| MARKET
FORCES
Mood-altering drugs have been used by people in virtually all
countries throughout history. Anyone who believes that this entrenched
pattern over thousands of years can be simply and suddenly ended
by government fiat is naive in the extreme. From time to time,
countries prohibit certain drugs. Alcohol was illegal in the USA
from 1920 to 1933. Opium for eating was taxed and legal in Australia
until 1906 and was then banned. Heroin was prohibited in Australia
in 1953. Before 1953, heroin could be lawfully prescribed by doctors
in Australia. There is no pharmacological or public health logic
to the classification of some drugs as legal and others as illegal.
These decisions about declaring different drugs in different countries
to be illegal or legal at different times have all been arbitrary
historical accidents more influenced by politics than logic or
science.
While there is a strong demand for a drug, a source will always
emerge. If there is no legal source, illegal sources will emerge.
Suppliers of illegal drugs compensate for the risk of getting
caught and punished by increasing the price of the drug. Higher
prices increase the profits made. The higher the risk of getting
caught and the more severe the punishment, the higher the price
and the higher the profit. The higher the profit, the more people
who are attracted to becoming drug traffickers and the greater
the quantity of drugs available for sale. This is the Achilles
heel of drug prohibition. What has often happened in drug prohibitions
is that dangerous drugs were driven out by even more dangerous
drugs. In Asia over the last half century, anti-opium policies
have had pro-heroin effects. During alcohol prohibition in the
United States, beer disappeared and was replaced by wine and spirits.
In Australia in the last seven years, amphetamines have taken
over during the heroin shortage.
Whatever we may think about drugs, they are markets with buyers
and sellers just like real estate or ballpoint pens or any other
commodity. Access Economics estimated in 1997 that the market
for mood altering drugs in Australia was worth $29 billion a year.
Drugs that we call illicit accounted in 1997 for $7 billion of
that $29 billion total. These days, since the fall of the Berlin
Wall, few are now brave enough to attempt to defy powerful market
forces. Only North Korea, Cuba and drug war warriors still believe
that they can ignore powerful market forces.
Everyone else knows that sooner or later it is inevitable that
a heavy price will be paid for trying to ignore powerful market
forces. Harm reduction, a widely and possibly often wilfully misunderstood
term, is a simple concept. It means that we focus primarily on
reducing the adverse consequences of drugs, such as deaths, disease,
crime and corruption. The alternative to harm reduction is use
reduction, as in the war against drugs. In use reduction, we focus
primarily on reducing drug consumption, whatever the impact on
deaths, disease, crime and corruption. The most important point
about harm reduction is that the scientific debate about harm
reduction is now over. Harm reduction is recognized widely to
be effective, safe and cost effective.
Five Labor and three coalition governments, in Tasmania, Queensland
and the Northern Territory, adopted harm minimisation as our official
national drug policy in April 1985. Every state and every territory
government since then, whatever its political hue, has adopted
and implemented harm minimisation. The current federal government,
despite its public stance, sensibly but unfortunately discreetly,
continues harm reduction in several forms, including a $10 million
a year enhancement of state-territory needle syringe programs,
generous funding to support HIV prevention among injecting drug
users in Asia, vigorously carrying the torch for harm reduction
in debates within the UN system and by diverting drug-using offenders
from the criminal justice to the drug treatment system. Needle
syringe programs in Australia from 1988 to 2000, according to
a Commonwealth department of health commissioned study, by 2000
prevented 25,000 HIV infections and saved up to $7.7 billion,
while by 2010 needle syringe programs will prevent 4½ thousand
deaths from AIDS. If this committee wants to scrap harm reduction
in this country, you will have to take personal responsibility
for the HIV epidemic that Australia then has to have.
There is growing realisation that relying on drug law enforcement,
Customs, police, courts and prisons to control illicit drugs in
the last several decades has not worked, is not working and can
never work. In the decades of global drug prohibition, drug production
and consumption has soared around world. It is now a global $322
billion a year industry, of which 26 to 58 per cent may be profit.
Drug problems have got worse and worse over the decades. Governments
have spent more and more taxpayers’ money. This is a typically
high-taxing, big government approach. Many fiscal conservatives,
such as the Nobel prize winning economist Professor Milton Friedman,
condemn these futile attempts to arrest and imprison our way out
of our drug problems.
What we have to do is redefine drugs as primarily a health and
social issue, with funding for health and social interventions
raised to the level enjoyed by drug law enforcement. Criticism
of harm reduction and drug law reform may be clever politics in
the short term, but the war against drugs has been an expensive
way of making a bad problem worse. If drugs are treated primarily
as a public health problem, as suggested recently by Justice Don
Stewart, deaths, disease, crime and corruption will fall, and
I expect that drug consumption will also fall once the huge profits
of the industry are removed. In the current system, criminals
and corrupt police control the drug market. Regulating this market
mainly using public health measures is the least worst way of
responding to these drugs.
There are two ways of responding to difficult problems in our
community such as illicit drug use. One way is to stress the community’s
condemnation of the rejected behaviour—in this case, the
consumption of prohibited substances—but place less emphasis
on the actual outcomes of the prohibition. The other way is to
focus on reducing the harms of the rejected behaviour—in
this case, time to reduce those deaths, disease, crime and corruption,
investing in what science shows us works while respecting the
human rights of all of our citizens, including those citizens
who still choose to use prohibited drugs.
Harm reduction and drug law reform are steadily gathering national
and international support. Support for zero tolerance and a war
against drugs approach is steadily declining. What we need now
is to find ways so that good policy can also be good politics.
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