07 June 2012

On drugs

The series of articles on drug laws and the need for reform in The Sydney Morning Herald has been positive, arising from the Australia21 report on the issue. The SMH have much to show their News Ltd colleagues about fostering a debate rather than running a campaign. While it's telling that so many major figures have come out against prohibition, with Mick Palmer not the least of them, this has been a debate that's been part of our lives more broadly. Drug law reform can't and shouldn't succeed until its scope is broadened; it is a shame that both Australia21, and the SMH, have overlooked that.

There's more to the drug debate than just prohibition vs decriminalisation. You can see that in the debates going on elsewhere that both Australia21 and the SMH has rigorously quarantined from its coverage of drug law reform. Perhaps they have done this in an attempt to bring clarity to what everyone agrees is a complex issue. I disagree that it will be effective or desirable in either securing drug decriminalisation, or in mapping out what might or should happen once drugs that are now illicit become legalised.

People want drug addiction to be seen as a public health issue. Let's do that, and in so doing let's look at a public health campaign that has been hard-fought and almost won, and which is not at all unrelated to the debate on other drugs: tobacco.

The first thing to remember is that tobacco is a more serious health problem for Australians, in themselves and in terms of costs to taxpayers and the economy more broadly, than illicit drugs. The cost of prohibition should take account of the averted costs of its alternative, rather than simply being written off as some sort of dead loss.

The second is that, just as the tobacco industry faces the prospect of sinking to its knees under the weight of plain packaging, it faces the prospect that decriminalisation will not just throw it a lifeline but open a cornucopia of commercial opportunities. All of those charges levelled at tobacco and alcohol companies about marketing to minors will come back with a vengeance when tobacco growers get a licence to grow cannabis, and when smaller companies that form part of the tobacco distribution network see the opportunities in now-illicit drugs as compensation over the government's war against tobacco. Big companies will sneak their special-treatments in with the smaller ones, and government will give them. Those hoping for additional funds to be spent on healthcare can only watch the money flow away from them as "incentives" for those who have waged war on public health campaigns.

You may think that your local neighbourhood drug dealer sidling up to the kids after school with a collection of little baggies is A Threat To Our Children, if not to Our Way Of Life. Wait until the perfectly legal, expensive and sophisticated marketing campaigns hit full stride. Look at the success that junk food has had over a younger generation, and imagine how successful similar campaigns for illicit drugs would be. Now contrast that against the odd junkie scuttling into the shadows for their hit in terms of the length and breadth of a real social problem, and ask yourself whether you are really making things better.

These companies will make the case that they can take the illicit trade out of the hands of thugs - subjecting them to taxation and regulation - just as legalisation did for gaming and abortion. They will be right, too. Do not doubt that those interests will prevail over those who would tightly regulate those drugs that are now illicit, as per the Australia21 report.

Purists will maintain that illicit drugs should be reserved for medicinal purposes only, e.g.:
  • Pure heroin for use in safe injection environments, as part of programs to work addicts off the drug, or
  • Distillation of those chemical compounds within cannabis that stimulate appetite and create feelings of well-being to counter the ravages of chemotherapy.
Setting up this new regulatory environment will require a great deal of expenditure on the part of government with little or no offsetting income. There will be adjustment difficulties that make government look stupid. It will still require the enforcement of prohibition against those who desire drugs and have the means to pay for them, but who have no need for them as determined by medical programs operating within government regulation and budgets.

Peter Baume was a moderate Liberal who was Health Minister in the Fraser Government for less than a year before it lost office, the last Federal minister in that portfolio who didn't have to deal with Medicare. He was a factional opponent of John Howard and the Liberal right and he retired from the Senate ahead of the boot as the party changed around him. Many of the arguments that appear in the Australia21 Report are those which he tried to push through the Liberal Party in opposition, including trying to push through the Young Liberals during my time there. The moderates were under such sustained attack that to support Baume was a factional stand in favour of a pluralism that has now gone. Baume became tetchy when challenged, even by moderates, which detracted from messages like this:
Heroin was legal and could be prescribed by doctors in Australia until 1953. That is, heroin became a problem after, and not before, it was prohibited.
In 1953 authority had a greater hold over the population than it does today. The campaigns against the non-medically sanctioned use of opiates in the nineteenth century still applied in 1953: it was something that was the preserve of Asian people and was proof, for those who sought it, of their inferiority to White Australia.

