tag:theconversation.com,2011:/us/topics/harm-minimisation-6466/articlesHarm minimisation – The Conversation2023-08-14T06:30:45Ztag:theconversation.com,2011:article/2110382023-08-14T06:30:45Z2023-08-14T06:30:45ZWhat happens in a ‘sobering up’ centre?<figure><img src="https://images.theconversation.com/files/542065/original/file-20230810-25-nv6v1l.jpg?ixlib=rb-1.1.0&rect=0%2C4%2C2948%2C1838&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">adhy savala/unsplash</span></span></figcaption></figure><p><em>Aboriginal and Torres Strait Islander readers are advised this article names and references deceased persons.</em></p>
<p>This month the Victorian government <a href="https://www.health.vic.gov.au/alcohol-and-drugs/public-intoxication-reform-0">announced</a> it’s establishing a permanent “sobering up” centre as part the state’s decriminalisation of public drunkenness.</p>
<p>Instead of arresting or fining you, police can take you to a “sobering up” centre if there is one in the area. </p>
<p>This is in line with a general move to treat alcohol and other drug problems, such as intoxication, as a health rather than policing issue. Most other states and territories (including Western Australia, the Northern Territory, South Australia and Queensland) have established sobering-up centres.</p>
<p>So what happens in these centres, and who will benefit from them? </p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1687271646682583040"}"></div></p>
<h2>Sobering-up centres</h2>
<p>Sobering-up centres are safe places where people who are too intoxicated to look after themselves can go to recover.</p>
<p>It’s safer than being in a police cell because there are health professionals who can provide health care if someone is sick or injured.</p>
<p>Sobering-up centres provide something to eat, a shower, clean clothes and a laundry service. There are beds so people can rest or sleep, usually for up to 24 hours but sometimes longer. </p>
<p>The centre’s health workers are usually alcohol and drug workers, case workers or Aboriginal health workers. They sometimes include nurses and counsellors. The workers assess and monitor the person’s level of intoxication while they are at the centre and can arrange medical intervention if needed.</p>
<p>When some people stop drinking, they can become very unwell as the alcohol <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/clinical+programs+and+practice+guidelines/substance+misuse+and+dependence/substance+withdrawal+management/alcohol+withdrawal+management">leaves their body</a> so they may need to be moved to a hospital withdrawal setting. This can happen just a few hours after they stop drinking. Some people have seizures, severe shaking, hallucinations and dangerously high blood pressure during withdrawal.</p>
<p>The centres can also provide access to help and support, including referral to treatment, such as withdrawal and rehabilitation services, once the person is feeling better. They also may offer on-the-spot brief counselling about the person’s alcohol use or other issues, and provide harm-reduction information so next time they drink they have a better chance of avoiding being in risky situations.</p>
<p>When someone has a problem with alcohol, the first step is to reduce immediate harm because it can sometimes be a slow process to change longstanding drinking behaviours. Think about how hard it is to stick to those New Year’s resolutions we have all made. Even when people are really motivated to make changes it can be difficult and they may have several goes before they achieve progress.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Run-down building on inner city street" src="https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=336&fit=crop&dpr=1 600w, https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=336&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=336&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=422&fit=crop&dpr=1 754w, https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=422&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/542068/original/file-20230810-27-h7ryy0.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=422&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The proposed site in Collingwood, Melbourne.</span>
<span class="attribution"><a class="source" href="https://www.youtube.com/watch?v=8V3ta85Ojrg">7 news, screenshot Youtube</a></span>
</figcaption>
</figure>
<h2>Do sobering-up centres work?</h2>
<p>Sobering-up centres are effective at <a href="https://www.hri.global/files/2011/07/21/06.1_Brady_-_Role_of_a_Rural_Sobering-Up_Centre_%28South_Australia%29_.pdf">reducing the harms</a> caused by alcohol including accidents, self-harm and harm to others. <a href="https://www.researchgate.net/publication/344430965_Utilisation_sobering_up_centres_Western_Australia_1990_-_2005">One evaluation</a> of the use of sobering-up centres in WA over a 15-year period found the use of these centres, compared with traditional police lockups, resulted in:</p>
<ul>
<li><p>reductions in police time and resources previously involved in detaining and monitoring intoxicated people in lockups</p></li>
<li><p>reduced use of court time and resources</p></li>
<li><p>reduced levels of domestic violence and other problems associated with alcohol abuse</p></li>
<li><p>reduced burden on hospitals because of fewer hospitalisations for alcohol-related illnesses and accidents.</p></li>
</ul>
<p>Surveys of law enforcement overseas indicate <a href="https://www.policinginstitute.org/wp-content/uploads/2022/12/Evaluating-the-Utility-of-Sobering-Centers_National-Survey-Report_FINAL.pdf">strong support</a> by police for the use of sobering-up centres, over traditional arrest, for non-violent individuals who are publicly inebriated. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/from-tough-love-to-interventions-what-works-when-a-loved-one-is-struggling-with-addiction-184138">From tough love to interventions, what works when a loved one is struggling with addiction?</a>
</strong>
</em>
</p>
<hr>
<h2>Can anyone access them?</h2>
<p>A person will be able to access the sobering-up service if they:</p>
<ul>
<li><p>are intoxicated in public</p></li>
<li><p>are within the service region </p></li>
<li><p>do not have urgent health needs that require an emergency response</p></li>
<li><p>consent to receive the service</p></li>
<li><p>do not pose a serious and imminent safety risk to themselves or other people.</p></li>
</ul>
<p>As well as being taken there by police, a person can take themselves to a sobering-up centre or be taken by a friend or family member.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/alcohol-problems-arent-for-life-and-aa-isnt-the-only-option-8-things-film-and-tv-get-wrong-about-drug-and-alcohol-treatment-180946">Alcohol problems aren't for life, and AA isn't the only option. 8 things film and TV get wrong about drug and alcohol treatment</a>
</strong>
</em>
</p>
<hr>
<h2>Are sobering-up centres a good idea?</h2>
<p>Public drunkenness laws disproportionately affect Aboriginal and Torres Strait Islander Peoples and homeless people, partly because they are more likely to be in a public place when drinking, and partly because of <a href="http://classic.austlii.edu.au/au/journals/AboriginalLawB/1993/59.html">overpolicing</a> of these populations.</p>
<p>The Victorian government <a href="https://www.premier.vic.gov.au/historic-laws-passed-decriminalise-public-drunkenness">committed to decriminalising</a> public drunkenness in 2019 during the coronial inquest into the death of Yorta Yorta woman Tanya Day. She was arrested for public drunkenness in 2017 and died while in custody after hitting her head on the concrete wall of her cell. The coroner said her death was preventable.</p>
<p>There have been five more Aboriginal deaths in custody in Victoria since 2020. The death in custody rate for Aboriginal people in Australia is disproportionately high compared with the rate for non-Aboriginal people, representing <a href="https://www.aic.gov.au/publications/sb/sb17">one in five</a> custody deaths.</p>
<p>Sobering-up centres are a <a href="https://onlinelibrary.wiley.com/doi/abs/10.1080/09595230600644657?casa_token=Q085WUWAqEgAAAAA:38iwp9J1MEVNF7Yk2TiM2majiPd8iXIMcRaOqCE0feGZB4zIUc8vx3TS91ldo5oY0IodqrFleNrWQg">more effective</a> and <a href="https://www.researchgate.net/publication/344430965_Utilisation_sobering_up_centres_Western_Australia_1990_-_2005">less harmful</a> response to Aboriginal and Torres Strait Islander people found intoxicated in public places than a police cell.</p>
<p>There has been a general shift in both policy and community sentiment away from criminal justice approaches to alcohol and other drugs, and towards health and welfare approaches. <a href="https://www.aihw.gov.au/getmedia/23e94b50-bdfc-4395-a591-e74a60a3fe14/aihw-phe-270-9-Perceptions-and-policy-support-tables.xlsx.aspx">More people</a> in the community endorse spending on education (41.2%) and treatment (32.1%) to address alcohol issues than law enforcement (26.7%). Support for harm-reduction measures for illicit drugs is showing the same trend.</p>
<p>A US study found every dollar spent on drug and alcohol treatment <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681530/">saves the community $7</a> by reducing use and criminal behaviour, and improving health, wellbeing, and participation in the community and employment.</p>
<p>Shifting alcohol and other drug responses from law enforcement to health and welfare reduces the harms associated with coming into contact with the criminal justice system, saves money that can be reinvested into effective prevention programs, and increasingly has the support of the general community.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/to-reduce-harm-from-alcohol-we-need-indigenous-led-responses-204030">To reduce harm from alcohol, we need Indigenous-led responses</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/211038/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee is CEO at Hello Sunday Morning and also works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into alcohol and other drug prevention and treatment.</span></em></p><p class="fine-print"><em><span>Jarryd Bartle does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Victoria has just announced a new sobering-up centre, bringing it in line with other states. Here’s a look at what goes on inside them.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityJarryd Bartle, Associate Lecturer, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1902342022-09-23T01:34:20Z2022-09-23T01:34:20ZShould I give my teen alcohol? Just a sip, the whole can, or none at all?<figure><img src="https://images.theconversation.com/files/484784/original/file-20220915-7253-tne7uf.jpg?ixlib=rb-1.1.0&rect=0%2C2%2C1916%2C1074&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.pexels.com/photo/group-of-friends-clinking-beer-bottles-7148673/">Kindel Media/Pexels</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>You’re at a barbecue and the adults are enjoying a few drinks. Everyone is relaxed and having a great time. One of your friends has just given their teen a beer. Next thing you know, your 15-year-old is asking for one too.</p>
<p>You don’t really want them drinking alcohol yet, but they’ll probably try it sooner or later. You’d rather they get it from you than somewhere else. But you’re also worried about what trying alcohol now might lead to in the future.</p>
<p>What do you do? </p>
<p>The results of <a href="https://doi.org/10.1016/j.drugalcdep.2022.109533">our study</a> show that not offering your teen alcohol is best. But if you do, a sip is less risky down the track than giving your teen a whole bottle or can.</p>
<h2>Parents play a key role</h2>
<p><a href="https://doi.org/10.1093/eurpub/ckaa193">Fewer teens are drinking alcohol</a> than in previous generations. Nevertheless, alcohol is still one of the <a href="https://doi.org/10.1016/s0140-6736(16)00648-6">biggest contributors</a> to death and illness in young people, including via injuries, accidents and suicide.</p>
<p>Parents play a key role in providing teens with the tools to make healthy life choices. They’re also one of the main sources of alcohol for teenagers. </p>
<p>In fact, many parents give their teens alcohol thinking it’s the <a href="https://doi.org/10.1186/1471-2458-12-491">safest way</a> to introduce it.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-are-young-people-drinking-less-than-their-parents-generation-did-172225">Why are young people drinking less than their parents’ generation did?</a>
</strong>
</em>
</p>
<hr>
<h2>No alcohol is best. But is that realistic?</h2>
<p>We set out to understand common patterns of alcohol supply from parents and peers, and whether some patterns increased the chance of binge drinking, alcohol-related harms, and problem drinking as young adults. </p>
<p>So we <a href="https://ndarc.med.unsw.edu.au/project/can-parents-teach-their-children-drink-alcohol-responsibly-or-one-drop-drop-too-many">surveyed</a> the same group of young Australians every year from when they were 13 to 19 years old.</p>
<p>We <a href="https://doi.org/10.1016/j.drugalcdep.2022.109533">found</a> not providing adolescents any alcohol is the least-risky option in terms of preventing later binge drinking, alcohol-related harms (for example, accidents, blackouts, fights) and problem drinking. </p>
<p>Young people who were not supplied alcohol, or only supplied minimal amounts under the age of 18, had the lowest risk of binge drinking, experiencing alcohol-related harms, and reporting symptoms of alcohol abuse, dependence and alcohol use disorder in early adulthood. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three teenagers (two female, one male) standing chatting" src="https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/485043/original/file-20220916-18-q3bp3k.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Adolescence can be a time of experimentation.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/-Xv7k95vOFA">Alexis Brown/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>This aligns with <a href="https://doi.org/10.15288/jsad.2014.75.590">previous research</a> that not allowing any alcohol before the age of 18 is the best way to reduce the chance adolescents will <a href="https://doi.org/10.1111/acer.13525">binge drink</a> and develop <a href="https://doi.org/10.1111/add.16036">physical, psychological, or social problems</a> due to alcohol. It also aligns with
the current <a href="https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol">Australian alcohol guidelines</a>.</p>
<p>However, this is sometimes unrealistic as adolescence can be a time of experimentation. Parents can also feel <a href="https://doi.org/10.1186/1471-2458-12-491">pressure</a> to supply alcohol to their teen if other parents they know are doing so.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-parents-guide-to-why-teens-make-bad-decisions-88246">A parent's guide to why teens make bad decisions</a>
</strong>
</em>
</p>
<hr>
<h2>What other options are there?</h2>
<p>We found young people who received whole drinks from their parents earlier in adolescence (aged 14-16) and/or were mainly supplied by their peers drank more heavily during adolescence. They were also much more likely to binge drink, report symptoms of problem drinking and experience alcohol-related harms in early adulthood.</p>
<p><a href="https://doi.org/10.1111/add.15005">Earlier parental supply</a> and <a href="https://pubmed.ncbi.nlm.nih.gov/20649775/">supply from peers</a> have previously been linked with greater alcohol consumption and alcohol-related problems (with the risk increasing for each year earlier supply occurs). Earlier escalation of heavy drinking comes with an increased risk of a range of <a href="https://doi.org/10.1080/10826084.2018.1517172">negative outcomes</a>, including those related to physical and mental health, school or work, and social problems.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Table of food and alcohol, outside" src="https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484979/original/file-20220915-47124-hyzs32.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">OK then. Just a sip.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/y1XXWct5rBo">Lee Myungseong/Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span>
</figcaption>
</figure>
<p>Sitting in the middle of the risk continuum were young people who received sips only from their parents in early to mid-adolescence (14-16 years), and were then supplied whole drinks from around age 17 by their parents, and to a lesser extent, their peers. </p>
<p>These young people were more likely to binge drink or experience alcohol-related harms compared to those not supplied alcohol at all. But they were less likely than teens who received whole drinks during early-mid adolescence and/or who were mostly supplied by peers.</p>
<p>Regardless of the intent, <a href="https://doi.org/10.1016/j.addbeh.2017.07.030">any supply</a> may normalise and signify approval or permissiveness of alcohol use to adolescents. </p>
<p>While it is safest to not supply alcohol in adolescence, if parents do, providing sips only in early to mid-adolescence, and delaying supply of whole drinks for as long as possible is likely to result in less harm than earlier supply of whole drinks, or allowing supply from peers.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/three-ways-to-help-your-teenage-kids-develop-a-healthier-relationship-with-alcohol-80892">Three ways to help your teenage kids develop a healthier relationship with alcohol</a>
</strong>
</em>
</p>
<hr>
<h2>Tips for parents</h2>
<p>Here are some tips for parents of teens to help their child make healthy life choices about alcohol:</p>
<ul>
<li><p>ideally, <a href="https://www.nhmrc.gov.au/about-us/publications/australian-guidelines-reduce-health-risks-drinking-alcohol#block-views-block-file-attachments-content-block-1">do not supply</a> alcohol to anyone under 18; waiting as long as possible to start drinking alcohol is safer</p></li>
<li><p>if you are providing sips, do so <a href="https://adf.org.au/talking-about-drugs/parenting/preventing-aod-uptake/evidence-interventions/family-domain/">under supervision</a>, for example, at home </p></li>
<li><p>know who your teen’s friends are; if they go out make sure you know where they will be and who they will be with; if they will be home late, they should check in with a parent or caregiver. This monitoring reduces the chance of your teen being in an unsafe environment and their friends supplying them with alcohol</p></li>
<li><p>establish some <a href="https://parents.au.reachout.com/common-concerns/everyday-issues/things-to-try-alcohol/set-expectations-with-your-teenager-about-alcohol">alcohol-specific rules</a> (for instance, no alcohol from friends, only allowed to drink if a parent or caregiver is there to supervise)</p></li>
<li><p>limit access to alcohol at home (for instance, keep alcohol in locked cupboards, don’t keep too many drinks in the fridge)</p></li>
<li><p><a href="https://parents.au.reachout.com/common-concerns/everyday-issues/things-to-try-alcohol/make-healthy-choices-about-alcohol">model positive alcohol behaviours</a> (for instance, eating before and while drinking, and sticking to the <a href="https://www.health.gov.au/news/australian-alcohol-guidelines-revised">recommended number</a> of drinks per day or week)</p></li>
