The+Harm+in+Harm+Minimisation

Student Number: n8883726 Tutor: Abbey Diaz
 * The Harm in Harm Minimisation **
 * “The drugs don’t work; they just make it worse…” **


 * The Artefact **

//"Drug taking is illegal and therefore a zero tolerance policy is the only way to go. By advising impressionable young people about safe ways of taking drugs is like saying OK use drugs but please be careful. Dangerous driving is illegal and could kill innocent people and the perpetrators so why don't we put out a booklet advising would be dangerous drivers to try and do so in a safe way?" //

The artefact is a comment posted in response to an article on the Sydney Morning Herald website titled //Accepting Drug Use Does Not Mean Condoning It.// The article describes the NSW Department of Health's 2006 brochure //Drug Safety – Guide to a Better Night Out// and encourages the harm minimisation approach. The above comment disagrees with the article and suggests that a zero tolerance approach should be used in relation to illicit drug use and that the harm minimisation approach will encourage further illicit drug use.

The artefact represents the public health issue of illicit drug use in Australia, more specifically current public opinions of the two main forms of treatment of drug addiction, abstinence and harm minimisation. The article at which this comment is directed at briefly describes a campaign which has used the harm minimisation approach and suggests that since people taking drugs is inevitable it is import to reduce the harm of those drugs, conversely the comment made in response to this uses a prohibitionist perspective which supports abstinence possess a zero tolerance for illicit substance use (Mendes, 2008).
 * Public Health Issue **

Prohibitionists employ a zero tolerance perspective on illicit substance use and view it as immoral and a criminal behaviour rather than a health issue. A common belief amongst prohibitionists is that harm minimisation will not end substance use and its negative impacts on society; it will just make it safer for the individual to use illicit substances. They therefore prefer abstinence as a treatment method for illicit drug addiction (Mendes, 2008).
 * Literature Review **

This zero tolerance approach was first seen in Australia in 1976, starting in Queensland and New South Wales, Australia started its own “War on Drugs”. This and Australia’s establishment of abstinence laws was influenced by the American “War on Drugs“ which aimed to use a “tough on drugs” right winged approach and police crack downs to reduce the drug supply, thus diminishing the drug problem. (Jiggens, 2004) This same approach was seen during the prohibition of alcohol sale in America during 1919 to 1933. However, it was found that although there was a significant reduction in alcohol consumption initially, over the course of a few years alcohol consumption increased to almost the same as it pre-prohibition level. This is due to the fact that this approach failed to incorporate the demand of alcohol instead focusing on reducing the supply, which led to alcohol being supplied via the criminal underground. (Miron & Zwiebel, 1991)

Despite laws and treatments there is still a high level of supply and demand of illicit drugs in Australia and the amount of harms associated with drug use has increased (Wodak, 2012). Therefore the National Drug Strategy, established in 1985, was based on the principal of harm minimisation and involves the cooperation of the Commonwealth, state and territory governments and the non-government. The National Drug Strategy has three key aims; to reduce the demand for drugs, to reduce the supply of drugs and to reduce the harm associated with illicit drug use. (National Drug Strategic Framework, 2011)

It is assumed that if the demand for illicit drugs reduces so will the supply. Methadone treatment has been used as a way to reduce the demand for illicit since 1969 and it has been seen as an effective method of treatment. (Review of methadone treatment in Australia, 1995) In Australia the National Methadone Policy was established in 1997, this policy outlined the guidelines for providing methadone treatment in Australia. (National Policy on Methadone Treatment, 1997) Methadone is used as a substitute for heroin and it is effective in this matter as it inhibits the development of withdrawal symptoms and reduces cravings. (Clinical guidelines and procedures for the use of methadone in the maintenance treatment of opioid dependence, 2003)

The key way in which the harms associated with drug use are minimised is through Needle and Syringe Programs. Needle and Syringe Programs were established in Australia in 1987, these programs enabled needles and other injecting equipment to be legally distributed to drug users. The aim of this program is to reduce the amount of blood born viruses such as HIV and hepatitis C being contracted through the sharing of needles and other injecting equipment and then spread through to the general public. This is achieved by providing users with access to sterile injecting equipment and other drug treatment services as well as proving information relevant to the user (Department of Health, 2010). It has been shown that in cities with Needle and Syringe Programs the amount of blood born viruses has decreased compared to cities without Needle and Syringe Programs in which the prevalence of blood born viruses have increased (Commonwealth of Australia, 2002).

Prohibitionists believe that focusing on harm minimisation will not reduce the uptake of drugs and therefore do not support it (Mendes, 2008). Research has shown that harm minimisation methods such as methadone and needle and syringe programs do work in terms of reducing the harms associated with illicit drug use, however statistics from the Australian Institute of Health and Welfare (2011) show that illicit drug use has increased over the past couple of years. Nevertheless, public opinion is still in favour of harm minimisation methods as seen in a study carried out by Matthew-Simmons, Sunderland and Ritter (2013) which examined 6 different categorized groups of individuals, including prohibitionists, legalises and various groups in between, and found that majority of the public opinion was in support of harm minimisation methods.

