Foreword

Due to certain limitations, this document does not pertain to perceive and report on every aspect necessary in the development of Strategic Drug Controls. Instead it attempts to cover issues that are regularly overlooked, or ill conceived by popular media and the general community.

For a full copy of this document with all end notes in Microsfot 'Word' (97) format, please email the Law Library at lawlibrary@hotmail.com.au

Introduction … 4
Strategy Structures … 5

Introduction … 7
Audience Recognition … 7
Schooling … 8
Family Support Structures … 11
Community Involvement … 12
Media Control … 13
Conclusion … 14

Introduction … 16
Methadone… 18
Naltrexone … 19
Heroin Prescription … 20
Outpatient Drug Free Treatment … 21
Short Term Drug Free Treatment … 21
Long Term Drug Free Treatment … 21
Rehabilitation Follow Up – Retention – Relapse … 22
Safe Injecting Rooms … 23
Conclusion … 24

Introduction … 25
Effective & Ineffective Enforcement … 25
Current Enforcement Initiatives … 27
Drug Courts … 29
Prisons Based Treatment … 29
Conclusion … 31

Highlights In Brief … 32

Appendix 1 Drug Types
Amphetamines – Speed … 34
Hallucinogens … 35
Opioids – Heroin … 36
Ecstasy … 37
Cocaine … 38
Cannabis – Marijuana … 39

Appendix 2 Maslow’s Pyramid … 40
Appendix 3 Cognitive Behaviour … 40
Appendix 4 Prison Subculture … 40

Figure 1 Demand & Supply … 42
Figure 2 Maslow’s Theory … 42
Figure 3 Treatment Improvement Results … 43
Figure 4 Short Term Inpatient Treatment (STI) … 43
Figure 5 Long Term Residential Treatment (LTR) … 44

Table 1 Proportion Of Year 11 Students Who have Used Drugs ... 45
Table 2 Treatments In Use ... 45

Australia has become a primary drug consuming country in the midst of a major social and health dilemma. During 1995 one in five deaths was linked to drug use, whilst in 1998 approximately 22,500 Australians died for the exact same reason, with a further 175,000 being hospitalised, equaling a disturbing total of 23 Australians adversely affected per hour. Opiate related deaths alone increased by 700 percent between 1979 and 1995, and estimates by the United Nations International Narcotics Control Board indicate a further 25 percent increase in supply from the second largest industry (after firearms) this year alone.

"Cannabis is the only illicit drug known to be cultivated in Australia" (other than the licit poppy industry in Tasmania), which despite vigorous eradication efforts has not declined, becoming more entrenched with the use of sophisticated indoor hydroponics operations. On the other hand, amphetamines and methamphetamines (Appendix 1) production is on the increase, with small quantities of synthetic heroin known as ‘home bake’ being developed locally.

There is an intimate link between illicit drugs and growth in crime. Property crime committed by those addicted to drugs in 1998 costs the community $1.6 billion, a figure which is obviously higher now and unanimously agreed upon to continue rising. On average, regular intravenous drug users require up to $1,000 per week to fund their addiction. Unless these individuals have enough private income to buy their drugs, they will either resort to (1) property crimes such as burglary of homes, stores, cars and bag snatching, (2) prostitution or even (3) drug dealing. In fact "research shows that more than half, and possibly up to 80 percent of property offences have some drug involvement. Between 45 and 60 percent of convicted offenders committed property crimes to support drug habits". In a recent study conducted in Sydney, it was found that 70 percent of heroin users surveyed admitted to having committed a property offence within the last month.

"The cost of illicit drug addiction is more than the cost to users themselves. It has been estimated that the social and economic cost to the community in Australia exceeded $1.68 billion during 1992", and has now reached the catastrophic amount of $18 billion. The recovery of these costs is derived through increased taxes to the general community. During 1996, $450.6 million was spent on law enforcement activities relating to illicit drugs, $230.5 million for prisons, and a further $64.1 million to fund the court system – totaling over half the cost of administering and operating the entire criminal justice system. Given the much wider prevalence of drug use within today’s society, that figure is now much higher.

With statistics such as these, it is no wonder so many debates exist within communities over drug use, treatment and law enforcement techniques. It should be noted, these figures take no account of the personal and family anguish, or the personal costs of violence caused by, or related to, drug use and dependency. In essence, a coordinated multi-agency and multi-strategy approach is urgently required to engage the national and transnational criminals who traffic in illicit narcotics.

Several strategic plans have emerged over the years to satisfy the ever-increasing community concerns. Most National Drug strategies have supported ‘harm minimisation’ frameworks consisting of up to three major elements, namely: reducing supply through law enforcement; reducing demand through education and rehabilitation; and finally reducing harm through maintenance and needle exchange programs. Each of these elements alone would fail. Furthermore, the majority of these strategies have failed to encompass each of the essential factors of drug control.

Simply turning off the supply through law enforcement would have a superficial effect at best. "The sad fact is that virtually every police commissioner in Australia has acknowledged that major police efforts have been ineffective in reducing the supply". Police and customs estimate that only 10 percent of drugs imported into Australia are ever detected – a figure many argue is overly generous. South Australian research conducted by Mr. Punckun in 1996 strongly suggested that the control rate is in fact only about 3.5 percent, a figure that can only be described as a minor dent to the entire market.

Whilst law enforcement efforts remain imperative, effective demand intervention should be considered the first line of defence, as it stands to economic reason that reduced demand ultimately causes supply to contract (Figure 1). By 1998, 46 percent of Australians had used some form of illicit drugs, whilst 55 percent of all 17 year olds also had experimented with banned substances. The challenge here requires the development of an environment that actively discourages and protects the vulnerable and impressionable from being drawn into narcotics abuse - particularly among youth. It is important to recognise that young people are vulnerable in a society that can at times be harsh with a lack of security. Through well-designed drug education schemes and positive encouragement to remain in school, numerous paths can be developed creating stepping-stones to employment, bolstering confidence and control. At present, many parents of drug users have criticised the current level and approaches of drug education within the schooling systems - for reasons we will soon see.

With this in mind, it is obvious that Australia needs to tackle this challenge in a more sophisticated, comprehensive manner with a combination of resources. This means a complete national coordinated strategy is required that utilises several diverse and smaller strategies in the areas of supply and demand reduction, social support and rehabilitation, increased health services and a proactive attack on supply countries.

This will ultimately take great amounts of up front funding, but can be justified by the fact that in time, it will save Australia a lot more than just money. Furthermore, in order to assert the effectiveness of any strategies close and continued evaluations must take place at regular intervals, which combined with flexibility should allow for changes to be implemented as required. This ultimately means that strategies should not be long term, instead, short term with one major goal.

