Showing newest posts with label Dr. Alex Wodak. Show older posts
Showing newest posts with label Dr. Alex Wodak. Show older posts

Thursday, 27 August 2009

How to Cure Devine Madness - Call Dr. Wodak

At last! A sensible drug related opinion piece from the Sydney Morning Herald NOT written by Miranda Devine. Instead, we are treated to some much needed wisdom from Australia’s leading advocate for drug reform, Dr. Alex Wodak.

I would be safe in saying that many readers are sick of reading selectively researched and totally biased dribble from the Devine Miranda. You see, Dr. Wodak is an expert in his field and relies on medical facts, science and human compassion. This is a stark dichotomy compared to Miranda Devine. Appealing to the ignorant masses or stroking the ideological G-spot of anti-drug zealots may be Devines forte but it just uncovers her real agenda ... her belief that drug use is a moral issue and drug users need to be punished. Ironically, it’s Devine who regularly accuses Dr. Wodak and other medical professionals as having an agenda under the guise of that evil scourge called Harm Minimisation. The very policy that has saved millions of lives, given hope to desperate addicts and aims to treat people humanely. According to Devine, these “elitists” who support Harm Minimisation have a secret agenda to legalise drugs and they must be stopped. But what Devine and other prohibitionists conveniently overlook is that drug reformers simply want a system that works better than the current "War on Drugs" strategy. And their reasoning is simple ... drug use and addiction is a medical/social issue, not a law & order problem stemming from a moral decision to use drugs. It’s the likes of Miranda Devine who simplify an extremely complex issue to what they consider is right or wrong, good or bad, righteous or sinful, holy or evil. No wonder one side consists of doctors, specialists, medical experts, scientists, researchers, welfare workers, academics, realists, human rights supporters etc. and the other side is made up of moral crusaders, the religious right, modern conservatives, evangelists, born again Christians, politicians, the ignorant, neocons etc. Who would you trust?


Tide Turns In Favour Of Drug Reform
By Alex Wodak
Sydney Morning Herald
August 2009


One hundred years ago, the US convened the International Opium Conference. This meeting of 13 nations in Shanghai was the beginning of global drug prohibition.

Prohibition slowly became one of the most universally applied policies in the world. But a century on, international support for this blanket drug policy is slowly but inexorably unravelling.

In January, Barack Obama became the third US president in a row to admit to consumption of cannabis. Bill Clinton had admitted using cannabis but denied ever inhaling it. George Bush was taped saying in private he would never admit in public to having used cannabis. When Obama was asked whether he had inhaled cannabis, he said: ''Of course. That was the whole point.''

Obama has candidly discussed his drug use. ''Pot had helped, and booze; maybe a little blow [cocaine] when you could afford it.'' He has also admitted the ''war on drugs is an utter failure'' and called for more focus on a public health approach.

In February, a Latin American drug policy commission similarly concluded that the ''drug war is a failure''. It recommended breaking the ''taboo on open debate including about cannabis decriminalisation''. The same month, an American diplomat said the US supported needle-exchange programs to help reduce the transmission of HIV and other blood-borne diseases, and supported using medication to treat those addicted to opiates.

In March, the United Nations Commission on Narcotic Drugs met in Vienna as the culmination of a 10-year review of global drug policy. A ''political declaration'' was issued which, at the urging of the US, excluded the phrase ''harm reduction''. This omission caused a split in the fragile international consensus on drug policy and resulted in 26 countries, including Australia, demanding explicit support for harm reduction in a footnote.

In April, Michel Kazatchkine, of the Global Fund to Fight Aids, Tuberculosis and Malaria, argued in favour of decriminalising illicit drugs to allow efforts to halt the spread of HIV to succeed. The same month, a national Zogby poll in the US provided evidence of changing opinion on the legalisation of cannabis: 52 per cent supported cannabis becoming legal, taxed and regulated.

In May there was movement on several fronts. The Governor of California, Arnold Schwarzenegger, said: ''I think it's not time for [legalisation], but I think it's time for a debate.'' He was supported by a number of other American politicians, while Vicente Fox, a former Mexican president, said he was not yet convinced it was the solution but asked: ''Why not discuss it?'' The Colombian Vice-President, Francisco Santos Calderon, is already convinced. ''The only way you can really solve the problem [is] if you legalise it totally.''

Obama's drug czar, Gil Kerlikowske, the director of the Office of National Drug Control Policy, said he wanted to banish the idea of fighting a ''war on drugs'', while the United Nations Secretary-General, Ban Ki-moon, said criminal sanctions on same-sex sex, commercial sex and drug injections were barriers for HIV treatment services. ''Those behaviours should be decriminalised, and people addicted to drugs should receive health services for the treatment of their addiction,'' he said.

