Making submissions to governmental and parliamentary inquiries is an important avenue through which to have one’s voice heard and to influence policy, whether as a researcher or a member of the public. This bulletin outlines insights and experiences from DPMP team members involved in making a submission to the ACT Legislative Assembly, Inquiry into the Drugs of Dependence (Personal Use) Amendment Bill 2021.
The bulletin aims to
Laws concerning the detection and sanctioning of drug driving are one of the newest and most contested additions to the drug policy landscape. A thorough understanding of the drug driving laws is important to inform policy debates. This bulletin outlines the drug driving laws as of January 2020 in Australia – the first country to introduce Roadside Drug Testing laws – focusing on three types of drug driving laws:
This bulletin provides an overview of the demographic profiles, patterns of festival attendance and drug use, policing experiences and help-seeking behaviours of 5155 Australian music festival attendees surveyed in late 2018. Specifically, it outlines:
Background and aims
Mandatory (or compulsory) treatment is a tool often reached for by governments during moments of alcohol and/or illicit drug crises. It has come to the fore as a potential policy panacea in recent times in response to ongoing concern about the rise of crystal methamphetamine (“ice”) use, regional concerns over alcohol abuse, and the desire to address alcohol and other drug (AOD) problems in young people.
However, in public debate there is a significant lack of clarity about what mandatory treatment is, who benefits from it and how it might be implemented. In addition, there is confusion about the existing evidence base and the extent to which mandatory treatment is an effective and cost-effective approach for people with AOD problems.
The aim of this bulletin is to:
Background and aims
There have been, and continue to be, many calls to reform the drug laws in Australia. Some of the reform proposals concern the legalisation of currently illicit drugs, and the establishment of a regulated market. Other calls are for the removal of criminal penalties for personal use and possession of drugs (without creating a legal regulated market). In the latter, supply of illicit drugs remains a criminal offence, but illicit drug use itself or possession of quantities of illicit drugs for personal use is no longer a criminal offence. These latter reform options are referred to as decriminalisation.
There are a number of different models of decriminalisation, and indeed, when there are calls for decriminalisation there might not be a shared understanding of what that means, and which model is under consideration.
The aim of this document is to provide a relatively simple summary of the various models for the decriminalisation of personal use/possession of illicit drugs. We take current Australian laws as our starting point, and describe four possible models with reference to Australia. Nonetheless, this work is also relevant for other countries.
Our hope is that this paper provides a basis for generating a shared understanding of the key features of different decriminalisation models, enables robust debate and operates as a decision-support tool for those considering decriminalisation.
This bulletin summarises data from a nationally representative survey of Australians (The National Drug Strategy Household Survey) which asks people their opinions about the legal status of drugs in 2016. We differentiate what Australians think about “legalisation” versus “decriminalisation” for four different types of drugs (cannabis, ecstasy, heroin and meth/amphetamine) across three survey years: 2010, 2013 and 2016. We also explore how the Australian public think money should be directed in responding to illicit drugs.
Drug checking (or 'pill testing') services invite members of the public to anonymously submit psychoactive drug samples for forensic analysis and then provide individualised feedback of results and counselling as appropriate.
The rationale for the operation of these services is to inform people who decide to use currently illegal drugs or new psychoactive substances (NPS) about the content and purity of the products, so they can make a more informed decision about whether to use them or how to use them. These services also monitor drug market changes and when particularly dangerous drug samples are identified, they can issue tailored public alerts and inform specific harm reduction interventions.
This bulletin sought to identify and document the features of drug-checking services operating worldwide as at 2017. In this bulletin we profile 31 drug-checking services operated by 29 organisations, spanning 20 countries across Europe, the Americas and Australasia. There has been an exponential increase in the number of organisations conducting drug-checking, with almost half of the organisations who responded to our survey beginning operations in the last five years. These new organisations join a contingent of established services, many with decades of experience. Our bulletin profiles how services receive submissions, the analytic methods used to identify and in many cases quantify the ingredients of drug samples, the amount of drugs required for analysis, service model aspects including wait times and offering secure disposal, how analysis results are communicated, funding arrangements and service evaluations.
Contact details are provided in the profiles appendix to facilitate direct contact with each service.