Baume has been impeccable against race-baiters, and I defer to his understanding of the dimensions of heroin addiction as a real public policy problem; but in an age where Authority in general is much diminished there is no equivalent social repellent to turn Australians away from a dangerous drug. Public health campaigns against addiction have the appearance of make-work schemes, doing worthy work but too little against a problem that can only grow.

The first group of Australians to experience heroin addiction as a significant problem were much overlooked in their time, especially in terms of their health. They were the first Australians who travelled to and from Southeast Asia in their thousands: Vietnam veterans. They had problems with alcohol and Agent Orange exposure too, and these problems were simply and flatly denied. The fact that heroin was illegal, that alcohol wasn't and that nobody went out sculling DDT is to ignore the lessons of that time.

Simply legalising and containing heroin addiction within health programs is an inadequate response to a much wider problem. It's foolish to graft on yet another health program to the ragged patchwork already in place and expect any benefit beyond the marginal, at a cost that will have to be massive in order to be realised. Let's not even talk about co-ordination of other policies beyond law-and-order and health (e.g. housing, welfare payments).

Baby-boomers weren't politically powerful in 1953. Decisions were made on their behalf by a waste-not-want-not people, in the parliament, in the bureaucracy, in pharmacies and doctors' clinics and police stations, and in the community more broadly. They pushed for drug decriminalisation in their youth for lifestyle reasons, and now as they enter their dotage they appeal to medicine and palliative care. The political question is, do baby-boomers still have the power to command public resources for a policy that suits them, and won't necessarily benefit the rest of us? Will they tolerate health funds being diverted toward younger people, away from them?

It's a basic flaw of the Australia21 report that it focuses on heroin overdoses and other drug deaths. It refers in passing to incidental crimes committed by addicts to fund their habits, but there is more to the drug problem than that and costs from widespread, normalised drug use should have been factored in, even if funding for the report did not allow for detailed modelling. I'd be fascinated to see the soil degradation, runoff and other environmental impacts from an industrial-sized cannabis crop (what do you mean, no modelling has been done?).

Australians in particular mix drugs. Australian policy must relate to Australians. "Social smokers" who consume tobacco when under the influence of alcohol, and who combine alcohol with drugs of varying legality and chemical composition, show that demarcating illicit drugs in the name of 'clarity' or 'focus' are chasing a mirage and doing the country a disservice. The report skates over mental illness in drug use, particularly for those abused as children, but it needs to be part of a bigger solution than decriminalisation. Anyone who thinks that illicit drugs is so different to pokies, alcohol etc. can shove their apples and their oranges; those issues are more similar than different.

The other fundamental flaw with the Australia21 is a misreading of the political system. The report is predicated upon an assumption that bipartisan support for their position is desirable and even achievable, despite a sop of realism to the pressures on politicians to avoid controversy. This is so wrong that it completely undermines the report, and is puzzling from a board that has operated at the highest levels of government.

Led by Tony Abbott, the Coalition have trashed bipartisanship. The changes to the Liberal Party that forced Peter Baume into retirement have continued to the point where a latter-day Baume would flee from his first branch meeting, and would have no hope in a preselection. There is no way that the Coalition as currently configured can or will consider legalising now-illicit drugs. Any individual Liberals who might have considered it are keeping their heads down and toe-ing the Abbott line (e.g. Joe Hockey, Marise Payne), or are marginal figures (e.g. Mal Washer), and put together they couldn't actually change policy and spend additional money.

Consider that Peter Dutton has been shadow health minister before and since the last election, and this is the nearest thing he has produced to a policy. His most substantial policy after all that time is reaction and denial about an issue from the fringes of significant public health issues affecting this country.

If ever there was a field where the status quo of 2004 is inadequate for 2014 (which is the central message of the whole Howard Revival), health is it. Dutton has not contributed in any meaningful way to health policy debates: the former health minister was promoted, whereas if Dutton was an effective shadow she should be political roadkill. A new minister is firmly established in the portfolio free of any challenge from her "shadow".

