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Australia needs a new strategy to deal with illicit drug use

Posted By on February 25, 2019 @ 11:00

Australia’s first responders and health officials are dealing with an ever-growing number of drug users and addicts, who are now dying in record numbers. The use of methamphetamines, particularly crystal methamphetamine (‘ice’) has plagued the country for years, and Australia’s addiction and use rates are now some of the highest among industrialised nations. We’re also in the midst of an opioid crisis, as are Canada, the UK and the US. Unless something changes, Australia is facing continued and increasing use of dangerous and addictive legal and illegal drugs.

A 2017 report [1] tallied 1,808 drug-induced deaths in Australia in the previous year, caused by benzodiazepines (such as Valium), legal opioids (such as oxycodones), methamphetamines and heroin, in that order. This suggests that our current and previous drug strategies haven’t been effective, and that we need innovative approaches to get to where we need to go. Everyone from police officers to academics and state and federal politicians has acknowledged that we can’t arrest our way out of this problem, but that’s what we’ve been trying to do. It’s well known that most illegal drugs and their precursors come from China [2], but there’s now growing access to legal drugs, particularly opioids, sold illegally in Australia. In my 32 years of policing and more than seven years in public service and research, I’ve never seen a problem as severe as this one.

In my view, it doesn’t matter how much money and resources are thrown at the problem; if our primary focus is on interdiction and law enforcement, we can expect scant success. That this drug use is happening across multiple age, cultural and socioeconomic groups makes intervention even more difficult. Law enforcement agencies’ traditional key performance indicators measure seizures, charges, arrests and prosecutions, but those activities don’t address the health of addicts, which is what we should be focusing on.

Our failure to significantly reduce the use of ice and opioids places the health of Australians at greater risk. A strong drug strategy must include both action against illegal activity and a robust harm-reduction model that targets areas of greatest risk. As evidenced by recent record drug overdose deaths [1], this is a wake-up call that our drug strategy must be capable of responding as conditions change.

The current drug strategy is aimed mainly at ice, alcohol and tobacco addiction, but the importance of flexibility and capability in particular areas can be lost in the drive for a long-term strategy. The Western Australian Network of Alcohol and other Drug Agencies (WANADA) [3] has identified a number of issues with the strategy’s responsiveness, purpose and key principles. WANADA notes, as ASPI did in its report on ice in 2015 [4], that success will be possible only when integration becomes the norm. The potential for a strategy that deals with drug use as a health problem must be addressed, as has been done with both alcohol and tobacco.

Many countries have introduced thoughtful strategies in an integrated manner while having a direct impact on drug addicts, such as the massive rollout of naloxone to first responders to deal with opioids and opioid replacement therapy programs being run in Europe [5] and piloted in Canada and parts of the US. Focusing on the addict and how the addict is moved from harm into harm reduction will dictate the success of such programs.

The rollout of naloxone beyond the current program and into the hands of first responders will almost surely save lives. In Canada during 2016, more than 200 people were saved because of immediate access to naloxone, administered by civilians or non-medical first responders. Similar success can be expected when Australia makes this lifesaving drug more readily available.

Opioid replacement therapy using products such as methadone is well known as a way to reduce the addict’s demand for other serious opioids, enabling them to carry on a more normal life and step back from their addiction. However, there have been other innovations, such as replacement drug therapy in which addicts receive a drug such as diamorphine (often referred to as a ‘medical-grade heroin’). A program in Switzerland [6], now being piloted in other countries, has been successful in reducing overdose deaths, cutting into the illegal drug trade and, most importantly, managing opioid addiction. The program provides addicts with a replacement that enables them to stop using street drugs.

Indeed, we can’t arrest our way out of this problem. We must now focus on what can be done to improve the lives of drug users and ultimately the communities in which they live. We need to focus on building new community-based initiatives in which the drug problem is owned and shared between agencies, instead of confining it in the silos of law enforcement and medical intervention. It’s clear that no one agency can defeat the problem, but that success will come from new strategies that combine resources.

Areas of concentration for Australian federal and state officials where impact is focused on the user include increased availability of residential drug treatment programs, education, prevention and support. These can be easily achieved with the right resources and by making programs more accessible. Adding innovative approaches that build on the success of other nations facing similar problems will greatly assist the effort in Australia.



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URL to article: https://www.aspistrategist.org.au/australia-needs-a-new-strategy-to-deal-with-illicit-drug-use/

URLs in this post:

[1] report: http://www.abs.gov.au/ausstats/[email protected]/Lookup/by%20Subject/3303.0~2016~Media%20Release~Drug%20Induced%20Deaths%20Increase%20in%202016%20(Media%20Release)~9

[2] China: https://www.everydayhealth.com/opioid-addiction/china-commits-greater-regulation-fentanyl-g20-summit/

[3] (WANADA): http://www.wanada.org.au/index.php?option=com_docman&view=download&alias=30-wanada-response-to-draft-national-drug-strategy-2016-2025&category_slug=advocacy-and-campaigns&Itemid=265

[4] 2015: https://www.aspi.org.au/report/methamphetamine-focusing-australias-national-ice-strategy-problem-not-symptoms

[5] Europe: https://www.heroindetoxeurope.com/substitution-therapy.html

[6] Switzerland: http://reformdrugpolicy.com/beckley-main-content/new-approaches/future-directions-for-drug-policy-reform/switzerland/

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