<li><p>understand the alcohol <a href="https://adf.org.au/insights/understanding-secondary-supply/">secondary supply laws</a> in your state or territory. These relate to the laws about supplying alcohol for people under 18.</p></li>
</ul>
<hr>
<p><em>If you’re worried about your own or someone else’s use of alcohol or other drugs call the National Alcohol and other Drug Hotline on 1800 250 015, free from anywhere in Australia.</em></p>
<p><em>Evidence-based online resources and services for parents and teenagers include: <a href="https://positivechoices.org.au/parents/should-i-give-my-teenager-alcohol">Positive Choices</a>, <a href="https://parents.au.reachout.com/common-concerns/everyday-issues/alcohol-and-teenagers">ReachOut</a>, <a href="https://adf.org.au/talking-about-drugs/parenting/talking-young-people/">Alcohol and Drug Foundation</a>, <a href="https://kidshelpline.com.au/">Kids Helpline</a> and <a href="https://www.lifeline.org.au/get-help/information-and-support/substance-misuse-and-addiction/">Lifeline</a>.</em></p>
<hr><img src="https://counter.theconversation.com/content/190234/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexandra Aiken is an Adjunct Associate Lecturer at the National Drug and Alcohol Research Centre. The Australian Parental Supply of Alcohol Longitudinal Study (APSALS) was funded by a 2010–2014 Australian Research Council Discovery Project Grant (DP:1096668), two Australian Rotary Health Mental Health Research Grants, a Research Innovation Grant from the Australian Foundation for Alcohol Research and Education, a 2018-2022 National Health and Medical Research Council project grant (APP1146634), and the National Drug and Alcohol Research Centre, University of New South Wales Sydney,
Australia, which is supported by funding from the Australian Government under the Drug and Alcohol Program.</span></em></p><p class="fine-print"><em><span>Amy Peacock receives funding from the Australian Government Department of Health and Aged Care, the National Health and Medical Research Council, the National Centre for Clinical Research on Emerging Drugs, and ACT Health. She has previously received untied educational funding from Mundipharma and Seqirus for post-marketing surveillance of pharmaceutical opioids; these organisations had no involvement in study design, conduct and reporting, and funding was for work unrelated to that presented here. </span></em></p><p class="fine-print"><em><span>Philip Clare receives funding from the Medical Research Future Fund, and previously received funding from the Australian Government under the Research Training Program. These organisations had no role in the conduct of any studies, and funding was not directly for work presented here.</span></em></p><p class="fine-print"><em><span>Wing See Yuen received funding from the Australian Government under the Research Training Program and the National Drug and Alcohol Research Centre. She works for the National Drug and Alcohol Research Centre at UNSW Sydney. </span></em></p>Should teens drink alcohol? Ideally, no. But in the real world, here are some tips on how to minimise harm.Alexandra Aiken, Adjunct Associate Lecturer, UNSW SydneyAmy Peacock, Senior Research Fellow, UNSW SydneyPhilip Clare, Biostatistician, University of SydneyWing See Yuen, Research fellow, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1700072021-10-21T19:16:44Z2021-10-21T19:16:44ZForgotten how to party? Safety tips from a drug and alcohol expert<figure><img src="https://images.theconversation.com/files/427412/original/file-20211020-20-smslqk.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C1000%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/fun-disco-559484653">Shutterstock</a></span></figcaption></figure><p>Cancelled dance parties, festivals and other events have shaped how Australians use alcohol and other drugs during the pandemic.</p>
<p>Now restrictions are easing, some people who have not used alcohol or other drugs recently may start to use them again, and need to be aware of their reduced tolerance.</p>
<p>Here’s what <a href="https://ndarc.med.unsw.edu.au/program/drug-trends">survey data</a> released today by the National Drug and Alcohol Research Centre, tell us about drug use and drug markets during the pandemic.</p>
<p>And here’s what to think about if your drug use during the pandemic has changed, and you’re about to head off to a party.</p>
<h2>Cocaine up, ecstasy down, alcohol stable</h2>
<p>Of the two yearly surveys released today, one relates to people who inject drugs such as heroin. The other relates to people who use ecstasy and other party drugs, who typically use drugs occasionally.</p>
<p>The group using ecstasy and other party drugs showed significant changes in drug use between 2020 and 2021. This variability is probably because this group tends to use in specific contexts and is more strongly influenced by access and opportunity.</p>
<p>More people used cocaine in 2021 than in 2020, continuing the upward trend in recent years. We don’t know why cocaine use has been increasing. But the frequency of cocaine use was very low at just a few days in the past six months. </p>
<p>Cocaine purity in Australia tends to be fairly low and has been <a href="https://www.acic.gov.au/sites/default/files/2020-09/Illicit%20Drug%20Data%20Report%202018-19_Internals_V10_Cocaine%20CH.pdf">decreasing</a>. So, although other data also show that cocaine has increased in popularity in the past few years, we haven’t seen a big increase in harms. </p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/weekly-dose-cocaine-the-glamour-drug-of-the-70s-is-making-a-comeback-88639">Weekly Dose: cocaine, the glamour drug of the ’70s, is making a comeback</a>
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</p>
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<p>Fewer people used ecstasy in 2021; the frequency of use also decreased (from 12 days in the past six months in 2020 to seven days in 2021).</p>
<p>But this was not just because of closed venues or cancelled events. People surveyed said it was also harder to get. The closed international border has restricted importation of ecstasy and the chemicals used to make it. In the past year, ecstasy purity has reportedly decreased and the price increased.</p>
<p>More people said they used “magic mushrooms”, <a href="https://theconversation.com/weekly-dose-anaesthetic-and-recreational-drug-ketamine-could-be-used-to-treat-depression-81468">ketamine</a>, and non-prescribed pharmaceutical stimulants such as <a href="https://www.healthdirect.gov.au/medicines/brand/amt,30571011000036106/dexamphetamine-sulfate-sigma">dexamphetamine</a> and <a href="https://www.healthdirect.gov.au/medicines/brand/amt,17251000168101/ritalin">methylphenidate</a>. The frequency of use of these drugs was very low at just a few days in the past six months.</p>
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<strong>
Read more:
<a href="https://theconversation.com/weekly-dose-anaesthetic-and-recreational-drug-ketamine-could-be-used-to-treat-depression-81468">Weekly Dose: anaesthetic and recreational drug ketamine could be used to treat depression</a>
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<p>The rate of alcohol use was stable. This is in line with <a href="https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia/contents/impact-of-covid-19-on-alcohol-and-other-drug-use">other data</a> showing that, although alcohol use may have increased slightly in the early months of the pandemic, it stabilised after that. Spending on takeaway alcohol at bottle shops increased, but the opportunities to drink at pubs, bars and restaurants decreased.</p>
<p>The surveys are not intended to represent all people who use drugs, so should be interpreted alongside other sources.</p>
<h2>What might happen as restrictions ease?</h2>
<p>As festivals and dance parties start up again, some people may start to use these drugs again.</p>
<p>When you use a drug, including alcohol, regularly, your body gets used to having it in your system and you need to use more to get the same effect. This is known as “<a href="https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front6-fa-toc%7Edrugtreat-pubs-front6-fa-secb%7Edrugtreat-pubs-front6-fa-secb-8%7Edrugtreat-pubs-front6-fa-secb-8-2">tolerance</a>”.</p>
<p>If you haven’t used a drug for a while, your tolerance may have decreased. You’ll need less to get the same effect. So if you start using the same amount as before you might unintentionally use too much and experience unwanted side effects, including overdose.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Person at home holding small bag containing white powder" src="https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/427416/original/file-20211020-23-yoiztt.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Taking a drug at home can be very different to taking it while dancing all night at a club.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/drug-addict-dealer-closing-bag-cocaine-1019419879">Shutterstock</a></span>
</figcaption>
</figure>
<p>If you have increased use during the pandemic, your tolerance may have increased, so the effects at your usual dose may be reduced. This can also lead to unintentional overdose because, although you don’t feel the effects, the drug may still be toxic at high enough doses.</p>
<p>The setting you use a drug in also changes the effects you might feel. So if you have been using ecstasy quietly at home during the pandemic you’ll have different effects to using it while dancing all night.</p>
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<strong>
Read more:
<a href="https://theconversation.com/how-does-mdma-kill-109506">How does MDMA kill?</a>
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</em>
</p>
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<h2>What can you do to use more safely?</h2>
<p>With changes in the market, the strength and purity of illicit drugs you used before the pandemic might also be different to those you have access to now.</p>
<p>If you can have your drugs checked to see what’s in them you can decide whether to still take them or not. The ACT government has announced funding for a <a href="https://www.canberratimes.com.au/story/6888821/pill-testing-site-could-be-coming-to-the-city-this-summer/">trial of a drug checking service</a>. New Zealand passed interim legislation to <a href="https://theconversation.com/after-the-last-summer-of-terrible-drugs-its-time-to-make-nzs-temporary-drug-checking-law-permanent-165612">make drug checking legal</a> last year. It’s due to finalise the full legislation at the end of this year to <a href="https://www.loc.gov/item/global-legal-monitor/2021-04-14/new-zealand-government-indicates-that-drug-checking-law-will-be-made-permanent/">make it permanent</a>.</p>
<p>If you don’t have access to a drug checking service, you should be extra cautious the first few times you use a drug again after a break:</p>
<ul>
<li><p><strong>“<a href="https://wearetheloop.org/crush-dab-wait">crush/dab/wait</a>”</strong>: take a quarter of a pill or a dab of powder at first then wait an hour or two to see the effects. You can always take more if wanted, but you can’t get it out of your system if you take too much</p></li>
<li><p><strong>avoid mixing drugs</strong>: the more drugs you take at the same time the more likely you are to have problems, like overdose. Some drugs reduce your ability to feel the effects of other drugs. For example stimulants can mask the effects of alcohol, then you can drink too much</p></li>
<li><p><strong>check what’s circulating</strong>: the <a href="https://www.health.nsw.gov.au/aod/public-drug-alerts/Pages/default.aspx">New South Wales</a> and <a href="https://www2.health.vic.gov.au/alcohol-and-drugs/drug-alerts">Victorian</a> governments regularly release alerts to the public about contaminants found in seized drugs or from hospital data. Other states also sometimes release alerts.</p></li>
</ul>
<p>Tolerance also applies to legal drugs like alcohol. If you’ve been drinking more during lockdown, your tolerance might have increased and you might drink more than you intended. You might not feel drunk, but your brain function may still be affected and you can still be over the legal limit for driving.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Man drinking beer about to grab car keys, friend holding back arm" src="https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/427418/original/file-20211020-21-1rg745s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">If you’ve been drinking more in lockdown, you might feel OK but be impaired and still be over the limit.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/do-not-drink-drive-cropped-image-572252890">Shutterstock</a></span>
</figcaption>
</figure>
<p>If you have been drinking less, your tolerance may have decreased so a smaller amount of alcohol will affect you more than normal. So, if you drink the same amount as you did before the pandemic you might get drunk more quickly.</p>
<p>Start slowly, monitor the number of drinks you have and pay attention to how drunk you are feeling.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/getting-back-on-the-beers-after-lockdown-heres-what-you-should-know-140454">Getting back on the beers after lockdown? Here's what you should know</a>
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<h2>How to get help</h2>
<p>If you’re worried about your own or someone else’s use of alcohol or other drugs call the National Alcohol and other Drug Hotline on 1800 250 015, free from anywhere in Australia.</p>
<p>If you want support to manage your drinking, <a href="https://hellosundaymorning.org/">Hello Sunday Morning</a> offers a free online support community where you can connect and chat with others who are actively changing their alcohol use.</p>
<p>You can also chat online with a counsellor at <a href="https://www.counsellingonline.org.au/">Alcohol & Drug Counselling Online</a>, join an online support group at <a href="https://smartrecoveryaustralia.com.au/">SMART Recovery</a> or talk to your GP about seeing a psychologist. You may be able to access support via <a href="https://www.digitalhealth.gov.au/initiatives-and-programs/telehealth">telehealth</a>.</p><img src="https://counter.theconversation.com/content/170007/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment. She is a member of the Australian National Advisory Council on Alcohol and other Drugs and the board of directors of Hello Sunday Morning and The Loop Australia.</span></em></p>Now restrictions are easing, some people who have not used alcohol or other drugs recently may start to use them again, and need to be aware of their reduced tolerance.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1514722020-12-07T19:06:54Z2020-12-07T19:06:54ZCaring for 66,455 revellers at risk delivers $7.5m harm-reduction benefit for Sydney<p>Our time of social isolation under COVID-19 restrictions has reinforced the importance of taking care of each other, particularly the most vulnerable in our community. As we consider what our post-COVID social world will look like, we have an opportunity to deliver services that make our cities safer and more inclusive. An example of how we might achieve this can be found in a Sydney harm-reduction service that has assisted tens of thousands of nightlife revellers who are vulnerable, in distress or at risk of harm since 2014. </p>
<p>A newly released <a href="https://ndarc.med.unsw.edu.au/resource/evaluation-take-kare-safe-space-program">evaluation</a> conservatively estimates the benefits of the <a href="http://thomaskellyyouthfoundation.org.au/take-kare-safe-space">Take Kare Safe Space</a> (TKSS) program from December 2014 to April 2019 at A$7.46 million. That benefit includes the value of serious harm averted and the value attached to lives saved through program interventions.</p>
<p>While it may have been less prominent in our public and political consciousness this year, nightlife, and the way we socialise after dark, is a major part of our social and cultural life. It will return. </p>
<p>In Sydney, where trading restrictions – the so-called <a href="https://www.smh.com.au/national/nsw/sydney-s-lock-out-laws-to-be-wound-back-from-january-14-20191128-p53eyh.html">lockout laws</a> – were lifted in January following five years of controversy, we need to do nightlife better. We need to find the balance between safety and vibrancy. The city is a great place to go out, but also a place where we need to provide the right services for when things inevitably go wrong.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/where-are-they-now-what-public-transport-data-reveal-about-lockout-laws-and-nightlife-patronage-73521">Where are they now? What public transport data reveal about lockout laws and nightlife patronage</a>
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<h2>One part of the solution</h2>
<p>The TKSS program has been doing this throughout the lockout period in Sydney. Now operated by Stay Kind, the TKSS program was launched in 2014 following the unprovoked attack and subsequent <a href="https://www.smh.com.au/national/nsw/kieran-loveridge-sentence-for-killing-of-thomas-kelly-doubled-on-appeal-20140704-zsvk2.html">death of Thomas Kelly</a> in Kings Cross in 2012.</p>
<p>Operating year-round from 10pm to 4am on Friday and Saturday nights, it’s a non-judgmental, non-government, harm-reduction service. The program looks after nightlife revellers who are vulnerable, in distress or at risk of harm.</p>
<p>Teams of Take Kare ambassadors work in co-operation with the City of Sydney’s CCTV control room and other nightlife services to patrol key precincts, acting as critical intermediaries between emergency services. </p>
<p>During the evaluation, TKSS operated three static safe spaces at Town Hall, Kings Cross and Darling Harbour. Here, nightlife revellers can go to chill out, get help, charge their phones, or receive basic first aid.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/aUMQLVHCbkM?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A 2019 Current Affair report on Sydney’s Take Kare Safe Spaces.</span></figcaption>
</figure>
<p>Between December 2014 and April 2019, TKSS supported 66,455 people. Two-thirds of them were aged 18-25. Many (46%) were perceived as heavily intoxicated and at risk of harm.</p>
<h2>What is the evidence? Does it work?</h2>
<p>Researchers from UNSW Sydney and Central Queensland University recently completed a comprehensive independent <a href="https://ndarc.med.unsw.edu.au/resource/evaluation-take-kare-safe-space-program">evaluation</a> of the TKSS program. Funded by the NSW Department of Communities and Justice, the evaluation team analysed crime, emergency department and ambulance data to establish the benefit-cost ratio of the program. We also interviewed key stakeholders and “clients” about their perceptions of the program.</p>
<p>From December 2014 to April 2019 (inclusive), the benefits were estimated at $7.46 million. With operating costs of $2.79 million, the benefit-cost ratio was 2.67:1. In other words, a $1 investment in the program resulted in $2.67 of benefits. When the TKSS program was fully operational in all three safe space sites (in 2016-17), the benefit-cost ratio increased to 3.83:1.</p>