Dutton seriously regards prohibition as a good idea that has never been fully tried. This is a clear indication of:
  • His ability to address issues in the community;
  • The quality of the man as a future minister; and
  • The sheer futility of expecting, or even hoping for, bipartisanship on this issue.
The Coalition clearly regards illicit drugs as a law-enforcement issue (supposed concern for addicts is so much mealy-mouthed bullshit waiting to be scythed in expenditure review - c'mon people, am I the only one who has learned how Abbott works?). Like Dutton, Brandis grew up in Queensland under Bjelke-Petersen; he'd know all about drug prohibition. The silence from the alleged shadow attorney general on this issue - a normally voluble man who goes on and on about much lesser legal issues - is deafening.

Forget the Coalition. Forget bipartisanship.

The only hope for an enlightened drug policy, with a carefully thought-out public health response and a sound communications strategy, rests entirely with Labor. It would have to be led by a strong and progressive leader such as we have not seen in a generation, and the prospect of which is indiscernible to those who watch federal politics closely. That leader would have to be prepared to go all out to secure their policy against both internal opponents (who would want scarce health resources spent on anything else). That leader would need the courage to prevail against nervous nellies inside their party (including those armed with polls and conference-floor delegates), go the polls with a consistent policy, defeat a prohibitionist Coalition and divert health funds away from baby-boomers in order to ease druggies off their addictions.

Nope, me neither.

I'm sure that the Australia21 board and supportive contributors to the SMH are aware of the current political situation. I share their optimism that it is a passing phase - not only the defeat of an Abbott government but also President Obama defeating the US Republicans this November will hopefully break reaction as political strategy. However, I've been wrong before, and so has Peter Baume; the prospect that the future of Australian politics lies in the major parties emphasising their differences (while "playing it safe" with the status quo in drug law) should not be discounted.

Look, I dare you, at the shambles that is the regulation of poker machines and alcohol in this country. Know that this is the fate for the regulation of drugs. Listen to the cries of alcoholics and pokie addicts in their more lucid moments, and of those who care for them despite everything. Know that those travails can and shall be compounded by the direct and indirect victims of legalised drugs. Forget policy that makes things harder rather than easier.

For those who like the personal touch injected into this debate, my late brother was an alcoholic who died in a motorbike accident. Readers can take comfort in my assurance that this is not the start of a campaign to ban alcohol, nor motorbikes for that matter; as the report points out, alcohol is also a much greater issue than all illicit drugs put together. I realise that piecemeal efforts against drugs that are now illicit are inadequate, but the alternative is worse because it hasn't been thought out properly.

Proponents think they are being clever by separating drugs off from other problems like pokies, alcohol, tobacco etc., but I'd suggest they are not being clever enough. Like the republicans of the 1990s they are mistaken in thinking that they are being clever in proposing a small reform and selling it as a big one. There should be linkages across disciplines among people doing good work and making whole-of-government NDIS-style solutions. I am just not interested in any policy that will detract from efforts against real problems, and the prospect that they might add to them leaves me cold. I am sick to death of rallying behind well-meaning but ill-considered policies and getting run over by the foreseeable.


  1. Sorry Andrew, you've lost me on this one. Firstly, the campaign against tobacco needs to stop. I think we've reached reasonable levels of understanding of the harm. It's up to people how they deal with it and most people seem to have got the message.
    Secondly I believe that alcohol harm prevention is done with an extremely light touch given the much wider circle of harm it spreads compared to tobacco. Why is this so? I suspect there are deeper cultural and economic forces at work.
    Thirdly, history doesn't repeat. Modern alcohol and tobacco companies are the product of the industrial revolution. We're past that. In the case of cannabis I foresee the Amsterdam/San Francisco model as being the more likely scenario rather than vast fields of dope harvested by massive pot combines.

  2. Thanks Patrick.

    1. Disagree about tobacco, the fact that consumption is rising among young women belies your point.

    2. Agree with the light touch on alcohol, but again consumption is going up and alcohol-related harm is a real if often hidden issue.

    3. "We" might be, but government isn't. Look at alcohol; small-scale niche operators have a role but multinationals dominate the market.

    1. Point 1: Yes but overall trend has been downwards, like religion. Not sure about your 3rd rebuttal as it misses my point. Large scale alcohol and tobacco production are 18th century creations. I don't think it's safe to assume that the same would happen with cannabis.

