The last issue of The Activist Guide reported that behind-the-scenes pressure from the US government against proposed heroin maintenance trials in Australia had provoked anger on the part of Australians while being virtually unreported in the United States (Meddling Abroad, Issue #8). As of July, the proposal seemed to be "dead in the water," according to Australian Capitol Territory Chief Minister Kate Carnell, who had proposed the trial. "It's a pity," Carnell said, "because a lot of research went into it, and of course this decision won't do anything to change the huge heroin problem in the country." However, federal Minister of Health Dr. Woolridge intervened to keep the proposal alive in the face of the objections of a majority of Australian governments, and the ministerial council agreed to further explore the trial and endorsed the Commonwealth to convene a subcommittee of the National Drug Strategy to consider and advise on the national implications of the trial. (Source: Sydney Morning Herald and Weekend Australian.)
Nevertheless, the drug debate down under is further along than in the US. On April 12, the Australian reported that the Premier of the Australian province of Victoria, Mr. Kennett, had suggested decriminalizing marijuana for a three year trial period. The proposal was the most controversial recommendation of the report of the Premier's Drug Advisory Council, chaired by Professor David Penington. "What we've got to try and do is work out how we can stop people smoking dope and how we can ultimately stop some of those who smoke dope falling victime to those barracudas out there who probably sit in their lounge rooms in wealthy suburbs peddling drugs to a weaker community," said Mr. Kennett. Church leaders, lawyers, youth workers, the police and welfare agencies welcomed the chance for debate but were divided about the proposal.
On March 5 the Australian Associated Press reported on the Seventh International Conference on the Reduction of Drug Related Harm in Hobart, Tasmania. The AAP article quoted harm reduction expert Imani Woods, who predicted that abstinence would remain the sole drug policy of the United States until "little Chelsea [Clinton] starts getting high. People are going to address that issue when it gets really personal."
DRCNet board member Don Topping attended the Tasmania conference and wrote the following report:
The Seventh International Conference on the Reduction of Drug-Related Harm, held in Hobart, Australia, March 3-7, 1996, was attended by 630 delegates from thirty-five countries. This conference was notable for the large numbers of representatives from Asian countries, where drug policy is not generally in the public debate, and rates of HIV transmission through needle-sharing among IV drug users has become a public health crisis.
Opening the conference was Mr. Richard McCreadie, Deputy Commissioner of Police for the State of Tasmania, and Chairman of the National Drug Strategy Committee. Mr. McCreadie began his talk with the candid assertion that few police believe they are succeeding in the enforcement of prohibition. He set a positive direction for the conference with his statement, "Harm Reduction has brought about a new spirit of cooperation.We are committed to a meaningful partnership." During his presentation, Mr. McCreadie emphasized Australia must take the lead in teaching Harm Reduction in Asia, where rising rates of drug use and HIV infection are alarming. He pointed out that more and more political and intellectual leaders around the globe are calling for a change in drug policy which will incorporate more HR measures, and include closer working relationships between health and law enforcement agencies.
Mr. McCreadie's stated position was supported by other law enforcement officials who spoke later at the conference, including Mr. John Johnson, Commissioner of Police for Tasmania, and Mr. Raymond Kendall, Secretary General for INTERPOL, the largest police organization in the world, with membership from 176 countries. In his plenary address titled "The Role of Law Enforcement in Reducing Drug Related Crime," Mr. Kendall stated that "The time has come..." to shift the emphasis from supply reduction to demand reduction, because organized crime is quick to respond to demand. Although he made it clear that he does not favor legalization, Mr. Kendall expressed his strong preference for the medical regulation of drugs.
Other speakers at the morning plenary included Australians Dr. Alex Wodak and Nick Croft, both pioneers of the HR movement in Australia. Dr. Wodak welcomed the need for closer collaboration between law enforcement and health officials, as stated by Commissioner McCreadie, and emphasized the importance of upholding the three basic tenets of HR: tolerance, inclusiveness and compassion. He concluded with the touch of realism: "Harm Reduction will only survive if it proves itself effective."
Among the many outstanding speakers at the conference were three American academics whose research on drug policy is well known: Peter Reuter and Jonathan Caulkins (both formerly with the RAND Corporation), and Alfred McCoy, author of The Politics Of Heroin. While their presentations were not intended to complement each other, they arrived at compatible conclusions: supply reduction is not working, and a shift to HR principles, including demand reduction, would be more effective, economically as well as socially. Dr. McCoy predicted a major increase in heroin production around the world as a result of the restructuring of the global economy, which is creating desperate economic conditions in many of the new political entities. Referring to his mathematical model, Dr. Caulkins cited the need for more precision research on the impacts of harm reduction. Dr. Reuter presented a detailed account of the correlation between lowered state assistance programs for indigent drug users and increased crime rates. While SSI payments may lead to an increase in drug use, there is a corresponding reduction in criminal activities to support drug use habits.
