I’m pleased to be at the launch of Harm Reduction Australia – an association of individuals and service providers with expertise in one of the three limbs of the National Drug Strategy.
I can’t pass up the opportunity to observe the irony that Canberra is the chosen site for this launch.
The National Parliament has not always been an enlightened force in the area of drug policy and harm reduction strategies.
For my Coalition friends who fear a partisan swing at the Howard Government’s 1997 decision to scuttle the ACT’s proposed heroin trial – you can stand easy. I was in fact thinking about a much earlier experiment in zero tolerance by one of my own.
It was Labor’s King O’Malley, the Minister for Home Affairs, who managed to persuade his Prime Minister Fisher and fellow teetotaller, to declare the federal Capital a prohibition zone or at least a place where no new liquor licences would be granted.
It was of course a singular failure. Residents simply crossed the border to Queanbeyan for binge drinking sessions drink and brought bottles of grog back home – around 140,000 bottles a year according to one source.
It wasn’t our first or most tragic example of policy failure where the forces advocating zero tolerance did more harm than good.
The penal colony of New South Wales was supposed to be founded as a dry colony.
Captain Phillips orders required him to rigorously execute laws against drunkenness amongst other sins. Far from enforcing the law the officers were amongst the first to flout it as alcohol became a currency.
The politics of drug policy is always difficult. Too often harm minimisation strategies are smuggled in like policy contraband under cover of war-like rhetoric, photo shoots of seizures and crackdowns.
It is possible to break out of the binary that pits harm reduction against zero tolerance if we get the objectives of drug policies right. If improving national health and wellbeing is our aim than the evidence can speak for itself.
In the 1980’s the Hawke Labor Government led the world in its response to the HIV epidemic.
Needle and Syringe Programs aimed at reducing risk and the spread of infection were an important part of this response. There are now around 3,500 NSPs in Australia distributing over 30 million needles and syringes a year.
Between 1988 and 2000 approximately 25,000 HIV infections were estimated to have been prevented among injecting drug users and, by 2010, approximately 4,500 deaths from HIV and 90 deaths from hepatitis C were projected to have been prevented.
Subsequent studies estimated that between 2000 and 2009, needle and syringe distribution via NSPs had prevented 32,050 cases of HIV and 96,667 cases of HCV.
The Australian National Council on Drugs has said that: “…there is overwhelming evidence to illustrate that the provision of sterile injecting equipment has been an important part of Australia’s success in containing the HIV epidemic among injecting drug users”.
It was not only lives that were saved.
While Australian government’s spent $122 million on NSPs between 1988 and 2000 they saved between $2.4 billion and $7.7 billion in health expenditure.
For every dollar invested in NSPs Australia saved $4 in health care costs and $27 in overall costs to the community.
Opioid substitution therapy is another. This is about replacing heroin with longer-lasting substitutes such as methadone or buprenorphine.
You won’t be surprised to learn that such treatments result in net financial benefits.
One study from Victoria found that each person in methadone treatment costs $5,000 less per year in attributed health and crime costs than an illicit drug user not in treatment.
Once again the numbers speak for themselves. An earlier Australian study found that for every $1 spent on methadone maintenance treatment, the community gained $4 to $5 in terms of reduced health care costs, reduced crime and other benefits.
Despite these obvious benefits harm reduction is the poor cousin in our National Drug Strategy.
Australian governments spend a total of $1.7 billion every year combating illicit drugs.
This includes programs to prevent or delay the commencement of drug use in young people, drug treatment services and harm reduction strategies. It also includes police detection and arrests in relation to drug crimes and policing the borders of Australia for illegal importation.
From this pot of funds, 64.1 per cent is dedicated to law enforcement. But just 9.7 per cent is spent on prevention and 22.5 per cent on all government-funded treatment services.
And finally when it comes to harm reduction, it is just 2.2 per cent. 2.2 per cent on policies that can and do save lives.
The evidence is there, we don’t need to make this harder than it has to be.
The 2013 National Drug Strategy Household survey found that most people supported harm reduction strategies such as measures to reduce problems associated with injecting drugs.
For example, 67 per cent of respondents supported needle and syringe programs as well as methadone/buprenorphine maintenance programs.
The formation of a national association on harm reduction is timely.
It comes as the federal Government reviews the National Drug Strategy. It also comes as state and federal governments have elevated the use of one particular drug – crystal methamphetamine – to the centre of the political debate.
Although it receives just 2.2 per cent of the nation’s total Australia’s total budget combating illicit drug use, we know that harm reduction initiatives are working.
And as we contemplate the renewal of our National Drug Strategy we should not avert out gaze from the evidence of what works. I welcome the frank admission from the head of the National Ice Task Force – Ken Lay – “that we cannot arrest our way out of this problem.”
It’s true now, and has been for over 200 years.
I started with an observation about the settlers’ attitudes towards alcohol and their desire for a temperate European outpost.
It is worth noting that neither the law nor the lash were an effective deterrent to alcohol abuse among the early settlers.
But what historians have found is that there was a remarkable drop off in the rate of alcohol consumption in the latter half of the nineteenth century.
It coincided with two things – urbanisation and an equalisation in the ration of men to women in the colony. It took about 100 years for the ratio of men to women to shift from 1:5 to 1:1.
We shouldn’t be surprised about the effects of loneliness and social isolation. But we so often are.