Pharmacists could have a greater role in harm minimisation under the recommendations of a new report

The Australia 21 report, Can Australia respond to drugs more effectively and safely, has recommended moving psychoactive drugs from the black market to the “white” market, amid a suite of harm minimisation policies.

The report makes 13 recommendations for illicit drug reform, including making harm minimisation the overriding objective of Australia’s national policy on drugs.

Drug-related deaths, diseases, injuries, crimes and social costs continue to rise despite more than 80,000 consumer arrests in Australia each year, the report says.

Launched by Jeff Kennett, founder of BeyondBlue and former Liberal Premier of Victoria, and Bob Carr, former Labor Minister for Foreign Affairs and former Premier of NSW, the report tables solutions backed by the very people who were enforcing drug laws until recently.

It comes out of an unprecedented Roundtable convened by Mick Palmer, who has served as Commissioner of both the Australian Federal Police and Northern Territory Police.

“What we now have is badly broken, ineffective and even counterproductive to the harm minimisation aims of Australia’s national illicit drugs policy,” said Mr Palmer.

“We must be courageous enough to consider a new and different approach.”

The recommendations are aimed at:

  • minimising harms for drug users and those around them;
  • reducing the use of untested, unregulated drugs in unsafe environments;
  • providing health and social programs to reduce drug-related problems;
  • reducing and even eliminating criminal control of the drug market;
  • reducing the prison population and its associated progress to hard drug use; and
  • supporting police and the judicial system to focus law enforcement more usefully.

One recommendation is that “the policy should include substantially reducing, if not eliminating, the size of the criminal marketplace by incrementally moving psychoactive drugs from the black market to the ‘white’ market.

“This should be accomplished by regulating and, where possible, taxing the supply of currently illicit drugs, with the regulation of supply being gradually phased in and assessed on an ongoing step-by-step basis, starting with drugs which are known to do least harm and are least contentious.

“Ongoing assessment and review will determine the desirability and extent of regulation and whether regulation should eventually be extended to all psychoactive drugs.

“Advertising of any legalised and regulated drugs should not be permitted. Some drugs will require stringent controls, such as prescription by a doctor.”

Pill testing, which has recently been discussed in AJP, is another of the recommendations.

Liam Murphy, founder of the Roaming Pharmacist, told the AJP that this recommendation alone would go a long way to reducing harm done by illicit drugs, and that pharmacists can have a significant role to play at the forefront of such policy.

“If you look at the national drug strategy, the three arms of reducing harms are supply reduction – the work the police are doing; demand reduction, which is about education and encouraging people to say no; and then there’s harm minimisation, which is everything else,” he said.

“But the balance seems to be a bit out of skew, and focused heavily towards supply reduction. With harm reduction, there’s an opening for greater intervention by health professionals, rather than police officers.

“Pill testing makes sense as the next step forward to provide an intervention strategy to address a lot of the harms associated with drug use, and open up the conversation between users and health professionals.”

The erosion of social stigma for drug use is also key in helping people make better decisions about their drug use and wider health, Mr Murphy says.

“There’s such an opportunity for intervention on many fronts, and pharmacists are quite capable of having very open conversations with drug users. Something we’ve seen from preliminary data collected in the Snowy Mountains is that the majority of users of illicit substances are refraining from talking to a health professional about it.

“So by doing something like pill testing, you’re breaking down barriers, you’re making it easier to communicate and you’re paving the way for a lot of opportunistic health care, especially in spaces like mental health and addiction.”

Recommendations also include the expansion of drug treatment and associated social services, especially in rural areas.

Opium Substitution Treatment (including methadone and buprenorphine) should be available for all prisoners, the report says; high co-payments are also a significant price barrier.

The report has been welcomed by stakeholders including leader of the Australian Sex Party and Victorian MP Fiona Patten.

“Every time I have put forward a policy, I am met with the line ‘what would police say?’” Ms Patten said.

“Well here is what the police, prosecutors and judges say: treat drug use as a medical issue, not a criminal one.

“Criminals and politicians are the only people benefiting from current drug policy.”