This article appeared in the Sydney Morning Herald this week and I believe it warrants a speedy response. For what they are worth, here are my thoughts:
I just had a few points I wanted to raise in relation to the Weatherburn/Hall piece. Now I know my credentials are far outweighed by the gentleman responsible, but if you got a spare minute or thirty, I thought we might have the opportunity to share:
Firstly, to represent the existing paradigm as being comprised merely of two diametrically opposed 'sides' is greatly misleading. I am puzzled why anyone of stature would place 'harm reduction' and 'black and white' in close proximity as the authors do here. Harm reduction is a philosophy that embraces the 'grey area' and has been a saviour in the 'black and white' world of Prohibition. Furthermore, the regulatory perspectives that have been presented over time do not preclude the role of law enforcement and do not advocate for a world of 'free drugs', as has been presented elsewhere. The authors here unfortunately support the continued, tedious misrepresentation of pro-regulationists like Release in the UK.
Gee, if you get arrested in a fair, regulatory, post-Prohibition environment, you probably deserve it!
Next I would like to yet again speak out against dodgy analogies. That is, comparing oranges to apples; chalk and cheese; that kind of thing, yeah? So, when the esteemed authors compare the failure of the 'War on Drugs' with drink driving I was kinda disappointed. As far as I am aware, the 'War' has the clear intention of eradicating the selected drugs; no two ways about it. 'Booze buses' on the other hand are a harm reduction measure, right? As far as I am aware, the designers of breath testing have always acknowledged that people will not stop drinking and driving (they even established a legal limit), and if they really wanted to do that they would need to ban alcohol (or driving). But hang on, they won't do that because it wouldn't work. But hang on, so why do they maintain the ban on other drugs... Oh, sorry, I'm getting all tangled up here.
Anyhow, I then go on to read that the 'War on Drugs' is not designed to eradicate the selected drugs and the massive rise in prices is the key. Ohhh, I must have misinterpreted the meeting about a "drug-free world by so and so year". Well okay, so now I'm meant to change the way I perceive a war that 'protects' the masses at the expense of the most vulnerable. That's right, because who most often ends up trying to meet those ridiculously high prices, regardless of the consequential risks and poverty? That's right ladies and germs: the most vulnerable. Those of us who end up risking our safety with street-based sex-work; those of us who have suffered abuse; those of us who are poor in developing countries; those of us most damaged. And who ends up paying when such desperate people resort to crime? That's right, the 'protected' masses. Also, the higher prices don't prevent wealthy people from affording these drugs and this reinforces double standards in society, whereby it's okay for the rich because they can get away with it.
And then, the heroin shortage is cast in a positive light due to a reduction in crime, morbidity and mortality! That may well be the case folks, but here in Melbourne we saw people swapping to other (often more risky) drugs and an increase in self-harming amongst marginalised youth. Again, the most vulnerable lose out.
The authors then confuse me further when they seem to unintentionally expose a gross inconsistency. If decriminalisation has little impact on prevalence, why the hell don't they raise this point in relation to the price-hiking 'success' of the 'War', thereby exposing a serious flaw? They state that Prohibition reduces consumption and harm to levels lower than what they would be without law enforcement. But hang on, you have then written that decriminalisation has little impact on prevalence. So if enforcing the law reduces harm and consumption, why doesn't removing the criminality of a law increase use and therefore the harms? They also state that treatment is far more effective than punishment for already-dependent users and they are the ones who will use more if legalisation occurs. In which case, just make it legal and reduce the harms for those who do use because the rest of the community will be okay and an increase in use does not always lead to disaster! Am I the only one perplexed here?
From what I have seen over the last fifteen or so years, I think I would rather see more people using a cheaper form of heroin in a non-discriminatory society than less people using prohibitively expensive dope in a 'junkie-hating' world. I don't think I need to explain why. Plus, this is where the misrepresentation of regulation comes in again. The drugs in question would pose a serious risk to illicit producers because they would not just be offered to seriously dependent users, but would also be available to others in a pure form, dispensed with appropriate equipment by qualified professionals. Or that is how one model goes, because, contrary to this article, there is a variety of models up for consideration.
