In October, the ACT announced it had passed legislation decriminalizing possession of illegal drugs. It is the first jurisdiction in Australia to do so.
“The ACT has led the nation with a progressive approach to reducing the harm caused by illegal drugs with a focus on distraction, access to treatment and rehabilitation, and reducing the stigma associated with drug use,” said Secretary of Health Rachel Stephen. -Smith.
Under the changes, which take effect in October 2023, possession of “small amounts” of drugs such as heroin, MDMA or cocaine will be treated in the ACT as a health issue rather than a criminal case, and will result in a warning, a fine or a health intervention.
“This sensible reform is based on expert advice that a health-focused, harm-reduction approach produces the best outcome for people who use drugs,” said Stephen-Smith.
Drug-related arrests have skyrocketed in recent years. Figures from the Australian Institute of Health and Welfare showed there was a record 166,321 drug-related arrests nationwide in 2019-2020. This represented a 96 percent increase over the past decade.
But at the same time, Australia has seen a significant increase in the number of fatal drug overdoses. Earlier this year, the Penington Institute, the non-profit drug and alcohol research center, said the number of deaths in 2020 could exceed 2,440 once all data is collected.
In 2014 there were 2,043.
Data from the institute also showed that 2020 was the tenth year in a row where there were more than 2,000 fatal overdoses in Australia.
So while proponents say decriminalization will reduce harm to drug users, can it help reduce fatal overdoses? And is decriminalization indeed the best outcome for drug users?
How will decriminalization help?
In August, Professor Mark Stoové of Victoria’s Burnet Institute said drug law reform, including decriminalisation, would help reduce fatal overdoses.
In a statement, he said: “The criminalization of drug use is driving and perpetuating the overdose crisis through stigma and fear. There is evidence that people who avoid criminal records have better social, educational and employment outcomes. People who fear arrest, incarceration, stigmatization and discrimination are also less likely to access health and harm reduction services.”
Other proponents agree, saying decriminalization will remove barriers for those who need help with drug-related health problems.
“The new laws will make a huge difference to people who use drugs in the ACT. It means people who use drugs casually will not face a criminal conviction,” said Emma Maiden, general manager of Advocacy and External Relations at Uniting. ABC told RN Breakfast.
“But hopefully it also means that people who use drugs and may have more of a problem with drug addiction are less isolated, have less stigma and are more likely to seek help and support.”
The criminalization of drug use, Maiden said, causes unintended harm to affected drug users and limits their ability to live normal lives.
“It can affect their ability to find work to rent a property, and so it affects their life aspirations,” she said.
She added that this impact is worse for those who depend on drugs.
“So for those people, the fact that it’s criminal really isolates them. It means they don’t have conversations with doctors, with their loved ones, with the people who are in their lives about their drug use.”
This isolation can also be a factor in drug-related deaths. Research has suggested that the stigma associated with drug use may increase the risk of overdose. A 2016 study found that one of the barriers to opioid overdose prevention programs was the stigma attached to drug use.
Maiden said so it took about “19 years” for someone using drugs to seek help.
“So what we’re seeing abroad and other jurisdictions is [when we] remove the criminal penalty, we create more connections and we make it more likely that people will seek help.”
‘Not a silver bullet’
However, not everyone agrees that there is a link between decriminalization and a reduction in fatal overdoses.
Dr. John Ryan, the CEO of the Penington Institute, is one of them. He said there is no one cure.
“From the perspective of the Penington Institute, there is no silver bullet for the overdose problem. That is why we want to develop a national overdose prevention strategy… [together]” he said.
“One is to improve the community’s understanding and education about overdose, the signs of overdose and how to respond in an emergency,” he added.
He pointed to other measures such as increased access to naloxone, a drug that reverses opioid overdoses, and the introduction of “safe supply,” a harm reduction initiative that has gained momentum in places like Canada.
In recent years, academics have indicated that a safer supply of opioids could address the number of fatal overdoses in North America.
Dr. Ryan attributed the increase in overdoses in Australia to a lack of action on this issue.
“I think the biggest factor is that we don’t pay enough attention to it,” he explained.
“Basically, if you don’t really address the problem, it will only get worse. And I think what we’re seeing is a failure to actually address the underlying issues related to overdose and that’s why the toll continues.” to get up.”
Other academics also question whether decriminalization would reduce fatal overdoses.
“I don’t think we have enough evidence to say how good [decriminalisation] is, apart from the large naturalistic studies conducted in countries that have been decriminalized [drugs] like Portugal,” said Dr. Jonathan Brett, a specialist in clinical pharmacology, toxicology and addiction medicine at St. Vincent’s Hospital in Sydney.
Portugal introduced decriminalization in 2001 and reportedly saw the number of fatal overdoses drop from 369 in 1999 to 27 in 2016.
Like Dr. Ryan, Dr. Brett pointed to a more action-based approach as a means of reducing fatal overdoses, including a greater focus on naloxone availability and consideration of polydrug use or the use of more than one substance.
He added that the most effective measure to reduce overdoses would be to better understand the reasons why people use drugs.
Research has pointed to a link between the environment and drug use, as well as drug-related harm.
For example, University of Chicago economist Casey Mulligan published a working paper in December 2020 suggesting that the isolation of the pandemic may have led to an increase in fatal overdoses. This echoed a similar claim from the US Center for Disease Control that same month.
And in 2018, The Lancet published a study showing that those who left prison with mental illness and a substance use disorder were four times more likely to be harmed than those without neither.
“So I think tackling those big things is the elephant in the room, but [that’s] not necessarily low-hanging fruit,” Dr. Brett said.
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