Back to previous page

When you see a line of coloured and underlined hypertext, this means that you can click on that text to go to another information page.


Heroin addicts and the law: should Australia trial regulated heroin distribution and supervised 'shooting galleries' for addicts?




Echo Issue Outline 1998 / 43 - 44: copyright © Echo Education Services
First published in The Echo news digest and newspaper sources index.
Issue outline by J M McInerney

What they said ...
'Do we really want a society where drug dealers make millions of dollars destroying the minds and bodies of our youth and our pathetic response is to give free drugs to those at the bottom of the barrel?'
Mr Barry Kearney, in a letter published in The Age on November 1, 1998

'The illegally supplied drugs that long shamed and finally killed her should have been available as supportive, life-extending, legal prescriptions'
Mr Duncan Campbell, whose daughter died of a heroin over-dose in September, 1998

On October 23, 1998, the Prime Minister, Mr John Howard, recommitted his Government to attempting to overcome 'the menace of drugs'.
The Prime Minister's statement appeared to reiterate the 'Tough on Drugs, National Illicit Drug Strategy' his Government announced in its first term of office.
This strategy involves law enforcement, with an emphasis on preventing the importation of drugs; a 'zero tolerance' approach within schools; and, within the broader community, rehabilitation for addicts.
On September 16, 1998, the Lord Mayor of Melbourne, Mr Ivan Deveson, had argued that supplying addicts with free heroin should be trialled in Australia. The Prime Minister has previously indicated his opposition to heroin trials.
There is significant debate surrounding these conflicting approaches.

Background
The possession and use of heroin is a crime within all Australian states and territories.
Despite this numerous states have well-established needle exchange programs for addicts designed to reduce their risk of contracting AIDS or hepatitis by sharing needles.
There have also been proposals that we trial supervised injection depots and the regulated distribution of heroin to addicts.
Some commentators have suggested that a number of the drug management initiatives tried or proposed in Australia represent a 'harm minimisation' or 'harm reduction' approach.
A 'harm minimisation' or 'harm reduction' approach starts from the premise that some level of drug-taking will always occur within a society and, therefore, governments need to adopt strategies which will help to reduce the risks to drug users and the society at large. Needle exchange programs are included among such strategies.
Also part of a harm minimisation approach is the provision of safe injection venues, often referred to as 'shooting galleries', and education programs which give information on how to use drugs with relative safety.
The extreme end of the harm minimisation approach would appear to be the medically regulated provision of heroin to addicts.
Over a five year period the Australian Capital Territory developed a proposal to trial the controlled distribution of heroin to registered addicts. This initiative was ultimately quashed by the federal government in August, 1997. The Prime Minister, Mr Howard, in particular, indicated his strong disapproval of the ACT scheme.
On November 2, 1997, the Howard Government announced its own drug strategy, titled 'Tough on Drugs, the National Illicit Drug Strategy'.
The strategy appeared to adopt a three-pronged approach - reduce supply (primarily through law enforcement efforts against importers and traffickers); reduce demand (primarily through a 'zero tolerance' approach within schools); and harm minimisation.
Though the strategy uses the term 'harm minimisation' what appears to be referred to is the 'treatment of illicit drug users'.
The strategy promotes research with 'a stronger focus on abstinence-based treatment'. It also provides additional funds for the trial of non-heroin drugs designed to replace addicts' dependence on heroin and/or to help them detoxify.
On March 16, 1998, the Prime Minister announced the second installment of the National Illicit Drugs Strategy (NIDS).
In this second installment 'harm minimisation' is not separated out as an individual strategy but is grouped with the 'demand reduction' strategies.
Again there is an emphasis on 'treatment', including research into abstinence-based treatments.
Grants are to be made to non-government treatment organisations, their progress is to be evaluated and their outcomes monitored.
A somewhat different emphasis from that of the federal government appears to have been developing in Victoria.
In March, 1996, the Victorian Premier's Drugs Advisory Council released its report, Drugs and Our Community. (The Drugs Advisory Council is commonly referred to as the Pennington Committee after its chairman, Professor David Pennington.)
The Council's report essentially proposed a harm minimisation approach, making eight recommendations, including that marijuana be decriminalised. This recommendation and another that would have reduced penalties for heroin users were not adopted by the Victorian Government.
In June, 1998, Melbourne's Lord Mayor, Councillor Ivan Deveson, proposed a return to the previously considered ACT regulated heroin distribution trial. He also indicated that the Melbourne City Council was looking at the possibility of setting up supervised injection depots in the city for the use of heroin addicts.
It has been claimed that the regulated distribution of heroin has been successfully trialled in Switzerland and that supervised injection depots have been established in Frankfurt.
In September, 1998, Cr Deveson indicated that there was insufficient community support for the establishment of safe injection centres. The Lord Mayor, however, again called for a heroin distribution trial as proposed by the ACT.
At the same time, Melbourne is about to trial offering drug treatment to prisoners on remand for drug related offences.
Such treatment would be a condition of their receiving bail. The approach appears to be modelled on the pre-sentence treatment being offered addicts in New York's 'drug courts'.


