Legislative Council
The Hon. M.J. ELLIOTT: I move:
That the Legislative Council notes the drug policies of the
Netherlands and Switzerland and their impacts, and therefore—
I. Supports the separation of the cannabis market from the market
of other illegal drugs; and
II. Calls on the Federal Government to allow the proposed heroin
prescription trial to proceed in Australia.
On Thursday 8 October this year—in fact, the day before I left to travel
overseas—the State Police Commissioner, Mal Hyde, announced that 34 heroin users had
died in South Australia so far this year. It seems reasonable to assume that, by the end
of the year, the death rate will have reached somewhere approaching 50, which is around
about the ballpark of what it has been for the past couple of years—I believe that it
has been 50, 60 and slightly over. As I said, that was the day before I departed for two
countries that I believe have made encouraging progress in the drugs area, namely, the
Netherlands and Switzerland.
Some people might wonder why I should spend my time on heroin addicts. I believe
that there has to be an appreci-ation that drug users are people: they are someone's son,
daughter, sister, brother, father or mother. They come from all sectors of our society;
they are ordinary people; but they have an extraordinary problem—and we must
acknowledge that. They have a health problem that needs to be confronted.
In Australia we introduced drug laws to protect people. We did that with the best of
intentions. We believed that, by introducing laws that came down hard not just on those
who sold but on those who might consider using, we would stop their use. We now have a
long enough history to know that what has happened instead is that the very laws we
introduced to protect people are killing people. The laws we introduced to protect people
mean that they are now leading lives of crime and prostitution, over which they have no
choice, because of what the addiction is doing. They have enough of a sentence from the
addiction itself without our considering some other penal reaction to it.
South Australian laws are costing not just the individuals and their families dearly
but ultimately they are also costing our community dearly. We are all sharing the cost of
the crime that is generated by the habit and the need for the drug and the need for the
money to get the drug.
After spending two weeks in those two countries studying their drug policies and
their implementation—of course, I have looked at them from a distance for some time
but it is not quite the same as being there and meeting with the various players—I
have come back convinced that there is not a single solution to the drug problem. In fact,
there is no solution as such. However, there is a suite, or a range, of approaches which
together offer some hope and clearly offer an improvement on the situation in which we
currently find ourselves. Yes, we need law enforcement, but law enforce-ment should not be
targeting the users: it has to be targeted at the pushers—the people who are inducing
people to use drugs and who are making the mega profits out of the misery that is being
created. Let the police focus their efforts there: do not have them chasing around after
the people who have a problem and, in fact, exacerbate their problems. We need a health
and a social approach adopted towards the users.
I witnessed the programs in the Netherlands and Switzer-land. I spoke with health
professionals, politicians, police and drug users. I went into the clinics and user rooms,
etc., and saw what was happening. I even experienced first-hand drug-related theft, in
that in the second week when I was in a tourist office obtaining directions to find my way
to a suburb of Bern a bag was taken from my feet. It was found about 50 minutes later in a
park that drug users frequent. They had been through it and taken the money from it but,
luckily, had not taken my passport, tickets and notes. I was most worried about the notes
that I had taken, because at that stage I was about three-quarters of the way through the
tour. So, I suppose I had contact from almost every aspect of the drug situation in those
countries.
I believe it would be most productive if I took the two countries separately
because, while there is some clear overlap between what they are doing, there are also
some clear differences. I will talk about the Dutch experience first: what they are doing
and those things that appear to be working and, in some cases, just comment about it. I
will do the same with the Swiss, and I may spend more time focusing on the heroin
prescription situation in Switzerland, because that is where they have been doing it the
longest, and I will focus on other matters in Holland, where they have had greater
experience.
The Netherlands reported 65 drug deaths from a popula-tion of 15.4 million in 1995.
Compare that with South Australia, which has had 34 drug deaths so far this year from a
population of 1.3 million, and your maths will tell you pretty quickly that our rate of
death from use of hard drugs is about eight times as great as that in the Netherlands. In
fact, I commend to members (and I will quote from it later) a publication The Annual
Report on the State of the Drug Problems in the European Union, which is put out by
the European Monitoring Centre for Drugs and Drug Addiction and which contains a table of
deaths over the period 1986 to 1995. In the Netherlands, the number of drug deaths was 55
in 1986. It went down to 40 in 1987, varied through the 50s, 60s, 70s and up to 82 and 84
in 1993 and 1994, and went back down to 65 in 1995. There is a bit of variation there, but
it is relatively flat.
In the United Kingdom the number of deaths was 1 212 in 1988 (when it started
compiling figures) and that country has had a rising line with very little relief in it.
By 1995, it had reached its highest figure of 1 778 deaths, in a population of 58 million.
France—another near neighbour of the Netherlands—with a population of 58
million, had 465 deaths in 1995—a significantly higher death rate than that of the
Netherlands. And Germany (a country that is very tough on drugs) had 1 565 drug deaths in
1995, in a population of 81 million. I believe that is about 20 times as great as the
figure in the Netherlands, its neighbour, which it also criticises for its drug policies.
In some ways it is rather amusing, I suppose, that countries that are failing in their
approach to the drug problem, such as the United States, Australia and Germany, condemn
countries that are making not only a very real effort but also some achievement in that
area as well.
The Dutch drug policy is pragmatic that is, its ideological or normative aspects are
less important. Its primary objective is health protection, and the key concept is harm
reduction. The outcome that the Dutch are seeking is assistance to drug users, aiming
primarily at minimising health risks, with drug abstinence as a secondary aim. That does
not mean that they do not want drug abstinence: they are setting themselves what are
achievable goals and are achieving them. However, the aim of the Dutch drug policy is
broader: it is to minimise the risks of drug use for individual drug users, their
immediate environment and society at large.
Besides minimisation of health risks, other important issues in the Dutch drug
policy are to limit nuisance and criminality caused by addicts and to combat illicit drug
trafficking. Therefore, the Dutch drug policy follows a two track approach which consists
of repressive measures based on legislation, drug law (that is, criminal law) and
law-based regulations—and I will give the Council some statistics later on just how
much they are achieving in the repression area. They are not soft on drugs; indeed, they
are very successful in the repression area. The other track is the social and health care
measures. There are three distinguishing features: first, in general, a pragmatic
orientation; secondly, in the field of social and health policy, drug problems are defined
primarily as health problems; and, thirdly, in the field of criminal law, there is a less
repressive approach towards users.
With a pragmatic orientation, as well as harm reduction there is also what they call
normalisation, which is a key concept of the Dutch drug policy, entailing the following
connotations: getting the drug issue to normal proportions is just one health issue
besides others; integrating drug treat-ment services as far as possible into general
health services; and getting the drug problem under control. This concept of normalisation
is an example of the pragmatic orientation, `pragmatic' meaning effect or result oriented
and not principle oriented.