In Germany, the federal parliament voted 63 per cent in favour to allow heroin prescription treatment.

In July, the Economic and Social Council, a UN body more senior than the Commission on Narcotic Drugs, approved a resolution requiring national governments to provide ''services for injecting drug users in all settings, including prisons'' and harm reduction programs such as needle syringe programs and substitution treatment for heroin users. This month, Mexico removed criminal sanctions for possessing any illicit drug in small quantities while Argentina is making similar changes for cannabis.

Portugal, Spain and Italy had earlier dropped criminal sanctions for possessing small amounts of any illicit drug, while the Netherlands and Germany have achieved the same effect by changing policing policy.

It is now clear that support for a drug policy heavily reliant on law enforcement is dwindling in Western Europe, the US and South America, while support for harm reduction and drug law reform is growing. Sooner or later this debate will start again in Australia.

Alex Wodak is director of the Alcohol and Drug Service at St Vincent's Hospital.

Related Articles:
The Ballad Of Alex And Miranda
Miranda Devine Vs. Reality
A Devine Nutter & That Booklet
Miranda Devine - Bitch Slapped by the Doctor
Are Flat Earth Journalist Intelligent? No ... Just Dangerous

Saturday, 9 August 2008

Did They Really Say That? Part 2 - Politicians

This is the second part in a 3 part series that puts the spotlight on some of the most remarkable comments aimed at brutalising drug policy in Australia.

Marijuana leads to homosexuality ... and therefore to AIDS

 - White House Drug Czar Carlton Turner, 1986

Do politicians make more silly remarks about drugs than journalists? That’s debatable but what is not up for discussion is the importance of their responsibility to tell the truth. 

Some of the media can interpret events and facts according their particular agenda but why are politicians more renown for this shady practice? Doesn’t this defeat the whole process of democracy and elections? Politicians either lying or not knowing the facts when talking about extremely important issues is not acceptable and to even compare them with journalists for being deceitful is worrying. For politicians, it seems that lying or being void of the facts is acceptable as long as it is in the interest of their party, no matter how important the issue is.

It's time for Morris Iemma and Labor to wake up and realise that protecting families from drugs is more important than securing preferences from the Greens.

[...]

Ice is a scourge on our society. It's killing young people, it's undermining a whole generation and yet you have the Greens Party proposing decriminalisation.

-Peter Debnam. NSW Opposition Leader

The Greens drug policy including decriminalisation that Peter Debnam is talking about, caused much controversy in the media but it was mainly the politicians that used it as ammunition. The policy itself was very thorough and based on evidence. The problem was that in an effort to ride the current wave of controversy, the major political parties didn’t fully study the Greens drug policy and made some wild accusations that in hindsight, don’t really reflect the Green’s policy at all.

The Greens are not just about the environment. They have a whole lot of other very, very kooky policies in relation … to things like drugs and all of that sort of stuff.

-John Howard. Prime Minister.

That's why we're setting up specialised services in our hospitals to deal with this. It is just an absurd and ridiculous and disgusting policy.

-Morris Iemma. NSW Premier (In response to a proposal by The Greens to regulate drugs)

any MP who supported such a policy was completely out of touch with reality

-Morris Iemma. NSW Premier (In response to a proposal by The Greens to regulate drugs)

But I don’t think you can have at the core of it a message which says using heroin is ok. It is a deadly dangerous drug and I don’t think we want a party in Australia arguing that is actually is a good thing.

-Nicola Roxon. ALP - Opposition Health Minister

Any Member of Parliament who thinks we should de-criminalise drugs, including ‘Ice’, should take a good hard look at themselves, do the community a favour, and resign

-Peter Debnam. NSW Opposition Leader

One of the recent drug issues to cop a political hammering is a pure form of methamphetamine called ice. As we have heard over and over from the politicians and media is that ice is the most dangerous new drug to come out for a long time and it’s effecting us in epidemic proportions. The fact is, ice has been around for a long time and usage peaked many years ago. It’s only recently that we have seen reports of hospitals being ripped up by violent ice addicts and the epidemic levels of ice use but when use was highest, we hardly heard a peep. The effects of ice were largely over exaggerated but made a convenient issue for politicians to apply their “toughest on drugs” rhetoric.

Some of the stories of the way in which people have been terrorised and the way in which those who are addicted to ice lose all semblance of control and lapse into violent, uncontrolled, often homicidal rage and it is a frightening drug and we need a special emphasis.

-John Howard

Enough is enough, we must act before ice gets totally out of control as it can be purchased for $50

-Kevin Rudd

Ice had crept into the number one spot as Australia’s new problem drug. S.E. Asian crime organisations switched from heroin as their main export to ice but Howard and the AFP missed it. They were still trying to convince the public (and themselves) that they had stopped the heroin epidemic via the tough on drugs campaign ... which they hadn’t.