"Unlike the field of public health, where a one time intervention (e.g. inoculation) will prevent terrible consequences such as smallpox and polio, substance abuse problems do not yield to simple prevention strategies. Prevention efforts need match the intensity of the problem and provide continuous focus on the solution to be successful". Furthermore, the likelihood of success increases in proportion to the level of communication, and organisational cooperation. In short, the harm minimisation and education issue can become less overwhelming when broken down into the smaller, more manageable components of target recognition, family support structures, schooling, community involvement, and media control. By enlisting assistance from broad groups it is easier to discourage abuse, allow for prevention efforts to be enhanced and in turn have a "greater impact on target populations".

To begin implementing any form of education or harm minimisation strategies, it is important to first develop a clear understanding of the audience targeted, then tailor efforts for optimum results. In order to do so, "consider questions like these:

• Who is the target population?
• What are the demographics of the population (e.g. gender, age and geographic location)?
• Do prevention planners have experience with understanding the target audience?

Particular consideration should also be given to the patterns of substance use, cultures, value systems, and the likelihood of positive response to the prevention effort" This combined with the acquired knowledge of audience should greatly assist in quality designed programs. Setting clear, realistic goals will also allow programs to move from conception development to implementation with the desired effects more smoothly, and in a measurable manner.

Because early involvement with any drug tends to lead to increased risk of later drug use and criminal activity, early childhood education should remain the prominent and key focus of any educational and preventative policy. The more severe the early involvement, the greater the risk that antisocial behaviours will emerge in future.

In order to develop professional and useful educational models it is important to understand the audience, their needs, and then develop a timeframe for introducing them to drug education so that it will have optimum effect. Developing a clear understanding of the intended audience will also determine what will work and what will not. For instance, telling scarey stories about drugs often increases curiousity and may even inspire thrill seeking. Forbidding the use of drugs may cause such forms of backlash as prompting children to challenge authority and begin experimenting. Moralising, lecturing, and pumping information might seem like the immediate answer to all drug education, but it rarely helps. Sociology and psychology have both shown us that children, like adults, are more likely to listen, understand and respect experiences or advice if educators and parents alike are willing to listen and discuss – after all, no one likes being spoken down to.

To further enhance these experiences, it is important to develop an understanding as to why a particular group acts as it does. In the case of children, drug use exists for a variety of reasons, including among other things, imitation of others, experimentation, defiance of authority, emotional and personality problems, peer group pressure, to have fun and to provide a false sense of courage. Unless education is sculpted to deal with the exact causes of illicit substance use, they will not even be remotely effective.

Although drug education is the center point to curbing the drug dilemma, it remains one of the most commonly contested forms of drug control because of its perceived long history of failure.

Mr. Duncan Stalker, President of the Victorian Secondary School Principals’ Association has publicly opposed schools undertaking drug education because in his mind, it did not prevent young people from using drugs. Research conducted over the last twenty years that tested drug education programs against subsequent use by adolescents of popular drugs such as tobacco, alcohol or cannabis, concur with Mr. Stalker’s beliefs that young people have continued to experiment with those substances (Table 1). Such data gives way to the presumption that drug education obviously is not being introduced into youth’s lives early enough to have any desirable effect.

To fully understand this train of opposition, it is necessary to review the unsuccessful history of drug education. "First generation programs, from the 1960s sought to provide students with factual information on the notion that if they understood the dangers of drug use they would not use them. Often the programs were laced with fearful messages designed to scare would be drug takers. In the ‘second wave’, personal development programs stressed decision making skills and value clarification. They were based on the view that drug use resulted from deficiencies in young people’s coping skills. The third wave in the 1980s emphasised social competence by developing social skills or by teaching ‘resistance’ skills to help young people refuse offers of drugs". It assumed that drug use resulted from externally applied peer pressure.

With the argument that drug education at school is bound to fail still fresh in our minds, let us consider a completely unrelated case study. In 1970 the road toll numbered over 1000 deaths in Victoria, whilst in 1997 it was only 400. Yet there were more licensed drivers, more cars and more kilometers traveled. How did the road toll decline in such a fashion? Well, since 1970 many changes have taken place. Compulsory fitting and wearing of seat belts; P plates for new drivers; red light cameras; amphometers; hand held radar guns; random breath tests; availability of low alcohol beer; improved road engineering; divided highways; traffic calming; the overly gruesome yet effective Transport Accident Commission advertisements; driver training programs; and more difficult license tests. Which of these individual strategies actually caused the road toll to decrease? The answer simply remains that not one of those factors alone could possibly have caused the decrease – it was a combination of many that in the end had the desired effect. With this in mind it is easier to comprehend the need to persist with school drug education - it will not single handedly stop drug use, but it will contribute positively to the overall desired outcome.

Essentially drug education ought to prepare young people for living in a drug using society. It should aim to ensure that young people understand the nature and chemical properties of psychoactive drugs, their likely effects, how these effects are not always predictable, personal metabolism, how drugs effect individuals or society, the potential of two or more drugs taken together, the implications of diseases such as the AIDS virus, how problems can be avoided, and how drugs impact on the domain of public policy. Above all else, it should be made extensively clear that absolutely no drug is safe, and all carry their own special side effects. These are educational needs consistent with the cultural role of schools, and the needs of students. They do not burden drug education with fantastic objectives.

As an added bonus, drug education should assist students in developing abilities they can use to reduce drug-related harm in their personal lives. These may include the ability to reduce and manage stress without resorting to drugs, and a reduction in exposure to drugs and drug using communities (removal of temptation).

During 1997, the Victorian government committed $14 million to a three year long drug education policy – the largest commitment in its history. Though a remarkable amount worthy of praise, it is microscopic by comparison to the total value of the illicit drug market. Consider the alcohol industry within Australia that spent over $1 million per day promoting itself during 1995 and then contrast it with the amount of money involved within the International drug industry. In retrospect, the $14 million spent on education suddenly seems remarkably insignificant.

At the beginning of 2000, the Victorian state government had made it abundantly clear within their promotional material (such as their "Young People and Drugs – Strategic Framework") that they were dealing with, and developing policies for drug education within schools. Unfortunately, their strategies are at best weak – choosing to revolve namely around tobacco and alcohol, and simply sweeping over anything to do with ‘harder’ drug types – drugs that have become much bigger concerns than tobacco or alcohol combined.

Interestingly "data has shown that students who do poorly in school are more likely to be problem users of…drugs than students who do well. Research has also linked that students commonly at risk are less likely to turn to drugs if they are able to develop a bond with supportive adult mentors. Therefore, prevention efforts should establish mentoring programs within their framework. Other key elements of such a framework should include ongoing updated information from the field; issues of causation versus correlation; focus on motivation to use… drugs; and factors that link prevention with current use".

Further research "shows that well implemented substance abuse policies in schools help prevent drug and alcohol problems among students. Yet effective implementation requires the leadership of key decision-makers in the school system, the cooperation of teachers and other school staff, the endorsement of parents and students. If any of these groups resist the change, the effort can be defeated".

