Frequently Asked Questions
What is a Peer Worker in the context of Harm Reduction?
One of the most important aspects of Harm reduction is Peer Education, where drug users are employed to talk and work with people accessing Alcohol and Other Drug Services. QuIHN Ltd. and QuIVAA Inc. are a good example of this as they seek to ensure that lived-experience is incorporated into the planning, design, delivery and evaluation of all programs. In addition, many staff have a lived-experience background and as such, they all have a good understanding of the numerous issues which drug users face in their everyday lives. This usually makes it much easier and much quicker to build a rapport, and often makes it much easier to communicate and to understand one another.
What is a Harm Reduction Approach?
Harm reduction approaches are aimed at reducing associated dangers of substance use without enforcing an abstinence approach, the focus being on responsible use of drugs and alcohol and reducing harm associated with those behaviours [1]. It fills the large gap policies and laws have created with a zero-tolerance policy, by offering care, support and education because regardless of the laws, people still use drugs [2]. “When we talk about harm reduction, we often reduce it to a public health framework. One of reducing risks. That’s harm reduction with a small hr. Harm reduction is meeting people where they are at and not leaving them there. But Harm Reduction with a capital HR – this is the movement. One that shifts resources and power to the people who are most vulnerable to structural violence”. (Monique Tula – Executive Director, Harm Reduction Coalition, 2018) [1] Hughes C, Stevens A. (2007). The effects of decriminalization of drug use in Portugal: Discussion paper. Oxford; UK. [2] Kuhn, C., Swartzwelder, S. and Wilson, W. (2019). Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy 5th ed. Duke University and Duke University School of Medicine. W.W.Norton & Company, Inc., New York.
What harm is caused by our current Australian drug laws?
Our drug laws are failing people and countries with a zero-tolerance policy have resulted in overwhelming negative outcomes and haven’t prevented people from consuming [1]. Illicit substance use and dependence is highly stigmatised. The discrimination that stigma fuels has real world impacts on both individual and public health. [2]. In a cross-cultural study by the World Health Organization, illicit substance use dependence was ranked as the most stigmatised health condition and alcohol-dependence as the fourth-most stigmatised health condition [2]. Each day someone dies from a drug overdose, that person is someone’s friend, partner, parent, child. Families and communities have been torn apart from forced incarceration of illicit drug users. Each day people who use drugs face discrimination and stigma from multiple facets in life and society. This can also impact on access to equitable health care and other essential services, meaning people who use illicit drugs can often have very poor access leading to worsened health status. A harm reduction approach and peer-led programs provide a valuable opportunity to educate and support a cohort of experienced and novice drug users on safer behaviours and harm reduction, often being a first opportunity to engage with drug specialists without judgement. [1] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20 the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf [2] Alcohol and Drug Foundation. (2019). The Power of Words: Having conversations about alcohol and other drugs: a practical guide. Victorian Government of Health and Human Services. https://cdn.adf.org.au/media/documents/The_Power_of_Words_-_Background_Document.pdf
Do harm reduction approaches encourage drug use?
Hi-Ground does not promote drug use, we encourage help-seeking behaviour and the sharing of non-discriminatory health information. We acknowledge that people throughout history have used psychoactive substances and that people still choose to use drugs regardless of health and law consequences and an unregulated market creates more risks. Rather than cast judgment on people who use drugs, we believe that we should reduce the harms associated with drug use and provide opportunities for people to stop using drugs if and when they choose to do so. Harm reduction programs, such as needle and syringe programs and drug safety checking (e.g. ‘pill testing’) programs have been shown to not lead to increased drug use. There is research that shows such programs can actually lead to a decrease in drug use [1] . [1] Harm Reduction Australia (HRA). (2018). What is Harm Reduction. https://www.harmreductionaustralia.org.au/what-is-harm-reduction/
What are the current limitations and assumptions around drug use?
Little scientific information and evidence is effectively translated for the public regardless of scientists' advances in understanding the actions of chemicals and their effects [1] . Many of the contemporary efforts by Government and Health Organisations to educate people about the effects of alcohol and other substances are misdirected, inadequate or oversimplified which include interpretations slanted by political, ideological, cultural and moral agendas [1] . Australian Legislators need to understand the scientific facts, take advantage of data produced by other Countries who have embraced progressive harm reduction approaches on drug use and shift this issue from a criminal stance to a health and social perspective. [1] Kuhn, C., Swartzwelder, S. and Wilson, W. (2019). Buzzed: The Straight Facts about the Most Used and Abused Drugs from Alcohol to Ecstasy 5th ed. Duke University and Duke University School of Medicine. W.W.Norton & Company, Inc., New York.
