SUBMISSION OF FAMILIES AND FRIENDS FOR DRUG LAW REFORM TO THE INQUIRY OF THE HUMAN RIGHTS AND EQUAL OPPORTUNITY COMMISSION AND THE MENTAL HEALTH COUNCIL OF AUSTRALIA INTO THE HUMAN RIGHTS OF PEOPLE AFFECTED BY MENTAL ILLNESS INCLUDING THE NEED FOR BETTER MENTAL HEALTH CARE
- Families and Friends for Drug Law Reform urges the Human Rights and
Equal Opportunity Commission and the Mental Health Council of Australia to pay
close attention to the links between drug policy and mental health.
- There is a large overlap between those using illicit drugs and those with a
mental illness. To take heroin dependency as an example, “research has repeatedly
shown that heroin users experience high levels of psychological distress” (Ward et
al. 1998, 80-82 &, generally, 419-36).
- Drug dependency and mental illness or disorders work on each other. The
difficulties flowing from one – the distress, economic hardship, stigma and shame –
magnify the difficulties of the other. The scarcity and inadequacy of services for one
are even more so for people with both conditions. The predicament of families
known to Families and Friends for Drug Law Reform where a member is dependent
on illicit drugs is often desperate. Their predicament is aggravated more than twofold
where comorbidity with a mental illness or disorder is involved. The mental illness
or disorder we refer to is over and above that of substance dependence that is
regarded as a mental disorder (Ward et al. 1998, 419; FFDLR 2004, para. 6).
- What is more, all the evidence points to a high and still increasing level of
comorbid substance abuse and mental illness or disorders.
“The use of illicit drugs such as cannabis and psychostimulants such as
amphetamines and cocaine is . . . higher amongst young adults with severe
mental illness compared to either the general population or to other
psychiatric comparison groups” (Baker et al. 2004, 155).
This is putting more pressure on the health system and families than they can bear.
“Hospital morbidity data show a dramatic rise in the number of psychotic
disorders due to psychostimulant use from 200 in 1998-99, to 1,028 in 1999–
2000 and a further but smaller increase to 1,252 in 2000-01” (ibid., 156).
- In order to cope with crises, scarce resources are being siphoned away from
already chronically underfunded services providing low and medium level
interventions – that is, from most cost effective to least cost effective interventions.
Of course, this deprivation of resources from where needs are low or medium leads
more people into crisis thus compounding the health, social and fiscal problems.
- The link between drug dependence and mental illness or disorders is not
confined to the pharmacological effects of the drug concerned. The Commission and
the Council should not therefore rest content with a platitudinous recommendation
that illicit drugs, because they have deleterious effects, should be made less
- Mental illness or disorders are also brought about or aggravated by the
stresses on dependent users associated with existing steps to make them less
available. Furthermore, there are other less direct but still potent links. The
ineffectiveness of drug treatments leaves an increasing number of children exposed
to greater risk of becoming mentally ill or disordered themselves by virtue of the
addiction of their parents, other adults or their peers. In particular, the substance
dependence of parents is a risk factor directly associated with their children
developing a mental illness or disorder. It also contributes to other recognised risk
factors of mental illness or disorder such as low birth weight, neglect and school drop
out (Dept. of Health and Aged Care 2000, 16).
- This examination of the various links between mental health and abuse of
illicit substances should not lead to a defeatist conclusion that treating effectively and
humanely those with comorbid conditions is incompatible with policies that
effectively reduce supply of dangerous drugs to young people. The Commission and
Council, therefore, should consider what measures can reasonably be expected to
make dangerous drugs associated with a mental illness or disorder less available.
- After considering the negative impacts of current illicit drug policy on mental
health, this submission examines three main obstacles to securing improvement.
These is, firstly, a moral belief of dominating influence, though probably not widely
shared, that overcoming addiction should take precedence over all other issues.
Secondly, there is a fear that existing policies, whatever their negative effect, have
worked to make dangerous drugs less available. In fact the net effect of existing
policies is most probably to promote the distribution of illicit drugs among
vulnerable populations. The third obstacle examined is the failure to be guided by the
best available evidence in formulating measures to give effect to drug policy.
- The submission concludes by looking at the current National Mental Health
Plan and Drug Strategy. These peak policy documents fail in any meaningful way to
address the links between mental health and illicit drug substance abuse. The
National Mental Health Plan 2003-2008 passes responsibility for drug and alcohol
problems to the national drug strategy. The National Drug Strategy: Australia’s
integrated framework 2004-2009 makes the platitudinous point that there should be
strong partnerships with the treatment services and integration of policies and