In relation to social and health policy, the drugs problem is defined in the first
place as a health problem. The Ministry of Health, Welfare and Sport is responsible for
coordinating drug policy. The basic aim of the Dutch drug policy is harm reduction to help
drug users to live a life as healthy as possible and to survive with a subsequent aim of
drug-free treatment. Therefore, low threshold programs are a priority, that is, easily
accessible services where drug users do not have to fulfil certain requirements to be
accepted as clients. These activities entail: the provision of methadone, sterile needles,
food, medical care and accommodation. Most of that is not really different from what we
are doing in Australia.
The choice of harm reduction is a pragmatic one. The principal and moral imperative
that drug users should give up drug use resulting in an approach offering treatment as the
only solution has proved to be not realistic, and realism is what is necessary in all of
this. Harm reduction, as stated before, is important for individual drug users to prevent
damage to their health. It is important for their immediate environment, preventing
infection risks, reducing social problems and keeping children alive and relatively
healthy, as well as for society at large.
We want to decrease the cost of health measures, law enforcement and criminality
generally. Besides low threshold facilities, a variety of facilities offer treatment.
There are brief detoxification periods of up to three weeks, short-term admittances of up
to three months, longer-term admittances with a maximum of one year, part-time treatment
and outpatient treatment.
The third point involves legislation and regulations. In drug law itself there is
only one distinguishing feature, and that is the distinction between soft and hard drugs.
They make a distinction between cannabis and the other illicit drugs. The outcomes are
that penal provisions for soft drug offences are milder than those for hard drug offences.
The possession of up to 30 grams of cannabis is seen no more as a crime but as a
misdemeanour. That is not dissimilar from the South Australian approach.
The main rationales are a separation between the market for soft drugs and the
market for hard drugs, preventing cannabis users from ending up in an illegal environment
where they are difficult to reach for the purpose of prevention and intervention. A minor
distinguishing feature is lower maximum penalties, and another major distinguishing
feature—perhaps the most important one—is the expediency principle which is
included within the Dutch penal code. The expediency principle empowers the public
prosecutor to refrain from prosecution of criminal offences if this is in the public
interest.
Guidelines for detecting and prosecuting offences under the Opium Act contain
recommendations regarding the penalties to be imposed and priorities to be observed in
investigating and prosecuting offences. Priorities according to these guidelines, which
were amended on 1 October 1996, are: punishable offences involving hard drugs other than
for individual use take the highest priority; punishable offences involving soft drugs
other than for individual use; and investigation and prosecution for possession of hard
drugs for individual consumption, generally .5 of a gram, and soft drugs to a maximum of
five grams. To my mind, the most significant action that the Dutch have taken with their
pragmatic approach and the move to separate markets is the separation of cannabis from
drugs such as heroin, cocaine and amphetamines.
There are many people who prescribe to the stepping stone hypothesis: an assumption
that cannabis consumers run a higher risk of switching to hard drugs, especially heroin.
This idea was first put forward in the 1940s in the USA and has since greatly influenced
public opinion, as well as American and international drug policies. Opinions differ as to
whether or not the hypothesis is correct. Regarding a possible switch from cannabis to
hard drugs, it is clear that the pharmacologi-cal properties of cannabis are irrelevant in
this respect. There is no physically determined tendency towards switching from soft to
harder substances.
Social factors, however, do appear to play a role. The more users become integrated
into an environment (a subculture) where, apart from cannabis, hard drugs can also be
obtained, the greater the chance that they may switch to hard drugs. Separation of the
drug markets is therefore essential and forms the basis of the cannabis policies of the
Netherlands.
As part of that policy, the police and public prosecutors have allowed the
establishment of coffee shops. The law does not. It is the fact that the expediency
principle is in operation within their legal system that allows them to have coffee shops.
These coffee shops are established and sell cannabis and have been doing so for over a
decade. They will not suffer the wrath of the law unless they go over a set of published
criteria.
The first criterion is that coffee shops will not advertise: no commercials, no
promotion. They will have no hard drugs for sale, nor will they allow hard drugs to be
used within them. They will allow no public nuisance and no selling of soft drugs to
persons under the age of 18 and in no great quantities, which means more than five grams
per transaction. The maximum trade stock allowed is 500 grams, so they cannot have more
than half a kilogram in a coffee shop at any one time, although councils can set a lower
maximum. Depending on specific local problems, some local councils have added several
stipulations in the form of a covenant: for instance, there may be no parking in the front
of the entrance and a closing time may be set.
According to police estimates, the number of coffee shops in the Netherlands was 1
200 to 1 500 in 1991. A research bureau estimated their number at 1 460 in 1995 and 1 293
in 1996. So, over the past couple of years the number has decreased. It is also fair to
say that there are estimates which place higher and lower figures on them.
Coffee shops are mainly small cafÈ-like enterprises. I issue a warning for people
who go to Amsterdam or Rotterdam: if you are looking for coffee, go to a cafÈ; if you are
looking for cannabis, go to a coffee shop. The cafÈ-like enterprises cater for a diverse
public from various social backgrounds. Most offer a wide range of hashish and marijuana
products from various countries and of varying quality. Coffee shops have various
functions. Some act solely as shops. In others, people may use drugs if they buy
something, whilst others serve mainly as meeting places where little is bought and people
stay longer.
I visited a couple of cannabis coffee shops and spoke with their owners and some of
the customers. Anyone who has been to a hotel and then goes to one of these coffee shops
would see a remarkable difference in the behaviour of people. In a hotel you may see
aggressive drunks. In coffee shops I saw a number of people sitting around engaging in
social discourse. I personally do not smoke, but they were having a smoke, and they
certainly were not creating a public nui-sance. Most importantly, from a drug perspective,
this environment that they were in was not providing links with other drugs such as
heroin, cocaine and LSD, etc.
It is worth noting that the consumption of cannabis in the Netherlands is about on a
par with neighbouring European nations. Again, quoting from the Annual Report on the State
of Drug Problems in the European Union, in relation to cannabis consumption among
teenagers—and this is a question not as to who are regular consumers but as to who
have ever consumed—in the Netherlands it stands in the age range 16 to 19 at about 30
per cent. Compare that with the United Kingdom, which has much harsher laws, where in the
same age group it is 36 per cent. If you compare it with the French, ages 18 to 24, it is
30 per cent. The Germans claim that from 18 to 20 (which is just a two year age range) it
is 22.6 per cent.