<p>These results are conservative. The return on investment is likely to be much higher given the analysis does not quantify the full spectrum of benefits associated with the program. These include: improved public safety and amenity; more efficient resource allocation for service providers; improved partnership, communication and resourcing to manage Sydney nightlife; and flow-on effects for tourism and investment.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/sanitised-nightlife-precincts-become-places-where-some-are-not-welcome-95870">'Sanitised' nightlife precincts become places where some are not welcome</a>
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<h2>What are the strengths of TKSS?</h2>
<p>These non-quantifiable benefits featured strongly in interviews with stakeholders. They included staff from NSW Police and Ambulance, St Vincent’s Emergency Department, City of Sydney, licensed venues and those who used the service. They highlighted a number of key program strengths, including:</p>
<p><strong>1.</strong> the program fills a critical gap in nightlife safety – TKSS staff act as intermediaries between licensed premises and emergency services by providing services in public city spaces where people are most vulnerable – and it’s also easy to deploy in different locations as needed</p>
<p><strong>2.</strong> the non-judgmental, non-authoritative nature of the program meant intoxicated, vulnerable and distressed nightlife patrons were more comfortable speaking with TKSS ambassadors than other services – such as police, ambulance, venue security or city rangers – and this rapport helped encourage at-risk patrons to willingly get medical help when needed</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/fewer-alcohol-related-visits-to-inner-sydney-emergency-room-since-lockout-laws-introduced-92343">Fewer alcohol-related visits to inner Sydney emergency room since 'lockout laws' introduced</a>
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<p><strong>3.</strong> police, ambulance and accident and emergency staff said the TKSS program allowed them to focus on more urgent and pressing jobs</p>
<p><strong>4.</strong> the ambassadors are able to de-escalate conflict and provide welfare services through their early, proactive and non-judgmental interventions.</p>
<p>The evaluation shows the TKSS program provides a critical harm-reduction service in Sydney after dark. Its net economic benefit to the city is greatest when the full complement of Safe Spaces are operating and supported by sustained and stable funding. There is a clear case that the program should be part of the long-term future planning of a safe, inclusive and vibrant night-time economy.</p>
<p><em>Note: The TKSS program was suspended in March 2020 due to COVID-19 and is due to re-open in January 2021.</em></p><img src="https://counter.theconversation.com/content/151472/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Phillip Wadds was one of the academic team who undertook the evaluation of Safe Spaces. That evaluation was funded by the NSW Department of Communities and Justice. He does not currently receive any other external research funding. Since 2018, Phillip has been a member of the City of Sydney's Nightlife and Creative Sector Advisory Panel. </span></em></p><p class="fine-print"><em><span>Anthony Shakeshaft was one of the academic team who undertook the evaluation of Safe Spaces. That evaluation was funded by the NSW Department of Communities and Justice.</span></em></p>Amid the controversy over Sydney’s lockout laws, a program that looked out for people at risk of harm in the city’s nightlife precincts more than proved its worth.Phillip Wadds, Senior Lecturer in Criminology, UNSW SydneyAnthony Shakeshaft, Professor and Deputy Director at National Drug and Alcohol Research Centre, UNSW SydneyChristopher Doran, Professor of Health Research Economics, University of NewcastleLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1417972020-07-16T06:00:42Z2020-07-16T06:00:42ZDrive-in music festivals allow you to social distance. But what happens when you add drugs and alcohol?<p>The cancellation of events due to the COVID-19 pandemic has hit Australia’s music industry hard, with reports of losses up to <a href="https://www.abc.net.au/doublej/music-reads/features/how-to-help-musicians-bands-coronavirus-covid-19/12064538">A$200 million</a>.</p>
<p>But music festivals have quickly adapted. First, they moved to <a href="https://www.billboard.com/articles/columns/pop/9335531/coronavirus-quarantine-music-events-online-streams">live streaming</a>. Now drive-in music festivals are popping up across the globe.</p>
<p>In response to the pandemic, the world’s first drive-in rave took place <a href="https://edm.com/news/germany-hosted-the-worlds-first-drive-in-rave-amid-covid-19-lockdowns">in Germany</a> in May. Australia followed suit with <a href="https://www.facebook.com/airwavesfestival/">Airwaves</a> on the Sunshine Coast earlier this month. <a href="https://www.the-drive-in.com.au">The Drive-in</a>, a series of pop-up gigs in Melbourne, was also planned for this month but has now been cancelled.</p>
<p>While drive-in festivals allow physical distancing, they bring new challenges for promoters, police and health workers.</p>
<p>People will be driving to and from venues where alcohol is available, and in some cases where illicit drugs are used.</p>
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<strong>
Read more:
<a href="https://theconversation.com/australias-drive-ins-where-you-can-wear-slippers-crack-peanuts-and-knit-to-your-hearts-content-139876">Australia's drive-ins: where you can wear slippers, crack peanuts, and knit 'to your heart's content'</a>
</strong>
</em>
</p>
<hr>
<h2>Risk of drink and drug driving</h2>
<p>Normally, festival-goers can reduce risks of harms from alcohol or illicit drugs by not driving to and from the event. And some festivals are multi-day events where people stay overnight, so they can plan not to be intoxicated for the drive home.</p>
<p>But drive-in festivals require people to bring their own car. And they need to drive home immediately afterwards.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/young-australians-are-drinking-less-but-older-people-are-still-hitting-the-bottle-hard-90024">Young Australians are drinking less – but older people are still hitting the bottle hard</a>
</strong>
</em>
</p>
<hr>
<p>The Victorian code of practice for safer music festivals <a href="https://www2.health.vic.gov.au/about/publications/researchandreports/Code-of-practice-for-running-safer-music-festivals-and-events-2013">explicitly says</a> alcohol- and drug-affected people should be strongly discouraged from driving.</p>
<p>Although <a href="https://austroads.com.au/publications/assessing-fitness-to-drive/ap-g56/drivers-legal-bac-limits">legally</a> you can have small amounts of alcohol in your blood while driving, the <a href="https://www.towardszero.vic.gov.au/campaign/drinkdriving">key message</a> is not to drive if you have had any alcohol at all.</p>
<p>This is because most people cannot accurately estimate their <a href="https://adf.org.au/insights/blood-alcohol-levels/">blood alcohol concentration</a> after drinking. And people who are <a href="https://doi.org/10.1007/s00213-016-4233-x">riskier drivers</a> tend to underestimate their blood alcohol levels.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/getting-back-on-the-beers-after-lockdown-heres-what-you-should-know-140454">Getting back on the beers after lockdown? Here's what you should know</a>
</strong>
</em>
</p>
<hr>
<h2>Alcohol and other drug testing</h2>
<p>One option is to conduct roadside tests for alcohol and illicit drugs as people leave drive-in festivals. Police already do this <a href="https://www.echo.net.au/2019/12/falls-festival-police-say-safe/">routinely</a> at festivals.</p>
<p>There is good evidence alcohol breath testing is effective in <a href="http://casr.adelaide.edu.au/T95/paper/s29p4.html">reducing road crashes</a> and deaths. Breath testing could prevent road incidents after drive-in festivals in the same way it has reduced incidents among the general population.</p>
<p>Blood alcohol testing detects current levels of alcohol. The higher your blood alcohol concentration, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345970/">more impaired</a> you are behind the wheel. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/347818/original/file-20200716-15-1akyr1c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Police could breathalyse people as they leave drive-in music festivals.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/perth-wa-oct-27-2019australian-traffic-1548022427">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>But illicit drug testing is not a direct measure of impairment at the time of testing. It only indicates whether you have used a drug within the window of the test. Some drugs can be detected in the system for <a href="https://adf.org.au/insights/roadside-drug-testing/">several days</a> after use. Drivers could <a href="https://www.abc.net.au/news/2020-06-18/drug-driving-laws-cannabis-nsw-unfair-magistrate-david-heilpern/12361312">test positive</a> but not be affected by drugs at the time.</p>
<p>There are also questions about the <a href="https://onlinelibrary.wiley.com/doi/10.1002/dta.2687">reliability of the tests</a> and <a href="https://onlinelibrary.wiley.com/doi/10.1002/dta.2687">very little evidence</a> roadside drug testing is associated with fewer crashes.</p>
<h2>What else can we do to reduce harms?</h2>
<p>Peer organisations, like <a href="https://www.hrvic.org.au/dancewize">DanceWize</a>, provide harm reduction information and outreach at music festivals. They provide a safe space for people to chill out, chat with peers or ask questions about drugs and mental health concerns. </p>
<p>But during a drive-in festival, people need to sit in their cars. So there is less opportunity for them to access outreach services in the usual way.</p>
<p>Event-based harm reduction services like DanceWize have already responded to COVID-19 by sharing harm reduction advice through <a href="https://www.facebook.com/watch/live/?v=918141765368345&ref=watch_permalink">Facebook Live events</a> and <a href="https://www.instagram.com/dancewize_vic/?hl=en">Instagram</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/347820/original/file-20200716-21-1s3sq87.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Festival goers could receive harm reduction messages and support on their phones.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-redhead-woman-driver-taking-selfies-1707137554">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Online harm reduction communities that have been operating for years, like <a href="https://www.bluelight.org/xf/">Bluelight</a>, and more recent digital communities, like <a href="https://www.facebook.com/seshsafety/">Sesh Safety</a>, could provide harm reduction information specifically aimed at drive-in festival goers, through their existing digital channels.</p>
<p>Usually at a music festival, attendees are standing, dancing or moving around the festival ground. So, security, outreach workers and other patrons can look out for people who may have been affected by alcohol or other drugs and take them for medical or first aid treatment. </p>
<p>But with drive-in festivals, there is less incidental opportunity to direct people to help.</p>
<p>So promoters could distribute information about where to access harm reduction information, and about available medical and first aid help, as people drive into the festival.</p>
<h2>Drug checking</h2>
<p><a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/Global%20review%20of%20drug%20checking%20services%20operating%20in%202017.pdf">Drug checking</a> allows people to anonymously submit drug samples for forensic analysis so they can make informed decisions about what they’re about to take. Counselling is also offered.</p>
<p>We know drug checking is <a href="https://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827">effective in reducing harms</a> at music festivals, but it is <a href="https://theconversation.com/when-the-coroner-looked-at-how-to-cut-drug-deaths-at-music-festivals-the-evidence-won-but-what-happens-next-126669">not available</a> in Australia outside specific trials.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/when-the-coroner-looked-at-how-to-cut-drug-deaths-at-music-festivals-the-evidence-won-but-what-happens-next-126669">When the coroner looked at how to cut drug deaths at music festivals, the evidence won. But what happens next?</a>
</strong>
</em>
</p>
<hr>
<p>Running a drug checking service from a drive-in festival in COVID-19 times would be more challenging, but not impossible, by using technology to deliver feedback via text or app. </p>
<p>Festival-goers could chat by text with the drug checking team to discuss their specific drug-use history, circumstances, and the results of the analysis. But there would be less anonymity than a usual drug checking service.</p>
<h2>Promoters, police, health workers and young people</h2>
<p>Although smaller music venues are <a href="https://theindustryobserver.thebrag.com/small-music-venues-will-be-re-opening-australia-wide/">slowly reopening</a> in some states, large music festivals are likely to remain closed for some time. So drive-in festivals might sound appealing.</p>
<p>But they throw up specific risks promoters need to address to ensure the safest possible environment for people eager to access COVID-safe live music venues.</p>
<p>So promoters need to work closely with police, health workers and young people themselves to effectively address some of these additional risks.</p>
<hr>
<p><em>You can find harm reduction information at <a href="https://www.bluelight.org">Bluelight</a>, DanceWize <a href="https://www.hrvic.org.au/dancewize">Victoria</a> and <a href="https://www.dancewizensw.org.au">NSW</a> and the <a href="https://www.globaldrugsurvey.com/free-online-resources/">Global Drug Survey</a>. If you are worried about your drinking or drug use, or want support to make changes, you can call the National Alcohol and Other Drug Hotline on 1800 250 015; chat online with a counsellor at <a href="https://counsellingonline.org.au">CounsellingOnline</a>; talk to your GP about seeing a psychologist or counsellor; or try <a href="https://www.hellosundaymorning.org.au">Hello Sunday Morning</a>, an online community of people actively changing their alcohol consumption.</em></p><img src="https://counter.theconversation.com/content/141797/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment. She is a member of board of directors of Hello Sunday Morning and volunteers for The Loop Australia.</span></em></p><p class="fine-print"><em><span>Monica Barratt receives funding from Australian (National Health and Medical Research Council, the Australian Institute of Criminology, the National Centre for Clinical Research into Emerging Drugs) and international (US National Institutes of Health, NZ Marsden Fund) funders. She has recently conducted commissioned research for the NSW Coroner's Office, the WA Mental Health Commission and the Victorian Department of Health and Human Services. Monica also volunteers for not-for-profit harm reduction organisations: The Loop Australia and Bluelight.org</span></em></p>With regular music festivals, people can more easily seek help or advice about drug and alcohol or mental health issues. But with drive-ins we need to be creative to minimise harms.Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityMonica Barratt, Vice Chancellor’s Senior Research Fellow, Social and Global Studies Centre and Digital Ethnography Research Centre, RMIT UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1427202020-07-16T03:56:59Z2020-07-16T03:56:59ZMore Australians back legalising cannabis and 57% support pill testing, national survey shows<figure><img src="https://images.theconversation.com/files/347804/original/file-20200716-17-1l14z53.jpg?ixlib=rb-1.1.0&rect=7%2C100%2C5145%2C3150&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">David Crosling/ AAP</span></span></figcaption></figure><p>A growing number of Australians support the legalisation of cannabis, while almost three in five back the idea of pill testing, according to a new national survey. </p>
<p>The 2019 <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey-2019/contents/table-of-contents">National Drug Strategy Household Survey</a> also shows Australians are drinking and smoking less, but some illicit drug use is on the rise. </p>
<p>Importantly, this national snapshot, released on Thursday, shows the Australian community is becoming more open to less punitive measures around drug use. </p>
<h2>Changes to drug use</h2>
<p>The National Drug Strategy Household Survey is conducted every three years. The 2019 results showed an increase in illicit drug use from 2016. </p>
<p>This includes the proportion of Australians who used cannabis (up from 10.4% to 11.6%), cocaine (2.5% to 4.2%), ecstasy (2.2% to 3.0%) and ketamine (0.4% to 0.9%).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/history-not-harm-dictates-why-some-drugs-are-legal-and-others-arent-110564">History, not harm, dictates why some drugs are legal and others aren't</a>
</strong>
</em>
</p>
<hr>
<p>The increase in cocaine use was notable, particularly among young men. The proportion of males in their 20s using cocaine in the 12 months before the survey almost doubled, from 7.3% to 14.4%.</p>
<p>There was also a drop in the non-medical use of painkillers and opioids (like codeine and morphine) from 3.6% to 2.7%. This coincided with codeine switching to a <a href="https://www1.racgp.org.au/newsgp/clinical/here-s-what-happened-when-codeine-was-made-prescri">prescription-only drug</a> in 2018.</p>
<h2>Smoking and drinking</h2>
<p>The 2019 survey recorded the lowest rate of daily smoking ever at 11% (down from 12.2% in 2016), mostly driven by young people not taking up the habit. </p>
<p>Risky drinking remained stable, but there was an increase in the number of people who don’t drink at all (8.9%, up from 7.6% in 2016). </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/347822/original/file-20200716-27-15j5g4y.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">More Australians are staying away from alcohol.</span>
<span class="attribution"><span class="source">James Ross/ AAP</span></span>
</figcaption>
</figure>
<p>The number of 14 to 17 year-olds who have never had a drink also increased to 66%, compared to only 28% in 2001.</p>
<h2>The legalisation debate</h2>
<p>For the first time in the survey’s history, more Australians support the legalisation of cannabis (41%) than oppose it (37%). This is almost double the level of support in 2007 (21%).</p>
<p>This is significant, because while there has been <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/ndshs-2016-detailed/contents/table-of-contents">overwhelming community support</a> for removing criminal penalties for cannabis possession (sometimes referred to as “decriminalisation”), this has not been the case with legalisation.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/347807/original/file-20200716-15-7qvty.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A growing number of Australians support legalising cannabis.</span>
<span class="attribution"><span class="source">www.shutterstock.com</span></span>
</figcaption>
</figure>
<p>The ACT, Northern Territory and South Australia decriminalised cannabis for personal use three decades ago. Most other states and territories have some kind of de facto decriminalisation in place already through <a href="https://www.mcv.vic.gov.au/find-support/diversion">police diversion</a>. This is where people arrested for possession of small amounts of cannabis can be diverted to education or treatment. </p>
