Science Blog

Australia's illicit drugs policy
Dr David Caldicott
31 May 2007
Dr Caldicott is an Emergency Doctor and recognised drug expert. He was project manager of a recent study The impact of drugs on road crashes, assaults and other trauma and was used as an expert witness in the Dianne Brimble case.

This is Dr Caldicott's response to an opinion piece published in the Adelaide Sunday Mail on 20 May 2007 by Mr Christopher Pyne, the Minister responsible for the Australian Government’s illicit drug policy.

Click here to read the Sunday Mail article.

There appears to be two main types of politician in today’s Australia, as far as illicit drugs policy is concerned. There are those who privately admit that American-style prohibition policies are futile and probably dangerous, and yet fear the repercussions of publicly entering into the debate, and there are those who don’t allow an ignorance of drugs policy or illicit drugs to temper their public commentary. Mr Christopher Pyne, the Minister responsible for the Australian Government’s illicit drug policy’s latest missive in last week’s Adelaide newspaper, the Sunday Mail might suggest he belongs to the latter group.

The Minister’s allegation that ecstasy is ‘usually’ cut with hydrochloric acid is disturbing. There is not a shred of evidence to support this. MDMA certainly exists as a hydrochloride salt, but then again, so do many antibiotics. Any year 12 chemistry student would know that this is very different to finding ‘hydrochloric acid’ in ecstasy. If drug users are to be persuaded that their behaviour is mistaken and dangerous, it needs to be done by people who appear to have some idea about what they’re talking about.

Yet Australians find themselves in a position where they are obliged to rely on Minister Pyne’s insights into the current drugs problem to protect their children. In the article there is a reference to a scenario where pill testers tell consumers that a drug is ‘safe’. However, in all formally supervised pill-testing programmes, it is policy that health workers inform every consumer, at every visit that no drug is safe, no matter what the results of testing. Advocates of pill-testing in Australia seek among other things, to convert the informal self-administered system currently in play to a formal system by which consumers are forced to interact with trained health professionals. The aim is not to reassure, but to take consumers out of their comfort zone, forcing them to acknowledge the potential health risks associated with their behaviour.

You might excuse a politician from being unfamiliar with the scientific literature, but to be unaware of one’s own government’s recommendations is astonishing. The suggestion in the article that the NSW heroin injecting room has been discredited is nonsense. The Minister admits that he arrives at his conclusion from reading the newspapers. However, if he had turned to something more scientific such as the reports commissioned by his government, he would quickly see that the programme is far from discredited. Between 1988 and 2000, as a result of the introduction of needle and syringe programs, 25,000 HIV infections and 21,000 hepatitis C infections were prevented among people who injected drugs. As a consequence, 90 hepatitis C related deaths and 4,500 HIV related deaths would have been prevented by 2010. This translates for the taxpayer - and this year, the voter - into cost savings of up to $783 million for hepatitis C treatment and up to $7025 million for HIV treatment. All this, for an estimated cost of $150 million - peanuts in public health terms. Put simply, for every tax dollar put into the program, nearly fifty are saved. This year, the Minister’s own government’s senate inquiry into Amphetamines and other Synthetic Drugs supported the development of Victoria’s intention to run a trial of pill testing. Sadly, we’ve missed the boat in South Australia - despite the recommendations by the experts at the July 2002 SA Drugs Summit to conduct a trial of pill-testing, these have quietly been ignored by state government.

Having returned from an international emergency conference in the Netherlands this month, I had the opportunity to review and discuss the formal drug monitoring system in place there. They are very happy with the system currently in place. The Netherlands has a lower rate of MDMA use, as well as a lower injury rates and a lower deaths rate from that drug than Australia or the USA. Recently they have expanded their testing program to include substances seized from amnesty bins at nightclubs. In Australia, substances seized on the door by bouncers have a tendency to find themselves back on the market. Are the opponents of pill testing so convinced of their position that they would prefer to have illicit compounds circulating and available to their voter’s children, rather than to have them confiscated and tested? Do they think that it’s unreasonable to be able to test the substances that arrive in emergency departments, in the possession of critically unwell patients, to see if some new, highly toxic substance has been released on the market? Or should parents content themselves with post-mortem results?

The Minister’s suggestion that his government is winning the ‘war on drugs’ smacks of George Bush’s now-infamous “Mission Accomplished” speech from the deck of the USS Abraham Lincoln. The article is very selective in its use of statistics. The decrease in drug consumption like the heroin figures quoted, is more likely to be despite federal drugs policy and as a consequence of simple market forces and demand, rather than due to any inspired leadership on the part of the Government. Is the Minister aware of a drug called methamphetamine? Anyone for ‘ice’? - the biggest drug problem facing Australia in a decade, and nothing to say? The inelegant, unintelligent manner in which the federal government has conducted its bogus war on drugs guarantees an even more protracted engagement. Bullying of researchers, funding research on the basis of ideology not merit, manipulation of statistics and the conservative media, policy decisions behind closed doors which are subsequently immune to FOI enquiries, all ensure that it will be 10 years before we can undo the damage from “Tough on Drugs/ War on Drugs” campaigns. The tragedy is that we could have been so much further ahead in reducing the harm caused by drugs in Australia, were it not for wowsers playing to fringe electoral groups for cheap votes.

It is fine for the Minister, or anyone else for that matter, to believe in ‘zero tolerance’ on moral grounds - there is certainly a moral dimension in the debate on drugs. In medicine, we respect the wishes of patients to decline blood transfusions, even though that decision may result in their death. It doesn’t mean that we would ever consider closing the blood banks because certain individuals are opposed to transfusion. Yet we are being asked to accept the Minister responsible for the government’s illicit drug policy’s support of zero tolerance in the face of everything we know to be true from science and medicine. The Australian Medical Association - which incidentally, supports a medically supervised, ethically approved trial of pill testing - has said that a zero tolerance drug policy for Australia would have ‘catastrophic consequences’ for the country.

The Minister’s 'opinion piece' is another example of a political ‘free kick’, whereby politicians, both state and federal, hide behind press-releases and sound-bites, never having to personally face the scrutiny of science. If politicians want to persuade the public that ‘zero tolerance’ is the way forward, let them stop shirking behind the skirts of their minders and debate it formally in a public forum, against scientists and doctors. If they don’t know what they’re talking about, they should simply not be allowed to determine policy in such an important arena. Let’s sell tickets and give the money to charity. The Australian public are bright enough to understand the truth about drugs and drugs policy, if they are ever told the truth.
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