What’s the current data around consumption habits of Australians?
The National Drug Strategy Household Survey recently released the following consumption trends: The key findings of consumption habits in 2019 compared to 2016 are: Marijuana/cannabis use up to 11.6 per cent from 10.4 per cent Ecstasy use up to 3.0 per cent from 2.2 per cent Cocaine use up to 4.2 per cent from 2.5 per cent Risky alcohol consumption stable at 25 per cent Proportion of ex-drinkers up to 8.9 per cent from 7.6 per cent. It also found that: In 2019, for the first time, more people said they supported the legalisation of cannabis than opposed it (41% compared with 37%). Almost 3 in 5 Australians (57%) supported potential drug users being able to test their pills or other drugs at designated sites. There has also been a shift towards education, rather than law enforcement, as the preferred strategy to reduce the use of illicit drugs — when asked where money should be spent, people allocated more funds to education than to law enforcement for the first time in 2019. Between 2016 and 2019, there was also a decline in support for policies aimed at reducing the problems associated with excessive alcohol use. For example, support for reducing trading hours for pubs and clubs declined from 39% in 2016 to 31% in 2019. [1] Australian Institute of Health and Welfare (AIHW). (2020). National Drug Strategy Household Survey 2019: detailed findings. Canberra: AIHW.
What’s the difference between decriminalisation and legalisation of illicit drugs?
In the 19th century, Australia had a laissez faire attitude with respect to drugs. Most drugs were legally available, and regulation was minimal. Cannabis, opium, heroin and MDMA were all legal products in Australia in the first half of the 20th century. The boundary between what is legal and illegal has evolved over time [1]. ‘Decriminalisation’ is when drug offences like use and possession and personal use are repealed so criminal charges are no longer applied. The legalisation of illicit drugs means regulation to establish a legal market, like with alcohol or tobacco. Criminal and/or civil penalties still occur for production, sale or consumption that occurs outside of regulations. Removing the penalties for drug use and personal possession removes some of the stigma people who use drugs experience. Treating drug use as a health and social issue is likely to increase help seeking behaviour and confidence to discuss their substance use than when it is treated and seen as a criminal and legal issue [2]. Criminal charges for possession and personal use are currently managed through the court system and involve charges brought against the person by police and legal practitioners on behalf of the Government. If found guilty and convicted the person will have a criminal record and punishment may include jail time. Having a criminal record can severely impact on a person’s life, for example it can affect future employment, housing, travel options and personal relationships. The process of decriminalisation means criminal penalties may be replaced with civil penalties such as receiving referrals to education or treatment programs, or a fine. Legalisation removes all penalties for possession and personal use however regulations are established to manage where and how the legal drug can be produced, sold and consumed just as alcohol is regulated in Australia. According to the Queensland Productivity Commission Report, Reform that legalises lower harm drugs (cannabis and MDMA) and decriminalises other drugs is likely to provide net benefits to the Queensland community of at least $2.8 billion and reduce the prison population by around 1,050 people by 2025. Legalisation, in conjunction with supporting regulatory frameworks and improved health responses, would provide more benefits than decriminalisation, because it would reduce the many unintended harms that arise from criminalising the supply of drugs. While many of the benefits of legalisation are difficult to quantify, the Commission estimates that the legalisation of cannabis, alone, would shift $3.7 billion in profits from criminal activity to more productive use (such as harm minimisation strategies) [1]. It is important to note that decriminalisation and legalisation are not single solutions and that if implemented advocates emphasise the need to increase funding and investment in services that provide drug treatment, support and education as well as expand them to reduce wait times [3]. [1] Queensland Productivity Commission. (2019). Inquiry into Imprisonment and Recidivism [Report]. Queensland Government. https://qpc.blob.core.windows.net/wordpress/2020/01/FINAL-REPORT-Imprisonment-Volume-I-.pdf [2] Benfer I, Zahnow R, Barratt M, Maier L, Winstock A, Ferris J. (2018). The impact of drug policy liberalisation on willingness to seek help for problem drug use: A comparison of 20 countries. International Journal of Drug Policy.;56:162-75. [3] Hughes C, Stevens A. (2007). The effects of decriminalization of drug use in Portugal: Discussion paper. Oxford; UK.
What is a Police Drug Diversion for minor drug charges?