<p>According to the 2019 survey, fewer people thought possession of cannabis should be a criminal offence, compared to previous years (down from 26% to 22%). And fewer people supported an increase in penalties for the sale or supply of cannabis (down from 50% to 44%). Most people (54%) thought it should only attract a caution, warning or no action.</p>
<p>Interestingly, if cannabis were legal, 78% of surveyed Australians said they would not use it. Only 3% said they would increase their use.</p>
<p>Multiple jurisdictions <a href="https://www.routledge.com/Legalizing-Cannabis-Experiences-Lessons-and-Scenarios/Decorte-Lenton-Wilkins/p/book/9781138370906">around the world</a>, including Uruguay, Canada and a number of states in the United States, have already legalised the sale and possession of cannabis. New Zealand is set to hold a referendum on the issue this year.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/reforming-cannabis-laws-is-a-complex-challenge-but-new-zealands-history-of-drug-reform-holds-important-lessons-141113">Reforming cannabis laws is a complex challenge, but New Zealand's history of drug reform holds important lessons</a>
</strong>
</em>
</p>
<hr>
<p>This year, the ACT allowed people to <a href="https://theconversation.com/act-cannabis-laws-come-into-effect-on-friday-but-they-may-not-be-what-you-hoped-for-130050">legally grow cannabis</a> for personal use.</p>
<p>A number of government inquiries in Australia have recommended legalisation of cannabis and some other drugs, including a 2019 <a href="https://qpc.blob.core.windows.net/wordpress/2020/01/SUMMARY-REPORT-Imprisonment-.pdf">Queensland Productivity Commission’s</a> report into imprisonment and recidivism.</p>
<blockquote>
<p>After many decades of operation, illicit drugs policy has failed to curb supply or use. The policy costs around $500 million per year to administer and is a key contributor to rising imprisonment rates … Evidence suggests moving away from a criminal approach will reduce harm and is unlikely to increase drug use.</p>
</blockquote>
<p>One of the most significant harms from cannabis is the risk of contact with the criminal justice system. More than 70,000 people are <a href="https://nadk.flinders.edu.au/kb/cannabis/cannabis-crime/how-many-cannabis-related-arrests-are-there-each-year-in-australia/">arrested for cannabis offences</a> each year. More than 90% of those are for possession.</p>
<h2>Safe injecting facilities</h2>
<p>The survey asked about safe injecting rooms for the first time. </p>
<p>Just under half of Australians surveyed support “supervised drug consumption facilities”, with 47% in favour and 32% opposed. Support was strongest among people under 40. </p>
<p>Drug injecting rooms have been a <a href="https://www.theage.com.au/national/victoria/police-say-richmond-crime-has-risen-since-safe-injecting-room-opened-20190522-p51pxb.html">controversial community issue</a>, although a 2017 Victorian parliamentary inquiry saw 46 out of 49 submissions <a href="https://theconversation.com/a-medically-supervised-injection-facility-matters-for-victoria-and-for-more-inclusive-mental-health-support-79761">in support </a> of a Melbourne facility.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-australia-needs-drug-consumption-rooms-53215">Why Australia needs drug consumption rooms</a>
</strong>
</em>
</p>
<hr>
<p>These health services give people who inject illicit drugs access to clean equipment and a place off the street to use their drugs under the supervision of doctors and nurses. There are <a href="https://static1.squarespace.com/static/56eddde762cd9413e151ac92/t/5ca1db7571c10bfe7fc5ddb2/1554111351177/Room+for+improvement+-+How+drug+consumption+rooms+save+lives+-+Jarryd+Bartle.pdf">more than 100</a> of these services around the world. They <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685449/">reduce fatal overdose</a> and improve access to treatment. </p>
<p>There are currently two supervised drug consumption facilities in Australia. One in <a href="https://www.uniting.org/community-impact/uniting-medically-supervised-injecting-centre--msic">Sydney’s Kings Cross</a> has been operating for 20 years. Another in Melbourne’s <a href="https://nrch.com.au/services/medically-supervised-injecting-room/">North Richmond</a> opened in 2018. A <a href="https://www.abc.net.au/news/2020-06-05/second-safe-injecting-facility-announced-for-melbourne/12324222">second Melbourne facility</a> has been announced by the Andrews government.</p>
<p><a href="https://www.uniting.org/content/dam/uniting/documents/community-impact/uniting-msic/overview-of-international-literature.pdf">Evaluations</a> of safe injecting rooms around the world have shown these facilities can decrease criminal activity, such as robbery and property offences. They also reduce public injecting and discarded needles.</p>
<h2>Pill testing</h2>
<p>This was also the first time the survey asked about pill testing or drug checking.</p>
<p>More than half of the Australians (57%) surveyed supported drug checking, with only 27% opposed. The greatest support came from 14-39 year olds (61%), but there was still significant support from people over 40 (52%).</p>
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<img alt="" src="https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/347803/original/file-20200716-37-ud0cvx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The majority of surveyed Australians support pill testing.</span>
<span class="attribution"><span class="source">Steven Saphore/AAP</span></span>
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<p>This is consistent with polls on the topic, with a <a href="https://essentialvision.com.au/pill-testing">2018 Essential poll </a>finding 59% of Australians suppport pill testing.</p>
<p>These facilities allow people who intend to use illicit drugs to get them tested by a chemist using special lab equipment. Usually, they also speak to a health worker. Testing can occur where people are likely to use the drugs (such as festivals) or separate from where people will use the drugs (for example, a health facility).</p>
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Read more:
<a href="https://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827">Testing festival goers' pills isn't the only way to reduce overdoses. Here's what else works</a>
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<p>Although this service is common in the United Kingdom and Europe, it is very contentious in Australia.</p>
<p>However, the recent inquest into the deaths of six young people at various NSW festival the <a href="https://theconversation.com/when-the-coroner-looked-at-how-to-cut-drug-deaths-at-music-festivals-the-evidence-won-but-what-happens-next-126669">coroner recommended </a> the state government introduce drug checking.</p>
<h2>Lessons for policy makers</h2>
<p>The survey also asked people how they would allocate $100 between education, treatment or law enforcement to reduce illicit drug use. For the first time, respondents allocated more money to education than law enforcement ($36.00 compared with $34.80). </p>
<p>This is at odds with government spending on alcohol and other drugs. A <a href="https://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/24%20Government%20drug%20policy%20expenditure%20in%20Australia%20-%202009_10.pdf">2013 report</a>found the majority was spent on law enforcement (66%), with only 22% to treatment and the rest to prevention (10%) and harm reduction (2%). </p>
<p>The results of the survey suggest an important shift in the community’s thinking, particularly about illicit drugs. Australians have moved further away from viewing drugs as a law enforcement issue and are open to a less punitive approach to drug policy. </p>
<p>Policy-makers should know they have the support of the Australian community to bring us in line with best practice around the world.</p><img src="https://counter.theconversation.com/content/142720/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jarryd Bartle works as a consultant in the alcohol and other drug sector. Jarryd also works as a policy advisor for The Eros Association, the industry association for adults-only goods and services which has a commercial interest in the legalisation of recreational cannabis.</span></em></p><p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector and a psychologist in private practice. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment. She is a member of board of directors of Hello Sunday Morning and volunteers for The Loop Australia, a drug checking service.</span></em></p>New research shows Australians are becoming more open to less punitive responses to drug use.Jarryd Bartle, Sessional Lecturer, RMIT UniversityNicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1279192019-11-29T03:55:15Z2019-11-29T03:55:15ZParents of teens, here’s what you really need to know about MDMA<figure><img src="https://images.theconversation.com/files/304200/original/file-20191128-176629-1msht1l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Just around 3% of teens have used MDMA (ecstasy) in the past year.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/girl-cheering-crowd-sitting-upon-shoulders-63911971?src=ed7875ef-bfd7-4bb9-9c82-906ad7006c79-1-31">Franz Pfluegl/Shutterstock</a></span></figcaption></figure><p>We all want to reduce drug-related harm and ensure young people don’t take unnecessary risks. But <a href="http://www.emcdda.europa.eu/attachements.cfm/att_93977_EN_Health%20Development%20Agency%20Review%20of%20Reviews.pdf">decades of research</a> shows fear isn’t an effective way to do this. </p>
<p>This week, Newscorp Australia released <a href="https://www.dailytelegraph.com.au/search-results?q=ripple+effect">The Ripple Effect</a>, a series of articles and <a href="https://www.dailytelegraph.com.au/news/rippleeffect/drugs/the-ripple-effect-education-video-part-one-molly-and-the-toxic-relationship-that-can-turn-deadly/news-story/ead6e1f87dc712deea960f841529a653">accompanying videos</a> about party drugs, aimed at parents of young people.</p>
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Read more:
<a href="https://theconversation.com/is-your-teen-off-to-schoolies-heres-what-to-say-instead-of-freaking-out-126203">Is your teen off to schoolies? Here's what to say instead of freaking out</a>
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<p>Rather than drawing on the science about reducing harm, the series overstates the nation’s drug problem and the likelihood of problems from taking MDMA (ecstasy). And it’s likely to scare the wits out of parents of teens.</p>
<p>So, what do parents really need to know about party drugs?</p>
<h2>Most young people don’t use drugs</h2>
<p>Illicit drug use among teens is low and has <a href="https://www.aihw.gov.au/getmedia/15db8c15-7062-4cde-bfa4-3c2079f30af3/21028a.pdf.aspx?inline=true">been in decline</a> for nearly a decade.</p>
<p>Although Australians overall have a relatively high rate of MDMA use compared to similar countries, only a small proportion of teenagers (around 3%) and young adults (7%) have <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/contents/table-of-contents">used MDMA</a> in the last year. Among high school students, the overwhelming majority (94%) have <a href="https://www.health.gov.au/resources/collections/australian-secondary-school-students-alcohol-and-drug-assad-survey-2017">never tried</a> MDMA.</p>
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Read more:
<a href="https://theconversation.com/three-charts-on-who-uses-illicit-drugs-in-australia-110169">Three Charts on who uses illicit drugs in Australia</a>
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<p>Normalising the idea that drug use isn’t that common is a key <a href="https://www.unodc.org/documents/prevention/UNODC_2013_2015_international_standards_on_drug_use_prevention_E.pdf">prevention strategy</a> in drug education. If young people think “everyone” is using drugs, they are more likely to want to do it too.</p>
<h2>Scare tactics don’t work</h2>
<p>As the <a href="https://www.dailytelegraph.com.au/news/rippleeffect/drugs/nsw-health-ditches-mdma-fear-campaign-in-favour-of-stayok/news-story/fbfa1cfe6b42e33776e9fc5ef2cd2bd9">Ripple Effect</a> notes, NSW Health decided to drop a “shock campaign” on MDMA. The <a href="https://bmjopen.bmj.com/content/5/9/e007449">evidence</a> shows scare tactics don’t help reduce young people’s drug use.</p>
<p>Fatal overdoses are relatively rare. Most people who use party drugs have no adverse consequences. So when young people see messages suggesting all drug use is dangerous, they know it’s not true and may switch off, ignoring effective harm reduction messages. </p>
<p>Describing drugs as “deadly” or “dangerous” can actually make them more <a href="https://www.tandfonline.com/doi/abs/10.1080/09581590601045220">appealing</a>, encouraging some people to seek out more of the potent product.</p>
<p>A far more effective approach is to <a href="https://www.unodc.org/documents/prevention/UNODC_2013_2015_international_standards_on_drug_use_prevention_E.pdf">normalise not using alcohol or other drugs</a>.</p>
<p>Two examples of <a href="https://www.ncbi.nlm.nih.gov/pubmed/22455104">effective</a> approaches were the <a href="https://abovetheinfluence.com">Above The Influence</a> and <a href="http://myowninfluence.org">Be Under Your Own Influence</a> media campaigns by the US <a href="https://www.whitehouse.gov/ondcp/">Office of National Drug Control Policy</a>. These campaigns promoted not using drugs as a way to support the goals of autonomy and achievement.</p>
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<h2>Prohibition doesn’t work either</h2>
<p>The idea we can eliminate drugs from society by telling young people to “<a href="https://en.wikipedia.org/wiki/Just_Say_No">just say no</a>” is, at best, misguided. Campaigns with a prohibition approach are <a href="https://www.scientificamerican.com/article/why-just-say-no-doesnt-work/">not effective</a>.</p>
<p>These interventions fail for <a href="https://www.indiana.edu/%7Eengs/articles/drughysteria.html">many reasons</a>. They don’t teach teens the interpersonal skills needed to refuse drugs; they don’t address internal motivation to experiment or take risks; and they don’t take into account the “forbidden fruit” effect in which restricted or banned activities become more desirable. </p>
<p>Young people who use drugs say the threat of police and drug dogs <a href="https://www.ncbi.nlm.nih.gov/pubmed/30176423">does not deter</a> them from taking drugs. The NSW Coroner recently noted that some police practices at festivals, such as strip searches and sniffer dogs, can result in young people making more <a href="https://theconversation.com/when-the-coroner-looked-at-how-to-cut-drug-deaths-at-music-festivals-the-evidence-won-but-what-happens-next-126669">dangerous decisions</a> about drug use, such as taking multiple doses at once. </p>
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Read more:
<a href="https://theconversation.com/when-the-coroner-looked-at-how-to-cut-drug-deaths-at-music-festivals-the-evidence-won-but-what-happens-next-126669">When the coroner looked at how to cut drug deaths at music festivals, the evidence won. But what happens next?</a>
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<h2>Harm reduction is effective</h2>
<p>The reality is that a small percentage of people will experiment with drugs and some will continue to use them. Harm reduction accepts that reality and seeks to keep those who choose to use drugs as safe as possible. Most people who <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/contents/table-of-contents">use drugs</a> do so only occasionally and for a short time in their lives.</p>
<p>While all drug use <a href="https://theconversation.com/how-does-mdma-kill-109506">carries risks</a>, most drug-related problems, including fatal overdoses, are preventable. This is because drug-related harms are heavily dependent on a range of factors such as temperature, knowledge of what you are taking, and how you take a drug.</p>
<p>How events such as music festivals are <a href="http://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827">regulated</a> impacts the kinds of harms that arise. Freely available water, medical staff who understand drug use, peer support and education can greatly reduce risks.</p>
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Read more:
<a href="https://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827">Testing festival goers' pills isn't the only way to reduce overdoses. Here's what else works</a>
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<p>We recently conducted a review of drug-checking facilities internationally and found compelling evidence these services can <a href="https://www.360edge.com.au/assets/uploads/2019/11/360Edge-What-works-Testing-drugs-for-harm-reduction-November-2019.pdf">reduce risky behaviour and reduce the chance of finding adulterants in illicit drugs</a>. Many MDMA related deaths can be traced to people not knowing the contents or dosage of the pill they have taken.</p>
<p>Data from a dance festival pill testing initiative in Portugal found <a href="https://www.ncbi.nlm.nih.gov/pubmed/28635119">74% of participants</a> would not use the tested drug after receiving unanticipated results; they said they were concerned about the “unknown” nature of the adulterants or potential harms of known adulterants.</p>
<p>In countries where pill testing is well-established, tested samples <a href="https://www.ncbi.nlm.nih.gov/pubmed/28582668">more closely match what people think they are buying</a>, compared to countries not using these services.</p>
<h2>Talk early, openly and often to young people about drugs</h2>
<p>Remember, few young people use recreational drugs. And if they do, their drug use is most likely to be occasional. More than half the people who use MDMA use only <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/contents/table-of-contents">once or twice a year</a>.</p>
<p>Preventing drug use and reducing harms can start at an early age, even before school. Early and age-appropriate education about medicines, tobacco, alcohol and illicit drugs means a young person already has well-formed attitudes before the influence of their peers kicks in.</p>
<p>Children are strongly influenced by their <a href="https://theconversation.com/how-does-ice-use-affect-families-and-what-can-they-do-41186">parents’ attitudes</a> when it comes to alcohol and other drug use. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4393944/">For example</a>, exposure to parents’ drinking or drug use can increase risk of teens drinking and using drugs; an inattentive approach to monitoring children’s activities is associated with teen alcohol and other drug use; and openness to discussing drugs is associated with lower rates of substance use. </p>
<p>Young people with parents who keep an open and honest dialogue about drugs are more likely to discuss difficult issues with them.</p>
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Read more:
<a href="https://theconversation.com/history-not-harm-dictates-why-some-drugs-are-legal-and-others-arent-110564">History, not harm, dictates why some drugs are legal and others aren't</a>