    2. Trends can reverse, particularly if you take your eye off the ball: no reason to do so now.

      Don't care when they were created, they still dominate the market and will use that market power against well-informed debate and the interests of public health generally.

  3. Some thoughts:

    1. Tobacco is not only a harmful drug in itself, but encourages cannabis abuse. Cannabis users who mix their pot with tobacco smoke far more pot than those who don't, because, unlike many drugs, once you're stoned off your gourd you don't get any higher by consuming more.

    Mixed with tobacco, however, the smoker keeps coming back for the nicotine hit and consuming more cannabis in the process.

    So, from that point of view, tobacco is still as harmful as ever, and cannabis use is actually preferable.

    2. Apart from being convenient, cannabis is smoked because it's the most cost-effective way of consuming something that grows on trees but is very expensive. If prices became more reasonable, many users would eat it instead, which may offset the respiratory disease burden.

    3. A recurring theme of these discussions is an assumption that legal access to drugs will result in an outbreak of crippling addictions.

    Legalisation would certainly increase the number of addicts, but from the population of people who are prone to addiction, who are already using the legal alternatives.

    It's well established that the most severe drug addicts are opportunistic: heroin might be their drug of choice, but if they can't get that, they'll take speed, or alcohol if that's what's left.

    That's why there's been such an outbreak of methamphetamine use. It's a horrible drug that no user would preference, but it's cheap and easy to make and therefore widely available.

    For those reasons, we don't know how many people would, for example, wean themselves off a ravaging alcohol dependence onto a much safer pattern of opioid or cannabis use.

    The other assumption in that vein is that it's necessarily crippling and degrading, as though everyone who likes a joint in front of the telly or an oxycodone with their strong black is headed inexorably toward rehab, but there's no evidence to support those assumptions.

    4. Regarding the farming and environmental effects of cannabis, commercial crops are far more likely to be indoor hydroponic affairs than outdoor plantations, which comes with hazards, but not strictly those of outdoor farming.

    5. I don't care much for the argument that modern societies aren't obedient enough to authority to be allowed access to mood-altering drugs, but that doesn't mean it's not relevant.

    I would say, though, that the human weakness for drug addiction is greatly overstated, and that access to cannabis and opioids won't lead to otherwise happy, productive people turning their lives over to drugs.

    Research into pain management addressed the concerns of hospital patients that using morphine for pain during treatment would turn into opioid dependence, and found it to be completely false.

    Neurologically, emotional pain is the same as physical pain, and heroin addicts are simply doing for their brains what a doctor does for a patient in agony. There's no inherently addictive quality to drugs, and I say that as someone who TRIED to become a cigarette smoker as an adolescent, but couldn't get into it.

    So, it's great that there's some discussion happening about the legality of drugs, but it still rests greatly on uninformed assumptions people make about drugs and drug users.

    1. Thanks for your thoughful contribution, Sancho.

      1. You're right, and I see no point in easing up on tobacco by opening multiple fronts.

      2. Perhaps so, but then there have been campaigns in the US to revive chewing tobacco - more information needed IMHO.

      3. I'm not sure abourt crippling addictions necessarily being the main concern, though any increase would represent a failure. I'm concerned about the prospect of a society where drugs are normalised. There should be more people getting into it than out of it, otherwise we are all easier to maniplulate.

      4. Perhaps, but there are still environmental issues - the small-scale opium poppy farms in Tasmania are very strict on containing runoff and the spread of pollen, but more widespread application could see side-effects that aren't clear at the moment.

      5. When I refer to 'authority' I not only mean politicians, law enforcement etc., I refer also to the authoriy of science - witness the climate debate - basically, if we as a society had a clear warning that substance X did more harm than good, how would we put that genie back in the bottle? Goes to the point in your final sentence.