DPMP has produced a new briefing paper on Australian deemed supply laws. These laws operate in eight of nine Australian jurisdictions and sanction drug trafficking solely on the weight of drug on an alleged offender.
Dr Caitlin Hughes and Professor Alison Ritter from the Drug Policy Modelling Program, NDARC, UNSW Australia, along with Nicholas Cowdery AM QC, former Director of Public Prosecutions in NSW have completed research into the laws. This raised a number of concerns about the laws. The briefing paper outlines the central findings and policy recommendations from this research.
The full article outlining the research findings can be accessed here:
Hughes, C.E., Cowdery, N. & Ritter, A. (2015). Deemed supply in Australian drug trafficking laws: A justifiable legal provision? Current Issues in Criminal Justice, 27(1), 1-20. http://search.informit.com.au/documentSummary;dn=366887334489689;res=IELHSS
This bulletin summarises data from a nationally representative survey of Australians on the legal status of drugs. We draw an important distinction between what Australians think about “legalisation” versus “decriminalisation”, and what Australians think about different types of drugs (four drugs are compared: cannabis, ecstasy, heroin and meth/amphetamine).
Society is constantly bombarded with mass media messages by way of television, radio, newspapers and online. News outlets have limited space to dedicate to issues, but illicit drugs are clearly newsworthy. In spite of the media being identified almost 10 years ago as a “new battleground” for the alcohol and other drug sector (Proctor and Babor 2001), knowledge remains scant on the nature of news media reporting in Australia – how much space is devoted to drugs, how issues are framed, who speaks and who does not.
Even less is known about the impacts of news media on attitudes towards drugs, particularly on those who are most likely to use illicit drugs – youth. Other fields have demonstrated that media reporting related to violence, body image and tobacco smoking can have a potentially powerful and even dangerous influence upon attitudes and behaviour (see for example Anderson, Berkowitz, Donnerstein, Rowell Huesmann, Johnson, Linz, Malamuth and Wartella 2003). We also know that, common assumptions aside, youth remain active consumers of traditional news media such as newspapers and television news (Essential Research 2010; Hughes, Spicer, Lancaster, Matthew-Simmons and Dillon 2010).
The question remains, how and to what extent can news media messages on illicit drugs influence youth attitudes towards (or demand for) illicit drug use? Can, for example, media messages increase the likelihood of illicit drug use? Conversely, can it reduce the likelihood of illicit drug use? And, how important is the framing of media messages, eg. a criminal justice vs a health issue.
Understanding the role of the media is becoming ever more pertinent due to the ever increasing volume and types of media in modern society (Cunningham and Turner 2010). This project starts to address the intersection between media and illicit drug use by examining two major aspects of news media: media production – as denoted by patterns and trends in Australian news media reporting on illicit drugs – and media effects – as denoted by impacts on youth attitudes to illicit drug use. An overview of the core findings is provided herein.
We do not know the value of the cannabis market in Australia. ‘Per plant’ estimation of the street value of cannabis is a helpful measure – if we can derive an estimate of the value for one cannabis plant, then we can measure the value of a seizure of many plants; and estimate the overall value of the Australian market based on cannabis crops. The purpose of this bulletin is to provide estimates of the ‘street value’ of an individual indoor, hydroponic cannabis plant, taking street price and yield into consideration.
In Australia’s federal system drug legislation is made by the federal, state and territory governments. The Customs Act covers international trafficking and the importation and exportation of drugs. Each of the states and territories have devised their own legislation that deals with offences relating to drug manufacture, distribution/trafficking, possession and use and drug-related behaviour, eg. drug driving. The distinction between the offences relating to possession, manufacture and traffic has historically been based on quantity. Here we focus on the threshold that relates to trafficking.
Illicit drugs, their use and the associated harms are not going to be eliminated, but their impact can be significantly reduced. The ways in which drug policy is developed and implemented can have a major influence (both positively and negatively) on drug use, drug users and those around them. Throughout public policy, the use of best available evidence to inform decision-making is being actively sought. At the same time the provision of evidence alone can be insufficient to produce policy change.
DPMP involves various levels of integration:
Although the need for integration to better deal with complex problems, like illicit drug use, is now widely recognised and discussed, formalised processes for achieving this have been slow to develop.