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<img src="https://counter.theconversation.com/content/127919/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jarryd Bartle works as a paid consultant in the alcohol and other drug sector. </span></em></p><p class="fine-print"><em><span>Nicole Lee works as a consultant in the alcohol and other drug sector, including education and training for parents on drugs. She has previously been awarded funding by Australian and state governments, NHMRC and other bodies for evaluation and research into drug prevention and treatment.</span></em></p><p class="fine-print"><em><span>Paula Ross works as a paid consultant in the alcohol and other drug sector and has a private practice.</span></em></p>Few teens use MDMA and scare tactics, like those we’ve seen recently, are unlikely to reduce existing drug use further.Jarryd Bartle, Sessional Lecturer, RMIT UniversityNicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin UniversityPaula Ross, Sessional psychology lecturer, Australian Catholic UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1262032019-11-14T19:06:57Z2019-11-14T19:06:57ZIs your teen off to schoolies? Here’s what to say instead of freaking out<figure><img src="https://images.theconversation.com/files/300590/original/file-20191107-10973-1jz81bm.jpg?ixlib=rb-1.1.0&rect=4%2C5%2C994%2C658&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Schoolies is a rite of passage for many Australian teenagers as they finish their exams and leave school. But are you prepared?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/multiethnic-group-friends-partying-on-beach-528965440">from www.shutterstock.com</a></span></figcaption></figure><p>For many parents whose teenage children are completing Year 12, this time of year means mixed emotions. Parents might feel proud, exhausted and excited. And as young people start heading to schoolies and leavers’ celebrations, many parents may also feel nervous — maybe a little freaked out.</p>
<p>Part of the appeal of schoolies celebrations, which <a href="https://www.schoolies.com/when-is-schoolies">start this weekend</a> in some areas, is they give teenagers a chance to exert their independence and experiment with their identity as a young adult.</p>
<p>This is a <a href="https://www.tandfonline.com/doi/pdf/10.1300/J194v04n02_05">normal part of growing up</a>. But for some parents, this can create <a href="http://www.psychwiki.com/dms/other/labgroup/Measu235sdgse5234234resWeek2/Danika2/Hock%202001.pdf">anxiety</a>. And this anxiety can manifest in overly protective behaviours known as helicopter parenting.</p>
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Read more:
<a href="https://theconversation.com/too-much-love-helicopter-parents-could-be-raising-anxious-narcissistic-children-116182">Too much love: helicopter parents could be raising anxious, narcissistic children</a>
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<h2>How to avoid a crash landing</h2>
<p>This anxiety also affects their young adult children, who in turn <a href="https://link.springer.com/article/10.1007/s10826-016-0466-x">are more likely to be anxious</a>.</p>
<p>These young people <a href="https://www.law.uh.edu/ihelg/monograph/11-12.pdf">find it hard</a> to make decisions and have poor time management. They might also avoid telling their parents things that might freak them out.</p>
<p><a href="https://pdfs.semanticscholar.org/5d09/c3b0848096c5755ebbd1beac7d3bafd4b0df.pdf">Good communication</a> is the key to reducing parental angst and potential hovering. More importantly, it provides an opportunity to talk about high-risk situations. It also means a young person will feel they can contact their parents if they get into trouble. </p>
<p>So how can parents avoid freaking out and keep the channels of communication open? Think of going to schoolies as taking a flight.</p>
<h2>Pre-flight safety briefing (tips for good communication)</h2>
<p><strong>1. When entering the aircraft, mind the generation gap</strong></p>
<p>Young people are often scapegoated by the previous generation (think Gen Z and avocado toast). So don’t react to the media hype about the dangers of schoolies.</p>
<p>Last year there were concerns about an epidemic of nitrous oxide (laughing gas) at schoolies. However, <a href="https://theconversation.com/explainer-what-is-nitrous-oxide-or-nangs-and-how-dangerous-is-it-108019">these claims were unfounded</a>.</p>
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Read more:
<a href="https://theconversation.com/explainer-what-is-nitrous-oxide-or-nangs-and-how-dangerous-is-it-108019">Explainer: what is nitrous oxide (or nangs) and how dangerous is it?</a>
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<p>Parents might roll-their-eyes at teenage behaviour in videos previous schoolies produce, such as the one below. However, from a school leaver’s perspective, these behaviours are a rite of passage. </p>
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<figcaption><span class="caption">Here’s what Ben and his mates really got up to at schoolies.</span></figcaption>
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<p>Most of these behaviours — such as developing group norms, hazing rituals, pranks and testing limits — are about <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1751-9020.2011.00411.x">young people developing their identity</a>. And ultimately, most of these behaviours are relatively harmless. </p>
<p>Parents need to be well informed as to what schoolies is all about. Queensland Independent Schools has developed some good <a href="https://www.parentsnetwork.qld.edu.au/2018/11/06/schoolies-webinar-everything-parents-need-to-know/">resources</a>. If young people believe their parents know what they’re talking about, they’re more likely to listen.</p>
<p><strong>2. Your life-jacket is under the seat</strong></p>
<p>It is important to access objective information rather than media hype. While the media often focuses on <a href="https://www.news.com.au/lifestyle/parenting/teens/who-isnt-on-stuff-schoolies-are-drinking-less-but-theyve-replaced-it-with-something-else/news-story/1fa7bcb2c37440a3a4eb33ef1f40671d">illegal drug use</a>, <a href="https://theconversation.com/sex-drugs-and-alcohol-what-really-goes-on-at-schoolies-20654">most young people</a> do not use drugs at schoolies.</p>
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Read more:
<a href="https://theconversation.com/sex-drugs-and-alcohol-what-really-goes-on-at-schoolies-20654">Sex, drugs and alcohol: what really goes on at schoolies?</a>
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<p>The risky use of alcohol is <a href="https://researchmgt.monash.edu/ws/portalfiles/portal/231556154/39908555_oa.pdf">more concerning</a>. Perhaps then it is not surprising many young people engage in <a href="https://theconversation.com/sex-drugs-and-alcohol-what-really-goes-on-at-schoolies-20654">risky sexual behaviours at schoolies</a>. </p>
<p>Parental discussions about reducing the risk from alcohol use and safe sex are not only likely to have the most impact on reducing harm, teens will also see them as more relevant. </p>
<p><strong>3. Know your exits</strong></p>
<p><a href="https://journals.sagepub.com/doi/pdf/10.1177/1363459315628042">Young people are sceptical</a> of information about risky behaviours they think is exaggerated. Information about risky behaviours is likely to be perceived as more credible when it is balanced. </p>
<p>For example, when talking about drugs, teenagers will perceive information parents provide as more credible when positive, neutral and negative effects of the drug are all considered. A good source of balanced and credible drug information is <a href="https://www.erowid.org/psychoactives/psychoactives.shtml">Erowid</a>, a drug education website run by a not-for-profit harm reduction organisation. </p>
<p><strong>4. Brace position</strong> </p>
<p>Most young people take risks. Testing the boundaries is a normal part of growing up. What did you get up to as a young person?</p>
<p>Appropriate disclosure of the parent’s own risk taking behaviour creates an environment of trust. It also fosters the <a href="https://sml.stanford.edu/ml/2013/02/jiang-cr-from-perception.pdf">disclosure reciprocity norm</a>. When somebody discloses something personal about themselves, we feel the desire to disclose something personal about ourself.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=501&fit=crop&dpr=1 754w, https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=501&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/300588/original/file-20191107-10961-1ht6itf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=501&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Parents can help their teens navigate the new-found freedom at schoolies.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/gold-coast-nov-27-2018australians-highschool-1241671957?src=c771dd01-c789-44ad-9a75-91bad19c0d15-1-1&studio=1">from www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>It is also important not to appear to know something when you don’t. This would be inauthentic. You gain more credibility by acknowledging when you don’t know something and are open to working together to finding out. </p>
<p><strong>5. Fasten you seat belts</strong> </p>
<p>If you are authentic and are open to a balanced discussion, young people are <a href="https://sml.stanford.edu/ml/2013/02/jiang-cr-from-perception.pdf">more likely to disclose</a> past behaviour or future intentions that might concern you. </p>
<p>Remember to stay calm. Discuss the potential consequences, both good and bad, in a matter-of-fact manner. Reacting negatively is likely to shut down the conversation.</p>
<p><strong>6. Oxygen masks may drop</strong></p>
<p>Some parents might be concerned about “peer pressure”. While your child can be trusted, can you trust their friends?</p>
<p>The likelihood of a young person succumbing to peer pressure is reduced when there is a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4777050/">good relationship with their parents</a>. This is a chance to discuss creative “ways out” of risky situations. </p>
<p>The popular belief that young people value their friends’ beliefs more than their parents’ is <a href="https://www.ncbi.nlm.nih.gov/pubmed/30088777">not true</a>. While young people are more likely to be influenced by peers on matters such as style and appearance, parents are still more likely to have an influence on issues such as <a href="https://pdfs.semanticscholar.org/9390/f51a79d4cd5284005028288b4aa4e43bf84c.pdf">morality</a>.</p>
<h2>Cleared for take-off</h2>
<p>Experimenting and exerting independence provides young people with excellent opportunities for learning and self development. </p>
<p>Though some learning experiences can be costly, through good communication, the risk of harm can be minimised. </p>
<p>In the end, parents need to trust they have instilled their values and common sense.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/schoolies-toolies-and-foolies-in-the-market-for-a-rite-of-passage-20566">Schoolies, toolies and foolies – in the market for a rite of passage </a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/126203/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephen Bright does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Schoolies and other leavers’ celebrations are a chance for teenagers to exert their independence and experiment with their identity as a young adult. And yes, you can help without losing your cool.Stephen Bright, Senior Lecturer of Addiction, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1221282019-10-23T04:59:37Z2019-10-23T04:59:37Z‘My friends are taking MDMA at raves and music festivals. Is it safe?’<figure><img src="https://images.theconversation.com/files/288664/original/file-20190820-123736-amjiz1.png?ixlib=rb-1.1.0&rect=77%2C59%2C3892%2C1916&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">No drug is 100% safe. </span> <span class="attribution"><span class="source">Wes Mountain</span></span></figcaption></figure><blockquote>
<p>My friends are taking ecstasy at raves and music festivals. Is it safe? — Anonymous</p>
</blockquote>
<h2>Key points</h2>
<ul>
<li>no drug use, including ecstasy, is 100% safe</li>
<li>festivals can present unique risks </li>
<li>look out for friends, know the risks and where to get help.</li>
</ul>
<p><a href="https://theconversation.com/au/topics/i-need-to-know-66587"><img src="https://images.theconversation.com/files/290837/original/file-20190904-175686-polw3q.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=90&fit=crop&dpr=2" width="100%"></a></p>
<h2>What is ecstasy or MDMA?</h2>
<p>Ecstasy is a slang term for drugs <em>meant</em> to contain 3,4- methylenedioxymethamphetamine (MDMA), a stimulant that can also cause mild hallucinations at high doses. While ecstasy was traditionally sold as tablets, it’s <a href="https://ndarc.med.unsw.edu.au/sites/default/files/National%20EDRS%20Interview%20Report%202018_1.pdf">increasingly sold in crystal, capsule and powder forms</a>. </p>
<p>According to the <a href="https://www.aihw.gov.au/reports/illicit-use-of-drugs/2016-ndshs-detailed/data">most recent data</a>, only 1% of Australians aged 12-17 said they had tried ecstasy. However, studies suggest young Australians who attend music festivals are <a href="https://www.ncbi.nlm.nih.gov/pubmed/29304871">much more likely</a> to have tried it.</p>
<hr>
<p><iframe id="rsqsA" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/rsqsA/1/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<hr>
<h2>So, is it ‘safe’?</h2>
<p>There seems to be a common perception ecstasy is “safe”. But no drug use — legal or illegal — is completely safe. While drug experts <a href="https://www.ncbi.nlm.nih.gov/pubmed/31081439">rank</a> ecstasy as less harmful than other drugs, such as “ice” and alcohol, there are still significant risks involved:</p>
<ol>
<li><p>given ecstasy is illegal, the market is unregulated. As a result, drugs sold as “ecstasy” <a href="https://www.harmreductionaustralia.org.au/wp-content/uploads/2018/06/Pill-Testing-Pilot-ACT-June-2018-Final-Report.pdf">commonly do not contain MDMA</a> and may contain something far more dangerous. This means the effects can be unpredictable</p></li>
<li><p>even if your drugs contain MDMA, the dose or potency can <a href="https://www.acic.gov.au/sites/default/files/illicit_drug_data_report_2017-18.pdf?v=1564727746">vary hugely</a>. Recently, <a href="https://www.smh.com.au/national/nsw/tragic-reveller-told-friend-he-would-push-through-inquest-hears-20190716-p527lm.html">very high purity ecstasy</a> has been detected in Australia. This can significantly increase the risk of overdosing or having serious side-effects </p></li>
<li><p>even pure MDMA at normal recreational doses can be risky in the <a href="https://www.ncbi.nlm.nih.gov/pubmed/24899699">wrong conditions</a> (for instance, when it’s very warm)</p></li>
<li><p>common short-term effects also include <a href="https://www.ncbi.nlm.nih.gov/pubmed/16771886">increased heart rate and body temperature, teeth grinding and anxiety</a>. While evidence on the long-term effects of taking MDMA is still emerging, there may be lasting impacts on <a href="https://www.ncbi.nlm.nih.gov/pubmed/23881877">memory, mood, cognition and sleep</a>.</p></li>
</ol>
<h2>What are the risks when taking it at festivals?</h2>
<p>In recent years, there have been more reports of <a href="https://www.smh.com.au/national/nsw/music-festival-deaths-inquest-set-down-for-july-20190228-p510sz.html">drug-related deaths at festivals</a>. While the media typically describes deaths involving ecstasy as “overdoses”, most ecstasy-related deaths are <a href="https://www.tandfonline.com/doi/abs/10.1080/14659891.2018.1436607?journalCode=ijsu20">not</a> the result of simply taking too much. </p>
<p>Drug experiences can be influenced by <a href="https://www1.health.gov.au/internet/publications/publishing.nsf/Content/drugtreat-pubs-front12-fa-toc%7Edrugtreat-pubs-front12-fa-secb%7Edrugtreat-pubs-front12-fa-secb-2%7Edrugtreat-pubs-front12-fa-secb-2-5">lots of different things</a> and music festivals can sometimes result in a “perfect storm” of risk factors. For example, an experienced male taking an ecstasy pill at a quiet gathering at home is likely to have a very different experience to an inexperienced female taking her ecstasy pills at a crowded festival on a 35°C day. </p>
<p>Females, those with lower body weight, and/or those who haven’t used ecstasy before, and therefore haven’t built up any physical tolerance, should use a smaller dose.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=559&fit=crop&dpr=1 600w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=559&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=559&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=702&fit=crop&dpr=1 754w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=702&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/292154/original/file-20190912-190044-elzxfw.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=702&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Drug experiences can be affected by lots of different things.</span>
</figcaption>
</figure>
<p>Some key risks at music festivals include:</p>
<ul>
<li><p><strong>hyperthermia aka heatstroke:</strong> MDMA <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008716/">affects the body’s ability to regulate temperature</a> (it can increase body temperature and also make it harder to cool down). Environmental factors at festivals such as warm weather, crowds and dancing can significantly increase the risk of overheating (see <a href="https://dancesafe.org/heatstroke/">tips</a> for staying cool)</p></li>
<li><p><strong>hyponatremia aka water intoxication:</strong> MDMA can <a href="https://www.ncbi.nlm.nih.gov/pubmed/23476039">disrupt the body’s water/electrolyte balance</a> (can make your body <a href="https://cjasn.asnjournals.org/content/3/6/1852">retain water</a>). While you need water to avoid dehydrating, drinking too much can also be dangerous. Read up on these <a href="https://drugaware.com.au/getting-the-facts/staying-safe/#Dehydration-and-overhydration">guidelines</a> on dehydration and overhydration for more information</p></li>
<li><p><strong>dodgy on-site sellers:</strong> <a href="https://www.ncbi.nlm.nih.gov/pubmed/30541674">UK research</a> found people buying drugs on-site (inside the festival grounds) were more than twice as likely to buy drugs that did not contain what they thought. There have been cases where festival goers thought they were buying MDMA but actually bought N-ethylpentylone (a riskier stimulant linked to psychosis and <a href="https://www.dea.gov/press-releases/2018/08/31/dea-acts-against-dangerous-deadly-designer-synthetic-drug-linked-151">deaths</a>)</p></li>
<li><p><strong>policing or legal problems:</strong> festivals often have a heavy police presence with sniffer dogs and being caught with drugs can lead to possession or supply charges. However, it’s very important not to panic and swallow your drugs if you see sniffer dogs. This has been linked to at least three <a href="https://www.pedestrian.tv/news/defqon-1-drugs-death-reignites-sniffer-dogs-debate/">festival deaths</a> in Australia.</p></li>
</ul>
<h2>Worried about your friends?</h2>
<p>If you’re going to a rave or festival and suspect some of your friends might take illicit drugs, it’s important to be aware of the risks, look out for your friends and know where to get help. Here are some tips:</p>
<ol>
