SUBMISSION TO THE PREMIERS DRUG ADVISORY COUNCIL INQUIRY INTO ILLICIT DRUGS IN VICTORIA

INTRODUCTION

The Victorian Council for Civil Liberties (VCCL) is a voluntary organisation which is commited to
protecting the legitimate rights and freedoms of individual Victorians against the incursion of
more powerful organisations such as Government, large corporations and the media. In
determining its position on existing drug control policies and developing recommendations for
changing those policies, the VCCL must necessarily balance their demonstrated potential to
reduce social dysfunction, injury and death in the general community against their potential to
intrude into individuals' privacy and freedom of choice and exacerbate inappropriate
discrimination and alienation.

Humans have always used drugs as social and medical agents. We will continue to use drugs of
one sort or another to change the way we function. Sometimes, we use drugs as medicinal
agents to maintain or restore health. In some cases, we use drugs to reduce the secondary
symptoms of ill health such as pain or psychiatric or psychological illness. At other times, we
use drugs as part of cultural or religious rituals or to facilitate social interaction.

Historically, different cultures used different drugs for different purposes. Their choice of drugs
was largely influenced by availability and by the drugsí pharmacology. Although alcohol was
used as a health, religious, cultural and social adjunct by all indigenous people except the
Australians and some North Americans, use of other drugs generally reflected the indigenous
plants and the climate of the places in which each culture developed.

More recently, distinctions beween races or cultures in their use of or preference for particular
substances has broken down with increased mobility and trade. Caffeine was introduced to
Europe by the Middle Eastern traders. Anglo-celtic settlers introduced the Australian and
American aboriginal populations to alcohol. Columbus and Drake took tobacco to Europe from
North America. Similarly, opium was imported from China and other parts of Asia into the Middle
East and Europe. Cocaine was imported into the United States from South America by traders
and by the original manufacturers of Coca-Cola. Perhaps ironically, use of these drugs was
legitimised as a symbol of authority and wealth in the societies into which they were introduced.
By the end of the 19th century, some jurisdictions were beginning to use the criminal law to
control the movement and use of some drugs. This change was associated with the following
important social changes:
a) Paternalistic sensitivity to and intolerance of racial and cultural difference resulting from
colonialism;
b) Increased voting rights which changed the authority of the Parliaments of countries such as
England, Australia and the United States to reflect that of the democratic majority;
c) The expansion of Government intrusion into traditionally private areas of social life and
culture;
d) The establishment of police forces within Government buraucracies which have power to
enforce the legislation;
e) Increased influence of education and media which ensured dissemination of selective,
biassed information about the negative health effects of some drugs; and
f) A consequent shift toward reliance on legislation, criminal law enforcement and severe
penalties as the principal method of imposing social control on the behaviour of minorities,
including their use of culturally preferred drugs.

This means that, in general, drugs have been selected by the Parliaments of western countries
for prohibition for racially discriminatory, political and, otherwise, arbitrary reasons. Legislative
prohibition remains one of the few vestiges of colonialism which is still tolerated in the otherwise
egalitarian society of the late 20th century.

In the 1920's, legislative prohibition of alcohol use failed. It led to entrenched public and private
corruption, black market supply, dangerously contaminated product and inappropriate
expenditure on the criminal justice system. It did not and could not prevent alcohol consumption.
Alcohol prohibition has been successfully replaced by a pragmatic system of controlled
production and distribution, imposition of excise which compensates the state for the negative
effects of alcohol abuse including its contribution to the provision of treatment programmes,
community education and age limits on availability.

In spite of these historical lessons, the United States and countries such as Australia, which
remain affiliated with her, have expanded selective legislative prohibition of some drugs in
attempts to control the use of substances preferred by minorities such as youth, socially deprived
urban dwellers, Asians and African-Americans. This drug prohibition enables law enforcement
agencies to criminalise and otherwise arbitarily interfere in the lives of those without the power to
confront the system or the money to corrupt it. Further, the United Nations General Assembly
has adopted some of these provisions to legitimise political and even military intervention in
countries which have now become otherwise independent states under international law.
As with alcohol seventy years ago, prohibition has failed to prevent drug use or abuse. It has led
to individual and social problems which are essentially the same as those which resulted from
alcohol prohibition.

