A young Croakey reader, Jess Pearson, commented on the recent post on Sydney’s medically supervised injecting centre, raising concerns that the centre might encourage more young people to try drugs.
Michael Moore, CEO of the Public Health Association of Australia, asked Croakey to post this response to Jess on his behalf. I thought it worth putting up as a follow-on post.
And Jess, if you’re still reading, Dr Alex Wodak also responded to your concerns at the bottom of the previous post.
Michael Moore writes:
Jess Pearson disagrees with the whole idea of allowing people, teenagers, to do illegal drugs!
Actually, Jess, those of us who advocate for a supervised injecting room and even to trial provision of pharmaceutical heroin and other injecting drugs at the same time would love to see no one using such drugs. The thinking behind all harm minimisation policies is multi-layered.
Since the prohibition of drugs such as heroin has been pushed from the 1950s onward, particularly by the United States, there has not been a reduction in drug use. There has been a rapid increase.
As it seems a huge task to challenge the whole concept of prohibition, despite its clear abysmal failure to achieve its goals, policy makers in Australia and other places have sought to find alternative solutions.
As we cannot obtain what we believe is the best solution, we look for the “least worst” solution. There is no evidence that availability of clean needles or an injecting facility increases or encourages drug use any more than availability of condoms encourages young people to have sex.
In both cases the availability of appropriate devices simply protects those who make these decisions from dire consequences of their actions. Very few people would argue that the poor choice by these people should be ‘punished’ by a shortening of their life or a devastating medical outcome.
Even for a hardline economic rationalist, as far as our role in spending taxpayers’ money on the provision of devices or facilities goes – it is simply a long term investment. There is no doubt that treating people for HIV/AIDS or Hepatitis for example will be much, much more costly to the taxpayer than the cost of running a supervised injecting facility.
What is really unfortunate is that in 1997 when the Ministerial Council on Drug Strategy approved a scientific trial of a Medically Supervised Injecting Facility that also provided the heroin it was stopped on the personal whim of John Howard.
Until such an approach is tried we will not know the extent to which such an approach will improve the health of individuals, reduce the spread of disease in the community and possibly undermine the pyramid sales system that is engendered by prohibition and the black market.
In spite of the folly of the Howard decision for Australia we do have some knowledge as such facilities are run in about a dozen countries worldwide – including the conservative Switzerland that has been doing so for a decade and a half. A referendum in that country has supported having them continue.
The people understand that sometimes when our policies cannot achieve everything that we want, we need to have a backup plan that will deliver the really critical things – like saving the lives of individuals and stopping the spread of disease into the broader community.