Pynes pain

http://www.news.com.au/adelaidenow/story/0,22606,21832051-2682,00.html

An op-ed by Dr. David Caldicott , in Adelaide, South Australia, criticizes an Australian politician’s fearmongering about MDMA, his misguided advocacy of “Americian-style Prohibition policies” and his “ignorance of drug policy and indeed illicit drugs themselves…”

Pyne’s pain

By Dr. DAVID CALDICOTT

Published on 1 June, 2007
in the Advertiser Adelaide, Australia

THERE appears to be two main types of politician in today’s Australia, as far as illicit drugs policy is concerned.

There are those who privately know and admit that American-style prohibition policies are futile and probably dangerous, and yet fear the repercussions of publicly entering into the debate, and there are those who don’t allow their ignorance of drugs policy or indeed illicit drugs themselves to temper their public commentary.

Mr Pyne’s latest missive in last weeks Sunday Mail seems to suggest that he belongs to the latter group.

His allegation that ecstasy is ‘usually’ cut with hydrochloric acid is both hilarious, and disturbing.

Hilarious, because there is not a shred of evidence to support this, and disturbing, because it reveals the true profundity of his ignorance regarding the very illicit substances themselves, never mind the even more difficult subject of drugs policy. MDMA certainly exists as a hydrochloride salt, but then again, so do many antibiotics.

He merely had to consult with any year 12 chemistry student to discover that this is very different to finding ‘hydrochloric acid’ in ecstasy. If drug users are to be persuaded that their behaviour is mistaken and dangerous, it needs to be done by persons who appear to have at least some vague idea about what they’re talking about.

And yet Australians find themselves in a position where they are obliged to rely on his myopic insights into the current drugs problem to protect their children. His recounting of a scenario where pill testers tell consumers that a drug is ‘safe’ can only be interpreted in one of 2 ways.

Either he has trouble intellectually with the process, in which case parents might rightly express concern about his influence on Australian drugs policy, or he does understand the process, but is happy to misrepresent it for his own political aspirations.

In all formally supervised pill-testing programmes, it is axiomatic to inform the consumer that no drugs are safe, no matter what the results of testing. Advocates of pill-testing in Australia seek, among other things, to convert the informal self-administered system currently in play to a formal system by which consumers are forced to interact with trained health professionals.

The aim is not to reassure, but to take consumers out of their comfort zone, forcing them to acknowledge the potential health risks associated with their behaviour.

You might excuse a simple politician from being unfamiliar with the scientific literature, but to be unaware of your own government’s recommendations is frankly lazy. His suggestion that the NSW heroin injecting room has been discredited is nonsense.

He admits that he arrives at his conclusion from reading the newspapers. If he, for example, turned to something even slightly more scientific (say, the reports commissioned by his own government), he would quickly see that the programme is far from discredited.

Between 1988 and 2000, as a result of the introduction of needle and syringe programs, 25 000 HIV infections and 21 000 hepatitis C infections were prevented among people who injected drugs. As a consequence, 90 hepatitis-C-related deaths and 4500 HIV-related deaths would have been prevented by 2010.

This translates for the taxpayer- and this year, the voter- into cost savings of up to $783 million for hepatitis C treatment and up to $7025 million for HIV treatment. All this, for an estimated cost of $150 million- peanuts in public health terms.

Put simply for the reader, for every one of your tax dollars put into the program, nearly fifty are saved. Now that was 5 years ago, and perhaps Mr, Pyne hasn’t quite had a chance to catch up with his reading.

But this year, his own government’s senate inquiry into Amphetamines and other Synthetic Drugs supported the development of Victoria’s intention to run a trial of pill testing. Sadly, we’ve missed the boat in South Australia- despite the recommendations by the experts at the July 2002 SA Drugs Summit to conduct a trial of pill-testing, these have quietly been ignored by state government.

Mr. Pyne attacks ‘trendy answers’ to the drug problem, presumably because his department and the government he represents are bereft of any new ideas to address a dynamic and ever changing drug market.