The tough-on-drugs campaigns have worked, it's just that ice has suddenly emerged in a way that the government wants to nip in the bud if it can

-Christopher Pyne 2007. During the peak of the so called “ice epidemic”

Poor Chris. under his watch, ice was here. Yes, ice was indeed here, but the government was still spinning their other successes.

And as a result of our strategy hundreds of young Australians spent last Christmas with their parents who otherwise would have lost their lives or taken their lives as a result of heroin abuse

-John Howard. 2007. During the peak of the so called “ice epidemic”

Whilst on heroin, a quick quote from that flossy ex opposition leader, Alex Dolly Downer. A classic “no WMDs” comment when asked about the growing opium trade in Afghanistan since the war on terror.

There may be links to the Taliban but it is certainly not believed to be a major source of funding for the Taliban (it was).

-Alexander Downer

As opposition leader, Kevin Rudd was not going to be left behind in the race to fight the ice problem but his dilemma was whether he appeared to be tough on drugs whilst trying to follow evidence based policy. So he announced Labor’s new ice initiative.

Australia needs new ideas and fresh thinking when it comes to dealing with critical and continuing problems such as drugs and crime. 

But our response must be tough, targeted and evidence-based

-Kevin Rudd. Federal Opposition Leader

And the great plan was - 3 new initiatives: a ban on the importation of crack pipes to smoke ice, a ban on the sale to minors of pseudoephedrine and a ban on the sale of pseudoephedrine over the internet. Very good Kevin, that should do it.

The real debate though was being “tough on drugs”. A recent development was that, instead of debating drug strategies, the politicians would try to score brownie points for being the toughest of the tough and try to brand their opposition as “soft on drugs”. Howard aligned himself with the Zero Tolerance cheer squad including Bronwyn Bishop, Ann Bressington, Christopher Pyne etc. and attacked Harm Minimisation including terminology like recreational / party drugs, state cannabis laws and anything else that was not Zero Tolerance.

As I have said previously concerned parents need to watch closely who opposes the measure that will send a clear message that drugs are not normal teenage behaviour, whether that be members of parliament educates or health care professionals it will be an indication of who is soft on drugs.

-Ann Bressington

Labor's preference deal with the Greens, who were soft on drugs, showed the ALP was not as strict on the issue

-John Howard

No-one can accuse the Iemma Government on being soft on drugs

-John Watkins. NSW Police Minister

No-one can accuse this Government of being soft on drugs

-Chris Ellison. Federal Justice Minister

I wish the Greens wouldn’t be soft on drugs ... and national security

-Ron Boswell. Nationals Leader in The Senate

Dr. Alex Wodak gives his “soft on drugs” quote.

Howard can't lose on this. If he wins, he'll be wrapped in the Australian flag as protecting the youth of the future. If he loses, then the states get labelled 'soft on drugs'."

-Dr. Alex Wodak

Being tough on drugs never quite worked out though in the real world. The ice issue was got plenty of attention but what about other issues. Drugs in sport.

The NRL applies limited sanctions for the first position, and for the second, a more serious penalty. This accords precisely with the Government's approach - we don't give any quarter to anyone about drugs.

-Christopher Pyne. Congratulating the NRL on their 2 strike policy being an example of the government’s 1 strike policy

The Medically Supervised Injecting Centre (MSIC)

He (Mark Latham) wants to read books to kids when they're five and he wants to give them access to drug injecting rooms when he's 15.

-Tony Abbott. Health Minister

Politicians loved the MSIC. So much so, that when other states showed interest in the service, the federal government threatened to step in.

We would look at what the Commonwealth could do constitutionally. If there were any further proposals in Australia for heroin injecting rooms, we would look at what action we could take

-Chris Ellison. Federal Justice Minister

How about the Medically Supervised Injecting Centre AND ice

The Commonwealth Government does not support the heroin injecting room, and if it is becoming the ice injecting room we think that is the wrong approach

-Christopher Pyne

... how about everything ... including graffiti.

...social issues that are all too often underpinned by substance abuse, such as youth suicide; teenage pregnancy; abortion; unemployment; welfare dependency; poor school retention rates; family breakdown; child abuse, neglect and abandonment; domestic violence; prostitution; crime; road rage; road fatalities; and even graffiti, believe it or not.

-Ann Bressington

... and think of the children

We do not hearabout how many babies are born addicted in this country. Now he was not just a heroin baby; he was a methamphetamine baby, a methadone baby, a dope baby, a pill baby. God knows how he turned out normal.

