Echo Issue Outline: copyright Echo Education Services
First published in The Echo news digest and newspaper sources index.
Issue outline by J M McInerney
Should heroin use be either legalised or decriminalised within Victoria?
On Monday, December 4, 1995, the Victorian Premier, Mr Kennett, announced that his government was about to set up a Drugs Advisory Council, made up of seven eminent Victorians. The person chosen to chair the Drugs Advisory Council was former vice-chancellor of Melbourne University, Professor David Penington.
The Council's task was to investigate ways of combating the trafficking of illegal drugs and of overcoming the problem of drug addiction.
People were initially invited to make written submissions before December 31. After receiving more than one hundred submissions it extended its deadline to January 12, 1996.
Public hearings began in late January. On Tuesday, January 2, the Council issued a preliminary report, outlining some of the options it believed it should consider. Prominent among these were systems such as the British where addicts are registered and supplied legally with either heroin or methadone.
This statement has served to regenerate the public debate over whether heroin ought to be either legalised or decriminalised.
Background
Heroin is a morphine or codeine derivative. It was developed by the German company Bayer in 1898.
Over time it was found to have some undesirable side-effects and has now been declared illegal for private sale in almost every country in the world.
Australia banned the importation, sale and use of heroin in 1953.
In most countries heroin prohibition has meant that everyone along the chain from manufacturer through distributors to user is likely to be prosecuted and probably imprisoned if apprehended.
Some nations have, however, developed a management strategy that does not rely solely on prohibition.
In the Netherlands, for example, trafficking, manufacturing and the laundering of drug monies are severely punished.
However, possession for personal use is regarded more leniently, such that those in possession of less than 0.5 grams of heroin are rarely prosecuted. 75 per cent of addicts in The Netherlands maintain contact with rehabilitation or care centres.
In the United Kingdom certain specialist doctors are licenced to prescribe heroin and a heroin substitute methadone, as part of a broader treatment and education program. All doctors must notify health authorities of addicts.
In 1994, Switzerland began trialing the supervised distribution of heroin to some 300 addicts and claims that the results have been promising.
Before 1953 Australian addicts were registered with the government and collected their drugs in linctus form from local chemists.
After prohibition virtually all supply of heroin was conducted illegally.
In the 1970s a range of methadone treatment programs were set up in Australia.
Methadone is normally distributed to registered addicts via approved agencies.
There are, however, those who maintain that heroin should again be made available in a limited and controlled manner.
This suggestion does not usually involve legalisation in the sense that the drug could be legally manufactured and sold like any other unprohibited substance, but it would make it possible for certain approved bodies to distribute the drug.
Other proposals include decriminalising heroin, which again would not mean that the drug would be legally available as are most legitimate, commercially produced substances, rather it would mean that private users would not be readily prosecuted.
Proposals that heroin either be decriminalised or legalised normally specify that distribution would be carefully monitored and controlled.
Australia-wide estimates in 1995 put the number of recreational or non-dependent heroin users at 200,000. Some 50,000 Australians are estimated to be addicted to or dependent upon heroin.
It has been claimed that in some areas heroin is easier to obtain than marijuana. Part of the attraction of heroin for dealers is said to be that it is not bulky and has a high mark-up.
Heroin use in Victoria has recently received media attention in part as a result of suggestions that the state's new gambling culture has led to an increase in heroin use.
The media has also linked Vietnamese migrants with a supposed increased availability of heroin.
Published estimates as to the extent of the problem have varied. One claims that there were over 50 heroin-related deaths in Victoria in 1995, compared to 35 the year before. Another estimate suggests that more than 100 heroin users died as a result of their habit in Victoria last year.
The fatality figure generally given for the country as a whole in 1995 is 500.
Arguments in favour of the legalisation or decriminalisation of heroin
There are four principal arguments offered in favour of the legalisation of heroin. The first is that making the sale and use of heroin illegal has not been effective in preventing its distribution and consumption. The second is that current methods of control appear to be making the problem worse. The third is that were heroin use and possession either legal or decriminalised it would be possible to regulate it and the fourth is that the public health danger heroin is claimed to represent has been exaggerated.
