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On December 2, a motion in the ACT Legislative Assembly made consideration of the passage of a bill to decriminalise possessing small quantities of illicit drugs dependent on the government coming up with a plan for effective treatment of co-occurring mental health and substance dependency problems.

This was probably not the first time that the Assembly has resolved on a course that will undermine and delay the outcome that it seeks.

The continued subjection of people who use certain substances to the non-therapeutic, stressful processes of criminal law compounds the underlying problems that may have led to their drug use. It can also exacerbate, and even initiate, any mental health problems that they may have.

The criminalisation of drugs is a notorious driver of stigma and is one of the main reasons people who use drugs are reluctant to seek treatment, as well as being behind the crisis in the Australian mental health system. Criminalisation and the associated stigma that goes hand in hand with illicit drug use disinclines many mental health professionals from having anything to do with people in trouble with drugs.

The select committee that considered the territory's decriminalisation bill heard witnesses describe the failure of the mental health system to provide help when it was needed. Mental health services were stretched to breaking point. For example, speaking on behalf of the AMA, Professor Jeffrey Looi, the head of psychiatry and addiction medicine at the ANU Medical School, observed that mainstream health services "frequently struggled to meet levels of demand that they face, because of unsustainable under-resourcing, understaffing and lack of infrastructure". He added that there were "constant problems with the level of capacity in relation to bed flows; having sufficient beds to care for people with acuity of conditions, with a substantial overlap of addiction medicine problems, including substance abuse ..." The committee also heard from parents at their wits' end. Mental health services, to whom parents had reached out for help, left them to handle their child's challenging conditions without meaningful support.

It is of inestimable sadness that the intolerance of some parents to the drug use of their children pushes the recovery they yearn for more and more out of reach.

The picture painted by witnesses speaking on behalf of drug treatment services was more optimistic, whereby even those who displayed florid co-occurring mental health and substance dependency problems were successfully engaged, retained and stabilised in a treatment service. Those services were also struggling with funding sufficient for only half the estimated demand, but, in responding to people with co-occurring conditions, they were clearly in a far less dysfunctional state than hospital emergency and mental health services. They all articulated the need for services that are accessible, effective and non-stigmatising. No wonder they solidly supported decriminalisation.

It is vitally important that those services co-operate with one another so that the best outcomes can be achieved for those seeking help.

Services like the King's Cross and Canadian medically supervised injecting centres have documented improvement in the mental health of patients. Heroin-assisted treatment now available in six or seven European and North American jurisdictions has also produced better mental health outcomes.

A primary goal of drug services is to stabilise people so they are in a position to make better choices, rather than insisting on them being drug-free. Certainly everyone wants their loved one to be free of addiction, but if the choice is between continuing drug use and the higher risk of death from enforced abstinence, life should win.

An Anomalous Century of Drug Prohibition

The US led the push for global drug prohibition early last century. On the domestic side, this commenced with the 1914 Harrison Act, while, internationally, Washington pressed for the first international drug control treaty, the 1925 Geneva Convention, which it refused to be a signatory to.

Over the following decades, a series of international drug control treaties were negotiated. These were eventually consolidated under the 1961 United Nations Single Convention on Narcotic Drugs: which is the key document of the prohibition era.

US President Richard Nixon then launched his official war on drugs in June 1971, marking an intensification of the law enforcement arm of prohibition. His administration did so with the aim of criminalising and controlling African American communities and the rising antiwar movement.

Forty years later, the former heads of state and leading intellectuals that comprised the Global Commission on Drug Policy condemned the drug war as a failure, which has increased drug use, led to mass incarceration and caused the development of a huge transnational criminal network.

On February 21 NSW Health issued a warning about methamphetamine and cocaine being contaminated with the dangerous opioid fentanyl.

Several people who had taken these illicit stimulant drugs presented to Sydney hospitals with symptoms of opioid overdose, raising the alarm. Drug tests found fentanyl and acetyl-fentanyl had caused the overdoses.

It's believed to be the first time fentanyl has been found in stimulant drugs in Australia.

People using stimulants like methamphetamine and cocaine are not looking for the depressant effects of opioids. They would not have expected their drugs to contain fentanyl.

While you never know for sure what you're getting when you buy illicit drugs, this is an extreme case.

There is nothing simple about drug use and it is essential to have a sense of perspective.

Drug use is widely considered to be an overpowering social ill, a perennial threat. Yet in truth, the picture is ambiguous in the extreme. As the historian, Lucy Inglis comments in Milk of Paradise: a History of Opium, many of us will end our lives being given morphine to dull pain. 

A growing number of Australians support the legalisation of cannabis, while almost three in five back the idea of pill testing, according to a new national survey.

The 2019 National Drug Strategy Household Survey also shows Australians are drinking and smoking less, but some illicit drug use is on the rise.

Importantly, this national snapshot, released on Thursday, shows the Australian community is becoming more open to less punitive measures around drug use.

Between 2017 and 2018, 62% of the 130,000 individuals presenting to drug and alcohol treatment were there because of problems relating to either alcohol or methamphetamine (‘ice’) use. Unfortunately, relapse after treatment remains the norm, with a national study showing that only 52% of treatment-seekers substantially reducing or quitting their substance use a year later.

Antony Loewenstein will be appearing at the Melbourne Town Hall on the 9th September to launch his new book, 'Pills, Powder and Smoke: Inside the Bloody War on Drugs'. The evening will also feature a panel discussion with community leaders including Fiona Patten, Julian Burnside, Laura Turner, Mick Palmer, Greg Barns and hosted by ABC Radio journalist, Jon Faine. Antony Loewenstein will speak about the issues raised in his book and be available afterwards for a book signing.

When I started writing about the war on drugs many years ago, I soon realised its connection to the other bogus war in the last decades, the war on terror. Both conflicts are unwinnable and yet countless governments around the world invest billions of dollars annually into a militarised battle that’s done nothing to address the reasons so many people consume drugs.

Instead, drug use and abuse are soaring around the world, including in Australia, and the results are clear to see; overdoses, dirty and untested pills consumed at music festivals and ever-present stigmatisation around anybody who uses illicit substances.

Millions of Australians use, or have used, illicit substances at some point in their life, while millions more are regular users of legal drugs such as alcohol, tobacco or sleeping pills.

While some people become heavy users of alcohol or other drugs as a way of coping with past trauma or mental illness, this is not the story for millions of others. Young (and older) people use drugs and alcohol for fun, enjoyment and socialisation.

In describing in her findings arising from a wide ranging inquest into six fatal opioid overdose events, current illicit drug policy as “futile” and likely to exacerbate drug related harm, the NSW Deputy State Coroner, Harriet Grahame, urged the NSW Government to have the courage to commit to conducting a summit on drug decriminalisation.

On any reading of her findings, it seems clear that these are opinions directly driven by the facts as presented at the inquests and the coroner’s frustration, in the face of this evidence, at the continuing refusal or inability of the government to do more to stem the frequency of overdoses across the State.