Monday, 17 September 2007
Family and Human Services Committee; Report
Debate resumed from 13 September, on motion by Mrs Bronwyn Bishop:
That the House take note of the report.
The winnable war on drugs: the impact of illicit drug use on families is the second report on this issue by the House of Representatives Standing Committee on Family and Human Services and its predecessor the House of Representatives Standing Committee on Family and Community Affairs. I have taken part in both inquiries, which has meant an involvement of more than six years with this issue, and I could add to that my interest in the issue for some years prior to the first inquiry.
What has been significant for me—and I am sure that I can say the same for all other members who have taken part in these inquiries—is that we have all been touched by the human stories we have encountered. We often hear terms like ‘war on drugs’ and ‘the fight against drugs’ but, having met with the full range of people in some way involved in the treatment of illicit drug users, I feel humbled by the small role played by parliaments in addressing the many problems associated with drug abuse.
As members of parliament we can be very much like armchair generals in the so-called war on drugs. While we can afford the luxury of being able to sit back and talk about strategies, there are those in the trenches who see the grim realities on a day-to-day basis. I think of those who attend incidents of overdose and trauma resulting from drug abuse: our police and our ambulance services. In recent years we have seen a dramatic decline in the number of fatalities occurring from drug overdoses. With the assistance of new treatments, together with the dedication and compassion of those officers, many lives have been saved. For our hospital staff who work in detox units, the medical staff who begin the process of rehabilitation and the social workers who do their best to put broken lives back together, these are often thankless tasks and are not well appreciated by the community.
As we know all too well, successful outcomes in the field of drug rehabilitation are not all that common. It takes extraordinary dedication on the part of these people to continue to work in this field. We also owe them our respect for their experience and professionalism in their field. It is offensive to dismiss these professionals as elites and to give equal standing to so-called common-sense remedies rather than strategies and treatments based on scientific studies and reviews.
Of those that we have heard from in our inquiries, it is the families and friends of those involved in illicit drug use that have had the most profound effect on me. The grief, anguish and frustration has come through in so many submissions and discussions that I have had over the years. The parents, brothers and sisters and especially the children of illicit drug users can truly be considered the victims. Yet they also suffer most from the stigma that attaches to illicit substance abuse. In the main they form the backbone of many agencies active in the field of drug awareness, referral and rehabilitation. As we all know, they are active lobbyists. Those parents, siblings and friends are very much at the coalface. What strikes me most is their dedication. Many have lost someone close, yet their response is to devote a great part of their lives to help others. They participate to spread the message about the harm of illicit drugs. But, for many, the most important service they perform is assisting in the counselling of families with an illicit-drug-using member. For other families, their close support of rehabilitation services is the backbone of those services.
I should not forget those who have devoted their professional lives to the treatment of drug addiction. These are people like Dr Alex Wodak, a man I greatly admire, a recognised world leader in the field. When I met with leading researchers and professionals in the field of drug addiction treatment in Europe in 2003, almost everyone I met was aware of the work of Dr Wodak and recognised his great leadership in the field. Witnessing the work of people like Dr Wodak, someone who sees the effects of drug addiction each and every day, you cannot simply dismiss them as elites or part of a drugs industry. There are no silver bullets to cure drug addiction. It takes years of painstaking research to understand this complex problem. It is unworthy of a parliamentary committee to malign the reputation of such dedicated professionals.
From the terms of reference, the committee’s inquiry and report might have been expected to deal with specific issues related to the impact of illicit drug use on families. Instead, the inquiry focused on attempting to legitimise the political stance of the Prime Minister. From the outset, in paragraph 1.2, the report’s introduction takes its lead from the quotation attributed to the Prime Minister’s statement of 16 August 2007:
This government will never give up in the fight against drugs. We will never adopt a harm minimisation strategy; we will always maintain a zero tolerance approach.
This statement flies in the face of the National Drug Strategy adopted by the Council of Australian Governments. The purpose of the report is to provide a fig leaf for the government’s denial of the success of the National Drug Strategy. The government uses the language of ‘tough on drugs’, but at agency level it supports the principles of harm minimisation. The committee’s rejection of evidence based analysis and insistence on zero tolerance and drug-free treatments puts at risk the valuable work of government and non-government agencies which lead the world in addressing the health, social, economic and law enforcement consequences of illicit drug use.
