The overriding objective of Australia’s national policy on drugs should be the minimisation of harm to those who choose to use psychoactive drugs and those around them, and a reduction in the likelihood that those who use such drugs, choose substances that harm their health and the wellbeing of others. The emphasis should shift from trying to stamp out personal use of these drugs, to assisting people to make wiser choices about their use and minimising harms when they make unwise choices.
2. The policy should include substantially reducing, if not eliminating, the size of the criminal marketplace by incrementally moving psychoactive drugs from the black market to the ‘white’ market. This should be accomplished by regulating and, where possible, taxing the supply of currently illicit drugs, with the regulation of supply being gradually phased in and assessed on an ongoing step-by-step basis, starting with drugs which are known to do least harm and are least contentious. Ongoing assessment and review will determine the desirability and extent of regulation and whether regulation should eventually be extended to all psychoactive drugs. Advertising of any legalised and regulated drugs should not be permitted. Some drugs will require stringent controls, such as prescription by a doctor.
3. Community understanding of Australia’s current drug laws and practices should be promoted, including evidence that disproportionate funding is going into ineffective drug law enforcement, while inadequate funding is available for harm minimisation and treatment of those who are addicted to illicit drugs. Understanding that use of drugs of all kinds is primarily a health and social issue, not primarily a law enforcement issue, and that Australia has already progressed a long way down the path of decriminalisation of possession and use of some psychoactive drugs, has been distorted by the way current policy has been implemented.
4. While law enforcement will always be important to managing illicit drug use in Australia, the focus should not be on whether a user has taken or possesses these drugs for personal use but rather on associated criminal or antisocial behaviour including dealing effectively with the black marketeers. The criminal and antisocial behaviour that is a common consequence of habitual psychoactive drug use is largely a result of the high costs of maintaining a drug habit supplied by the criminal marketplace, as well as, in some cases, the specific effects of the drug.
5. Currently, people purchasing illicit drugs from criminal sources have no idea about the purity or safety of the drugs they plan to consume. In order to be better informed and protected, users should be able to submit the drugs for testing in a controlled environment. In a number of overseas countries this is being done in proximity to music festivals where psychoactive drugs are extensively sold and used. Making such facilities available in Australia will help prevent avoidable deaths and overdoses.
6. Current practices to test drivers for the presence of psychoactive substances in their blood should be rigorously reviewed with respect to efficacy and cost effectiveness. The purpose of such testing should be to ascertain whether the driver is unsafe or unfit to drive as a result of psychoactive drug use, not to ascertain whether he or she has consumed a proscribed psychoactive drug. This issue will become a particular concern as the proposed new laws governing use of medicinal cannabis come into effect.
7. To the extent that police in any jurisdiction operate under Key Performance Indicators (KPIs) that include arrest rates for use and possession of psychoactive substances, such KPIs should be considered only partial measures of ‘success’ unless they also include harm reduction measures. Policing to achieve certain arrest rates risks being counterproductive to the central aim of harm reduction.
8. Drug treatment and associated social services should be expanded especially in rural areas. Savings made from cutting back unproductive law enforcement activities should be re-allocated within law enforcement to areas that provide more benefit to the community. Increase in resources available for drug treatment and social integration services should be funded from other sources.
9. Opium Substitution Treatment (OST) including methadone and buprenorphine should be available for all prisoners, sentenced and remanded, who meet agreed criteria for heroin dependence, and continue to be available following release at reduced cost. Current high co-payments for people undergoing OST, a predominantly low income population, are a significant price barrier that delays or prevents entry to treatment and encourages premature attrition from treatment.
10. An expanded OST service, together with further investigation into the drivers of prison costs, could lead to substantial reductions in the Australian prison population and in the costs of prison arrangements. This should be systematically explored by both state and federal jurisdiction task forces and warrants serious attention by the Australian Productivity Commission and the Australian Law Reform Commission.
11. In view of the long and successful operation of the medically supervised injecting centre in Sydney, serious consideration should be given to the establishment of controlled drug consumption rooms in other parts of Australia. Staffed by professionals, these would help minimise fatal and non-fatal overdoses, reduce HIV and other blood-borne viral infections, provide detoxification services, and encourage referral for health and social assistance. They would be community centred and lead to safer neighbourhood environments.
12. Australian authorities should review the 2013 New Zealand Psychoactive Substances Act and consider its suitability for adoption with such modifications as may be necessary to suit contemporary Australian conditions.
13. While many of these recommendations are supported by international experience and evidence, their adoption here will require carefully evaluated local evidence. Two pilot projects to trial and evaluate the health and social programs recommended in this report should be conducted — one in a remote disadvantaged community and another in an urban community with substantial social and drug related problems. Both projects should target critical local health or social problems and identify local champions to encourage community involvement in program design and delivery. Evaluation of the pilots should guide expansion of the programs elsewhere.