We know that controlled, legitimate availability of alcohol has reduced many of the social,
criminal, economic and health problems which were seen under alcohol prohibition and provided
a system where users can pay for the continuing unavoidable negative consequences of its
abuse. Similarly, the Government of Victoria has acknowledged that prohibition of prostitution
led to more problems than it solved and, instead, has implemented a system of controlled
availability, taxable services and provision of health and planning controls.
The VCCL is commited to reducing the negative consequences of all drug use. Therefore, it is
particularly concerned about the individual and social harm which arises as the direct result of
selective legislative prohibition of some drugs.

This harm includes:

• Selective drug law enforcement and sentencing practices associated with consequent
  corruption,
• Economic consequences for individuals and for society including the health effects of
  malnutrition and the economic effects of diverting cash flow into the black market,
• Inability to impose taxes on drugs at the wholesale and retail levels,
• Criminal behaviour such as property crime,
• Dangerously uncontrolled quality of product, and
• Inappropriate restrictions on choice of drug for medical and social use.

The Council is urged to adopt recommendations for State imposed control of currently illegal
drugs which are similar to those now in place for alcohol and prostitution. They should be based
on two fundamental criteria:

I. OBJECTIVE INFORMATION
II. HARM MINIMISATION

Using these criteria, the VCCL has identified three different types of appropriate drug control
measures. These are:
1. The Government of Victoria should undertake well-designed accurate community education
programmes which aim to demythologise the stigma and fear which has developed in the
community around currently illegal drugs and drug users;
2. The Government of Victoria should maintain and, in some cases, increase the availability and
diversity of drug treatment programmes available to all drug users; and
3. The Government of Victoria should implement a staged programme of controlled
decriminalisation of all drugs in Victoria associated with objective evaluation of changes in
drug excise collection and drug abuse indicators.
This submission deals with the Terms of Reference of the Inquiry under these general
recommendations. It relies on published data, anecdotal information available to VCCL and the
experience of VCCL committee members. The VCCL apologises to the Council for not providing
full references to the data on which its submission is based. This is one of the consequences of
the short time-lines and the time of the year in which this submission is prepared.
The Government of Victoria should undertake well designed accurate community education
programmes which aim to demythologise illegal drugs and drug users
Illegal drugs are not generally more dangerous and do not have greater social effects than legal
drugs except as these factors are influenced by criminalisation of drug use and drug users.
a) Alcohol continues to cause more social problems than all other drugs combined. This effect
is associated with its pharmacology, which disinhibits usersí behaviour and leads to increased
aggression in those who are otherwise keeping it under control, and the Australian culture
which encourages alcohol intoxication, particularly among young men and some women.
b) Tobacco continues to cause more health problems than any other drug. This is because it is
generally smoked and therefore increases the risk of lung cancer, and because nicotine is
probably the most addictive drug available in Australia.
c) Historically, the factors which influenced criminalisation have been racist and politically
motivated. The Council is referred to papers by Professor Terry Carney, Dr D. Manderson,
Dr Ian Dobinson, Professor Norval Morris and others. An educational programme which
emphasises the racial and cultural discrimination exercised in selecting drugs for prohibition
could build on the social awareness of these issues established by Aboriginal people.
d) Information about illegal drug use which is disseminated by the popular media and in some
schools is strongly influenced by those with real but irrational fears and those with vested
interests in maintaining the status quo. This information needs to be countered with accurate
information, such as that produced by the National Campaign Against Drug Abuse for drug
and alcohol professionals, which is delivered in a manner acceptable to the general
population.
e) The VCCL is aware that funding of some existing drug education programmes has continued
despite negative evaluation. All educational campaigns must be sensitively delivered and
objectively evaluated for their ability to increase accurate knowledge and reduce drug-related
harmful behaviours without increasing abusive drug use.
Circulation of accurate information about drug use will be a difficult and challenging task
because it is (and should be) fundamentally boring.