The first argument usually offered in favour of the legalisation or decriminalisation of heroin is that the current method of prohibition is not working.
Those who claim this point to comments supposedly made by key members of Victoria Police, claiming that there are limits to what they can do to curb the problem.
It has also been claimed that the Federal Police have downgraded the priority given to preventing the illegal importation of heroin into Australia.
It has been claimed that since last year (1995) there has been a marked increase in the amount of heroin coming into Australia from South-East Asia.
Also noted is the rising number of fatalities attributed to heroin use.
Secondly, those who favour the legalisation or decriminalisation of heroin distribution and use argue that making it illegal has contributed to the problems heroin poses.
According to this line of argument while distributing and taking heroin remains a crime any heroin user who has an adverse reaction to the drug will generally not seek medical help, nor, should they be in the company of others, will their friends seek help on their behalf.
Thus, it has been claimed, the fact that it is illegal to possess and use heroin actually increases the likelihood that heroin users will die.
A further argument offered in support of the suggestion that making heroin illegal actually increases the problem it represents is that it forces the heroin user into the world of organised crime to obtain his or her supply.
It has also been argued that while the substance is illegal it is easy for suppliers to use this fact to inflate its price. Inflated prices, it is claimed, only further increase the interest of criminals in supplying the substance and so the cycle continues.
Dr James Bell, director of the drug and alcohol unit, Prince of Wales Hospital, Sydney, has claimed, `Criminal sanctions ... have inadvertently created a lucrative blackmarket which maintains drugs as a problem.'
A similar point has been made by Dr Nick Crofts, head of epidemiology and social research at the Macfarlane Burnet Centre for Medical Research, who has claimed, `What we can definitely prove is that the prohibition approach increases the likelihood that harm will come from drugs ... It's profit that is keeping [the] blackmarket turning over. And it's profit that gives the opportunity for corruption ...'
According to this argument, if heroin use were decriminalised or legalised and the drug were supplied cheaply to registered addicts, then the profits from the trade in heroin would no longer be available to organised crime and their current heroin supply networks would largely collapse.
In addition to this, it has been argued, high costs increase the likelihood that users will have to resort to other crimes in order to make the money needed to support their habit.
Robert Richter, QC, president of the Victorian Council for Civil Liberties has claimed, `By decriminalising and regulating, you will do away with about 60 per cent of crime ...'
The Age, it its editorial of December 3, 1995, summed up the harm that is attributed, by some, to the illegal status of heroin.
`By outlawing drugs such as heroin we have simply handed the franchise to organised crime and given it every encouragement to resort to extortion, intimidation and corruption to sustain its profits. By making such drugs illegal and expensive, we have driven those who want them or need them to cheat, burgle, rob or prostitute themselves, and to push drugs to others.'
Related to this is the claim that much of the energy of our law enforcement agencies is misdirected while they spend their time attempting to capture and prosecute drug users and small-scale dealer-users, whom many regard as the victims of drug abuse, rather than as criminals who should be further punished.
The third major argument offered is that if heroin sale and use were not illegal it could be properly monitored and controlled and so far fewer deaths would result.
Tim Read, a doctor at an inner-city community health centre with a busy needle exchange has stated, `The main health problems of heroin - overdoses and blood-borne viruses - have only become significant since prohibition, and arise from unsupervised injection of unregulated quantities of heroin.'
It has been claimed that the unregulated and largely secret use of heroin has encouraged the spread of blood-borne diseases through needle-sharing.
Some 2 per cent of heroin-users are HIV positive and some 60 per cent have hepatitis C.
Given the apparent scope of hepatitis C in particular, many health care workers dealing with heroin-users believe that needle exchange programs cannot adequately address the problem and that the drug must be decriminalised and its use properly supervised.
It has also been claimed that the problem of overdoses is largely attributable to the blackmarket which supplies the illegal drug making it impossible for the user to know the purity of the heroin he or she is using at any given time.