So, the allowance of coffee shops has not led in the Netherlands to this rapid
escalation in consumption relative to the surrounding countries which have entirely
different laws. Although I do not have the Australian figures with me, I have no doubt in
terms of those who will have consumed at some time that the figure would have been higher
in Australia and is definitely much higher in the United States. The laws have not led to
increased usage. It is important that one understands that the Dutch not for one moment,
having allowed the coffee shops, were saying, `Look, cannabis is a good thing.' I brought
back a large amount of material from the Netherlands in relation to the education programs
being run in the Netherlands, in their schools and outside. I quote from Fact Sheet No. 5
`Education and prevention policy alcohol and drug' put out by the Netherlands Alcohol and
Drug Report, as follows:
The Government is striving to prevent a situation in which
judicial measures do more damage to the drug users than the drug use itself. The sale of
small quantities of soft drugs in coffee shops is not prosecuted provided that the owner
complies with a numberof rules. One important aim of this policy is the separation of the
markets for soft drugs and hard drugs. . .
Effective prevention requires a combination of voluntary
restraint on the part of people themselves and restrictions imposed by the authorities in
form of legislation and regulation. In addition, great importance is attached to strong,
well-organised social controls. The government also takes a positive view of
self-regulating initiatives developed by the industry and its umbrella organisations, such
as the trade organisations for beer and liquor. . .
Although a great deal of attention is devoted to the Dutch
government's relatively lenient attitude to drugs compared with other countries, the
supply of drugs is in fact much more stringently restricted, both legally and in practice.
Supplying drugs is completely banned. . . while supplying alcohol is primarily regulated.
. . The distinction between soft drugs and hard drugs is also considered of great
preventive value. This is why a distinction is being made between drugs that carry an
unacceptable risk (heroin, cocaine, LSD, amphetamines, hash oil, XTC), listed on Schedule
1 of the Opium Act, and hemp products (hashish and marijuana), listed on Sched-ule 2 of
the Opium Act. By making the distinction between drug users and dealers, the government is
attempting as much as possible to prevent drug users from entering an illegal environment,
where they are difficult to approach for prevention and intervention.
Finally, the cohesion within the policy as a whole is also
important, with accessible and outreaching care also being realised along with prevention.
And what is more, the care is not only provided by highly specialised facilities, but also
by primary care facilities—close to the population—which also provide help and
prevention.
In relation to the education programs, the fact sheet states:
The Alcohol Education Plan (AVP) aims at providing people with
more information on the effects of alcohol, making them more aware of the negative
consequences of excessive drinking and motivating them to moderate their consumption
(therefore, less often and less per occasion). The AVP uses four instruments: the
conducting of national education campaigns, the initiation of projects, individual
information supplied to the public, social organisations and the media and the conducting
of research. Since 1986, there have been five general mass-media campaigns and five
campaigns targeted at specific groups, particularly young people and young adults.
Commercials on radio and television were comple-mented by commercials in cinemas, on
billboards in railway stations, on the metro and in schools, together with leaflets and
other written information. Such materials can also be developed specifically for
intermediaries. . .
The interactive computer game `Zefalo' is a recent development.
It is available in shops but can also be accessed on the Internet. A free-phone Alcohol
Information phone-line is being set up to increase the range of existing information line.
In addition to the national campaigns, small-scale information
and education actions are being organised at local level, for instance in schools and
youth centres. There are 20 regional AVP Support Centres that cooperate with other local
prevention organisations. The AVP budget for 1995 was $3 million guilders [which is
about $A3 million].
In June 1996 the AVP became part of the National Institute for
the Promotion of Health and Prevention of Illness.
What is worth noting—I have not gone through the detail of the programs
themselves—is that between 1986 and 1994 alcohol consumption fell from 8.6 litres of
pure alcohol per capita to 7.9 litres. This reduction is partly the result of increasing
numbers of non drinkers. In 1995 young people between the age of 15 and 25 who used
alcohol drank 6 per cent less than in 1994. That is a quite interesting result. Within one
year they had decreased consumption of alcohol by 6 per cent. The percentage of non
drinkers rose from 19 per cent to 31 per cent.
I have also been supplied with a one page summary sheet of data in a brochure called
the Healthy School and Drugs Project. This is about an education program which is
in schools and which compares control groups who did not receive the education programs
with those that do. It looks at the age group 12, 13 and 14 in relation to three drugs:
tobacco, alcohol and cannabis.
From time to time I have heard people suggest that, if you supply an education
program, you need to get the age right or you might have the opposite effect. I am not
sure whether that might partly explain why in relation to tobacco the project group showed
marginally more consumption of tobacco than the control group. It was 9 per cent for the
project group and 8 per cent for the control group for the consumption of tobacco.
Interestingly, by the age of 13 it had flipped around the other way—14 per cent in
the control group, 12 per cent in the project group—and by the age of 14 the
difference had grown further to 29 per cent of the control group and 25 per cent of the
project group. That is a 5 per cent difference in those who were consuming tobacco.
Clearly, that education program was biting.
If we look at alcohol, at age 12 the control group was a little over 35 per cent,
while the project group were at about 30 per cent. By the age of 14 and those who had
consumed (that does not mean regular consumers), the project group was still significantly
lower at about 59 per cent compared to the control group who were at 67 per cent. I would
be concerned that that many people had actually tried it in either group but, importantly,
the education had had some effect—and a measurable and distinct effect.
In fact, the most profound effect was achieved with cannabis where, at the age of 13
(they did not supply figures for age 12), 3.5 per cent of the project group had tried
cannabis, whereas with the control group it was about 2.5 per cent. But by age 14 a marked
difference was showing: in just over one year the control group had gone up to 13.5 per
cent, compared to the project group, 9 per cent. I have seen material that the Dutch have
produced for their schools and I know that they are rewriting it and further refining it
even as we speak. So, the Dutch have not given up on drugs. Clearly, they are following a
different approach.
When I went away I was clearly intending to look at the cannabis rules and policies
of the Netherlands and to look at the heroin prescription trials in Switzerland, but I was
also going to look at any other matters that came up. The one matter which got in my face
really as an issue and one for which I was not prepared was the issue of consumer rooms,
of user rooms. I must say that I went away with some vague awareness of them and not
feeling happy about them at all and, having visited several of them and having seen them
in operation, in terms of my own discomfort I felt probably even worse. In fact, after
being in the second consuming room and the third time having seen people actually
injecting while I was there, I was really feeling very ill. But having said all
that—and I will talk more about specific experiences later—I am absolutely
convinced in my own mind that they are part of an overall program and, when I get to the
end of my speech, I hope I will have stitched it all together. All these things are
components.
The first consumer room that I visited was a room in Rotterdam. I went to a church,
Paulus Kerk, near the Rotter-dam Central Station. The pastor there some 18 years before
had said, `I welcome into my church all those who are homeless and who are in need of care
of whatever sort.' Every night since then large numbers have slept in the church and he
has had social workers based in the church offering assistance. In among those people were
drug users.
