Contents

| Chapter VI. Conclusion | Chapter VII. Questions and Answers | Chapter VIII. Bibliography |

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Chapter VI. Conclusion.

The conclusion of this book is relatively simple. For almost 70 years in Australia we have banned cannabis. For over 40 years we have banned heroin. When it seemed that this policy was not working well we devoted more resources to law enforcement and stiffened penalties. When that did not work, we devoted even more resources to law enforcement and further increased penalties. Now it is becoming clearer to more and more people that prohibition has not worked and never will.

Prohibition has failed to restrict the cultivation of drugs. It has failed to restrict the production or refining of drugs. Only a small percentage of drugs transported from supplier to consumer country or within consumer countries are intercepted. Prohibition is implemented in all countries in the world. Yet availability of most drugs in most countries, including Australia, has increased alarmingly. Drug-related deaths are increasing in many countries. In Australia, deaths due to heroin have doubled in the last ten years and drug-related crime is increasing

Prohibition does not come cheap. In 1989 the annual turnover of the cannabis industry in Australia was estimated to exceed $2.5 billion, while turnover for other illicit drugs was not far behind. Little if any taxation is paid on that turnover. Money spent enforcing prohibition is unavailable for schools, hospitals, the long-term unemployed, Aboriginal health, or enhancing Australia's export industries.

As if that were not enough, prohibition also creates a great deal of "collateral damage". Our civil liberties are eroded. Prohibition breeds corruption; it helps to keep wealthy a criminal underworld and an international network of terrorists.

Prohibition was introduced for reasons which under closer examination now seem arbitrary. Prohibition ignores the inexorable laws of economics. One thing most people agree on is the fact that we will never get on top of an illicit drug industry that globally has a turnover of $US500 billion a year, including, about $US350 billion of profit. We know that if the authorities stop drugs being grown in one part of the world, growers switch to another site. If it becomes too difficult to grow drugs in one part of Australia, they will find somewhere else to hide in the seven and a half million square kilometres available. If it is no longer safe to grow drugs in the open, cultivators shift them under the trees. When that is no longer safe, they are shifted indoors. When it is too dangerous to use large amounts of water and electricity to grow plants indoors, cultivators find ways around that too. We know that traffickers will always be able to find a part of the world where there is enough poverty, political instability and good growing conditions. The more the world improves conditions for legal trade, the more we also help the drug traffickers. Every technological improvement which helps communication and makes industry and banking more efficient also makes it harder to track down drugs and the profits flowing from their illegal trade.

It is time we gave up making war on drugs and drug users, and instead made peace with people who use drugs. We should try where we can to limit the damage that drugs do to people, and endeavour to keep drug users alive and well. Sooner or later, most will give up drugs when they are ready.

Drug policy will develop by evolution, not revolution. We must abandon the search for perfect solutions. There are none. In the first instance, we should try to eliminate criminal penalties on personal use of cannabis. This will probably lead us to another stage where we regulate the sale of cannabis. Ultimately, we can and must also regulate the production of cannabis; large scale unauthorised growing or sale of cannabis should be penalised, just as we penalise unauthorised large scale production or sale of other mood-altering substances such as alcohol.

The Canberra heroin trial at the Australian National University demonstrates how we should investigate managing other currently illicit drugs. After the heroin trial, it may be worth investigating other drugs such as amphetamines. Each drug should be handled on its merits. We should research them one at a time.

At the end of the day, we face a choice. One option is for people who are determined to use drugs whatever we may say or do, to obtain contaminated supplies of unknown concentration from criminals. That is society's present preference. A second option is for such people to have some kind of an assessment from health professionals. If they fit certain criteria and all other measures have already failed to stop them harming themselves and others, we should consider permitting provision of sterile supplies of known concentration of currently illicit drugs in association with assistance and support. Some call this controlled availability. This is the choice we prefer.

We believe that there is growing support among community members recognising the futility of current policies, to find more effective, less expensive and less counterproductive ways of dealing with this issue. What we now need is to find a way of dealing with these long-term problems in a political system which rewards short-term benefits and tolerates long-term costs. Obstacles to reform are crumbling, but the political perception that there are no votes in junkies remains. There will be votes in junkies soon when a few more people start to realise how the current system maximises costs and minimises benefits.

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Chapter VII. Questions and Answers

1. Cigarettes and alcohol cause enough problems already; why do you want to allow dangerous drugs like heroin and cocaine to become freely available?

First, we would rather government controlled the availability of drugs like heroin and cocaine than surrender control to criminals as at present. Second, if governments controlled heroin and cocaine availability, associated deaths and crime would probably fall. At present, health damage and crime from drugs like heroin are increasing, but deaths and diseases due to legal drugs like alcohol and tobacco are decreasing. The system we advocate would make heroin and cocaine harder to get than they are now.