Tim Read has commented, in reference to this problem, `Users of illegal heroin can only guess at the dose they inject, usually cursing it for being too weak, sometimes falling victim to an unexpected rise in purity that can sedate them or even arrest their breathing.'
According to this line of argument, if heroin were decriminalised as it is in The Netherlands and Switzerland, it would be possible to monitor supplies, regulate their purity and oversee the circumstances under which the drug was injected.
This, it is claimed, would substantially reduce the likelihood of users dying either from overdoses, contaminated doses or from infected needles.
Supporters note that in The Netherlands, where people in possession of less than 0.5 grams of heroin are rarely prosecuted and where 75 per cent of the nation's 20,000 heroin addicts maintain contact with rehabilitation or care centres, deaths from heroin overdoses have fallen by a third in the last ten years.
The final general argument offered in support of the legalisation of heroin is that the dangers of its use have been exaggerated, especially if taking the drug were no longer an offence and the quality of the drug could be adequately controlled.
On the question of heroin over-doses leading to fatalities, it has been claimed that the majority of fatalities occur not because the user has been supplied with unexpectedly pure heroin and so inadvertently over-doses, rather, it has been argued, most heroin-related deaths involve the taking of other substances, such as alcohol or benzodiazepines, and it is the combined effect of these drugs which proves fatal.
Thus, it is argued, it is not the toxicity of heroin which is the problem, rather it is the ignorance of the user.
According to this line of argument, if heroin users were better informed about the danger of taking drugs in combination then many of these fatalities would not occur.
Also, it has been claimed, large doses of high-quality heroin can be smoked, rather than injected, by established users with what is claimed to be no ill-effect.
Similarly, it has been argued that heroin is not as addictive as is commonly believed.
Dr Nick Lintzeris, who treats drug-using patients at the Turning Point centre in Fitzroy, has claimed that users often have to `work hard at it' before they become addicted, injecting regularly over several weeks or perhaps months.
Arguments against the legalisation or decriminalisation of heroin
There are four main arguments offered by those who wish to see the use and distribution of heroin remain illegal.
The first argument is that because a law is difficult to enforce it does not follow that the law should be done away with. The second argument put is that having the sale and use of heroin illegal serves to discourage the use of heroin in a number of ways. The third argument offered is that heroin has properties which make it inappropriate that it be decriminalised and the fourth argument offered is that decriminalisation or legalisation does not solve all the problems associated with heroin and may in fact create further ones.
Those who hold that heroin use and distribution should be neither legalised nor decriminalised frequently begin by arguing that because a law is difficult to enforce it does not follow that the law should be scrapped.
Mr Ken Smith, Victorian MLC for South Eastern province, has said, `It should not in any way, shape or form be decriminalised. What sort of society have we got? Too hard to police so we legalise it.'
According to this point of view, many, if not all laws, do not succeed in eradicating the behaviour which they prohibit and many, if not all laws, are difficult to police. However, it is argued, these are not reasons for removing the laws themselves.
Secondly, it is argued, having the use and distribution of heroin illegal helps to discourage the use of the drug.
That the drug is illegal is held by some to be an effective educative measure, suggesting the extent to which the practice of heroin taking is frowned upon by Australian society at large without giving young potential users the sort of information which might inadvertently increase the drug's attractiveness.
This is said to be significant as it has been argued that graphic anti-heroin education campaigns tend to increase the mystique of the drug and thus increase its appeal to potential users, especially among the young.
Another reason for having the drug illegal either to use or distribute is that this gives the police the authority to confiscate any heroin they come upon and to arrest its users and distributors.
Supporters of the drug being illegal argue that if the substance remains a growing social problem even with these sorts of measures being taken, then it is likely to be a more severe problem if the police were not able to act in this way.
Further, it is argued, the fact that the drug is illegal serves to discourage its use on two other levels. Firstly, that it can only be obtained illegally, at inflated prices and at the risk of arrest and prosecution, can be assumed to dissuade many potential users from ever taking up the practice.
Secondly, these same factors are said to discourage established users from continuing with the practice.