Near the Rotterdam station, to which, as I said, the church was quite close, there
was a major public drug scene, if you like, including the consumption of heroin etc.
around the station and a huge amount of public nuisance of all the sorts you can imagine.
The police wanted to close this down, but to some extent when you squeeze in one place it
comes up somewhere else. In this case, the police squeezed and it came back up inside the
church. The church allowed people to consume heroin and cocaine within the church itself,
it appears with the police blessing, although to some extent, having had no experience
with it before, they did not know quite what to do, particularly as it was in a church.
The program is about a number of things. First, it is about compassion. These people
are coming into the church and they have available to them all the assistance of various
sorts that they might want. Obviously, it offers the sort of assist-ance you would expect
any church to offer, but it also has more. It has social workers, health workers and an
enormous team of volunteers are working there. Coming into this place are people who are
at the most desperate end of the heroin scene. They are people who have not gone into
methadone programs; people who have probably tried them and failed; people who have
probably tried abstinence a couple of times and failed. They are in desperate trouble.
There is a human relationship, I guess, established between those people working in
the church and the people coming into the injecting room. Through that human relationship
they work to get those people into a fixed place of abode or into a residence. They work
to try to get them jobs. The church has no requirement of them in terms of abstinence. In
fact, as I said, it allows consumption to happen. But, importantly—and I think this
is true with drug users—you cannot help them until they are ready to be helped. The
church tries to get as much of their life into order as it possibly can when they have
that dreadful habit. When the people are ready to go further, it will take them further.
In fact, there are two consumer rooms in the church. Many of the Dutch do not
inject; it is one of the few countries of which I am aware where heroin is actually
inhaled. It is heated on aluminium foil and inhaled through a straw—they call it
`chasing the dragon'. In one consumers' room people were consuming heroin in that way and
in another consum-ers' room people were injecting. A limited number of people are in the
room at one time; I think it was eight in the injecting room—one person out, one
person in. Health workers are available and if somebody needs health assist-ance it is
there. So many of the drug deaths which happen are drug overdoses, and they happen where
people are in an isolated spot where medical assistance is not available.
To put it quite simply, for a person to die in a consuming room would be a rarity.
The first thing about a consuming room is to ensure that people do not die from an
overdose. The second thing about a consuming room is that health professionals are
available to address some of the other problems. I remember seeing one lady in a consumer
room in Bern and her face was covered in sores. I was told that that was likely to happen
because she was injecting cocaine. I do not understand these things, but I was told quite
matter of factly that that is what it was. There was a doctor treating her at the time.
So, those very immediate health issues are being attacked.
The two consumer rooms that I visited—and I understand it is a regular
practice—also sell a cheap and healthy meal, because malnutrition can be a major
problem among drug addicts. Then, importantly, other help is there for people when they
need it. Some people would say that they should be forced to take the help but, if you try
to force them to take the help, they disappear from the system. If they are put into gaol,
they come out worse than when they went in. I spoke to a person who telephoned me only
today to speak to me about this. She said that her sister went into gaol and came out a
worse addict than when she went in.
The heroin problem is a very difficult one, and all the experts tell me that,
unfortunately, people will not get over it until they are ready to get over it. They will
follow many different paths. Some people will follow abstinence; for some people religion
is their solution; for some people it is methadone programs; naltrexone seems to be
offering some hope; and, of course, there are the heroin consumer trials.
I had great difficulty finding the first consumer room—which, I guess, must be
promising in one sense. People expect consumer rooms to create a great deal of public
nuisance. At the first site I visited, frankly, from the outside you would be struggling
to know that a consumer room was there, and in Bern I left a consumer room and within 80
to 100 metres of that consumer room I sat down to have a meal in a restaurant which was
full of people who were quite oblivious to what was so close to them. I commented before
that after my last visit to a consumer room I was not feeling particularly well, and I
must say that it was a meal that I did not enjoy.
I, like everyone else in this place, cannot fathom why anyone would ever want to do
it, why anyone would want to stick a needle in their arm. It has me beaten and, when I
looked at them, I could not see where the joy of it was. But, it does not matter whether I
can see it. They are there and they are doing it, and they are doing it for reasons that
are beyond, I suppose, the comprehension of a person who has not experienced it. All I can
do is look at the practical impacts of the various programs that are being tried.
Some people with all the best will in the world have said that we have to be hard on
these people. I can tell you that being hard on them will kill them; it will mean that
they will stay in crime and the women will stay in prostitution against their will. Even
if it means that they continue to use drugs for some time, offering programs of compassion
and care means that they stay alive and may re-establish human relations with other
people, that those who care for them still have them and that they may commit less crime.
That is the sort of thinking which drove the heroin trials in Switzerland. Before I leave
the Netherlands I should note that the Netherlands itself has now commenced a heroin
trial, which is very much modelled on the Swiss one, but it might be better to reflect on
the Dutch experience once I have talked about the Swiss, who now have experience over a
period of some four or five years.
I will make a couple of final observations about the Dutch. The Dutch are certainly
tough on traffickers. In 1995, 351 kilograms of heroin were confiscated. The Netherlands
is not a major transit country for heroin, and most consignments that are confiscated come
through other European countries. In 1995, 4 851 kilograms of cocaine were confiscated;
that was 23 per cent of the total amount confiscated in the European Union in that year.
In 1994, 215 kilograms of amphetamines were confiscated, in addition to 143 000 pills
containing other synthetic drugs, mainly MDMA, MDA and MDEA. Seventeen illegal
laboratories for the production of synthetic drugs were dismantled in 1995, while a total
of 50 were dismantled in the EU in the same year. In 1995, too, 549 337 hemp plants and
332 tonnes of cannabis were confiscated. That is 44 per cent of the total amount
confis-cated in the EU in that year. In 1994, 323 illegal hemp nurseries were dismantled.
So, if anybody thinks that the Netherlands is soft on drugs and allowing trafficking to go
on, they are wrong: the Dutch are not soft on these things at all.
I will quote from the April 1997 document: Drugs Policy in the Netherlands
put out by the Ministry of Health, Welfare and Sport. In a short section here entitled
`Results of public health policy,' it states:
There were 2.4 drug related deaths per million inhabitants in the Netherlands in
1995. In France, this figure was 9.5; in Germany, 20; in Sweden [which is a country
notoriously tough on drugs], 23.5; and, in Spain, 27.1 [a very conservative
nation]. According to the 1995 report of the European Monitoring Centre for Drugs and
Drug Addiction in Lisbon, the Dutch figures are the lowest in Europe.
There is no doubt that what the Dutch are doing is having a very real impact and result on
people.