-Ann Bressington

Ah, Ann Bressington ... Chris Pyne with a bogan haircut. Chris Pyne and Ann Bressington are birds of a feather. Both are from S.A., both with strong views against drugs, both with out a shred of credibility and both wanting to ban drug paraphernalia. What is Pyne speak for “ban the bong”?

I'm certainly concerned about the proliferation of apparatus for the use of illicit substances

-Christopher Pyne

This was par for the course. If they couldn’t stop people from using drugs, they were going to make it hard for them. It didn’t matter if it actually stopped drug use or not as long as there was a sound bite to go with it.

Imposing a ban on the sale of drug paraphernalia not only sends the message that drugs are socially unacceptable, but it makes it more difficult for first-time drug users to experiment with illicit substances.

-Christopher Pyne

First time drug users of course didn’t give a shit about whether they had a bong or not, they could just whip one up at home with their neighbours garden house and a orange juice container. 

Ann had a different reason why the proliferation of apparatus for the use of illicit substances was wrong. It was for their own good because they didn’t really enjoy it.

... in her 11 years of experience she has not met one drug user that has not had underlying emotional issues, and this is why they use drugs, to avoid dealing with those issues. People who know how to enjoy themselves don’t use drugs.

-Ann Bressington

Arh, Bressington logic. That explains why the millions who have used drugs, don’t know how to enjoy themselves.

With all this tough on drugs talk and each politician trying to get one up on the other, it was bound to happen. Yep, fighting amongst themselves was inevitable.

The Labor party room is divided in its attitudes to drugs. Duncan Kerr, a member of Mr Rudd's frontbench, is the convenor of the Parliamentarians for Drug Law Reform. This group supports decriminalisation and harm-reduction policies ahead of a tough, no-nonsense approach

-Christopher Pyne

I don't want to name those members but sometimes you have thoughts particularly if they are campaigning to legalise marijuana, cannabis and they think it's a harmless drug

I think the deduction could be, if that's their view, that they are using it themselves.

-Fred Nile. Politician - Christian Democrat

All health professionals and law-enforcement agencies are horrified by the impact of ice on our community, and here you see the State Government condoning - in fact, promoting - the use of ice

-Peter Debnam. NSW Politician. Alarmed that addicts were allowed to inject ice in the MSIC centre

What about the politicians nightmare, cannabis? The issue of personal use being decriminalised has seen several states reduce the penalties for cannabis possession to on-the-spot fines or similar. Moving towards a more rational approach on cannabis is long overdue but the previous government had other ideas. Alcohol was fine and received very little attention but a drug that causes a tiny percentage of problems in comparison was not. 

We have to treat it(cannabis) as an illicit drug as dangerous as heroin, amphetamines or cocaine

-Christopher Pyne

Even though alcohol causes 100 times more damage than cannabis, the Howard government just couldn’t take the focus off grass. The National Cannabis Strategy was released, portraying marijuana as a dangerous, evil drug when the National Alcohol Strategy had this to say:

Alcohol plays an important role in the Australian economy. It generates substantial employment, retail activity, export income and tax revenue. Alcohol also has an important social role...

Personally, I like this quote about alcohol:

Woman: "Sir, you are drunk." 

Winston Churchill: "Indeed, madam, and you are ugly. But tomorrow I shall be sober."

We know that governments like to take credit whenever there is a dip in drug use statistics, but when those statistics aren’t so flattering, why try and explain it away, just make up your own results. This classic quote is from Christopher Pyne, answering criticism about research into a national anti-drug advertising campaign that found Australians already know the dangers and it was not actually stopping people from using drugs

It confirms research (it didn’t) that the Government's done, which shows that younger people, in particular, are becoming very well aware of the harmful effects of cannabis and other illicit drugs on their mental state -Christopher Pyne

Yes, it’s true, he did say this.

It seems obvious now that tough drug policies, especially Zero Tolerance is the way to go if you want to be a successful politician. The problem is that Harm Minimisation is Australia’s official drug policy but it’s probably best not to let the public in on that. HM underlies all the success but ZT is the political profile that gets votes. 

They are evil, all of them, and there should be an uncompromising social condemnation of drugs. Why can't we have the same attitude towards drugs that a large section of the community has developed towards tobacco?

-John Howard

Well for the life of me I can't see why we shouldn't have a completely zero tolerance, an uncompromising approach to illicit drug taking

-John Howard

The first and most important thing governments have got to do is communicate a message of unconditional hostility to the use of illicit drug

-John Howard

If only it was that simple. You see, Zero Tolerance doesn’t work and never has. Basically it’s prohibition but puts users in the same class as the big dealers and manufacturers. But the criminals at the top are very hard to catch, so rounding up users becomes the strategy to show success. The larger the drug problem grows, the more that easy pickings like users and small time dealers are targeted. It’s known as “drugs on the table” or the “numbers game”. It doesn’t help anyone but as the problem grows, the more the public want results so showing that the police are being tough on drugs is hailed as the answer. The problem being that the answer is the actual cause.