For example:

• At any one time, at least 80% of illegal drug users are not using drugs in an addictive or
  dependent manner. The Council is referred to the Canberra study on cocaine use and Dutch
  studies of heroin, amphetamine and cannabis use. The exception to this generalisation is
  tobacco. Therefore, education which is based on the numbers and characteristics of users
  who come to notice does not provide a legitimate assessment of changes in the general
  population of drug users.
• Surveys of drug use and sensational educational programmes can increase or legitimise
  existing use of drugs unless they are implemented in a sensitive manner. The Council is
  referred to the work of Steven Wallace, Sally Casswell, Jane Hendtlass and others in
  determining appropriate drug survey, media and education programmes. Therefore, all drug
  education programmes and surveys must be sensitive to the special problems associated with
  sensational drug reports and must be evaluated continually against harm reduction criteria.
• Crime associated with illegal drug use is strongly influenced by the criminal associations
  established by illegal drug users and by the artifically inflated price of illegal drugs. The
  Council is referred to papers published by the Australian Institute of Criminology, the New
  South Wales Bureau of Crime Statistics, the Neave Inquiry into Prostitution, Victoria Police
  papers on drugs and criminality and the effects of criminalising amphetamine. Therefore, the
  media needs to be persuaded to discuss drug-related crime in the context of the relationship
  between criminality and property or other crime rather than the relationship between use of a
  particular drug and the crime.
  

Health consequences of drug use are frequently caused by their method of use rather than by
their pharmacology. For example, the potential for drug-related spread of HIV and hepititis B
is related to injection of drugs. Similarly, the potential for lung and throat diseases associated
with cannabis use is caused with the smoking rather than the drug. therefore, education
programmes should ensure that distinctions are made between the pharmacological effects of
drugs and the effects of their method of use.

The VCCL recommends that the Government of Victoria establish and fund an education
campaign which aims to provide objective, sophisticated information to the community about the
positive and negative effects of all drugs and to demythologise the current inappropriate fear and
anxiety associated with currently illicit drugs and drug users.

The Government of Victoria should maintain and, in some cases, increase the availability and
diversity of drug treatment programmes available to all drug users

The inverse side of the data presented above is that at least 10% of all drug users are
sometimes addicted to or dependent on drugs to the degree where professional intervention is
required to minimise the harm which they impose on themselves and on society. These drug
users are legitimately the responsibility of the health and social welfare professions.
VCCL advises the Council that the effectiveness of these programmes should be assessed in
terms of harm minimisation rather than drug abstinence although, in some individual cases, the
two criteria are not mutually exclusive. The Australian community accepts that drug treatment
programmes are equally able to "cure" heroin dependent users and to help them to "lead a
normal healthy life, with a regular job , support their family, and not break the law, even while still
using heroin"(G. Bammer, "The heroin trial, abstinence and community expectations" (1995) 14
Drug and Alcohol Review 357).

In the absence of reliable data, it is difficult to assess the success of drug treatment
programmes in terms of illegal drug use. The criminality of drug using and associated
problem behaviour continues to preclude their objective assessment at the individual and the
community level.

• Nearly all abusers of nearly all currently illegal drugs routinely reduce their criminal activity
  and their drug intake while in treament. This is, of itself, sufficient reason to encourage and
  maintain their participation in treatment programmes.
• Many drug abusers use more than one drug and change their abuse from one drug to
  another. It is therefore important to address abuse of criminalised and decriminalised drugs
  in the same programme and to assess effectiveness accordingly.
• Total abstinence is an impossible and irrelevant aim which is used to exclude many potential
  clients from drug treatment programmes, particularly those currently subject to court ordered
  urine screening. It is therefore not the only or the most important appropriate criterion for
  assessing effectiveness of treatment programmes.
• Different drug abusers repond to different treatment programmes differently. Programmes for
  alcohol addiction are not always used to treat clients who abuse prescription drugs or illegal
  drugs. Single clients are sometimes separated from clients in supportive relationships.
  Women and men may have different therapeutic needs which require their segregation. For
  the same reasons, sufficient programme diversity is required to cater for the wide spectrum of
  people who seek help with their abuse of currently illicit drugs.
• Drug treatment options are still evolving. Scope for this experimentation should be
  encouraged by the funding and accreditation criteria for treatment centres. For example,
  naltrexone may be appropriate for some heroin users who seek abstinence. The
  appropriateness of similar cocaine antagonists needs to be further assessed. Trials with
  heroin prescription in the ACT should be encouraged by the Victorian Government.
• Effective drug treatment involves multiple admisssions. Therefore, no limit should be put on
  the number or type of admsissions available to individuals.
• Many drug abusers ìmature outî of inappropriate drug use. Therefore, it is important to
  maintain their health as well as attempt to reduce their drug use.
• Free, unsupervised syringe exchanges need to be maintained to avoid transmission of AIDS
  and hepatitis B through shared needles (see the work of Eddy Engelsman, head of the
  Alcohol, Drugs and Tobacco Branch, The Netherlands).

