Drug Lore - Edited Transcripts of Proceedings

AUSTRALIAN DRUG LAW REFORM FOUNDATION PARLIAMENTARIANS' INQUIRY DRUG LORE EDITED TRANSCRIPTS OF PROCEEDINGS WREST POINT CONFERENCE CENTRE HOBART 4 - 6 MARCH 1996 Witnesses Appearing before the Inquiry Listed in order of appearance

Monday, 4 March 1996

Commissioner John Johnson - Commissioner of Police, Tasmania - Chairman, Australian Bureau of Criminal Intelligence, Australia

Richard McCready, Deputy Commissioner of Police, Tasmania - Chairman of the National Drug Strategy Committee - Past Chairman of the National Drug Crime Prevention Fund, Australia

Professor Alfred McCoy, Lecturer, South East Asian History, University of Wisconsin, USA

Dr Sutton, Senior Lecturer, Department of Criminology, University of Melbourne, Australia

Professor Peter Reuter, Professor of School of Public Affairs, Department of Criminology, University of Maryland, USA

Dr Patricia Erickson, Senior Scientist, Addiction Research Foundation, Toronto, Canada and

Associate Professor, University of Toronto, Canada

Dr Robert Haemmig, Psychiatrist, Medical Director, Drugs Branch, University of Psychiatric Services, Berne, Switzerland

Mr Urs Vontobel, Operation Manager, Crossline Clinic, Social Welfare Department, Zurich, Switzerland

Dr Erik Fromberg, Chief, Training Methodology Department, Institute of Alcohol and Drugs - Teacher, Central School of Criminal Investigation, The Netherlands

Dr Rob Moodie, Director, Division of Country Support, UNAIDS

Tuesday, 5 March 1996

Ms Alison McClelland, Deputy Director, Brotherhood of St Lawrence, Australia

Prof Ernest Drucker, Professor of Epidemiology and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, Chair of International Harm Reduction Association, USA

Professor Diane Riley, Faculty of Medicine, University of Toronto, Canada

Ms Sujanta Rana, President, Lifesaving and Lifegiving Society (LALS), Nepal

Mr Luke Samson, Head of Sharan, a voluntary organisation assisting those in deprived socio- economic areas in New Delhi, India

Wednesday, 6 March 1996

Dr Ernst Buning, Psychologist, Bureau International Affairs, Amsterdam Municipal Health Services, The Netherlands

Mr Raymond Kendall, Secretary-General, Interpol, Paris, France

Ms Bernadette Shields, Director, Aboriginal Living with Alcohol Program, Northern Territory Health Services., Australia

Ms Kate Dolan, National Drug and Alcohol Research Centre, Sydney, Australia

Dr John Strang, Director, National Addiction Centre, London, UK

Dr Tony Millar, Director of Research, Lewisham Sports Medicine Clinic, Sydney, Australia

Dr Jonathan Caulkins, Associate Professor of Operations, Research and Public, Public Policy School, Carnegie University, Co Director RAND's Drug Policy Research Centre, Mellon University/RAND, Pittsburgh, USA

Monday, 4 March 1996

Plenary Hall

Chair: Mr Michael Moore, ACT, MLA

Panel:

Mr Neil Bell, Northern Territory, MLA

The Honourable Mike Elliott, South Australia, MLC

Mr Bryce Gaudry, Labor NSW, MLA

The Honourable Alannah MacTiernan, Western Australia, MLC

The Honourable Jean McLean, Victoria, MLC

The Honourable Ann Symonds, NSW, MLC

The Honourable John White, Tasmania, MHA

Mr Michael Moore, Chair - The parliamentarians you see here today making up this panel are members of the Australian Parliamentary Group for Drug Law Reform which consists of parliamentarians from the whole political spectrum and from all states of Australia. The initial meeting of this group was held in Canberra in 1993 and was addressed by Justice Michael Kirby, now a high court judge, who impressed upon us the need to change the current draconian and counterproductive drug laws. We have been growing ever since. Many of our group who have contributed a great deal in this area can't be here because of a recent election. Some of them who have really stuck their necks out have even lost their seats. Not I might add, because of their stance as they have won elections in marginal seats since their outspokenness. They include Peter Cleeland and Jim Snow.

Witnesses:

Police Commissioner John Johnson - Commissioner of Police - Tasmania, Chairman of the Australian Bureau of Criminal Intelligence.

Richard McCready, Deputy Commissioner of Police, Tasmania, Chairman of the National Drug Strategy Committee, Past Chairman of the National Drug Crime Prevention Fund.

Commissioner Johnson's statement:

The Criminal Justice system in Australia spends about half a billion dollars a year attempting to control the use of illicit drugs throughout Australia using the police departments, the courts and the prisons. Our experience has been that that policy has failed and that police officers and other people involved in the system who are thinking about drug harm minimisation are asking the community, the thinking people, to think through the problems and look at some other techniques that the community might be able to use to reduce the dependence on drugs, particularly amongst our young people in our community.

That is my personal view in respect of the problem that we are confronting at the present time. It's not the view of everyone in the criminal justice system but it is mine, and I not only come from the point of view of Commissioner of Police in Tasmania but also in my capacity as Chairman of the Australian Bureau of Criminal Intelligence, which is a national police intelligence organisation with a direct responsibility for measuring the effect of drug abuse on law enforcement in Australia and also measuring, to some extent the effect of drug abuse on our population, particularly young Australians.

Deputy Commissioner McCreary's statement

I guess from the perspective of law enforcement I'd like to be able to confidently assert that law enforcement is winning the war but I can't, and I guess that's where my involvement in a whole raft of activities comes from. I don't see that there's any one answer. I don't see that the immediate answer is in the abandonment of some traditional law enforcement approaches but I think that everything must come up for critical review, everything must be on the table and everything must be considered in terms of getting a better result.

Mr Michael Moore, Chair - I understand that you've been involved in an International Group of Police in Vienna who look at drug law enforcement and certainly associate with the International Narcotics Control Board, who said in 1992, in fact it was the director, Georgio Giocomelli that the illicit drug trade is now the second most lucrative trade in the world. What has been the international approach to drug law reform and what can we expect from it?

Commissioner Johnson - I have attended on a number of occasions, meetings of the divisions of narcotics drugs, that's a UN body in Vienna where narcotics drug trafficking and the effects of human beings is considered each year by members of the medical profession, particularly doctors associated with the WHO and other UN type bodies, as well as law enforcement officials from around the world. What struck me on each visit I've made to Vienna, is that every year the report to us is that things have got worse, not better. We're spending half a billion dollars here in Australia, around the world there's countless billions of dollars being spent, and if the report of the conference in Vienna is something to go by with very little result. We're not winning the battle as my colleague here has said. That's why I'm arguing that we need a fresh look at the approach to this problem in Australia with a view to devising some other system which may include of course, law enforcement and some traditional approaches but I believe there's a need for some other approach that might involve the medical profession, teaching, other community support groups as well as the police.

Mr Bryce Gaudry, NSW, MLA - Commissioner, in NSW at the moment we're having a very powerful demonstration of the problems of policing and drug laws. In particular with the Royal Commission and the sorry relationship that it's demonstrating between the police and criminals in terms of drugs and drug supply. I wonder if you might comment generally on the effectiveness of the present prohibition method and policing in terms of limiting the supply of drugs and perhaps the impact of attempting to police in that context, on police morale and perhaps the opening of police to corruption.

Commissioner Johnson - I don't have any complaint about the commitment of police officers in general to try and do what they perceive to be their job to be and that is, to detect people who are either trafficking in drugs or importing it into Australia and prosecuting them. Some of the work they've done has been truly outstanding and I'm proud to be associated with them. My problem is that I don't think it's having any effect on the supply in Australia. I think that what we do quite regularly when we catch some of the Mr Bigs is that we make life much easier for some of the other Mr Bigs who haven't been prosecuted and caught. We've put their competition in prison and left the world open for them and they're extremely difficult to catch and they go on with their business so there is a problem in dealing with some of the Mr Bigs in Australia because of those problems and associated ones. The other issue about police corruption of course is a major problem in this country. There are huge amounts of money involved in narcotics trafficking. Probably people in the US can come up with higher figures. I know of one case in the US where I think the Los Angeles Police, in investigating a drug matter raided a house in Los Angeles and found forty million dollars stashed in the basement.

Now I know that the people involved in that would have given the police the forty million dollars to let them go. I know of another case that I was involved in and numerous cases when I was Deputy Commissioner of the Federal Police. One case involved police officers who were constables working in Sydney. If anyone knows the life of someone who works on a constable's wage in Sydney, they realise the personal stress they're under. They found in a lock up garage in Sydney that was being used by drug runners, five million dollars in money that they brought back and used as evidence against the people who were being prosecuted. The temptation there for them must have been enormous. I wouldn't want to reflect on their personal integrity because they showed they were people of integrity by bringing it back, but they're human beings like all of us who have to live in this world and if there's temptations of huge amounts of money being handed out or available to forego your duty, there are human beings I know who would accept it and forego that duty for that purpose. So the effect on police corruption, of trying to deal with major narcotics matters is enormous and will continue that way until we work out some other way of dealing with this phenomenon in our community. What the answer is I don't know.

The Hon Mike Elliott, SA, MLC - Commissioner, having had the opportunity to speak with law enforcement officers in a number of jurisdictions overseas, two questions. Firstly, is there general agreement that the war isn't being won and I imagine in those discussions, the other question is where to go from here? From your knowledge, those jurisdictions that have tougher penalties, if you like, are they doing any better?

Commissioner Johnson - I don't think they are. I wouldn't like to mention who they are because some people come from different jurisdictions than we do and much more difficult governments to deal with but I was recently in Beijing where there was quite a deal of discussion amongst police from all over the world about the problem of drug law enforcement and I was speaking to some people from a country where being caught in possession of significant amounts of narcotics would probably result in death or possibly extremely long prison sentences. They're overwhelmed with the problems in their country. They don't know how to get on top of it. They're asking us for advice and assistance when really it's beyond us. It's beyond any experience we've ever had so I can't say that using the most draconian of penalties actually works when there is an opportunity there for people to become rich beyond everyone's wildest dreams overnight by being involved in narcotics movement. It's that part of the human existence that persuades people to become involved in narcotics trafficking. I don't think they think about being caught and executed or sent to prison for a long time.

Deputy Commissioner McCready - I guess in my experience that there's any amount of anecdotal and good research that indicates that there's no strict correlation between penalty and deterrence. I guess for me we need to be thinking in two streams I suppose. Those who become hopelessly addicted and are subject to prison penalty, and I see that as a difficulty, and those who prey on the people who can and will be come hopelessly addicted. I guess there always must be some sort of penal sanction for those sorts of people. I guess putting them away forever is not the answer but in Australia, from a police perspective, there must an understanding that if you play the game and lose that there must be some certainty of penalty. I see them falling into two different groups and we shouldn't be considering penalty in terms of just the groups of drug dealers/users.

The Hon Jean McLean, Vic, MLC - I'd like to ask both our witnesses, given that it is generally admitted that a very large percentage of our prison population are now there for drug or drug related reasons and also that we have the added problem of drugs in prison, the use, abuse, illegal and otherwise, would you agree that if we changed our policies on drugs that we would be able to reduce enormously the number of people that we incarcerate and thereby actually to be able to have polices where we could genuinely rehabilitate people that we send to prison rather than building private prisons which is what we're sort of going crazy about in Victoria and the rest of the country?

Commissioner Johnson - If we're talking about people committing crime in order to support an addiction that they find impossible to personally control I think that particular policy has got merit. If we have people who have say a thousand dollar a week habit and need to support it by committing crime well, then the rest of us pay doubly because, not only do we have to employ a police department to catch them and then courts to hear the cases and prisons to look after them, but the rest of us pay for it through our household insurance premiums that go up and up because all of these crimes are committed. If someone needs a thousand dollars a week to support a habit they probably need to steal three thousand dollars a week worth of our videos while we're down here talking at a conference to get enough money to support it so there is a benefit in that area. The other side of the coin that Richard mentioned is the people who have found that this is a great way to get rich quick and who aren't actually involved in drug use themselves. They're the people who have to realise that if they're caught they go to prison for a long time. The other people who are really the poor wretched people at the end of the line are the ones who need our help and support which is not always there if we have them committed to prison.

Deputy Commissioner McCreary - I have a position in relation to black market. It's often contended of course that if you legalise you simply take the black market out of the system but I guess nobody's suggesting that you would legalise for people under sixteen, the people who are ardent smokers and so forth at the moment. So I think that there is always going to be a fertile black market that needs to be considered and we shouldn't be naive enough to think that in talking about abolition of prohibition that black markets will automatically dry up. I think that there will simply be opportunities to perhaps cause dysfunction in other areas and we would want to think about that very carefully.

The Hon Alannah MacTiernan, WA, MLC - Commissioner, you made some reference to the enormous amounts of profit that is available from trade in drugs. From time to time we hear some worrying rumours about the intersection between, shall we say legitimate business, particularly perhaps in the finance sector, and organised crime and in particular, drug running. From your vast experience in the Federal Police and your work with the Australian Bureau of Criminal Intelligence as well as your current position, can you give us any information, even if it is not entirely corroborated, on the sort of nexus in Australia between legitimate business and the drug business. Obviously one of the big concerns, I think of anyone who is a democrat would have is, that with these enormous profits also comes enormous amounts of power and capacity to really unduly effect the whole political process.

Commissioner Johnson - There haven't been that many people caught in Australia who would be seen by everyone as legitimate business people. There have been people caught in Australia though that are involved in business who have been using their resources to finance drug importations. I remember one case where the particular individual who in 1982 was on the dole. In 1987 owned three and a half million dollars worth of real estate in Sydney. That individual had moved from being down and out through a period of narcotics importation into legitimate business. If legitimate business is owning property. He had the property leased out for genuine people to carry on business. I don't know whether he went on to use other money he generated from his legitimate businesses to bring narcotics into Australia, I can't recall that, but he is one. What we've found in Australia is that a lot of people who have been quite legitimate business people and the ordinary sort of man next door type of individual has decided to take the risk and try and import some heroin into Australia.

One group I remember decided that they would do it by pretending to learn to fly aircraft. They did some aircraft flying training and then went to an aero club in Victoria and asked the principal instructor there to take them on a navigation flight to Bangkok, or to Thailand. Then once he'd decided to do that and they thought they had his confidence, they told him that they had a box welded into this aircraft where they intended to secrete 60 kilograms of heroin and fly it back. Their only problem was, this fellow who'd been a Qantas captain before he took on this job was also a former NSW police officer and reported them correctly to us. Of course, they were caught and when they were caught, none of them had been in any trouble with the police ever in their lives. They were business men who decided they would take this risk and try and import drugs from overseas that would make them rich beyond any of our dreams. They're now in prison for long terms. Frequently that's the case. Someone asked once if we have really Mr Bigs in Australia. Not really, but we've got plenty of Mr Big enoughs and these sort of people are really in that area. The three and a half million property and the businessmen who nearly pulled it off but didn't. There are numerous ones like that throughout Australia.

The Hon Ann Symonds, NSW, MLC - I'm aware of the fact that there are increasing numbers of prominent people expressing the opinion that the war on drugs has failed and that we ought to be trying something else. Gary Sturgess in NSW is the latest to come out and say that it is not a question of whether we will legalise drugs, but when. I'm not confident that the when is in the foreseeable future and I am interested in the extent to which public policy can effect harm reduction measures while we're waiting for legal changes. I understand that in the Netherlands the decision is, that although the law stands, the policy is not to prosecute in the public interest. I wonder to what extent there is the opportunity within the police department to take some public policy options that within the current legal framework would reduce harm and actually perhaps, provide some cost savings such as dealing with personal use as a caution and not a prosecution. Is there any likelihood that we could actually embark upon that path?

Deputy Commissioner McCreary - I think that the danger would be to leave it in the discretionary form because of the very problems we've talked about before. I mean if you can take it or leave it and people can pay you're more likely to leave it and I think that that adds to the burden of police. I think that if public policy demands change about what's seen to be legal or illegal then it ought to be taken out of the realms of the police and it ought to be spelled out. The politicians need to be brave enough, bold enough, to set the law and an agenda that meets the requirements of the public. It should not be left to the police.

The Hon Ann Symonds, NSW, MLC - That's what I wanted to hear, thank you.

Mr Michael Moore, Chair - I think it wouldn't be hard to convince the members of parliament here but 90% of our colleagues here need convincing.

Mr Neil Bell, NT, MLA - Commissioner, you said this morning that methadone programs have assisted in the containment of crime in Tasmania. I come from the one jurisdiction in Australia, the Northern Territory where there are no methadone programs. I'm interested in your experience that justifies that comment and the related question of whether there are formal statistics available on the levels of property crime in Tasmania.

Commissioner Johnson - When I made the comment this morning I wasn't specifically referring to Tasmania but I made the comment from general experience and a belief that there are some studies that tell us that if people are in methadone maintenance programs that they're less likely to have a requirement to commit the two thousand dollars worth of household burglaries every week to maintain a habit. And on that basis it would be difficult to argue that crime is not reduced when people are in well managed programs. That's the position I was putting. I think Dr Robert Ali is over there and he's indicating that there probably are significant amounts of studies that would tell us in more than an anecdotal way that that is a fact.

The Hon John White, Tas, MHA - I'm very grateful that you have made public your view that we have to consider alternatives but speaking generally and picking up the Deputy Commissioner's comments about politicians being brave enough, my experience with Australian politicians generally are that they are not prepared to adopt a reformist attitude in relation to drugs because they're generally frightened of their police forces in their home states. The police forces association and the police force's public relations are frequently very strong in enforcing the status quo. At a conference I attended when I was Minister for Health with police ministers before the Commissioner was appointed, the majority of my colleagues, both Labor and Liberal, all said, "Look, we've got to take some money back. We've got an election coming soon. We can't afford to have the police force offside. I find that the view stated publicly by the pair of you is out of step generally throughout Australia by the police public relation's arms of the police force and also the police officers associations as well. Could you comment in relation to that please?

Commissioner Johnson - I think to an extent what you saying is true. I don't know what acts on the minds of the politicians that you've discussed it with , but I've no doubt that that is right. I've discussed the issues with most of my colleagues from around Australia, the issue that I've expressed here. I haven't had any of them come out and say that I'm wrong, by the way, very few have come out in public and said I'm right as well. So I think they're probably wrestling with the same sort of pressures that their political leaders are wrestling with as well. They're wondering what they should do because in being a police commissioner, you've got several roles. One of them is to be the leader of the police force. If the police force is without a good leader, the police force will fall away and won't stop deaths on the road and domestic violence and all of the other issues that we have to deal with. So they need a leader there that they can look up to and follow. So we need to be out there saying things that most of our people, who these days, are progressive young men and women, would think is appropriate. It has been my judgement that most of our people think the way I do, having in mind that most of them these days are university graduates. They are people with a much broader education than police had before. They are more able to grapple with these issues that we're talking about here today and give a sensible response to it. I think we live in a changing world and that when more and more people speak like Richard and I do about the problems that confront society then our people who have to change the laws will feel more confident about doing it.