Zero Tolerance is the basis for the "War on Drugs". Bronwyn Bishop even named her infamous report, “The Winnable War on Drugs”. Is it really winnable?

There are naysayers who believe a global fight against illegal drugs is unwinnable. I say emphatically they are wrong. Our slogan for the Special Session is "A Drug Free World - We Can Do It!" The United Nations and the International Drug Control Programme (UNDCP) will help lead the way. - Towards a drug-free world by 2008 - we can do it…

-Pino Arlacchi. 1998. United Nations Under-Secretary-General

“We can do it” ... we didn’t. Not only didn’t we reach the goal of a drug free world, drug use increased. Those zany, crazy UN people.

Prohibition has been proven not to work for both drugs and alcohol. Funnily enough, we always refer to alcohol prohibition as a huge failure but it is minor in comparison to the failure of drug prohibition. This is what one of the greatest minds ever known had to say about prohibition.

The prestige of government has undoubtedly been lowered considerably by the prohibition law. For nothing is more destructive of respect for the government and the law of the land than passing laws which cannot be enforced. It is an open secret that the dangerous increase of crime in this country is closely connected with this.

-Albert Einstein

John Howard was optimistic though.

We are making progress in the war against drugs, but we have a long way to go

-John Howard

There was one positive though according to US Republican and political commentator, P.J. O'Rourke .

Drugs have taught an entire generation of American kids the metric system.

-P.J. O'Rourke

So who is right? Howard? Rudd? Pyne? Roxon? Which policy is best for Australia? Harm Minimisation? Zero Tolerance. John Howard never really knew what the official drug policy was for Australia and always said we have to be tough on drugs including users. Does Rudd support ZT or does he support evidence based policy? Well that’s hard to tell because there has been no official drug policy from Labor since they took office. Let’s see what the Rudd and Howard governments have said previously. BTW, Harm Minimisation is still the official drug policy since 1985.

Labor strongly condemns illicit drug use and supports a “tough on drugs” approach as a means of protecting Australians from the terrible consequences of drug use and abuse.

Nicola Roxon. ALP - Opposition Health Minister

We will never adopt a harm minimisation strategy; we will always maintain a zero tolerance approach.

-John Howard

We're judgemental when it comes to the undesirability of starting drug taking in the first place. We shouldn't be judgmental about people who have become addicted. We should be helpful towards them, we should offer them support, we should offer them rehabilitation and we should offer them comfort and affection.

-John Howard

Our general approach when it comes to drugs policy is one of zero tolerance

-Kevin Rudd. Opposition Leader.

I believe in evidence-based policy

-Kevin Rudd. Prime Minister

And finally we turn to Christopher Pyne for the final word on the complex issue of drug policy in Australia.

We firstly have to make people understand that using drugs is wrong, it's bad for them, it's bad for the general society because of all the problems that it causes.

-Christopher Pyne

Yes, again, he did say this.

So there we have it, evidence versus politics. It might be of interest to note that recently, nearly every credible report commissioned by a government into a strategy for making progress on the drug problem has been completely ignored by the government itself. Our politicians cannot defend themselves as not having adequate information on alternative policies or not knowing the damage that current strategies are having on society. The quotes I have presented might be humorous or even absurd but politicians, of all people, should be taking this subject seriously. Yes, we hear it all the time now, that this subject or that subject is above politics but illicit drugs are the second largest industry on the planet. Larger than oil or legal drugs and only out shadowed by weapons/miltary spending. It is responsible for much of the world’s crime and divides communities more than any other subject except maybe religion. The biggest issue though, is that the above issues which are man made and preventable keep getting documented and ignored by politicians. That’s truly shameful.

In thoughtful circles, the debate is over, harm reduction wins. 

Now the task is to get this through the political maze

-Dr. Alex Wodak

Previous: Did They Really Say That? Part 1 - The Media

Next: Did They Really Say That? Part 3 - The Religious Right

Monday, 2 June 2008

Miranda Devine - Bitch Slapped by the Doctor

Zero Tolerance zealot, Miranda Devine recently wrote an opinion piece in the Sydney Morning Herald condemning an ad hoc speech given by Dr. Alex Wodak where he suggested that marijuana be regulated like alcohol or tobacco. Devine’s evidence for her attack on Dr. Wodak’s speech was the usual mismatch of cherry picked research and threats of moral decay which we pointed out in a previous article but more importantly was addressed by Dr. Wodak himself in a reply letter. Apparently dismayed that Dr. Wodak had the cheek to discredit her opinion with real facts, Devine responded with more misinformed opinions and flawed evidence. She was following the great tradition of anti-drug proponents with the thinking that if you repeat it enough times, it may come true. 