<span style="font-family: Cambria,serif; font-size: 12pt;">There is a negative stigma surrounding illicit drug users, a stigma is a mark of social disgrace that suggests that they are deviants. These attitudes towards problematic drug users are common among the general public. (Lloyd, 2013) Due to this stigma, Labelling Theory can be applied to illicit drug users. Labelling theory suggests that if a person is labelled or assumed to behave in a certain way, they will eventually behave in such ways as is expected or assumed of them. This is due to the fact that when a person is labelled or assumed to behave in a certain negative way they will eventually accept this assumption of themselves and adopt those assumptions; in essence they will behave in that way because it is assumed that they will do so. (Bernburg, Krohn, & Rivera 2006) Therefore as it is assumed that problematic drug users are deviants, according to labelling theory they will continue to behave as such because they have accepted societies view of themselves and have adopted this view resulting in the continuation and expansion of deviant behaviours in problematic drug users. However, one limitation of this theory is that it only provides insight as to why behaviour continues not as to why it starts.
 * <span style="font-family: Cambria,serif; font-size: 12pt;">Cultural and Social Analysis **

<span style="font-family: Cambria,serif; font-size: 12pt;">The artefact shown above is a good representation of illicit drug use in Australia as it represents public opinion on the issue, two opposing viewpoints, and raises the argument of which approach is more important harm minimisation or zero tolerance. The article encourages a harm minimisation approach stating that illicit drug use is inevitable and thus there should be more focus on reducing the harms of drug use then stopping drug use altogether. Conversely the comment opposes the article and provides a current popular opinion relating to harm minimisation. The comment suggests that harm minimisation will accomplish nothing except possibly the idea that illicit drug use is OK and possibly encourage illicit drug use rather than eliminate it; it also employs a prohibitionist perspective which possesses a zero tolerance for illicit drug use.
 * <span style="font-family: Cambria,serif; font-size: 12pt;">Analysis of the Artefact and Reflection **

<span style="font-family: Cambria,serif; font-size: 12pt;">Before researching this topic I too had a zero tolerance for illicit drug use and agreed with the comment, I thought that harm minimisation would encourage the uptake of illicit substances by focusing instead on making it safer to use illicit drugs rather than preventing he uptake in the first place. However, through researching this topic I have now realised that a zero tolerance approach, as seen in prohibition in America, does not significantly reduce substance use and that illicit drug use is inevitable. Due to this I have now realised that it is more important that people who are using drugs or who are going to use drugs know how to do so safely and are provided with the help that they need to reduce the risks associated.

<span style="font-family: Cambria,serif; font-size: 12pt;">Australian Government. (2011). National Drug Strategic Framework. Retrieved from: []
 * <span style="font-family: Cambria,serif; font-size: 12pt;">References **

<span style="font-family: Cambria,serif; font-size: 12pt;">Bernburg, J., Krohn, M., & Rivera, C. (2006). Official labeling, criminal embeddedness, and subsequent delinquency: A longitudinal test of labeling theory [Abstract]. //Journal of Research in Crime and Delinquency//. doi:10.1177/0022427805280068

<span style="font-family: Cambria,serif; font-size: 12pt;">Bowen, M. (2010). Accepting drug use does not mean condoning it. //The Sydney Morning Herald//. Retrieved from: []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Australian Institute of Health and Welfare. (2011). //2010 National Drug Strategy Household Survey report (25).// Retrieved from []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Department of Health. (2003) //Clinical guidelines and procedures for the use of methadone in the maintenance treatment of opioid dependence.// Retrieved from the Department of Health website []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Department of Health. (2010) //National Needle and Syringe Programs Strategic Framework 2010-2014.// Retrieved from the Department of Health website []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Department of Health. (1995) //Review of methadone treatment in Australia.// Retrieved from the Department of Health website []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Department of Health. (2010) //National Needle and Syringe Programs Strategic Framework 2010-2014.// Retrieved from the Department of Health website []

<span style="font-family: Cambria,serif; font-size: 12pt;">Commonwealth of Australia, Department of Health and Aging. (2002). //Return on investment in needle and syringe programs in Australia: Summary report.// Retrieved from []

<span style="font-family: Cambria,serif; font-size: 12pt;">Jiggens, J.L. (2004). //<span style="font-family: Cambria,serif; font-size: 12pt;">Marijuana Australiana : cannabis use, popular culture and the Americanisation of drugs policy in Australia, 1938-1988. //<span style="font-family: Cambria,serif; font-size: 12pt;"> PhD thesis, Queensland University of Technology.

<span style="font-family: Cambria,serif; font-size: 12pt;">Lloyd, C. (2013). The stigmatization of problem drug users: A narrative literature review. //Drugs: Education, Prevention and Policy. 20//(2), 85-95. doi: 10.3109/09687637.2012.743506

<span style="font-family: Cambria,serif; font-size: 12pt;">Matthew-Simmons, F., Sunderland, M., & Ritter, A. (2013). Exploring the existence of drug policy ‘ideologies’ in Australia. //Drugs: Education, Prevention And Policy//, //20//(3), 258–267. doi:10.3109/09687637.2012.755494

<span style="font-family: Cambria,serif; font-size: 12pt;">Mendes, P (2008). "Fighting the drugs war: The role of prohibitionist groups in Australian illicit drugs policy". //Dissent (New York)//, //2// (1), 3-16.

<span style="font-family: Cambria,serif; font-size: 12pt;">Miron, J.A., & Zwiebel, J. (1991) Alcohol consumption during prohibition. //The American Economic Review, 81//(2), 242-247. Retrieved from []

<span style="font-family: Cambria,serif; font-size: 12pt;">Wodak, A.D. (2012) The need and direction for drug law reform in Australia. //The Medical Journal of Australia, 197//(6), 312-313. DOI: 1 0 <span style="font-family: Cambria,serif; font-size: 12pt;">.5694/mja12.10959

<span style="font-family: Cambria,serif; font-size: 12pt;">One: [] Two: []
 * <span style="font-family: Cambria,serif; font-size: 12pt;">Comments **