The following information has been provided by Kahler Lawyers in Queensland, it’s intention is for information only and should not be relied upon as legal advice (2016). There are two kinds of drug diversion available in Queensland. Police drug diversion If police arrest someone in possession of a small quantity of cannabis (less than 50 grams) or an implement that has been used to smoke cannabis the police officer MUST offer the offender an opportunity to attend a drug diversion assessment program instead of charging them with a criminal offence in certain circumstances. This is obviously a much better outcome than going to Court as it means there is no criminal conviction for the offence whatsoever. The following conditions have to be met for the drug diversion to be offered: The person must not have also been arrested for another indictable offence associated with the minor drug offence – for example, burglary of a home to obtain the money to buy the drugs. The person must not have been offered drug diversion before. The person must admit to possessing the drugs or smoking implement in an electronically recorded interview. The person must not have any criminal history for violence. The person must not have been sentenced to a term of imprisonment before for drug trafficking, supplying drugs or producing drugs. Court ordered drug diversion This type of drug diversion is available to people who commit minor drug crimes and have never had any kind of drug diversion before, or have had police or Court drug diversion once before. Court ordered drug diversion is available for a much wider range of minor drug offences, including possessing small quantities of schedule 1 drugs like cocaine, heroin, ecstasy and speed. If a person is eligible for Court ordered drug diversion and the Magistrate thinks it is appropriate, they are sentenced to a good behaviour bond that includes a condition that they attend a Drug Assessment and Education Session. No conviction is recorded. [1] Kahler Lawyers. (2016). Possession of Dangerous Drugs in Queensland. https://www.kahlerlawyers.com.au/possession-of-drugs/
Who is using drugs in Australia?
In the National Drug Strategy Household Survey (NDSHS) in 2016, revealed almost 8.5 million (42.6%) Australians aged 14 years and over reported use of illicit drugs in their lifetime, with 3.1 million (15.6%) reporting use in the last month. Prevalence was highest in the 20–29 years age group, of which 28.2% reported use in the last 12 months (AIHW, 2017). [1] Australian Institute of Health and Welfare (AIHW). (2017). National Drug Strategy Household Survey 2016: detailed findings. Canberra: AIHW.
Why is it difficult for people who use drugs to seek professional medical help?
In a cross-cultural study by the World Health Organization, illicit substance use dependence was ranked as the most stigmatised health condition and alcohol-dependence as the fourth-most stigmatised health condition [1]. The Queensland Mental Health Commission outlined that stigma and discrimination is prevalent in health care and public health settings further discouraging help related behaviour from people who use drugs. In contrast to health professionals, peer workers are more likely to empathise with and understand the needs of people who use drugs, providing appropriate support and educational information when medical intervention is not necessary [2]. [1] Alcohol and Drug Foundation. (2019). The Power of Words: Having conversations about alcohol and other drugs: a practical guide. Victorian Government of Health and Human Services. https://cdn.adf.org.au/media/documents/The_Power_of_Words_-_Background_Document.pdf [2] Queensland Mental Health Commission. (2018). Changing attitudes, changing lives, a report on the impact of stigma and discrimination on people experiencing problematic alcohol and other drug (AOD) use, including options for reform. Queensland Government: Brisbane. https://www.qmhc.qld.gov.au/documents/changingattitudeschanginglives
How is the harmfulness of a drug determined?
There are several factors which increase the risks associated with drug use. These include the dosage and types of drugs which are taken. For example, a recent survey which examined factors associated with festival attendees who sought emergency medical treatment as a result of legal and illegal drug use, found that those who had taken alcohol, MDMA, LSD, cannabis or cocaine were more likely to require medical treatment [1]. In addition, mixing drugs increases the likelihood of harm, with the same survey showing that 81% of the respondents who required medical assistance took MDMA with alcohol and/or other illegal drugs [1]. Environmental factors can also contribute towards the risks associated with drug use. This includes ambient and body temperature, which tends to be more extreme in festival and nightlife settings and can cause heat stroke and hydration issues. The presence of, distance and location to medical emergency services can also be a factor in adverse drug related events. This is because the sooner someone can access medical care in a drug related emergency the better the outcomes may be. Furthermore, individual factors such as weight, pre-existing health problems, mood, tolerance and gender are also known to influence the likelihood of drug related hospitalisations and deaths [2] . [1] Barratt, M., Hughes, C., Ferris, J. & Winstock, A. (2019). Australian music festival attendees: A national overview of demographics, drug use patterns, policing experiences and help-seeking behaviour. Drug Policy Modelling Program (DPMP) Bulletin No. 28. Sydney: National Drug and Alcohol Research Centre, UNSW. https://ndarc.med.unsw.edu.au/resource/bulletin-no-28-australian-music-festival-attendees-national-overview-demographics-drug-use [2] Grigg, J. (2019). ‘My friends are taking MDMA at raves and music festivals. Is it safe?’. The Conversation. https://theconversation.com/my-friends-are-taking-mdma-at-raves-and-music-festivals-is-it-safe-122128
How many deaths occur in Australia from substance use?