Read on as Dr. Wodak again rips apart Devine’s junk evidence and self important opinion with the one thing that the Zero Tolerance crowd can never get around ... facts.

An Open Letter to Ms Miranda Devine from Dr Alex Wodak:

A shorter version of this letter (without references) was offered to the Sydney Morning Herald but declined. This commentary is a response to arguments made in an article by Ms Devine published in the Sydney Morning Herald on 15 May 2008.  

REDUCING THE HARMS OF CANNABIS AND CANNABIS POLICIES

In her recent article on cannabis in the Sydney Morning Herald [1], Ms. Miranda Devine expressed three main concerns about taking this drug out of the domain of law enforcement and into the domain of public health. Firstly, that a public health approach will inevitably increase cannabis use in Australia at a time of declining consumption. Secondly, that cannabis increases psychosis. Thirdly, that the Swedish zero tolerance approach demonstrates best how to reduce illegal drug consumption. Some support for each of these views may be adduced from partial quotation of selected research and opinions, including a recent letter [2] to the Sydney Morning Herald by Dr. Don Weatherburn and Professor Wayne Hall.  However, a thorough review of research to date does not support Ms. Devine’s case.

Assertions that cannabis use is certain to increase if the drug is taxed and regulated are just beliefs, no doubt strongly held, but unsubstantiated beliefs nonetheless. A European comparative study and an overview of research conducted in the USA and Australia found [3] no convincing relationship between drug policies and prevalence rates of cannabis use. In his evaluation of the effects of the 1987 partial decriminalisation on cannabis use in South Australia, Professor Hall concluded [4] that the increase in consumption in South Australia was not significantly greater than the average increase in the other three states included in the study.

Ms. Devine cited criticism [2] by Weatherburn and Hall of a study by Reinarman, Cohen and Kaal comparing [5] cannabis consumption in San Francisco and Amsterdam as evidence against my views. Weatherburn and Hall argued that differences in demographics may have explained the higher consumption in San Francisco. But it is clutching at straws to believe that the small demographic differences that were found in this study can explain a more than three-fold greater prevalence of smoking cannabis in the city with the more punitive approach. The study also found that the prevalence of use of every other illicit drug was dramatically higher in San Francisco. National surveys in both countries consistently confirm these same differences. If the peer reviewers for the top public health journal in the world had considered demographic differences to be a serious limitation of the study, they would have demanded that the authors indicate this.  

Weatherburn and Hall are correct that the samples were not exactly matched. But both were rigorously random, representative samples of experienced users in the household populations of the two cities and the survey instruments and measures used were identical.  

The fact that the findings of this study were consistent with virtually all other studies in showing that the great majority of cannabis users clearly reduce use or cease altogether as they get older suggests that the slightly higher average age of the San Francisco respondents was more likely to have reduced use in San Francisco relative to Amsterdam rather than to have increased it.  Dr. Weatherburn and Professor Hall have it backwards.

These researchers also appear to cite the comparative study selectively. They did not mention that the slightly higher likelihood of unemployment in the two years before the study was conducted in San Francisco was most likely due to temporary problems of the high technology industry at the time of the study. It is difficult to believe that Weatherburn and Hall could argue that this temporary slightly higher unemployment explains the threefold higher cannabis consumption found in San Francisco.  

It is also misleading for these researchers to claim that ‘consumption increased substantially in the Netherlands after the creation of a de facto legal market’. While cannabis use did increase in the Netherlands at that time, it also increased in almost every other Western country where cannabis prohibition was continued. In some countries, cannabis consumption increased even more than in the Netherlands. Thus, the causal claim that these respected researchers make is too simplistic. Cause cannot be established without proper comparisons and when these comparisons are made, the increase in use cannot be solely attributed to the de facto decriminalization of cannabis in the Netherlands.

Although Dr. Weatherburn and Professor Hall say in their letter that ‘in research in NSW, most regular cannabis users say they would use it more often if it was legal’, Weatherburn’s own study suggests otherwise. Weatherburn and a colleague concluded [6] ‘that two-thirds of respondents definitely wouldn't use more cannabis if it were made legal. The remainder, however, would not rule out using cannabis more frequently if it were legal. Four per cent of the sample said they definitely would use more cannabis, about 10 per cent said that they would probably use more and about 19 per cent said that they probably wouldn't use more but, nonetheless, did not rule out the possibility’.