There are a large number of Internet sites that deal with proposals for countering Australia's heroin problem.

The Prime Minister, Mr John Howard's launch speech for Tough on Drugs - the National Illicit Drugs Strategy (NIDS) can be found at http://www.nor.com.au/users/gaiaguys/drugspe.htm
The speech was delivered on November 2, 1997, at the Ted Noffs Foundation, Randwick, Sydney.
It gives a detailed account of the three main emphases that make up the strategy. It also suggests what the federal government means when it refers to 'harm minimisation'.

An overview of stage two of the federal government's National Illicit Drug Strategy (NIDS) can be found on a sub-site of the federal Government's Public Health site. The overview was first released in March, 1998, and has been supplemented since. It outlines the different approaches to be employed in the second installment of NIDS and indicates the amount of funding to be directed toward the various components of the strategy.
The overview can be found at http://www.health.gov.au/pubhlth/strateg/drugs/illicit/index.htm

The Age has a useful News Special feature dealing with the extent of the heroin problem in Melbourne and the various methods that have been considered by the City Council to address it.
These methods include the regulated distribution of heroin and the establishment of supervised injection depots.
The News Special reproduces a series of articles that were first published in The Age on June 21 and June 22, 1998.
The first of these articles can be found at http://www.theage.com.au/daily/980621/news/news20.html
Links to the other articles in this series are listed down the left hand side of the page.

A summary of the1996 Victorian Drug Advisory Council Report can be found at http://www.vicnet.net.au/vicnet/vicgov/dac/dac.htm
Otherwise known as the Pennington Report, the recommendations of this report have influenced Victorian Government policy.
Though its recommendations were not adopted in full, measures such as cautioning of marijuana users and rehabilitation while on remand for heroin users, which are currently being piloted in this state, are foreshadowed in the report.
This document runs for 14 pages. It is a useful summary of the original which is some 140 pages in length.