A unique aspect of DPMP is its close link with the new cross-cutting specialisation of Integration and Implementation Sciences. The specialisation draws from a range of disciplines, such as political science, systems thinking, complexity science, participatory methods, management and information science, and aims to help make better-founded decisions on complex social problems by applying integrative methods to:
Thus the new specialisation provides theory, methods and skills to facilitate comprehensive examination of issues and problems, as well as effective mobilisation to action. Integration and Implementation Sciences also seeks to incorporate the effective use of research-based knowledge to help bring about change.
Specifically, Integration and Implementation Sciences is developing theory and methods for:
DPMP has built on the insights gained as Integration and Implementation Sciences have developed. This has allowed some of the best leading edge ideas and methods developed in other areas to be introduced to the illicit drugs field.
Among the most challenging aspects of making decisions is dealing with the inherent uncertainties. There are uncertainties in how to frame or approach the issue under consideration, as well as lack of information due to relevant areas not being investigated or because available methods are limited. Furthermore, some things are just unknowable and sometimes we are not aware of what we do not know. These are the aspects that the DPMP ‘uncertainty project’ is tackling, as outlined below.
Not surprisingly, numerous ways have been developed to understand and deal with uncertainty. What is surprising is that there has been relatively little exchange between or synthesis of these different approaches. This project is a step in fostering such interaction and integration. It responds to growing recognition that uncertainty cuts across disciplinary and practice boundaries and that we need to trade ideas and experiences to develop better tactics and methods for conceptualising and coping with uncertainty. Exposure to current debates and competing perspectives will highlight unresolved issues and stimulate new understanding and approaches.
The overall aim is to improve available methods for dealing with uncertainty, especially in relation to illicit drugs policy, although this research will also have a broad-reaching impact. The objective is to allow us to be better equipped to deal with the different dimensions of uncertainty.
The most obvious uncertainty that DPMP confronts is lack of data about a whole range of aspects of illicit drug use. While there are standard ways of dealing with this, such as estimation techniques and sensitivity analyses, the uncertainty project aims to provide a more comprehensive catalogue of methods to compensate for lack of data, so that new methods and combinations of approaches can be trialled and assessed. This is also the case for lack of information about how different factors involved in illicit drug use relate to each other.
A second dimension of uncertainty central to DPMP relates to how problems are approached. Any particular approach necessarily excludes or marginalises other ways of considering the problem. Thus if drug use is considered to be a criminal problem, questioning of the legal status is excluded and treatment is marginalised. Because DPMP is taking a broad view of drug use, it is in a good position to explore and highlight the consequences of different ways of framing drug-related problems. The uncertainty project will provide a template for exploring the consequences of problem framing, as well a catalogue of techniques for dealing with competing approaches, which can be trialled and assessed.
A third key dimension of uncertainty has two aspects – managing the unknowable and dealing with what we do not know. An example of the unknowable is the number of illicit drug users, which we can never know precisely because the problem is hidden. One approach is to keep refining estimates, another is to use numbers that suit political purposes. Again the uncertainty project will look for new ways of dealing with this dimension of uncertainty. In order to deal with issues we are not aware of, we need to foster an openness to new ideas, new thinking and new information. That there are some aspects of drug use that simply have not been thought about is best illustrated by an historical example. Thus, for a long time it was widely believed that all drug users came from dysfunctional homes. It was not until ordinary parents gathered the courage to speak out and band together that we realised that the social backgrounds of drug users were much more diverse. The uncertainty project will also provide a foundation for DPMP to think broadly, and sometimes radically.
The uncertainty project involves collating different disciplinary- and practice-based approaches to uncertainty in order to make researchers and policymakers aware of other useful approaches. It also involves developing new combinations and syntheses of approaches that will improve the ability of researchers and policy makers to deal with uncertainty. The size and diversity of the DPMP project itself makes it an ideal test bed for the ideas generated.
In terms of the four key strategies underpinning drug policy – law enforcement, treatment, harm reduction and prevention – prevention is arguably the weakest. It is currently narrowly conceived and does not have an effective guiding idea, in contrast to substitution therapy for drug treatment. It also does not have a dedicated practice sector, unlike law enforcement. It is noteworthy that popular culture is key in normalising attitudes to illicit drugs, and that this is largely ignored in the prevention literature. We are not suggesting that there is a simple or direct causal link, but instead that the cultural milieu can influence the acceptability of illicit drug use.