2. Legalising drugs like heroin means more drug use; more drug use means more problems. That can be seen with alcohol and tobacco. Surely that will also happen if you make drugs like heroin legal?

First, if we take the profits out of the illegal drug market, the market will inevitably shrink. Therefore, controlled availability will mean less not more drug use. Second, legal drugs like alcohol and tobacco are quite toxic in themselves. Therefore, the more they are consumed, the higher the death rate. Deaths and diseases from drugs like heroin today are mainly caused by their illegality rather than their pharmacology. Controlling their availability so that users can obtain clean supplies of known concentration means fewer overdose deaths, fewer infections and fewer deaths. Third, Australia is committed to harm reduction. Therefore, reducing drug-related deaths, diseases, crimes and other complications matters more than the quantity of drugs consumed.

3. How do you expect us to tell our kids drugs are bad if you make them legal - isn't that sending the wrong message?

We are more successful influencing consumption of legal than illegal drugs because governments can influence the market. Where we cannot limit consumption of currently illegal drugs, we must rely on limiting damage from their use. Drug-related harm is the real enemy, not drug use per se.

4. Aren't all drug users and pushers merely criminals and prostitutes?

No. Most people who use currently illicit drugs look conventional and are employed, stable and functional. Some users alternate between functional and dysfunctional periods (during which they may be heavily involved in criminal activities and prostitution). Some people out of control on drugs in their twenties are firmly in control in their thirties. Finding ways for these people to minimise damage to themselves and others is what this debate is all about.

5. If you legalise heroin, won't more people use the drug?

First, we are against legaliusation of drugs like heroin in the sense that they would become available uncontrolled over the counter. Second, Australia is committed to reducing harm from drugs, not simply suppressing use. How much harm occurs is more important in Australia than how many people are using a drug. Third, prohibition increases the health, social and economic costs of drug use to deter users and potential users in the hope that this leads to less harm overall. The controlled availability approach we support reduces the health, social and economic costs of drug use and the black market inevitably shrinks when its enormous profits are removed. This will mean less harm from drug use and fewer users as well. Fourth, there has been no detectable increase in cannabis use in the dozen jurisdictions around the world which liberalised policies on cannabis. Many reported substantial savings on cannabis law enforcement.

6. If you start by decriminalising marijuana, won't that just be the thin edge of the wedge - a gateway to harder drugs?

First, we support the maintenance of strict controls on the marijuana market after reform. We should not repeat the mistakes of the tobacco era and allow cannabis to be produced and marketed with hardly any regulations. Second, there is no valid evidence to show that use of marijuana leads to so-called harder drugs like heroin or cocaine.

7. Cannabis causes lung cancer - like cigarettes - and mental illness, and is a much more dangerous drug than people admit. Isn't it logical, then, to ban it?

However dangerous cannabis really is, and most authorities now believe that it causes relatively few health problems, the real question is which policy minimises the costs. Current policy is expensive, probably results in some potential cannabis consumers switching to far more dangerous injectable drugs like amphetamines, gives many users a criminal record and makes it difficult to encourage cannabis smokers to use filters, to a void cannabis if they have a history of mental illness and to avoid driving for several hours after smoking.

8. Heroin is a really dangerous drug. Why make it available for anyone to use it?

Heroin is not a particularly dangerous drug if the concentration is known and it is used under medical supervision. Deaths from heroin these days are mainly caused by depressed breathing leading to an overdose. This happens often at present because drug users do not know the strength of street heroin. The most common side effect of heroin used under medical supervision is constipation.

9. What's next - are you also going to give out cocaine, amphetamines and any other drug that comes along?

Under prohibition, the drug market is inherently unstable as new traffickers try to gain a niche by selling new drugs. Also, under prohibition more dangerous drugs (like amphetamines) drive out less dangerous drugs (like cannabis) because the less dangerous drugs are bulkier and easier to detect. The more concentrated the drug, the likelier there will be side-effects. Prohibition in Asia drove out opium smoking which was replaced by heroin injecting. Under controlled availability, safer drugs would drive out more dangerous drugs. It would be logical to provide stimulant drugs (to those with a long history of using them already) in a form which was less dangerous than that already in the marketplace. But this would need to be tried out in research projects similar to the proposed Canberra heroin trial.

10. If prohibition doesn't seem to work, isn't that because we have not been tough enough for long enough?

Heroin has been totally prohibited in Australia since 1953 and cannabis since 1926. If prohibition worked, we should know by now. If spending a quarter of a billion dollars a year on illicit drug law enforcement is not enouch, how much do we need to spend? Half a billion? Three quarters? One billion? If 8000 prisoners serving drug-related offences in Australia at any time is not enough to make prohibition work, do we need 12,000, 16,000 or 20,000 to make prohibition work? Or do we look to the United States for answers? The United States spends about 60 billion dollars a year on illicit drug law enforcement and has more prisoners per head of population than any other western country. Despite lavish funding and severe penalties, they still have much higher levels of drug use and drug problems than any other western country.