Arguments against regulated access to heroin and the establishment of 'shooting galleries'
The primary argument against regulated access to heroin and the establishment of supervised injection depots is that such strategies appear to accept the drug problem rather than attempt to combat it.
There is the concern that making heroin more readily available without legal penalties might encourage others to use it.
Mr John Heller, in a letter published in The Australian on September 31, 1998, summed up this position. '[... if heroin were legally available, then everyone would ... use it ...' (Though he refers to this argument, Mr Heller does not share this view.)
There is also concern that strategies which seem to accommodate heroin use undermine efforts to prevent illicit drug taking in the wider community.
Those who hold this view are particularly apprehensive that appearing to accommodate heroin use will negate the government-sponsored education program to discourage young people from starting on drugs.
The federal government is directing significant resources into schools in a bid to educate students about the hazards of drug taking.
Mr Howard has recently reiterated his government's 'zero tolerance' policy for drugs in schools. The federal government is also attempting to support parents in their efforts to prevent their children experimenting with drugs.
It is claimed that regulated access to heroin for addicts might hamper these initiatives by suggesting either that heroin use was sanctioned within Australian society or that Australian authorities had given up their efforts to prevent it.
The second point made by those who oppose heroin trails and other more liberal management approaches is that law enforcement strategies are capable of containing the drug problem.
According to this point of view, while it may never be possible to prevent all illicit drugs entering Australia, it is possible to make large inroads into their availability and so help to reduce illicit drug use.
Mr Howard recently congratulated New South Wales and Federal Police forces and Customs for their large and successful heroin bust south of Port Macquarie during October.
The Prime Minister claimed, 'That represents ... the law enforcement part of our strategy.'
The Prime Minister suggested that it was important to recognise the successes of the law enforcement strategy rather than always to focus on the difficulties of preventing drug smuggling into Australia.
'It's very easy for a cynical media or a cynical public to take shots at the inability of law enforcement agencies to catch every criminal,' Mr Howard argued.
The New South Wales Premier, Mr Bob Carr, praised the authorities for their success in making the recent haul and suggested that it could prevent some 75 overdose deaths in New South Wales alone.
At the same time the federal Justice and Customs Minister, Ms Amanda Vanstone, claimed, 'seizures ... make the product watered down or powdered down - and that is a good thing.'
Ms Vanstone argued that powdered down heroin supplies would reduce the incidence of overdoses.
The third point made against the legal availability of heroin and the establishment of injecting depots is that there are other treatment strategies which can work without appearing to encourage heroin use.
The Government has directed significant funds to community-based treatment centres.
It would appear that the Government expects a measure of success from the programs it has funded as included in the funding are resources to finance outcome-based evaluations of the different programs.
It has also been suggested that directing funding to rehabilitation programs makes more sense than permanently supplying addicts with heroin at government expense.
The leader of the federal Opposition, Mr Kim Beazley, has said that if he were to become Prime Minister he would rather invest more money in the 'grossly under-funded' rehabilitation programs that already exist than supply addicts with heroin.
It would also appear that the new policing strategies about to be trialled in Victoria for dealing with heroin addicts might also fall within the range of treatment strategies endorsed by the federal government.
When the National Illicit Drugs Strategy was announced in November, 1997, the Prime Minister Mr John Howard, declared, 'The Commonwealth will ... discuss with the States, Territories and volunteer and community organisations a better approach for the diversion of drug users from prison to treatment programmes, with a view to breaking the cycle of drug dependency and criminal behaviour.'
One Victorian treatment approach designed to break the link between heroin addiction and crime was announced in July, 1998.
It appears that Victoria Police will pilot a cautioning system for small-scale marijuana users apprehended for the first time. Under this system marijuana users would receive a formal warning rather than be taken into custody.
If successful, a similar scheme will be applied to heroin users. Stricter conditions would apply for heroin users who would have to undergo mandatory treatment.
Such a scheme is designed to secure treatment for many of those found in possession of heroin, rather than automatically sending them before the courts.
Further, in November, 1998, a new method of dealing with young addicts who do appear before Victorian courts will be tried for nine months.
This new treatment-based approach also appears to fall within the ambit of strategies endorsed by the federal government.
The new scheme will enable the court to order drug treatment as part of bail conditions for young prisoners on remand. Funding will be directed to the treatment agencies to support their work with addicts on bail.
The program will target first-time offenders, young addicts, small-time offenders and other non-violent offenders.
Police will identify suitable candidates and take them to the magistrates courts' trained professionals for assessment. The Victorian Offender Support Agency, VOSA, will arrange places in detox and rehabilitation centres within 72 hours.
Candidates will then be taken before the court to have their bail conditions fixed.
A similar scheme has been in operation in some jurisdictions in the United States, except here addicts who appear before the 'drug court' are directed for treatment after they have been found guilty of a crime.
If the treatment is successful and they do not re-offend and remain drug free for a specified period their sentence is waived.
It has been claimed that about 70 per cent of those who enter rehabilitation with American 'drug courts' complete the 12-month program. It has also been claimed that since the drug courts began, more than 2,500 parents have regained custody of their children after completing the program.
It has been argued that treatment schemes such as these make it possible to break the connection between heroin use and crime without having to make heroin legally available.
On the specific question of supervised injection depots, its has been argued that the scheme has too little community support to be implemented. It has also been suggested that providing better lighting in areas typically used by addicts would help address the problem.