Our aim was to determine if it was feasible to investigate the impact of popular culture on illicit drug use and we therefore undertook a pilot study on popular music.
One of the key components of the first phase of the DPMP project has been to develop a quantitative dynamic model of drug use in Australia. Using a stocks and flows approach, derived from similar work undertaken in the US on cocaine prevalence by Caulkins and collaborators, the key aim of this component of the DPMP has been to examine whether methods can be applied to the Australian context using available data. If a plausible model could be developed, then the subsequent aims were to use the model to describe: 1.The prevalence of drug use in Australia over time; and 2. the effects of changes in model parameters upon the prevalence of injecting drug use and the associated social costs.
Complexity Theory is a loose cluster of theories and methodologies aimed at understanding the properties of complex adaptive systems. Complex adaptive systems (CAS) are ones characterised by: emergence, path dependency, non state equilibrium and adaptation. The heroin drug market fits these characteristics nicely. The tools we have available to understand and model such CAS include Multi-Agent Systems, Dynamical Systems, and Network Theory. Scientists using Multi-Agent Systems tend to focus on the individual components interacting within a given system. This is a purely bottom-up approach where representations of the individual components – the agents – display a large autonomy of action. Hence, system-level behaviours and patterns emerge from a multitude of local interactions. Scientists using Dynamical Systems tend to focus on the flows of information, mass and energy within a given system. Practically, modellers describe systems as a set of modules or compartments (stocks) interlinked by flows and controls. Scientists using Network Theory tend to focus on the structure of interactions between individual components of a system.
The Complexity Theory group considered the advantages and limitations of using these approaches for DPMP. Two key issues shaped the boundaries and content of the present project: finding a case study that would contain – a priori – as much complexity as possible and would provide the information needed to build a consistent model; and fitting into the actual structure of the DPMP project in order to interact efficiently with relevant experts and to avoid undesirable overlapping with other on-going research.
Dynamical Systems were already being explored within the epidemiology team. Looking at the Australian illicit drug markets through a cross-scale approach, it seemed that urban districts constituting a ‘drug scene’ involved most of the actors (with exception of importing syndicates and production cartels) while displaying a maximal complexity. We chose the multi-agent system (rather than network theory) because most of the potential agents in the system were clearly identified but various aspects of their interdependent links were ill-defined. In addition, the high level of transdisciplinarity that was needed advocated for an intuitive modelling approach.
We sought to inform the following stylised policy choice. A dependent heroin user has come to the attention of authorities in a form that allows a one-year prison term, a course of pharmacotherapy maintenance or a stay in a residential rehabilitation to be pursued, eg. the individual has been arrested. How would each perform in terms of both program cost and reduction in drug use?
While a great variety of systems approaches have been developed, they all have some common characteristics: a recognition of the need to deal with complex issues by looking at the ‘bigger picture’; the evaluation of multiple policy options prior to (and often during and after) implementation; and exploring interconnections and potential consequences to identify and minimise unwanted ‘side-effects’ of policy. While this focus of systems thinking on dealing with complexity has been found to be useful in many other policy contexts, such as policing and sustainable cities, systems approaches have been used less frequently in policy making on illicit drugs. However, given that this area of policy can be highly complex, characterised by tensions between stakeholder groups and requiring difficult balances to be struck between enforcement, prevention and treatment, it seems worthwhile to explore what added value systems approaches can offer, and what barriers to their use might be encountered. This DPMP project was designed to scope the potential uses of systems thinking for developing policy on illicit drugs.
There are many things not known about the heroin market in Australia. Its illicit status and the relatively low numbers of participants give researchers and policymakers few opportunities to develop a precise understanding of its size, composition and dynamics. Singer (1971) demonstrated that, in such a situation, simple quantitative analysis can provide insights. In his analysis of the amount of crime committed by heroin addicts in New York City, Singer compared numbers against each other and used general knowledge to show that widely used figures had no basis in fact. The approach has also been used to develop plausible numbers where none exist.
One example where simple quantitative analysis can provide insights is in the area of the impact of heroin seizures on consumption. The purpose of this project was to establish the rate of heroin seizures relative to the overall size of the heroin market in Australia. In addition, it provided the opportunity to review various useful ‘numbers’ that will be used in Stage Two DPMP analyses.