During the month of August (2000), we conducted our own small, yet highly resourceful survey regarding drug education. The survey was conducted via phone, utilised 70 candidates, ranging in age from 16 to 40, and sought to gather information from a variety of suburbs in Melbourne (Victoria). Results indicated that of the 70 people interviewed, only 20 could remotely remember anything about drug education being taught at school. Of these 20, all agreed that anything they had learnt was remote and ineffective. Worse still – those who did receive any form of education only received it as a one of thing. Thus it was concluded that a void of education existed within the schooling environment.

Amidst all the confusion, schools have a mandate and the capacity to educate, but alone face an impossible task. Only when combined with other forms of social education such as community intervention and involvement, positive parenting and support, and control over the media can any form of education hope to be successful at contributing to the overall harm minimisation framework. Realistically, it is doubtful that any education or public awareness campaign introduced today will have any impact for several years, but we should be looking at the bigger picture, and the benefits to come.

The family structure is by far one of the most promising methods to instill the ability within youth to forego using drugs.

Baring in mind that most "adolescent social adjustment is profoundly affected by early childhood interactions", it is important that good quality parental behaviour and guidance exists from the very beginning. With this in mind, it is important that parents develop role model like interactions, whereby they do not engage in any illegal, unhealthy or dangerous practices, in order to provide working examples consistent with the messages they wish to reinforce within their children. When children are subjected to poor upbringings, their likelihood of making good adolescent adjustments, social and otherwise, decreases. "When Cairns and Cairns (1994) tracked 695 young people growing up over a fourteen-year period, they saw the youngster’s early patterns revealed forcefully as the years went on. These researchers argue that the trajectories of social development do not change much; troubled boys and girls stay troubled, and happy well adjusted children are more likely to stay well adjusted".

In later years a child’s environment expands to include the effects of culture, subculture, family, school, television and sorted peers. At this stage, the two most important sources of influence come from family and peers, though the later seems more prominent with teenagers - thus the importance of early education from family infrastructures. "Peer groups are people who identify with and compare themselves to one another. They often consist of people of the same age, gender, and race… as adolescents spend more time away from parents and home, they experience increasing pressure to conform to their peer group’s values in relation to society, government, religion, and music… These peers sometimes praise, sometimes cajole, and constantly pressure one another to conform to behavioral standards, including standards for dress, social interaction – and forms of rebellion, such as shoplifting of drug taking". Most importantly, peers influence adolescent’s concept of self.

In order to protect the young from this form of potential danger, it is important that parents help develop and maintain their children’s confidence. This can be done by praising children when they do well, building their confidence when they find the going tough, encouraging responsibility for actions, placing them on equal levels when discussing issues (don’t talk down to them), provide leadership so that they may learn to set limits on their own behaviour, but most importantly – listening. Listening not only encourages interaction, but also indicates to youth that the parent is trying to understand how they are feeling. All these factors can only be achieved if the parents are willing to spend quality time with their children in order to make them feel as though they are part of a whole – the family. A good and easy to follow local source of information regarding family bonding and the development of children’s sense of self is available through the Scout Association of Australia. It is designed to "help parents teach their children protective behaviour models that encourage children to be aware of their body signals. In it are basic protection strategies and activities that parents may pursue with their children".

Furthermore, three recent studies conducted by the National Institute of Drug Abuse (NIDA) have found that culture and ethnicity can be critical protective factors against drug abuse by reinforcing the concept of existing "connections to supportive social, family and community systems". These results offer valuable insight for prevention program managers and staff about bringing aspects of ethnic history and culture into prevention efforts.

Above all else, it must be remembered that the most effective method of drug control within any family structure is the proactive approach. It is important to play, work and talk together in a normal day to day environment, because when problems do strike, youth will be better equipped to handle issues and even feel comfortable communicating their problems. If parents do nothing and simply wait until a problem arises, it will almost certainly be too late to have any positive influence on their youth’s present and future activities.

"For prevention planners to develop sound organisational structures for activities, they must incorporate community wide participation from the beginning" in order to create programs that promote supportive and caring relationships between youth and members of their families, communities and peer groups. In particular, emphasis should be placed on the active involvement of community members in the planning and execution of decisions.

"To avoid duplicating efforts, program staff can consider the array of other efforts that are occurring or are planned at national, state and local levels. By taking a systems approach that connects various parts within the same system, the prevention community can maximise program effectiveness by building on other efforts and creating a cohesive solution to the community problem". At the same time, well-qualified staff are required to concentrate on program organisation, public relations, record keeping and other factors that increase the success of prevention efforts. Because activities and results may change as new conditions and opportunities arise, efforts need to be made that carefully document and enhance programs, then distribute these results to other organisations to emulate or grow on in an effort to develop a unified and joint effort. For this reason, prevention programs should be planned with evaluation measures in mind. Throughout the planning and implementation phases, open communication between members of each prevention program’s staff will provide evaluators with information to highlight outcome measures and anticipate any program shortfalls. In the case of a shortfall, staff must be willing and able to adjust strategies in a timely manner - ultimately enhancing the overall effort.

In order to develop a successful information sharing network, it would be necessary to create some form of adaptation of Maslow’s ‘Pyramid’ design (Appendix 2) for reporting and information exchange. Maslow’s theory, though deeply rooted within psychology as a form of ‘need’ development in fact is reasonably similar to the ‘needs’ of those desiring drug reform. At the bottom of the pyramid, which is made up by parents, family and peers, we find the dominant needs. At the top, consisting purely of governmental bodies, we find those who need to take direct responsibility in developing strategies for information gathering and sharing. To develop these strategies the top level must utilise the efforts of those within the middle of the pyramid - made up of government funded organisations as well as private and community based groups (Figure 2).

"These guidelines, which reflect the best knowledge of promising prevention efforts, afford the prevention community a framework for developing successful programs". By incorporating idea development, structure, information sharing and implementation considerations into the design of prevention activities, planners may increase their potential for program success.

Advertising can be considered one of the most powerful forms of ‘peer pressure’, with the potential to greatly contribute toward the escalation, or elimination of illicit drug use. It is pressure from the media that may ultimately determine and influence grade school children’s attitudes and behavioral patterns.

One study conducted by the department of pediatricians at the John Hopkins University of Medicine demonstrated the positive effects of anti drug advertising on younger audiences. 83 percent of all participants were familiar with anti-drug advertisements, 97 agreed that the ads convinced them of the dangers, 84 four percent of students listed these ads as an important source of information about drugs, whilst another 28 percent labeled them as their most important source of information. Although this survey and others like it demonstrate the importance of media in effectively channeling anti drug messages, we must not forget that these positives are often "overshadowed by contradictory images" from the same medium.

International studies have found beer, wine and tobacco advertisements outnumber substance-related public service announcements 50 to 1 - and this is not even taking into account the vast multitude of negative imagery portrayed in actual movies or series. Thankfully restrictions apply within Australia as to what can and cannot be depicted within bulk media, requiring programs to be rated – though this then ultimately relies on parental guidance in controlling material.