<li><p><strong>make emergency plans with friends:</strong> download the festival map, have a meeting point, make sure mobiles are charged, stick together and know where on-site support services are </p></li>
<li><p><strong>look out for <a href="https://drugaware.com.au/getting-the-facts/staying-safe/#Signs-someone-needs-immediate-help">red flag symptoms</a></strong> (for instance, feeling hot, unwell, confused or agitated) and never be scared to seek help from on-site medical or support services. They’re there to help you, not judge or arrest you</p></li>
<li><p><strong>be informed:</strong> <a href="https://drugaware.com.au/getting-the-facts/staying-safe/">Drugaware</a>, <a href="https://www.dancewizensw.org.au/patron/#block-yui_3_17_2_1_1524198824688_25530">Dancewize</a> and <a href="http://www.boomtick.com.au/listen-out-perth-save-a-mate-training/">Boomtick</a> all have great information about drugs and how to keep safe.</p></li>
</ol><img src="https://counter.theconversation.com/content/122128/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jodie's doctoral research was funded by a scholarship from the Australian Government Department of Health. The National
Drug Research Institute at Curtin University is supported by funding from the Australian Government under the Drug and Alcohol Program.</span></em></p>A person’s drug experience can be influenced by many different things, such as heat, access to water and dosage.Jodie Grigg, Research Associate at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1201612019-07-18T00:50:41Z2019-07-18T00:50:41ZThe profile of festival drug takers might be different to what you expect<figure><img src="https://images.theconversation.com/files/284245/original/file-20190716-173355-jec7mx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The average festival goer is young, white, well educated and employed.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/cEUl-0DSM9s">Gbarkz</a></span></figcaption></figure><p>A <a href="https://www.smh.com.au/national/nsw/music-festival-deaths-inquest-set-down-for-july-20190228-p510sz.html">NSW Coronial Inquest</a> investigating a series of drug-related deaths at Australian music festivals has heard evidence of festival goers <a href="https://www.theguardian.com/australia-news/2019/jul/08/festival-overdose-victim-took-multiple-pills-before-event-to-avoid-police-detection">taking multiple concurrent doses</a> of MDMA to avoid police detection and not receiving <a href="https://www.news.com.au/national/nsw-act/courts-law/doctor-reveals-hellish-scene-as-he-battled-to-save-man-who-overdosed-at-festival/news-story/9cb71e88be6c3908f40f024131676567">adequate medical attention</a>. </p>
<p>But a lack of knowledge about the drug use patterns and demographic profile of festival goers has stymied capacity to develop evidence-informed policy responses. </p>
<p>Yesterday we published two <a href="https://socialglobal.org.au/cms/wp-content/uploads/2019/07/emt-gds-report.pdf">data reports</a> to inform the inquest and shed light on these patterns. Both <a href="https://ndarc.med.unsw.edu.au/resource/bulletin-no-28-australian-music-festival-attendees-national-overview-demographics-drug-use">reports</a> are based on data from more than 5,000 Australian festival goers who completed the <a href="https://www.globaldrugsurvey.com/">Global Drug Survey</a> from late 2018. </p>
<p>It suggests common assumptions about Australian festival goers and the risks they take may be wrong. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/testing-festival-goers-pills-isnt-the-only-way-to-reduce-overdoses-heres-what-else-works-118827">Testing festival goers' pills isn't the only way to reduce overdoses. Here's what else works</a>
</strong>
</em>
</p>
<hr>
<h2>Who goes to music festivals and what drugs do festival goers take?</h2>
<p>Most Australian music festival attendees we sampled were young (with a mean age of 22.4), male (55%), heterosexual (76%) and white (87%). </p>
<p>They were well-educated and most were employed (85.6%). Very few reported having a criminal conviction (6%). </p>
<p>And while it’s often assumed that people going to festivals are “hardcore” or regular attendees, almost half (49.6%) reported going to only one or two festivals a year. </p>
<p>The most common drug they took, unsurprisingly, was alcohol. Of the illicit substances, the most commonly used were MDMA, cannabis and cocaine.</p>
<p>We asked about drug use in all settings, not just festivals, and not just on the day of the festival. </p>
<p>While nearly half (44%) reported drinking alcohol weekly or more often, 64% typically drank at least five standard drinks.</p>
<p>Festival goers who used MDMA typically reported use ten times in the last 12 months. Those who used cocaine typically did so five times in the last 12 months. </p>
<p>Although MDMA use is the focus of the NSW Coronial Inquest, and public debates about festival safety, our data show that alcohol remains the biggest contributor to drug-related harm among festival goers.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284247/original/file-20190716-173351-a7fo6c.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Festival goers who reported using MDMA typically took the drug ten times in the past year.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/DSB1MZWsGco">Krists Luhaers</a></span>
</figcaption>
</figure>
<h2>Festival goers’ experiences with policing</h2>
<p>Our analysis showed most festival goers (75%) reported they encountered police in relation to their drug use in the last 12 months. Some 69% reported drug dog encounters at festivals. </p>
<p>This is a concern because encounters with drug detection dogs are often traumatic and can lead to more harmful practices, such as taking multiple doses to avoid detection. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-drug-detection-dogs-are-sniffing-up-the-wrong-tree-57343">Why drug-detection dogs are sniffing up the wrong tree</a>
</strong>
</em>
</p>
<hr>
<p>NSW festival goers were 1.3 times more likely to report encounters with drug detection dogs than those from other states (79% versus 62%). This is notable, given our earlier analysis showed encounters with drug detection dogs are already <a href="https://www.sciencedirect.com/science/article/abs/pii/S0955395918300756?via%3Dihub">seven times higher</a> in Australia than in New Zealand. </p>
<h2>Who seeks medical treatment?</h2>
<p>Few festival goers we sampled sought medical attention. Just 280 respondents (6%) reported seeking medical help after alcohol or other drug use at least once in the last 12 months. We cannot tell from these data where these young people were located when they sought medical help, whether at a festival or in the community.</p>
<p>Young women aged 16 to 20 years were the most likely to report seeking medical help after drinking alcohol or taking other drugs (8.7%), followed by young men in the same age group (7.3%). Just 4.9% of men aged 21 and over and 5.2% of women in the same age group reported seeking help. </p>
<p>Festival goers who had problems with alcohol were more likely to seek help (4.3% of users) than those who were struggling after using other drugs including MDMA (2.5%), LSD (1.48%), cannabis (0.96%) and cocaine (0.67%).</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-does-mdma-kill-109506">How does MDMA kill?</a>
</strong>
</em>
</p>
<hr>
<p>Festival goers seeking help for alcohol consumption typically drank 15 standard alcoholic drinks. </p>
<p>The most commonly mentioned symptoms here were nausea or vomiting (45%), accident or trauma (40%) or passing out (37%). Some 65% reported being admitted to hospital. </p>
<p>Those seeking help after taking MDMA typically consumed three pills or 0.4g during the session. The majority (56%) reported taking a larger than usual dose of MDMA on that occasion. </p>
<p>Just 28% reported starting the session with a smaller “test dose” of MDMA.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/284249/original/file-20190716-173325-14djqrv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Festival goers commonly mixed alcohol with other drugs.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/IB5bld_weak">Marvin Meyer</a></span>
</figcaption>
</figure>
<p>Most (81%) reported combining MDMA with alcohol and or other illegal drugs. And most of those who drank alcohol with MDMA said they were “already drunk” before taking the MDMA. </p>
<p>The most common symptoms they experienced were confusion (40%), anxiety and panic (40%) and very low mood in the days afterwards (40%). Almost half (48%) reported being admitted to hospital.</p>
<h2>What does this data tell us?</h2>
<p>Despite the understandable focus on the harms from illicit drugs, most illicit drug use among Australian festival attendees appears to be occasional and isn’t problematic. </p>
<p>Nevertheless, there is a small but notable group of young people who experience higher rates of drug-related harms. </p>
<p>To reduce these harms, we should expand access to peer education services, such as those provided by the <a href="https://www.dancewizensw.org.au/about-us">DanceWize</a> team. DanceWize provides credible information about safer partying. It delivers harm-reduction services, including crowd care services (water, sunscreen and information). It also hosts a safe space for festival goers. </p>
<p>We should also expand trials of on-site drug checking services at festivals and outside these settings (for example, drop-in services at urban centres). <a href="https://ndarc.med.unsw.edu.au/resource/bulletin-no-24-global-review-drug-checking-services-operating-2017">Drug checking (or pill testing) services</a> invite members of the public to anonymously submit drug samples for forensic analysis and then provide individualised feedback of results and counselling as appropriate.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
</strong>
</em>
</p>
<hr>
<p>Given their high rates of policing, particularly with drug detection dogs, Australian festival goers may be reluctant to seek medical advice or support if they are afraid of being detected in possession of drugs. </p>
<p>Reducing the use of drug detection dogs at festivals, as well as expanding non-criminal alternatives for personal use and possession offences, should be prioritised to reset the balance between public health and public safety.</p><img src="https://counter.theconversation.com/content/120161/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Monica Barratt receives funding from the National Health and Medical Research Council, the Marsden Foundation (NZ) and the National Institutes of Health (US). She is the lead Australian researcher on Global Drug Survey. In addition to her academic research role, she volunteers as Director of Research at Bluelight.org and as Victorian Strategic Engagement Coordinator at The Loop Australia.</span></em></p><p class="fine-print"><em><span>Adam Winstock is the owner and founder of Global Drug Survey Ltd, an independent research organisation based in London. GDS received remuneration from both the NSW Coroners Office and WA Mental Health Commission to support data access and report preparation that underpins many of the issues discussed in this article. GDS revives funding from research organisations, government and corporate groups to provide data based reports and harm reduction tools that offer data collection and local data reporting such as the Drinks Meter. No oversight was provided nay any funding body in the preparation of this article.</span></em></p><p class="fine-print"><em><span>Caitlin Hughes has received funding from the Australian Research Council, Commonwealth Department of Health, National Drug Law Enforcement Research Fund, Australian Institute of Criminology, ACT Government and the Irish Department of Justice and Equality. She is visiting academic at the National Drug and Alcohol Research Centre which receives funding from the Australian Government under the Substance Misuse Prevention and Service Improvement Grants Fund and Vice President of the International Society for the Study of Drug Policy. </span></em></p><p class="fine-print"><em><span>Jason Ferris is part of the core research team for the Global Drug Survey. He receives funding from Australian Research Council and Australian National Health and Medical Research Council, grants from State (Tasmania, Victoria, Queensland) and Federal Governments, National Drug Law Enforcement Research Fund, Foundation for Alcohol Research and Education, University of Queensland, National Institute of Health, Global Drug Survey. He is affiliated with the Global Drug Survey and the Queensland Mental Health Commission. </span></em></p>Most drug use among Australian festival goers appears to be occasional and isn’t problematic. But a small group experience higher rates of drug-related harms.Monica Barratt, Vice Chancellor’s Senior Research Fellow, Social and Global Studies Centre, RMIT UniversityAdam Winstock, Honorary Clinical Professor, UCLCaitlin Hughes, Associate Professor in Criminology and Drug Policy, Centre for Crime Policy and Research, Flinders UniversityJason Ferris, Associate Professor, Program Leader for Research and Statistical Support Service and Program Leader for Substance Use and Mental Health, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1080672019-06-06T19:30:55Z2019-06-06T19:30:55ZCan a $12 pill test for ecstasy save lives? Well, it’s complicated<figure><img src="https://images.theconversation.com/files/278224/original/file-20190606-40719-1veur7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">New research into pill testing at festivals shows not everyone reacts to a test result the way you'd expect.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/1368670571?src=K3Dkbaqdun0O9Mz6rnoToQ-1-4&studio=1&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Can a A$12 pill test prevent deaths from ecstasy? Our research, <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/dar.12936">published today</a>, finds pill testing provides no magic answer. </p>
<p>We found not everyone acts on the result of a pill test in the same way. It depends on the result, whether they have used ecstasy before and how willing they are to take risks.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-does-mdma-kill-109506">How does MDMA kill?</a>
</strong>
</em>
</p>
<hr>
<p>Ecstasy users could end up in hospital or dying as they do not know the chemical composition of the substance they are taking. That’s because their pill could contain higher than expected doses of ecstasy or toxic contaminants, both of which could be fatal.</p>
<p>So identifying what’s in their pill, using a pill checking service at a festival or a club, is one option to reduce the risk.</p>
<p>It’s an option that <a href="https://www.ncbi.nlm.nih.gov/pubmed/28635057">Australian research</a> suggests would be popular; some 95% of party-goers who used illicit drugs said they would use a pill checking service if it were available.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/heres-why-doctors-are-backing-pill-testing-at-music-festivals-across-australia-109430">Here's why doctors are backing pill testing at music festivals across Australia</a>
</strong>
</em>
</p>
<hr>
<p>But only two official services have been offered in Australia. </p>
<p>In 2018, the first government-supported <a href="https://www.abc.net.au/news/2018-04-30/groovin-the-moo-pill-testing-finds-lethal-product/9710112">pill testing trial</a> took place at the Groovin’ the Moo music festival in Canberra. In 85 tests, two lethal substances were detected and five users disposed of their substance once told what they contained. </p>
<p>In 2019 at the same festival, <a href="https://independentaustralia.net/life/life-display/pill-testing-a-life-saving-success--its-time-for-government-funding,12651">a repeat trial</a> detected seven dangerous substances, which were disposed of.</p>
<p>But what would someone do if they discovered their ecstasy was purer than average? Or the pill test was unable to identify the substance? Would this knowledge lead to safer behaviour? This is what our research tried to answer.</p>
<h2>What we found</h2>
<p>We presented almost 300 people at a music festival with different scenarios to find out who was most likely to continue to take risks after a pill test.</p>
<p>Almost 60% of people interviewed said they had used ecstasy before. These prior users said if the pill testing showed a high dose of ecstasy or the test was inconclusive, they would not necessarily take precautions, such as throwing away the pill or taking less of the pill.</p>
<p>But if they discovered their substance contained a toxic contaminant they would be very likely to take precautions.</p>
<p>These findings are important considering some of the recent <a href="https://www.sbs.com.au/news/more-festival-deaths-could-be-examined-in-nsw-inquest">ecstasy-related deaths at Australian festivals</a> have been linked to high doses of ecstasy. </p>
<p>The people who said they had never used ecstasy before were more cautious, regardless of the outcome of the test. They said they would be more likely to take precautions in all the scenarios we presented.</p>
<h2>Why don’t people always act?</h2>
<p>Educating people generally gives them information to make choices. But, for some, simply giving more information about their substance won’t change their tendency to use it.</p>
<p>Our study showed that people who are risk takers in general (referred to as sensation seekers) would be more likely to take risks with a substance if a test was inconclusive or if the substance contained harmful contaminants. </p>
<p>Importantly, these risk takers would also be less likely to take precautions after finding out their pill contained a high dose of ecstasy.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-how-our-understanding-of-risk-is-changing-79501">Explainer: how our understanding of risk is changing</a>
</strong>
</em>
</p>
<hr>
<p>So, pill testing in itself is not the magic answer. This new research suggests that pill testing services at music festivals would be most effective for reducing harm in people who might be trying ecstasy for the first time. </p>
<p>Generally, people who had used before were only more likely to take precautions if the ecstasy contained a toxic contaminant. </p>
<p>And prior ecstasy users who are also risk takers are statistically at the greatest risk of harm even after taking a pill test.</p>
<h2>Do ecstasy users already know what’s safe?</h2>
<p>Could people who have used ecstasy before know more about ecstasy use?</p>
<p>Apparently not. We found people who use ecstasy need drug education to help reduce their risks of harm. They were no more knowledgeable about sensible ecstasy doses or the harmfulness of dangerous contaminants than people who have never used.</p>
<p>So, it is important that formal pill testing services also offer counselling and drug education alongside the test result to decrease the chance of harmful choices, hospitalisation and even death.</p>
<p>Because we found almost 50% of prior ecstasy users said they did not know or trust their supplier, it suggests some people are knowingly taking considerable risks. If these people had access to a pill checking service then their ability to manage these risks would be greatly improved.</p>
<h2>Who pays for pill testing?</h2>
<p><a href="https://www.smh.com.au/national/nsw/pill-testing-trial-ridiculous-baird-20160228-gn5n0l.html">Political</a> <a href="https://www.abc.net.au/news/health/2018-12-21/guide-to-pill-testing-at-australian-music-festivals/10638732">opponents</a> to pill testing are wary of supporting or providing funds for quality-control services for illegal drugs. </p>
