NSW Drug Summit post mortem

The NSW Drug Summit was called when, in the lead up to the NSW election, a front page Sunday tabloid carried a photograph of a young user shooting up in the inner city suburb of Redfern. Quite correctly the Government judged that a drugs debate prior to an election would be a disaster and committed to holding a drug summit in the first two weeks of the new Parliament.

Australia has a proud record of minimising HIV spread among injecting drug users. Because of the early and well-resourced implementation of needle and syringe programs in Australia we have very low prevalence rates of HIV among our injecting drug user population (about 2-3%). Clean needle services and methadone programs have, however, come under increasing attack at a local level.

Given this background and that Premier Bob Carr had been well known for his strong personal stand against drugs, many who have worked for years for a harm minimisation approach to illicit drug use were very concerned that current programs would be at risk in a populist process.

Following discussions with a number of contacts across health and law reform organisations we invited a range of individuals from a number of organisations likely to share at least a core of these concerns to an initial meeting. This diverse group, which eventually became known as the Communities for Constructive Drug Action, included the AIDS Council of NSW, Parents and Citizens Association of NSW, the NSW Users and AIDS Association, Family Drug Support, Family Support Services Association, We Help Ourselves (a treatment program), a senior clinician from St Vincent’s Hospital, the Hepatitis C Council, the Royal Australasian College of Physicians, the NSW Law Society, Doctor’s Reform Society, and a number of prisons rights groups.

The aim of this group was to engage with the Drug Summit process in the most effective way we could. By working together for a common set of agreed principles we might not push as hard for all of our own individual organisation’s views but would have the most impact for those we share. We also made the decision as a coalition to push for a real program from the Summit, engaging openly with other points of view rather than becoming defensive.

A briefing paper was prepared and distributed before the summit to media and all the delegates. It proposed a program based on the goals of reducing death, disease, crime, corruption and discrimination resulting from illicit drug use. We proposed objectives of reducing drug related deaths by 50% in 5 years and a reduction of imprisonment resulting from illicit drug use.

The program we proposed included concerted action in the areas of:

• harm reduction;
• treatment services;
• law reform; and
• policy, research and consultation

Arriving at the Summit it became clear both that it was incredibly important to have organised ourselves as we did but also that the challenge would be huge for both community delegates and parliamentarians alike. Squashed into the confines of the Legislative Council chamber and into an equally tight agenda were all members of both Houses of Parliament and 70 community and ‘expert’ delegates, all eyeing each other somewhat warily.

The set pieces on the first day indicated an encouraging open mindedness on the part of the Premier, whose interventions throughout the week were genuine in their leadership and thoughtfulness, and the Leader of the Opposition who strongly maintained an open vote for her party members. The Leader of the National Party and a queue of individual MPs, however, rose to declare their lack of openness to change.

It was a busy and at times emotional and frightening week. Debate and opinion seemed to swing from one side to the other as speaker after speaker put their point of view. Conservative opponents of drug reform, such as Normie Rowe and Fred Nile, stood up time and time again saying the "War on Drugs" must continue and the approval of such initiatives as safe injecting rooms would ‘send the wrong message’ to young people and was condoning the use of illicit drugs. These delegates argued that abstinence was the only acceptable outcome for drug users and elimination of drugs from our society should be the stated goal of the Summit.

However the overwhelming evidence of experts, field workers and drug users themselves slowly began to influence even the most hardened thinkers. Contrary to the fears many of us held going into the Summit we actually started to see views change, some of ours included.

Committed proponents of harm minimisation and of abstinence programs conceded to each other that we agreed about the overwhelming number of issues before us and that in our everyday work we engaged in more common strategies than we were admitting to in the heat of debate.

There were key moments in the debate. When Annie Maddern, co-ordinator of the NSW Users and AIDS Association, spoke on the second day she confronted the Summit with the humanity of her constituency. In HIV we have known and have mostly won the argument in public that discrimination is a killer. We have achieved high levels of government support for programs and strategies which speak to gay men in their own language and images because to do otherwise, to moralise and discriminate, will not be effective in changing risk behaviours.

