Drug Summit was triggered by the publication of a photograph in a Sydney tabloid
newspaper of a twelve year old boy injecting heroin with equipment obtained from a needle
syringe program. This provoked a furious debate about illicit drug policy. With only two
months to a state election, the NSW Minister for Health acted swiftly, but perhaps
unwisely. The needle syringe programme responsible was promptly suspended. Then it became
known that the supposedly under age boy was really sixteen years old. It also later
transpired that the needle syringe programme had fully complied with departmental policy.
Some weeks later, Premier Carr announced publicly that, if his government was returned at
the forthcoming elections, a drug summit would be held after the polls. This has had the
effect, some might even say intended effect, of dampening down a frenetic public debate.
At the elections, Labor was returned with an
enlarged majority. A Drug Summit was duly announced. As news filtered out about the
arrangements, many reform minded commentators argued that the list of invited participants
was unbalanced. The ‘family’ contingent at that stage consisted only of zero
The NSW Drug Summit proved far more successful than
most expected. The meticulous arrangements were completed within a few weeks and
demonstrated the often derided public service at its very best. The Summit occupied a full
week (May 17-21). It took place in the oldest parliament in Australia, involving all
members of the new Parliament and another 70 invited delegates. On four days, there were
plenary presentations in the morning with working groups in the afternoon and early
evening. On the third day of the Summit, all delegates had an opportunity to visit drug
treatment centres. The key recommendations were debated on the afternoon and evening of
the fourth day. The Summit was remarkable in many respects.
Inevitably, the few controversial recommendations
were well reported. But many universally supported (but barely reported) recommendations
will have far greater impact. Many politicians were shocked by what they saw in the drug
treatment centres and subsequently referred to the "one third-two thirds" rule.
This meant that at most drug treatment services, only one third of people seeking help can
be accepted while two thirds are turned away because of lack of resources. Consequently,
greatly increased funding for drug treatment attracted unanimous support. Even more
remarkable, there was strong support for improving drug treatment in prison. Many of the
clinicians who have been around for a few years have heard such honeyed phrases many times
before. This time the commitment is real and has strong bipartisan support. I well recall
a (former) Commonwealth Minister for Health telling me that "there are few votes in
junkies and even fewer in prisoners". The case for increasing funding for drug
treatment in the community and prisons is now so overwhelming, even on fiscal and crime
control grounds - let alone public health - that there may even be some votes in funding
for drug treatment in the community and prisons in the not too distant future.
Shylock argues in the Merchant of Venice ‘when
you prick me do I not bleed?’ Another major outcome of the Summit was the astonishing
discovery that drug users are, after all, also human beings. The need for a more
compassionate approach to drug users was widely endorsed, although only grudgingly by
Another major area to benefit was prevention.
Delegates heard a fascinating presentation by Professor Vimpani
regarding the effectiveness of early interventions for troubled families. The case for
taking prevention seriously has never been more cogently argued. Likewise, a more
comprehensive approach to rehabilitation was strongly endorsed. There is, of course, more
to drug treatment then drug treatment. But it needs money.
The almost 180 recommendations will now be
considered by Cabinet. The fat lady will then sing in about 5 weeks. Although some of the
more controversial recommendations may still be rejected by Cabinet, it seems likely that
most will be accepted. Some zero tolerance supporters were quick to decry the
recommendations as covert legalisation. Yet many of the boldest recommendations have long
been accepted elsewhere in Australia. The argument that the whole Summit was rigged for
reform might have had more credence if zero tolerance supporters had raised this
possibility before the recommendations they so bitterly opposed were accepted by a
majority of delegates. Significantly, a recommendation to support a NSW heroin trial was
It is hard not to comment on the very different
performance of the Government and the Opposition. There was also a striking difference in
the performance of supporters of evidence based change compared to those advocating
retention of a morality based approach. The Premier’s few interventions were striking
and stylish. He began well by opening the Summit with a plea for open minds. Although the
Leader of the Opposition responded well, the Leader of the National Party proudly
announced that members of his party were not going to change their opinions just because
of evidence presented at the Summit The Government came across as disciplined and
strategic. The Opposition case was often argued by an irascible and poorly informed
National Party backbencher who would be a liability to any side of a debate. Many
clinicians were heartened by the Opposition support for greater funding increases for
treatment services than the Government was prepared to provide.
Was the whole event a carefully contrived set up as
some claim? Or was the outcome largely a reflection of the far stronger case made for
modest change? It may well be the case that polling available to the NSW Government before
the election demonstrated strong public support for change. Announcing before the election
a Summit to be convened following the election calmed the debate before the election and
certainly gave the Premier an opportunity to demonstrate leadership by publicly changing
position after hearing fresh evidence. But if this interpretation is to be taken
seriously, it raises the question ‘Why did the Opposition not also change their
position?’ Is it conceivable that the NSW Opposition is too broke to afford opinion
polls, too divided following their heavy loss to agree on change, or their leadership too
dependent on Prime Ministerial support for survival.
The establishment of a Tolerance Room at the Wayside
Chapel before the Drug Summit altered the deliberations in a critical but hitherto
unreported way. When leaders of the gay community saw public health advocates fighting all
too familiar battles over discrimination and HIV control, they generously provided to drug
users and their supporters consummate strategic skills, discipline and a sense of focus.
If this new coalition is sustained, the future of advocacy involving drug use and public
health in Australia will be changed forever.
Perhaps the most interesting and fruitful
development of the Summit was the process itself. The combination of all involved parties
- parliamentarians, drug users, families of drug users, lawyers, police, clinicians,
researchers and government officials - talking to each other directly rather than through
the media was time consuming and costly. But in the long run this process will be seen as
an efficient and effective way of achieving progress with some of our most difficult to
resolve social policy issues.
There can be no doubt that in some sense, the Drug
Summit marks a watershed. NSW has now joined the conservative jurisdictions of Victoria
and the ACT in recognising that illicit drugs is first and foremost a health and social
issue. Tasmania and South Australia seem to be heading in the same direction. The split,
it should be remembered is within and not between the political parties. An increasing
number now want to be part of the steam roller although some still obstinately want to be
part of the road.
The five day Drug Summit may well in fact last 15
years. We will only know in five years if it has been successful. And then only if drug
use, deaths, disease, crime and corruption have dropped.