DOUG TAYLOR. Kicking goals in the fight against drugs

The heroics of Cristiano Ronaldo at the World Cup puts Portugal on the world stage. But behind the bright lights of the soccer World Cup, Portugal is leading the world in another arena: its efforts to curb drug abuse.  

It is an issue that Australia is failing miserably at. Indeed when measured against other nations, our performance on tackling illicit drugs has been so bad that, in World Cup terms, we would fail to qualify.

Not so long ago, Portugal, was a heroin capital of Europe.

The population was suppressed for decades by an authoritarian regime, Coca-Cola was banned and even owning a cigarette lighter required a licence. So when the regime fell and the prosperity of the 80’s arrived, the drugs also flooded in.

By the late 1990’s, one in ten people were using heroin. The country was crippled by an unprecedented national health emergency.

That was then. Today the number of deaths due to drug overdose in Portugal is 0.35 per 100,000.

That is over 20 times less than the overdose death rate in Australia (7.5 per 100,000).

Portugal’s solution? The government changed how it dealt with people who use drugs: decriminalising drug use and possession in small quantities, while enhancing treatment options.

The radical approach has been hailed internationally as a success. In stark contrast, Australia’s current approach to tackling drugs is failing.

The Uniting Church’s NSW and ACT Synod in 2016 passed a resolution calling on governments to direct greater investment in demand and harm reduction practices and the further decriminalisation of personal drug use – the only church in the world to do so.

There are compelling reasons why we must see drug addiction primarily as a health and social issue rather than a criminal justice issue.

Evidence suggests most illicit drug use does not result in severe harm. Each year, about 2,800,000 Australians use illicit drugs and about 7,800,000 have done so at some time in their life. Only a very small proportion of people use illicit drugs frequently and in a way that carries substantial risks.

Globally it is estimated that only one in ten illicit drug users are, ‘problem drug users’.

Australia has a longstanding national drug strategy based on the model of harm minimisation. This bipartisan policy is comprised of three pillars: Supply Reduction (law enforcement), Demand Reduction (treatment services) and Harm Reduction (needle and syringe programs and injecting centres).

The tragedy is that we provide the bulk of funding to the least effective measure.

Law enforcement measures receive around 70% of our national drug budget with much more limited funds going toward evidence-based demand reduction strategies like treatment (21%) and even less for harm reduction initiatives (2%).

In reality there is no link between a law enforcement approach to reducing the rate of drug use. Of the more than 80,000 Australians charged with drug related offences in 2014/15, 66% were charged only with personal possession or use, and this number is increasing.

Decriminalisation does not mean legalisation. Under decriminalisation there is no legal means to obtain drugs for personal use. Decriminalisation is simply the removal of criminal penalties for drug use/possession.

A decriminalisation approach coupled with investment in harm reduction and treatment services can have a positive impact on both individual drug users and society as a whole.

And here we come back to Portugal. It decriminalised use, acquisition and possession of all illicit drugs when conducted for personal use. The country also expanded and improved prevention, treatment, harm reduction and social reintegration programs. Put simply it has worked.

Portugal has experienced reduced problematic drug use, reduced drug use by adolescents, fewer people arrested and incarcerated for drugs, more people receiving drug treatment, and reduced incidence of new HIV/AIDS cases among people who inject drugs.

In June this year,  more than 700 people packed into St Stephen’s Uniting Church in Sydney on a cold, rain swept night for a discussion on drug law reform. The headline speaker was Dr Manuel Cordoso, one of the key people behind decriminalising drug use in Portugal.

More than 15 years ago the Uniting Church supported the establishment of the Uniting Medically Supervised Injecting Centre (MSIC). This was the first supervised injecting facility in the English- speaking world. There are now 110 such services in 10 different countries.

The Uniting MSIC has successfully treated thousands of overdoses, reduced the spread of diseases like HIV and Hepatitis C, taken public injecting off the streets and provided a pathway into health and social services for people who might otherwise have not contacted them. There have been no deaths since it started. The Uniting MSIC now enjoys broad support including from the police to the Australian Medical Association. Despite the success it remains the only one in NSW and Australia.

It is now time for Australia to change its approach to illicit drugs. Portugal has shown a path to success and the evidence is clear that if we continue on with our current approach we will continue to fail.

Doug Taylor is a senior executive of Uniting (NSW and ACT) which runs the nation’s only medically supervised drug injecting centre.

In late July/early August, we will be posting a series of articles on drug law reform in Australia.  


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2 Responses to DOUG TAYLOR. Kicking goals in the fight against drugs

  1. Stjepan Bosnjak says:

    Is the figure of 7.5 per 100,000 for all drugs or just heroin?

  2. Michael Hart says:

    There are also two significant issues on the failure of our approach to certain forms of drugs and the community The first and major one is the complete failure of supply reduction or law enforcement approach and the proof is purely economic and is not to be found in any discussion by the advocates of such policy. The cost of law enforcement nationally when I last did the data on this some two decades ago, was then about $600 million dollars annually to the States and Commonwealth which was about 10% of the cost to the United States ($6 billion plus then). The numbers now would well be over the billion dollar mark now. That is an enormous annual burden on all of Australian society in terms of opportunity cost and the loss of those funds from worth while community needed activity. The additional evidence is very simply obtained and straightforward, the cost of buying ‘illegal’drugs, they have remained constant adjusted for inflation for nearly 30 years. So if any so called supply interdiction and reduction was effective then the price would have increased because the supply would have decreased, it has not and does not -what is that telling you? Law enforcement is a completely ineffective policy to deal with a market supplying substances that people like to use or want to use or have to use, recreationally or for other psychological dependency or social reasons. We can also add onto that the cost of maintaining incarceration of people for drug offences, prisons, of whom about 80% of their customers are there because of drug laws.

    We have paid absolutely no attention to the outcome of the same failed policy tried over 75 years ago called prohibition, then against alcohol or the outcome, it just provides the capital and income to those comfortable living in and who are part of the criminal millieu of any society and thus enrichens such individuals and groups who are quite adept at mergers, take-overs and market development just like all businesses. Society again bears the cost for fostering and helping capitalise the criminally minded. That corrodes all of society. How many Royal Commissions have we had into Police Forces in this Country in the last 40 years and what was at the heart of the corruption of those institutions – drug law enforcement. We have learned absolutely nothing and we especially have lacked leaders of conviction and courage to stand up and say, this will happen, people will use drugs but let us not put them in gaol let us understand that some people have personalities that lends itself to this form of behaviour so how about we minimise the harm, avoid the stigma and cost of dealing with a social psychological problem with ham fisted and brutal law enforcement, and how about we save ourselves a hell of a lot of money in the process, collect some taxes on this and redirect the same funding to health, education and other public goods.

    The second is the evidence from any other sane society that has taken the Portugese approach that, usage drops dramatically, the customer base of the criminal class is diminished, otherwise law abiding citizens are not forced into the underbelly and social millieu that people who are anti-social and criminal inhabit. The medical costs and burden disappears as major health issue as well, so your left what you will always be left with, the health care costs of people who abuse their physical health. That is a manageable minority and it will always be with us.

    I also note that the reactionary SA Government this week has announced is going to double down on the failures of the past by ramping up the penalties and so-called interdiction for marijuana. That will work! So just when you thought we may have developed a modicum of commonsense, and in the same week that the Doctors have shown that they are also not against the concept and supply of medical marijuana, we are provided with the it seems common political spectacle of a fools who understand nothing but their own prejudices and biases returning to policy that has failed, repeatedly has never worked and never will. I think it is called ‘flogging a dead horse’.

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