The witnesses withdrew.

Witnesses:

Professor Alfred McCoy, Lecturer, South East Asian History, University of Wisconsin.

Dr Sutton, Senior Lecturer, Department of Criminology, University of Melbourne.

Mr Michael Moore, Chair - Given that prohibition in Asia was introduced following considerable pressure from developed countries, is it reasonable for what are basically rich white countries now today, to return to Asian countries and recommend that instead of the prohibition policies that we've almost forced them into, we should now recommend harm minimisation policies to them?

Prof McCoy - First of all, it would ideally be done on a bilateral basis, although the US still conducts its policy independently that way, the US has run into reaction when it has tried to do so. Increasingly I think, drug policy is going to evolve on a multilateral basis. Heroin, for example in Asia is now emerging into what we might call a world drug. There is hardly a region that somehow escapes either production, consumption or trafficking. So that it is going to be increasingly multilateral, and these power imbalances that have led to these kinds of colonial issues are going to disappear.

Mr Bryce Gaudry, NSW, MLA - Dr Sutton, given this research you've done with drug enforcement in Australia, in terms of the police force involvement, do you consider that the level of training is sufficient for police officers in that particular drug enforcement area and, in terms of the long term trend that we're hoping for, would you see that police forces would have the ability to change from their more traditional approaches given perhaps policy change?

Dr Sutton - I think the main conclusion that we found from our studies is that police still aren't properly in with a harm reduction approach to drug law enforcement. Particularly the rank and file don't have a good understanding of harm reduction principles. That may be partly training, but I think it's also the ways their jobs are set up. Basically, once you move into a dedicated drug squad you're told that you're task is to chase high level traffickers and that doesn't matter whether you're in the Northern Territory, where that might mean an enterprising backpacker or say, the DEA in NSW where that might mean an off shore financier. In a sense it's not just a problem of training but also a matter of trying to restructure drug law enforcement so that harm reduction becomes relevant to police work.

The Hon Alannah MacTiernan, WA, MLC - To what extent is it realistic to expect the police to be involved in harm reduction? One of the things that your paper showed is that whilst the law enforcement drug agencies and the drug squads of the police force have this policy that we're going to focus on Mr Bigs, the reality is that the vast majority of people who are prosecuted for drug offences are in fact users, and largely users of cannabis. You gave the explanation of the fact that it was largely the uniformed officers and the regional detectives that in fact made the bulk of the prosecutions and they did not share this policy. When we discussed that with the police officers this morning, they said that they didn't believe that it was possible to say to uniformed officers, I think you said yourself, and the detectives, not to prosecute these offences. If that's the case, realistically, what harm reduction processes can go on? Isn't it the case that the real impetus has to lie with the legislatures with the community generally? We have to change the law. It's unrealistic to expect that the police can partially, selectively, enforce laws that are in place.

Dr Sutton - My argument on that would be that willy nilly, police, in the way they enforce laws, whether they're uniform police or whether they're dedicated drug squad members, have an effect on drug related harm. For example, if your local police are doing a terrific blitz on cannabis consumption and as a result they're driving all the local school kids to try out amphetamines, maybe even inject, now that is relevant to drug related harm. So, as the laws stand at the moment, they are involved in one way or another, in activities that are relevant to harm reduction. The problem is that we don't have policies in place and the policy mechanisms to make sure that police at that local level, whether they're drug squad police, whether they're non-uniformed detectives or uniform police, have any sort of capacity to understand those relevant harms that might arise out of law enforcement and modify their activities accordingly. I don't think that that's impossible. In fact, our report sets out in quite a lot of detail, twenty three recommendations that, in fact, policies might be put in place so that police are more aware of harm reduction aspects of their work.

The Hon Ann Symonds, NSW, MLC - Are you aware of the response of the British police in this area? There's quite a strong move from the British police to seek changes to the law which is being met by a totally concrete wall in the form of Michael Howard, the Home Secretary. When I was there in 1994 and spoke to Edward Ellis, recently retired from the London drug squad, about what was happening at that time, in the face of opposition from the politicians, policies were emerging from the police force that meant that they were not proceeding to prosecution but requiring people who were apprehended to register for treatment in the knowledge that if they did not register for treatment within a certain space of time, prosecution would proceed. This had the unintended consequence of allowing the newspapers to say drug usage and addiction rates in the UK had gone up remarkably in the last six months but it was the direct result of the police trying to have some alterations of their own management of drug misuse in their community. Can you see that as a possible means of doing something here?

Dr Sutton - The fact is that police don't have infinite resources and they have to exercise discretion in one way or another in how they enforce drug laws. It's possible for police to be going full pelt at the local level in drug squads and still to be implementing a harm reduction approach. They will always exercise discretion. What we're saying in our report is that perhaps we should look at restructuring the way they do their jobs so that they're more able to measure the consequences of enforcement activities. To see, for example, whether people are shepherded from a less harmful drug to a more harmful drug; less harmful mode of administration to more harmful mode of administration and take that into account when they're exercising their discretion. I don't necessarily say, don't change the laws, in fact I would probably advocate that that happen. I'm saying that even if our politicians are too lily livered to do that, there is a lot of room for reform without changing the laws, even within the existing framework. In fact, those kinds of initiatives by police might provide for society more generally, and politicians generally, to recognise that it's about time we had some changes.

The Hon John White, Tas, MHA - Professor McCoy, I wonder whether you could comment for me in relation to a comment by William Kell who was Chief of the Drug Enforcement Agency at least in 1989, I don't know whether he still is, but he said it is people like us, that is, politicians who want to find alternatives who stop police winning the war against drugs. "The war against drugs is like the war in Vietnam, with more men, resources and power, we would have won it." Are you able to comment on that for me?

Prof McCoy - As a no doubt loyal Australian ally of the US, I think it's your obligation to save us from ourselves. As you tried to do in Vietnam. Let me explain, it is my feeling that the drug war is becoming increasingly irrational in the face of changes in the global opiates market and I will restrict my comments to the Asian opium trade as I know very little about Latin America or it's dominant drug, cocaine. There's a very real possibility that a complex of changing economic and geopolitical forces that arose in the wake at the end of the cold war will drive an explosive increase in Asian opium production. I think we can look forward to at least a doubling of world supply within the decade, maybe within five years, and a sustained increase of those proportions for the foreseeable future. This increase in supply is going to make a mockery of the drug war that we're now fighting. Even with the proportions of the drug supply that we now have, the US drug war isn't working. Let me explain why.

Within the logic of the drug war, if you take Commissioner Johnson's idea of the Mr Big-enoughs and the Mr Bigs, implicit within his remarks are the ideas of police enforcement within the drug war idea. To work up the distribution chains and get to the top ... to get the really Mr Bigs, the heads of the cartels, the big Burmese drug lords. You may have followed in the international press the downfall of the king of heroin, Khun Sa in Burma over the past two months. Let's look at Khun Sa. I'm an historian and I can only figure out the significance of an event when it's already happened. I can't look at the present and make any sense of it. It's got to be all over before I can make any sense of it. I've been following Khun Sa's career and talking about him for twenty five years. I've never been able to figure out what the meaning of that career was until last month when it finally ended. Now I can get a perspective on it.

Let me now tell you what it means with the wisdom of that hindsight. Khun Sa, when I met him at his camp in 1984 was the world's most powerful drug lord. The epithet king of heroin, the emperor of heroin. He was grand. More than any other single individual in the three hundred years of the drug as a commodity, he had left his imprint upon it. Through his period of dominance in Burma from 1981 to 1989, he increased Burma's heroin production by 500%. Moreover, he increased exports of Burmese heroin to the US at such a level that he raised through the so called China white drug, which is actually Burmese heroin, the average purity in the US between 1990 and 1994 from 3% to 30%, severing the link between HIV and completely changing the demographics of the drug. So both within Burma and the international market, Khun Sa left his imprint upon the problem that we now have. He had an army of twenty thousand men, he had the declared the secession of the state of ten million people; he was truly a powerful individual. More power over the trade than any other person ever had and yet when he fell from power, not a ripple. His fall was of absolutely no consequence whatsoever. Even if he'd been dragged to Brooklyn where he is now under indictment before a Federal judge, charged and convicted, it would have made no difference whether he was retiring to Rangoon to enjoy his millions or convicted and broken, it would make no difference.

Similarly, the death of Pueblo Escobar. It made no difference. So if bringing down the biggest of the big makes no difference, how can the drug war possibly work? A second element that has to be considered is that even when we're successful, let's look at the situation in Thailand in the 1980's. During the 1980's in Thailand, the UN and allied nations embarked on the opium eradication program and crop substitution.

hat was the net result? Twofold. One was to create market incentive for that explosive increase of production in Burma as Thailand's production went down; second, it shifted highland drug use in Thailand from opium and pipe sharing to heroin and needle sharing contributing thus to that intersection of vectors, prostitution and IV drug use and the gender problem of the imprisonment of minority women, leading to this explosive riot of HIV infection. So I would say for that complex of reasons the drug war isn't working and one of the messages that I think Australian parliamentarians and the Australian Government should be giving to the US is contributing Australia's voice to an ending of this drug war.

The witnesses withdrew.

Witnesses

Professor Peter Reuter, Professor of School of Public Affairs, Department of Criminology, University of Maryland.

Dr Patricia Erickson, Senior Scientist, Addiction Research Foundation, Toronto; Associate Professor, University of Toronto.

Mr Michael Moore, Chair - Professor Reuter, can you tell us how effective law enforcement is at reducing drug supply in North America?

Prof Reuter - Drug enforcement has a lot of elements. Some things are even less useful than others. I think that one can say fairly confidently that efforts to control drug supply in the US, through either enforcement or crop substitution in producer countries, particularly in the Andean region, had utterly negligible consequences in terms of reduced supply. Not negligible consequences for the producer countries themselves. When you get to enforcement that's closer to the user, you get more complicated results. It certainly is the case that the tough enforcement there is responsible for making drugs in the US extremely expensive, even though they're well below the historic highs, and in some cases, drugs that are reasonably difficult to find. You have to find them in places that are dangerous and awkward for much of the population. A lot of harm resulted from that but you could make a case that the supply of drugs that has been substantially effected by local law enforcement.

Mr Michael Moore, Chair - There are those who argue that without a very strong law enforcement approach the situation would be even worse than it is now. Is there any evidence to support that?

Prof Reuter - The situation would be different and I think that with less stringent sentences you would probably see very little change in either the price or availability of drugs and when we talk about enforcement, it's useful to make a distinction on the one hand between policing and prosecution and corrections on the other. You could see substantial reductions in incarceration and very little consequence whatsoever in the supply of drugs. In terms of reducing the aggressiveness of policing and the accessibility of drugs, I'd be less confident that that would have no consequence.

The Hon Jean McLean, Vic, MLC - Professor Erickson, in regard to Canada and law and order policies, do you think that more resources and harsher penalties make law enforcement more effective at reducing the supply of drugs in your country?

Prof Erickson - One aspect of the market is, of course, the perception of availability of drugs by the consumer and the would be consumer, and we have data over time from our surveys and it's actually reflective of a similar pattern in the US, that the perception that illegal drugs are very easy to get has been constant for the twenty years we've been collecting the data. So while enforcement resources have fluctuated and use levels have fluctuated the perception that drugs are easy has been very constant among the youthful groups surveyed. Also we would see virtually no correlation between fluctuation in penalties and resources and use levels. I think that the impact of the law on the decision of users is vastly overestimated. That there are many other factors that go into people's decisions beside the severity of penalties and the likelihood of being arrested. So if you want to really make an impact on that you have to do more that just throw resources into enforcement. You have find a way to increase people's chances of being arrested and because of the very nature of drug use it is extremely difficult to detect without extraordinary police powers. We've given our Canadian police some of the most extreme powers in any democracy and yet even with them, they are still only arresting a tiny fraction of all users.

Mr Bryce Gaudry, NSW, MLA - Dr Erickson, I'd be interested in knowing just what those powers are that have been given to the Canadian police and I guess in Canada it would be similar to my community, where ad hoc statements about the availability of ecstasy, speed, marijuana and to a lesser degree, but still quite available, heroin, that the supply is quite available despite the prohibitions and despite the police presence. What factors do you see as important in terms of heading towards harm minimisation?

Prof Erickson - Until quite recently, the police could search someone without any reason other than the very general suspicion. If they found drugs, that became a justifiable reason for the search and the evidence was admissible in court so there was virtually no recourse. I think the police have withdrawn from the more aggressive searching and seizing of soft drugs, nevertheless it's still there for police to use those powers. They have rights of warrantless search. If it's difficult to get a warrant, that's acceptable. We go a long ways in Canada to make it easy for police to wage a drug war and to maximise arrests. If that's your criteria for success, we're able to do that very effectively. For the police to move in the other direction, I think there has to be something in it for them. There has to be both a concern about the harm they may be doing in the community by aggressive enforcement and rewards for being more service oriented, for being concerned about public order and safety rather than making arrests.

What I found in some of my research is that aggressive drug squads, and there are very real motivations for them to be aggressive and to be successful, they have to use the somewhat unusual powers they have of getting informers. However among the police who are policing difficult, multi-ethnic communities the drug squads in a sense are operating at odds with them. I think this is an issue that the police could very well work out better among themselves as they're working at cross purposes. When in the last five years, you have an 800% increase in arrests and incarceration of black males in Toronto versus the doubling of whites, this is causing additional stress in the communities. It makes the job of regular police extremely difficult and it would seem to me to be one incentive in Canada. In any community with a lot of ethno-cultural tensions and differences to try to find ways of policing a community fairly. If you go after drugs aggressively, it seems that you can do a lot of damage to relations between the police and the community.

Prof Reuter - Harm minimisation is still a term of abuse in the US and police forces certainly don't consciously undertake anything that looks like harm minimisation. I think that there has been some change in the orientation of drug enforcement by police largely because of the growth of community policing where there is more concern to be responsive to the concerns of the community and so, for example, in cities, there's more interest in trying to get drug markets to be less conspicuous rather than to arrest many people in the course of drug marketing. To that extent there has been a lessening of aggression by the police and probably something that is more consistent with harm minimisation but it doesn't yet bear that label. I would say the serious issues revolve around the sentencing rather than the policing at the moment.

The Hon Alannah MacTiernan, WA, MLC - Just to follow up on that point and continuing the Vietnam war metaphor, there was a gradual protest movement that built up and had to be taken notice of eventually. Is that happening in the US? Are these people becoming more and more concerned and saying stop, we've got to change our policies?

Prof Reuter - If you look at broad based opinion polls, you don't see that. If you ask whether amongst the elite, more are speaking out that there needs to be some major change. I think there is some movement but it's hardly a powerful wave. It's always useful to remember historically that prohibition ended surprisingly rapidly. In 1930 it was not an issue and in 1933 it was gone. It's very hard to see a ground swell at the moment. In part that's because, we can argue that the victims of enforcement are predominantly poor, increasingly a minority. Those that see themselves as benefiting from the toughness are the middle class, predominantly white. So they hear about the drug wars in some sense like you do in this country. They watch the same CNN that you watch and I think there is an increasing detachment from the drug war by the middle class. In some sense, that makes this less of a political issue.

The Hon Ann Symonds, NSW, MLC - I'm interested to know whether or not you can explain to us why it is that the US takes such an interest in the internal policy of every country around the world?

Prof Reuter - This is an explanation not defence. When you're the world's only remaining super power, the responsibilities are just overwhelming. Someone once said that the real liberation of American foreign policy will be when the State Department does not believe that it is required to comment on everything that happens in the world. We seem to be far distant from that, notwithstanding the reduction in the State Department's budget. You see the US as intrusive about drug policy. They're intrusive about a whole range of issues. Their argument is that this is a global issue and that the US in some sense, is the principal victim. You don't understand, little Australia that when you start making these harm minimisation noises, in international circles, that this could really send the wrong signal and thus undermine the global resolve to really deal with this problem. That is the explanation of why they have that attitude. I'm not defending it.

The Hon Mike Elliott, SA, MLC - During one of the sessions this morning there was some information that intrigued me about the relative level of AIDS among opiate users in Toronto, Montreal and Vancouver. It appears that if there is an overarching national policy there must be some differences in the way enforcement occurs and other policy differences. Can you comment on what differences are between the provinces in Canada and perhaps on what we might learn from that? I'm also interested in policy differences across states in the US.

Prof Erickson - We had a visitor at ARF recently who put up a very enlightening graph of the number of needle exchanges in Canada and the US and it was one of those little thrills you rarely get on the northern border of this country. Canada was speckled with needle and syringe exchanges and there were three or four on the map in the US. In Canada we never stopped the availability of needles in pharmacies and this predated the AIDS epidemic. So when HIV became an issue we already had a policy that it was fairly easy to get clean works. Of course, users would say, "Am I crazy? Would I not get clean works?" Then there was also the need for concerted public health effort to actually have needle syringe exchanges and they were worked out with these communities, not without some difficulties but basically, there was a kind of presumption that this was a public health issue. Pharmacists became more on side in terms of giving out needles and syringes. They had been put in the awkward position of being a watchdog before and that was clarified. So this has never been a major issue. The new drug bill that will probably come back to the Canadian parliament has provisions in

there about criminalising containers that make many of us nervous about the threat to needle exchange but we have been assured repeatedly by politicians that it's not really meant for this type of drug delivery but the history of how drug laws have been used in Canada would suggest differently, that there is always a chance of abuse of these broad powers.

Prof Reuter - There's enormous variations across US cities in terms of the HIV rates amongst intravenous drug users. HIV rates amongst drug users in New York metropolitan area by the way I'm about the 137th most expert person on AIDS in this conference and will stand corrected on almost any of these figures have been over 35% for quite some years. In San Francisco where HIV was very significant amongst the gay population, the HIV rates amongst IV use have been, I think, maintained at a fairly low rate. I don't believe that that is driven predominantly by policy. It is sometimes said that the New York Police Department is more aggressive about enforcement of possession of paraphernalia and that explains the growth of shooting galleries in New York. My impression is that there are a lot of other factors in New York that are just as powerful as anything the police did. Policy is overrated as an influence here and a lot of this goes back well before there was an articulated policy with respect to dealing with HIV related issues.

Mr Neil Bell, NT, MLA - I want to shift the focus slightly to the area of alcohol abuse which is a huge problem in northern Australia particularly in the Northern Territory. One of the strategies that's been adopted there has been restricted areas and these have been decisions taken by aboriginal communities on aboriginal land. They're very like, for example, villages in the South West of Alaska or Innuit villages in the north west territories in your country, Professor. I have a problem philosophically. There is a sharp distinction between harm minimisation and the abstinence model upon which the restricted areas are predicated. How does a working politician like me, philosophically, rationalise the two?