Next, the authors write of "toxic drugs" with "quite toxic mental effects". Wooaaahh, dude, the state could never support those kinds of drugs. One minute, I just need to attend to yet another client who is suffering from the toxic effects of alcohol and alprazolamdexamphetamine AND ritalin - he seemed positively jubilant and healthy. Also, such drugs would not be regulated merely to remove the black market (even though that is a mighty fine reason), as the authors write. The primary benefit would be for the people who use or may use these substances and the wider community - the authors seem to forget about the person in the equation. Their safety; their dignity; the financial cost to society; the prevalence of viruses. The list goes on. And we may be able to have greater control over who uses the drug, and at what age - the strength of the black market means these decisions often lie in the hands of people who aren't qualified to make such calls, with availability rampant due to the profitability.
So then the authors mention the problems we face with pharmaceutical opioids. Now I'm not telling anyone how to suck eggs, but it is essential to comprehend a problem before using it as an example to support an opinion. So what then is the problem with this form of prescribed drug? From my point-of-view it goes a little like this:
a) people experiment with drugs like Oxycontin because they might be more accessible due to their legality and the growing popularity of opioid-based pain management
b) people who are already opiate users seek out such preparations due to reduced quality of heroin, unavailability of heroin, lower prices or assurance of purity.
c) some people perceive it to be less dangerous due to the licit status of the drug/s
d) people who receive legitimate prescriptions change the mode of administration to increase bioavailability and speed up onset of action (these people are often frustrated by the treatment they receive from medical professionals, whereby they experience judgement and a seeming absence of genuine compassion)
e) people inject the tablet, patch or capsule preparations and experience related harms as a consequence (systemic infection, localised infection, vein damage etc.)
The nature of this problem, far more involved than the passing reference by the authors, strikes me as one borne of a society that refuses to acknowledge that injecting is an enduring practice that is far better managed in a compassionate and health framework, where injectable preparations are required (like they are required, and exist, in other countries). To merely frame this point as "medicalisation doesn't necessarily mean a reduction in crime and corruption - look at prescription opioid misuse as evidence of this", is misleading and comfortably fits into the dangerously simplistic presentations we too often see in the mainstream media. As is always the case, the prescription opioid issue is part of a much bigger picture and exists within a continuing Prohibitionist system. Of course crime and corruption persist, because the issue is not yet medicalised (it is still criminalised of course), with these medications solely prescribed for chronic pain (not drug dependence) and available in a limited range of preparations (no injectable forms and very restricted access to medications with rapid onset of action).
Last, but not least, I must have missed the memo that stated that coerced treatment is effective. I thought we had already established that voluntary treatment with the widest variety of options was the best way to go for the vast majority of people and adheres to human rights principles. The authors present a "sad" situation where people enter treatment only when financial or legal troubles arise. And yes, it is sad when people seek treatment too late for whatever reason. However, in specific relation to this article's information, we should be arriving at an understanding that people might actually fare better if provided with education and support that allows people to manage their own drug use, without the threat of arrest/imprisonment or ongoing poverty/financial ruin. Especially when the drug being used is not causing significant harm and is actually contributing to the person's happiness. Imagine that? A person having a positive experience with drugs, whereby paternalistic sterility is replaced with something meaningful and enjoyable? I'm just a stupid dreamer, aren't I?
There are positives in this article, like the exploration of police seizures, but does the topic always need to be framed in terms of 'treatment'? Real education supported by a humanist and drug-aware framework is the best way to manage, and even prevent, drug use. Education that isn't patronising, is honest and recognises the complexity of the subject matter will do wonders. A society that also prioritises support, rights and equality cannot be underestimated either.
Maybe Gandhi (I think it was him) said it best when he explained that the worth of a society can be judged by how it treats its most vulnerable.