Australian data shows that in 2018, there were 1,740 drug-induced deaths and 1,366 registered alcohol-induced deaths in 2017 [1]. This equates to nearly five drug-induced deaths per day [2]. Opioids (natural and synthetic) are the main drug cited in drug-induced deaths with an increasing rate involving psychotropic medicines (e.g. benzodiazepines, antipsychotics), and the rate of deaths attributed to amphetamines (e.g. methamphetamine, MDMA) has increased substantially [2]. [1] Australian Institute of Health and Welfare (AIHW). (2020). National Drug Strategy Household Survey 2019: detailed findings. Canberra: AIHW. [2] Man, N., Chrzanowska, A., Dobbins, T., Degenhardt, L. & Peacock, A. (2019). Trends in drug-induced deaths in Australia, 1997-2018. Drug Trends Bulletin Series. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney.
What are the social and legal issues for people who use drugs?
Currently in Queensland the following penalties for a person in possession of drugs according to the Drugs Misuse Act 1989 include 20-25 years for Schedule 1 substances, and 15-20 years for Schedule 2. Possession is not the same as owning the drug, you can be in possession of a drug even if you did not buy it or have not used it [1]. The intersection between illicit drug use and criminality has far reaching implications. Criminalisation has been in place for many decades, but it has proven ineffective at significantly reducing the consumption of illicit drugs and has not achieved sustained reductions in supply. The criminalisation of drug use has also resulted in unintentional harms, these harms arise largely because criminalisation encourages the creation of more harmful and dangerous drugs [1]. Aside from high rates of imprisonment among illicit drug users there are many social and legal implications currently surrounding this issue. These include, but are not limited to things like; unlawful strip searches by Police, trauma caused from strip searches, panic consumption due to Police scare tactics and incarceration numbers and costs. It is also a sad fact that some young people took fatal overdoses of drugs in their possession at festivals, called panic consumption, to avoid detection by law enforcement with detection dogs [2]. Research also reflects that often users of drugs have had traumatic experiences in their lives and treating these people as criminals is an incorrect response and causes more damage to a person’s wellbeing and life [3]. The current social and legal reactions to illegal drugs have placed an enormous economic strain on the resources of countries, especially with the cost of imprisonment and drug related sentences continuing to grow. [1] Queensland Productivity Commission. (2019). Inquiry into Imprisonment and Recidivism [Report]. Queensland Government. https://qpc.blob.core.windows.net/wordpress/2020/01/FINAL-REPORT-Imprisonment-Volume-I-.pdf [2] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20 the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf [3] Grewcock, M. and Sentas, V. (2019). Rethinking Strip Searches by NSW Police [Report]. University of New South Wales. https://apo.org.au/sites/default/files/resource-files/2019-08/apo-nid254776.pdf
Is heavier Policing methods working to deter drug use?
A national survey to show that drug law enforcement has a minimal deterrent effect on drug use and supply at Australian music festivals, but that specific modes of policing can lead to more harmful practices such as increasing drug purchasing within festival grounds [1]. Police deployment of drug detection dogs can increase internal concealment of drugs or hasty drug consumption on site of dogs known as panic consumption [1,4]. This was the cause of some young people’s deaths due to consuming all their substances in fear of detection [2]. Additionally, in-depth interviews with Australian festival attendees revealed the negative social and emotional impacts of being screened by drug detection dogs [3,4]. [1] Hughes, C.E., Moxham-Hall, V., Ritter, A., Weatherburn, D. & MacCoun, R. (2017). The deterrent effects of Australian street-level drug law enforcement on illicit drug offending at outdoor music festivals. International Journal of Drug Policy, 41: 91–100. [2] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20 the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf [3] Malins, P. (2019). Drug dog affects: Accounting for the broad social, emotional and health impacts of general drug detection dog operations in Australia. International Journal of Drug Policy, 67, 63-71. [4] Grigg, J., Barratt, M. & Lenton, S. (2018a). Drug detection dogs at Australian outdoor music festivals: Deterrent, detection and iatrogenic effects. International Journal of Drug Policy, 60: 89-95.