Arguments in favour of regulated access to heroin and the establishment of 'shooting galleries'
The harm minimisation approach, which culminates in the regulated supply of heroin to addicts, seems to centre on three main arguments.
Firstly, it is claimed that there are some people who may never overcome their heroin addiction.
Secondly, it is argued that it is not possible to prevent the illegal importation of heroin into Australia.
Thirdly, it is suggested that untreated or unsuccessfully treated addicts acquiring illegal heroin results in further crime and health risks to the addict.
The first of these propositions, that some people may not overcome their heroin addiction, has been argued by Duncan Campbell.
Mr Campbell is a former diplomat who is now a current affairs commentator. His daughter died in September of a heroin overdose.
Mr Campbell has written of his daughter, 'She did not want ... [drugs]. She would so proudly and happily have stayed away from them, but could not'.
Mr Campbell then outlines the different treatments and support networks his daughter tried to overcome her addiction. He details seven methods she used, all of which, he claims, were unsuccessful.
According to Mr Campbell, the only appropriate treatment for someone such as his daughter would have been to supply her legally with heroin on prescription.
Mr Campbell argues, 'The illegally supplied drugs that long shamed and finally killed her should have been available as supportive, life-extending, legal prescriptions.'
The second argument offered in favour of the regulated supply of heroin to addicts is that it will never be possible to cut off completely the supplies of heroin smuggled into Australia.
This comment has been made several times since Australia's record illegal heroin confiscation on October 14, 1998.
Mr Greg Rumbold, a researcher from the Turning Point Drug Centre in Fitzroy, has suggested that the recent heroin haul is likely to have little impact on the availability of heroin on the street.
Mr Rumbold has claimed, 'There are so many ways heroin comes into this state and it is such a huge job to try to monitor all of that and Customs just doesn't have the resources.'
A similar point has been made by Mr Wesley Noffs, of the Ted Noffs Drug Rehabilitation Centre.
Mr Noffs has claimed in relation to the recent haul, 'I applaud the Federal Police for their diligence, and I think this is an incredible result, but I don't think law enforcement provides long-term solutions to heroin abuse.
If anything, there will be a temporary interruption in supply.'
Relatedly, it has also been argued that attempts to eradicate heroin use at a street level by arresting traffickers and arresting or moving on users have proved unsuccessful.
According to this line of argument placing addicts in jail does not remove their addiction. There is, it is claimed, a major drug problem within Australia's prisons, and addicts, even if drug-free while in prison, tend to resume their habit once released.
It has also been suggested that moving addicts on from one area of a city to another does no more than relocate the problem.
Melbourne Lord Mayor, Councilor Ivan Deveson, has claimed, 'We have proved you can't police it away and putting people in jail who are addicts doesn't work.'
The third argument offered by those who favour approaches such as regulated heroin supply and supervised injection sites is that while there are unsupported addicts and illegally available heroin there will be crime and growing health risks for addicts.
According to this line of argument, it is the inability of addicts to acquire heroin legally which brings them into contact with criminal suppliers.
This point has been made by Mr Duncan Campbell, referring to his daughter. 'Imagine desperately finding money and faking your life away. Imagine having to depend on the most callous criminals.'
It is argued that for as long as criminals supply the heroin distribution network and fix the price then users will be driven to crime in order to support their habit.
Mr Paul Dillon of the National Drug and Alcohol Research Centre has claimed, 'Heroin is expensive, people need to use a lot of it, and many of those people are unemployed, or on low incomes, and so they turn to crime and prostitution.'
Age reporter Caroline Overington has cited 'a study into the link between crime and drug abuse, conducted by the [National Drug and Alcohol Research] Centre in 1994, [which] found as much as 80 per cent of all crime against property, such as theft, could be linked to drug abuse.'
Melbourne Lord Mayor, Mr Ivan Deveson, has pointed to a trial of the free supply of heroin recently conducted in Switzerland.
Mr Deveson has claimed, 'In Switzerland, independent assessments of such a trial, released a year ago, showed a dramatic decrease in criminal activity - from 70 per cent of the participants at the beginning of the trial to 10 per cent at the end.'
According to this point of view, supplying heroin freely to addicts would dramatically reduce their involvement in crime.
It has further been argued that even successful police drug hauls, such as that recently made in New South Wales, may only increase the crime rate related to drugs.
Those who hold this view argue that if a drug haul succeeds in reducing the availability of heroin on the street, scarcity will drive the price up and users will resort to more criminal activities to finance their habit.
In addition it has been claimed the regulated supply of heroin and supervised injection depots would reduce the health risk to addicts.
Those who argue for such an approach claim that the health of addicts is threatened not simply because they take heroin.
Instead, it is argued, the risk comes because addicts acquire their heroin from illegal suppliers who adulterate or cut it with substances that may be toxic.
It is also claimed that addicts are at risk because they have no way of knowing the purity of any heroin they buy illegally and so can easily die as the result of an overdose when heroin is purer than they anticipated.
Those who favour the legal, regulated supply of heroin to addicts claim that this would remove the dangers inherent in addicts not knowing either the strength of their most recent purchase or what it may have been cut with.
This point has been made by Mr Duncan Campbell who has complained of the supposed absurdity of current drug policies which result in 'a dose of street heroin proving murderous because it's "too pure"'.
'Shooting galleries' where addicts may inject heroin in clean conditions and with access to medical assistance are also seen as a way of reducing deaths from overdoses and preventing the spread of diseases such as AIDS and hepatitis. .
Those who argue for the more extreme elements of a 'harm minimisation' approach generally maintain that the heroin user is a victim of his or her addiction, not a criminal, and that heroin addiction should be treated as a medical problem rather than a law enforcement issue.
This point has been made by Mr Wesley Noffs, of the Ted Noffs Drug Rehabilitation Centre.
Mr Noffs has argued, 'I don't think you should make criminals out of victims.'
While those who adopt this approach may support the arrest of drug pushers, importers and suppliers they tend to oppose legal action being taken against users.