His policies clearing failing and the source of increasing scorn and derision by the research community, his solution out of the hole of ‘zero tolerance’ is to dig faster. Like King Canute, holding out his hand and ordering the advancing tide of designer drugs to merely stop, he and his cronies are destined to fail.

Having returned from an international emergency conference in the Netherlands this month, I had the opportunity to review and discuss the formal drug monitoring system in place there. They are very happy with the system currently in place, and since it has been functioning since 1993, were highly amused (and somewhat flattered) that anyone would consider it ‘trendy’.

As Holland has a lower rate of MDMA use, as well as a lower injury rates and a lower deaths rate from that drug than Australia or the USA, one must presume that Mr Pyne’s concerns regarding pill testing are at some sort of existential level.

Recently they have expanded their testing program to include substances seized from amnesty bins at nightclubs. In Australia, substances seized on the door by bouncers have a tendency to find themselves back on the market.

Are the opponents of pill testing so convinced of their position that they would prefer to have illicit compounds circulating and available to their voter’s children, rather than to have them confiscated and tested?

Do they think that it’s unreasonable to be able to test the substances that arrive in emergency departments, in the possession of critically unwell patients, to see if some new, highly toxic substance has been released on the market? Or should parents content themselves with simple post-mortem results?

Mr Pyne’s suggestion that his government is winning the ‘war on drugs’ smacks of George Bush’s now-infamous “Mission Accomplished” speech from the deck of the USS Abraham Lincoln. Mr. Pyne is very selective in his use of statistics.

Diminution in drug consumption, like the heroin figures he quotes, is more likely to be despite federal drugs policy, and as a consequence of simple market forces and demand, rather than due to any inspired leadership on his part.

Is he aware of a drug called methamphetamine? Anyone for ‘ice’? The biggest drug problem facing Australia in a decade, and nothing to say? Hardly winning the war on that front, are we now? The inelegant, unintelligent manner in which the federal government has conducted its bogus war guarantees an even more protracted engagement.

Bullying of researchers, funding research on the basis of ideology and not merit, manipulation of statistics and the conservative press cadre, policy decisions behind closed doors, which are subsequently immune to FOI enquiries, all ensure that it will be 10 years before we can undo the damage from “Tough on Drugs/ War on Drugs” campaigns.

The tragedy is that we could have been so much further ahead in reducing the harm caused by drugs in Australia, were it not for wowsers playing to fringe electoral groups for cheap votes.

It is fine for Mr Pyne, or anyone else for that matter, to believe in ‘zero tolerance’ on m
oral grounds- it’s his personal right, and there is certainly a moral dimension in the debate on drugs. In medicine, we respect the wishes of patients to decline blood transfusions, even though that decision may result in their death.

It doesn’t mean that we would ever consider closing the blood banks, because certain individuals are opposed to transfusion. And yet we are being asked to accept Mr Pyne’s version of drugs policy, his support of zero tolerance in the face of everything we know to be true from science and medicine.

The Australian Medical Association- which incidentally, supports a medically supervised, ethically approved trial of pill testing- has said that a zero tolerance drug policy for Australia would have ‘catastrophic consequences’ for the country.

Mr. Pyne’s polemic is yet another example of a political ‘free kick’, whereby politicians, both state and federal, hide behind press-releases and sound-bites, never having to personally face the scrutiny of science.

If politicians of this ilk want to persuade the public that ‘zero tolerance’ is the way forward, let them stop shirking behind the skirts of their minders and debate it formally, personally, in a public forum, against critical scientists and doctors.

If they don’t know what they’re talking about, they should simply not be allowed to determine policy in such an important arena. Let’s sell tickets and give the money to charity. The Australian public are bright enough to understand the truth about drugs and drugs policy, if they are ever told the truth.

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A strong op-ed by Dr. David Caldicott in South Australia’s Adelaide Advertiser criticizes an Australian politician’s fearmongering about MDMA, his misguided advocacy of “Americian-style Prohibition policies” and his “ignorance of drug policy and indeed illicit drugs themselves…”