Overall, the mass media bombards youth with images that glamorise the use of drugs. To counter these images, anti-drug advertisements are needed in order to educate youth about the dangerous reality of illicit drugs, and promote negative attitudes towards such substances.

By supporting effective anti-drug advertising campaigns and limiting the availability of drug glorifying imagery, the prevention community will be able to develop strategies to help young people become critical viewers by allowing them to distinguish what is good and what is bad. Such multifaceted prevention efforts, "concentrating on audience specific ad campaigns and education" are an important element to any practical strategic drug control program.

Many adolescents, even though living in high-risk environments, seem to posses personal resilience that helps them avoid drug use. How is it that, despite their exposure to severe risk factors, these youth are able to develop social competence, overcome the odds and lead drug free lives?

"Research suggests that most children are born with innate resiliency and have an inborn capacity for self-correction, transformation, and change". Identifying the protective factors that some adolescents posses and determining how they can be instilled in youth is a worthy challenge. So far we have found that the most effective way is by meeting children’s basic needs with programs that facilitate:

• "Resilience by establishing safety and basic trust through caring relationships that are grounded in listening and conveying compassion, understanding, respect and interest.
• Communication of high expectation messages that provide firm guidance, structure and challenge as well as conveying a belief in the youth’s innate resilience by focusing on strengths and assets, as opposed to problems and deficits.
• Creating opportunities for the youth’s meaningful participation in and contribution to the community".

It has been noted by U.S. congress that this form of resilience is greatly depleted within children and youth under the age of 21 who have been conditioned by:

• "Parents who abuse alcohol or drugs,
• Physical, sexual, or psychological abuse,
• Dropping out of school,
• Teen pregnancy,
• Economic disadvantage,
• Neighborhood crime and violence,
• Preadolescent and adolescent gang activity,
• Involvement in violence or delinquency,
• Suicide attempts or other mental health problems,
• Placement in institutions, foster care, runaway or homeless shelters".

Ultimately, resilience to illicit drugs can only be gained through the process of connectivity, of linking people, groups, associations and community to youth and in turn strengthening the very fabric of society. The real concentration in the future has to be on the education of not only our youth, but also all members within society by providing opportunities to experience and explore drug deterrents. Using real life scenarios of users, addicts, police, health workers in the classroom and within media will effectively contribute to this.

Harm minimisation and rehabilitation is a secondary step to strategic drug control, unlike drug education that is a primary control method that seeks to stop individuals from experimenting with substances in the first place. However it remains a useful concept in dealing with people who either did not receive the appropriate warnings to begin with, or ignored them. Once an individual is taken by the cravings of addiction, it is no longer appropriate to preach "just say no" campaigns. In these instances it is necessary to give support, understanding, and even offer schemes by which to eliminate drug dependence, be it via emotional or medical programs.

In developing such a strategy, it should be acknowledge that no single harm minimisation program can effectively deal with all forms of drug use, as each has its very own unique effects and dependency attributes. Furthermore, no simple solutions can be had because drug use tends to be embodied by such common themes as difficult "economic circumstances, unemployment, social isolation, low self esteem, family conflicts, poor communication skills, lack of positive work opportunities and the inability to escape negative peer groups. In areas with a strong drug subculture, involvement in the excitement of drug trafficking can seem the closest thing to a real job and a real income to may people growing up with few alternatives". For a minimisation and rehabilitation scheme to be even remotely effective, we must be able to acquire an understanding of each individual’s special situation, and provide appropriate methods for reforming these issues through the "incorporation of many components, each directed to a particular aspect of the illness and its consequences".

It has become common throughout the world to hear such terms as ‘Methadone’, ‘Naltrexone’, ‘needle exchanges’, ‘safe injecting rooms’ and ‘heroin prescriptions’. This list of terms, which remains far from extensive, all relate to harm minimisation and rehabilitation schemes. During 1997 the Australian Capital Territory proposed it’s own trial of prescription heroin, but the Federal Cabinet rejected the concept. One year later, most of Australia’s states and territories were performing trials into new treatments for heroin addiction, including Naltrexone, LAAM (levo-alpha-acetylmethadol), buprenorphine, slow release oral morphine and tincture of opium (Table 2). The reason for this turn around in policy can be attributed to the newfound understanding that economic and social costs of such addictions are disproportionately high in comparison to treatment. In fact, it is a common belief that the level of drug abuse within Australia will continue to escalate until it reaches the same levels found within other plagued countries – ultimately resulting in even higher costs.

During 1997 the Commonwealth Government of Australia announced a $414.6 million drug budget, of which $95.5 million as allocated to harm minimisation initiatives, including:

• Establishment or enhancement of non-government treatment facilities ($50.3 million over 4 years),
• More than $7 million over four years for research and evaluation,
• Training for frontline professionals and dissemination of best practice ($3.1 million over 4 years), and
• Data collection and monitoring ($3.7 million over 4 years).

Three decades of scientific research and clinical practice have yielded a variety of effective approaches to drug addiction treatment. Extensive data has been documented that drug addiction treatment is as effective as are treatments for most similarly chronic medical conditions, yet "in spite of scientific evidence that establishes the effectiveness of drug abuse treatment, many people believe that treatment is ineffective. In part, this is because of unrealistic expectations. Many people equate addiction with simply using drugs and therefore expect that addiction should be cured quickly, and if it is not, treatment is a failure. In reality, because addiction is a chronic disorder, the ultimate goal of long term abstinence often requires sustained and repeated treatment episodes".

Admittedly, the failure rate of some treatments are as high as 80 percent, with most addicts falling off of the wagon at least once, and often several times before successfully kicking their habits – whilst others never manage to stop. "Yet it is also clear that the costs to society of providing inadequate treatment or no treatment at all are far greater in the long run. As a recent report from the Center on Addiction and Substance Abuse has noted, imprisoning addicts and criminals with drug addictions, and leaving their addictions untreated, is both expensive and ineffective". In order to improve the rate of success, it is imperative that a system emerge to match treatment settings, interventions, and services to each individual’s particular problems and needs – as one single treatment does not fit all.

Programs and commissions in favour of prominent treatment programs include the American ‘National Treatment Improvement Evaluation Study (NTIES)’ that found "drug selling decreased by 78 percent, shoplifting declined by almost 82 percent, and assaults… declined by 78 percent. Furthermore, there was a 64 percent decrease in arrests, and the percentage of people who largely supported themselves though illegal activity dropped by nearly half – decreasing more than 48 percent" (Figure 3). A further 40 to 60 percent drop was also noted in drug use alone.

In it’s present state, harm minimisation programs which make treatment compulsory for some who may neither need it nor want it, is creating a significant treatment gap, leaving desperate individuals who truly desire treatment stranded on waiting lists for months. Because individuals who are addicted to drugs may be uncertain about entering treatment, taking advantage of this uncertainty can be crucial. Potential treatment applicants can be lost if treatment is not immediately available or not readily accessible.