Prof Erickson - You mean in terms of the partial prohibition of alcohol?

Mr Neil Bell, NT, MLA - Well it's not a partial prohibition, it's a restricted area and they're thousands of square miles.

Prof Erickson - We have, I guess, a comparable problem in Canada in that if communities go dry what you create is a parallel to the illicit market again. You have illegal imports, profits to be made, drunkenness; or if the reserve, the dry community, is close enough to a legal outlet of alcohol you see increased harm with people having accidents going back from town or freezing to death walking back from town. So it hasn't been a very satisfactory solution and I really don't know what the answer is. The extension of harm reduction to aboriginal peoples is a very challenging area.

The Hon John White, Tas, MHA - If it's against the law to traffic in drugs, why does, and I must make it clear it's not only American law enforcement agencies such as the CIA, others do it as well, how do they justify the importation or trafficking in drugs so they can claim to catch the Mr Bigs by doing so? Just to make it balanced, the NSW police force in the 1980's grew a marijuana plot under the heading of Operation Seville where they claimed they were growing this crop so they could put it on the market and somehow catch the Mr Bigs as well. How do you justify this under social policy?

Prof Reuter - You're not asking for my opinion about this, you're asking how is it justified and the answer clearly is that some notion of ends justifies the means. It's a pragmatic policy that you can control delivery, which is the term used in much of Western Europe, it enables you to, in fact, catch more serious offenders and I do think it's an appropriate balancing act. I don't know if they've done it well. The time when the principal transportation business in the eastern seaboard was run by DEA, the agent in charge of this had the improbable name of Robert Weed and they claimed that they were able to seize all of the shipments that they made through a transportation company. I've always been sceptical that that claim was correct because presumably after the seventeenth seizure by the Weed transportation company out of seventeen shipments, there must have been some suspicion on the part of the customers that this was in fact not a very effective transportation network. I have some scepticism of the claim that they have always managed to control delivery is correct but in the context of enforcement which attempts to combine punishment, that is, to put at risk those at the more senior levels of the trafficking organisations, that's sufficient justification.

The witnesses withdrew.

Witnesses

Dr Robert Haemmig, Psychiatrist, Medical Director, Drugs Branch, University of Psychiatric Services, Berne.

Mr Urs Vontobel, Operation Manager, Crossline Clinic, Social Welfare Department, Zurich.

Mr Michael Moore, Chair - One of the issues that was raised with reference to the heroin trial that has been proposed, the one that was proposed long before you started and you've been going for some time, the concern is that users that are on such a trial will demand more and more heroin as part of that trial when they know it's available freely to them. What has been your experience in both Zurich and Berne on that Matter?

Dr Haemmig - If this would be true you could calculate when someone takes his own body weight of heroin. This is not the case. The effects of heroin, morphine and everything else from the opioids is quite limited so you cannot go over a dose of one gram a day. It make no sense. It's just wasting good stuff and the feelings of the users are not better if they take more; the feelings are better if they take less because to have a kind of rush from the heroin you have to free your receptors in the brain and this is the only way to feel a rush. If you have a high dose in your blood all the time you don't feel anything of a rush.

I can give you figures on that. At the start they start wanting more and more because that's their deficit, that's part of the addiction but in our program it has gone down from 44 milligrams a day to 331 milligrams a day which is a reduction of 24% during the first one and a half years. They have the opportunity to come three times a day so the maximum is three consultations, so the figure there is that the average consultation was 2.7 in the beginning and it's now 2.01.

Mr Bryce Gaudry, NSW, MLA - The shooting rooms, are these for heroin dependent in a controlled situation or is open for people who are just taking up this form of drug use?

Dr Haemmig - You must understand that if you talk about heroin prescription, it's for people who have failed in every other sort of program. It's a last chance program, in a way. It's quite the same way as it used to be for the methadone maintenance some years ago. The same indications of being an addict on IV drug use for more than two years and minimum age and so on.

The Hon Jean McLean, Vic, MLC - I'll ask both of you, could you give us an idea of the attitude of your law enforcement agencies? How do they feel about the very bold experiments that you're carrying out in both your areas?

Dr Haemmig - It's quite a difficult situation at the moment because there are two tendencies. Normal law and order police attitude and the justice system which is acting a bit more intelligently than the police are. Our way was to try and work with the public prosecutors and to involve them in the whole business so they are normally quite favourable about our work. In Switzerland, there has been a report of an official national study group and they proposed that the consumption of drugs should be legalised and the president of this expert group was a former national state prosecutor. So this is quite sensational. Because one part of the police force is this way and the other part is the other way, there is no clear opinion.

Mr Vontobel - In Zurich I have to admit that, at the beginning the police force were more or less strongly opposed to heroin programs and these days we don't hear a lot of comment anymore.

The Hon Alannah MacTiernan, WA, MLC - Have you actually changed the law? Was there a legislative change to enable you to do this or has it just been done as a matter of policy and have you done studies on the impact of the lifestyles of those people who are participating in your programs? Has it enabled people who were formally unable to work to get jobs? Has it reduced the incidence of their involvement in crime, generally on their self esteem and place within the community?

Dr Haemmig - There has been a small, small change of the law just by signing the 71 Convention of Psychotropes because Switzerland was under international pressure of INCPA an UN. All the rest is still the same. We do all the things under our existing narcotic law which is almost the same text as the single convention. There is a study on the impact on criminal behaviour of the users. We will have the results of this in 1997.

Mr Vontobel - I can't comment on the studies but I can comment on the people in our program. For example, a third of the applicants were homeless, there's none of them homeless any more. Most of them didn't have any kind of job or occupation and there is close to 40% who now have jobs or are working in working programs of the City of Zurich. Health wise they have stabilised enormously. I think Robert can say more about that as a doctor. When it comes to social nets, this is probably the hardest thing to address since these people in our programs have been on the street and have been in the drug scene for over ten years and that was just their home. It still is their home; the only people they know and they relate to are people from the drug scene. So we are working on that in group sessions and individual talks.

The Hon Mike Elliott, SA, MLC - How much of a negative has it been, the requirement to actually attend the clinic to receive the dosage and has that led to a loss of any clientele?

Dr Haemmig - Yes. Some people say this is not for me because I don't want to give up my driver's licence. I don't want to go three times a day to this place and I cannot work besides. Some of them even prefer the freedom of the illegal drug scene. Some clients think the programs have a bad reputation but normally other clients are not very well informed of the real situation. Many addicts in a way are conservative people. What we're doing is a new thing and it's so new for them that they just wait and see what happens. The other thing is that we cannot guarantee drugs beyond the end of the trials which means that if someone starts now maybe they can have heroin for one year and then they may be stopped by law and forced to take oral methadone or go into detoxification.

Mr Vontobel - We conducted a survey in Zurich. We went to contact places in Zurich and asked people if they had heard of our programs and whether they had applied and if they hadn't applied, why not and yes, indeed a lot of people have not applied because of these reasons. But, of the people that had applied, the retention rate is close to 90%. It's not the optimum I think. It's not the program for the future, but it's a start.

The Hon Ann Symonds, NSW, MLC - I'm very interested to know what the community attitudes are to your programs. Is there general community approval? Did you seek any community comment on it before you established the programs? Is there a vocal opposition to what you're trying to do?

Dr Haemmig - The whole project could only start because of the pressure of the community and mainly the larger cities of Switzerland. That is, those with populations of 50,000 to 500,000. The communities had to suffer from the drug users so they were very eager to have new ways and so they put pressure on the national level and it was on the national level that the response came and we could start.

Mr Vontobel - I might point out here that there was an uproar in the neighbourhoods. When people heard that there was going to be a clinic near them there was an uproar. Some people even mentioned shooting the people if there was any trouble. But over the two years that we've been operating we have had no trouble with the neighbourhood.

The witnesses withdrew.

Witness

Dr Erik Fromberg, Chief, Training Methodology Department, Institute of Alcohol and Drugs, Teacher, Central School of Criminal Investigation, The Netherlands.

Mr Michael Moore, Chair - Erik, I understand that from a lot of reports we get, that the

Netherlands policy that we're quite conscious of, is now considered a failure and it's going to be reversed. These sorts of reports are very common. Can you tell us how you perceive what's happening in the Netherlands?

Dr Fromberg - When one reads the recent policy paper of the Dutch Government which will be discussed in Parliament this month, you will observe immediately that it states clearly that it's an evolution of the policy of the past twenty years and that the main issues of that policy are to continue.

Mr Michael Moore, Chair - I understand you've done some work on ecstasy in particular. This is a fairly recent phenomena in Australia. Particularly in NSW, where a young woman died following taking ecstasy. There is widespread community concern. What is the Dutch policy in dealing with drugs like ecstasy?

Dr Fromberg - The main Dutch concern on the use of ecstasy is health. In the Netherlands we had until recently, eight cases of death ascribed to the use of ecstasy. We first realised ecstasy is just a name given to tablets, and often we don't even know what's in those tablets. Our main concern is health and not law enforcement with regard to the users. So, for example, when you control people going to a rave and you seize one or two tablets that they have for personal use, the chances are that they have access to more dangerous pills. At all the raves where the dealers are, it is possible to get pills inside. Then you increase the risk so the general idea is help the user to use as safely as possible and on the other hand we prosecute and invest lots of energy in arresting the producers. Although this has no significant result. It costs us a lot of money.

The Hon Ann Symonds, NSW, MLC - Can I follow that up then? As you say, there is a government paper which concludes that you will continue with the current approach, we are constantly being told here that there is enormous unhappiness with the Dutch system and that it is going to be reviewed. What is the community attitude to the continuation of your current program?

Dr Fromberg - The community orientation is that quite a number of people in the Netherlands feel we are too lax. But we have experiences as Dutch people about the implications of das goezoenden volks aanfinden, which we dealt with between 1940 and 1945. That's the reason our government does not always follow das goevenden's volken finden. You may find in the Netherlands a small number of people in favour of capital punishment but it is political suicide to propose the introduction of capital punishment. That's just not done.

The Hon Jean McLean, Vic, MLC - I just wondered how ever the pressures are from other EEC countries for the Netherlands to fall in with their policies rather than the other way around. This was certainly the impression I got at the European Parliament a couple of years ago that the Netherlands would have to fit in with us.

Dr Fromberg - Sure, the European Union is one of the influences that necessitated us to reconsider our policy. Ten years ago our greatest critic was the Federal Republic of Germany. Nowadays we hardly anything from the Federal Republic, except that German Ministers of Public Health and Justice come to the Dutch Government asking us to go on with our policies because they will follow our policies as well. Even the Bunderscouncillor of Germany hardly says anything because he knows that the majority of the German states are in favour of our policy and only a minority of them still criticise us. On the other hand we have the problem of the French.

The Hon Ann Symonds, NSW, MLC - We've also had a problem with the French.

Dr Fromberg - I might suggest that our product is more popular with the young people of France than theirs is with ours but it's a serious situation. The French Prime Minister, Mr Chirac, attacks us viciously like only the Americans can do as well, but there is happily an Atlantic between Europe and the United States. He's attacking us viciously, shouting that, for example, the majority of drugs being seized in France are coming from the Netherlands. The French police provide data that show only 4% of the drugs seized in France comes from the Netherlands which is quite logical because most cannabis comes from Morocco and so enters France by Spain. The whole issue about the Schengen Treaty was abused by the French Prime Minister because he simply doesn't want the Schengen Treaty implemented. Not because of the Dutch drugs but because of the influx of people from North Africa and it's damned easy to shout at the Dutch, that they don't want to implement Schengin because of the Dutch drug policy. It's a lot more difficult to say that he doesn't want to implement Schengin because of his fear that the Spanish and the Italians and his own customs are unable to control the influx of people from those countries. So it is political expediency to reproach the Dutch as loud as possible.

The other factor is that if you look at the street level of cannabis in France it is not very much different from the situation in the Netherlands, as it is no different from any other country in the world. The only difference is that the Dutch are realistic and if there is a cannabis trade, let's have it out in the open and let's see it. That's completely contrary to the French cultural style to admit that. "Yes, there's some thing that everybody knows about but you don't talk about it and let's not show it". This explanation, by the way, was given to me by a Frenchman.

Mr Bryce Gaudry, NSW, MLA - Just in terms of law enforcement and approaches by the police, what role do the police play in the Netherlands in relation to drugs of any type? Is there an enforcement approach at all or is it more just monitoring and community relations?

Dr Fromberg - There is enforcement on the level of international trafficking, production and trade. There is no enforcement on the level of individual use. The main issue of the police in the street is reduction of nuisance to others. One of the consequences of our slightly different drug policy is that we have a phenomenon called drug tourism. Drug users from France, parts of Germany and Belgium come to the Netherlands to buy drugs because it can be done more or less in the open. This is the cause of a certain level of nuisance for the Dutch population and the most clear demonstration of that was in Rotterdam where in one of the parts of the city, Spangen, where the heroin trade especially for French customers, was really unbearable to the local population so they started to protest about this. However, the same people who protested about the French, arranged for housing for the junkies of that same region. The view is that that's our problem but the French should take care of theirs.

Mr Michael Moore, Chair - I understand that you're involved in the education of young Dutch police. Can you tell us just briefly the sort of principles that you use in terms of education of police, as far as your concerned about drugs?

Dr Fromberg - I was invited to become a teacher in 1975 and then I asked the people what they wanted me to teach. Their answer was very simple. Make it clear that there are other ways to look at the drug phenomenon than by the so called blue model. So, what I try to teach them is the role drug use has for human beings. The way substances work on your brain, the influence society has, the influence on the individual, let's say, the drug set and setting. My final conclusion is always that prohibition creates more problems for society than the drugs, whatever their properties can do. We have to get rid of this extremely damaging situation as quick as possible and that I wish them well in their hopeless job.

The witness withdrew.

Witness

Dr Rob Moodie, Director, Division of Country Support, UNAIDS

Mr Michael Moore, Chair - Can you tell us what you see as the record of harm reduction in interrupting epidemics in HIV, especially amongst IV drug users?

Dr Moodie - Certainly the programs that have run globally and the research that has surrounded that, very strongly suggest that harm reduction programs are very successful in limiting epidemics of HIV amongst injecting drug users and in addition to that, the often silent side effects of encouraging and promoting drug use, recruiting younger users, even having a lot of side effects of discarded needles. These are not found to be significant in the studies being done.

Mr Bryce Gaudry, NSW, MLA - I wonder if you have any evidence in terms of an economic rationalistic model, cost benefit analysis of harm reduction programs with injecting drug users?

Dr Moodie - Not really, it's not my special field. But if you just look at Baltimore, for example, where they described the program costing $160,000 US a year and the cost of looking after someone with AIDS was well over $100,000 US a year. The program in a sense, had to prevent people from getting HIV and in the long run, to be cost effective. Again, you'll have to refer to others in the audience to give you this information.

The Hon John White, Tas, MHA - In Tasmania, the laws relating to illegal use of drugs come under the Minister for Health. The enforcement of that, though, is almost given totally to the police and so, the Minister of Health is responsible although he has no control over the attempts by the law enforcement agencies to prohibit drugs. When we try to bring in a needle exchange program, the conservative Minister for Health said that he couldn't make his mind up until he had discussed the matter with the police. Do you think it would be better if there was more control by health authorities rather than law enforcement agencies in relation to the prevention of the spread of HIV? Or do the police have a role to play?

Dr Moodie - I think the police, in virtually every culture, have a major role to play if you're talking about a substance that is deemed illegal, then the police will obviously come into the play no matter what. I guess you have to be a little careful when issues are medicalised rather than in the legal field because often the issue of medicalisation can promote greater restrictions and greater penalties because the actual issues are far less clear than when they're in the statutes, where it is clear if something is illegal or legal and what the penalties are. But in the case of where the past quarantining of people on the grounds of rather very confused public health legislation has been used, whatever happens it's going to be a mix of the two. I think that you have to be clear about what the rules are, what the laws are and what has been evident about what has been successful in harm reduction in every place is a very close co-operation between police, interior ministries, health and other authorities. You have to have this intersectorality to make it work. That's why at harm reduction conferences we need as many police and law enforcers as we do representatives of any other discipline.

Mr Michael Moore, Chair - In you UN role, I suppose one of the greatest concern in this area of the world is the possible spread of HIV through Asia. How urgent is the development of harm reduction policies in Asian nations and what chance have we got as a world of going about that?

Dr Moodie - It's not a possible spread, it's a real spread and it's a real spread within Asia, Latin America, Central America, Europe, Eastern Europe and Northern America, now starting up in Africa. So, related to the areas of production in Asia, you have the HIV epidemic following the epidemic of drug use. The HIV epidemic in many parts of Asia is a major emergency, if you like, but the level of response is nowhere near the level of the problem. There's a tremendous sense of urgency to implement harm reduction programs where there is significant injecting. That injecting is increasing. It's incumbent on us to advocate and push for widespread harm reduction programs. We've got a lot to battle against because of the difficulty of instituting harm reduction programs politically and again, a lot of that relates to the most economically powerful country in the world that has polices that are very much against harm minimisation. That has a negative impact on the development of harm reduction programs in the rest of the world, particularly in Asia.

The Hon Mike Elliott, SA, MLC - I was wondering if our witness could give some statistical backup to differences to HIV infection in perhaps societies which are comparable where one has implemented harm reduction programs and one hasn't. Also whether you have any statistics that indicate where programs are running long enough, whether or not it actually brings infection rates back down rather than simply slowing down the infection rate.

Dr Moodie - I don't hold the statistics in my head. In relation to your second question, I guess the recent work in Canada showing a declining of incidence of HIV amongst injecting drug users which in a sense answers your question. After you hit a peak you can see a declining incidence with continued use of needle exchange programs. In terms of directly related to control populations you can see that there have been studies showing those who have been attending needle exchange programs against those in the same area but I would refer to Alex Wodak and others who are aware of the epidemiology more than I am. It's hard to have exact controls because the situation is difficult. Often cited are the situations in Edinburgh and Glasgow and the differences where harm reduction has been instituted in one city and has lower HIV rates. Then again, to draw very solid conclusions without having a control study is a little bit difficult.

Mr Michael Moore, Chair - Thank you very much. Another thank you to all the witnesses and to the members of parliament who have formed this panel.

The witness withdrew. End of Session One

Tuesday, 5 March 1996

Wellington Room

Chair : The Honourable Ann Symonds, NSW, MLC

Panel:

Mr Neil Bell, NT, MLA

The Honourable Mike Elliott, SA, MLC

Mr Bryce Gaudry, NSW, MLA

The Honourable Jean McLean, Vic, MLC

Mr Michael Moore, ACT, MLA

The Honourable Kevin Rozzoli, NSW, MLA

The Honourable John White, Tas, MHA

The Hon Ann Symonds, Chair - Yesterday, we concentrated more on law enforcement issues and today I think the overall tenor is largely about social policy. It is in order for anyone to send submissions to this inquiry which we will consider and make recommendations arising from that evidence.