A number of the sessions highlighted the importance of drug user groups in developing and implementing harm reduction policies. In most communities, drug users are excluded from mainstream society. They need to be heard as well as included in decisions that affect them. Aaron Peake emphasized how user groups can provide a valuable information base. Methods for organizing and utilizing user groups are varied, and are dependent on the community attitudes and practices. Several of these discussions emphasized the loss of human rights as a result of drug policies that focus on supply reduction through punishment and incarceration. Dr. Samuel Friedman noted that user groups are rare in the U.S., numbering around nine or ten for the entire country.
Another under-represented group of people directly affected by drug policy are the Families and Friends of Drug Law Reform, a relatively new organization in Australia made up of parents whose children have been harmed, and in some cases killed by drug use. Rather than blaming the drugs, several spoke at the conference about the need for education about drugs for everybody in the hope of preventing further harm.
Throughout the conference, U.S. drug policy was targeted for criticism time and again, particularly for the way in which the U.S. imposes its own values and policies on other countries. One panel focused exclusively on the topic, featuring the noted Australian drug researcher, Dr. James Rankin, whose presentation was titled "Lantern on the Stern: U.S. Drug Policy as a Study in Folly." Dr. Rankin noted that every policy study conducted in the U.S., including those ordered by President's Kennedy and Nixon, has recommended change, and that all of them have been ignored. In spite of President Clinton's toning down of the rhetoric of the War on Drugs, the policies and practices remain unchanged.
A session that drew a large audience was the report on heroin maintenance programs in Switzerland, United Kingdom, The Netherlands, and the proposed heroin trials in Australia, scheduled to begin later this year. The objectives of the Swiss program, now in thirteen cities, were spelled out succinctly: 1) to reach IDU's; 2) to improve health; 3) to reduce risk-taking behavior; 4) to compare results with other treatment programs. Although none of these programs is practiced on a wide scale, the early reports are positive in terms of reducing crime, improving health, and establishing better rapport between users and treatment providers. Each of these programs now keeps careful records for purposes of evaluation. A poll of physicians in the U.K. showed that the majority of doctors there favor prescription heroin for addicts; only 13% responded "never".
One of the high points of the conference was the Parliamentary Inquiry (Congressional Hearing), in which eight members of Australian state parliaments interrogated a number of different "witnesses", including representatives from law enforcement, medicine, academia, treatment, and parents with respect to problems of establishing and maintaining drug policies. All of the basic issues were drawn out and examined from the various perspectives of the witnesses.
Another unique event was a plenary session billed as "Hypothetical," where a panel of nearly twenty assorted "experts" representing a range of specialties were given a difficult hypothetical situation (e.g. marijuana for a cancer patient, heroin for relief of pain in a hospital situation), and then asked what course of action they would take. The moderator of the panel was a skilled attorney who posed very difficult questions to the panel of experts, each of whom represented a different experience and perspective. It was during this panel that the Secretary General of INTERPOL commented, "Heroin would not be illegal if physicians would get their act together." The purpose of the "Hypothetical" was to underscore how multifaceted the question of drug policy is.
Although the conference was divided along thirteen different tracks, drug policy issues were discussed throughout the conference in various sessions. Some of the reports were of successful moves towards the HR model, while others told of setbacks as a result of new legislation and/or interpretations by law enforcement officials. Keith Evans, Director of the Alcohol and Drug Branch of the Queensland Department of Health, noted that Australia is perceived by outsiders as progressive. However, the last two years have been difficult, partly because of complacency on the part of the reformers, and partly because of the lack of accord among the various HR groups within the country. The need for closer cooperation between Health and Police Departments is as critical in Australia as well as in the other countries reported on. Status reports on efforts to promote HR in Hawai`i were presented in two different sessions by Don Topping and Pam Lichty.
Dr. Alex Wodak gave the Rankin Oration in a plenary session. His title was, "Injecting Nation: Will the 'Minimalist Approach' Achieve Control of Hepatitis C in Australia?" Dr. Wodak reviewed the history of injection drug use in Australia, which began in 1953 when heroin was outlawed. Before that time heroin addiction was virtually unknown in Australia. Since then, Australia has become an "injecting nation" where heroin addiction is now commonplace. Dr. Wodak proposed a concept for consideration by drug policy reformers which bears the acronym NIROA - non-injecting routes of administration. Encouraging IV drug users to shift to other forms (e.g. smoking or snorting) would serve as a harm reduction measure in two ways: 1) It would eliminate the transmission of blood-borne disease; and 2) it might serve to move users towards less harmful substances. In reference to the polarizing nature of the drug policy debate, Dr. Wodak compared Harm Reduction to a "dimmer switch, not an off-on switch", which allows room for a spectrum of ways to deal with the problems of substance abuse.
The annual International Conference on the Reduction of Drug Related Harm is the largest gathering of experts in HR from around the world. Each year the conference has been well-attended by delegates from an increasing number of countries. The 1997 conference will be held in Paris, France in early March.
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