This report stands in stark contrast to the report of the Parliamentary Joint Committee on the Australian Crime Commission which recommended that:
... in the execution of the National Drug Strategy, harm-reduction strategies and programs receive more attention and resources.
The major point of disagreement with the majority report is the approach to the policy of harm minimisation. The report, at paragraph 1.50, places its interpretation on this policy, stating:
is undermined in the community by those who advocate for a harm minimisation or harm reduction approach, that merely seeks to reduce the harm arising from drug use without the goal of seeing each individual drug free.
The report then states, at paragraph 1.52:
The zero tolerance approach to drug policy has been hindered by drug industry elites within Australia who advocate for treatment approaches that aim to reduce harm—but do not have the aim of enabling users to become drug free.
In accepting submissions of individuals and agencies committed to zero tolerance based largely on anecdotal evidence and rejecting the substantial submissions put forward by the recognised government and non-government agencies, the report fails to make an objective assessment of harm minimisation. The report includes in harm minimisation programs the following: methadone and buprenorphine maintenance programs, needle and syringe programs, supervised injection facilities, non-injection routes of administration, overdose prevention interventions, pill testing, RaveSafe interventions and tolerance zones. Of these, only the last does not apply to the opiate drug heroin. Yet the report states that heroin use appears to have stabilised and declined in recent years and, at paragraph 1.18, states:
Heroin use dropped from 0.8 per cent of people aged 15-64 years in 1998 to 0.2 per cent in 2004.
While much of this decline is attributed to the heroin drought, the report states that there were almost 39,000 people receiving pharmacotherapy treatment in June 2006. At the same time, the report states:
... the rate of admissions to hospitals for opioid use has declined significantly since 1998-99
So I would think that any minister who took the recommendations of the committee on board would be praised by the heads of their department as very courageous—in a Yes, Minister fashion. The committee ignores the fact that for many agencies dealing with drug addiction, their immediate goal is to limit the clients’ reliance on illicit drugs and to stabilise their lives as much as possible.
When we introduce criteria that require goals for clients to be drug free, do we mean drug free now or drug free at some time in the future? One thing that research tells us is that age cures drug addiction. So we could say that, if we keep addicts alive long enough, they will eventually be drug free—but we must keep them alive. My concern with the requirement for so-called drug-free treatments is that accepting these criteria for funding may lead to established treatments losing their funding. As I said, there are currently 39,000 people on methadone and maintenance programs. What would happen if we were to have a zero-tolerance drug-free approach? The results of such a policy would be unthinkable.
I was amazed to hear the remarks of the deputy chairman, the member for Fowler. They cannot be reflected in the minority report because it says that Labor supports the majority of the report’s 31 recommendations. The member for Fowler must be expressing personal views and not those of her party or of the committee.
‘Labor members support the aim of helping those who use to become drug free.’ That is a statement that supports making sure that people do have an opportunity of living a drug-free life, and that should be the aim of every agency and every professional. What we have failed to hear from the Australian Labor Party, particularly the deputy chairman, is that that is their personal goal—that everybody should have the object of becoming drug free at one stage or another in their lives. That should be the goal. That is a life set free. That is a life that is saved permanently. That is the only way; it is the only philosophy that should guide drug programs.
I was part of the committee that presented the Road to recovery report in August 2003. Four years later we have a similar report, The winnable war on drugs. One of the main features in the 2003 report was to have a recovery program for every addict. I believe cannabis was outed for the first time in that report as being a serious problem and an addictive product, particularly the products that are grown under hydroponic circumstances. Cannabis was outed as a serious problem. Also in that 2003 report, there was support given for successful programs and not necessarily the loudest claimants. So the recommendation was that governments look at successful programs, ones that are producing results, rather than funding the loudest claimants.