I just had a few points I wanted to raise in relation to the Weatherburn/Hall piece. Now I know my credentials are far outweighed by the gentleman responsible, but if you got a spare minute or thirty, I thought we might have the opportunity to share:
Firstly, to represent the existing paradigm as being comprised merely of two diametrically opposed 'sides' is greatly misleading. I am puzzled why anyone of stature would place 'harm reduction' and 'black and white' in close proximity as the authors do here. Harm reduction is a philosophy that embraces the 'grey area' and has been a saviour in the 'black and white' world of Prohibition. Furthermore, the regulatory perspectives that have been presented over time do not preclude the role of law enforcement and do not advocate for a world of 'free drugs', as has been presented elsewhere. The authors here unfortunately support the continued, tedious misrepresentation of pro-regulationists like Release in the UK.
Gee, if you get arrested in a fair, regulatory, post-Prohibition environment, you probably deserve it!
Next I would like to yet again speak out against dodgy analogies. That is, comparing oranges to apples; chalk and cheese; that kind of thing, yeah? So, when the esteemed authors compare the failure of the 'War on Drugs' with drink driving I was kinda disappointed. As far as I am aware, the 'War' has the clear intention of eradicating the selected drugs; no two ways about it. 'Booze buses' on the other hand are a harm reduction measure, right? As far as I am aware, the designers of breath testing have always acknowledged that people will not stop drinking and driving (they even established a legal limit), and if they really wanted to do that they would need to ban alcohol (or driving). But hang on, they won't do that because it wouldn't work. But hang on, so why do they maintain the ban on other drugs... Oh, sorry, I'm getting all tangled up here.
Anyhow, I then go on to read that the 'War on Drugs' is not designed to eradicate the selected drugs and the massive rise in prices is the key. Ohhh, I must have misinterpreted the meeting about a "drug-free world by so and so year". Well okay, so now I'm meant to change the way I perceive a war that 'protects' the masses at the expense of the most vulnerable. That's right, because who most often ends up trying to meet those ridiculously high prices, regardless of the consequential risks and poverty? That's right ladies and germs: the most vulnerable. Those of us who end up risking our safety with street-based sex-work; those of us who have suffered abuse; those of us who are poor in developing countries; those of us most damaged. And who ends up paying when such desperate people resort to crime? That's right, the 'protected' masses. Also, the higher prices don't prevent wealthy people from affording these drugs and this reinforces double standards in society, whereby it's okay for the rich because they can get away with it.
And then, the heroin shortage is cast in a positive light due to a reduction in crime, morbidity and mortality! That may well be the case folks, but here in Melbourne we saw people swapping to other (often more risky) drugs and an increase in self-harming amongst marginalised youth. Again, the most vulnerable lose out.
The authors then confuse me further when they seem to unintentionally expose a gross inconsistency. If decriminalisation has little impact on prevalence, why the hell don't they raise this point in relation to the price-hiking 'success' of the 'War', thereby exposing a serious flaw? They state that Prohibition reduces consumption and harm to levels lower than what they would be without law enforcement. But hang on, you have then written that decriminalisation has little impact on prevalence. So if enforcing the law reduces harm and consumption, why doesn't removing the criminality of a law increase use and therefore the harms? They also state that treatment is far more effective than punishment for already-dependent users and they are the ones who will use more if legalisation occurs. In which case, just make it legal and reduce the harms for those who do use because the rest of the community will be okay and an increase in use does not always lead to disaster! Am I the only one perplexed here?
From what I have seen over the last fifteen or so years, I think I would rather see more people using a cheaper form of heroin in a non-discriminatory society than less people using prohibitively expensive dope in a 'junkie-hating' world. I don't think I need to explain why. Plus, this is where the misrepresentation of regulation comes in again. The drugs in question would pose a serious risk to illicit producers because they would not just be offered to seriously dependent users, but would also be available to others in a pure form, dispensed with appropriate equipment by qualified professionals. Or that is how one model goes, because, contrary to this article, there is a variety of models up for consideration.