Strip searches, are they good? bad? or violating Human Rights?
Current data in Australia shows Police target certain people due to race, age and gender profiling, including strip searches in NSW doubling in a year [1,2] . In 2019 the Redfern Legal Centre commissioned a report ‘Rethinking Strip Searches’ focusing on strip searches by New South Wales Police [1]. This report was prepared by the University of New South Wales Law academics Dr Michael Grewcock and Dr Vicki Sentas. This report, which was the first of its kind in Australia, gathered all available data under freedom of information laws, and explored the operation of strip search laws across the country, police powers, concerns around transparency and lack of publicly available data. The number of NSW Police searches has increased by almost 50 per cent in the four years from financial year 2014-15 to 2017-18. 296 minors were the target of field strip searches over a two-year period between the financial years 2016-17 and 2017-18. One of those was as young as the age of 10. Twenty-year old’s were subject to the most searches of any single age in 2017-18 alone. As well as the shocking rates of young, mostly men, being strip searched. 10 percent of all recorded strip searches in the field revealed to be Aboriginal or Torres Strait Islander people. The systemic racism and trauma created from strip searches is reported to mimic and/or trigger the same emotional and physical response as that in sexual assault and rape as many witnesses have reported in their experiences [1]. [1] Grewcock, M. and Sentas, V. (2019). Rethinking Strip Searches by NSW Police [Report]. University of New South Wales. https://apo.org.au/sites/default/files/resource-files/2019-08/apo-nid254776.pdf [2] Hagar, C. (2018) Number of strip searches in NSW doubles in a year, triggering Law Commission inquiry. Australian Broadcasting Corporation. https://www.abc.net.au/news/2018-11-13/nsw-police-strip-search-rise-triggers-law-commission-inquiry/10491032
Is a harm reduction approach cost effective compared to our current strategies to minimise drug use?
Some economists argue that harm reduction programs, such as needle and syringe programs, have seen the most cost-effective use of government money in Australia’s history. As stated in the Return on Investment Report for NSP cost effectiveness, every dollar invested in NSPs was found to return more than four dollars in healthcare cost-savings in the short-term [1]. The money we spend on policing and prisons for drug users is certainly much less cost-effective. For instance, increasing access to pharmacotherapy programs, assisting peer-based user organisations and establishing needle and syringe programs all contributed to our low infection rates that have saved millions of dollars [1]. [1] Wilson, D., Kwon, A., Anderson, J. and Thein, R. (2009). Return on investment 2: Evaluating the cost-effectiveness of needle and syringe programs in Australia. Sydney: National Centre in HIV Epidemiology and Clinical Research, UNSW.
The cost of having an imprisonment punishment stance?
Criminalisation has created significant costs and unintended harms. It helped to create an illegal market worth at least $1.6 billion (with high levels of violence), made the quality of supply uncertain (resulting in increased morbidity and mortality), and impeded treatment of harmful use. Expenditure on the enforcement of drug laws is around $500 million annually [1]. Drug offences have contributed notably to the growth in imprisonment. Between 2012 and 2018, drug offences contributed 32 per cent of the increase in Queensland’s sentenced prison population [1]. In Australia as of 2015, the average cost of putting one person in prison for a year was $109,821 [2]. Also revealed, 22 percent of females in Queensland prisons are there for drug related offenses, making it the most common offence for female imprisonment. For men it is the second most common offence for incarceration at 15 percent, a total of 6,573 prisoners, with 89 percent of men incarcerated also having secondary drug related charges [3] . That figure of males alone equates to $721,853,433 per year to keep solely drug related offenses in prison. This money could be redistributed to illicit drug services, rehabilitation, affordable housing, education programs and good scientific research that addresses further understanding of substances, problems and solutions. [1] Queensland Productivity Commission. (2019). Inquiry into Imprisonment and Recidivism [Report]. Queensland Government. https://qpc.blob.core.windows.net/wordpress/2020/01/FINAL-REPORT-Imprisonment-Volume-I-.pdf [2] Knowles, L. (2017). Australia spending more on prisons, policing than other comparable countries: report. Australian Broadcasting Corporation. https://www.abc.net.au/news/2017-08-08/australia-spending-more-on-prisons-than-other-oecd-countries/8784466#:~:text=In%20Australia%20in%202015%2C%20the,cent%20from%20a%20decade%20ago. [3] Australian Bureau of Statistics (ABS), 2019. Prisoner Characteristics, Australia. Commonwealth of Australia. https://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4517.0~2019~Main%20Features~Prisoner%20characteristics,%20Australia~4
Why is there so much focus on young people and music festivals?