<p>However, the festival attendees we surveyed said they would contribute an average $12 towards the cost of such pill testing.</p>
<p>So, given the low knowledge levels in ecstasy users, let’s reframe pill testing as a gateway to engage with illicit drug users to provide other services, such as education and counselling. </p>
<p>This combined harm-minimisation approach could reduce the rates of harm to mostly ill-informed young people attending festivals.</p><img src="https://counter.theconversation.com/content/108067/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>New research shows some festival goers are willing to take a dodgy pill regardless of the test result. So, let’s use pill testing to educate them and others about reducing their risk.Ross Hollett, Lecturer, Edith Cowan UniversityNatalie Gately, Criminology Courses Coordinator, Edith Cowan UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/937312018-04-02T19:57:27Z2018-04-02T19:57:27ZPublic housing ban on people with drug records likely to do more harm than good, research tell us<p>The New South Wales government <a href="https://www.sbs.com.au/news/nsw-govt-defends-drug-dealer-housing-ban">plans to ban</a> people with a history of drug offences from living in social housing in parts of inner-city Sydney. The desire to provide an environment that helps people who are trying to minimise their drug use and stay away from drug markets is understandable. The reality is there is no evidence that this is what the policy will achieve.</p>
<p>The policy involves a one-year trial in which anyone charged with or convicted of drug dealing or manufacturing in the past five years will not be allowed to live in public housing estates in Surry Hills, Glebe, Waterloo and Redfern. The state’s minister for social housing, Pru Goward, <a href="http://www.abc.net.au/radionational/programs/breakfast/ban-drug-dealers-from-inner-city-social-housing/9522000">told ABC Radio</a> the aim is to reduce temptation for drug users living in these estates.</p>
<blockquote>
<p>Once a person is released from prison on drug offences, it’s the first five years that are critical in keeping them away from crime.</p>
</blockquote>
<h2>Helping rather than punishing people</h2>
<p>Let’s start with the minister’s first claim, that the purpose of the policy is to help people experiencing problems with their drug use. Research tells us that the most effective approach to reducing the harms of drug use involves environments in which:</p>
<ul>
<li><a href="https://onlinelibrary.wiley.com/doi/abs/10.1080/09595230500170258">heavy policing is minimal</a></li>
<li>funding for treatment services is secure</li>
<li>a <a href="https://books.google.com.au/books/about/The_Reduction_of_Drug_Related_Harm.html?id=4fxEAQAAQBAJ&redir_esc=y">harm-minimisation</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1080/09595230600944529">philosophy</a> guides service provision</li>
<li><a href="http://roar.uel.ac.uk/1622/">crisis accommodation and public housing are available</a> to support people having problems with drug use.</li>
</ul>
<p>Underlying this well-evidenced and highly effective approach is this basic principle: the way to reduce the harms of drug use is to help rather than punish people who experience problems with their drug use. </p>
<p>In Australia, though, <a href="https://www.mja.com.au/journal/2016/204/4/alcohol-and-other-drug-treatment-policy-australia">less than half</a> of the people who are suitable for and seek out treatment actually receive it. This is the most significant barrier to improving outcomes for people who have problems with drugs. It needs to be the first priority of policy and funding.</p>
<p>Policies like the one being adopted in NSW threaten to undermine this evidence-based approach.</p>
<h2>Sending the wrong message</h2>
<p>In <a href="https://www.westernsydney.edu.au/staff_profiles/uws_profiles/doctor_kev_dertadian">my research</a> I’ve learnt that people who sell drugs often also use them. I’ve seen how selling drugs in inner-city areas is more likely to be done out of desperation than out of greed or malice. Just like we need to help people whose drug use leads them into desperate behaviour, we need to help people with previous drug convictions to find stable living arrangements and legitimate sources of income.</p>
<p>As <a href="https://fortunesociety.org/">The Fortune Society</a> president and CEO, JoAnne Page, <a href="https://www.hrw.org/report/2004/11/17/no-second-chance/people-criminal-records-denied-access-public-housing">told</a> Human Rights Watch:</p>
<blockquote>
<p>What you want is a way for housing projects to be safe. Some restrictions based on real safety make all the sense in the world, but you want those restrictions to be reasonable, and you want people to be able to earn their way back in.</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/212372/original/file-20180328-109207-kaqztg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The people barred from public housing in inner Sydney will still need housing and a legitimate source of income.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/mic_n_2_sugars/4394862964/in/photolist-81JCL1-81FtLe-7AnqKF-ipa6hz-7BZe3F-7BZdsg-7CRbD2-7GmPDo-7GhDKV-7A93cc-7ChavS-7BZd12-7Lbyab-7HakHL-4BQeUZ-7BZeBR-7GhAgr-7GhJv6-7zSyZg-BupHd-7Ghser-7ADdCJ">mic wernej/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-nd/4.0/">CC BY-NC-ND</a></span>
</figcaption>
</figure>
<p><a href="https://www.hrw.org/report/2004/11/17/no-second-chance/people-criminal-records-denied-access-public-housing">Stable housing is enshrined in human rights law</a> as an essential principle for human survival and dignity. This means the government still has obligations to house the people it forces to move out of the inner city.</p>
<p>The people affected by the policy have already served their time. Barring them from public housing in the inner city sends the wrong message by further punishing and marginalising people who have already been dealt with in the proper way; that is through the criminal justice system. </p>
<p>The policy also gives the impression that people with previous drug convictions are not good enough to be housed in the trendy suburbs of our inner city, but they can be housed elsewhere.</p>
<p>Community groups and organisations that help to reintegrate offenders into the community have raised valid concerns about the discriminatory impact of the policy. They have warned that it will have disproportionate impacts on Indigenous Australians, who make up about 25% of people released from prison who live in the affected areas. While the policy may not be targeting Aboriginal people, its outcomes are likely to include significant disruption of their families and communities.</p>
<p>People need to be given the opportunity to rebuild after the criminal justice system has intervened. The last thing they need is to have to manage constant, ongoing and disruptive changes to the systems of support attached to social networks and family, and the community of caring for one another that they provide.</p>
<h2>Heed the lessons from elsewhere</h2>
<p>It’s not as though we haven’t seen policies like this before. The NSW approach mimics aspects of US drug policy, which has sought to deny a range of services, including welfare and access to public housing, to people with drug convictions.</p>
<p>Crucially, the <a href="https://www.opensocietyfoundations.org/reports/life-sentences-denying-welfare-benefits-women-convicted-drug-offenses">evidence from the US</a> and elsewhere <a href="https://www.tandfonline.com/doi/abs/10.1080/10511482.2017.1336638">shows that denying or limiting access</a> to social services of people with previous drug convictions may make it <a href="http://wisconsinlawreview.org/wp-content/uploads/2015/05/Silva-Final.pdf">more likely that they will reoffend</a>.</p><img src="https://counter.theconversation.com/content/93731/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kev Dertadian does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The evidence is clear on the sort of support that is needed to reduce the harms of drug use. A punitive approach that denies people a second chance makes it more likely they will reoffend.Kev Dertadian, Lecturer in Criminology, Western Sydney UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/773432017-05-15T20:07:49Z2017-05-15T20:07:49ZAustralia should stop beefing up its steroid laws – that won’t help users<figure><img src="https://images.theconversation.com/files/168686/original/file-20170510-7904-9futrr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">There has been a dramatic increase in the amount of steroids seized at the Australian border over time.</span> <span class="attribution"><span class="source">AAP</span></span></figcaption></figure><p>The use of image and performance enhancing drugs – in particular steroids – is a growing area of concern <a href="https://www.ncbi.nlm.nih.gov/pubmed/24582699">globally</a>. </p>
<p>The use of these drugs has traditionally been limited to elite athletes and professional bodybuilders. But now their use is becoming normalised as part of a <a href="http://onlinelibrary.wiley.com/doi/10.1111/hsc.12326/pdf">fitness and beauty regime</a> for people who want to gain muscle, become leaner, and improve their appearance.</p>
<p>Several <a href="http://www.tandfonline.com/doi/abs/10.3109/09687637.2015.1061975">population studies</a> have shown the use of image and performance enhancing drugs in Australia is relatively low. However, the dramatic increase of <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813">steroids detected</a> at the country’s borders, and the number of users <a href="https://www.ncbi.nlm.nih.gov/pubmed/26644363">accessing needle and syringe programs</a>, seem to indicate otherwise. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=273&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=273&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=273&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=344&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=344&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168825/original/file-20170510-21593-cled6x.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=344&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Number of performance- and image-enhancing drug detections at the Australian border, 2005–06 to 2014–15.</span>
<span class="attribution"><span class="source">DIBP</span></span>
</figcaption>
</figure>
<p>If Australia is to respond to image and performance enhancing drug use effectively, we need to improve our prevention and harm-reduction strategies – and not merely further criminalise users.</p>
<h2>Potential health harms</h2>
<p>The most-researched (and targeted) image and performance enhancing drugs are steroids. But other examples include <a href="https://theconversation.com/health-warning-about-body-sculpting-drug-clenbuterol-23815">clenbuterol</a> (to lose weight) and <a href="http://www.news.com.au/lifestyle/health/health-problems/melanotan-ii-sold-illegally-online-to-people-desperate-for-a-tan/news-story/878a895097e72cfe6b723e5d9f4234ed">melanotan II</a> (a tanning agent).</p>
<p>The inappropriate and excessive use of these drugs has been associated with a range of negative <a href="http://www.sciencedirect.com/science/article/pii/S0376871608001919">physical</a> and <a href="https://www.ncbi.nlm.nih.gov/pubmed/19769977">psychological</a> health consequences. Steroid use, for example, has been linked to high blood pressure, heart attack, stroke, acne and skin infections, liver damage, tendon rupture, premature baldness and stunted bone growth in adolescents. There are also psychological implications such as addiction, mood syndromes, and body image disorders. </p>
<p>Another issue is that the widespread use of <a href="https://www.ncbi.nlm.nih.gov/pubmed/20355210">illicitly manufactured products</a> sourced through the black market puts drug users at risk of adverse reactions to tainted products.</p>
<p>In addition, as many of these substances are injected, there are potential harms from unsafe injecting practices. For example, <a href="http://www.tandfonline.com/doi/abs/10.1080/09595230802392568">research</a> has found that 41% of Australian men who injected steroids reported an injection-related health problem such as such as fevers, scarring and abscesses. </p>
<h2>Beefing up steroid laws</h2>
<p>In Australia, increases in the detection of these drugs at the border, coupled with <a href="https://theconversation.com/why-organised-crime-should-not-be-used-to-shape-anti-doping-policy-42385">contested concerns</a> about <a href="http://www.tandfonline.com/doi/abs/10.1080/09595230802392568">links to organised crime</a>, has led to greater levels of law enforcement. </p>
<p><a href="https://www.legislation.qld.gov.au/Bills/54PDF/2014/SafeNightOutLAB14E.pdf">Queensland</a>, Australia’s steroid capital, reclassified steroids a <a href="https://www.tga.gov.au/scheduling-basics">schedule-one drug</a> in 2014. This means they are now classed alongside heroin, cocaine and ice in the highest category of dangerous illicit drugs. </p>
<p>Under this legislation, the maximum penalty for possession or supply of steroids is 25 years’ imprisonment. Similar tough penalties apply in <a href="http://www.criminallawyers.net.au/reclassification-of-steroids-as-narcotics/">New South Wales</a> and <a href="https://www.sentencingcouncil.vic.gov.au/sites/default/files/publication-documents/Major%20Drug%20Offences%20Current%20Sentencing%20Practices.pdf">Victoria</a>. </p>
<p>However, there is little evidence that tougher penalties have resulted in reductions in steroid availability. The total number of seizures at the border fell in 2013-14. But <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813.">there is evidence</a> of increases in recent years. </p>
<p>The <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/06/oca2015.pdf">Australian Crime Commission</a> suggested in 2015 that any decrease in border interceptions could be the result of an increase in domestic production, coupled with increasingly easy access to drugs over the internet. </p>
<p>Despite having the toughest legislation, Queensland accounts for the greatest proportion of <a href="https://www.acic.gov.au/sites/g/files/net1491/f/2016/08/acic-iddr-2014-15.pdf?v=1470178813">national steroid arrests</a> (58% in 2014-15). But the greatest proportion of those arrested are steroid consumers – not suppliers. This suggests the current criminal justice approach may have limited capacity to limit distribution. </p>
<p>That growth in steroid use is most apparent in jurisdictions where recent legal changes have increased penalties suggests enhancing law enforcement measures may be an ineffective response to steroid use. <a href="https://theconversation.com/australias-recreational-drug-policies-arent-working-so-what-are-the-options-for-reform-55493">Other research</a> on the impact of drug policies on other illicit substances have reached similar conclusions. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=324&fit=crop&dpr=1 600w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=324&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=324&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=407&fit=crop&dpr=1 754w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=407&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/168826/original/file-20170510-21620-1c28tgl.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=407&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Number of national steroid arrests, 2005-06 to 2014-15.</span>
<span class="attribution"><span class="source">ACIC</span></span>
</figcaption>
</figure>
<h2>Consequences of a tough law enforcement approach</h2>
<p>As is the case with drug use broadly, users of enhancement drugs can be considered rational consumers who make a deliberate choice to use steroids to achieve a desired outcome.</p>
<p>But social and cultural factors are also very influential in the decision to use drugs. <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=10737421139&libID=10737421138">Research</a> suggests people considering drug use rarely take the illegality of a particular substance into consideration. </p>
<p>Increasing penalties associated with the use and possession of image and performance enhancing drugs are unlikely to prevent uptake or encourage users to stop. Instead, this may result in several unintended negative consequences. For one, it can hinder <a href="https://link.springer.com/article/10.1007%2Fs12117-014-9235-7">access to medical services</a> and information by discouraging both users and healthcare practitioners from talking about drug use.</p>
<p>Tougher penalties can also distract from key harm-minimisation measures, such as safe injecting practices. </p>
<p>Other unintended negative consequences of criminal justice responses to such drug use include:</p>
<ul>
<li><p><a href="http://www.springer.com/gb/book/9781461482406">a growing black market</a>;</p></li>
<li><p><a href="http://www.sciencedirect.com/science/article/pii/S2211266915300086">geographical displacement</a> of users and suppliers; and </p></li>
<li><p><a href="https://www.ncbi.nlm.nih.gov/pubmed/20355187">increased risk of bad-quality drugs</a>. </p></li>
</ul>
<h2>What about harm-reduction strategies?</h2>
<p>Victoria’s existing harm-reduction initiative, the <a href="http://www.publish.csiro.au/py/pdf/PY02022">Steroid Education Project</a>, lags far behind services for alcohol and other illicit drugs in its funding and resources. It provides face-to-face and over-the-phone counselling to steroid users, and delivers training to needle and syringe program staff. </p>
<p>Greater resourcing is required to extend this program to allow for training in needle and syringe programs across Australia, and to deliver training to GPs. Given the reluctance of users to engage <a href="https://harmreductionjournal.biomedcentral.com/articles/10.1186/1477-7517-11-19">with traditional drug services</a>, GPs may be an <a href="https://www.youtube.com/watch?v=IQiZ4gGflKo">important avenue</a> for providing harm-minimisation messages to this group.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/IQiZ4gGflKo?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
</figure>
<p>There is an urgent need to reconsider steroid use as a public health issue, as opposed to a criminal justice concern. Harsher penalties will do nothing to tackle misinformation about steroids or underlying issues of body image dissatisfaction, depression and mental health concerns among users.</p><img src="https://counter.theconversation.com/content/77343/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There is an urgent need to reconsider steroid use as a public health issue as opposed to a criminal justice concern.Katinka van de Ven, Research Fellow, National Drug and Alcohol Research Centre, UNSW SydneyRenee Zahnow, Postdoctoral Research Fellow, Faculty of Humanities and Social Sciences, The University of QueenslandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/733732017-02-22T19:19:21Z2017-02-22T19:19:21ZWhy there’s no legal barrier to a Melbourne drug injecting room, despite political setbacks<figure><img src="https://images.theconversation.com/files/157802/original/image-20170222-20326-17q0zh3.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Medically supervised injecting facilities can prevent overdoses turning into a medical emergency. So why has progress in Victoria stalled?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/download/confirm/532689901?src=xX5-YaxaqXGzz0cOgctlpw-1-24&size=medium_jpg">from www.shutterstock.com</a></span></figcaption></figure><p>Drug injecting rooms have made news this week following a