Having spent a week in the Netherlands (and for those who want to know precisely to
whom I spoke, that will be all in the report which I will table in the Parliamentary
Library in due course), I move on now to the Swiss. According to current estimates, about
30 000 of the 7 million inhabitants of Switzerland are dependent on illegal narcotics,
with the primary use by this group being heroin and cocaine—and, I must stress,
predominantly heroin. In addition, a number of people use drugs regularly or from time to
time without actually being addicted. It is nearly impossible to determine the size of
that group of drug users. Cannabis is the most frequently used drug, followed by heroin
and cocaine. The use of synthetic drugs, especially of Ecstasy/MDMA, seems to be
increasing. Seen as a whole, however, drug use in Switzerland has remained stable in past
years, and the number of deaths related to drug use has decreased. In 1992, 419 drug
related deaths were recorded, while in 1997 there were just 241. In a period of five years
the Swiss had almost halved the number of drug related deaths. With the closing of the
open drug scenes in the spring of 1995, drug addition has become less visible. As a result
of the economic recession and the spread of AIDS, many drug addicts remain socially
marginal-ised.
Switzerland is an interesting country to look at, because its structure is very
similar to ours. It is a federation where the primary responsibility for drug law resides
with the cantons, which are equivalent to our States. Although the cantons are reliant
upon the Federal Government to provide a lead and coordination, it is the cantons and the
cities which ultimately have most of the responsibility. In view of the apparent
increasing drug problems, the federal government decided in 1991 to intensify its
commitment considerably in this area. In order to fight the harmful effects of drug abuse,
the federal government is pursuing a policy comprising four strategic elements. It has
what it calls a `four-fold approach' to drugs, of prevention, treatment or therapy, harm
reduction and repression or law enforcement.
In relation to prevention—the most important strategic element—it is a
matter of convincing young people not to use drugs and to adopt a healthy lifestyle
(primary prevention) as well as keeping occasional users from developing an addiction,
while maintaining their social integration in the family, at school and at work, which is
secondary prevention. Therefore, the federal government supports and encourages cantonal
and private projects for prevention and early intervention. It coordinates cantonal and
private projects, provides technical assistance and guidelines and takes part in planning
and funding of pilot projects. Certain target groups, such as socially deprived youth and
migrant populations or certain environments such as schools, youth homes and youth events
as well as sporting events, receive special attention.
I turn now to therapy. Those who have become drug dependent should be encouraged to
enter therapy. In addition, specific means and individual support have to be made
available in order to overcome addiction. The federal government supports various state
and private programs for treatment and reintegration. It offers coordination and supports
quality assurance and evaluation. At present about 100 institutions in Switzerland are
specifically designed to provide drug therapy. In-patient therapy is available for a total
of 1 750 persons. The declared goal of these therapies is abstinence and social
reintegration. That is 1 750 out of the total addict population of 30 000. In 1996 more
than 2 100 individuals began therapy. The federal government also offers recommendations
by experts concerning oral metha-done treatments and supports evaluation of this method of
treat-ment. About 14 000 methadone users live in Switzerland, so almost half of the heroin
addicts in Switzerland are within the methadone program.
At the end of 1995 the Swiss Federal Commission on Narcotic Drugs published a report
on the practical and technical aspects of methadone treatment. The report is available in
German, French and English at the Swiss Federal Printing and Material Centre. The federal
government also offers support for patients who suffer from psychological problems as well
as from drug abuse—a double diagnosis. That appears to happen in about 30 per cent of
cases, from my recollection, where you will get a double diagnosis of both psychological
problems and drug abuse, and it is very difficult to prove which came first. There is no
doubt that drug abuse has the capacity to cause psychological problems, but it is also
true that people with psychological problems find the drug culture fairly easy to fit
into.
Since 1994 the federal government has been supporting scientific studies of
medically prescribed narcotics for severely addicted individuals. These studies aim at
clarifying whether marginalised drug addicts who have already tried treatment several
times can be integrated into yet another therapy that leads to health improvements, social
rehabilita-tion and finally to abstinence. That is the heroin prescription trial to which
I will come back shortly. It has been running in Switzerland for some four years. The
third plank is harm reduction. Drug addiction represents for the majority of people
concerned a limited period of several years in their life. It needs to be recognised that
most heroin addicts do eventually get out the other end. Unfortunately, a number do not
get out for a considerable period but, for a great majority of people, it is something
that lasts for several years in their life and then they do eventually emerge out the
other end. I would never say they emerge unscathed, not by any measure.
The third plank relates to measures intended to limit harm that aim at protecting
the health of addicts during the addition period as much as possible. Drug addicts are at
great risk of being infected with HIV and hepatitis. Depending on the group, the rate of
HIV infection among drug addicts is between 5 and 20 per cent. I note that hepatitis C is
looming as a far bigger threat than HIV among drug users: its level is up around 75 or 80
per cent, I understand. Hepatitis C is far more contagious than HIV. At this stage HIV
appears to be responding to a range of medical treatments, not that that is any comfort
because they are still invasive sorts of treatments and it is a dreadful disease.
Hepatitis C leads eventually to cirrhosis of the liver, cancer and the like, and people
are still unsure at this stage precisely what that will mean for us in health terms in
years to come.
We desperately need programs to curb the spread of hepatitis C amongst the using
population because the experience is that, like HIV, it moves from the using population
into the general population and continues to spread. We now find with HIV that the major
people catching it are outside the early danger groups. Hepatitis C could be the same. It
is in everyone's interest that harm reduction takes place. The federal government
therefore supports a variety of measures, for example, needle exchange programs, housing
and employment programs to improve health and the lifestyle of drug addicts and to prevent
the spread of HIV and other infectious diseases. Compared with the late 1980s, HIV
prevalence among drug addicts has decreased.
Switzerland has also followed the Dutch example and is setting up consuming rooms. I
referred to having visited one in Bern. At this stage they have set up relatively few
facilities compared with the Dutch but I think the Swiss have come to the same conclusion
that, by the establishment of consumer rooms, it brings in those people previously outside
the system. If you go outside the methadone and abstinence programs—and now the
heroin prescription programs—you are still reaching only between 50 per cent and 60
per cent of addicts and another 40 per cent are out there injecting in parks, lanes, flats
and units, spreading HIV, catching hepatitis C, dying from overdose, totally and socially
dislocated in almost every sense, committing crimes and working as prostitutes, etc. The
consumer rooms are reaching out to these people, bringing them in and trying to improve
their health status, trying to keep them alive and trying, bit by bit, to restore their
human dignity, with the long term goal of getting them off the habit.