For many of Australia’s young people, going to music festivals and nightlife events is a rite of passage. Often these experiences is a way of disconnecting from their everyday lives, a time of experimentation, self-discovery as well as a way to form deeper connection with their peers and explore new relationships [1]. Youth culture and young people’s pleasures have often been the target of concern, for example in the 1950s modern ballroom dancing was seen as ‘degenerate’, especially while drinking alcohol, leading young people to ‘sexual immorality’ and ‘unruly behaviour’ [2]. Now, with the rise and increase of music festivals, electronic dance music and substances, it seems to reiterate historical discourses around youthful pleasures and chemical cultures [2]. Alcohol consumption and illicit drug use are frequently part of the culture and exploration, and it is important to note that this type of experimentation is a normal aspect of adolescent development [3]. Such behaviour satisfies curiosity, assists the young person to establish their identity, creates social bonding and can increase status within a social group [4]. It is also arguable that young people who attend music festivals may be more visible to policy decision makers, possess more social capital and more socially mobile due to differences in socio-economic status and social disadvantage than other populations who may frequently use illicit drugs. [1] Packer, J., & Ballantyne, J. (2011). The impact of music festival attendance on young people’s psychological and social well-being. Psychology of Music, 39(2), 164–181. doi:10.1177/0305735610372611 [2] White, R., Wyn, J., Robards, B. (2017). Youth and Society 4th Edition. Oxford University Press, Australia. [3] Nagel, C. M., & Scholes, L. (2016). Understanding development and learning: implications for teaching. Melbourne: Oxford University Press. [4] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20 the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf
Why do we need to focus on delivering harm reduction to young people and festival attendees?
It is also important to note that many young people and festival goers are rarely provided with credible and non-judgemental education about alcohol and other drug harm reduction education for responsible and safer drug use. For example: there is a widely held belief that ecstasy is safe, and whilst it is acknowledged as being less harmful than some other drugs, the unregulated market means young people are buying ecstasy not knowing its potency or whether it contains harmful substances [1,2]. Such misunderstandings may be because most Australian music festival attendees are young, the average age being 22 years old, little drug education and use of the substance ‘normalised’ amongst peers [3]. This can mean this cohort are frequently inexperienced drug users who are not familiar with all of the potential risks associated with such behaviour which proves evident by the recent spate of drug related deaths at Australian music festivals, which prompted an inquiry to the New South Wales Coroner in 2019 [4]. [1] Grigg, J. (2019). ‘My friends are taking MDMA at raves and music festivals. Is it safe?’. The Conversation. https://theconversation.com/my-friends-are-taking-mdma-at-raves-and-music-festivals-is-it-safe-122128 [2] Grigg, J., Barratt, M.J., & Lenton, S. (2018). Double dropping down under: Correlates of simultaneous consumption of two ecstasy pills in a sample of Australian outdoor music festival attendees. Drug and Alcohol Review, 37(7), 851-855. [3] Barratt, M., Hughes, C., Ferris, J. & Winstock, A. (2019). Australian music festival attendees: A national overview of demographics, drug use patterns, policing experiences and help-seeking behaviour. Drug Policy Modelling Program (DPMP) Bulletin No. 28. Sydney: National Drug and Alcohol Research Centre, UNSW. https://ndarc.med.unsw.edu.au/resource/bulletin-no-28-australian-music-festival-attendees-national-overview-demographics-drug-use [4] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf
What’s the current data about drug use at Music Festivals?
The Global Drug Survey (GDS) which has been running for nine years gathers the world’s largest anonymous web survey data of psychoactive substance use . The Global Drug Survey 2019 (GDS2019) is open to anyone aged 16 and over who consented to participate and includes a range of questions on patterns of use of alcohol, tobacco, illicit drugs, pharmaceuticals, and new psychoactive substances as well as including a section on festival attendance. A total of 7,864 Australians participated in GDS2019 and of total 5,155 people reported attending festivals in the last 12 months. Analysis of 5,155 Australian music festival attendees, showed that most festival attendees are infrequent attendees, and they are a young, white, educated, professional population. Amongst the most popular and commonly used illegal substances used were MDMA, cannabis and cocaine amongst Australian festival attendees. These patterns of use however vary significantly particularly between alcohol and illicit drugs, with alcohol being the most frequently used substance often at binge levels. [1] Barratt, M., Hughes, C., Ferris, J. & Winstock, A. (2019). Australian music festival attendees: A national overview of demographics, drug use patterns, policing experiences and help-seeking behaviour. Drug Policy Modelling Program (DPMP) Bulletin No. 28. Sydney: National Drug and Alcohol Research Centre, UNSW. https://ndarc.med.unsw.edu.au/resource/bulletin-no-28-australian-music-festival-attendees-national-overview-demographics-drug-use
Why should the Government fund Peer Harm Reduction Initiatives?