Witnesses

Ms Alison McClelland, Deputy Director, Brotherhood of St Lawrence, Australia.

Prof Ernest Drucker, Professor of Epidemiology and Social Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, New York, Chair of International Harm Reduction Association.

Mr Michael Moore, ACT, MLA - I'd like to raise the issue of disadvantage in the areas of the Bronx that you've seen. Can you explain to us how you see the social policies in somewhere like that having a ramification on drugs policy and what we can learn from that situation.

Prof Drucker - The Bronx, where I've worked for almost 30 years is not typical of the US. It is a very dense, very poor urban area. The county has 1.2 million people with about 35% living below the poverty level, crowded conditions similar to the great depression, levels of tuberculosis are now the same as in the great depression in the 1930's. We have had 12,000 cases of HIV diagnosed as of this year which is more than a number of countries in Europe. Drug use levels are very, very high and have been the for the last 20 years, principally the IV use of heroin and cocaine.

For me the drug issue has always been subsidiary to the social neglect of the fundamentals of housing and social support for families and education of which the Bronx is a classic example around the world for good reason. In the face of that neglect, two issues; the drug trade is an economic activity that has filled a vacuum left by other forms of employment and the collapse of our public health system over the last few years has meant that that door has begun to close. That used to be the place where the drug problem presented itself. Simultaneously, through expansion of arrests and imprisonments, the criminalisation of not just the drug use but since drug use is so prevalent, essentially the criminalisation of the entire under class population of the borough. Not all of them go to prison but every family network has members who are imprisoned or are under control of the criminal justice system at any given time. Simultaneously it's a community in which I guess fewer than 25% of the eligible voters, vote. So you can have a classic pattern of disenfranchisement and neglect and almost no empowerment relevant to the political apparatus of the current regime of the city as it does not depend on this borough for its election.

Mr Michael Moore, ACT, MLA - The 1993 American Drug Strategy which I went through

recently suggested in fact that there was a reduction in drug use across the US in the previous year. Are you familiar with that claim by the American Drug Strategy and if so, isn't that perhaps an indication that prohibition is delivering at least something?

Prof Drucker - Well, drug use over all in the US population has been declining since the late seventies with the notable exception of the inner cities minorities who have been using, if anything, more drugs since the mid eighties with the introduction of cocaine and crack in large quantities. The only thing that has gone down in the last few years in New York is the homicide rate, which is interesting and paradoxical because in many ways the conditions have grown worse as measured for example, by overdose rates of drug users which have increased by two or three fold in the last five years. That seems to be due to changes in the drug trade. The enforcement practices of large sweeps in large communities have essentially driven the drug trade off the streets into bodegas which are grocery stores and family businesses where the whole intersection is based on who knows who. You can't get in unless you know people. The street trade which was really the most violent place where you have different people bumping up against each other, where you have the random violence and the bystander murders took place. That's generally abated and that's probably the source of the decrease in the homicides but every other marker we have, suggests that things are the same or worse over these last few years, at least in New York. I don't know about nationally but in most of the drop in drug use had been going back to the seventies for the harder drugs among more middle class people but in the poor segments of society, really not a huge change.

The Hon John White, Tas, MHA - Ms McClelland, I want to set a preamble to the question. Tasmania has the largest drug bureau per capita in the nation and whilst we've heard the police hierarchy advocate harm minimisation, the politics of the police association and the drug bureaus in particular is in fact the very contrary and want no change whatsoever. Where we have non-government organisations coming to governments and saying, please can we have assistance or funding to carry out these projects. As you would be well aware, you have to have a particular type of organisation, you have to have a particular structure. At the end of the day, you have to have your work evaluated in one form or another. The question really comes down to what action will you take politically to get my colleagues in the parliament, both Labor, Liberal and others to become aware of the problems that exist and also to ask that other organisations such as the police become accountable in relation to the funds and powers they get which are quite the opposite to those I understand the Brotherhood of St Lawrence would get. In other words, I'm saying that whilst we here on this panel may have a collective view, what can you do to change the minds of our colleagues who don't want to know about the problem?

Ms McClelland - I thought you might tell me that. We're trying reasonably hard. It seems to me that there's probably three things. First of all, we still need to maintain good research and policy analysis, good ideas and putting them forward to you and your colleagues. That's a very important thing we need to do. Of course one of the difficulties we have these days is finding funding to do that. One of the problems that non-government organisations such as us do face is that government funding is increasingly related to what governments want to see done and are often reluctant to fund research where the researcher insists on being free to publicise the findings as we at the brotherhood do insist on. Otherwise how else can we be sure that it is able to be communicated and lead to social action? Even given that problem, the need to continue to support and to fund good research and policy is critical.

Secondly, we find it very important to put a lot of energy into submissions and lobbying and to support collective attempts, like the Australian Council of Social Service and will continue to do so but in the end our efforts are dependent on community support and community awareness and that relates to having a media that is receptive to what we're trying to say and be able to get our message across to the public more generally. So that it's not just us that are putting on pressure and it's not just confined to the welfare lobby or the drugs lobby, but there is a greater community awareness and understanding so that the acceptance for what we want is more generally shared.

The Hon Mike Elliott, SA, MLC - When we are looking for solutions to the drug problem, I wonder if we have a another problem in that the decision makers are generally speaking from the middle classes or occasionally atypical working class backgrounds and whether or not there is a single drug culture or a number of drug cultures. What got me thinking about this was the question that Michael asked about this and the fact that there were claims that drug use was declining and it crossed my mind that perhaps we're seeing people who are using drugs in a purely recreational sense, maybe responding to laws in one way, whereas other people are using drugs for other reasons. Then listening to Ernie before, underlining the problems of colour, I don't know whether I'm putting a false construct on all of this but do we in fact have a number of drug cultures? Not a single one and, as a consequence of that do we actually need solutions that are even more complex than I imagined which was simply moving to regulated availability?

Prof Drucker - I think you're right. The drug problem doesn't really describe drug use accurately. The licit drug use of alcohol and tobacco are the major health problems, so immediately we have a disjunction between patterns of drug use and public health and illegality. But even within the illicits, the majority of people who use them both in a lifetime, within the last year, regular users would not best be understood as problematic users other than the problems that are inherent of them using an illegal substance and the risk that that exposes them to which is a function not of the drugs but of drug policy and its enforcement. In the US, the figures are about 40 million lifetime users of cocaine, somewhere in their lifetime, they've used cocaine. I'd say a tenth of that having used in the last year. One quarter of that, maybe one or two million being best understood as problematic users where the use of the drug is disrupting their lives, they're getting arrested, messing up their family, jobs and so on.

With heroin the numbers are something like 20 million lifetime and a million problematic current users so one of the problems is that a policy that doesn't discriminate, which is driven by this drug being illegal and anyone who uses it will be at risk, has far more impact on the non-problematic user, driving them towards problematic use. For example, having to use a drug that's clandestine means you never know what you're getting, it's purity, potency, what its been cut with, the conditions under which you use it are to maximise risk, hiding in a closet somewhere, having to keep it a secret. The alcohol user by comparison is really out there in the open and we're learning as we become more sophisticated to recognise someone who has a drinking problem Even the terminology of it is important because the whole system is skewed now to seeing something earlier. Whereas in the other case of illicit drugs the whole system is skewed to concealing it to the whole point where it has become very difficult to manage. Drug treatment is not a simple matter once someone has become a compulsive user. I guess the answer to the question is that the differences, the heterogeneity of drug use, is not recognised in this very homogenous policy, this one policy, it's illegal, "just say no". We only see the tip of the iceberg. That becomes our stereotype of the drug user and that in turn, that little piece, is used to determine our future policy and to gauge the success of the old policy. It's really on its head.

Ms McClelland - Two quick comments. I don't know about the cultural differences but it seems to me that a difference that is often not acknowledged in social policy, and drug policy is probably the same, is people's different choices. Particularly the different choices that people who have got few economic resources have compared with those who've got many. We hear a lot of rhetoric that we will do this so people can choose to do that. If you are a sole parent trying to bring up children with very little money, your choices are much different than if you have the support of a partner and you are on a high income. That will relate to your capacity to give up a drug such as tobacco or your capacity for you to get help to minimise harm. I think it's very worrying in the current debate and the new discourse we have that choice is so often talked about as if it is uniform for different groups. We must acknowledge that. Governments have got a key responsibility to help those people who have few choices. How can I encourage colleagues? I think it is encouraging a greater understanding about what the role of government and the role of public responsibility is in social policy. A key priority must be to assist those most who are experiencing severe pain which is unequally shared and is likely to be harmful. I think a better understanding of the proper role of government, the fact that very often it's going to have to intervene in the market in ways that governments are increasingly not prepared to do if it's going to achieve that.

The Hon Ann Symonds, Chair - One of the most frustrating elements of being in the position of a parliamentarian is the perception that you're involved in so many aspects of the delivery of government and in fact what we do get to do is debate proposed laws and debate legal changes to various aspects of society. What is very difficult to participate in, if not impossible, is the budget debate. This is the debate we have when the decisions have been made and getting access to this process is the difficult question for us which should have a priority in determining what policies actually attract funding.

The Hon Jean McLean, Vic, MLC - Ms McClelland, if as we know worldwide, developed and underdeveloped countries can continue to see high levels of unemployment for many years to come, in fact one of our problems we have, is people surplus to need. When I was speaking to the European Commission representative on unemployment, he said in Europe alone we've got about 36 million unemployed and when I asked what he thought he could do about it, he suggested that one of the main things was to train people for jobs that haven't been invented yet. He said we've got to find someway of encouraging people to study for things that might come out of the study that they do. He did, however, suggest that 36 million people in Europe could be a problem if they all got together, therefore, there was still a hope for finding something for them to do so that they don't all get together. What do you think can be done in these areas to find some sort of mainstream employment or getting these surplus to need people back into society?

Ms McClelland - The unemployment question is a serious one and however good an Australian government was it would take some time to get everyone in this country who wants a job, a paid job. However, I do believe that the biggest obstacle to reducing unemployment Australia and worldwide, is lack of political will and a lack of belief that it is possible and the overriding belief that governments leave it to private enterprise to create jobs. Now that is not to say that the market doesn't have and won't continue to have a key role in providing jobs. Greater political will is needed and a better balance of objectives of fighting inflation and finding employment. Another important requirement is international activity to promote economic stability of the kind that we haven't been able to see over the past 20 years which is also been a contributor. We also need very good polices that are going to help unemployed people get jobs as they become available but I don't think that means training people for jobs that we don't know about yet. One of the things that unemployed people say to us that frustrates them as much, if not more, as going to the CES where they can't help them because there are no jobs, is doing short term training courses for which there are no jobs. They feel very demeaned and demoralised by that. I do believe that it is very worrying that at a time when we have so many people out of work we are prepared to cut jobs in the area of socially useful work such as community services, education and health and as a society, we need to think about priorities both in terms of what needs to be done and in terms of the lives of people if we're going to continue to do that. Finally I do think that we're going to have to acknowledge a range of ways that people that people can make a contribution which isn't paid work for a while, otherwise we're going to have some very unhappy and demoralised people.

Mr Bryce Gaudry, NSW, MLA - You've both painted a picture for the need for a more interventionist approach. Ms McClelland, in terms of government, do you see that approach to be provision of budget or direct provision by government in the area of social welfare. There has been obviously in this country, and I'm sure in the US, a contraction of government from direct service provision and an increasing call on the private sector, particular community sectors, to provide that ground contact and the sort of programs that we're talking about here.

Ms McClelland - I think it could be both and what it should be would be on a case by case basis. So I wouldn't have an overall answer to that however, my clear warning is that we're contracting out purely as a way of reducing government costs and reducing accountability of government. There are clear problems of public accountability and also in terms of the efficiency and effectiveness of what is ultimately delivered. So where it's done as a cost saving technique forcing the voluntary and the private sector to pay lower wages, to provide a lower quality job or to make up money from community donations, I think is a problematic strategy.

Prof Drucker - I would turn it on its head actually. I think you have to examine the things that we're doing now which incur costs immediately and in the future and look closely at them. I'm very impressed that the drug policies are a major sink that absorb huge financial resources and simultaneously destroy social capital. I think if we did what the Europeans call Green Economics, where you actually look at all the costs associated with a factory; the balance sheet may show we make so much equipment and supplies, we turn out so many cars and we sell them, but who pays for the effects of the pollution that comes out of the chimneys? Someone pays because they degrade other parts of the environment, someone has to clean it up and pay for the kids whose brains are damaged by lead emissions and so on. Characteristically those costs which are much longer term and difficult to attribute but quite real are ignored. I think we can't afford to do that in looking at social policies. We have to really cost out a social policy such as drug prohibition very fully.

Even in the short term in a city like New York, we have a 30 billion dollar annual budget and it seems that between 2 and 4 billion a year of that budget ( most of that budget is service delivery, fire, maintenance and so on), and perhaps $8 - $10 billion is available for social programs, health and so on. 2 to 3 billion dollars of that year is spent on prosecuting, chasing down, incarcerating. paroling, rearresting drug users right now. We arrest 120, 000 people in New York City each year of who about 60% are on drug charges. About 2 or 3 hundred arrests a day. It costs about 10 thousand dollars an arrest in New York City. If you divide the number of arrests by the budget of the police force, you have huge expenditures. That's the money that might be used to ameliorate the conditions in the Bronx that would lower the prevalence of drug use. Then there is of course, you set someone up for a lifetime, basically make them unemployable for life, you taint them as far as the ability to make a respectable marriage and have a stable household. The likelihood of recidivism is about 60% I suspect. You make a decision, you begin a process which for a 16 year old who gets arrested on a crack offence, may mean that over his lifetime, we'll spend a million and a half dollars on keeping him and us miserable. Multiply that by 2 or 3 thousand times in New York and you've committed yourself to a huge expenditure for the rest of that generation. Of course his children aren't going to do too well either, because their father's going to be in prison a lot of the time and he's a drug addict the rest of the time. We need to shift our model to the kind of way of thinking about the real expenses of these things.

Mr Neil Bell, NT, MLA - A question to both witnesses. I'm concerned about the sociological and social causes of drug dependent behaviour, particularly alcohol and the illicit drugs. Isn't it fair to say that even a progressive policy like harm reduction is just a stab in the dark and isn't it fair to say that we simply don't know what causes those harmful drug dependent behaviours? If we don't know those causes, how can we develop sensible public policies that are going to stop our children being recruited into those harmful behaviours?

Prof Drucker - We don't know why if 20 million people try heroin, 2 million of them become addicted and the others don't. There's obviously an individual difference that has some biological and genetic basis that's important. But we do know that the prevalence or frequency of problematic use is much higher in people with misery and marginalisation. We knew that from Dickens' London about alcohol, so there's nothing new or mysterious there. Miserable conditions create the need to escape , to salver the pain in some and if the thing you use to do that takes on a life of its own as addictive drugs do, there you are.

How to get out of that hole? Obviously not to dig it in the first place. Once you're in it, let's develop effective treatment. I'm very optimistic about the means of developing effective treatment for addictive disorders in the future. If we begin to get serious about our goals of public health, a meaningful life for someone who uses drugs, recognising that they go in and out of drug use as we accept with cigarette smoking. We accept that if someone who smokes 2 packs a day cuts down to 1 pack a day or if they're drinking 50 ounces of alcohol which we know will cause an awful lot of health problems that will cost money in the future, if we can cut them down to 20 ounces a week of alcohol, that's a good idea. Alex has worked on research that has demonstrated the cost benefits of that, so I think we have the models and the techniques. In the illicit drug area we are unwilling to consider the application of those models. We keep going around the same circle.

Ms McClelland - I agree with that. There are many entrenched problems where the causation is unknown and uncertain but we still have a responsibility to deal with them in a way that we know best, particularly to do with the harm that rises from them. I think that those in the conference know much better than I do what relates to harm, but I m sure that stress, exclusion, uncertainty, marginalisation is related to harm.

Mr Neil Bell, NT, MLA - Is there a bibliography of the asking of that question that goes back to Dicken's London?

The Hon Ann Symonds, Chair - See the Canadian Addiction Research Foundation.

Prof Drucker - I don't think there is really any specific details on this. I got my information from his novels. The sanitarian and public health movements of the 19th century which gave us among other things, prohibition, came out of an awareness between drug and alcohol use. That when people starting drinking heavily, they became dysfunctional at their jobs, began to beat their kids and wives and the temperance movement in the mid 19th century came out of that. But alcohol use has been with us a long time. My friend Harry Levine wrote a paper called The Discovery of Alcoholism which is a late 19th century phenomenon. Before that people drank, they got drunk, that's just what people did. It was never understood as a disease but only with industrialisation, with the need to get people into harness, to show up at work five days, suddenly the drinking patterns became of concern to society at large. Until then it was part of life. Blue Monday wasn't Blue Monday because it was wash day but because after a weekend of drinking you couldn't do anything in the blacksmith shop except inventory work.

The Hon Ann Symonds, Chair - I've been interested in women's prison policy over a ten year period in Parliament and examining the records of the first inquiry into women's prison, one of the problems identified was gin. The same percentage of women in prison today have the problem of heroin or prescription drugs or a mixture of both. I find that the difficulty of most people in public positions talking about these issues is that they're not able to talk about the underlying cause which is as you said, pain. We ought to be talking about suffering more than we do.

Prof Drucker - The analogy would be to taking gun shot homicides and say they're related to lead. They are, but it misses the point.

The Hon Kevin Rozzoli, NSW, MLA - What has come out so far is the enormous complexities of what we're doing and Mike mentioned that perhaps we've been looking at perhaps too simplistically and I certainly think we are. I've got about thirty questions here which obviously I'm not going to get a chance to ask. Firstly, in the attitude of society towards drug taking, or dug use, are we actually talking about use or addiction? Is the problem about addiction or use, given that the vast volume of abuse comes from alcohol and tobacco which are both legal substances? Are we talking about the question of , if we make all drugs legal, will the people who stand to gain much from the trafficking in illicit substances find something additional? Could we ever catch up with the problem by legalising or do we drive the drug barons into another area that is harmful for the community because the illicitness itself is an attraction? Thirdly, is it a health problem? A law enforcement problem? A social services problem? Or is it an amalgam of the three, and I suspect it is? Do we in fact need to design a totally new approach and social strategy that goes right behind the front line that we see in the actual use and problems of addiction and go to trying to research what are the trigger factors in human behaviours that lead towards people seeking some sort of solace and excitement or whatever it might be from taking a substance on board?

The Hon Ann Symonds, Chair - We all recognised that Kevin just asked about ten questions and you can answer any part of anything that he referred to. Please don't comment on what causes excitement or someone will outlaw it.

