Approaching drug use as a health issue, rather than a criminal one

The Victorian Parliament’s Law Reform, Road and Community Safety Committee (the Committee) recently released a comprehensive report into potential drug law reform in the state.
 
The 18-chapter report makes 50 recommendations and suggests a reorientation to a health-based framework with a focus on providing treatment and support to people who use drugs, rather than sending them through a more punitive courts and prison-based system.
 
‘A reorientation to a health-based framework does not suggest going soft on crime, but rather emphasises that responses to illicit drug use should focus on trafficking and punishment of criminal behaviour arising from use, while people apprehended solely for use and personal possession be directed to a range of treatment and support options, where necessary,’ Committee Chair, Geoff Howard MP, said.
 
Dr Ines Rio, a GP at North Richmond Community Health, the location of the Victorian Government’s trial of a medically supervised injecting facility, believes the report signals a step in the right direction.
 
‘I am strongly supportive of an approach that looks at addiction and drug-seeking and usage behaviour in the context of harm minimisation, health and of broader social issues,’ Dr Rio told newsGP.
 
‘I think that’s the only effective way of looking at it, with a rehabilitation-based model that’s nuanced, personalised and uses cross-sector approaches.’
 
Dr Rio believes the current approach of criminalising drug use is not effective, and may in fact exacerbate the problem.
 
‘When we make [drug use] a criminal issue, we’re taking it out of an area where health professionals can be effective in supporting that person to come out of their addiction,’ she said.
 
By contrast, a harm-minimisation approach may provide a way to support and treat a greater number of people, including those connected to the person experiencing issues of drug use.
 
‘Harm-minimisation processes don’t ostracise people, but engage them into other modes of access, treatment and management,’ Dr Rio said.
 
‘That is beneficial, obviously for the person and the care that we are able to provide that person. But it’s also a way into providing safety mechanisms for children, partners and families, because if you can access that person, you can then also have a broader effect on that person’s immediate circle of influence.’
 
There is evidence for the effectiveness of harm-minimisation strategies in relation to drug use from countries such as Portugal. Dr Rio also cites supervised injecting facilities, such as the Kings Cross site in Sydney and the trial site at her own practice, as smaller examples of the effectiveness of harm-minimisation strategies.
 
‘[Supervised injecting facilities] help decrease overdoses, transmission of infections such as HIV, utilisation of emergency services such as ambulance, police and ED [emergency department],’ she said.
 
‘I think it’s really vital to have cross-partisan support so the issue [of harm-minimisation strategies] doesn’t become a political football, but something we all agree is really important.’

Correction: This article originally incorrectly stated Dr Ines Rio is an addiction medicine specialist.

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