One key parameter of the heroin market available for DPMP is the purity of illicit drug seizures made by the Victoria Police and analysed by the Victorian Forensic Sciences Centre. To date the information derived from this purity data has not been systematically examined in Victoria. The aim of this component of the research was to examine the purity series available for heroin and amphetamines in detail, with a view to determining the nature of heroin seizure purity changes in the context of the change in heroin supply known as the heroin ‘drought’ and whether they are sensitive to assumed changes across the chain of drug supply. During the period immediately around the drought we consider the changes in purity at both the wholesale and retail levels and how the markets recovered in the period after the drought. Through comparisons with the supply in the market of methamphetamine we consider the impacts on this market and evidence for one of the possible substitution effects that may have occurred.
There has been an increasing awareness of the importance of using price information to understand illicit drug markets. Internationally, researchers have found relationships between illicit drug prices and other market characteristics such as the numbers of drug users, the proportion of arrestees testing positive to drugs and the number of drug-related emergency department incidents.
This work aimed to assess whether the Australian heroin market shares the same basic characteristics (e.g. real prices falling over time, significant price variability) as other illicit drug markets where more price analysis has been done; and begin to explore the relationship between price and harm. It is hard to measure how much heroin is being consumed with any precision, making it extremely difficult to understand the relationship between drug use and the harmful consequences that result from use. On the other hand other market characteristics, such as price, can be better measured. If there are relationships between price (as an indirect measure of consumption) and harms, we can use price (and potentially other market data) to assess harms and policy responses.
Estimating the prevalence of drug use is one of the key focal areas of alcohol and drug epidemiology. Estimation of the extent of alcohol and drug use in the Australian community has primarily been undertaken using surveys of the general population. Nevertheless, it is widely understood that prevalence estimates derived from general population surveys underestimate the true extent of drug use in the community for drugs of low use prevalence (e.g. heroin) because of issues around sampling (e.g. response rates and the extent to which crucial samples such as the homeless are missed in household surveys) and the truthfulness of responses to questions concerning illegal or hidden behaviours. In response, epidemiologists have applied specialised statistical techniques to the analysis of data sources on the extent of drug-related harm (e.g. opioid overdose deaths) to produce estimates of the extent of problematic drug use in the Australian community.
Prevalence estimation using secondary data sources has generally been undertaken only in relation to heroin use in Australia. This work has used a variety of techniques (e.g. capture-recapture, back-projection, multiplier) in accordance with a general consensus that has emerged around the application of such techniques to the estimation of problematic drug use. In applying these methods Australian work has developed multiple estimates using available statistical estimation tools with convergence among estimates used as the source of the most parsimonious estimate (e.g. the median of the estimates derived). While this approach is appealing, the resultant ‘best’ estimates are derived primarily from the application of simple mortality multipliers (e.g. 1% annual mortality rate for heroin users) to the number of opioid overdose deaths occurring in specific Australian jurisdictions (generally NSW). The problem of this multiplier approach is highlighted by the effect of the heroin shortage in Australia.
The aim of this component of the DPMP was to develop plausible estimates of the prevalence of heroin use in Melbourne with a view to informing various elements of DPMP projects. The work was also designed to provide a method for estimating the extent of injecting drug use more widely (specifically through application to amphetamines). It was funded by a Travelling Scholarship from the Victorian Premier’s Drug Prevention Council awarded to Paul Dietze.
The systematic review of police-led law enforcement strategies had three goals:
This is the first systematic review of drug law enforcement strategies to be undertaken with a broad mandate, including those strategies implemented at international, national, state and local levels. It has been endorsed as a Campbell Crime and Justice Group Systematic Review.
Any comprehensive approach to drug policy needs to establish and document all the possible drug policy responses – perhaps surprisingly this has not been done to date. This project sought to document all drug policy responses as well as provide a useful taxonomy and user-friendly policy tool. The project had three primary aims:
Ideas matter! All policy is underpinned by ideas and the quality of the ideas can make or break the policy. Three key ideas provide the effective foundations for current Australian illicit drugs policy – harm minimisation, substitution treatment and problem-based community-oriented policing. Harm minimisation acknowledges that while abstinence is the surest way to prevent harm, not everyone will choose this path. Therefore other strategies are necessary to assist illicit drug users, who range from occasional to chronic, to reduce negative personal and community consequences as far as possible.
