Friday, June 8, 2012

On drugs

Andrew Elder | Politically Homeless | 7 June 2012

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.

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