The NSW Coroner in 2019 recommended targeted education programs with an emphasis on harm reduction which was clearly stated in their report ‘The Inquest into the deaths of six patrons of NSW music festivals’. In addition, the report recommends funding and expansion of “peer-delivered harm reduction services” [1] . A harm reduction education approach focuses on reducing harm associated with those behaviours without pushing for an abstinence agenda [2]. Types of initiatives already implemented in Australia are Needle and Syringe Programs aimed at preventing the spread of blood borne viruses (like hepatitis C and HIV) and festival programs like DanceWize funded by both NSW and Victorian Governments. A successful component to delivering harm reduction initiatives are the use of peer workers [2]. [1] Grahame, H. (2019). Inquest into the death of six patrons of NSW music festivals. State Coroner’s Court of New South Wales, Lidcombe. http://www.coroners.justice.nsw.gov.au/Documents/Redacted%20findings%20in%20 the%20joint%20inquest%20into%20deaths%20arising%20at%20music%20festivals%20including%20annexures%20-%208%20November%202019.pdf [2] Munn, B. M., Lund, A., Golby, R., & Turris, S. A. (2016). Observed benefits to on-site medical services during an annual 5-day electronic dance music event with harm reduction services. Prehospital and Disaster Medicine, 31(2), 228 – 234. doi.org/10.1017/S1049023X16000054
What kind of success has drug checking (‘Pill Testing’) had in preventing deaths or hospitalisation?
Data from the ACT Pill Testing trial in 2019 indicated the success of patron’s disposal of substances after receiving information about the potential harms of N-ethylpentylone, all seven patrons in possession of a drug containing that substance discarded the drugs [1]. Without this service it’s highly likely they would have required medical care, hospitalisation or worse case, been fatalities. Pill testing isn’t a new concept and has been used internationally as a harm reduction strategy to screen for adulterants as early as the 1990s in the Netherlands and other European nations [2]. There is evidence that drug checking has helped improve healthcare services, reduced overdose frequency, deters consumers from taking adulterated or lethal substances whilst increasing knowledge of substances and harm reduction principles [2]. [1] Vumbaca, G., Tzanetis, S., McLeod, M., and Caldicott, D. (2019). Report on the 2nd Canberra GTM Pill Testing Pilot: a Harm Reduction Service [Report]. In.: Harm Reduction Australia [2] Groves A. (2018). 'Worth the test?' Pragmatism, pill testing and drug policy in Australia. Harm reduction journal, 15(1), 12. https://doi.org/10.1186/s12954-018-0216-z
How have needle and syringe programs reduced HIV?
One of the most efficient transmission means of HIV and other blood-borne viruses is via contaminated needles/syringes and injected equipment. Needle and Syringe Programs (NSP’s) allow people who inject drugs the opportunity to protect their own health by getting access to sterile injecting equipment. The programs also bring many people who inject drugs into contact with health professionals for the first time in many years. Today, Australia has one of the world’s lowest rates of HIV among people who inject drugs and the evidence is clear that this success is a result of the early introduction of needle and syringe programs, as well as peer-based organisation involvement [1]. [1] Harm Reduction Australia (HRA). (2018). What is Harm Reduction. https://www.harmreductionaustralia.org.au/what-is-harm-reduction/
What are Blood-Borne Viruses?