David McDonald, senior criminologist at the Australian Institute of Criminology, has been paraphrased in The Bulletin claiming, `One of the reasons people give up using the drug is that they get sick of mixing with a criminal subculture, of dodging police and hiding their use from colleagues and family.'
Thirdly, it is claimed, heroin has properties which make it inappropriate to decriminalise or legalise it.
The central reason offered for not legalising heroin is that it is addictive and thus can remove from the user control over his or her habit.
Nick Stafford, a needle exchange worker at Bondi Junction in Sydney, has claimed, `Someone might use three times a week for six months and then stop. After about six months, if you continue doing it, you have a chance of wanting to need it every day.'
According to this line of argument it is not appropriate to make legally available to people a substance the consumption of which may ultimately fall outside their control and which, it is claimed, can have undesirable side-effects, such as a loss of drive and generally impaired performance.
The major side-effect to concern critics is that heroin taken in too large or too pure a dose, can be fatal. This is a problem, particularly for inexperienced users, who have developed no tolerance for the drug. However, it has been suggested that given that the body does build up a tolerance to the drug there is a tendency among experienced users to take larger and larger doses placing them too at risk of overdosing. The likely cause of death brought about by a heroin overdose is respiratory arrest.
Finally, critics argue, the legalisation or decriminalisation of heroin does not remove all the problems associated with it.
The nexus between heroin and crime will not, it has been claimed, automatically be broken by decriminalising or legalising heroin.
Firstly, it is argued, certain sorts of crime, such as prostitution, are inevitably associated with drug-taking.
Secondly, all proposals for the legalisation or decriminalisation of heroin, hinge on it being carefully monitored and regulated. No one appears to suggest that uncontrolled market forces should be allowed to determine the manner in which heroin would be produced, sold and consumed, were it to be decriminalised or legalised.
Thus there would remain an opportunity for criminals to supply unregulated heroin to those who wished to avoid the controls imposed upon its sale and use.
There is also the concern that once legalised or decriminalised heroin could become the sort of legal problem that alcohol is, with, for example, users seeking to drive under its influence.
Critics note that in centres such as Holland and Switzerland, where heroin has been decriminalised, problems with the law have not disappeared.
Dr Joe Santamaria, chairman of the Addiction Research Institute, has stated, `The police in Zurich claim that they can no longer guarantee the safety of its citizens. Many syringes are found in places frequented by families.'
It has been claimed that were Victoria to legalise or decriminalise heroin use the state would be likely to face a further problem.
Critics claim that the example of Holland suggests that when a country or state decriminalises heroin it then attracts to it drug users from all around the world. (This has apparently been the Dutch experience.) Such a concentration of immigrant drug users, some with a criminal record and in poor health, would, it has been suggested, create significant problems for police and public health officials.
It has also been noted that in Sweden, where heroin was legalised in 1966, the number of crimes committed under the influence of heroin and the rate of heroin use in prisons doubled within the first two years.
There is also the suggestion that even were heroin legalised or decriminalised fatalities would continue to occur.
This claim relates to research which suggests that many, if not most, fatalities attributed to heroin, are in fact the result of the toxic effects of a combination of drugs.
Thus, critics claim, merely legalising heroin use and attempting to monitor it would have little impact on the death rate of those with what is referred to as a `polydrug' problem.
According to this line of argument, legalising or decriminalising heroin does not remove the problems associated with its use so much as it increases the number of people who are users.
Further implications
The immediate implications of the issue of heroin legalisation or decriminalisation are political.
Though Victorian premier, Jeff Kennett, has somewhat softened his opposition to drug law reform his public statements still suggest he is strongly opposed to either the decriminalisation or legalisation of heroin.
The Victorian electorate is also likely to share the view that laws prohibiting heroin should not be liberalised.
With a state election scheduled for March 30, it seems unlikely that the premier will have his Drugs Advisory Council report before then, despite the fact that its recommendations were at one point expected by February 26 and then in early March.
The much touted `war against drugs' is probably too contentious a political issue to have crop up in the middle of an election campaign.