The fourth plank is law enforcement. Swiss drug policy relies on strict regulation
and prohibition of certain addiction causing substances and products. This asks for
criminal prosecution of illicit production, of illicit trafficking and illicit consumption
of substances regulated by law as well as the strict control of authorised use of
narcotics in order to prevent abuse. That is one difference from the Dutch approach. The
Dutch do not have consumption as an illegal act, whereas the Swiss do.
As to the heroin prescription trial, I had the opportunity to meet with the person
in charge of the program in Geneva, Dr Mino, and I also met with one of the principal
architects of the whole heroin prescription program in Switzerland, Dr Robert Haemmig,
from Bern. I like to believe I gained a good insight into the heroin prescription trial.
Basically, people cannot go into the heroin prescription trial unless they have been
addicted for at least two years, although the reality is that most people who entered that
program had been addicted for five years and longer. I spoke with one addict who had been
addicted for 20 years and another for 15 years. They were people who had to have failed
other treatments on several occasions. They had to have failed abstinence and methadone
programs, etc.
There has to be an indication of adverse effects of drug use on health in those
individuals and their social relations. One could not just roll up and say, `I want to be
in the heroin prescription trial.' People had to prove that they had made genuine efforts
in other forms of rehabilitation previously and failed at them. People also had to be a
Swiss resident. The clinics work in such a way that they open three times a day, seven
days a week for 52 weeks a year. They are open for about two hours, once in the morning,
in the middle of the day and early in the evening. Participants in the program report and
are under observation for about 10 minutes so that the nurse or social worker is confident
that they are not under the influence of some other drug, because they do not want to add
a drug to a drug and risk an overdose. Only eight people can enter the room at any one
time and it is very much like the consumer room in that regard.
Participants come up to a counter and ask for a quantity of heroin. Each person will
be prescribed perhaps a different amount; there will be a maximum dose for the day and a
maximum dose at any one time. I am told that users usually come about twice a day and not
three times a day and ask for heroin. They say how much they want and the nurse checks
with the computer that they are not asking for more than what is prescribed. Of course,
the hope is that they are reducing their dose, but there is no forcing of reduction.
The patient is then provided with a needle, which has the heroin put into it and
injects there and passes the needle back where it is put into a receptacle. There is no
chance that the heroin can be taken out of the room and resold. Some of these people are
really bad cases and need assistance from nurses on some occasions. Their veins have
collapsed and they are doing intramuscular injections. What we are not seeing in these
programs, and what we are seeing in the consumer rooms and what is clearly rife in the
consuming populations outside these programs, is the skin infections and the like. Because
people are no longer hunting for money to get their fix they are well nourished and their
physical status has improved markedly. In fact, the only deaths from the program have been
due to pre-existing illnesses such as HIV and the like which they got before they entered
the program. The program is aimed to stop the spread of disease and to improve
significantly the health of people in attend-ance.
I will quote now from the Final Report of the Research Representatives of the
Program for Medical Prescription of Narcotics, which is a summary of the synthesis
report published on 10 July 1977. This was the two-yearly report: the trial had been
running for two years and this is what it found at that point. First, in relation to
substance related results, it stated:
Recruitment of patients, retention rate (the duration of
continuing participation) and compliance. . . were better with the prescription of
injectable heroin than with that of injectable morphine and methadone.
It started off making comparisons between the two but found that morphine and methadone
were not retaining people within the program. It continues:
Of the injectable narcotics used, morphine and methadone proved
to be of limited use; heroin was also more suitable in therapeutic terms because of its
fewer side effects. There are as yet no apparent absolute contra-indications to the
prescription of heroin; particular caution is necessary in cases of pre-existing epilepsy.
In other words, it is saying that using heroin itself is not causing further health
problems. When people are receiving clean needles and known amounts, they are not
suffering other health problems, the only caution being, as I said, possible pre-existing
epilepsy. Also trialled were heroin cigarettes, and the report states about that:
Heroin cigarettes are relatively ineffective (up to 90 per cent
of the heroin is destroyed) and may be replaced by other non-injectable forms.
I move from substance related results to patient related results, and the report states:
This summarises the extent to which the designated target group
of heroin dependents could effectively be reached, what changes occurred in their state of
health during the treatment, how illicit drug use and social integration among patients in
the program developed, and what changes were observed in criminal behaviour. The program
was able, to a greater extent than other treatments, to reach its designated target group:
those with chronic heroin dependency, a history of failed attempts with other forms of
treatment and marked deficiencies in terms of health and social integration. Those
patients admitted to the project who had previously been following metha-done substitution
treatment had continued to use illicit heroin to a large extent during their methadone
treatment.
I turn now to the development of the state of health, as follows:
The improvements in physical health which occurred during
treatment with heroin also proved to be stable over the course of one and a half years and
in some cases continued to increase (in physical terms, this relates especially to general
and nutritional status and injection-related skin diseases). In the psychiatric area,
depressive states in particular continued to regress, as well as anxiety states and
delusional disorders. Pre-existing HIV infections were referred for suitable medical
treatment in the majority of cases; the same applied to other clinically apparent
infectious diseases. Three new HIV infections, four hepatitis B infections, and five
hepatitis C infections occurred during the study (in a total of 11 people).
We must note that close to 1 000 people were involved in this trial. The report continues:
This was very probably related to cocaine injected outside the
program.
The pregnancies and births which occurred during treatment were
adequately supervised and progressed normally (with the exception of one spontaneous
miscarriage during heroin withdrawal); there were no indications of developmental defects
in the neonates.
Regarding dependent behaviour, the report states:
Illicit heroin and cocaine use rapidly and markedly regressed,
whereas benzodiazepine use decreased only slowly and alcohol and cannabis consumption
hardly declined at all.
In a minority of patients, the continued regular use of cocaine
(5 per cent) and benzodiazepine (9 per cent) even after 18 months of treatment constituted
a difficult therapeutic problem to manage.
So, there is no doubt that the multiple users of drugs were the most difficult within this
heroin prescription trial. Concerning social integration, the report continues:
The participants' housing situation rapidly improved and
stabilised (in particular, there were no longer any homeless).
Nobody within the program was homeless. The report continues:
Fitness for work improved considerably; those with permanent
employment more than doubled (from 14 per cent to 32 per cent), and the number of
unemployed fell by more than a half (from 44 per cent to 20 per cent); the remainder lived
on benefits or irregular employment or were engaged in housework.
Debts during the treatment period were constantly and
substan-tially reduced. A third of patients who, on admission, were dependent on welfare
required no further support; on the other hand, others turned to welfare support (as a
result of the loss of illicit income).
Contact with drug dependents and the drug scene declined
massively, but was not adequately replaced by new social contacts during the observation
period.