It was indicated in that earlier report that families are intimately involved in recovery programs and in the management of addicts, and in many instances the responsibilities they accept are absolutely enormous. The report in 2003 indicated that there were inadequate detoxification opportunities and that harm minimisation should be replaced with a focus on harm prevention and treatment of dependent people. A far-sighted proposal was that there should be roadside testing for drug affected drivers.
In this current report being debated by the House, it is appropriate four years later to revisit the same scene. In many areas there had been some growth and improvement; in others, not a lot. The growth in the use of methamphetamines in particular and its impact on families and young people was something that was of great concern to the committee. Methadone remains the main treatment, and the naltrexone trial recommended by that previous committee has only just been commenced. That is a disappointment because, despite the wonderful results of dedicated researcher Dr George O’Neil, little attention has been paid to the processes and funding of that program to determine what is the very best. In the committee’s examination of and visits to the Perth naltrexone centre, I know that I for one was absolutely amazed and delighted with the results. They were not always permanent results, but they were results which could be measured and held and then, over a period of time, people could be set free from drugs.
There are still not enough detoxification opportunities around Australia. It was amazing to us that the National Drug Strategy set by premiers and the Commonwealth cannot be questioned by the body advising the Prime Minister. The advisory body is to give advice to the government; they should not be bound by any particular thing but should be able to give free and frank advice outside the normal approach.
I think that the committee was really taken by the words of Professor Gary Hulse, a professor at the University of Western Australia. Professor Hulse, in reviewing the work that has been done on drugs, mentioned harm minimisation in his comments. He said:
Harm minimisation should be, if anything, a stepping stone to stabilise someone to move them towards abstinence. Getting people out of the narcotic network should be the final objective. I am yet to meet a heroin dependent person who says, ‘I love being where I am. I love doing these things. I love ripping off people. I love having to do tricks for men down the road.’ They love heroin. It is an issue of breaking that nexus. Harm minimisation is very fine. Harm minimisation for those people who relapse is a necessary component, but it should be focused at then trying to shift them along that process back to where they are not using.
That is a fine objective. The committee was particularly taken by the results obtained in Sweden and endorsed strongly by the United Nations Office on Drugs and Crime, which Sweden has held up as a most remarkable landmark for their impact on reducing drug use amongst teenagers—from something over 20 per cent down to six per cent. Australia has a figure approaching 30 per cent of use by teenagers, of all drugs. That is one of the highest in the world. We can take a lesson from Sweden. Despite the detractors, they are getting great results. There is wide consensus in Sweden about the overall goal of drug policy. A drug-free society is what they want, and its objectives are to reduce the recruitment of young people to drug use, to enable drug users to stop their drug abuse and to reduce the availability of illicit drugs. That is the goal of Sweden and they are having marvellous success saving lives and giving young people new opportunities.
One of the recommendations of this committee was that naltrexone implants should be made available on the Pharmaceutical Benefits Scheme and that the success of that program should be monitored. In looking at families in particular, there were many areas where grandparents and kin were taking responsibilities far beyond what was reasonable. It appears that the family authorities in the states have an attitude that children, no matter what damage appears to be done to them, should remain with their mothers and their fathers. A more balanced approach is needed. There is far too much damage being done to children. Speaker after speaker and submission after submission from workers and from foster parents indicated that a more permanent arrangement is far more suitable for children.
Children are growing up in circumstances where they really do not understand the treatment being meted out to them by their parents. In fact, the most recent figures show that of the five-year-old children concerned, more than 50 per cent have had four to five placements with foster parents. So it is a constant movement from one parent to another parent hoping that they will find a solution. Children should not be with parents when they are undergoing treatment. The default proposal put forward in this report is a way of illustrating that, when all else fails, adoption should be considered. Adoption is never considered. Grandparents or kin adoption—to a sister, a brother or grandparents—is a solution that must be to the forefront and is one of the recommendations of this committee. Detoxification and rehabilitation are used and more is needed.
So this report is a worthy addition to known information. It builds on the previous report. It refines some areas. It dwells on families and the role of families. It also dwells on the new drugs that are on the market and the dreadful impact that those drugs are having on the lives of some of our young people. I commend the report. I thank those who participated, despite the differences.
Debate (on motion by Mr Neville) adjourned.