Revised US drug policy rhetoric needs reality check.

Brian McConnell, President for Families and Friends for Drug Law Reform

Gil Kerlikowske, Director of the Office of National Drug Control Policy and chief adviser to President Obama on drugs addressed a gathering in Parliament House, Canberra on Wednesday 14th November, on USA Drug Policy.

His presentation was about how the US has reduced drug use and how it provides 2,600 drug courts across the US to divert and compel people to recover from drug addiction or drug use. He stated also that the "war on drugs" was over. The US now sees drug use and drug addiction as a public health issue, "it is a brain disorder", he said. And that the US now adopts an evidence based approach with its drug policy, "a third way", he said, borrowing from a former president.

Significant additional federal funding is being provided for drug-free-communities, drug education and treatment, the HOPE program for prisoners who fail drug testing while on parole and programs targeting high-intensity drug trafficking areas.

Notwithstanding this the US still retains its hard line opposition to changing the drug laws. "Legalisers," he said, branding those who dared think of changing drug laws, "think that changing the laws and legalising will solve all the problems." And he said "if drugs are legalised use will increase."

The presentation took about 40 minutes, but it left many issues unsaid. For example how does the Whitehouse feel about increasing numbers of US states introducing medical marijuana or even legalising it, about Afghanistan where the US is at war with a country that produces the majority of the world's street heroin, the large number of arrests for personal use and the imbalance between funding for law enforcement compared to funding of health services.

His claim that the war on drugs was over may have been accepted had it not been for his overall emphasis on law enforcement to tackle drug use, such as with drug courts. Even the breakthrough in rhetoric saying that drug use and addiction was a public health issue - a brain disorder - was being tackled by law enforcement efforts. "If a person before the drug court failed a urine test they would find themselves in jail to complete their five year sentence", he said.

Some of the gaps in his presentation were filled in at question time. These included such things as needle and syringe programs that prevented the spread of blood borne viruses, supervised injection rooms that helped users remain alive and as healthy as possible even though they were still using, heroin on prescription for the severely addicted and how they were tackling synthetic drugs that were now appearing in the market.

The needle and syringe program is still not funded by the US federal government but programs do exist in some cities. On the other issues he either denied that they would be effective or that there was evidence to support them.

If this response was an example of evidence based policies then it leaves a lot to be desired. He was either poorly informed, which for someone in such a high position is hard to believe, or he simply refused to acknowledge the existence of evidence. Evidence based policy does not mean that evidence is only relevant if it comes from your own country and it does not mean that evidence that does not support your own, or your government's viewpoint is denied or ignored.

The evidence on many of these issues is clear and unequivocal: the Portuguese decriminalisation of all drugs did not result in sustained increased drug use and did reduce the number addicted; a study in the Czech Republic, after having criminalised possession two years earlier, again decriminalised following a study that reported that criminalising drug possession neither deterred use nor benefited health and was expensive; Australia's fully supported needle and syringe program has been extremely effective on many counts; supervised injecting rooms, not only in Australia but in Europe save many lives and improve health; and heroin on prescription has not only helped improve health, reduce the chaos in users lives but reduced crime by up to 95% in areas where it has been implemented.

Can Australia learn from the new US third way on drug policy? Fortunately Australia is ahead of the US on many issues; needle and syringe programs, methadone and buprenorphine programs, a strong emphasis on harm reduction, which the US strongly refuses to allow into its lexicon.

However there are some lessons to to be taken on board but they are not as Kerlikowske would expect. Importantly, it is that Australia should not expect the US to be the leader in drug policy but it should look with open eyes at the evidence from the whole world, including those from non-English speaking countries in an effort to make less harmful policies.

As for the US, the change of rhetoric that drug addiction is a brain disorder and thus a public health issue is to be applauded but its heavy reliance on law and order means that the US has along way to go to move from rhetoric to reality.