Next, the authors write of "toxic drugs" with "quite toxic mental effects". Wooaaahh, dude, the state could never support those kinds of drugs. One minute, I just need to attend to yet another client who is suffering from the toxic effects of alcohol and alprazolamdexamphetamine AND ritalin - he seemed positively jubilant and healthy. Also, such drugs would not be regulated merely to remove the black market (even though that is a mighty fine reason), as the authors write. The primary benefit would be for the people who use or may use these substances and the wider community - the authors seem to forget about the person in the equation. Their safety; their dignity; the financial cost to society; the prevalence of viruses. The list goes on. And we may be able to have greater control over who uses the drug, and at what age - the strength of the black market means these decisions often lie in the hands of people who aren't qualified to make such calls, with availability rampant due to the profitability.
So then the authors mention the problems we face with pharmaceutical opioids. Now I'm not telling anyone how to suck eggs, but it is essential to comprehend a problem before using it as an example to support an opinion. So what then is the problem with this form of prescribed drug? From my point-of-view it goes a little like this:
a) people experiment with drugs like Oxycontin because they might be more accessible due to their legality and the growing popularity of opioid-based pain management
b) people who are already opiate users seek out such preparations due to reduced quality of heroin, unavailability of heroin, lower prices or assurance of purity.
c) some people perceive it to be less dangerous due to the licit status of the drug/s
d) people who receive legitimate prescriptions change the mode of administration to increase bioavailability and speed up onset of action (these people are often frustrated by the treatment they receive from medical professionals, whereby they experience judgement and a seeming absence of genuine compassion)
e) people inject the tablet, patch or capsule preparations and experience related harms as a consequence (systemic infection, localised infection, vein damage etc.)
The nature of this problem, far more involved than the passing reference by the authors, strikes me as one borne of a society that refuses to acknowledge that injecting is an enduring practice that is far better managed in a compassionate and health framework, where injectable preparations are required (like they are required, and exist, in other countries). To merely frame this point as "medicalisation doesn't necessarily mean a reduction in crime and corruption - look at prescription opioid misuse as evidence of this", is misleading and comfortably fits into the dangerously simplistic presentations we too often see in the mainstream media. As is always the case, the prescription opioid issue is part of a much bigger picture and exists within a continuing Prohibitionist system. Of course crime and corruption persist, because the issue is not yet medicalised (it is still criminalised of course), with these medications solely prescribed for chronic pain (not drug dependence) and available in a limited range of preparations (no injectable forms and very restricted access to medications with rapid onset of action).
Last, but not least, I must have missed the memo that stated that coerced treatment is effective. I thought we had already established that voluntary treatment with the widest variety of options was the best way to go for the vast majority of people and adheres to human rights principles. The authors present a "sad" situation where people enter treatment only when financial or legal troubles arise. And yes, it is sad when people seek treatment too late for whatever reason. However, in specific relation to this article's information, we should be arriving at an understanding that people might actually fare better if provided with education and support that allows people to manage their own drug use, without the threat of arrest/imprisonment or ongoing poverty/financial ruin. Especially when the drug being used is not causing significant harm and is actually contributing to the person's happiness. Imagine that? A person having a positive experience with drugs, whereby paternalistic sterility is replaced with something meaningful and enjoyable? I'm just a stupid dreamer, aren't I?
There are positives in this article, like the exploration of police seizures, but does the topic always need to be framed in terms of 'treatment'? Real education supported by a humanist and drug-aware framework is the best way to manage, and even prevent, drug use. Education that isn't patronising, is honest and recognises the complexity of the subject matter will do wonders. A society that also prioritises support, rights and equality cannot be underestimated either.
Maybe Gandhi (I think it was him) said it best when he explained that the worth of a society can be judged by how it treats its most vulnerable.
Great comment that I missed from the original internet article's comments:
ReplyDeleteThe most direct comparison is with the legalised drugs tobacco and alchol. The black market trade in these is tiny, and there is no reason to suspect it would be different if other drugs were legalised. And although there are plenty of health problems with tobacco and alcohol, and crime problems with alcohol, these are manageable with regulation of sale and alcohol.
There are no convincing arguments for the continued criminalisation of certain drugs, although some have serious health problems if abused. Bottom line, the state should be less repressive on the free choices mad
e by responsible adults in our society.
rufus - September 22, 2010, 7:13AM