"A rational drug policy would investigate, experiment with, and promote a wide range of treatment options to reach the greatest number of addicted persons, even if that included treatment programs that focused on stabilising the addict within the context of active drug use, at the expense of an insistence upon abstinence. A humane drug policy would provide treatment on demand for all that desire it and for those who need it most. These are ideas that are gaining currency around the world, but have until recently been conspicuously absent from most drug policy debates" .

Methadone (Methadone Hydrochloride and Dolophine) is not a heroin substitute, instead a safe and effective medication administered orally to reduce opiate addictions. Methadone programs are a long established means by which to achieve stabilisation and ultimately withdrawal from illicit drugs. Currently many thousands of drug users utilise this method of harm control in order to get their life under some form of control.

There are various ways in which this style of program is organised. "Traditionally this has been through specialised clinics but recent experience based on prescription by General Practitioners and dispensing through local pharmacies appears to be the best current practice". The key to its success appears to be it’s decentralised setting, with continual monitoring and health support made available by distributors.

Injected, snorted or smoked heroin causes an almost immediate ‘rush’ for a brief period which quickly wears off, terminating in a ‘crash’. The individual then faces cravings of immense proportions to use more heroin in order to reinstate their euphoric feeling. This cycle of euphoria, crash, craving repeated several times a day leads to a cycle of addiction and behavioural disruption. Methadone on the other hand, has a far more gradual onset, and does not just stop - instead fades away gradually leaving the brain and body with less fluctuations of state. Patients stabilised on this type of medication do not experiences any ‘rush’, and find their desire for heroin to be greatly minimised. In fact, any regular user of methadone (once per day) would find little euphoric sensation if they were to try heroin again.

A major benefit of this type of stabilisation is that the drug user can end their criminal activity, as they no longer have a habit to support. This reduces the extent to which drug users engage in high risk and criminal behaviours by at least 40 percent with antisocial consequences for other individuals within society, allowing them the freedom to obtain employment, rebuild friendships and restore family support.

Unfortunately, other than costing around $35 in dispensing charges (a potentially significant disincentive to participants), methadone also has its own side effects. The most common include drowsiness, lightheadedness, weakness, dry mouth; urinary retention; constipation; slow or troubled breathing. Less common side effects include allergic reactions’ skin rashes, hives, itching, headaches, dizziness, impaired concentration, sensation of drunkenness, confusion, depression, blurred or double vision, facial flushing, sweating, heart palpitation, nausea, vomiting, anaphylactic reactions, hypertension, hallucinations, muscle twitching and myasthenia gravis. Risks of continued use include kidney failure, seizures, possibility of overdose and with most drugs – addiction.

Naltrexone is a reasonably new drug that has been hailed a miracle cure. It is a long acting synthetic opiate antagonist with few side effects, and when used daily or three times a week blocks opiates in the brain, removing all the sensation from taking heroin or alcohol. "The theory behind the treatment is that the repeated lack of the desired opiate effects, as well as the perceived futility of using the opiate, will gradually over time result in breaking the habit of opiate addiction".

Increased public scrutiny following the abandonment of the ACT heroin trial together with an intriguing public relations and marketing campaign by proponents of rapid opiate detoxification using Naltrexone have led to the commitment of funding for trials in most jurisdictions (except the Northern Territory). Promising results have been reported by pilot programs involving large numbers of users in Western Australia and smaller numbers elsewhere that claim high percentage rates of people abandoning their drug behaviour. As well as the official trials, several clinics are providing, at considerable cost to patients, rapid opiate detoxification using Naltrexone as well.

A recent paper issued by the Alcohol and other Drugs Council of Australia notes that this treatment is ‘without competitor as the best researched of all treatments for opioid dependence". However, Naltrexone is most effective for only those people who are strongly committed to achieving success and live in a supportive environment where they are under continued pressure to maintain their use of the product, as patient non compliance is a common problem. Therefore, favourable treatment outcome requires that there also be a positive therapeutic relationship, effective counseling or therapy, and careful monitoring of compliance.

The drug itself has no subjective effects or potential for abuse and is non addictive. Even though considered by many as a miracle cure, it can not help all addicts and should not replace methadone treatment, but work in unison to develop complete abstinence.

Heroin prescription treatment is not a step in the direction of general drug liberalisation. It is a strictly regulated therapy, under which the patient is subject to a number of obligations.

The aim of this treatment for addicts is an overall improved state of health and aptitude to work, whilst stopping consumption of non prescribed substances that are impure, a reduction in crime with lasting abstinence as the long term goal, and a decrease in infectious diseases.

This form of treatment, which is partially financed by health funds, leads to an improvement in psychological and physical situations of addicts, making them less often hospitalised, and other interventions are less frequent. In 1996 alone there were 526 heroin-related deaths in Australia – of which 85 percent were not in treatment. Furthermore, 40,000 hospital beds were used that year on drug related medical care, with a national cost of more than $7 billion. With heroin prescriptions in place, contamination and wrong dosages would be minimised, thus calling on the public system less, and in turn removing the cost to society.

From a study undertaken in 1998 to compare heroin prescription treatment with methadone treatment it appeared that patients having followed the first had markedly reduced their consumption of illegal heroin, cocaine and benzodiazapines and considerably limited their contacts with the drug scene. The number of people having interrupted treatment was also fewer in this group. This shows that heroin prescription has its place for a defined target group, thus representing a relevant compliment to harm reduction strategies, that can be justified by highlighting the fulfillment of drug dependent ‘s needs whilst protecting the security of the general population.

Let it be known that such prescriptions should remain a last resort in extreme cases, and be made only available to those few individuals who are gravely dependent and cannot literally, digest the benefits of other treatments.

Such treatment costs less than residential or inpatient treatment and often is more suitable for individuals who are employed or who have extensive social supports. Low intensity programs may offer little more than drug education and admonition, and thus are more suited for those with minor drug issues. "Other outpatient models, such as intensive day treatment, can be comparable to residential programs in service and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling is emphasised. Some… are designed to treat patients who have medical or mental health problems in addition to their drug disorder". In therapy, patients can address issues of motivation, build skills to resist drug use, replace drug using activities with constructive and rewarding nondrug using activities, and improve problem solving devices. "Behavioural therapy also facilitates interpersonal relationships and the individual’s ability to function" in family and community environments.

Compared to other treatments, short-term practices cater for more exclusive clientele with lower levels of drug dependency that are 3 to 10 times more likely to have high levels of education, steady jobs, private health insurance and 7 to 8 times less likely to be criminal justice referrals.

Results of this form of treatment show no significant level of change in employment rates afterward, but suicidal ideations fall by about 48 percent, whilst illegal activities decline by 58 percent. "Further tabulations showed a drop from 49 to 20 percent in being jailed in the year before versus after treatment, and those with arrests decreased from 26 to 20 percent" (Figure 4).