Prof Drucker - Why would you want to stop people from drinking the nice wines you're producing here? Even though some people doing that will become alcoholic and you make a social decision about that and you try to set out a safety net that will identify them early and perhaps treat them more. Maybe some day genetically we'll discover who's prone to become alcoholic among those who drink and warning them at an early age. That's not really feasible in the near future but we're getting closer to where we can do that but I think the larger question that you raised about the relation between the patterns of use of these drugs and other social problems just won't go away so you have to do both at the same time. It's sort of like the old problem of medicine, of doing preventative medicine and operating in casualty. You need to do both and you need to allocate the resources to both otherwise the analogy of putting a fence at the top of the cliff to catch the bodies is true. It's that paradigm again and again and it just won't go away. The fact that it's hard to hold both those things in one's mind at the same and it's hard to get the budget for them doesn't mean that's not the way it is. The way we operate now is a bit like figuring out the technology to launch a space ship and when we get it into space we figure out what we're doing there.

There needs to be more planning and it's laudatory that this group and your governments have done more than the government I've had contact with. I think the process is the key and given the complexity of this and how much ignorance there is, that you have to have an open process in which no possibility is unexamined. Where you use evidence in the decision making, look at the true costs of what's done now and don't assume these are God given polices. We know that some of the drugs that are illegal now were legal nineteen years ago and there are large parts of the world where the drugs that are legal here are totally prescribed. So if you keep an open mind and keep a process in place and take advantage of the kind of data that has become available. That's something that wasn't there before. Really we were ignorant of many of these aspects and we're not now. We know enough and we have the surveillance and monitoring systems to see the effects of what we do. For example, your drink driving programs which have been quite effective and your first cigarette' advertising. These are all models of what can be applied to the illicit drugs. If you break down that barrier and remove that distinction the prognosis is much better.

Ms McClelland - In relation to the last question, should it be this, this or that, in my experience on social policy, good polices are those that have balances. That don't say it's either this or it's that, but they have a package that balances the combinations that we need and we have to get away from the either or approach which can be very dangerous.

The witnesses withdrew.

Witness

Professor Diane Riley, Faculty of Medicine, University of Toronto; Founding member of the Canadian Foundation for Drug Policy.

The Hon Ann Symonds, Chair - Diana, are you working on any special projects at the moment that you'd like to alert us to?

Prof Riley - What I've been doing over the last several years has been to compare approaches in terms of drug policy around the world and how those polices effect harms and benefits not just to social issues but also to health medical areas and especially in the area of human rights. That's what I was doing at the Canadian Centre and that involved looking at work such as has been done in Mersey side, the Netherlands, now in Switzerland, also Australia and also looking at the effect of prohibition both in the US and Canada. A lot of that work involved looking at levels of HIV, Hepatitis, tuberculosis as well as the costs in terms of imprisonment. I've done a lot of work in prisons and with the correctional system and quite a bit with natives as well. The work that I do with the Canadian Drug Policy is based very much on the model of what you've done in Australia which is to educate the parliamentarians and the public and to try and stop the proposed new drug law, Bill C7 which may be resurrected.. We're in the process of trying to get new drug law in Canada.

The Hon Kevin Rozzoli, NSW, MLA - I'm just appalled at what you've told us about the reduction in your budget. I find it absolutely staggering. My question is, what were the factors that drove the government of the day to believe they could reduce a budget that far? Do you think we've done enough to shore up the intuitive evidence that we have, that there is great economic loss through substance abuse and that the amount of money we put into it is negligible compared to the cost to the community? Should we spending more time trying to quantify what the economic losses are arising from such abuse to try to take to Government an argument that they should put more money into substance abuse?

Prof Riley - We really don't know why the government cut in this way. Canada has an enormous deficit exacerbated by the last conservative government and its spending habits so that everything becomes deficit, deficit, deficit and it's said that things are done despite the deficit. On top of this we have the separation of Quebec which has always been on the agenda but has come to the fore in the last while. That really polarises the debate and takes a lot of resources. In that climate the new Liberal government wants to Americanise and streamline government and one of the parts of that process is to cut back on the health and welfare part of the government to the tune of more than 50% in the next year or so. We're part of that cut back. Although we are not a Federal organisation we're funded by Federal money, but we're supposed to be arms length. The second reason is that I've got into a surprisingly large amount of trouble for the criticisms I have made of the approach or lack of approach to drug policy and drug related harms. We were constantly being told that we must shut up because we were making the Canadian Government look bad.

We were created by an act of parliament in 1987 to be an independent voice on drug policy and drug related matters, but we increasingly came under the shortening arm of the government and the Clinton administration is just a telephone call away, quite literally. That was another factor. The other is that the local provincial level in Ontario which is the province or state that I'm from, which has a government a little to the right of the Ayatollah. Their idea of cutbacks are to cut the single mothers, the single parents and so forth so we're at the point of being hit by two major cutbacks. Having said that the fact that we have no official Canadian representation, because I'm here at this very important meeting under my own steam, gives you an idea of how important Canada sees this to be and also that the priority again is deficit.

Having said that, while the previous two witnesses were speaking I did a quick calculation of what the cost is for imprisonment for simple possession of cannabis alone per annum to our provincial and federal systems and that's 250 million dollars just for imprisonment. Just for simple cannabis possession alone. So you can see if we could only invert our system and put that money elsewhere and put it back into the sort of organisation I was with, I think it would make a difference.

Mr Bryce Gaudry, NSW, MLA - I'm interested in the situation in Canadian prisons and what efforts are made there in terms of rehabilitation or working with prisoners who have been sent to prison with drug related offences and the treatment of their spouses or partners. Anecdotally, I'm working with some partners of prisoners who, because they were themselves picked up for possession, their partners were moved to distant prisons and their visiting rights taken away. I wonder if you've got similar policies and what direction you would see prison policy going in terms of adequate approaches to drug related crime?

Prof Riley - Well, I think there's some good and bad news. Compared to a number of countries we've had a lot of progress in the prisons area, primarily because of a report that came out by the expert committee on AIDS in prisons. As a result of that report which was really stinging, it found that as many people know, the treatment of drug related problems in prisons is laughable. The kinds of approaches are strictly abstentionist and very limited. There is no methadone in Canadian prisons and that is because we have no methadone places in Canada in general. The report, stinging as it was, allowed us to get supposedly freer access to condoms in prisons and yet, inmates tell us that is not certainly the case in practice. It allowed us to get back the issue of bleach, because once it was found out that inmates were using bleach to clean their works, bleach was made an institutional offence. So now bleach is back on the agenda. When some of us writing that report said that bleach was certainly not enough especially with respect to Hepatitis, we called for syringe exchange. The response was absolutely not, but as a result of the very valiant efforts both in Switzerland and Australia, guards at least in the province of Colombia have come out in support of syringe exchange, so we are making progress.

Having said that, we have no methadone in prisons, people tell stories of staff taking great delight in pouring their methadone down the toilet in front of them. The kind of treatment there is, is very limited. The kind of work I've done in prisons has alerted me and also young offenders, to the revolving door, creating a whole class of society that will always be unemployable and always tainted, especially as we do drug testing in Canadian prisons and this has impact on parole. It also means that because marijuana has a much longer half life in the urine than does heroin and cocaine, people turn from marijuana use, which the guards like as well as the prisoners, as the guards like to have the quieter, more docile prisoners, the prisoners turn to harder drugs that are less detectable. They turn to injection for the bigger bang for the buck and also because the smoke is detectable and the injecting isn't. We have many people reporting that they inject for the first time in prison and that they take drugs for the first time in prisons. A number of us are starting legal challenges around this because we have so many of these cases coming up. Compared to a number of countries, we're making progress but that's not to say that the situation is still not appalling.

I, for one, believe that we have to do harm reduction in prisons and in corrections. In Canada, we have 1% positivity of HIV in the prisons, which is 10% our general population rate, but in some of our prisons, we have a 50% positivity rate. There are women's prisons in Quebec where 50% on the inmates are already HIV positive, not the alarming levels of Hepatitis B, C and so on. This is, of course, Canada who, like the US, sends drug users to prison for simple possession. Once they get in there, if they're not already using the needle, then they will very often start because of drug testing and what have you. Needles get used 50, 60, 70 times, maybe even gets used for 10 years. So we've got an incubator. Maybe it's better than other countries but its' bloody awful.

The Hon Mike Elliott, SA, MLC - As a member of a group of parliamentarians trying to get change, and thinking about how we work strategically I want to understand why things have developed in Canada the way they have. I note that you have said that Bill C7 was initiated by the conservatives, picked up by the liberals and is coming out of the Department of Justice. How much of what we see in Canada is the result of inertia of ignorant bureaucracy and how much of it is more blatantly political? Is there interference on some level which is causing this to happen, either internally or externally?

Prof Riley - So much of our influence comes from the US and also the UN. When Canada put in a submission to the UN along with other countries, on human rights and drug use, it turned out that the two countries that did not sign were Canada and Japan. The people who were representing Canada were part of external affairs and they claimed that this would get them into too much trouble with the US. This is constantly the kind of thing that we're being told. That to go against prohibition will just incur the wrath of the US and we can't afford to do that because the free trade of our agreement is not the least of our issues. We have been told directly that the UN is very loathe to consider funding countries who have harm reduction as their policy or approach and that we should limit ourselves in that respect as well.

Bill C7 seems to be the brainchild of a certain bunch of bureaucrats who have pushed this through the various governments and have told the various politicians that it's just a housekeeping act to bring us in line with international treaties. Once politicians actually started reading the bill and listening to deputants such as myself and others they realised that it was far more than this and that this doesn't have to be the only way. There are many bureaucrats who believe that this is the only way to go. There are bureaucrats in external affairs who are under tremendous pressure from the US and there's also a lack of political will because of the fear of being so close to the US and having a society that will attract so many people from the US. There is a also a distortion in the media of what's actually happening in the UK, Australia and Amsterdam. When we went before

the Commons with respect to Bill C7 and I presented in respect to the programs in Merseyside and so forth, one of the responses that came out at that time was from our RCMP, our Royal Canadian Mounted Police, it was also a response by a BC coroner, on the enormous number of overdosed deaths and the high levels of HIV.

The Mounties put out a press release that said that, as a result of prescribing methadone and heroin in the UK and elsewhere in Europe, there had been a massive heroin epidemic. This is the kind of misinformation that is put out and accepted by our people. As a result, what a number of us have done in The Canadian Drug Foundation for Drug Policy is constantly try and educate parliamentarians and I would suggest to you that the more parliamentarians that can come to our country and talk to our parliamentarians to counteract this misinformation the better and also that this be raised at the Commonwealth Parliamentary Association meetings.

Mr Michael Moore, ACT, MLA - Having just spoken at the last Commonwealth Parliamentary Association meeting in Sri Lanka on this very issue, much to the shock of many Commonwealth members of parliament, you'd be pleased to know that it is being raised in that sort of forum and we do see it as important. I was concerned yesterday. I heard your presentation where you presented some epidemiological evidence and then we had someone appear before our inquiry who gave us some information about levels of HIV. I believe you heard what was said and would like you to clarify for the record, what the situation is in terms of HIV transmission, needle exchanges and the effectiveness of Canadian policies in that area.

Prof Riley - Despite the fact that we do have a number of syringe exchanges and they were set up in the mid to late 1980's, it's a case of a little harm reduction is a dangerous thing because people think that syringe exchange is enough and of course it's only the beginning. As a result, despite what people think we have a very high prevalence level and incidence level with respect to HIV and IV drug users. It's not going down in homosexual and bisexual relations. While only around 7% of AIDS cases are IDU related, in many as between 10 and 20% of injecting drug users are HIV infected and we know from World Health that once the level of infection gets above 10% in injecting drug users, the situation can become explosive. Already in the city of Montreal, the prevalence level is 20%. In a number of our cities the incidence is 10% and above which is as high, if not higher than many American cities. Hepatitis levels are equally of concern.

(Prof Riley presented some Graphs and Papers to the Inquiry)

The Hon Jean McLean, Vic, MLC - I'd just like to know if you think that there is a deliberate policy of using illicit drugs, albeit not one to one, but using it as a control mechanism by government. In other words, do you believe that your government isn't necessarily interested in getting rid of the problems of drug addicts except by shoving them in prison and controlling them. Prof Riley - One of the things that we have in Canada, as well as in the US, is a history of puritanism. Many of the people who settled there were zealots who'd left their own country because they couldn't be tolerated and so there is an extreme form of puritanism. Witch hunts and McCarthyism have been replaced by chemical McCarthyism and as an outsider, as a Brit and part Australian, it intrigues me but it frightens me because there is a polarisation of issues. I think they need a scapegoat. Because under law, they can no longer officially, and I'm referring both to Canada and the US, persecute blacks, they have found ways to persecute blacks and other minorities through laws where a disproportionate number of offenders are black when the majority of drug users are white. Yet the majority of people who are incarcerated are black or native. I think that's deliberate.

The other thing is that they need a scapegoat. Drugs is a great one, it's evil and it's tangible. Can't we find life in outer space or somewhere to persecute or declare war on because I think this is part of the mentality. I don't think this is totally paranoid because I've worked with various levels of Government including a friend who was Associate Commissioner of the Royal Canadian Mounted Police who resigned because of parliamentary interference with the proceedings of the police under the Mulrooney Government. I have every reason to believe that drug trading and drugs for arms trading goes on at the highest levels of the Canadian and American Governments and I think that's a concern for all of us. One thing we should read is the book, On the Take, about the Mulrooney years which was written about Canada's old conservative government and also the book Above the Law which is about this colleague of mine, Rod Stamler and why he resigned from the Royal Canadian Mounted Police.

The Hon Ann Symonds, Chair - Diane Riley, thank you very much. I'm disappointed we haven't had time to talk to you about drug testing in prisons, its efficacy and its management but we've got your papers on that.

The witness withdrew.

Witnesses

Mr Sujanta Rana, President, Lifesaving and Lifegiving Society (LALS), Nepal.

Mr Luke Samson, Head of Sharan, a voluntary organisation assisting those in deprived socio-economic areas in New Delhi and networking on policy related to drug treatments in India.

The Hon Mike Elliott, SA, MLC - Could you please give me some understanding as the role that drugs have traditionally played in your societies and what the implications are of the impositions of UN type sanctions and requirements and whether or not they're having different impacts on your countries to ours?

Mr Samson - That is a very significant question because we didn't really have a drug policy until the mid 70's when something started to emerge. We had legal cannabis and legal opium in many of the states. There were hardly any arrests related to cannabis or opium use and the use of these substances was, by and large, traditional and ritualistic, linked to religious ceremonies and things and, for both of them, medicinal. I have a colleague here from the north east of India where they use marijuana leaves to mix with pig's food and it's traditional to use this when the pig is sick to cure the pig. With the development of the war on drugs sort of concept, what we suddenly saw was the destruction of many cannabis plants and a few of the poppies etc. India is one country which produces opium for medicinal use, licit opium. Of course there are a lot of questions about where that opium is going now. By and large traditional users became heroin users because when there was an act to make opium and cannabis illegal, all of a sudden we found a lot of illegal heroin on the market and those people who used traditionally started to use illegal brown sugar. Now we are having a very serious problem in terms of pricing. Suddenly the price of heroin went up; we had all these people addicted to heroin now who were forced to seek substitutes and then began to inject illegal substances. So now we have a very difficult situation where we have a lot of injecting drug users in India where we had virtually no drug problem. We had just traditional and ritual use of drugs. And that's still fairly recent. All the UNDCP pressure on the government and US policy on our government have led to a most unenlightened and unresearched approach to the management of drug supply.

The Hon Mike Elliott, SA, MLC - So you didn't have a problem until you tried to fix it up?

Mr Samson - Somebody else tried to fix it up for us.

Mr Rana - I think the situation in Nepal is very similar to what happened in India. Definitely UNDCP and the war on drugs had a great impact. There was a 1976 Narcotics Act and that was the first time these things were outlawed in possession. Paraphernalia laws were put in place but it wasn't until 1981 that cannabis cultivation was banned which was definitely at the behest of the US DEA, so that they could fund other programs, drug eduction programs and what have you. Aid is definitely linked to these polices. Again drug use is sanctioned by our religion. In fact yesterday was one of the days when you have to go out and have the seeds of the cannabis plant. Everyone has to go out and get stoned, basically. You do that a couple of times a year. Nepal is still on certain days of the year. If you are a holy man, a Sadhu, you can still get cannabis legally and you get these big hash packets with the King's seal still on it. But I know the US government is still trying to stop that but up till now the government is holding out. For a lot of people, older people as well as young people, it's become a real problem. It's become an illegal habit now instead of something we just used to do.

The Hon Mike Elliott, SA, MLC - Is it too late for reversal? I mean it seems to me that you

people would have a clearer perspective than anybody else.

Mr Rana - In some ways, yes it is too late but I think the opportunity is open to have harm reduction policies as part of a national AIDS policy and Nepal has just passed that. Our parliament just passed, a month ago, that harm reduction is part of the National AIDS Policy.

The Hon Ann Symonds, Chair - So that was passed as a resolution of Parliament not a change in the law?

Mr Rana - No, it won't effect the law but as a resolution it is something that is legal, allowable and feasible.

The Hon John White, Tas, MHA - My question is for Mr Samson because I'm told that you're a problem here for Tasmania. I'll put that in a context. Tasmania grows poppies that are worth between 50 and 80 million dollars to the Tasmania economy. Most of the poppy crop goes to America by way of 5% of medically imported opiates for morphine. We're told that if we legalise marijuana here or decriminalise or do anything to change the status quo which will also breach Australia's conventions, the Americans will stop buying our poppy crop and go and purchase it from India. I have no doubt your government has been told the same. If you don't do the right thing according to the American view of the world, you'll be punished one way or another the same as we will be. Have you got any comment on that, Mr Samson?

Mr Samson - At the time when this international policy on drug control was being developed, India actually had a stand off attitude towards US aid. We were more aligned to Soviet policy and just after that, there was a dearth of foreign aid. So the US Government came, and as a special case said, if you manage your drug problem in this particular way there is so much aid available. All you have to do is say no to drugs. I think it was a carrot very difficult to refuse except that we always have to contextualise things. Both India and Pakistan and now Afghanistan have developed ingenious ways of escaping the controls of heroin production and scapegoating marijuana. In Manipur, where we have huge quantities of heroin which are being shipped through, there would be busts of truckloads of marijuana which is so more abundant and they would say, we've captured 20 kilos or 20 tonnes of marijuana and 250 grams of heroin. All the heroin is going through for production anywhere in the world. All we've done is succeeded in breeding new production centres. The more illegal it is the higher the prices and the more value it has as a cash crop. I'm sure that Tasmania will find creative ways of getting past this problem.

The Hon Ann Symonds, Chair - Thank you very much for that creative answer.

Mr Michael Moore, ACT MLA - Perhaps as parliamentary colleagues we should get together with our Indian colleagues there and Tasmania should deal directly and come up with negotiations to undermine the US. I won't say imperialism but the word has trouble coming off my lips. What you've described for us is really a process of harm maximisation in both of your countries. Is there anything that we and our colleagues can do as members of parliament who have the harm minimisation attitude, members who are sitting here and nearly a hundred of us around Australia? Is there anything that we can do to assist in trying to change attitudes in your country and make changes?

