Families and Friends for Drug Law Reform
committed to preventing tragedy that arises from illicit drug use
|Lesson lost in the translation|
by Richard Walsh
[The Sydney Morning Herald, Monday 1 Mar 1999, p. 17.]
Just what does the Prime Minister think the Swedes can teach us about dealing with the heroin problem?
IN HIS latest foray into the heroin debate, the Prime Minister has pointed to lessons from overseas drugs programs and, in particular, urged us "to have a look at the Swedish experience".
But does Mr Howard have any detailed knowledge of what happened in Sweden, or is he merely depending on a summary being promoted by those with an axe to grind?
First. bear in mind that drug policy is a matter of intense political debate in Europe. The Swiss regard their experience as valuable; so do the Dutch and the Swedes, and it is difficult to find anyone who does not bring some degree of national bias to the debate.
The most comprehensive account of the Swedish. experience is provided by Tim Boekhout van Solinge's The Swedish Drug Control System (1997). While van Solinge is Dutch and his study was financed by the Dutch Health Ministry, it was supported by the Swedish National Institute of Public Health and contains a lot of data. Its tone is not polemical and its argument persuasive.
The most, important point to emerge from van Solinge account is that traditionally the illicit drug most widely used in Sweden has not been heroin at all but intravenous amphetamine (though today they are probably on an equal, footing). However, when the Swedes experimented with the legalising of drugs from 1965 to 1967 it was primarily of oral and IV amphetamine
This experiment was an absolute disaster. Of the 200 users involved, 156 received prescriptions from a single doctor who was so lax that people were virtually writing their own scripts. The experiment was so sloppy it is doubtful it could have any relevance to the current debate.
Sweden is a much more homogenous society than Australia, and very conformist. in the past, it has embraced a high level of social welfare and is more accepting than Australia of state intervention for the community good, Throughout this century it has battled alcoholism with repressive measures including home inspections, anonymous data-gathering, and a state monopoly on alcohol supply.
Because of this history, Sweden was ready to accept the harsh anti-drugs regime that evolved after the failure of the legalisation experiment - public opinion turned away from liberalisation so that by 1989 drug use was criminalised and jail terms introduced.
By the late 1980s authorities were carrying out 10,000 urine tests a year on suspected drug users (in a population of about 8.5 million), with up to 5,000 drug offences recorded each year. While the Swedes had a range of fines, up to a third of offenders were imprisoned, some for more than two years.
The claim that this policy resulted in a decrease of both experimental drug use and the number of drug addicts is based primarily on annual surveys of schoolchildren aged 15-16 and of male military conscripts.
On the basis of these surveys, the Swedes have held that their system is working and this claim has been echoed by their supporters in Australia.
But van Solinge raises serious doubts about the accuracy of the surveys. Schools and the military are disciplined state-run institutions where non-conformity Is not exactly encouraged. Given this - and that drug use carries a prison sentence - it in unlikely the surveys got candid responses.
Significantly, mortality of drug addicts in Sweden is high: heroin mortality is 3 to 4 per cent (against 1 per cent in Australia). But the occurrence of HIV is low probably because IV amphetamine users rarely share needles.
It should be added that the Swedish system was begun at a time of great national prosperity, with each offender put in treatment for two years, at a total cost of about $220 million a year. There were also increases in policing and prison costs. In the 1990s, however, Swedish prosperity has diminished and there has been a sharp reduction in resources and in the claimed effectiveness of the system.
This then is the Swedish experience, hardly one we would wish to duplicate in Australia. As in all drug policy, it requires further evaluation, preferably at some distance from political posturing.
It is most unlikely that there is any one answer to the problems created by habitual drug usage, let alone a magic solution that can be bought off the international shelf like some kind of computer software and employed holus-bolus in Australia.
Thoughtful politicians should be prepared to review international experience in this field with clear eyes and cool heads, and to build a consensus based on a range of measures that suit our very diverse culture.
And they should have no doubt that meeting this challenge will require a substantial investment.
Richard Walsh is chairman of the NSW Ministerial Advisory Council on Alcohol, Tobacco and Other Drugs.