Long-term residential programs are designed to cater for those with higher levels of drug dependence by providing 24-hour service, generally in a nonhospital setting. The best known residential treatment model is the therapeutic community (TC), but residential treatment may also employ other models, such as cognitive-behavioural therapy (Appendix 3).

"TCs are residential programs with planned lengths of stay of 6 to 12 months. They focus on the ‘resocialisation’ of the individual and use the program’s entire ‘community’, including other residents, staff, and the social context, as active components of treatment".

Those who most prosper from such treatment include adolescents, women, those with severe mental disorders and individuals from the criminal justice system with major criminal involvement. Because of their more sever background problems, it is essential that they stay in treatment for longer periods because in most cases they find it difficult to immediately develop working relationships with their counselors.

Results from this form of treatment show unemployment drop 13 percent, suicidal ideation fall by as much as 61 percent. "Further tabulations show a drop from 77 to 35 percent in being jailed in the year before versus after treatment, and those with any arrests decreased from 56 percent to 31 percent" (Figure 5).

It is well documented that those who stay in methadone treatment longest tended to recover from their ailment. Those who remain in treatment for longer than one year are four times more likely to beat their addiction than those who drop out earlier (within 3 months of treatment).

Those in long term drug free treatments that remain in treatment for at least 3 months have significantly better follow up outcomes on a variety of criteria than early drop outs. By comparison to short term treatments, long term patients tended to have almost double the benefits and manage to retain results a lot longer in follow up tests. These results are almost identical for outpatient programs.

Comparisons between each treatment model found that the retention rates of individuals are greatly influenced by such factors as age, sex, treatment history, psychological problems, and the types of dependencies – highlighting the fact that no single program is appropriate for all. With this in mind, program dropouts should not be perceived as a failure on the behalf of that treatment, but as a lack of suitability for that individual.

Recovery from drug addiction can be a long process and frequently requires multiple episodes of treatment. As with other chronic illnesses, relapse can occur both during and after treatment – even if that treatment was entirely successful. Addicted individuals may require prolonged treatment or even multiple attempts at different treatments to achieve abstinence.

Evidently, the single most important factor in any program’s ability to achieve it’s desired outcome remains with it’s rate of retention, though the appropriate duration will once again depend entirely on the individual and their unique problem. "Research indicates that for most patients, the threshold of significant improvement is reached at about 3 months… after this threshold is reached, additional treatment can produce further progress toward recovery". Because people often leave treatment prematurely, programs should include safeguards and strategies to engage and keep patients in programs. Furthermore motivation must be made available by the drug users from both family and friends – either that or from the criminal justice system, child protection services, and even employers.

Injecting rooms are a completely separate issue within themselves and shall not be reviewed with any depth herein, as it would required an entire discussion paper alone to cover this issue with any accuracy and usefulness.

The Royal Commission in New South Wales had made recommendations for the provision of such places, based on the view that such facilities are of major importance. How this decision was made is unknown, but let us hope that it had nothing to do with the faulty results published from the Swedish tests of 1965 through to 1967.

These Swedish tests were labeled by some as a success story, yet the majority view is that they were a complete disaster. Of the 200 users involved, 156 received prescriptions from a single doctor who was so lax that people were virtually writing their own scripts. The experiment was sloppy, and it is doubtful that it has anything to offer current debates. In fact, in Sweden where once the possessions of small quantities of cannabis were met with a fine, they are now dealt with as a criminal offence. There is no longer a distinction between ‘soft’ and ‘hard’ drugs because even cannabis, a relaxant lower risks of dependence, but not a drug without risk, is given the same zero tolerance as harder drugs because it can harm the "psychosocial development of teenagers". If Australia wishes to take direction from the Swedes, then they should consider the reasons for the huge turn around from a lax society to that of a zero tolerance.

Initially the needle exchange program was introduced to slow the speed of the AIDS virus among intravenous drug users – an honourable quest within itself. Ironically, new evidence indicates that the program has actually been responsible for spreading other infections such as Hepatitis C through continued sharing. Other accusations have also emerged that highlight the rate of heroin deaths with Victoria to have increased in almost the exact proportion to the increase in needle and syringe distribution. But regardless of the coincidence, it is hard to put weight on such claims – the most probably explanation would be the increased potency of street drugs.

A study conducted in 1998 of Canada’s Vancouver needle hand out program noticed a rise from 2 to 23 percent in the level of HIV prevalence among addicts who used intravenous drugs. Even though Vancouver operates one of the largest needle exchange programs in North America, providing over 2 million needles a year, its level of needle sharing continuos to remain high. The study found that 40 percent of HIV positive addicts had lent a used syringe in the previous 6 months and 39 percent of HIV negative addicts had borrowed a used syringe during the same period.

In order to effectively combat illicit drug control, it is necessary to perceive the situation primarily as a health problem so that policy may be formulated on the weight of evidence rather than the opinions held by populist media. International results indicate that such strategies are cost effective particularly when compared to incarceration, which is often the alternative, costing society anywhere up to $23,406 per inmate (US figures). Treatment costs range from $1,800 (US) per client to approximately $6,800 (approximately $4,700 per methadone patient). In fact, not only do these treatments help curb the problem but decrease welfare use by 10.7 percent, whilst increasing employment by 18.7 percent after only one year.

For these reasons it is important that Australia begin to invest more funds into present medical treatment programs to make them more widely available, as well as contributing to new experimental programs that show promise. After all, "every additional dollar invested in substance abuse treatment saves taxpayers $7.46 in social costs" ($4.00 is the suggested amount from other conservative estimates). When savings relating to health care are included, total savings can exceed costs by a ratio of 12 to 1.

By now it is evident that law enforcement should not be the first line of defence against illicit drug control. But for any strategy to be effective, and develop new and innovative demand reduction controls, it requires time to bit, which can only be attained via law enforcement (in the role of supply reducer). "We have to deal with the now while we prepare for the future". For this reason, enforcement should primarily seek to stop as many traffickers and importers as possible before they have the chance to sell narcotics to users or introduce narcotics to potential users. Furthermore, they need to restrain and seize the financial and material resources of organised criminals in order to negate their financial backbone.

Enforcement is made up of many unique public departments, including the Australian Federal Police, Australian Customs Service, National Crime Authority (these three are the prime front line defences within Australia) and the countless number of courts, police, criminologists, administrators, and schemes such as ‘Crime Stoppers’. During 1996, the Australian Drug Strategy estimated that these services cost between $300 to $400 million per year to maintain. But enforcement does not just stop there. For many years now, Australia has actively participated in a multitude of international schemes such as Interpol (one of the world’s biggest enforcement organisations), the 1988 UN Convention, the Commission on Narcotic Drugs, the Dublin Group, an agent exchange program with the United State’s DEA, providing assistance to developing countries and crop substitution programs. Unfortunately, there appears to be a lack of coordination or critical evaluation regarding these overseas activities and their success. "There is particular concern that a number of these strategies are unsustainable and have no more than a marginal effect".

It is also estimated that over 80 percent of the heroin detected entering Australia originate from Southeast Asia, with Sydney being the major importation and distribution centre.

Law enforcement has to date been effective at capturing and controlling many different drug imports and distribution networks before they could ever have any effect on society. Through such schemes as the ACT’s ‘Crime Stoppers’ concept, which alone stopped the circulation of $7 million in drugs in 1998 via public information, Australia is now boasting it’s active war on illicit.

Some 236.5 kilograms of heroin were seized by Australian law enforcement agencies in 1996-97. Significant seizures included a 23.6kg haul of heroin confiscated at Melbourne airport by customs concealed within wall hangings sent from Bangkok, "while 78kgs of heroin was discovered in a joint operation by the Australian Federal Police, New South Wales Drug Enforcement Agency and the Australia Customs Service. Although significant, these have been dwarfed by the seizure of… 400kg in October of 1998" off of Port Macquarie in New South Wales.

Despite the multitude of seizures, arrests, and the "considerable resources being spent on reducing the amount of illicit drugs coming into the country, illicit drugs are still readily available cheaper and pourer than ever". Even when major shipments are interrupted, little - if any difference is noted within drug using communities. A "continued 2,000 to 3,000 kilograms of heroin, with the street value of up to $3 billion", arrives every year, and can be attributed to suppliers producing enough illicit substances to furnish normal markets, and then a little more to cover anticipated government seizures.

Anti-enforcement advocates believe that police action within Australia is having no effect at all. By capturing and removing one supplier, room is made for another to take their place, particularly when we consider that the heroin trade is an extremely lucrative business, "offering 3000 times the farm gate price" at street level.

"Another fact that is creating an insurmountable obstacle for law enforcement is that unlike, say, robbery – drug dealing is a consensual crime; the purchaser of the substance wants a completed transaction just as much or more than the seller". This within itself creates an even greater mockery of the enforcement, because (in Victoria) police will only act on information about drug dealers and their activities if the information is provided by someone who has been a direct party of illicit material exchange – but realistically, parties to illegal activities rarely ever complain. Even if you know that your neighbor is selling vast quantities of narcotics to young children, your information will not be acted upon unless you have seen the activity-taking place right in front of your eyes. Even a yard full of ‘stoned’ individuals, or disregarded syringes lying scattered around will not be enough to promote police intervention.

Significant community concern has also been voiced regarding the effectiveness of Australia’s coastal surveillance. This concern was heightened "by the arrival on a Cairns suburban beach of a Chinese registered boat carrying 26 illegal immigrants. Coastwatch, the agency responsible for detecting unlawful arrivals, claimed not to have been aware of the boat until advised by a local newspaper agent". This matter does not relate to the illicit drug trade directly, but does build concern about how effective Australia’s coastal watch is at tracking possible drug importation activities. In defence, it can be said that a suffering in moral, faced by this agency and others like, based on cuts imposed in the 1996 budget and the lack of ability to control substances entering could be partially to blame (approximately no more than 20 percent (at best) of any imported drugs are interdicted, leaving 80 percent on the streets).

On the same level, the National Crime Authority (NCA), which acts as Australia’s specialist investigative agency, under section 30 of the National Crime Authority Act, is severely limited in it’s abilities to question suspects. Only in exceptional circumstances can the NCA compel a person to answer any questions that may incriminate them – directly or indirectly. In its present form, the provision hampers the ability of the organisation to combat organised crime, can be said to be out of date and limiting, unlike the powers given to the Australian Securities and Investment Commission or the New South Wales and Queensland Crime Commissions.

When the vast amounts of money involved in narcotics trafficking is considered, police corruption also becomes an issue, as with any other country. "For a police officer on a struggling wage, who sees that no matter how many he or she arrests and prosecutes for drug trafficking, the amount of drug supply and distribution does not diminish, the temptation must be extraordinary. It is not suggested that all police are corrupt but that prohibition has created a framework for police to be constantly faced with this dilemma and the police departments have no hope of controlling it when such quantities of funds are involved. It should also be considered that by sheer membership of our community, some officers are also drug users themselves.

Australia’s enforcement initiatives are many and varied, of which not all are based solely on native soil. In fact, the Australian Federal Police actively participate in intelligence gathering and distribution in order to determine trends and acquire information about importations by posting agents overseas – totaling 35 operatives within operatives in 16 different countries including the United States, Hong Kong, Singapore, and South America. Furthermore, it is through their continued efforts that law enforcement cooperation programs are emerging with other countries, particularly, and most importantly with the Asian/Pacific region.

During 1998 the Prime Minister of Australia announced funding directed toward supporting drug supply reduction initiatives including:

• $38.9 million to the Australian Federal police to establish seven mobile strike teams – in addition to the already existent three. These teams were to be deployed throughout Australia, assisting in targeting and proactively investigating major drug syndicates operations.
• Australia’s coastal surveillance and detection capacity in the Torres Strait to be enhanced by funding of $6.7 million over 3 years which will increase night surveillance, helicopter flying hours and marine surveillance.
• A further $3.9 million over 3 years to a National Heroin Signature program designed to identify trafficking patterns, improve research into drug crime links and increase funding for informant handling and witness protection.
• $7.3 million spent to improve information technology capabilities and communication. This was intended to provide secure, high volume IT networks for the flow of intelligence and operational information between relevant Commonwealth law enforcement agencies.
• $1.5 million to the Australian Financial Transaction Reports and Analysis Centre which monitors suspicious financial transactions.
• $1.5 to recruit additional intelligence analysts to work with Customs.
• $7.5 over 3 years on additional cargo examination capacity, supported by an electronic cargo profiling system (During 1997, 3 in every 10,000 cargo containers entering Australia are inspected).

During 1999, the federal government, under its ‘Tough on Drugs’ national illicit drugs strategy, established the Australian National Council on Drugs to provide high level advice, in dealing with both illicit and licit drugs. The council provides individuals and organisations with an ongoing opportunity to contribute to the development of policies and programs that address drug-related harm. This extends from the community groups that support the drug users and their families to those involved in the dismantling of organised crime involved in trafficking. Most importantly, it includes those community groups, which traditionally have close links with youth. These groups are most important in focusing on the prevention and reduction of illicit drugs in their own communities. Police must work closely with these groups and strive to increase their understanding of, interaction with, prevention strategies and people involved in their delivery.

Research has further shown that by combining criminal justice sanctions with drug treatment programs – such as the introduction of drug courts and prison treatment schemes, drug use and related crime can be greatly reduced.

Drug Courts

During 1998, the New South Wales government announced it’s intent to develop and trial one of the first ‘drug courts’ within this country – at a cost of $5 million. Several hundred of these courts have been tried within the United States since the late 1980s, and have become regarded as a successful innovation. The NSW version of the court intended to sentence those who decreed themselves guilty of heroin use and who were willing to participate to a 12-month rehabilitation sentence instead of prison. These individuals were required to undergo regular urine tests as insurance of their ceased activities. Failure to comply would result in sanctions such as imprisonment.