Mr Rana - I think at a government level, part of the problem is that Nepal is not a Commonwealth country which is good and bad, if you look at it that way. A lot of the things that happen in the region tends not to affect Nepal at that level because we're supposedly the only Hindu kingdom in the world, with a king who is supposed to be God and so on. At another level we've been really dominated by US aid policy. We were part of the restructural readjustments applied to us during the 1980's and we're still suffering from that. Its impact is felt in many ways, not just by drug users. I know recently, the Australian government organisations as well as NGOs have become more active in numerous programs in Nepal and I think that has been really good. Just to let people and the government know that there are other things beside the US Government and not just in terms of funding but there are other issues and other types of polices out there. That has been very important and I hope that will continue.

Mr Samson - We have to acknowledge that both of us are actually being helped in some way by the Australian Government. We have actually a very good rapport with Aussies. The McFarlanes Burnetts have been involved in the development of needle exchange programs. The first one in Nepal and the first one in India as well, the first legal one shall we say. We find that there is a very enlightened approach with the Australian Government. In fact our Health Minister from Manipur was supposed to come here and I have right now with me a report of his speech at the opening of our harm minimisation workshop in Gahati in the north east of India. I think opinion has been moved to at least publicly endorse harm reduction strategies. It hasn't been worked through well enough now but we know that two or three years back it was impossible to even conceive that we could have a needle exchange functional in Manipur today. So, there is a lot of help and I would wish that we would have those efforts continued and supported and increased although that we hear that there's been a change of Government.

The Hon Ann Symonds, Chair - We won't talk about that. Mr Samson, could you possibly spare us a copy of that speech? I know that we'd be very interested in the kinds of arguments that were put in that parliamentary debate. Thanks very much.

Mr Michael Moore, ACT, MLA - You should know that we had intended that your Minister would also join us as part of this inquiry and we were disappointed when we found out that he wasn't able to make it. If you can pass that back on, we would appreciate it.

Mr Bryce Gaudry, NSW, MLA - Knowledge is obviously a two way street and you've both said that drug use for religious and social purposes was a long historical thing within your countries. There must be some advice that you can give us in terms of dealing with this issue in a much more holistic fashion?

Mr Rana - Harm reduction answers a lot of those questions and contrary to what people in other developing countries would like to say, harm reduction is a policy for all health issues, not just for drug use. It's sad that the governments in our countries have gone to the other extreme. Whereas we had a history where there was socially sanctioned drug use, the governments have been too influenced by outside forces like the US and the UN organisations, and are in denial really, to a large extent. That's an uphill struggle for groups like us. They're denying that drug use was ever socially sanctioned. If there's a problem they see it as something the hippies brought into Nepal in the 60's, part of Western influence, western corruption. They've gone the other way and harm reduction is trying to help to bring a more holistic view to the problem and to what has gone before and what should happen in the future. The answer is in harm reduction for all countries.

The Hon Ann Symonds, Chair - Could you outline for us the role of the police? The way the policed deal with drug users in your countries please?

Mr Samson - There is a significant difference between India and Nepal. We have been influenced by the South Asian and the South East Asian policies. The law has been formulated on a very stringent, punitive kind of approach. We're not going as far as Malaysia, Singapore or Thailand but we believe in rigorous incarceration. In some ways the police are forced to take this sort of action. But in practice, it doesn't really work like that because the police don't believe the law. They are underpaid and therefore bribed into thinking that drug use is not so bad after all because it gives them additional income. The police are not really that interested in incarceration. We have a fascinating story. We were doing a detoxification camp and we had the local police involved and they were very supportive. One of the people in the camp had his cycle rickshaw stolen and he ran off to the police station. They brought the thief there and the police handcuffed him to a bed in our Detox camp and asked us to look after him for the night because he was so upset. "Can you give him some medication and we'll get them both in the morning and sort the problem out". They're not really interested in arresting what is obviously poor victims and undesirable elements.

Mr Rana - The laws in India are punishment based but the police are not so interested in arresting drug users. In fact one of our greatest supporters has been our Chief of Narcotics. He was one of the first people to endorse our program. He endorsed our program over the objections of the Health Ministry at that time because AIDS is under the Health Ministry and drugs is under the Home Ministry. So we got more help from the drug side, the drug enforcement people, than we did from the health people.

Mr Samson - There's one particular situation in Manipur. Because the act is so stringent, it is not bailable. In Manipur where you have between 50 and 70% of the injecting population which are HIV positive and a large number of them are in prison, it's non-bailable, some parents have put cases onto them to put them in prison. When they're really sick they can't access treatment which is a human rights problem. In Manipur and places like that, we have had a very poor response from the law and that situation really needs to change.

The Hon Ann Symonds, Chair - We're very grateful to you and all the other witnesses that you've been able to give us such an insight into so many areas. Thank you very much.

The witnesses withdrew. End of Session Two

Wednesday, 6 March 1996

Wellington Room

Chair: The Honourable Mike Elliott, SA, MLC

Panel:

Mr Neil Bell, Northern Territory, MLA

Mr Bryce Gaudry, NSW, MLA

The Honourable Richard Jones, NSW, MLC

Mr Michael Moore, ACT MLA

The Hon Kevin Rozzoli, NSW, MLA

The Honourable John White, Tasmania, MHA

The Hon Mike Elliott, Chair - This panel is made up of members of the Australian Parliamentary Group for Drug Law Reform which represents a cross section of parliamentarians from around Australia from all parties and independents, a group that has been working for drug law reform for a number of years now. This inquiry is giving us a chance to get some of the key speakers at this conference to answer direct questions that would not be possible otherwise and to facilitate our further thinking on the subject.

Witness

Dr Ernst Buning, Psychologist, Bureau International Affairs, Amsterdam Municipal Health Services, The Netherlands.

Mr Michael Moore, ACT, MLA - My question is two fold and I'd ask you try and put some of your answer in the context of how the Netherlands operates consistently with international treaties as you are a signatory of the 1988 Convention of Narcotic Substances. You always emphasise harm reduction but many people are also interested, particularly in cannabis, whether you get any heavy increase in use, both for a once only use and for constant use. Is there any research along those lines

Dr Buning - Holland has signed all the international treaties and the Dutch government believes that our policy is within the possibilities of the international treaties, but this is questioned by other countries and by international bodies. The coffee shop, where we condone the use and the selling of small quantities of soft drugs, and the police may even condone the movement of larger quantities of soft drugs that are available, that's not the idea of the international treaties. For the Dutch population, we think we do them a service. Sometimes we have a majority movement saying we should legalise and then another majority says we shouldn't, depending on how it is carried out.

But overall there is some sort of consensus that the use of soft drugs is not really that dangerous for health and the police and the criminal justice system have more important things to take care of. This is a very pragmatic approach where the police and the public prosecutor can actually discuss priorities with each other and have the whole list of crimes to solve, finding murderers, bank robberies or whatever and then somewhere comes the individual user of soft drugs. This person will be very low on their priority list. The practice is done in many countries all over the world, but it is done in a more hidden way and we do it an open way. That might be the difference between the Netherlands and other countries. It's an outspoken thing and of course. The phenomenon of the coffee shops makes it very visible. Recently the President of the International Narcotics Control Board was interviewed on Dutch TV, and this Dutch interviewer said, "It's working what we do, so why can't we keep on doing it?" Schroeder , the President, said, "I'm not really interested if it's working or not working. What I'm interested in is what you are doing within the lines of the international treaty. That's what we have to check. We're not really interested if it works or not." He takes a very bureaucratic stand. He said, so far, there are no other countries who question these treaties. Their role is just to check if countries are doing what they're supposed to be doing.

Politicians all over the world ought to start to question whether or not these treaties are actually doing what they're supposed to be doing, that is, to help us to minimise the harm for society and for individuals that the drug problem causes. To get to the second part of your question, yes, we do a lot of research. One of the advantages of the situation in the Netherlands is that it is a small country. 15 million people, highly, densely populated with an infrastructure that gives us the opportunity to keep a good eye on everything that is happening. The University of Amsterdam has carried out a number of household surveys every four years. They've just done the third one. They interviewed 4,000, then 4,000 and then 2,000 people. Face to face interviews and a random sample of the population between 14 and 65 years of age. They asked questions, among others, about alcohol, tobacco use, and all other illegal drugs. The lifetime prevalence of the use, that is, "have you ever used cannabis", has gone up, which is a very logical thing in 12 years. Those who are now aged 55 may have used cannabis 12 years ago. If you look at the use among younger people who use on a regular basis, we find 6% of those aged between 14 and 21 years old. That figure has stayed stable.

The Hon Mike Elliott, Chair - How do you define regular?

Dr Buning - I don't have the research papers here and of course, there are a lot of methodological questions you can ask. What is regular and how powerful is the type of cannabis? Are you using skunk which is very powerful Dutch grown stuff or are you using less potent Lebanon? You should make these differences. But because drugs are illegal you can't really do it like you do with alcohol. For instance, one can't ask how many standard glasses of alcohol would you drink so that you can actually calculate the exact millilitres of alcohol somebody is consuming. You can't do that in this case. What we see is that we are not down playing the effects of soft drugs. I work for a public health institute and we are in way promoting the use of soft drugs. We know there are young people who use soft drugs in a harmful way. They may be drop outs from school, maybe because of the use of soft drugs, although that's always difficult to define, but nevertheless they may use soft drugs for the whole day, it may be a very prominent thing in their lives. Although this group is very, very small. If you take into consideration how many people are taking these soft drugs, the number of people who get into problems is small.

If I could just add that this should be seen in the light of the Dutch culture. The Dutch culture places a lot of emphasis on individual responsibility so, from a very young age, we are told that we are responsible for our own life. We have to make something good out of it and if we create a population where most of the people feel that they have to have internal control, they do not depend on the state to tell them what is and is not allowed, but they actually internalise these norms of society. The availability of alcohol and drugs is different in our culture than in a state where people are used to looking up to the state and waiting for them to tell them what is good and what is not. In a state where the controls are external, and you then have coffee shops, then people would say, it is allowed, so I'm going to do it.

Mr Bryce Gaudry, NSW, MLA - Six per cent seems dramatically low for that age group. In a previous session, when talking about young offenders and their use of tobacco in a survey, it was something like 95%. What's the situation in the same age group with tobacco? Do you see this very low take up as a result of cultural approaches in Holland compared to Australia?

Dr Buning - Smoking is certainly not 95% in that group but it is high, somewhere between 40 and 50% and has gone up among the girls in that age group. Whether or not the figures can be contributed to your policy, I doubt it. If you ask a policy maker, he will answer yes. I think there are always, natural movements in any society. Like heroin is totally out of fashion in Holland. This is a normal thing, something comes in and goes away. I think our policy did not interrupt this natural wave effect. A lot of other polices have the unintended effect of making the use of heroin very attractive for young people. Not in our situation.

The Hon Richard Jones, NSW, MLC - Following on from that, do you know how and why heroin became unfashionable? Is there any correlation at all between cannabis and heroin use or is there a reverse correlation?

Dr Buning - There are a number of explanations. The visibility of the heroin problem in the

streets of our major cities has had a preventive effect. Although it may sound a bit cynical to say it but. If you see a 35 year old, dirty, down and out and on the street and you are 14 years of age, this is not what you want to be. In my day, it was the big pop stars who were using heroin which identified with, so that's probably one explanation. The other is the availability of methadone. A lot of heroin users, after the first two years of heroin use,( the honeymoon period), they get into a period where it's more difficult to get the money to buy the drug so they take different options then. One option is to recruit a group of younger people around them who they sell the heroin to and make a bit of money and with that money, they can support their habit. In our situation, after the honeymoon period, when it's getting more difficult to get heroin, people will go to one of our methadone programs, will still use heroin on and off but that's how they will deal with it and not actively recruit young people.

The third explanation is that with the availability of the coffee shops, young people can experiment with the use of drugs in an environment where hard drugs are not available. Normally, in other countries, a dealer may sell all sorts of drugs. Now, if you're a dealer, you have an economic interest to get this person from soft to hard drugs. You may make more money from selling hard drugs. In our situation, people who run the coffee shops have an economic interest in their patrons not becoming a heroin addict. Very simple economic law.

Mr Neil Bell, NT, MLA - Is there any political opposition to the cannabis policy you've outlined? Dr Buning - Of course. We are a country with a long moralistic, Protestant culture and we are also very liberal. We are very schizophrenic in that sense. We have both of these things. There are quite a lot of people who oppose. For example, along the smaller towns along the boarder with Belgium, people have started coffee shops in very conservative communities to serve Belgian clients. This has led to a lot of opposition and understandable opposition. Here is the Dutch salesman, thinking here is a good product that he can sell but that was not the idea of the coffee shops. So there is opposition

Mr Neil Bell, NT, MLA - Is there bi-partisan support from the major political parties in Holland?

Dr Buning - To my surprise, when we started the harm reduction policy, the left wing supported the whole idea because they thought it was good for the rights of individual people. And the right wing supported it because they thought it is good to cut criminality. They have their own reasons why they supported it but they all supported the same thing. Now we have a big debate raging about our drug policy where it is very clear that we are now stuck with a very old residual group of heroin addicts that cause a lot of problems in neighbourhoods. And the neighbourhoods don't want it any more. So, we are now looking for measures on how to handle that. It has two extremes. One is, provide heroin like in Switzerland and provide places where people can use safely and in a way that doesn't cause a nuisance to other people on the one hand, and on the other, the more conservative measure of taking them out of the system, putting them in a closed off environment and giving them treatment, if people keep on with their criminality. These two options will both be implemented very soon, probably.

The Hon Mike Elliott, Chair - Dr Buning, the Dutch are doing this by way of policy and not by way of law, as I understand it. If you had the opportunity, would you structure things differently either by way of policy or by way of law? Could it be done better than it's being done?

Dr Buning - I would legalise soft drugs, I wouldn't even hesitate about that. I have mixed feelings about the legalisation of hard drugs. On the one hand, I see all the damage that's being done by the drugs being illegal and how organised crime is creeping in like a cancer into our society. That's dangerous and it's endangering democracy as well. So, as a citizen, there is a real danger there that I don't like as a person living in a democratic country. On the other hand, working in a public health institute I have this vague ideal that it would be wonderful to have a society where people don't need drugs as I see a lot of damage being done by these drugs. A lot of people look at things on balance and sometimes the balance goes more one way and then, at other times, the other way.

The Hon John White, Tas, MHA - You've touched a number of times, on the economic aspects of the drug trade and the profitability of the drug trade. If we in fact legalise substances, are the drug traffickers going to give up their slice of the action or are they going to transfer their trade into other drugs? It's a bit like the dog chasing it's tail. As soon as we legalise and take it out of profitability, they move on to something else. Is there any research being done on that in Holland, on the use of economic tools to try and tackle the problem of profitability in the drug trade?

Dr Buning - The first question, I have no idea except to say yes, there is a possibility, depending on how organised the crime actually is. The second part of the question, regarding research on economics, there has been some research on the economics on the user level, but I'm not aware of research in my country of larger economic things.

The witness withdrew.

Witness

Mr Raymond Kendall, Secretary-General, Interpol.

Mr Kendall's statement - One of the reasons I was invited and why I came is because this is a harm reduction conference in which it has been rare up until now to see law enforcement representatives. I have been known to speak in favour of putting more resources into demand reduction, to balance those resources. The impact of what law enforcement has been doing up until now is not having any real impact on the abuse situation in our countries. I suppose the reason I'm adopting this attitude is because when I think in the early 70's, at the time when the film was made about the French Connection, on a hundred kilo operation between Marseilles and New York. At that time, there was virtually no serious drug abuse in Europe and within the space of 25 years we've gone from that to saturation point that we have today. I think we've seen that in most of our societies and I regard that as an alarming situation.

My attitude today is that we should be looking in a pragmatic way what this represents in term of the threat to our societies. The involvement of organised crime with drugs which is now inseparable in my view. The threat is even greater since the end of the East West conflict because the existence of the Soviet Union is no longer there. What is the biggest threat to our societies and democracies today? I believe we are dealing with this situation at the moment by putting the cart before the horse. That is decriminalisation, depenalisation, liberalisation, legalisation, whatever you want to call it, when I'm not clear that our real objective has been set out. I think unless you set out a real objective.... Is it going to be a society which is free of drug abuse? Is it going to be something else? Unless you set that objective right from the start, I don't believe it is possible in a pragmatic way to deal with the issues.

The Hon Mike Elliott, Chair - You're not actually winning the war, are you? Despite the fact that some of the biggest drug lords in recent times have been caught or died, the trade continues. And as far as it is interrupted, sometimes a more dangerous drug suddenly emerges in its place. Particularly the move into amphetamines which are even harder to handle because it's disorganised, not organised crime. Do you think that you are winning? Do you think that you can win just from a simple policing view point?

Mr Kendall - I certainly don't think we're winning and I'm not sure that we can win. And I'm certainly not sure that we can win if we apply the present policies that are being applied. One of the difficulties we have of course, is that not enough studies have been carried out into the nature of the economics of the problem other than those that have been done in the US and those that have been done by the RAND Corporation. If we have to look at it this way, the question that has to be asked is what percentage of drugs do you think are being seized from this illicit market? The estimates vary from as low as 10% to as high as 25 to 30%. Even if you accept the best estimate, that still leaves 70% out there circulating so we are dealing with a serious problem of availability.

While that availability is there and we can't contain it any better than we are doing, we certainly can't expect to win the battle simply by applying the measures we are applying in relation to law enforcement. Which means in my view that it has to be accompanied by something else. We're also told, estimates vary, something like 450 billion dollars a year is the product of this illicit trade. Where I see a dimensional difference between the situation in the early 70's and the situation today is that because of that dimensional problem, and the amount of money that is circulating and has to be laundered, the simple measures that we used in the 70's, when we could carry money around in a suitcase somewhere, we now have to see our international commercial systems and banking systems diverted to a certain extent and corrupted from that point of view. But above all, we should remember from the dimensional point of view, that because organised crime and drug trafficking cannot be separated, these people now have a capability to corrupt our institutions, be they banking, political or public service. They have this capability and have been seen to use it in a certain number of countries already that we would not have thought would have been corrupt. Traditionally we think of corruption being a third world problem, in fact, we're seeing it closer to home. So we're not winning the battle, and in real terms, we would have difficulty winning it in the near future.

The Hon John White, Tas, MHA - Who gives you your instructions?

Mr Kendall - My organisation is an inter-governmental organisation which is set up pretty well like the UN. There is an annual meeting of the General Assembly where policy issues are dealt with and they are the people who basically dictate the policy that will be applied in relation to any particular matter concerning criminality and international cooperation. Between these sessions of the General Assembly there is an appointed executive committee which oversees any action on a day to day basis.

The Hon John White, Tas, MHA - So, in other words, you're speaking with their authority?