Further implications
It seems unlikely that the trial of regulated access to heroin which was originally proposed for the ACT will be revived. The Australian Capital Territory is ultimately under the jurisdiction of the federal parliament and both the Prime Minister and the Leader of the Opposition have opposed such a trial.
The Victorian Premier, Mr Jeff Kennett, has indicated that he would be prepared to see such a trial proceed in Melbourne. However, Mr Kennett would only support the move if similar trials were to occur simultaneously in other Australian cities.
Mr Kennett's concern appears to be that trialling the supervised distribution of heroin in Melbourne or any other major Victorian city could attract heroin users to that region. It has been claimed that this would be less likely to occur if similar trials were occurring in other locations.
It may also be that the premier is looking for the support of other state leaders. Any attempt to allow a heroin trial in Victoria would be politically hazardous as a majority of Australians appear to oppose such a move. Were more than one state parliament to support such trials this might tend to dilute public opposition.
The long-term likelihood of measures such as supervised injection depots and heroin distribution centres is likely to depend on the success of other measures to control heroin use and related crime.
Melbourne Lord Mayor, Ivan Deveson, has recently claimed that deaths from heroin overdoses are outstripping alcohol-related road deaths. Recent figures on crime both within Victoria and in Australia as a whole indicate that some 80 per cent of crimes against property, primarily theft, are drug related.
If such trends continue there will be growing public demands for solutions.
It remains to be seen if the combination of law enforcement to reduce supply, together with anti-drug education, prohibition within schools and funding for rehabilitation centres and research into other treatment modes will remain the federal government's preferred mix.
The 'drug court' initiatives being tried in Victoria are interesting and, if successful, may reduce the calls from special interest groups for injection depots and regulated heroin supply.
The claim is frequently made that we are flying blind in our various approaches to controlling and eradicating heroin use. Supporters of many of the major strategies have suggested that we need to test the effectiveness of the different methods we try.
If this argument prevails it may be that regulated access to heroin and supervised injection depots will ultimately be tried purely in a spirit of experimentation, rather than because those promoting the trials already believe these methods are the solution.
There seems to be a tendency to adopt fixed positions in the drugs debate. It may be that the solution lies with a variety of approaches.