If we look at social integration matters, we see that the Swiss put a great deal of effort
into the provision of social workers to try to maximise social integration but that
development of new social contacts proved to be the most difficult of all of those,
although again the people to whom I spoke at least had improved the contacts with their
immediate families. That is a terribly important first step. In relation to criminal
activity the report continues:
Income from illegal and semi-legal activities decreased
dramati-cally: 10 per cent as opposed to 69 per cent originally. Both the number of
offenders and the number of criminal offences decreased by about 60 per cent during the
first six months of treatment (according to information obtained directly from the
patients' and from police records). Court convictions also decreased significantly
(according to the central criminal register).
With regard to the retention rate, the report states:
In some cases, the improvement in the participants' health and
social situation referred to above occurred soon after the beginning of treatment, but in
others not until after several months of treatment. The extent to which early
discontinuation of treatment can be avoided therefore plays a major role. The retention
rate in the study, 89 per cent over a period of six months and 69 per cent over a period
of 18 months, proved to be above average compared with other treatment programs for heroin
dependents.
This is a tough program. If you want it, you are required to turn up twice a day, seven
days a week, 365 days a year. You also have to hand in your driver's licence. So the
retention rate is quite staggering. Concerning drop-outs, the report shows that:
By the end of 1996 a total of 83 people had decided to give up
heroin and switch to abstinence therapy. The probability of this switch to abstinence
therapy grows as the duration of individual treatment increases.
So, the longer this treatment continues the more people will go to abstinence, and I will
give more recent data in relation to that in a moment. The report continues:
The longer a patient remains in treatment, the more the rate of
drop-outs and exclusions from treatment decreases. Severe physical illness, particularly
in conjunction with AIDS, is over-represented among drop-outs as it leads to
hospitalisation.
Improvements in the social situation which occurred in the course
of treatment persisted for at least six months, whether or not follow-up treatment was
administered.
The use of illicit drugs increased somewhat after withdrawal but
remained clearly below the initial level; the same applied to contacts with the drug scene
and illicit income.
So, even those who dropped out have gone, in some cases, to places where you would want
them to go—to abstinence or methadone programs. I have figures on that to which I
will refer later. Generally, even those other drop-outs, for the most part, have improved
their quality of life. The report continues:
Of the 1 146 patients in the study, 36 had died by the end of 1996.
It is important to note that none of those died due to overdoses within the program. It
continues:
Seventeen deaths were attributable to AIDS and other infectious
diseases; other causes of death include overdosage of non-prescribed narcotics, suicide
and accidents. . . .Despite a high toll on health, the annual mortality rate of 1 per cent
in the total cohort remains at the lower limit of what is known from other studies on
treated heroin dependents (0.7 per cent to 2.6 per cent per year). The mortality of
untreated patients is markedly higher.
I have a lot of other information about project related results in terms of what was done
to ensure that there were not disturbances in the local community, security problems, and
so on. If members are interested I would be happy to let them see that documentation.
I now move to the conclusions of this study. On the basis of these results, the
report came to the following conclusions and recommendations:
The continuation of heroin-assisted treatment can be
recommend-ed for the indications described in this research and as long as the general
organisational and operational conditions set out in the research protocol are
established.
If the program is continued, the unresolved questions and
problems mentioned in the report should be further examined and elucidated through
scientific research. The treatment itself should be appropriately monitored, documented
and evaluated.
The final recommendation was as follows:
It is apparent from these conclusions that a continuation of
heroin-assisted treatment can be recommended for the group targeted by this program,
provided that it is administered in suitably equipped and supervised outpatient clinics
which meet the general conditions and criteria as described above.
I also have another paper that has been prepared by Dr Mino and others specifically about
the heroin prescription program in Geneva, as well as a swag of other documents that I
will not quote from extensively here today.
The key messages are that a heroin maintenance program may be a useful treatment
option for patients who do not succeed in conventional drug treatment programs—and I
stress that they do not succeed in those other programs. Patients randomly allocated to
the Geneva heroin mainte-nance program fared better than patients in conventional drug
treatments in terms of street drug use, mental health, social functioning and illegal
activities. The results of the trial apply only to a subgroup of severely addicted people
who failed repeatedly in conventional drug treatments.
As one would expect, there was controversy about the heroin trial in
Switzerland—such controversy that a citizens initiated referendum was run last year.
The required number of signatures was obtained—I believe that about 131 000
signatures, or something like that, were gathered—and that referendum was aimed to
stop the heroin prescription program. When the vote was taken (in a community that most
people would recognise as quite conservative) it was defeated 79 per cent to 21 per cent.
Very few referenda will get votes of that sort. So, the Swiss themselves are absolutely
convinced that the heroin prescription process is one that works.
The Hon. T. Crothers: Other solutions that had been tried hadn't worked.
The Hon. M.J. ELLIOTT: Absolutely.
The Hon. T. Crothers: That is more what their concerns were.
The Hon. M.J. ELLIOTT: Yes, that's true enough.
The Hon. T. Crothers: As indeed are mine.
The Hon. M.J. ELLIOTT: But, as I have said, it is only one of many solutions, and we
must always keep our mind open for others. But, having witnessed at that stage the heroin
prescription process for three years, the people of Switzerland—79 per cent to 21 per
cent—said that it should continue. The Swiss Government will now expand that program.
As I understand it, that program will take in up to 3 000 persons, at which time it will
peak. The experts tell me that it is their belief that only about 10 per cent of heroin
addicts are suitable for this program. So, when they go to 3 000 that will be the
maximum—and I suppose once again that underlines the fact that there is nothing
magical about the heroin prescription trial. It is one of a range of treatments, and it is
something that will work and has worked for some people: other treatments will be
necessary for other people.
It is worth noting that the Dutch also have started their own heroin prescription
program. It currently involves 50 users, based in Amsterdam and Rotterdam. I had the
oppor-tunity to visit the clinic in Amsterdam (although at a time when it was not
operating) and to speak with some of the professionals there. As I understand it, that
trial, also scientifically constructed and also expected to be reassessed over time, will
expand to 1 000 users in the new year. So, the Dutch have clearly watched very closely
what happened in Switzerland. And, might I add, both Switzerland and the Netherlands
watched very closely what happened in Aust-ralia. A number of people there commented on
and gave praise to the scientific integrity of the trial that has been proposed for
Australia and then said, `What happened? Why did it stop? Why did the Prime Minister do
that?' I shrugged my shoulders and said, `I honestly do not know.' I do not know whether
it was because of his innate conservatism; whether Johnson and Johnson (I believe it is),
which is a major producer of methadone and uses a lot of the opium that we grow legally in
Tasmania, had made a threat in relation to that, as some people have hypothesised; or
whether the American Ambassador came knocking on the door—as he has a habit of doing,
as do other American Ambassadors around the world, sticking their nose into other people's
business—all by himself.