11. How would your system cope with people who have only started to use drugs?

Our system is aimed at the heavy user because we want to minimise harm and most harm is associated with heavy users. In the system we propose, recreational drug users would still buy drugs from a black market. This is not ideal but overall the system would still be better than what we have at present.

12. No country has legalised drugs. Why should we start?

Four countries have provided currently illicit drugs to drug users under controlled conditions. First, in the United States clinics in 44 cities dispensed injectable morphine to selected patients from 1919 to 1923. The project was stopped because it was considered inconsistent with the newly introduced prohibition of alcohol. Second, the United Kingdom has allowed doctors to prescribe drugs (including injectable heroin) to selected heroin users where other methods have failed to help them "lead a normal and useful life". This system has only been implemented on a small scale with minimal evaluation. Injectable heroin was compared with oral methadone in one study and found to be as effective overall. Many patients in the United Kingdom also receive injectable methadone. This has never been evaluated. Third, Italy had a large injectable morphine program in the 1980s which was as effective as the oral methadone program. Fourth, a small research project in the Netherlands in the 1980s found that provision of injectable drugs to a few heroin users with very serious mental problems was ineffective. Switzerland started a heroin trial in 1993 with almost 1000 patients. Early results showed that dispensing heroin is feasible and produces quick improvements in many, but the Study also shows that the heroin-dependent drug users are so severely damaged in so many aspects of their living, that considerable help will be needed for some time to come. The Netherlands has decided to start a heroin trial. A heroin trial has been under consideration in Canberra since 1991. A small number of patients have been maintained on injectable methadone in Queensland for about 15 years.

13. The community will never support legalising drugs - any politician or party advocating legalisation will be committing suicide.

In 1989, 38 per cent of Australians in a Saulwick poll supported the decriminalisation of personal quantities of heroin to stem the spread of HIV among injecting drug users. In 1994, 50 per cent supported legalisation and 75 per cent supported decriminalisation of cannabis. The Australian Democrats were the first Australian political party to support drug policy reform. Young Liberals and Young Labor both support reform. Professor Peter Baume, a senior Liberal Senator for NSW for 17 years, made no secret of his support for radical drug policy reform and still became a Federal Minister. The former Liberal Speaker of the NSW Lower House, Mr Kevin Rizzoli, has not been damaged politically by supporting reform. Over 90 members of Australian parliaments have now signed the Australian Parliamentary Drucg Law Reform Charter. All we are waiting for now is leadership.

14. You'll never be able to run any kind of system where drugs are given to drug addicts. How will you stop them trying to increase their dose or stop heroin from getting to under-age kids?

First, we have faced exactly these sorts of problems for over 25 years in methadone maintenance programs in Australia and are able to manage quite easily. Second, heroin users on the streets or patients on our methadone proaram do not keep on requiring more and more heroin so why should heroin users on a controlled availability program? Third, what stops under-age children getting street heroin today?

15. They tried giving drugs to addicts in England which didn't work and they legalised drugs in Holland where it was a disaster. Why try it here?

Prescribing heroin, amphetamines and cocaine in England over more than 60 years has only been undertaken by a few doctors with a small number of patients. As very little research was done, it is hard to evaluate the effectiveness of their approach. The Netherlands has never legalised drugs. Cannabis is available from carefully supervised coffee shops. The Netherlands still has the same drug laws as most western countries. Drug users found with personal quantities of illicit drugs are rarely prosecuted. Traffickers are prosecuted as in other countries. Despite claims to the contrary, drug problems and drug use are less in the Netherlands than most other European countries.

16. If you legalise druag, the pushers will simply turn to other kinds of crime and we will be no better off.

When the United States repealed prohibition in 1933, about a quarter of the criminals continued involvement in bootleg liquor, a quarter turned to other crimes, a quarter turned to the now legal alcohol trade while the remaining quarter moved to new legal activities altogether. This might be a guide to how things will turn out when we reform drug policy in Australia.

17. Prison is the only thing that will make most drug users give up drugs. Doesn't prison stop them harming themselves and their communities?

About half the drug-using prisoners stop using drugs when they go to prison. All but a few start as soon as they are released. Prisons are very damaging psychologically. Many learn in prison for the first time how to crack safes and commtt crimes undetected. Prisons are expensive. Medium security costs $123 per prisoner per day in NSW.

