No drug decriminalisation but we can still change drug laws to improve health outcomes

handcuffs

Recent public discussions about the decriminalisation of currently illicit drugs in Australia engendered by the A21 Report on Australian Drug Policy has  prompted me to think about the nature of Australian drug laws and how they impact upon harm reduction.

The response from our country’s leading politicians demonstrates once again that the notion of reducing the harms experienced by drug users, their families and friends by walking away from the highly damaging policy position of maintaining prohibition is highly unlikely in the near to medium future.

The decriminalisation and/or regulation of illicit drug markets remain a highly unlikely prospect in the current political and social climate.  Recent public discourse however, did demonstrate political good will from some quarters, supporting the notion of shifting the emphasis of policing efforts from individuals who use drugs and instead refocussing resources to target producers and large scale traffickers.

While less than ideal (attempting to police the ‘Mr. Bigs’ will still be akin to plugging the breach in a dam with very expensive band aids), the idea that individuals who use drugs are less likely to experience the harms associated with the enforcement of drug laws is a most welcome idea.  With this in mind I would like to take the opportunity to shine a light upon some of the current laws in Victoria that do nothing to reduce levels of drug consumption while at the same time increase the potential for drug related harm.

Banning bongs

Bong sold as a 'pourer'

January 1, 2012 the Victorian government enacted amendments to the Drugs, Poisons and Controlled Substances Act 1981 making it illegal for any retail outlet or market to display, sell or supply a bong as part of a business transaction.

  1.  To my knowledge the bong has never posed a health risk to the community beyond the risks directly posed to the individuals using them.  I have never seen concerns raised about the health risks posed to the community by poorly disposed of cannabis smoking paraphernalia for example.
  2. The prohibition of bongs is highly unlikely to have any impact on the prevalence of cannabis smoking.
  3. Some bong retailers appear to be circumventing the amended legislation by re-purposing products and selling them as ‘shot pourers’.  The end result you now have to buy your bong complete with a shot glass.

If these laws are in fact effective in reducing the supply of smoking implements (a highly doubtful assertion) then users are placed at greater potential risk as:

  1. The prohibition of bongs may lead to an increase in the use of homemade bongs (a phenomena that I would assert on the basis of anecdotal evidence already quite prevalent).
  2. The increase of home made bongs produced with whatever materials at hand will in fact increase the risk of exposure to toxic chemicals not designed to be either heated or inhaled.
  3. If the laws do reduce the usage of bongs, many people will move to less efficient means of using the drug, like joints or eating, requiring many people to buy more of the drug to get the same effect.  This may in fact increase the profits made by black market operators.

Whatever your personal position on drugs and cannabis specifically, it is not hard to see that such a law does nothing to eradicate the use of cannabis and only increases the likelihood of harms experienced by cannabis users.  So given these points why ban the bong?  The only conceivable purpose of such legislation is the targeting of individual drug users attempting to make it more difficult to obtain smoking implements.

Cocaine Kits and Ice Pipes

The banning of implements for the purpose of smoking cannabis is not unprecedented in Victorian legislation.  The previous state government enacted amendments to the Drugs, Poisons and Controlled Substances Act 1981 prohibiting the sale of both cocaine kits and Ice pipes.

According to the legislation cocaine kits are defined as:

“A cocaine kit is constituted by two or more of the following items packaged for use as a unit for the purposes of preparing for introduction, or for introducing, cocaine into the body of a person-

a)      razor blade;

b)       a tube;

c)       a mirror;

d)      a scoop;

e)      a glass bottle;

f)        any other item for use together with any item referred to in paragraphs (a) to (e) to prepare for introduction, or to introduce, cocaine into the body of a person.”

(Source: Drugs, Poisons and Controlled Substance Act 1981, Victoria, Australia)

Ice pipes are defined as:

a)      capable of being used or intended for use or designed for the  introduction, or for introducing, into the body of a person the drug  of dependence methylamphetamine, by means of smoking or inhaling of smoke or fumes resulting from the heating or burning of methylamphetamine in a crystalline form; or

b)      that is intended to be used as a device referred to in paragraph (a) but that is not capable of being so used because it needs adjustment, modification or addition.

(Source: Drugs, Poisons and Controlled Substance Act 1981, Victoria, Australia)

If actually effective there are two potentially harmful by products of such legislation:

  1. An increase in sharing of drug using equipment
  2. The potential increase in people engaging in the more risky act of injecting drugs

While there is limited evidence regarding the risks associated with the sharing of  inhalation and smoking implements it is conceivable that serious infections could be transmittable via the shared use of such equipment.

