ALEX WODAK. Drug Reform Series -Drug policy: prohibition and punishment is just not effective

Aug 7, 2018

The failure and futility of drug prohibition has been well accepted among political elites in Australia for a long time. It is time we debated the merits of regulation, combined with targeted health and social intervention, rather than blunt prohibition and punishment.  Such an approach is likely to be more effective, and fair.

In 1994, I went with Ms Ann Symonds, at that time a member of the NSW Legislative Council, to see the then Minister for Health, Senator Graham Richardson. We sought the meeting to argue that Australia’s drug policy had failed and was futile.  I presented the Minister with a report written by Stephen Flynn, who had worked for the US Coast Guard for years trying to stop drugs entering his country by sea. As his boat was being tossed around in the seas, Flynn often wondered how effective the vigorous efforts made by the US government might be in stopping drugs entering his country.

Flynn estimated how many planes, boats, trucks, buses, cars, motorbikes, pedestrians and packages and how much mail entered the USA every day. What was the volume of each of these compared to the volume of illicit drugs entering the USA every year that authorities were charged with intercepting? Flynn concluded that the volume of drugs was a tiny fraction of the volume of the various vessels and mail entering his country. Detecting most of the drugs entering the US, he decided, was even more unlikely than trying to find the proverbial needle in a haystack.

This situation has not changed. If anything, the likelihood of detection has only decreased over the intervening years. Every year about 900 million tons of freight including 12 million containers enters the USA by a variety of different types of transport. More than 35 million pedestrians enter the USA every year just from Tijuana, Mexico. At the busiest road freight crossing with Mexico, one truck enters the US from Nuevo Laredo every ten seconds. US customs can only search 20% of these trucks. The estimated 40-50 tons of heroin entering the US every year would fit into two 40-foot containers. But in 2015, the US Drug Enforcement Administration seized less than seven tons of heroin. The situation for other compact drugs such as cocaine is very similar. With 27,000 km of coastline and more than three million airline passengers and over five million containers arriving in Australia every year, the difficulties of detecting more than a fraction of the drugs entering this country shouldn’t be underestimated.

Richardson impressed me as a highly intelligent Minister. He listened carefully to our comments. As he was showing us out after a congenial meeting, Richardson said that no Australian government would ever reform its drug laws unless three conditions were met: changes would have to have reasonable international support, reasonable community support and reasonable support from the leaders of the medical profession. I offered to find out what leaders of the medical profession in Australian thought and report back.

I managed to (briefly) put three questions to about a dozen leaders of major health organisations, senior Professors and Deans of Medicine. I was astonished at the overwhelming support at that time among leaders of the medical profession for re-defining illicit drugs as mainly a health problem, regulating cannabis like alcohol or tobacco and undertaking a heroin trial in Australia.

I sent this information back to the Minister’s office and later received a formula reply showing how low community support in opinion polls was then for decriminalisation, let alone legalisation. In those days including the terms ‘decriminalisation’ or ‘legalisation’ in a question used in an opinion poll was guaranteed to produce a much more negative response than asking about attitudes to specific penalties then applying to specific offences.

A quarter century later across the globe, many retired and even serving Presidents, Prime Ministers and Police Commissioners acknowledge that under drug prohibition during the last half century, drug markets have steadily grown bigger and more dangerous. Even worse, critical outcomes such as deaths, diseases, property crime, violence and official corruption have progressively deteriorated. In many countries a discussion about policy options has started. In some countries, reforms are being cautiously implemented while other countriess are considering bolder moves. Once an international leader in pragmatic drug policy reforms, Australia has in recent years lagged behind. However, support for drug law reform is growing and the political cost of leadership on drug policy is falling while the political benefits are rising.

Harsh drug policies worked well politically for decades. That is why the policies lasted so well despite their dreadful outcomes. But the problem was that the very policies that were so easy to sell to large numbers of voters generated powerful market forces that undermined the very same policies. It is now obvious that there is no way for the round peg of drug prohibition economics to fit into the square hole of drug politics. Reform requires a few politicians to exercise adept leadership to find an approach that works politically as well as economically.

Re-defining illicit drug use as primarily a health and social issue is the threshold step. This will enable politicians to increase funding substantially for the health and social interventions that make a real difference. Expanding and improving drug treatment to the same level as other health services is critical. Improving drug treatment was one of the features of the successful Portuguese drug policy reforms of 2001.

Scrapping penalties for personal possession or use of all illicit drugs is another important step Australia has to take. By 2015, at least 25 countries had already done this.

Australia should try to regulate as much of the drug market as possible. We already regulate parts of the drug market with needle and syringe programmes, drug consumption rooms and methadone and buprenorphine treatment of heroin dependence. Australia will never be able to regulate all of the drug market. Nor should we ever try to. But the more the illicit drug market is regulated, the greater the benefits for people who use drugs, their families and communities.

Improving the expectations of young people is also critical.  Countries with larger populations of young people with miserable future expectations seem to have greater drug problems. Shrinking poverty is likely to mean fewer or less severe drug problems.

The ‘how?’ of reform is almost as important as the ‘what?’ Drug law reform should not be rushed. It requires considerable discussion within our parliaments, media and community. Respect for people with different views is essential. We should start with easier reforms and leave the most difficult reforms for later. Inevitably, some mistakes will be made. Rigorous independent evaluation is an essential part of the process.

Drug policy is not only about effectiveness and choosing least-worst options. Drug law reform is also about fairness. Just as it was unfair in the past for the majority to punish people with minority sexual preferences, so too is it unfair now for the majority to punish people with minority drug tastes. If this minority harm others, the criminal justice system can and should be used to deal with this behaviour.

Dr Alex Wodak AM is a physician and was Director of the Alcohol and Drug Service at St Vincent’s Hospital, Sydney from 1982 until he retired in 2012. He is now President of the Australian Drug Law Reform Foundation and a Director of Australia21. Dr Wodak and colleagues started Australia’s first needle syringe program in 1986 and Australia’s first Medically Supervised Injecting Centre in 1999 when both were pre-legal.




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