18. Do you seriously believe that we can do away with law enforcement for drugs altogether?

We will never do away with law enforcement for currently illegal drugs. The police (and customs) play an important role in regulating legal drugs. Someone trying to smuggle a suitcase full of whisky through customs risks penalties today. It will be the same with currently illegal drugs after drug policy reform.

19. Don't we need to keep prohibition to deal with people who drive when they are stoned on cannabis or other drugs?

This is a problem now under prohibition and will continue to be a problem after drug policy reform. We need an objective measure of cannabis intoxication for drivers under prohibition or reform. Cannabis-intoxicated drivers should be detected and punished whether we have prohibition or reform.

20. Switzerland tried to legalise drugs with their infamous "needle-park" experiment which failed and had to be stopped. Why should we try?

Switzerland did not try to legalise drugs in Needle Park. They allowed an open drug scene to develop while trying to provide an environment where drug users could get health and social services. There is now general recognition that open drug scenes do not work under prohibition. The Swiss government-controlled "fixing rooms" have been a success and are now being tried in other countries.

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Chapter VII. Bibliography

Advisory Committee on Illicit Drugs 1993, Cannabis and the Law in Queensland, A Discussion Paper, Criminal Justice Commission, Goprint, Brisbane.

Australian Bureau of Criminal Intelligence 1994, Australian Illicit Drug Report, Canberra.

Bennett, T. 1988, "The British Experience with Heroin Regulation", Law and Contemporary Problems, vol. 51, no. 1, Winter 1988, pp 299-314.

Bureau of International Narcotics Matters (BINM) 1992 and 1993, International Narcotics Control Strategy Report (INCSR), United States Department of State, Washington DC, March 1992 and April 1993.

Burrows, D. 1995, Hann Reduction?, Drug Law Reform Project, Redfern Legal Centre, Redfern, NSW

Carney, T 1981, "The History of Australian Drug Laws: Commercialism to Confusion?", Monash Law Review, vol. 7, June 1981, pp 165-204.

Center for Strategic and International Studies (CSIS) 1993, The Transnational Drug Challenge and the New World Order: New Threats and New Opportunities, US Government Report, Washington DC.

Commission on Narcotic Drugs 1995, Economic and Social Consequences of Drug Abuse and Illicit Trafficking: An Interim Report, United Nations Economic and Social Council, Vienna.

Commonwealth Department of Human Services and Health 1995, Statistics on Drug Abuse in Australia 1994, AGPS, Canberra.

Fox, R. and Matthews, I. 1992, Drugs Policy - Fact, Fiction and the Future, The Federation Press, Annandale, NSW.

Gerstein, D.R. and Harwood, H.J. (eds) 1990, Treating Drug Problems, vol. 1, Institute of Medicine, National Academy Press, Washington DC.

Hall, W, Solowij, N. and Lemon, J. 1995, The health and psychological consequences of cannabis use, DHSH National Drug Strategy, Monograph Series no. 25, AGPS, Canberra.

International Narcotics Control Board (INCB) 1993, Report of the International Narcotics Control Board for 1993, Vienna.

Kleiman, M. 1989, Marijuana: Cost of Abuse, Cost of Control, Greenwood Press, New York.

Krivanek, J. 1988, Addictions, Allen & Unwin, Sydney.

Krivanek, J. 1989, Heroin: Myths and Reality, Allen & Unwin, London.

Manderson, D. 1993, From Mr Sin to Mr Big. A History of Australian Drug Laws, Oxford University Press, Oxford.

McDonald, D., Moore, R., Norberry, J., Wardlaw, G. and Ballenden, N. 1995, Legislative Options for Cannabis in Australia, National Drug Strategy, DHSH Monograph Series no. 26, AGPS, Canberra.

Parliamentary Joint Committee on the National Crime Authority 1989, Drugs, Crime and Society, AGPS, Canberra.

Rydell C.P. and Everingham S.S. 1994, Controlling Cocaine. Supply versus Demand Programs, RAND Drug Policy Research Center, Santa Monica, CA.

Stevenson, R. 1994, Winning the War on Drugs: To Legalise Or Not?, Institute of Economic Affairs, London.

United States Attorneys and The Attorney-General 1989, Report to the President of the United States, US Government Report, Washington DC.

United States Commission on Organised Crime 1986, America's Habit: Drug Abuse, Drug Trafficking And Organised Crime, US President's Commission, US Government Report, Washington DC.

United States General Accounting Office 1993, Confronting the Drug Problem: Debate Persists on Enforcement and Alternative Approaches, US Government Report, Washington DC.

United States Office of Technology Assessment 1990, The Effectiveness of Drug Abuse Treatment: Implications for Controlling AIDS/HIV Infection, Office of Technology Assessment Report, Washington DC, September.

World Bank 1993, World Development Report 1993: Investing in Health, Oxford University Press, New York.

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