Services in Canada have run pilots distributing sterile smoking equipment to people who use crack (a smokeable form of cocaine).  While such programs are highly unlikely in Victoria (Australia to avoid any confusion), it runs contrary to any kind of common sense to legally restrict the sale of sterile equipment.  Additionally there is no evidence that such legislation does anything to decrease the prevalence of use of such drugs.

Secondary Supply of sterile injecting equipment

While Australia has an admirable track record of providing free sterile injecting equipment, recognising that such interventions have a marked effect in reducing drug related harms, there still remains legislation that effectively reduces the impact of needle syringe programs.

Victoria like each State and Territory in Australia maintains laws that prohibit the secondary supply of injecting equipment (i.e. supply of injecting equipment by someone other than an approved health professional or organisation such as an authorised needle syringe program).

This legal obstacle remains in place despite the evidence that demonstrates that the provision of sterile injecting equipment not only saves tax payer dollars through the prevention of potential transmission of blood borne viruses such as HIV, but more importantly results in a reduction of lives lost.

AIVL (2010) captures most concisely the arguments that prevent the removal of these legal impediments:

“The most often used argument against the support of peer distribution is that peers will sell the equipment ‘on the side’. Some service providers are concerned that sterile equipment will be on-sold by dealers for profit.”

As AIVL further asserts however, such considerations, must surely be considered secondary to the benefits that such free access to sterile injecting equipment poses.

By removing such legal barriers Victoria can legally support the widening of the reach of current needle syringe programs without spending one additional cent on these types of programs.

Summary

Laws that restrict the supply and therefore the availability of sterile drug using equipment have the potential to increase the likelihood of drug related harms while doing nothing to disrupt illicit drug markets.  A cynical writer would suggest that the aims of such laws has little do to with improving the health outcomes of our community and has more do to with presenting an image of ‘doing something about the drug problems in our communities’…

References

Australian Injecting and Illicit Drug Users League (2010) “Legislative and Policy Barriers to Needle & Syringe Programs and Injecting Equipment Access for People Who Inject Drugs”.  Australian Injecting and Illicit Drug Users League, Canberra

Victorian Government.  “Drugs, Poisons and Controlled Substance Act 1981”.  Victoria, Australia http://www.austlii.edu.au/au/legis/vic/consol_act/dpacsa1981422/ accessed 25th April 2012

Comments
6 Responses to “No drug decriminalisation but we can still change drug laws to improve health outcomes”
  1. tronica says:

    Thanks again for your insightful article. I agree. The particular laws you mention are ineffective and counterproductive. I think they are simply a show of government ‘doing something’ about the ‘drug problem’ rather than actually doing anything that will reduce harms to drug users and therefore to the community at large.

    • stonetreeaus says:

      Cheers Tronica, I think we can see a clear pattern of legislating at the expense of a marginalized group within our society in order to win political points. Not very nice and ultimately costs us all in terms of taxpayer dollars while we try and police laws that are unenforcable and actually contribute to drug related harms in our community

  2. evolutionjay says:

    Interesting and very articulate article. Although I agree that our current “War on drugs” is a miserable failure, I often wonder what the economic impact on our healthcare system will be if we ever did decriminalize. Would the rate of users increase or decrease, and would the users engage much more often without worry of consequence?

    • stonetreeaus says:

      Thanks for the comment evolutionjay. Despite the best efforts of law enforcement many people still choose to use drugs. There is no evidence to suggest that decriminalisation would result in a marked increase in use of these drugs and may indeed result in a reduction. Portugal effectively decriminalised personal use and diverted the resources expended on law enforcement into healthcare. Research 10 years on has demonstrated that for many demographics of Portugal substance use has decreased as a result of increased funding of treatment services. Currently the cost of enforcing drug laws is by in far way more expensive than providing treatment to people wishing to cease drug use

  3. jason china man says:

    wait a sec so theres needle programs here… which keeps junkies and their communities safer… but we still arent allowed to buy a bong?
    wtf

    • stonetreeaus says:

      Let’s be clear here Jason, while I in no way support the laws in Victoria that restrict the sale of bongs, we also need to acknowledge the provision of sterile injecting equipment to people who inject drugs is not just to the benefit of drug injectors themselves, but for the whole community. The provision of NSP’s is well evidenced to reduce the transmission of blood borne viruses in the community and to reduce both short and longer term health costs.

      I would also point out that the use of the word ‘junkie’ is considered by many to be a highly stigmatizing term especially when used by somebody who does not identify themselves as an injecting drug user. Advocates of NSP have demonstrated both a financial and health imperative for the provision of sterile injecting equipment and I would assert that if you want your argument for the lifting of restrictions on the sale of bongs to be taken seriously you would be better off following a similar course of action in relation to smoking implements (as I have attempted to do here) rather than suggesting a supposedly lesser valued group ( as inferred by your use of the word junkie) is somehow getting better treatment than you.

      Regards

      Matt

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