Given the nature of its early statements it seems at least possible that the Victorian Drugs Advisory Council will recommend a liberalisation of the laws currently prohibiting heroin use in Victoria and further that it will place a strong emphasis on rehabilitation.
As early as November, 1995, Premier Kennett had proposed using some of the Community Support Fund to sponsor advertisements highlighting the dangers of drug addiction.
This particular use of the funds is now likely to be rejected as expert opinion has suggested that such an advertising campaign may well encourage drug use.
What does seem probable is that some of this money will be used toward drug rehabilitation programs.
The Victorian Government directs some $1 million of the $900 million it receives annually from gaming or gambling taxes into the Community Support Fund. Currently legislation requires that the Fund be used to finance the arts, community welfare, tourism and sport. It would require a change in the law if some of this money is to be used to assist heroin addicts.
It is difficult to known what the long-term social prognosis is, whatever the Drugs Advisory Council recommends.
Despite the impressive drop in deaths from overdoses in The Netherlands, the extent of heroin addiction remains high there.
Underlying triggers appear to include unemployment, family breakdown, child abuse and the diminished self-esteem that can result from such causes.
As numerous authorities have suggested the causes of drug addiction are complex, solutions may have to be equally so.
Sources
The Age
30/11/95 page 11 editorial, `Drugs: we need more than a quick fix'
30/11/95 page 11 interviews by Sandra McKay, `Is it time to legalise hard drugs like heroin?'
3/12/95 page 12 editorial, `Let's have courage and legalise heroin'
4/12/95 page 3 news item by Nicole Brady and Sandra McKay, `Kennett softens stand on heroin'
5/12/95 page 4 news item by Clare Kermond and Victoria Button, `Backbench MPs fear Pandora's box of heroin'
5/12/95 pages 1 and 4 news item by Nicole Brady, `New drug council to advise Kennett'
5/12/95 page 1 news item by Jacqui MacDonald, `Police changes aid drug trade'
10/12/95 page 3 news item by Paul Robinson and Gervase Green, `Hamer supports legalising drugs'
30/12/95 page 11 comment by Dr Tim Read, `Is heroin really the villain of the piece?'
2/1/96 page 11 comment by Dr Nick Crofts, `Secret casualties of our war on drugs'
3/1/96 page 1 news item by Kendall Hill, `Legal drug plan to foil heroin trade'
4/1/96 page 4 news item by Kendall Hill and Danielle Talbot, `Experts cautious on drug scheme'
4/1/96 page 11 editorial, `A fresh look at drugs'
19/2/96 page 5 news item by Melissa Sweet, `Heroin often not the main factor in deaths: study'
The Australian
4/1/96 page 4 news item by Chip Le Grand, `Support may grow for heroin proposal'
The Bulletin
26/9/95 page 34 analysis by Diana Bagnall, `Heroin: hits, myths and habits'
The Herald Sun
30/11/95 page 1 and 4 news item by Matthew Pinkney, `Drug summit: Kennett pledges new fight'
30/11/95 page 12 editorial, `Uniting against drug menace'
3/12/95 page 30 news items by Peter Coster and Karen Murphy, `Death is cheap on our streets'
5/12/95 pages 1 and 4 news item by Damon Johnston, `Unmasking the Mr Bigs'
5/12/95 page 4 news item by Michael Pirrie, `Groups support tough approach'
5/12/95 page 4 news item, `Dispute as detox centre shuts down'
8/1/96 page 12 head-to-head opinions, `Can the war on drugs be won?'
25/1/96 page 13 comment by Dr Joe Santamaria, `Legal drugs also kill'
27/1/96 page 17 analysis by Michael Pirrie, `Fighting for drug peace'
28/1/96 page 18 analysis by Veronica Matheson, `David takes on a Goliath task'
What they said ...
`By making such drugs [as heroin] illegal and expensive, we have driven those who want them or need them to cheat, burgle, rob or prostitute themselves, and to push drugs to others'
Age editorial, December 3, 1995
`It (heroin) should not in any way, shape or form be decriminalised. What sort of society have we got? Too hard to police so we legalise it'
Mr Ken Smith, Victorian MLC for South Eastern province