Annie put it squarely before delegates. A war on drugs is actually a war on drug users. It is not fair to insist that users stop using when for two thirds of people who want access there simply is no program. Discrimination against users directly leads to self destructive secrecy and to people not seeking help. To say that abstinence is the only acceptable outcome is to devalue the lives of users and to ignore the importance of their health, now or when they are ready to get off.

She urged us to focus on the goals of, "stabilising health, getting a job, entering education, reducing or stopping criminal activity, increasing your personal ability to have open and meaningful relationships with families, friends and partners and a general improvement in the quality of life."

Other influential speakers included an ambulance driver who graphically outlined the dangers he faced at work as he tried to revive overdose victims in back lanes and abandoned buildings. Also Dr Ingrid van Beek, Director of the Kirkton Road Centre in Kings Cross, who throughout the summit calmly and intelligently presented facts and research to support her case for a combination of primary care services for users (including supervised injecting facilities), responsible community policing and local community drug action teams to bring together on one side all the players who so often get lost in conflict.

On Wednesday delegates went off for a half day of site visits, again a process which many of us had been very cynical about. The impact of these was again to break down people’s fixed positions.

On Thursday John Ryan MP, a conservative Liberal member of parliament rose to give his set piece. He started, "This is the speech I came here to give (putting it to one side.) This is the speech I am giving because I have learned." He continued to oppose the repeal of the offence of self administration, despite our arguments that this little used law in fact inhibits users accessing needle and syringe programs and leads directly to unsafe disposal of used equipment. But then he went on to declare that he could not, as a committed Christian, maintain his opposition to programs aimed at saving lives and showing compassion, such as properly supervised injecting facilities.

The crunch time of the week was Thursday night when the working groups put their draft resolutions to the floor for debate and then to a ‘conscience’ vote where politicians were not bound by party policy. From this process a communiqué would be drafted to be put to a final vote that encompassed all the resolutions of the working group and would influence the future of drug policy in this State.

It became clear at this time that the Summit would vote with cross party support for a comprehensive approach encompassing harm minimisation principles and programs and a much needed boost to treatment services, as well as a balanced approach to law reform, policing strategies and prevention education.

As we had expected there was almost unanimous support for improving the variety and number of treatment services and programs and community and education programs also received overwhelming support.

The very contentious and hotly debated issue of introducing injecting rooms was overwhelmingly passed with the qualifications that they be supervised by health personnel and only established in areas with community support.

The possession of small amounts of marijuana and other drugs for personal use was to be decriminalised and self administration and paraphernalia offences repealed.

A recommendation that heroin trials be established was lost by twelve votes. An amazing result considering the passionate and emotive debate that had focussed on heroin trials.

Where to now?

The Premier, Bob Carr, has set up a Cabinet committee to determine the Government’s response to the Summits recommendations. The government will release a detailed action plan setting out the Government’s intentions in the next fortnight.

The Communities for Constructive Drug Action continues to meet and continues to respond to ensure we maintain the momentum set by the drug summit.

A major challenge is responding to the conservative lobbies who are now mobilising against the outcome, despite the degree of cross party support achieved. Conservative mayors, disappointingly supported by the Federal Government, and some of the fairly isolated but vocal parents groups have been active.

We have harnessed the knowledge and talents of a very broad range of people who are willingly to speak publicly or work actively towards not just maintaining but improving harm minimisation programs. As a group we have broadened our perspectives. The alliance achieved between harm minimisers and treatment people has been a particularly significant outcome.

A process about which all sides were cynical, against which both liberals and conservatives made the charge of preset agendas and stacked invite lists, has turned out to have produced remarkable moments of insight and understanding. Our priority has to be to maintain the gains.

First among these for us: the assertion of the humanity of users and the role that ending discrimination against them must play in effective policy.