  4. The big three cancer causes are alcohol,Cigarettes and combined with diet (obesity) are the main factors which cause so many lifestlye related diseases and lengthy hospital stays/operations etc.
    I think we have a real problem in Australia with the yobbo drinking culture, I think this coupled with every other car ad showing a solo car taking corners like a V8 driver (allways alone and in control, never stuck behind a caravan or at the lights) contribute to the road toll.
    Heroin and Canabis cause problems too, and are a burden on the health system and society at large and I don't think there is an easy answer. The flicking of the switch to "legally accessable" mode doesn't seem like the solution.
    I think it's pathetic that Hemp isn't being used (nation wide)commercially for the wonder crop that it is. The fibres are far superior to those used in paper, the clothes are warmer than cotton and still breathe.
    I guess my point is that, ultimately each individual is responsible for their lifestlye choices, it should be evident by now, that people are going to stick whatever they want and whenever into themselves regardless of laws, hopefully the commonsense that we need to be shown also by the government as well on the treatment and management of drugs happens in our lifetimes.

  5. I'm not sure I completely agree with you, Andrew - I think I need to re-read and digest before I decide. However, I take your point that treating drug addiction as a medical problem in isolation is a mistake. Let me say, as a boomer entering his twilight years, I would have no problem with health resources being diverted from prolonging my life to dealing with addicted younger people. I may be unusual.

    One small point, though, on heroin addiction amongst Australian Vietnam veterans: I soldiered with quite a few of them, and none of them ever mentioned it. A few of them smoked weed, and a larger number had problems with alcohol, but I think herion addiction was much more an American problem.

  6. I reckon every 15 year old should be made to spend two minutes stuck listening to some coked-up bore in a pub. That should be enough to put anyone off drugs.

    By the way, I think I need to be on drugs to get past your increasingly bizarre anti-robot test!

    1. When I was at school in the '80s there was a guy in late '60s gear who would stumble down to our local pub with a thousand-yard stare, at the time of day when the school buses took us home. The kids called him Creeping Jesus, and legend had it that he was one of Australia's best guitarists until the wrong cocktail of alcohol and other drugs fried his synapses completely. He didn't scare everyone straight but everyone who witnessed him always pictured him at the back of mind when offered something.

  7. Interesting article, not something you often see since most of the public 'argument' revolves around the pro/anti prohibition discussion. Personally I'd tend to favour a model of legalisation along the lines of our current treatment of legal/prescription drugs however it's easy to see how legalisation could morph into pressure for further liberalisation to maximise the potential 'economic' benefits/tax revenue from this new market.

    Still given the limitations of our wretched political/media dynamic it's surely understandable that drug reformers adopt a 'small target' approach and try to overcome the initial hump of building broader public/political support for liberalisation. Wouldn't a broader range of proposals risk the sort of wilful misinformation/white anting campaign you see on issues like IR deregulation/carbox tax etc?

    1. In terms of broad-based reforms, compare the failure of the republicans of the late '90s to the relative success of the NDIS today. You can be not clever enough under the guise of being too clever.

    2. The republican debate is a fairer comparison and i'd agree that they shot themselves in the foot by adopting some sort of 'small target approach' to significant constitutional reform.

      I think the long-term development of the NDIS has been a pretty good model for sensible policy development but it never had to contemplate the sort of hysterical tabloid misinformation campaign that any mooted reform of drug laws has to deal with.

      Hopefully a labor victory at the next election will restore some belief in the virtues of implementing sensible, long-term policy. Until then one can understand why drug reformers are hesitant to waste their time developing complex policy proposals that will never be adopted. (Barring the sort of labor leader you describe in your article and given their gutless retreat on pokie reforms there is no reason to think this particular mirage is likely to appear anytime soon)

  8. Andrew,

    Out of interest, have you heard of a book called "Idiot America" by Charles P. Pierce?

    I think you'd enjoy it.

  9. I'm uncomfortable with any move to legitimise drug use - even marijuana.

    I know that there are plenty of people who who it responsibly and that it's relatively harmless to many people. However, it also has the power to activate latent schizophrenia in other people. The only way to find out which kind of person you are, is the hard way.

    I'm not for zero tolerance. I'm happy for a blind-eye to be turned to harmless users, although as someone mentioned earlier, they're all fairly boring people. But I don't think it's government's place to be seen to approve of something that really isn't good for you.

    I also think it's pretty lame that we have banned everything to do with tobacco except tobacco. A legal product ought to be able to identify itself. If we are serious about stamping out smoking, we should go the final step and ban it completely. I wrote about how that might be done here: