Tuesday, February 23, 2010

Law Commission on Drugs Part 3 - Drug Policy

Chapter 3 - An introduction to the current drug policy of harm minimisation, pages 37 - 43 of the Law Commission's Controlling and Regulating Drugs Discussion Paper

The Law Commission's goal in the discussion paper is to support and improve the effectiveness and efficiency of the government's drug policy (3.1). The drug policy is contained in the National Drug Policy 2007 -2012 (3.2). This is the second edition of the NDP. The first was introduced in 1998 by the National led coalition government. The idea behind the NDP was to coordinate local, central and non-government agencies involved in alcohol and drug treatment.

The NDP recognises that drug use is primarily a health issue, and the health-based response is summed up in the principle of harm minimisation (3.3):
The overarching goal of the National Drug Policy is to prevent and reduce the health, social, and economic harms that are linked to tobacco, alcohol, illegal and other drug use.

Let's just step back for a moment. The National Drug Policy was introduced by the Associate Minister of Health at the time, the National government's Roger Sowry. The second iteration was presented by then Associate Minister of Health, Jim Anderton under a Labour government. The third version is due in time for 2013. The future is unwritten.

Back to it. What does harm minimisation mean anyway? Here's 3.4:
Harm minimisation is an approach that is designed to limit the overall harms that result from the consumption of drugs. Strategies that are designed to reduce or eliminate consumption, to provide treatment to users, or to make the conditions under which drugs are consumed safer are therefore a means to an end rather than ends in themselves. The ultimate question to be asked in respect of any drug policy measure is whether it is a cost effective means of minimising harm, however defined.
Manage consumption, treat and care. Yep, that sounds like the Health sector to me. No wonder this namby pamby welfare of drug users is sometimes mistaken for liberal, pro-legalisation agitprop (3.5). Indeed, this ideological battle isn't confined to NZ shores, but is happening around the world.

There's three pillars ( I call 'em prongs) to harm minimisation (3.6), demand reduction, supply control and problem limitation. These will be explained soon. It's a shame that the ideology trumps the reality (3.7). The NDP attempts to side-step the prohibition argument, focusing instead on effective strategies:
[T]he harm that is eliminated by any strategy needs to be greater than the harm that it imposes.

This is tricky because, as mentioned earlier, harms are bloody difficult to quantify (3.8). The Law Commission is open to better ideas. Lacking alternatives, hey, it's not that bad either (3.10).

In describing the three prongs in more depth, the Law Commission introduces the United Nations Office on Drugs and Crime (UNODC) (3.11). I'm already getting a headache in advance thinking about writing up Chapter 6 of the report, which covers NZ's international obligations. My opinion of the UNODC is not high, seeing it has historically been an opaque, top-down, banana republic unto itself.

That said, perhaps things have changed. From 3.12:
The Executive Director of UNODC, Antonio Maria Costa, has suggested that there has been an imbalance in both resourcing and policy priorities between supply control measures and measures aimed at reducing demand and treating drug dependency and addiction.
OK, on to the three prongs (3.13):
supply control – measures that control or limit the availability of drugs;
demand reduction – measures that seek to limit the use of drugs by individuals, including abstinence; and
problem limitation – measures that reduce the harm that arises from existing drug use.

The first is Supply Control (3.15), and will already be familiar to anyone. It is regulation taken to the nth degree. Supply control means Cops, Customs, Courts and Prisons. Between 2000 and 2006, Police and Customs seized 453,746 kilograms of cannabis, 408 kilograms of stimulants, and under 14.5 kilograms of heroin (3.16).

The quality of these drug hauls is not mentioned, but I doubt that it was all primo and uncut. And by some police and customs estimates, seizure rates count for around one tenth of actual consumption. No-one really knows for sure. But by that reckoning, NZ went through 45 tonnes of cannabis in six years!

At least, that's illegal drug supply control. Legal drugs have more nuanced regulation. Doctor prescriptions is a form of supply control too, as is licensed premises for alcohol, or age limits on buying tobacco.

Demand Reduction focuses on "reducing an individual's desire to use drugs" (3.18). Prohibition is a demand reduction strategy in two ways. It shapes social attitudes and culture, as well as deterring people from using drugs (3.19). Drug and lifestyle programs also contribute. Think FADE's giraffe or Nancy Reagan's Just Say No! campaign. There's also other, less abstinence-only based programs, such as CAYAD (3.21).

The prong of problem limitation involves reducing the harms of existing drug use (3.22). It can include emergency services, drug treatment, ongoing social support and self-help programmes (3.24).

The NDP has this to say about the Harm Reduction prong (3.25):
Some problem limitation interventions do not seek to eliminate or reduce drug use in the short to medium term, but instead aim to reduce the related harm to the individual and community.

Some of these strategies have proven controversial, as they ignore completely the abstinence approach. The Needle Exchange Programme would be a good example. Methadone treatment is another (3.29). Some other countries provide supervised injecting clinics (3.30).

Another option is drug testing facilities, which will inform users what exactly they are taking (3.31). Such a measure can prevent fatal overdoses or poisoning from bad shit. Anecdotally, some overseas nightclubs perform this service as a matter of business.

Up Next: The history and development of drug regulation.