Mr Kendall - I'm speaking with the authority given to me as the Secretary General, and the confidence has been placed in me by two successive re-elections in my post and also from my own experience as well.

The Hon John White, Tas, MHA - You say, that what you're actually endeavouring to do is to get a balance between harm reduction and law enforcement?

Mr Kendall - No, that's not what I'm trying to do, that's what I'm advocating. There's a difference

The Hon John White, Tas, MHA - Isn't it a fact though that law enforcement agencies now throughout the world are recognising that not only have they failed but secondly, their very organisations have been corrupted at least in certain areas, by the drug trafficking in particular. Could it be said, cynically, that the role you're playing now in relation to advocating harm reduction, is only to assist the survival of the law enforcement agencies and in that I include the judiciary, lawyers, customs, police and almost any other area of society, and politics. So isn't this the survival of the law enforcement agencies that you're advocating?

Mr Kendall - Not at all. I think it's a natural result of evolution in the way things have happened over the last few years. As I said, because of the dimensional change and because of the recognition of the fact that law enforcement alone with the resources that it has at the moment, can't hope alone to achieve the sort of result that people would have hoped for in the past. I would accept, I have a cynical view myself about certain things, what I'm trying to say is, and I have a bit more freedom than people do in national law enforcement situations, most chiefs of police feel that they have to reflect government policy in what they say. What I have seen over the last two or three years, particularly in the UK is that more and more police officers are feeling free to state the situation as they see it.

Very often national policies don't lead to the sort of solutions that the police officers are seeing. Police officers are also less willing now to accept what they see as a responsibility for what is basically a social and behavioural issue which cannot necessarily be governed. You can't control human behaviour by making laws. More and more police officers are speaking out on this subjection than there were a few years ago. It's not the existence of those agencies which is an issue. It's a role that they have to play which is an issue and I think the role that we would like to see ourselves performing is the role for which we were created. That is to deal with, at its very basic level, the problem of the international trafficking and to deal with the distribution networks right down to street level, but not to be involved in dealing with the abuse problem as well.

Mr Michael Moore, ACT, MLA - It's about a cost benefit analysis, isn't it? On the one hand we have people like Georgio Giocomelli, the Executive Director of the International Narcotics Control Board saying in Canberra in 1992 that the illicit drug trade that year surpassed the petroleum industry and became the second most lucrative industry in the world, and on the other, we have the failure of the police, including the role of Interpol, to handle that and we also have a situation now where we see corruption in our police. The NSW police force, and my own police force was mentioned in the same Royal Commission, Queensland Police Force. I can see the costs, I haven't seen any of the benefits. Do you see any?

Mr Kendall - I would disagree with the previous person who gave evidence here. I think that a great deal of thought has gone into the preparation and adoption of the international conventions. I don't think that enough of the measures that are advocated, particularly in relation to demand reduction are being applied. When you're looking at what is cost effective, you have to look at which measures can be seen to be cost effective, in a percentage way or not. Once again, we have to turn to the US for the sorts of studies that would see any reflection of that. The last RAND study on cocaine and cocaine strategy in the US showed very clearly that at the present time, of the entire 100% cocaine strategy plans, as much as 93% is being spent in the eradication in the production areas, on getting rid of the illicit traffic and on national law enforcement measures. Only 7% is being directed into demand reduction. This is against the polices which are expressed in the International Conventions where they are suggesting that national strategy should be multi-disciplinary and shared across the board.

All I'm saying is, OK, we're doing what we can as far as law enforcement is concerned, but it doesn't seem to me that if in a market economy where there are producer countries, there's international trade and where we have a consumer country, that we're trying to put the responsibility on the parts of it that concerned us before it comes into our country and not acting on the responsibility of doing something about the consumer market. That's where I think, that if the balance were evened up, we might have a better chance of a common approach than simply insisting, what has generally been a political approach up until now has been to say this has been a law enforcement problem. Let's crack down. I think the reason it's been adopted that way is that if you put resources into law enforcement and you increase the Sydney Drug Squad by 50 officers, you'll arrest more traffickers, you'll have seized more drugs but you'll have done nothing about the basic problem of abuse. That's the message that I'd like to be giving. I don't believe that legalisation is an answer. I think that alternatives to law enforcement should be looked at for the abuser. I believe that if your aim is to have a solid society which is free from drug abuse then you have to apply certain coercive measures to make sure that people do correspond to what society wants to happen. I repeat, I don't believe that behaviour is something to control by law.

The Hon Mike Elliott, Chair - There seem to be some very mixed messages there

Mr Kendall - If we had the answer, we wouldn't be sitting here today.

The Hon Richard Jones, NSW, MLC - Is your understanding of the failure of the drug war and your view widespread amongst senior police enforcement officers around the world and what are they doing about it? Also is there any pressure to change the International Conventions from you and your colleagues?

Mr Kendall - There's certainly no pressure from either myself or my colleagues to change the International Conventions. Indeed, the 1988 Convention is one which we welcomed very much because it dealt with special measures to deal with money laundering. What I do feel about the International Conventions is that too many countries don't apply the provisions of these conventions immediately. They wait until they've modified their national laws. We think to approach an international problem with an international application of international instruments. I think if we're still living in the last century where we have to adapt our national laws to deal with the convention, instead of applying the convention to our national laws, we could make our way ahead much quicker. By that I mean, that many countries still don't have the sort of laws which are recommended by the 1988 convention to deal with money laundering. We would not be pushing for the conventions to be changed.

You used the term which I think, is important to use correctly. When we speak about the war on drugs or the war on organised crime, do we really mean the term war? Because if you were using the term war, in the way that you use it if you were under attack by a foreign power, the kind of resources that you would put into defending yourselves would be a million times greater than the sort of resources you're putting in to deal with the sort of war on drugs today. If you match the 450 billion dollars which is supposed to be derived from drug trafficking at the moment, with the effort you put into fighting the war as you put it, maybe we would see a difference. Do our resources correspond to the enemy that we're dealing with? That's a question that has to be asked.

The Hon Mike Elliott, Chair - Thank you very much. We could question you for hours.

The witness withdrew.

Witness

Ms Bernadette Shields, Director, Aboriginal Living with Alcohol Program, Northern Territory Health Services.

Ms Shields' statement - This program has been developed to meet the needs of aboriginal

communities out in the remote areas. It's a little bit different in that it's called "living with" rather than "living without". The message that has been in the past has been based on abstinence as a way for aboriginal people to go. This program is designed to share information with people in communities so that they can make an informed choice about whatever direction and control they wish to take for themselves, when it comes to the lives and with alcohol.

Mr Bryce Gaudry, NSW, MLA - I believe there are many dry aboriginal communities in the Northern Territories where they have prohibited alcohol. Do you see that as a negative in those communities?

Ms Shields - What I'm seeing now and I suppose I could refer back to my days as a health worker, working on a mobile clinic, is people coming in from remote communities and to come in to have drink. They said they came in from dry communities. What is happening now is that people want to enjoy the same rights that the rest of us have that live in town, which is, the right to have a drink. What it has caused is that they're coming into town, they're coming into other urban centres. Other people aren't happy about this now, they're sleeping on the streets. How can we look after them? People tried that and this is the consequence. We are getting more and more people from remote communities coming in to town because they want to enjoy the same advantages that we have which is to enjoy a drink. But coming from that is behaviour that is not acceptable.

The Hon Kevin Rozzoli, NSW, MLA - Ms Shields, as I understand it, some of the research that has been done into aboriginal drinking profiles indicate that populations actually move through a phase of heavy drinking and then come out of the phase into much more moderate drinking patterns so, quite clearly that's a plus for more harm modification approach, that once you've committed to heavy drinking, you're not necessarily stuck with it for the rest of your life. Do you see that amongst the aboriginal community there is a fertile ground for using positive programs of modification of the amount that's drunk to try and break down the effects of excessive drinking at an earlier age than it might otherwise happen?

Ms Shields - Yes, because what's happened in the past is what we call binge drinking so people would come into town and binge, out of control, and then go back to not having any. What's happening now in communities is, that they're having information that they didn't have before. That if you binge drink, it's harmful to your health. So they're starting to put in programs that constrict and control the amount of alcohol that's going into the communities. I've been working with one community who has decided on how much comes in and how. I've glad that you said that aboriginal people have gone through different stages. It's nice to hear that that's starting to be acknowledged that yes, we can be careful with alcohol.

Mr Neil Bell, NT, MLA - The level of abstinence in the non-aboriginal in Australia is about 20%, what's the level of abstinence in those remote communities that you talked about?

Ms Shields - You need to make that a bit clearer, Neil.

Mr Neil Bell, NT, MLA - In the majority society around Australia, 20% of people drink, from social to heavy drinkers. Can you tell us what the figures are for those aboriginal communities in the top end?

Ms Shields - I wouldn't be able to give you those sorts of figures. But let me tell you that it's only a small group of people who do drink within the aboriginal communities in that there's a large number of people who have chosen not to drink. As for giving percentages, that I cannot do.

Mr Michael Moore, ACT, MLA - I was fortunate enough to visit a range of remote aboriginal communities in the last couple of years and certainly include places like Lajamanu and others that you would be familiar with. One of the interesting things when driving there which prompted questions I had to answer for my children who were with me, was the number of beer cans around a marked out area. I had to try and explain to my children how to resolve these problems and, indeed, it's very interesting listening to the concepts you have. Isn't there really a significant underlying problem about employment, which is much more significant and the availability of that employment and the disintegration of the relationship between the people and their land and the ramifications that that has? Has that all been worked in to the same set of harm reduction principles that you're talking about?

Ms Shields - With this program, alcohol is the key but when you go into the communities and you sit and talk with people you peel back the layers and alcohol is the symptom of the world we live in today and what's happened. When you peel back those layers, what you find is disempowerment, control out of our hands, employment, housing, health services, who has say in the direction of the communities, who makes those decisions. Those are the sorts of things that come up and even the sorts of things that our children are being taught in our schools these days. Within the Territory at least, people still in some communities retain their language and their identity but within the urban centres that is not the case.

Mr Bryce Gaudry, NSW, MLA - Yesterday, Imine Woods, in speaking about the aboriginal of North America made a very strong statement about the fact that there was a resistance to harm minimisation within those communities because it was seen to be out of balance with perhaps the 2 or 3 hundred years of oppression and to the social approaches to those communities by the dominant community. Do you find the same thing when bringing that message to the aboriginal community?

Ms Shields - What I've found in the time that I've been working in this program is that people want to have control of their lives and they want to be able to do something and they want to do something about the way people see us when it comes to alcohol. They also want to bring a reduction in alcohol related violence, alcohol related crimes, accidents, murders. One of the things that they see as reducing that, is having programs where people themselves can go through a process. So if a community decides they want to change something that's happening in their community, they control that. Within our program, we also involve the police because we're talking about alcohol related crime, so of course the police are involved. Now the police figure very highly in speaking to our communities so, what's happened is that it's pulling all those people together and there has been a drop in crime. In this particular community that I've worked, there has been a change. It's important that people see themselves reflected in this so the report that is written is one that is based on their stories, written in their words so when they see it they recognise it as something they've achieved which then encourages them to think about doing other things.

The witness withdrew.

Witness

Ms Kate Dolan, National Drug and Alcohol Research Centre, Sydney

Mr Michael Moore, ACT, MLA - I understand that your study in prisons looked particularly at the use of bleach in prisons and needle exchange and issues there. Are you able to extrapolate about other communicable diseases, including Hepatitis, well there's a whole range of the alphabet now, but primarily Hepatitis C which is much more easily transferable? Can you comment on your research there and what the chances are of transmission using the current processes we have in prisons and what we can look forward to in terms of a change as policy in prisons as well?

Ms Dolan - I've been working with Tony Butler and he's done a study of prevalence and incidence of Hepatitis B and C in prison. He tested people on Intrium and then re-tested them in 6 months. He hasn't the results yet so I'm not at liberty to comment on that now but I know he has found some cases of transmission. Whether or not they occurred in prison is very hard to say but some people did sero-convert. They may have been infected just prior to entry but that study will come out very soon. With HIV, the spread has been underestimated and we've done a study on that which will come out in a few months as well. We're building up the evidence to show that transmission occurs. We probably don't have enough policies in place to prevent the transmission. The main route of transmission for those viruses is injecting with about 1 in 4 prisoners injecting and almost always sharing syringes. The other risk behaviour that is often overlooked is tattooing and about 1 in 6 tattoo while they're in prison and share tattooing needles. The risk is that the injectors are sharing with the non-injectors, whereas sexual activity is quite low. About 1 in 10 prisoners engage in sex in prison and yet we are about to get condoms in prison so, we've gone about it the wrong way.

Mr Michael Moore, ACT, MLA - There is an issue of duty of care, I would think . Does your study deal with that?

Ms Dolan - No, I haven't looked at the legal aspects.

The Hon John White, Tas, MHA - Yesterday in the hypothetical, Michael Moore became the Attorney General for Tasmania which was quite interesting. You've just become the Minister for Health and Corrective Services in Tasmania. What are you going to do?

Ms Dolan - Both portfolios? That might be a bit much. I don't know how the Tasmanian prison system works so it's probably best if I focus on the NSW one. Within NSW the health service is independent of the Department of Corrective Services and they aren't doing as much as they could. If they said, let's do condoms, it's a health matter, too bad what the Department thinks, too bad what the prison officers think, they could do it. There will be reactions, industrial action when they start the pilot in a couple of weeks. It would be more controversial to do a syringe exchange, for sure. But the best thing that we're not doing that we could be doing is methadone maintenance to a reasonable extent. In NSW there are 6,000 prisoners and only 10% are on methadone. But probably about 50% would qualify if the places were available, so that's about 3,000 places that probably needed compared to the 600 that are there. That's not particularly controversial. Most people accept methadone maintenance in prison now.

The Hon Mike Elliott, Chair - Unfortunately that's not happening in South Australia.

Mr Bryce Gaudry, NSW, MLA - Could I just follow up there? Are you indicating there that obviously that's the extent of illicit drug use that would now be in the NSW prisons?

Ms Dolan - Those people would qualify as they would have been on heroin prior to entering

prison. Within prison, only about half of the injecting drug users continue to inject. Probably about 1,500 prisoners in NSW inject at any one time. Given the opportunity probably more would and it's whether or not you get the right 1500 on, you might get some on that wouldn't have injected anyway.

The Hon Kevin Rozzoli, NSW, MLA - Many behavioural matters in prisons come out of the very peculiar culture which is a feature of any branch of society, but prisons seem to have developed their own cultures. If you look at prison reform over the years, it has endeavoured to look at the triggers for behaviour which can either be improved or otherwise by various things. In your work, is there any policy initiative that has emerged that may be of cultural significance in a prison to try and turn back the tide, which seems to be rising at the moment of drug use and HIV infection and so forth?

Ms Dolan - No, I don't think so. There's such a strong culture in prisons. I don't know if you heard Gino speak today. Unless you go to a prison and hang around there, you cannot appreciate the environment. There's a lot of self harm, people slashing themselves up, the suicide attempts, deliberate drug overdoses, sexual assault. There are things that you just can't really comprehend that would occur in a small environment outside. In prison there are very violent serious offenders. They're very angry, they're very bored, they don't have what they want, they can't see people, they don't have any money, they don't have any cigarettes. It's a boiling pot really for trouble. Looking at the policy side, if you tried to alleviate some of the pressures, perhaps if some of the people with serious drug problems didn't go to prison but to compulsory treatment programs. You can argue whether or not that's right, to coerce people into treatment but we coerce people into prison, so I would suggest treatment is better than imprisonment. The revolving door is remarkable. So many people go in and out in a very short period of time so it really isn't helping people by putting them in prison. It's not a solution.

The Hon Richard Jones, NSW, MLC - I was amazed to hear that 1500 out of 6000 prisoners inject, presumably fairly regularly. Can you tell me where they get the needles from and how many times they use them and what is the spread of Hep C and HIV amongst those who do inject? Ms Dolan - The needles come from all sources. We just did a feasibility study in prisons for needle exchange and that came up. Sometimes, they're stolen from clinics, sometimes they're inadvertently left out in clinics, purposely or whatever. Inmates have access to needles in clinics, court visits, they'll arrange and have a syringe passed. They'll go to a toilet in the courtroom and pick one up that's been dropped, visitors will bring them in, there's a whole lot of sources of supply in prisons. There's probably about 1 syringe to every 10 to 20 injecting inmates and I think the year following the stabbing of a prison officer, they clamped down and found 400 syringes. We asked the inmates what proportion that was and they said it's hardly anything. Four hundred in one year, they said there are thousands in there throughout the year and they're often taken out of circulation. We've collected some and when you see them, they've obviously been around. They're very worn out and have been used a lot. People don't inject very often. About once a month they inject in prison. As for the spread, I'm not at liberty to divulge those results but I can just say that the spread has been underestimated. If we look at Scotland, we can see there within 6 months at least 40, if not 50 people became infected in an area where there is 2 or 3% infected rate outside which is what we have in Sydney. It can be potentially enormous, the spread within prison.

The witness withdrew.

Witness

Dr John Strang, Director, National Addiction Centre, London

Dr Strang's statement - I started working in the field of drugs in 1978. I've worked as a National Health Scheme doctor in the drugs field over that time. Mainly working with drug users through the prescribing of methadone, heroin, cocaine and amphetamines. More recently involved in the national debate in that I've been the drugs adviser to the Department of Health in England for the last 10 years there. I reserve the right to change my opinion over the statements I make in this record. I know politicians aren't allowed to do that.

Mr Bryce Gaudry, NSW, MLA - In terms of the policy advice that you have given, is it generally taken up or are you firing policy towards politicians and is it cast aside in the political context of the UK?

Dr Strang - Especially as this is a written record, I would remind myself that I've signed the official secrets act with regard to the policy advice that I do and don't give in that capacity. However, I can comment on whether other people's policy advice is taken up which might be similar. The British system's been very interesting because, despite everyone's view on how policy might be formed, it's mainly policy by default. What happens is that there isn't a decision to stop a development rather than a decision to promote it. Needle and syringe exchange schemes are a good example. A small number of projects began to set them up and hence a decision needed to be made whether to stop that development or to embrace it as a pilot venture. As far as I'm aware, there has never been a decision in the UK to set up needle exchanges; it's just that there wasn't a decision to stop them.

Mr Bryce Gaudry, NSW, MLA - As you can't determine the kind of advice that you have given, perhaps if we do a bit of role reversal and put you in the role of the Prime Minister. What particular policy directions might you take to improve the situation of harm minimisation in the UK?