The VCCL recommends that the Government of Victoria maintain and, in some cases, increase
the availability and diversity of drug treatment programmes available to all drug users.
Decisions with respect to funding distribution should not discriminate between legal and currently
illegal drugs but should treat those who seek help in relation to their drug abuse problem on an
individual basis.

The Government of Victoria should implement a staged programme of controlled
decriminalisation of all drugs in Victoria associated with objective evaluation of changes in drug
abuse indicators.

There is no evidence that prohibition has reduced illegal drug use or drug-related harm (see for
example, statements by Commissioner John Johnston from Tasmania Police, Commissioner Jan
Wiarda from the Utrecht Police and the work of Dr Les Drew). On the contrary, there is little
doubt that the most of the drug-related harm in Victoria is attributable to the implementation of
legislative prohibition of individual drugs. This policy has many counterproductive effects
including :

• Dissemination of inaccurate information about some drugs and drug users which leads to
  inappropriate fear in and discrimination by the criminal justice system and the community in
  general.
• This, in turn, leads to higher prices for drugs and associated crime associated with obtaining
  money, obtaining drugs, corruption of public officials and counterproductive linkages between
  criminal and otherwise legitimate activities.
• Drugs which are only available on the black market are not subject to taxation which could
  pay for some of the negative consequences of their use such as treatment for dependence
  (for discussions of this issue see the work of Ian Leader-Elliott, Robert Marks, Richard Baldwin).
• Drug entrepreneurs develop new drugs to avoid the technicalities of the criminal law. Others
  develop more concentrated products or derivatives of existing drugs to avoid detection.
• The high cost of drugs diverts frequent users from buying food or shelter which would
  otherwise help protect them from the consequences of their environment.
  
• Illegal drug users who congregate learn to commit other crime to support their habit or
  because they learn to live in a crminal environment.

In theory, there is no reason why drugs which are currently illegal should not be distributed in the
same way as alcohol. However, the VCCL acknowledges that implementation of any quick
radical changes will be blocked by the fear of drug use engendered in the community by 100
years of stigmatisation and the consequent political climate.

However, the VCCL submits that Australia is ideally placed to trial and compare the
effectiveness of different methods of drug decriminalisation in different States. The Ministers for
Health and Community Services and the Attorneys General should cooperate in implementing a
wide range of practical options before uniform policies are adopted in the long term.

The VCCL counsels to Council to be selective when adopting international and Australian drug
control measures which have been established under different and changing social and political
conditions. For example, VCCL is aware that the Council is considering implementation of the
Dutch system. VCCL experience is that the Dutch system of cannabis supply and availability is
excellent. Cannabis is available to anyone at registered ìcoffee shopsî and is excised by the
state. However, although the ìmethadone busî concept based on maintaining usersí health until
they mature out has promise because it does not require any commitment to withdrawal, it does
not prevent their use and abuse of heroin. Therefore, in Holland, heroin supply remains in the
black market. Further, the Amersterdam authorities do not provide the resources required to
adequately monitor usersí health so that it may not be any more useful than could be achieved
by a minor policy change or the ACT trial here.

Similarly, the VCCL believes that the so-called British system of heroin prescription has changed
substantially under the Conservative government and bears little resemblance to that
recommended by Rolleston and believed, then, to be progressive and a useful alternative to
existing prohibition. VCCL submits that precribed heroin and amphetamines for addicts will
address some issues which relate to the health of addicts and nothing more (see above).
Further, these programmes could become self-fulfilling if they are implemented in isolation from
general decriminalisation of use and possession of drugs because registration of addicts
provides no incentive for them to reduce use qnd the requirement for addiction will, by definition,
lead to an increase in their apparent or real number at the expense of currently casual users.
The black market will still supply the casual users.

The newer Swiss model (which has been informally established in Kings Cross) of providing
identified places where addicts can obtain and safely administer drugs and congregate has yet
to be objectively evaluated. There have been problems with drug traffickers using the same
areas and consequent law enforcement problems.

