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Now the election’s over, let’s get back to the evidence

Many thanks to James Beckford Saunders (UnitingCare ReGen’s Director of Education and Advocacy) for his reflections on the absence of drug policy from election coverage and the challenges facing advocates for evidence based policy and treatment.

Amidst the flurry of the federal election campaign, drug policy received scant attention from the major parties (and the media).

All too often, drug policy is seen as all risk and no reward for those seeking the popular vote.  Interventions such as Opioid Replacement Therapies (e.g. methadone, buprenorphine), Needle and Syringe Programs and Medically Supervised Injecting Centres are regular targets for community and media criticism, in spite of the established evidence of their effectiveness in reducing harm to individuals, families and the wider community.

There are clear challenges for those of us who seek to advocate for evidence based drug policy.  The issues are complex, as are the possible responses.  They are not easily reduced down to a headline or sound bite, but those of us in the AOD sector need to get better at making the case for why communities should care about drug policy as much as they do about other health issues, housing, education or employment.

We need an improved and informed public discussion of AOD issues to support the development of evidence based policy.  In its absence, we are often faced with reactive political responses, driven by uninformed media coverage and accompanying community concern.

Two recent examples spring to mind.

In the past few months, the Federal and State governments have rapidly sought legislative solutions to the problem of emerging synthetic drug use.  This is in spite of evidence that existing policies on drugs like cannabis have, in part, driven demand for ‘legal highs’ and that rolling bans on emerging synthetics effectively promote the use of more obscure ‘research chemicals’.  In the context of sometimes sensationalist reporting, the haste of the political response is understandable.  While there are clear harms associated with synthetic drugs, the actual prevalence of their use in Australia may, however, be somewhat different to the public perception.

Methamphetamine (or Ice) is another drug that is frequently portrayed in the media as an emerging crisis.  A recent Fairfax focus on methamphetamine use in Victoria concluded with an article featuring the head of Victoria’s Drug Court calling for the introduction of dexamphetamine (an ADHD medication) for the treatment of methamphetamine dependence.  While the harms associated with increasing levels of methamphetamine use in Australia warrant serious attention, there is little evidence to suggest that dexamphetamine provides a viable treatment option.

Although the article was ostensibly about treatment, there was no consideration of the substantial international and Australian research activity focussing on identifying suitable medications to support methamphetamine treatment and it was not until the third-last paragraph that actual treatment providers (in this case, ReGen) were recognised as having anything to contribute to the discussion.  Our work to date on developing more effective responses to the particular needs of dependent methamphetamine users has shown that, while there is clearly more work needed, there are significant gains that can be made through relatively minor changes to existing treatment models.

Given the complexity of the causes and the significance of the harms associated with problematic AOD use in Australia, it is understandable when individuals, families or policy makers grasp at the prospect of a simple solution.  It is a mark of the desperation many feel in the face of lives seemingly out of control, and their hope for change.

There are no simple solutions.  But there is much that can be done.  There are many responses that are proven to be effective.  There are others that are still emerging as we build our understanding of new challenges and their implications for prevention and treatment.

Within the AOD sector, we need to ensure that the evidence (and the likely outcomes of its application) is clearly articulated to policy makers and the wider community.  We need to create an environment in which politicians can discuss AOD policy with the same passion and level of community engagement as childcare or hospital funding.

While the Abbott government’s drug policy intentions are currently unknown, we hope that it will respect the evidence for the current policy framework and carefully consider its options for new drug policy initiatives.

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