Sources
The Age
15/9/98 page 5 news item by Steve Butcher, 'Lock me up, woman pleads'
16/9/98 page 3 news item by Andrea Carson, 'Traders may act over heroin'
18/9/98 page 4 news item by Sandra McKay & Clare Kermond, 'Kennett backs revised heroin trial'
19/9/98 page 8 analysis by David Elias, 'Why Kim begged to go behind bars'
20/9/98 page 3 news item by Gabrielle Costa, 'Police refuse to blitz drug zone'
20/9/98 page 5 news item by Candace Sutton, 'Australia: The UN gives its verdict'
20/9/98 page 20 editorial, 'Fighting the drugs scourge'
21/9/98 page 14 comment by Christine Allison, 'The wrong way to fight drug problem'
15/10/98 page 1 news item by Caroline Overington, '$400m blow to heroin scourge'
15/10/98 page 4 news item by Brett Foley, 'Seizure to limit heroin deals'
18/10/98 page 4 analysis by Caroline Overington, 'Drug bust sparks crime alert'
18/10/98 page 4 news item by Fergus Shiel, 'Police give it their best shot, but the heroin flow barely slows'
22/10/98 page 13 comment by Barry Dickens, 'Children of the doorways'
24/10/98 page 18 news item by Brendan Nicholson, 'Howard talks tough on drugs'
28/10/98 page 15 news item by Ian Traynor, 'Addicts find safe house'
1/11/98 page 24 letter from Barry Kearney, 'Plea for society free of drugs'

The Australian
12/9/98 page 29 analysis by Georgina Safe, 'High anxiety'
17/9/98 page 9 news item by Rachel Hawes & Madeleine Coorey, 'Council gives up on shooting galleries'
13/10/98 page 14 analysis by Cameron Stewart, 'Trial system gives addicts a fighting chance of recovery'
24/10/98 page 1 news item by Claire Harvey, 'Zero tolerance: Howard declares war on drugs'
29/10/98 page 13 comment by Duncan Campbell, 'Addicts deserve a dose of empathy'
31/10/98 page 20 letters from John Heller and Bear Stanley, 'The bottom line: heroin trial could save lives'
14/11/98 page 31 (Review supplement) comment by Phillip Adams, 'Say no to drugs cant'

The Herald Sun
10/9/98 page 2 news item by Kristin Owen, 'Drug addict court test'
15/9/98 page 7 news item by Tim Stoney, 'Jail me, says drug addict'
17/9/98 page 15 news item by Scott Thompson, 'Plea for free heroin trial'
17/9/98 page 19 comment by Ivan Deveson, 'Saving young lives in the most liveable city'
18/9/98 page 18 editorial, 'Learning slowly to cope with drugs'
28/10/98 page 12 news item by Andrew Cummins, 'Vanstone vow on illicit drugs'
30/10/98 page 3 news item by Keith Moor, 'Explosion in street robberies / Heroin addicts blamed for increasing violence'
30/10/98 page 12 analysis by Keith Moor, 'Armed thieves hit softer targets'
1/11/98 page 5 analysis by Nik Garifalakis and Wayne Jones, 'The $5 ride to death'
1/11/98 page 5 news item by David Wilson, '$10m street of drugs'