The Police Foundation of the United Kingdom noted [7] in their ‘Drugs and the Law’ report in 2000 that ‘the consequences of drug use are more important than the numbers of users.’ Quite so. The fundamental principle of harm reduction is that reducing harm is more important than a single minded focus on reducing consumption, whatever the cost. Drug law enforcement authorities in Australia have also questioned [8] the wisdom of harsh penalties for cannabis use noting ‘[cannabis offences] … absorbed a significant proportion of resources dedicated to drug law enforcement. In addition, in contrast to most other illicit drug use, there appears to be a comparatively low rate of associated crime and harm to other individuals and the community. The decriminalisation of personal cannabis use and production may greatly reduce both police and legal resource expenditure’. 

Policy determination must include a balancing of benefits and costs. That is why the costs of cannabis prohibition should not be ignored. According to Professor Hall, the costs of cannabis prohibition include ‘the creation of a large black-market; disrespect for a widely broken law; harms to the reputation of the unlucky few cannabis users who are caught and prosecuted; lack of access to cannabis for medical uses; and an inefficient use of law enforcement resources’ [9].  Ms. Devine makes much of my somewhat facetious comments about the realistic options for selling cannabis. But she does not acknowledge the current realities: cannabis is now sold on the black market with no health standards or regulation. Ms. Devine should explain why she prefers cannabis to be sold with no health standards or regulation.

Despite Ms. Devine’s conviction that a causal relationship between cannabis use and mental illness is only questioned by drug law reformers, debate continues among experts. Professors Louisa Degenhardt and colleagues found [10] a ‘steep rise in the prevalence of cannabis use in Australia over the past 30 years’ but ‘no evidence of a significant increase in the incidence of schizophrenia’. They concluded that ‘cannabis use does not appear to be causally related to the incidence of schizophrenia, but its use may precipitate disorders in persons who are vulnerable to developing psychosis and worsen the course of the disorder among those who have already developed it.’ If cannabis use is associated with a significant risk of causing or worsening serious mental illness, why does Ms. Devine prefer cannabis to be sold only by criminals or corrupt officials? 

Ms. Devine’s conviction [1] that Sweden demonstrates ‘that prohibition is the most certain way to reduce drug use’ is shared by few others. What matters more: drug use or drug-related harms? For example, the rate of drug overdose deaths in Sweden (16.9/million) is more than twice that in the Netherlands (7.5/million) [11]. Not so long ago, all Scandinavian countries had the same drug policy. Now Sweden is the last Scandinavian country and among the last countries in Western Europe to reject harm reduction. In 2006, the UN Special Rapporteur on the Right to Health visited Sweden and specifically recommended [12] to the UN General Assembly that: ‘[T]he Government has a responsibility to ensure the implementation, throughout Sweden and as a matter of priority, of a comprehensive harm reduction policy, including counselling, advice on sexual and reproductive health, and clean needles and syringes’.

But surely if country comparisons with Australia are to be made, we should compare ourselves with a country that shares many of our social, economic, cultural, linguistic and political characteristics: the United States of America. In contrast, Australia has little in common with Sweden. Why does Ms. Devine chose to compare drug outcomes in Australia only with Sweden rather than with the United States of America? After all, Sweden and the United States of America both reject harm reduction and prefer zero tolerance. The US Congress even passed legislation in 1988 mandating that the country would become drug free by 1995. The reason is obvious. Drug-related deaths, disease, HIV, crime and corruption are out of control in the USA. With 737 prisoners per 100,000, the USA has the highest incarceration rate in the world - five times higher than Australia - and more than a third of these inmates are serving sentences for drug related offences. Ms. Devine compares only drug use in countries. But surely drug-related harms count for more than just drug consumption? While the relationship between levels of consumption of legal drugs and drug-related harms is clear both for individuals and communities, the relationship between levels of consumption of illegal drugs and drug-related harms is anything but clear. 

Although Ms. Devine quotes Professor Hall approvingly, she should be aware that in 2007, and with important caveats, he advocated [13] ‘a limited legal cannabis market’ accompanied by ‘grudging tolerance’.  Such a system would presumably need to include the same limiting measures I have advocated: taxation, strict regulation of cultivation and sale, health warnings, consumer quality controls, age restrictions on sale and assistance for users when trying to quit. No policy is ever going to be perfect but this approach is surely less costly to the community and less harmful to cannabis consumers than just leaving the market to the Al Capones of this world as Ms. Devine appears to favour. 

The wisdom of the decision to include cannabis with the global prohibition of opium poppy and coca plant in the 1961 Single Convention is now being increasingly questioned. The UNODC, the major organization implementing drug policy on behalf of the UN system recently acknowledged [14] ‘either the gap between the letter and spirit of the Single Convention, so manifest with cannabis, needs to be bridged, or parties to the Convention need to discuss redefining the status of cannabis’.  