Dr Strang - I hope that in the UK in the last few years there have been instances of policy development that have been more evidenced based and I think the weakness of what's happened in the UK is that it lurches one way or another according to fashion and whether there happens to be good advocate for one view or another view. Whether that's good or bad depends on the quality of the fashion or the advocate, not on the quality of the evidence. I think we've made a few moves in the UK which have been evidence based and the introduction of structured methadone programs in the last few years is an example of that. We had loads of methadone prescribing, but it wasn't very focussed methadone prescribing. It was not very clear what one was trying to achieve and largely, as a result of some of the work that was done over here and in particular, Jeff Woods" book on Methadone Maintenance. It was enormously valuable from my point of view. I have a special stock of them that I would drop on the desk. They make a nice noise when you drop them and this noise gives a sense of weighty evidence. My own view is that the future of drug policy formation becomes evidenced based rather than just as a result of debate in society.

The Hon Kevin Rozzoli, NSW, MLA - When it comes to forming government policy, of course, politicians are always irresponsive to what they see as the community's view of what ought to be done. We continue to run polls on this and that to find out what the trigger issues are that persuade voters to vote our way if we do the right thing in whatever is seen to be a major topic of interest. Has the drug problem ever been the focus of community interest in that sense in the UK? Is it about time that we used our endeavours as a community of people interested in this to raise the profile of community interest and awareness in this and therefore drive the politicians towards it because they see that's where the voting community's interest lies?

Dr Strang - I feel quite uncomfortable in this area because there are some things I'm fairly sure must be a good thing and it must be good to avoid it becoming a party political issue. If it becomes aparty political issue, that seems to me extremely bad news. I guess it's probably wrong to try and keep it out of the hands of politicians at all times. Probably the best thing is for the political and public concern to be arraigned to the level of investment society wishes to make in tackling the problem. I'm much more uncomfortable about the notion of people going to referendum all over the world where people believe the quality of the evidence is good enough. I have considerable doubts about whether the people receiving that evidence have the right type of skills to be able to weigh it appropriately. Hence you come back to this thing about who's the more skilful presenter and hence, I would prefer to see the public and the political debate being to do with the level of investment and having some balance then with a different process which judged the quality of the evidence for approach A versus approach B. I don't quite know how to do that, I can just see weaknesses in the way it tends to be done.

Mr Michael Moore, ACT, MLA - We've heard of beneficent dictators, democracy and oligarchy and that's sounded to me like academic oligarchy. I've certainly heard from the British political scene through the Commonwealth Parliamentary Association Meeting, and Kevin Rozzoli heard Sir Ivan Lawrence as a very strong exponent of prohibition. Certainly my discussions with his colleagues after they'd heard my speech indicated to me that there are strong political opinions already established in terms of these issues in the UK. The underlying discourse that goes on that gives politicians the ability to be able to make a decision one way or another and my understanding is, that in fact, the discourse is fairly much led by police in the UK rather than by the health movement, which we would find very strange. Can you explain how that's likely to come out with a positive harm minimisation outcome?

Dr Strang - I think that harm minimisation has been fairly well embraced by the health movement. If we consider that there's a health movement and a control movement. One of the successes of the last decade has been the Government, and particularly the Department of Health representing them, embracing the notion of harm reduction. Not as a new, revolutionary movement but as a perfectly straight forward, standard public health strategy to a problem. I remain bewildered why people can't define the objective. The objective is to reduce the level of harm accrued by the individual and accrued by society as it is for any other public health and individual health strategy. You've then got a little bit of detail to work out around the edges about what if there different harms and different benefits. Stephen Mugford's contribution four years ago in Melbourne was to do the job of researchers and such is to measure the different changes. Then it's up to society to say well, that ones gets a times four weighting and that one gets a times two weighting. I think that was enormously important that that was embraced. I remain disappointed that the significant contribution from the health arena is less than I think it ought to be. Partly it's because of various rivalries and tensions in the health arena, issues like medical versus non-medical, statutory versus NGO and particularly things around prescribing versus non-prescribing.

I actually think the injectable debate, the one you're looking at now, has held us back massively. One of the huge steps forward we could have made would have been to implement a universal availability of treatments of proven efficacy as main measures. Things like methadone maintenance. Here we are expending all of our energies talking about a type of treatment which is, in my view an interesting debate for an extremely small minority of the total target population. A very worthy debate when you've actually got on, and have in place, widespread availability of the treatment of proven effectiveness. We don't have that. All of the public debate is around the minority and I think you're way ahead of us in terms of delivering benefit to the people you serve by having concentrated on those areas first and then having the debate which I doubt will be resolved when our children's children will be sitting around these tables debating it.

The Hon John White, Tas, MHA - Ms Dolan said that the percentage of HIV in Sydney is something like 2 to 3%; what's the percentage of injecting drug users within the general community of HIV?

Dr Strang - You're way below 1% of general population. But amongst injecting drug users, it depends on which part of the UK you go. It's from 0% to 50%. There are some very surprising things about it that all of the predictions that were being made back in 1986, haven't really happened. We have a very flat epidemic. Yes, it is increasing but very slowly. A note of caution. Anybody giving evidence to you that their practice is why their local patch hasn't got an HIV problem, should be taken with a pinch of salt. Because I can give you instances in the UK where extremely liberal prescribing is associated with low HIV rates and adjacent patches where draconian prohibitionist movements are also associated with 0%. It's probably better to look at Hep B and Hep C markers as your measure and they continue to be very disappointing. One of the things we haven't really come to grips with, and a lot of the debate in this meeting has been about how come Hep B and, more significantly Hep C and Delta and such, and once I find out about it, G and H, J and K, how those have been transmitted so widely, while we've all been patting ourselves on the back for these significant changes that we think have occurred.

The witness withdrew.

Witness

Dr Tony Millar, Director of Research, Lewisham Sports Medicine Clinic, Sydney

Dr Millar's statement - A medical graduate of some 50 years. I was particularly interested in muscular- skeletal aspects of medicine which soon led me into the problems of sports injuries. Some 30 years ago I founded an Institute of Sports Medicine in Sydney and I maintain the Director's position still. Sporting injuries led to sporting performance which led to what can enhance performance and the obvious thing that was better than anything was an anabolic steroid. What I was taught was totally wrong. The drugs do work even though we were taught they didn't. The American College of Sports Medicine put out a statement in 1970 saying that they didn't work. Ten years later they put out one saying that they do work. There's a tremendous amount of literature available for those people in the usage field which is totally wrong but scientifically written and the users believe it. I thought we ought to do something about it so I reversed the process. I read it up, I didn't understand it, so I decided that the only way to go was to prescribe the anabolic steroids so that they got a pure preparation. I knew what the material was, I knew how much they were taking, I was able to impress the need to train heavily and to eat correctly. I've had no reason to regret that.

The Hon Mike Elliott, Chair - Have you also looked at the question of growth hormone which I understand is a growing problem? 5% of college students in football training in America are using growth hormones, I believe.

Dr Millar - In the higher performance sports there is no doubt about it. The cost is prohibitive but the gains at the end are such that the cost is relatively less than it would be to the person in, for example, body building for fun. It's increasing in use as it is here.

The Hon John White, Tas, MHA - I'm fairly interested in this debate, being 5 foot 8" but what happens when a person does have skills such as ball and eye skills and whatever else is necessary to be a cricketer or footballer at a national level, decide to play basketball and decide they need another growth spurt? Does that actually affect their ball skills in any way?

Dr Millar - What age are they?

The Hon John White, Tas, MHA - Say in their teens.

Dr Millar - They're wasting their time trying to get a growth spurt in their late teens. There's nothing that I know that suggests that it increases or decreases their performance but very obviously in basketball, if you can only reach 6'8", the 6'9" ball you've missed out, and if you've gone to 6'9", you're going to be a better basket baller. There's no proof of that but it does seem reasonable.

Mr Bryce Gaudry, NSW, MLA - Dr Miller, I'm a former patient of yours and unfortunately, I didn't get the anabolic steroids. I'm interested in the approach that you've taken. I take it that you see that as a harm minimisation approach, as you went to prescribing those athletes from the perspective of knowing the preparation that they were given and then being able to monitor its use. There are often media reports of very bad reactions to steroid use. It take it that's in an uncontrolled situation?

Dr Millar - My experience is that firstly it's hard to find out how much they took because they're using black market material. If you're going to deal with that sort of stuff, you've got to take your chances. The problems of black market materials, most of them are veterinary preparations, the problem is overdosage and the other problem is lack of education of the individual as to what to do with it. Some of them are absolutely counterfeit and made in the backyard. Those are the biggest single problems of all because it's easy to make once you know how to do it.

Mr Bryce Gaudry, NSW, MLA - So you could make it parallel with some of the illicit drug trade that does go on?

Dr Millar - Correct, but the difference with the anabolic user is, my experience over some 2000 patients now, is that the average length of use between day 1 and the last day is round about 2 years. Now, they don't take them all the time but they'll take them for a few months, knock it off for a few, take it for a few, knock it off and take it. This is a totally different concept with what you're doing with other types of drugs that we've been talking about. They deserve a different approach to the problem and it is something that can be fixed, I think, with medical prescription.

Mr Michael Moore, ACT, MLA - When I first started looking at anabolic steroids and I have to thank you for sending me quite a number of papers which I appreciated, quite a number of pharmacists said to me, look, when you're talking about heroin, amphetamines, cannabis, they're reasonably mild drugs, we know about them. But when you're talking anabolic steroids, then you're talking about something really dangerous. That's the same story I heard about heroin before I started looking into it. What is the truth?

Dr Millar - All mine are still alive, Michael, after 10 years, so I suppose that's a fair statement. The reasons they give you for not taking them, is that they cause cancer of the liver, heart trouble and psychiatric disturbances. These three things are also common with the oral contraceptive. You don't hear anybody saying don't use the oral contraceptive because of this, this and this. So we, the medical profession is dishonest in promoting it that way. Experience shows me that if you can get the person to control the dose, there's not a problem in their health aspects. Certainly a number develop gynaecomastia,, enlargement of the breasts), and this is due to the material being converted to oestrogen. It happens in very few but it does happen. There are a few who get acne on their backs and there are a few who will tell you straight out that they feel aggressive when they're on it. It doesn't happen with every preparation which I don't understand, but it certainly happens. They are the problems that I see in anabolic steroids. I've never seen a person develop hypertension. I've seen it stated that they do, that their blood pressure goes up but when I've looked at them and they've been raised, I've laid them down for 20 minutes, it comes down to normal and the same happens when they come back. I've not been able to document that. Others have said it happens. There are no other problems that I've dealt with.

Mr Michael Moore, ACT, MLA - Over 2000 people?

Dr Millar - Yes, approximately 2000.

The Hon Kevin Rozzoli, NSW, MLA - Following the recent excitement over the Samantha Riley issue which came from taking a headache tablet, is the drug interpretation of drug taking in sport in all its manifestations, actually got out of hand in interpretative terms? That would seem to us to be have been a total over reaction to what is basically the attitude of not allowing drug taking for performance enhancing purposes. Is there a generalisation of drugs in sport that has led to a complete confusion of what the role of drugs in sport are?

Dr Millar - Yes, it's totally hypocritical. In Seoul, there were 28 positives and 8 were acted upon, the other 20 were let go. Linford Christie was positive with pseudo ephedrine and he was let go. He says in his book, let's get rid of drug testing in sport, it doesn't work. He was one of those who got way with it. If Samantha Riley took it for her headache, she made a mistake. But why can't she take something for a headache if he can take insulin for his diabetes, somebody else can take Ventolin for their asthma and yet, who have coronary heart disease or hypertension, can't take a beta blocker because that's what I use for my blood pressure. All these things are unfair, unjust and irregular but I believe that if the law is there, it ought to be enforced. I disagree with it totally, absolutely. There are a lot of cheats at the other end who make those decisions in the Olympic Committee..

Mr Bryce Gaudry, NSW, MLA - Dr Miller, you agree with performance enhancing steroids, performance enhancing recreational drugs, like ecstasy, amphetamines. Would you agree that these also ought to be part of modern life?

Dr Millar - I don't agree with performance enhancing drugs. I think we would be better off if we didn't have them but we've got them and something has got to be done about it. I don't know anything about the others.

The witness withdrew.

Witness

Dr Jonathan Caulkins, Associate Professor of Operations, Research and Public, Public Policy School, Carnegie University, Co-Director RAND's Drug policy research Centre, Mellon University/RAND, Pittsburgh, USA

Mr Michael Moore, ACT, MLA - I was actually going to follow up on the Secretary General's, (Interpol) comments about RAND's research. Would you explain what the research found on cocaine so that we can understand it better?

Dr Caulkins - I actually have the slide for that research so I could give a very elaborate and long answer if that's required. The question addressed was, how would it be optimal to allocate a fixed budget to reduce the existing cocaine use in the US? The current allocation is heavily skewed to domestic enforcement. Basic strategy is to estimate cost effectiveness for the different broad programmatic areas, source country control interdiction, domestic enforcement and treatment. The method employed was a mathematical model. Briefly the results were that we could reduce cocaine consumption by 1% on average, discounted over a 15 year planning horizon by spending $750 million a year more than we now do on source country control. By spending about $370 million than we now do on interdiction, about $246 million more than we now do on domestic enforcement and $34 million on treatment. All of those will purchase the same outcome but of course treatment at a vastly less cost. The factor of 7 times better than the investment of supply/control measures. There are a whole host of other results too. They're simply the most commonly cited.

Mr Michael Moore, ACT, MLA - I have a recollection of Milton Freedman talking about the economics of the drug war and we've certainly had a number of writers in Australia recently saying that in very simple economic terms, it simply can't work. How do you respond to that?

Dr Caulkins - First of all I strongly object to the drug war metaphor. I think it's counterproductive. A useful harm reduction step is to stop mentioning that metaphor. Even the US office of drug control policy dropped it more than three years ago.

Mr Michael Moore, ACT, MLA - That's why we keep on saying it.

Dr Caulkins - Does a supply/control approach work? The answer is that it clearly has a dramatic impact on the market and on consumption. Does that achieve what you want it to? That's a different question as it depends on what you're trying to accomplish. It's clear that prohibition and aggressive enforcement make prices high. These drugs are semi-processed agricultural products that in the absence of any prohibition or enforcement would be very cheap. So they achieve a great inflation of price. There's strong evidence that consumption does respond to changes in price. Along with that presumed reduction and consumption as the result of prohibition, there are a whole host of consequences of which I think you are aware.

The Hon Mike Elliott, Chair - What has been the response to your study?

Dr Caulkins - Actually it has been very well received in many forums. Probably what is more relevant is to say what did the sponsors say. The sponsors are the Army, National Drug Control Policy and the Ford Foundation. How did they react? Army and the Ford Foundation and the Office of National Drug Control Policy was predictably split. Advocates of supply control were upset that we were saying that it was as cost ineffective as it was. Advocates of treatment were thrilled. In general though, the response has been enthusiastic and we've done a number of similar studies following up, looking at other related kinds of issues. It ends up being the first of a series of about 5 studies that are either now completed or under way.

The Hon Mike Elliott, Chair - Has there been any political response at this stage?

Dr Caulkins - Yes. The Office of National Drug Control Policy switched its focus and emphasised heavy users whereas in the past it emphasised all users, not discriminating. Also the administration responded by asking for a $350 million increase for funding of treatment. That did not get through the Republican Congress. The actual increase was about one tenth that.

Mr Bryce Gaudry, NSW, MLA - How would you feel if all of that supply side funding was transferred across to the domestic area in terms of harm minimisation tactics? Do you see that as being just as effective?

Dr Caulkins - The study actually gave figures predicting the exact effect, I shouldn't say exact, the effect of shifting one quarter of it was clearly beneficial. Some shift would be wonderful. To shift all of it would be a very risky thing with likely bad outcomes. That is, the benefits of enforcement are not at all linear. They don't increase in proportion to the energy spent on enforcement. The first 105 or so of the dollars we spend on enforcement and energy, we spend on enforcement and accomplish a lot. The marginal benefit of additional enforcement is very small and likewise if we peel back by a modest amount, a quarter, maybe even a half, that would be a good thing. Eliminating it all would not be a good thing.

The Hon Kevin Rozzoli, NSW, MLA - It's been said in several circles that if in fact you could tap into and take steps to counteract the international monetary flow coming from the drug trade, that that would provide the most single significant step to alleviating the drug problem but that most governments throughout the world do not have the will to carry through a policy such as that. Do you have any comment on that?

Dr Caulkins - Yes I do. The best way to think about efforts to control money and laundering is that it would be possible to make it more difficult for people, for drug traffickers to launder their money. It would not be possible to make it impossible to do that. That is, just as with most enforcement measures, what we could force them to do is to do their business in a less efficient, more costly, more complicated and convoluted way. Doing so would increase the costs of doing business which would eventually raise the costs of the drug a bit and have a modest impact on consumption. I'm not optimistic that the ability to impose inconvenience and cost on them through those financial measures is great. I don't see that as a particularly effective strategy.

Mr Michael Moore, ACT, MLA - Well Dr Caulkins, Mr Lee Brown, I understand is stepping down as Drug Czar and you've just been appointed in his place so what do you do to American drug policy?

Dr Caulkins - Too late, Barry McCaffrey already beat me to it. If General McCaffrey steps aside, there's a great many things that I would do. One of the things I would do would be to cut back the intensity of the enforcement and also the severity of sanctioning. We have very long sentences for some drug offenders, the number of people arrested. Those simple measures would be enormously beneficial. There a whole host of other things that you can do that have a harm reduction flavour. Try to control violence in neighbourhoods to preserve the quality of life who live near street markets would be important. Redouble efforts to control corruption. We've learnt a lot about how to control corruption. It's much less severe than it was 30 years ago but there's much more than we can do. Something that I personally would worry about as US Drug Czar is, what happens to Mexico. US has key strategic interests in what happens in Mexico. They are an important neighbour and the flow of drugs through Mexico is now enormous and I would worry about the democratic institutions in Mexico. And an increase in treatment, I should mention that as well.

The Hon Mike Elliott, Chair - Have you done any cost analysis work in relation to imprisonment?

Dr Caulkins - Yes, we're just completing a study now looking at the impact of mandatory minimum sentences for drug offenders. We looked at the impact on drug consumption, spending on drugs, the dollar value of the black market and on drug related crime, circo pharmacological, pathological, economic, compulsive and systemic.

Mr Michael Moore, ACT, MLA - Can you give us an indication of outcomes of any of those?

Dr Caulkins - Sure, the short answer is that the mandatory minimum sentences are particularly ineffective. Even a drug hawk should prefer to arrest and incarcerate traffickers using the old traditional sentences which weren't short but were shorter than to use mandatory minimums. It would take a fairly high level trafficker before you would want to impose something like a 10 year sentence. High level needs to be defined in terms of the perceived cost of being in prison. To give some sense of it, if they were trafficking in a couple of hundred kilograms a year, that might be appropriate but the mandatory minimums can be triggered by quantities as low as 5 grams and first offence and that's much too low for such long sentences.

The Hon Mike Elliott, Chair - Thank you Dr Caulkins. If you want to make a submission in writing, we would welcome it. They can be directed to Michael Moore at the ACT Assembly. The witness withdrew. Close of Session ThreeEnd of Proceedings
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