The most significant success associated with this idea is the containment of the Australian HIV/AIDS epidemic among drug users through the provision of needle and syringe exchanges, condoms and peer education. Substitution treatment provided a break-through in therapy for illicit drug use. Substituting illicit drugs with a long-acting oral medication has provided the most effective treatment to date, especially for heroin users. It allows them to cease or greatly reduce illicit drug use, stop other crime, and stabilise and normalise their lives. Problem-based, community-oriented policing recognises that the police service is responsible not only for solving crime, but for preventing it. It calls for a style of policing that is much more engaged with the community, incorporating visible patrols, concerted actions at ‘hot spots’ and other strategies to reduce fear in the community. Each of these ideas came to prominence in the 1980s and they are periodically challenged by competing ideas focusing on zero tolerance, abstinence-only treatment and results-based policing. As society changes over time, new accommodations between competing ideas and ideologies must be found.
Two key aspects of illicit drugs policy are not currently guided by effective high-quality big ideas. For both prevention and corruption resulting from illicit drug profits, society is largely floundering, applying piece-meal strategies, often despite evidence of no or, even worse, counter-productive effects. An important element of DPMP is therefore to give consideration to key effective concepts that underpin policy, both in terms of providing critique and analysis of current and alternative ideas, and in helping to generate new high-quality notions. While there are many methods for creating and disseminating new ideas, these have not been systematically documented or analysed. In the feasibility phase of DPMP, we focussed on one method – Executive Sessions – because this specifically deals with big concepts, aims to be nonpartisan (and indeed thrives on the respectful interaction of different ideologies) and has a track record in producing transformative social change. As a matter of fact, problem-based community oriented policing is a product of the most successful Executive Session.
Executive Sessions were developed at the John F Kennedy School of Government at Harvard University. They involve bringing together a small number (20-25) of influential and innovative policy and practice leaders with about five intellectual leaders to discuss and develop new approaches to large unwieldy problems that are too big to tackle in other fora. The leaders generally meet twice a year over 3-4 years. Discussion papers are produced to assist the deliberations and to disseminate ideas and generate feedback from a broader constituency.
In all, seventeen Executive Sessions have been held to date. Of these, eight have covered criminal justice issues, the other nine have covered a broad range of topics. Three Executive Sessions are considered to have transformed policy and practice – the Executive Sessions on Policing, Medical Error and Patient Safety, and Domestic Preparedness. As outlined above, the Executive Session on Policing introduced problem-based community-oriented policing and revolutionised the way police departments operate in the USA, Australia, the UK and other countries. The Executive Session on Medical Error and Patient Safety helped move the focus away from individual mistakes to concentrate on systems failures and how they can be rectified. There was significant potentiation between the Executive Session and a concurrent US Institute of Medicine report on the same topic. The Executive Session on Domestic Preparedness was about half-way through its deliberations when the September 11 2001 attack on the New York World Trade Centre occurred. It was able to significantly influence the subsequent policy response to September 11. (One of the participants, a New York Fire Chief, was killed in the direct response.)
This Stage 1 project explored Executive Sessions in detail to examine the feasibility of conducting an Executive Session on the topic of illicit drugs and to explore more general lessons for evaluating and creating new policy ideas in the next phase of DPMP research.
We understand very little about how research informs policy and how to improve that process, especially in highly politicised areas such as illicit drugs. One aim of DPMP is to significantly increase production of the highest quality evidence, which takes complexities and dynamic interactions into account. For this evidence to impact on Australian policy, we need to better understand how policy is made; the kinds of research that are most valued; and how research is best inserted into policy processes. Lack of appreciation of how policies are made is a major barrier to providing good decision support resources and processes.
While we do not subscribe to a naïve view that research should be the only, or even the most important, factor in policy making, we are keen to see research assume its proper role and, within that, to be maximally effective. Surprisingly, there has been relatively little examination of what ‘evidence-informed’ policy is, in drugs, public health, criminal justice or more broadly. There has also been very limited research to shine a light on the collective experience of policy making in an attempt to learn from that experience, so that we may pursue it more wisely in the future.