Those eligible to appear before such courts will be facing charges which include non-violent theft, possession, fraud or forgery, unarmed robbery (providing there is no physical harm involved), or even dealing in quantities of drugs below the indictable amount (Though this last case is questionable, because if someone is dealing drugs without an addiction of their own, then they should be treated in the same manner as someone selling illegal goods, not a drug user.). Cases involving injury or sexual offences will be excluded.

Research conducted within Arizona’s Supreme Court system noted that with the increased use of drug courts, tax payers saved a total of $2.6 million in one year alone, whilst 77.5 percent of those within assigned treatment tested negative after the program. These results indicated that drug courts are in fact a brilliant method of providing safer communities and assisting substance abusers in recovery, a scheme 10 times more cost effective than prison.

Prison based treatment can occur in both new specialist prisons or wings within old prisons that have been set up to provide such services.

The objectives of prison treatment is to recognise the nature of drug use within prisons, and by doing so, develop approaches to motivate, treat (rehabilitate) prisoners who were either using drugs prior to incarceration, or those who simply commence using whilst in prison, as a means of reducing their sentence. "Offenders with drug disorders may encounter a number of treatment options while incarcerated, including… drug education classes, self-help programs, and treatment based on therapeutic community or residential… therapy models. The TC model has been studied extensively and can be quite effective in reducing drug use and recidivism".

According to the National Centre on Addiction and Substance Abuse (U.S.), the cost of providing treatment for inmates, accompanied by education, job training and health care, averages about $6,500 per inmate. For each of these inmates who becomes a law-abiding citizen, the economic benefit is $68,800. Even if only 1 in 10 inmates becomes a law-abiding citizen after this investment, there would still be a net social gain of $3,800.

To achieve positive results, "those in treatment should be segregated from the general prison population so that the ‘prison culture’ (Appendix 4) does not overwhelm progress toward recovery. As might be expected, treatment gains can be lost if inmates are returned to the general prison population after treatment, as prisons have become major distribution points for drugs. Research shows that relapse to drug use and recidivism to crime are significantly lower if the drug offender continues treatment after returning to the community".

Prisoners successfully completing such a program should be entitled to have this taken into account in seeking parole. Prisoners, as a condition of their parole, must also keep to a program for a defined period of time upon leaving prison. Through parole and early release rewards, drug prisons provide an incentive for prisoners to address their chemical dependency. A recent study found that 6 months after release, the treated population was 73 percent less likely to be re-arrested and 44 percent less likely to use drugs than the comparison group .

One factor concerning both drug courts and prisons alike is the notion that treatment does not need to be voluntary to be effective. It is said that that sanctions or enticements in the family, employment setting, or criminal justice setting can significantly increase treatment entry, retention rates, and the success of drug treatment interventions. Unfortunately, this notion is incorrect for the most part. Criminal sanctions may be able to force someone to enter treatment, but as with leading the horse to water, you can not force success on them if they do not want it. As soon as treatment is completed, the chances are that they will head right back to their drug use. In support of this argument, forced drug treatment for adult drug abusers in the 1980s (U.S.) showed that the treatment never had any positive effect on drug users. This is not to say that such treatments are worthless, on the contrary, in fact they are very effective, particularly when we consider that 80 percent of prison populations are there for drug related offences – but only for those who submit themselves to such therapies under no compulsion other than their own.

Enforcement has been described at times as somewhat ineffective, like a dog chasing it’s own tail. However, this does not mean that we should ever just give up, in fact no country is willing to abandon it. "Part of the reason is clearly ‘politic real’, which nationally and internationally reflects an opposition to illicit drugs – a reasoning based upon a recognition that illicit drugs are harmful and their use should not be accepted or encouraged by governments".

When contemplating enforcement’s usefulness, we must have a realistic approach about what exactly it can and can not achieve. At best it will curb the market reducing the flow of illicit drugs, increasing cost and decreasing availability. By curbing markets and supply it is possible to restrict usage and even compel users to seek treatment. Another reason includes the level of fear it produces in some individuals (the concept of being caught and punished by peers), and can serve to curtail the number of recruits to the ranks of dependent users. But above all else, policing becomes evidently more effective when combined with education and health care. But to achieve such ends, several changes are required, particularly the allocation of resources to:

• Provide additional cargo searches - particularly at known entry points.
• The AFP and Customs in order to expand their monitoring and predicting power, whilst allowing them develop and expand in order to equal criminal trends.
• Developing comprehensive intelligence gathering to better identify key ports and communities targeted by drug traffickers.
• New developing schemes, such as that of the ‘Ecom Analyser’ being trailed by Western Australian Police to detect the presence of heroin, cannabis, cocaine and amphetamines in drivers.

Re-enacting legislation would also be appropriate, in order to equip police officers with the wider powers they require achieving their goals.

In essence, a coordinated multi-agency and multi-strategy approach is urgently required to engage the national and transnational criminals who traffic in illicit narcotics. No single area, be it education, rehabilitation, or enforcement can fully succeed if not combined.

Resilience and persistence is an integral part of all aspects of strategic drug control, but some failure is imminent and should be expected so that it is not looked down upon.

Rehabilitating and even removing the temptation for drug users requires the establishment of safety and trust protocols through caring relationships that are grounded in listening and conveying compassion, understanding, respect and interest. Family structures require high levels of communication, provision for firm guidance, structure and challenge as well as conveying a belief in the youth’s innate resilience by focusing on strengths and assets, as opposed to problems and deficits, thus providing ‘resistance’ skills to help young people refuse drug offers.

Abstinence further requires continued supervision and the creation of opportunities, providing meaningful participation in and contribution to the community.

Greater focus and policies need to be applied to such factors as:

• Parental drug and alcohol abuse, as well as physical, sexual, or psychological abuse,
• Dropping out of school,
• Teen pregnancy,
• Economic disadvantage, neighborhood crime and violence,
• Preadolescent and adolescent gang activity,
• Involvement in violence or delinquency,
• Suicide attempts or other mental health problems,
• Placement in institutions, foster care, or runaway or homeless shelters

Schools need take a more proactive approach to educating children at a much earlier age, removing the current void of suitable education, and thus preparing young people for living in a drug using society. Education must aim to ensure that people understand the nature drugs, their likely effects, their unpredictability, how drugs effect individuals and society, the potential of two or more drugs taken together, and the implications of diseases. Above all else, it should be made extensively clear that absolutely no drug is safe, and all carry their own special side effects

Media activity has the ability to greatly reduce drug use, and should be held liable for what it does and does not depict as suitable activities.

Government funding, as well as legislation must be enhanced to offer enforcement officials the required help they need to improve their efforts. Furthermore, this funding should be extended to newly developing ideas and programs that have promise in dealing with the issues at hand.

extracted from ARF Public Information Materials

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