Is the idea of cannabis taxation really so outlandish? After all, US Congress enacted the Marihuana Tax Act in 1937. This remained legislation until 1970. As recently as 2005, 500 US economists (including Professor Milton Friedman and two other Nobel Prize winners) published [15] an Open Letter to leading politicians including the President and members of Congress calling for the taxation of cannabis. 

Ms. Devine is right [1] that Britain recently reclassified cannabis from Class C to Class B (where Class A drugs are considered the most dangerous, Class B intermediate and Class C least dangerous). This was the first time that the British Government had ignored the views of its expert advisory body (the Advisory Council on the Misuse of Drugs). The UK police then announced that they would not change policing practices on cannabis because of this reclassification. Also, cannabis use had declined in the UK after cannabis was classified from Class B to Class C. Does Ms Devine believe that symbolism trumps outcomes or the reverse?

Ms. Devine expressed concern [1] that Australia ‘ranks in the top 10 drug users of 193 nations in the UN's 2007 World Drug Report’. But the Howard government introduced a ‘Tough on Drugs’ policy in 1997 and continued this policy until it lost office in 2007. Is the high ranking for drug consumption in Australia explained by the Howard government not being tough enough on drugs or does a supposedly tough drug policy have little impact on drug consumption even after ten years? 

One of the hallmarks of a poor argument and weak evidence is the use of personal attacks. Ms. Devine shows the weakness of her case by her reliance on gratuitously personal attacks on myself and my 26 years of practice, research and advocacy in this field.  

Yours sincerely,

Dr Alex Wodak, 

President, 

Australian Drug Law Reform Foundation, Darlinghurst, NSW 2010

References:

[1] Ms. Miranda Devine, Puff goes the drug liberalizer, Sydney Morning Herald, 15 May 2008

[2] Dr. Don Weatherburn, Professor Wayne Hall. Mismatch on dope figures (Letters) Sydney Morning Herald, 13 May 2008

[3] V. Maag.  Decriminalisation of cannabis use in Switzerland from an international perspective-European, American and Australian experiences.  International Journal of Drug Policy. 2003; 14 (3); 279 - 281.  

[4] Neil Donnelly; Wayne Hall; Paul Christie. The effects of the Cannabis Expiation Notice system on the prevalence of cannabis use in South Australia: evidence from the National Drug Strategy Household Surveys 1985-95. Drug and Alcohol Review. 2000; 19 (3); 265-269.  

[5] Reinarman C, Cohen PD, Kaal HL. The limited relevance of drug policy: cannabis in Amsterdam and in San Francisco. Am J Public Health. 2004; 94(5): 836-42.

[6] Don Weatherburn, Craig Jones. Does prohibition deter cannabis use?  Number 58, August 2001.  Contemporary Issues in Crime and Justice. Crime and Justice Bulletin. http://www.lawlink.nsw.gov.au/lawlink/bocsar/ll_bocsar.nsf/vwFiles/cjb58.pdf/$file/cjb58.pdf 

[7] Drugs and the Law: Report of the Independent Inquiry into the Misuse of Drugs Act 1971. The Police Foundation, London, 2000.

[8] The Australian Bureau of Criminal Intelligence. Australian Illicit Drug Report 1996-97.

[9] Wayne Hall. Reducing the harms caused by cannabis use: the policy debate in Australia. Drug and Alcohol Dependence. 62 (3); 163 - 174. 

[10] Louisa Degenhardt, Wayne Hall, Michael Lynskey. Testing hypotheses about the relationship between cannabis use and psychosis.  Drug and Alcohol Dependence. 2003. 71 (1); 37- 48. 

[11] European Monitoring Centre for Drugs and Drug Addiction, 2007 Annual report, Table DR5 Part (i) http://www.emcdda.europa.eu/stats07/drdtab05a 

[12] Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health, Paul Hunt. Addendum: Mission to Sweden. 

http://daccessdds.un.org/doc/UNDOC/GEN/G07/111/82/PDF/G0711182.pdf?OpenElement 

[13] Wayne Hall. A cautious case for cannabis depenalisation. pp 91-112. Pot Politics. Marihuana and the costs of prohibition. (ed) Mitch Earleywine. Oxford University Press 2007. 

[14] United Nations Office on Drugs and Crime, 2006 World Drug Report

[15] Open Letter to the President, Congress, Governors, and State Legislatures.

http://economics.about.com/gi/dynamic/offsite.htm?zi=1/XJ&sdn=economics&cdn=money&tm=38&gps=174_306_1008_577&f=00&su=p649.0.147.ip_&tt=2&bt=0&bts=0&zu=http%3A//www.prohibitioncosts.org/endorsers.html