Blood-borne viruses (BBVs) include hepatitis B, hepatitis C, and HIV. If untreated, HIV can cause Acquired Immuno-deficiency Syndrome (AIDS). Blood-borne viruses (BBVs) are viruses that are carried in the blood and bloodstream. They can also be carried in other body fluids like semen, vaginal fluids, breast milk, and lymph fluid. Depending on the virus, the person carrying it may have serious outward symptoms, or may show no symptoms at all [1]. In many cases a person can be totally unaware the virus is present and pass on the virus without even realising it. The best way to protect yourself from BBVs is to avoid anyone else's blood coming into contact with yours. All of these viruses (HIV, HBV, and HCV) are usually passed on through activities, like sexual intercourse without condoms, or sharing needles and injection equipment [1]. For more information on education and treatment of BBVs there are a range of health and hepatitis organisations, QuIHN also provides health services if you’re from Queensland or other harm reduction organisations in your area. A safe and effective vaccine for Hep B is available for prevention. In regards to treatment your GP can also prescribe Hep C treatment which has a 95% success rate. They can also advise on different antiviral medications for Hep B, however there are no cures for the virus and not everyone needs treatment, regular liver check ups every six months are recommended [2]. [1] Living Positive Victoria. (2016). HIV Transmission Facts. https://livingpositivevictoria.org.au/wp-content/uploads/2018/03/HIV-Transmission-Facts.pdf [2] Hepatitis Australia. (2019). Hepatitis Information. https://www.hepatitisaustralia.com/
Is Decriminalisation for personal use a good idea?
Criminalising people because they use drugs is actually more harmful and counterproductive. This is because it prevents users from accessing health and support services in a timely manner, jeopardizes the wellbeing of users as well as their communities, and necessitates extremely high expenditures on policing and correctional services. It would also be in the best interest to look deeper into how to better balance public health and safety at Australian music festivals, such as through reducing deployment of drug detection dogs, expanding police drug diversion programs and/or removal of criminal penalties for use and personal possession of illicit drugs [1,2]. In contrast, decriminalizing use allows governments to redirect funds towards prevention, support and treatment, resulting in improved social and economic outcomes for individuals, communities and societies. Reviewing the research and statistics of the situation in Portugal where the Portuguese Government has decriminalised drug use, thereby reducing drug related death by half [3]. Decriminalisation would also prevent the majority of the strip searches occurring here in Australia which are conducted for suspicion of minor offense possession [4]. Implementing progressive drug policies such as decriminalising personal use of substances, combined with harm reduction strategies would work towards an improved healthcare approach that may see better results not only for individual’s health and human rights, but improve communities and society itself as seen in Portugal [3]. [1] Hughes, C.E., Barratt, M.J., Ferris, J.A., Maier, L.J., & Winstock, A.R. (2018). Drug-related police encounters across the globe: How do they compare? International Journal of Drug Policy. 56: 197-207. [2] Barratt, M., Hughes, C., Ferris, J. & Winstock, A. (2019). Australian music festival attendees: A national overview of demographics, drug use patterns, policing experiences and help-seeking behaviour. Drug Policy Modelling Program (DPMP) Bulletin No. 28. Sydney: National Drug and Alcohol Research Centre, UNSW. https://ndarc.med.unsw.edu.au/resource/bulletin-no-28-australian-music-festival-attendees-national-overview-demographics-drug-use [3] Drug Policy Alliance. (2018). Drug Decriminalization in Portugal: Learning from a Health and Human-Centred Approach. New York. https://www.drugpolicy.org/sites/default/files/dpa-drug-decriminalization-portugal-health-human-centered-approach_0.pdf [4] Grewcock, M. and Sentas, V. (2019). Rethinking Strip Searches by NSW Police [Report]. University of New South Wales. https://apo.org.au/sites/default/files/resource-files/2019-08/apo-nid254776.pdf
What will be the impacts of harm reduction policies on policing and road safety?
Driving while impaired or otherwise unfit to drive is a high risk behaviour. Roadside alcohol tests assess a driver’s blood alcohol content (BAC) and 0.05BAC is the legal threshold determining impairment. Roadside drug tests look for trace amounts of common illegal drugs, that is THC in cannabis, MDMA, and methamphetamine and in some places cocaine. These tests and the science behind drug impairment thresholds are limited compared to BAC tests. People who use drugs, especially cannabis, are vulnerable to drug driving charges because the roadside drug tests only look for trace amounts in bodily fluids. A person could be fit to drive and it be days or weeks after the effective duration of a drug and still produce a positive result. Harm reduction policies advocate that people should still not drive whilst impaired, it is an unsafe driving practice. However in the instance people are not impared and still being charged with ‘drug driving’ can have a significant and detrimental impact on the social determinants to health, like losing your job and financial security. Therefore it is also in the interest of health promotion and harm reduction to advocate for upgrading the roadside testing for drugs so they can test for impairment levels rather than remnants of it still in a person’s system days after consuming the substance with no residual effects remaining.
