Drug reform in NSW: Evidence-based recommendations rejected

Desperately needed reforms to laws around illicit drug use have been rejected by the NSW Government.

The reforms were proposed by the NSW Special Commission into the Drug ‘Ice’, which reported to the Premier, Gladys Berejiklian, in late January. To declare an interest, I worked as an editor with the commission for a few months.

Evidence-based recommendations

The commission, led by Professor Dan Howard SC, a former President of the Mental Health Review Tribunal, a former Acting Judge of the District Court of NSW and a former NSW Deputy Senior Crown Prosecutor, made a raft of progressive and evidence-based recommendations. They’re based on the following principles.

1. The use of crystal methamphetamine and other illicit amphetamine-type stimulants (ATS) requires compassionate responses consistent with human rights approaches, rather than punitive responses that can compound the harms of use.
2. Effective responses must recognise and address the social determinants of ATS use, including trauma. Dependent use, in particular, frequently occurs in a context of broad socioeconomic disadvantage and trauma. ATS use is often a symptom, not the cause, of an individual’s problems.
3. There is a need to address the stigma attached to illicit drug use, and particularly to ATS use. Stigma prevents many people from accessing the treatment and services they urgently need. The criminalisation of drug use and negative media portrayals contribute to this stigma, which can extend to the family and friends of people who use ATS.

It’s impossible to summarise 109 recommendations, but the ones that seemed to me of most importance could be summarised as:

• NSW needs a coherent whole-of-government alcohol and other drug strategy that reflects international best practice – at the moment health on one side and police on the other have totally different approaches
• drug use should be either decriminalised or depenalised
• drug addiction should be treated as a heath issue, not as a criminal issue
• far more support should be offered for people trying to reduce drug use, both in the community (especially in rural NSW) and in prisons
• diversionary programs to keep people out of prison should be bolstered
• efforts should be made to reduce stigma.

Premier: Every option on the table

At the time she announced the inquiry, the Premier said: “We are establishing a powerful Special Commission of Inquiry because we want every option on the table to bolster our existing efforts to combat the evolving threat of this dangerous, illegal drug – and to get help for those who need it.”

The options on the table didn’t last long. Within a month of the report being delivered, the Government rejected options such as a needle and syringe exchange program in prison, and one or more medically supervised injecting rooms in the community, pill testing and stopping the use of sniffer dogs. It will consult with stakeholders to consider the remaining recommendations.

The 1200-page report is now available on the Department of Premier and Cabinet’s website, as is the NSW Government’s response. In that response the NSW Government says: ‘The Government has already put in place comprehensive measures to address alcohol and other drug-related harm in NSW.’

The Commissioner saw it differently.

Current policies inadequate

‘It is clear that our current drug policies are inadequate to meet the profound harms that crystal methamphetamine and other ATS pose to the health and fabric of our society,” he wrote. He says he:

• ‘received more than 250 submissions, including from AOD experts, organisations, peak bodies, government departments, local councils and individuals
• conducted 20 site visits and almost 50 stakeholder meetings
• held public and private hearings and 16 roundtable discussions over 47 days between March and October 2019 (including those listed below)
• heard from more than 150 witnesses at public hearings and received witness statements from a further 86
• heard from 35 people with lived experience of crystal methamphetamine, who shared stories of their own use or the challenges of caring for family members or friends who use the drug
• held six hearings in regional areas where ATS use is seen to be a problem: Lismore, Nowra, Dubbo, East Maitland, Broken Hill and Moree
• held eight private roundtable discussions with Aboriginal community members and stakeholders in regional NSW, including in Wagga Wagga, and in western Sydney, hearing from about 100 people about the challenges raised by ATS use and how they should best be addressed
• held roundtables on Health Service Responses, Planning and Funding of Treatment Services, Decriminalisation and Youth Diversionary Programs, hearing from service providers, academics, representatives of government agencies and departments, judicial officers, members of the legal profession and other experts in their fields
• convened a private Youth Roundtable to hear the views of young people about illicit ATS
• held private hearings with representatives of the NSW Department of Education, the Association of Independent Schools of NSW and Sydney Catholic Schools.’

It’s not clear what evidence the NSW Government gathered to reject some of the recommendations so quickly.

This article was first published by Croakey Health Media