Further, the VCCL submits that current American and Victorian policies which adopt the rubric
and substance of ìThe War on Drugsî are counterproductive (see for example the logo used in
this debate by the Herald Sun and comments in Head to Head by Assistant Commmisioner
O'Loughlin and Dr John Sherman, Herald-Sun 8 January 1995). They locate the illegal drug
problem in the drug users rather than in drug control policies and in society. They create
inappropriate fear and anxiety in the wider community. They emphasise the need to fight rather
than cooperate. They encourage discrimination against and alienation of drug users and
particular associated racial and social groups. They have been publicly acknowledged to
accomodate the skills and services of those made otherwise redundant by the breakdown of the
Cold War. Federally, Australia must withdraw from its harsh interpretation of its commitments
under the international drug treaties to which it is party. She must also encourage international
agencies to redraft all international instruments which inhibit amendment of domestic drug
legislation.

The South Australian expiation notice procedures for possession, use and cultivation of cannabis
for personal use do not go far enough. They provide a useful indication that, at that level,
decriminalisation is not associated with increased use. However, a large proportion of offenders
still choose to go to court which leaves open the opportunity for police corruption and does not
successfully reduce the drain of drug offences on Legal Aid funding.
Therefore, all changes to current drug control measures need to be preceded by a planned
education programme and a comprehensive, independent research programme to allow
objective assessment of the effects of each change on drug related harm.

The VCCL recommends that the Victorian Government adopt a staged programme of controlled
decriminalisation of drugs in cooperation, where possible with other States, based on the
following presumptions:

• If over 80% of drug users are not addicted or dependent on illegal drugs, then control of
  availability should be a social policy issue rather than a health or criminal justice issue.
  
• If up to 20% of drug users will have disabling health, social or economic consequences, then
  availability of drugs should be associated with an excise to cover the community costs of use.
• If use of some drugs, such as cannabis and heroin, is associated with reduced aggression
  and other social consquences, they should be legalised first.
  
• If some methods of use, such as oral ingestion, are associated with less severe health
  consequences, they should be encouraged.
  
• If alternative methods of drug control are proposed in other states, they should be supported
  by Victoria as long as they include objective evaluation on harm reduction principles.

The VCCL recommends that the Victorian Government immediately:

1. Maintain and expand well designed research programmes which objectively measure long-
   term changes in use and abuse of all drugs in Victoria;
2. Establish and fund an education campaign which aims to provide objective information to the
   community about the effects of all drugs and to demythologise the current inappropriate fear
   and anxiety associated with currently illicit drugs and drug users;
3. Withold Government funding from all education programmes which have been objectively
   demonstrated to increase abusive use of any drugs or have no long-term effect on studentsí
   accurate knowledge and understanding of drug use and abuse;
4. Maintain and, where appropriate, extend the number and diversity of treatment programmes
   for drug and alcohol dependent persons with a view to their long-term evaluation against
   harm reduction criteria;
5. Support the ACT programme to provide prescribed heroin to addicts with a view to its
   evaluation against harm reduction criteria and, if positive, integration into the treatment
   regimes available in Victoria;
6. Establish accreditation and funding criteria for drug treatment programmes which allow the
   trial of innovative approaches similar to that relating to heroin in the ACT, with a view to their
   evaluation against harm reduction criteria and, if successful, inclusion in the options available
   to all drug abusers who seek withdrawal;
7. Change the name, mandate and role of the current Liquor Control Commission to include
   control of supply and use of cannabis;
8. Remove cannabis from prohibitive control under the Drugs Poisons and Controlled
   Substances Act and place its use, sale and manufacture under controls and taxation
   measures which are analagous to those now governing provision and use of alcohol;
9. Amend the Drugs Poisons and Controlled Substances Act to include the option of expiation
   notices, analagous to those which have been successfully introduced for cannabis in South
   Australia, for offenders charged with use, possession, sale or manufacture of all currently
   proscribed drugs except cannabis in quantities below those now defined as traffickable.

Further, the VCCL recommends that the Victorian Government establish a long term programme
for implementation of controlled decriminalisation of all drugs by the renamed authority which
has control of alcohol and, on the recommendation of this submission, cannabis.