But, as I said, the Dutch are now following the Swiss in such a program, and when I
spoke with people in Switzerland and the Netherlands they told me that they believed it
would not be long before Germany followed the same path—and, indeed, France not long
after that. For a number of reasons, I believe that everywhere around the world people are
coming to the same realisation. They are looking to places such as the Netherlands and
Switzerland and seeing what is happening. There has been a change of Government in both
those countries, and those Governments appear to be more open minded and prepared to look
at alternatives.
In relation to the costing of the heroin programs, the Swiss have done their own
work, and they believe that they are making significant savings to the public purse. They
say that these heroin programs save close to 45 francs per patient per day. When they
compared the cost of running the program with all the health professionals and the
provision of the heroin against how much they would have spent in other programs and with
policing and courts, etc., they estimated that they would save, in Australian terms, close
to $A50 per patient per day.
So, it does not matter whether you look at it from the perspective of the individual
and our human and humane approach to them and their families, from the perspective of
Government expenditure or from the perspective of a society with less crime (indeed, any
way you look at it), this heroin prescription process is an improvement on the previous
situation. No-one can feel happy that people are still consum-ing heroin and that they are
still struggling to get their lives together, and I am certainly not happy about that.
However, I do appreciate the very real improvement that has been made within that program.
For those people who have been addicted for 20 years, one can only say, `If only
such a program had been available 10 or 15 years ago,' because there is no doubt that the
longer the addiction the more difficult it is to overcome it. How does a 38 year old, a
person who has been addicted for 20 years and who has no work experience, enter the work
force? How do they achieve normalisation? That person's mistake was made 20 years ago and,
20 years later, our society has worked out how it should respond to that mistake.
Hopefully, in future people will have been addicted for much shorter periods before we
offer appropriate treatment to give them a real chance at normalisa-tion.
There is one set of figures to which I said I would refer. The most recent data in
relation to the just over 1 000 people who began the heroin trial in Switzerland states
that 80 had gone into abstinence at the end of 1996, increasing to 120 in 1998; and 120
had gone on to methadone at the end of 1996, increasing to 200. So, close to one-third of
the people on that program after four years are in abstinence or have moved on to a
methadone program. As I said, it was the toughest of the tough who were involved in those
programs—those who had failed everything else despite their best efforts—so
those figures must be seen as encouraging. It would be so nice if we could wave a magic
wand and say, `I cure you of your dependency, please don't do it again', but that magic
wand simply does not exist.
We must be mindful to design laws that really work. We must ask ourselves what we
are trying to achieve and whether we are achieving it. Our current laws are not achieving
what we had hoped. We have major drug problems that are worse than those experienced in
other countries which are adopting different approaches. We have done many useful things.
Let us not neglect the good things that we have done such as the methadone and needle
exchange programs, which have been a success. We have done a number of things, but there
are still far too many people dying or becoming involved in crime and prostitution against
their will. As human beings, we must offer them real hope. As I said, there is no one
answer—there is a suite.
I ask members to consider this motion in the light of what has happened in the
Netherlands. That country has quite consciously and deliberately set about separating the
cannabis market from the market for hard drugs. This data shows us that cannabis
consumption has not taken off in the Nether-lands relative to other countries. It seems to
indicate that the recruitment of problematic drug users to heroin, etc. has been in
decline and that the drug death rate in the Netherlands is much lower than in other
European nations.
The one thing that stands out as different is the very long period during which the
Netherlands have been operating with this approach of separating cannabis from heroin and
other drugs. As I have said, they are not soft on cannabis use either. They are running
education programs—and those programs appear to be biting. Sensibly, those education
programs do not tackle only cannabis but also other drugs such as alcohol and tobacco. Let
not anyone who enjoys a tipple of alcohol become too pontifical about people who might
consume cannabis. Alcohol itself is a problematic drug. The Dutch have recognised that and
are running very good programs that are directed at all drugs.
The second part of my motion looks at what the Swiss have done, I believe so
successfully, and that is to run a heroin prescription trial. It calls for the Legislative
Council to support the heroin trial proceeding in Australia. It should be noted that all
the Health Ministers of Australia met with the Police Commissioners and the Federal Health
Commis-sioner and agreed for the heroin prescription trial to proceed.
There was consensus until the Prime Minister stepped in and said that this would not
happen. I strongly believe that he has made a mistake. He may have done this with the best
of intentions from a conservative viewpoint that says that people shall not take drugs, we
will not allow them to do it, we will tell them not to do it, and they should know better.
I can only ask the Prime Minister in all humanity to look at the conse-quences of that
decision. I believe strongly that a decision not to allow heroin prescription amounts to a
sentence of death for some and a sentence to a life of crime and prostitution for others,
a life of suffering, not just for those who are addicted but for their families. I have
talked with members of those families. In fact, they have been telephoning again today and
offering support.
We must realise the impact on the broader community of home invasions, the robberies
that are occurring as people seek to sustain their habit. The heroin prescription trial
seeks to address all these matters. It must be stressed that this would be a staged trial
that would start initially with a small number of people in the ACT. It will not proceed
beyond that stage unless people are satisfied with certain conditions that will be laid
down. It will continue to be a trial as, hopefully, it spreads to two other major cities.
Again, it will not continue unless the people have examined it and are satisfied with it.
The Swiss went through a trial process. They were convinced that it was a good
thing. Why would we not be prepared to allow such a trial to go ahead? For those who are
not prepared for a trial to go ahead, I would like to know what is there alternative. I
will tell you what their alternative is: it is that these people will continue to inject
in parks, alleyways and isolated locations, and they will continue to die, suffer and
commit crime, etc. Those who reject the heroin prescrip-tion trial support all those
things happening. They must be aware of that. They should not hide behind any personal
feeling about what is right or wrong about this. What is right or wrong is what we do to
people. What is right or wrong is whether we actually show humanity to other human beings.
The Hon. T. Crothers: What is right or wrong is whether it works or not.
The Hon. M.J. ELLIOTT: Yes, whether it works or not. That is the question that only
the trial can answer. If at the end of two or four years it is shown that I am wrong and
they are right, then they can gloat. I do not believe they will be in that position. The
worst that can happen is that those people will be told to go back to the streets and the
alleyways, to their isolated rooms and parks, and to go back to injecting in the way they
were. Because that is all there was before, and that is all there will be afterwards.
I urge members to support this motion. I have a great deal more information that I
have not presented, but I believe that I have covered the major points. If members respond
in the negative and start to raise their own questions, I could at that time go through
this material that I have and respond to any questions and doubts that they may have.
The Hon. T. CROTHERS secured the adjournment of the debate.
The State Government formally opposes the motion: 3 March 1999
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