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ice and heroin drugs bust
‘The Crime Commission has stated that law enforcement will always be a part of the mix in drugs policy, even in a regulated market. But a large spend on law enforcement is both difficult for the police to uphold and the investment yields a significant loss in terms of policing, courts and jail.’ Photograph: Matthias Engesser/AAPIMAGE
‘The Crime Commission has stated that law enforcement will always be a part of the mix in drugs policy, even in a regulated market. But a large spend on law enforcement is both difficult for the police to uphold and the investment yields a significant loss in terms of policing, courts and jail.’ Photograph: Matthias Engesser/AAPIMAGE

An injecting room worked for heroin. Let's have one to help beat ice

This article is more than 9 years old

To tackle ice, Australia needs brave leaders who understand that there will always be people who take meth, and no amount of law enforcement will ever change that

In its report on the methamphetamine market, the Australian Crime Commission has identified ice as the illicit drug posing the highest risk to the Australian community. As well as documenting the health, social and economic harms caused by the drug, the report comprehensively outlines the role of organised crime in producing and distributing ice. Additionally, it concludes that the market will continue to grow in the short to medium term. So how are we to cope with this relatively new and quickly growing problem?

Twenty years ago heroin was the great crisis. Levels of use were at historic highs, young people were dying of overdoses, used discarded needles were everywhere and HIV transmission was much feared. It was time for action. Eventually, both federal and state governments heeded the community’s demands and acted decisively and, in some cases, radically.

Both the federal Howard government and the NSW Carr government embraced harm minimisation approaches to drugs policy, which led to the establishment of a medically supervised injecting centre in Sydney’s Kings Cross. This strategy met with vociferous and often bitter criticism from politicians, media commentators, local business owners and many of the general public. Even the Vatican was critical – it decreed that the centre could not be operated by the Sisters of Charity Health Service.

In the 14 years since the centre opened, there has not been a single overdose death on the premises. A recent report by KPMG has found that 78% of local residents and 70% of local businesses are supportive. Since opening, the centre has been the subject of 11 reports by five different agencies. All of these found that it is saving lives and reducing injury from drug overdose, it is reducing public injecting and the number of syringes discarded in streets and parks, it is making contact with a vulnerable and hard-to-reach group of people who inject drugs and is referring them to treatment services. The brave decision to open this centre has paid off in spades, not just for drug users, but for the whole community. And now, heroin use is at its lowest level for years.

But now we have ice – and it’s a mounting problem. We certainly need a national strategy and an investment in treatment services to try to reduce the level of use as much as possible. However, and this may be an inconvenient truth but truth it is, we will never eradicate ice use completely. There will always be a group of people who will continue to take it. It is time once again time to adopt radical and less than universally popular approaches. We need to consider the lessons of previous successes. Perhaps it’s time to establish a safe place for ice users along the lines of the heroin injecting centre: a place where users can be monitored, where adverse physical and mental reactions to the drug can be professionally dealt with. This could, like the injecting centre, become a place where users develop a trust relationship with staff and are eventually amenable to referral into treatment.

Of course ice is nothing like heroin – it’s almost its antithesis. Instead of being “on the nod”, you’re off your head; it makes people incredibly aggressive. Organisations like the Noffs Foundation have developed the best clinical practices over decades to support someone going through the throes of ice use and coming off the drug. A space that regulated ice use, of course, like the injecting centre, would be safer for the community too. As the Howard government realised many years ago, it’s not enough to just try to stop people using. We also have to, for those who do use, reduce the amount of harm that they cause to themselves and to the community.

In fact it surprises many to discover that behind Howard’s “tough on drugs” stance in the 1990s, we saw the largest commitment to harm minimisation services the nation had ever seen. The Abbott government, on the other hand, has done a lot in a small amount of time to dismantle Howard’s investments and measures.

In NSW, Liberal premier Mike Baird has been courageous enough to support medicinal cannabis. I believe he also has the courage to invest more broadly in early drug intervention for young people but he hasn’t done so yet.

Baird has committed to three new stimulant treatment centres – essentially specific rehabs for ice users – but in terms of evidence-based clinical adolescent rehabilitation centres in Sydney and Canberra, we have 26 beds for the whole state and territory. Queensland has just invested in the Noffs Foundation to establish treatment centres in the Gold Coast, Brisbane and the Sunshine Coast but that is a day program model. Our hope is to setup Queensland’s first residential rehabilitation centre in the near future.

Some governments truly understand the evidence before them – that harm minimisation is the best strategy to deal with drugs and it is far better than pure prohibition. And some governments and leaders (including previous premiers and police commissioners) knew that prohibition was a failure. But drug prohibition is a hot potato that very few leaders will touch.

There is some hope, however, with Labor seemingly supporting the Crime Commission’s conclusion that law enforcement alone was not the answer.

The Crime Commission has stated that law enforcement will always be a part of the mix in drugs policy, even in a regulated market. But a large spend on law enforcement is both difficult for the police to uphold and the investment yields a significant loss in terms of policing, courts and jail.

The are two rules about illicit drugs that are true regardless of which drug we’re talking about. Rule number one: there will always be some people who use. Rule number two: governments, no matter how well intentioned, can’t change rule number one. An unfortunate and unpleasant truth perhaps; but it needs to be told.

There is only one thing a thinking person needs to know about harm minimisation and radical ideas like the injecting centre and that is they save lives.

We have seen a steady decline of drug use in our country over the past two years – it would be a shame to see that reversed.

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