coroner’s <a href="http://www.coronerscourt.vic.gov.au/resources/d48c9cdc-8db0-45b5-83c2-5ea6918e3ccd/ms+a_+241816.pdf">recommendation</a> to set up a trial of a supervised injecting facility in the Melbourne suburb of North Richmond.</p>
<p>Despite opposition from <a href="http://www.theage.com.au/victoria/premier-daniel-andrews-rejects-coroners-call-for-a-safe-injecting-room-20170221-guhuif.html">Victorian Premier Daniel Andrews</a> and <a href="https://www.theguardian.com/australia-news/2017/feb/21/victorias-health-minister-rejects-trial-of-safe-heroin-injecting-room">Health Minister Martin Foley</a>, there are no legal reasons to prevent one from being set up.</p>
<p>And despite media reports, such a facility would not “legalise drugs”. Rather, there are legal options to set up what the coroner described as an “essential intervention” that would likely save lives and prevent further overdoses.</p>
<h2>How can a drug injecting room be legal?</h2>
<p>Australia already has a legal supervised injecting facility, the <a href="https://uniting.org/our-services/for-adults/sydney-medically-supervised-injecting-centre">Medically Supervised Injecting Centre</a>, in Sydney’s King’s Cross. This is one of about <a href="https://theconversation.com/why-australia-needs-drug-consumption-rooms-53215">90 such facilities around the world</a>, mostly in Europe.</p>
<p>A <a href="http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/45DA3F157657671FCA2580C0007268EF/$FILE/581PM25exi1.pdf">private member’s bill</a> before the parliament proposes an 18-month trial of a supervised injecting facility. This would need similar law reform in Victoria to the types of reforms that occurred in New South Wales before the Sydney facility opened. If passed, the law would provide a licence for the Melbourne facility to operate under a series of strict conditions. </p>
<p>People who use the facility would need to be exempt from prosecution for being in possession of small amounts of drugs for personal use, and exempt from being prosecuted for using those drugs.</p>
<p>This exemption would apply to a designated area – immediately around the facility – to allow people using the service to get in and out of it without arrest. There would be nothing unusual about such an approach; most facilities around the world operate with similar exemptions.</p>
<h2>Part of wider harm reduction</h2>
<p>Many people who oppose supervised drug injecting facilities do so out of fear they undermine Australia’s criminal justice system.</p>
<p>One commentator <a href="http://www.heraldsun.com.au/news/opinion/tom-elliott/tom-elliott-injecting-rooms-are-at-odds-with-our-laws/news-story/3e6604c86d21db89f8463256d8176a04">argued</a> the proposal was an “appalling idea” that encouraged breaches of the law and sent mixed messages about the legality of drugs:</p>
<blockquote>
<p>While harmful drugs remain illegal, there’s no sound way society can tolerate a government-subsidised facility in which people are permitted to ingest them. Facilities like the one suggested for North Richmond, would force Victoria Police to ignore some of the important laws they’ve taken a serious oath to uphold.</p>
</blockquote>
<p>There is a flaw in this argument. Australia’s <a href="http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/nds2015">National Drug Strategy</a> involves measures aimed at reducing the demand for, and supply of, drugs. The strategy also recognises it is not possible to eradicate all drug use, and so it encourages harm reduction.</p>
<p>A supervised injecting facility would be yet another harm reduction measure.</p>
<p>Australia already has a suite of measures aimed at reducing harms from drug use. This includes a national <a href="http://www.health.gov.au/internet/main/publishing.nsf/Content/775BC0C9246B864ACA257BF000195991/$File/frame.pdf">network of needle and syringe programs</a> for people who use drugs to access clean needles, the <a href="http://www.anex.org.au/reducing-harm/needle-and-syringe-programs-nsps/">benefits of which</a> have been widely reported.</p>
<p>Australia was a <a href="https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=8&ved=0ahUKEwjF3N2S4qLSAhWFoJQKHeykASwQFghGMAc&url=https%3A%2F%2Fwww.turningpoint.org.au%2FMedia-Centre%2Fcentrepubs%2FGetFile.axd%3Foid%3D743daa22-e465-4cb3-b6b2-1b5c98380247&usg=AFQjCNHp34g-HGmut10JpFLXp3n1Z58jlQ&cad=rja">pioneer of harm reduction measures</a> like these. Such measures are now rightly acknowledged as a vital part of our national drug strategy. A supervised drug injection facility that offers support and access to other health services for people who use drugs is not all that different.</p>
<h2>At odds with the evidence</h2>
<p>Political opposition to a supervised drug injecting facility in Victoria is at odds with evidence finding they bring <a href="https://theconversation.com/why-australia-needs-drug-consumption-rooms-53215">health, social</a> and <a href="http://www.health.nsw.gov.au/mentalhealth/Documents/msic-fr.pdf">economic benefits</a> to the community. </p>
<p>For example, such facilities are often a gateway for connecting marginalised and disadvantaged people to vital health care and other support services. This includes, for those who want it, alcohol and drug treatment services.</p>
<p>Most importantly, supervised drug injection facilities around the world have <a href="http://dpmp.unsw.edu.au/sites/default/files/dpmp/resources/DPMP%20Bulletin%2022_0.pdf">prevented many fatal drug overdoses</a>. And Sydney’s Medically Supervised Injecting Centre has overseen nearly one million injections and managed over 6,000 overdoses <a href="https://uniting.org/__data/assets/pdf_file/0005/139370/Uniting-MSIC-Brochure-.pdf">without a single death</a>. </p>
<p>Calls for a such a facility in Melbourne have also received <a href="https://media.wix.com/ugd/6fc9bb_71256c598c034005b319e8db26b0ecd5.pdf">high-profile support</a> from doctors’ groups and former <a href="http://www.theage.com.au/victoria/kennett-renews-calls-for-safeinjecting-room-every-human-being-is-entitled-to-life-20151229-glw7jn.html">Victorian Premier Jeff Kennett</a>, as well as from <a href="http://www.heraldsun.com.au/leader/north/richmond-traders-change-tune-on-support-for-safe-injecting-room-to-combat-drug-use-on-victoria-st/news-story/b1dc86d6c5cee59ff04dc436e57d88df">local traders</a> and <a href="https://www.facebook.com/VictoriaStreetDrugSolutions/">residents</a>. </p>
<h2>We need to act now</h2>
<p>Law reform is simple, necessary and urgent if we are to prevent further overdoses. So, while there are <a href="http://creidu.edu.au/system/resource/9/file/Report-Nth_Richmond_Public_Injecting_Impact.pdf">drug overdoses</a>, the issue will remain on the political agenda.</p>
<p>As well as the <a href="http://www.legislation.vic.gov.au/domino/Web_Notes/LDMS/PubPDocs.nsf/ee665e366dcb6cb0ca256da400837f6b/45DA3F157657671FCA2580C0007268EF/$FILE/581PM25exi1.pdf">private member’s bill</a>, drug law reform is the subject of a Victorian parliamentary <a href="http://www.parliament.vic.gov.au/lrrcsc/inquiries/article/2809">inquiry</a>, due to report in March 2018.</p>
<p>The Victorian government needs to reconsider its position and implement the coroner’s recommendation without delay.</p><img src="https://counter.theconversation.com/content/73373/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kate Seear receives funding from the Australian Research Council through a Discovery Early Career Researcher Award (DECRA) Fellowship (DE160100134). Her research examines comparisons of addiction concepts in law across Australia and Canada. This article is based on research undertaken for that project, which has included an analysis of the establishment of Canada's first supervised injecting facility, Insite, in Vancouver. She also receives funding from the Queensland Mental Health Commission to study the relationships between stigma and discrimination through alcohol and other drug law and policy. </span></em></p>There’s no legal reason why Victoria can’t have its own medically supervised drug injecting room to prevent more overdoses, despite political setbacks.Kate Seear, Academic Director of Springvale Monash Legal Service & Senior Lecturer in Law, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/699842016-12-08T03:35:51Z2016-12-08T03:35:51ZOur drugs policies have failed. It’s time to reinvent them based on what actually works<figure><img src="https://images.theconversation.com/files/148810/original/image-20161206-25738-1580yhy.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">How should we deal with this?</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>There is only one way to make better decisions about illicit drugs and so save lives and money: we need to change the way drugs policies are made.</p>
<p>The alternative is to remain stuck in the same futile cycle. Every time a young person dies tragically and needlessly at a music festival or dance party, our commentators clamour for our politicians to respond immediately. </p>
<p>We make drugs policies on the run. But policy quick-fixes are mostly ineffective and we find ourselves no better prepared to avert future tragedies or drug-related harm.</p>
<p>We can do much better. We have decades of research that tells us what works and why, and we are continuously building that evidence base. Smarter drugs policy-making would use that evidence, in conjunction with other policy drivers such as public opinion and personal experience.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Ci60hOKTtpE?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">The author speaking at the UNSW UNSOMNIA event.</span></figcaption>
</figure>
<p>Eight million Australians, or 42% of the population, use an illicit drug in their <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs-2013/">lifetime</a>. Most don’t run into trouble. But, we also know that only <a href="https://ndarc.med.unsw.edu.au/resource/new-horizons-review-alcohol-and-other-drug-treatment-services-australia">half the number</a> of Australians who need and want treatment get it, and that global deaths from illicit drug use have risen by <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31012-1/abstract">32% in the past 10 years</a>. Worldwide, some 46.4 million people suffer a drug use disorder in <a href="https://www.unodc.org/wdr2016/">any one year</a>.</p>
<p>Our governments spend a great deal of money responding to illicit drugs use. That includes prevention programs, healthcare, treatment programs and harm-reduction services; the humane face of drugs policies.</p>
<p>But in Australia, as in other Western nations like the United States, Britain, Germany and Sweden, the lion’s share of funding – more than 60% – is spent on <a href="https://ndarc.med.unsw.edu.au/resource/24-government-drug-policy-expenditure-australia-200910">law enforcement</a>. While law enforcement appropriately focuses on disrupting supply chains, protecting borders and controlling access to precursor chemicals, much effort is also spent on arresting people who use drugs.</p>
<p>There are alarming examples globally of concentrated efforts against people who use drugs. In the <a href="http://edition.cnn.com/specials/asia/philippines-drugs-war">Philippines</a>, an appalling government program of extrajudicial killings spearheads a new “tough on drugs” approach, and in parts of Southeast Asia people who use drugs are confined to forced labour camps.</p>
<p>The outcome is neither safer communities nor a reduction in drug-related deaths or harm.</p>
<p>Yet, there are several policies with an established strong evidence base that could be implemented. First, get treatment to those who want and need it; some <a href="https://ndarc.med.unsw.edu.au/resource/new-horizons-review-alcohol-and-other-drug-treatment-services-australia">200,000 Australians</a> are currently falling through the cracks. </p>
<p>We can also improve treatment options. For example, randomised controlled trials have shown that <a href="https://theconversation.com/weekly-dose-treating-heroin-dependence-with-heroin-58424">heroin-assisted treatment</a> works for the small number of people who don’t respond to other current programs. </p>
<p>We also know that needle and syringe programs reduce the risk of HIV and other blood-borne viruses, and 90 countries have put them in place. Yet only <a href="https://www.hri.global/global-state-of-harm-reduction-reports">eight countries</a> have them in prisons. Australia isn’t one of them.</p>
<p>We should also decriminalise the personal use of drugs. In Australia, there are about <a href="https://www.acic.gov.au/publications/intelligence-products/illicit-drug-data-report">100,000 arrests</a> every year for drug use – not for drug supply, but for drug use. This represents an enormous cost, both economically and socially. International evidence shows that the decriminalisation of personal drug use <a href="http://bjc.oxfordjournals.org/content/50/6/999">reduces the cost</a> to society and to individuals, and does not significantly increase drug use.</p>
<p>We can also stop doing things that simply don’t work, no matter how sensible they might seem. For example, it’s now a decade since the NSW Ombudsman reported that sniffer dogs had “<a href="https://www.ombo.nsw.gov.au/__data/assets/pdf_file/0020/4457/Review-of-the-Police-Powers-Drug-Detection-Dogs-Part-1_October-2006.pdf">proven to be an ineffective tool</a>”. The original intention was to focus (appropriately) on drug supply, but sniffer dogs are now extensively used in entertainment precincts and at music festivals to detect drug use.</p>
<p>These examples make clear that current drug policy is rarely driven by evidence. Instead, it is driven by perceptions of what the public wants, fuelled by shock jocks and other outspoken media voices. All too often, this reflects responses to single events and tragedies, not patterns and outcomes established over years or decades of methodical research.</p>
<p>Drug policy researchers must get on the front foot and engage the media, the public, business leaders, policy makers and Australians who use drugs. We need a genuine contest of ideas, informed by evidence, to provide an alternative to knee-jerk policy on the run.</p>
<p>Consider the fierce debate over Sydney’s controversial <a href="https://theconversation.com/au/topics/lock-out-laws-25651">lockout laws</a>, which restrict the late-night availability of alcohol in the inner city. This too was policy on the run, made by the NSW government in response to several tragic “one punch” deaths. </p>
<p>However, a great deal of debate has happened since to illuminate many aspects of the issue, including the perceptions of the LGBTI community, local residents and the people affected by the policies.</p>
<p>These multiple types of knowledge and evidence need to be integrated and debated. Imagine if this kind of informed debate, bringing in all kinds of stakeholders, could inform policy making, including drugs policies, before – and not after – decisions are made.</p>
<p>Drugs policies are again in the news following the Greens’ announcement of a <a href="http://greens.org.au/new-approach">new platform</a>. The party’s call to legalise the use of some illicit drugs has provoked <a href="http://www.dailytelegraph.com.au/news/nsw/decriminalise-drugs-health-experts-slam-greens-drug-plans/news-story/1291e29963363783f471fddb38e51d75">predictable cries of opposition and alarm</a>. </p>
<p>What is much more interesting is a proposed new independent “national regulatory authority” to develop “continuously evaluated, evidence-based policies and programs”. </p>
<p>This suggests what is needed: politically neutral policy decisions based on the best evidence, integrated with other types of knowledge, and engaging all voices, including people who use drugs.</p>
<p>Few areas of policy-making are more emotionally charged than drugs policy. Yet if we resist knee-jerk calls to arms and engage in informed policy-setting that involves many stakeholders and types of knowledge, we can save many more lives, reduce needless suffering, and alleviate the financial burden of ineffective drugs policies.</p>
<hr>
<p><em>Professor Alison Ritter is Director of the Drug Policy Modelling Program at the UNSW-based National Drug and Alcohol Research Centre. She spoke at “UNSOMNIA: What keeps you up at night?” on December 1, the launch event for UNSW’s Grand Challenges program.</em></p><img src="https://counter.theconversation.com/content/69984/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alison Ritter receives funding from the NHMRC and the ARC and has conducted funded research on behalf of government. </span></em></p>Most of our drugs policies have failed to curb use or reduce their impact on individuals or society. It’s time for a more enlightened and informed approach.Alison Ritter, Professor & Specialist in Drug Policy, UNSW SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/596662016-05-20T02:16:39Z2016-05-20T02:16:39ZPolicyCheck: the Greens’ Harm Reduction Innovation Fund drug policy<p><em>Welcome to PolicyCheck, a new form of political coverage that aims to make better sense of policies launched by the major parties in the lead up to the 2016 election. Here, The Conversation’s academic experts look at the history of policies, whether they have been tried in Australia before, and how likely they are to succeed.</em></p>
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<p>The Greens’ leader Richard Di Natale used the International Society for the Study of Drug Policy <a href="http://www.issdp2016.com/">conference</a> in Sydney to announce a $10 million <a href="http://greens.org.au/harm-reduction">Harm Reduction Innovation Fund</a>. </p>
<p>While there are few details of how the fund will operate, it is designed to invest in new approaches to reducing harms and deaths associated with alcohol and other drug use.</p>
<h2>What is harm reduction?</h2>
<p><a href="http://www.harmreductionaustralia.org.au/what-is-harm-reduction/">Harm reduction</a> aims to reduce the negative consequences of alcohol, tobacco and other drug use for the user and the community by encouraging safer behaviours and creating environments that make use less risky. Examples include <a href="theconversation.com/what-is-drug-checking-and-why-do-we-need-it-in-australia-51578">drug checking</a> and <a href="theconversation.com/why-australia-needs-drug-consumption-rooms-53215">safe consumption facilities</a>.</p>
<p>Harm reduction accepts, without judging, that drug use is part of society and works to reduce the harms associated with drug use rather than focusing on trying to eliminate it.</p>
<p>Harm reduction is one of the three “pillars” of Australia’s current <a href="http://www.nationaldrugstrategy.gov.au">National Drug Strategy</a>, which guides Australia’s policy response to alcohol and other drugs.</p>
<p>The other two pillars are demand reduction (designed to prevent the uptake, and reduce the use, of alcohol, tobacco and other drugs in the community) and supply reduction (intended to disrupt the manufacture and supply of illicit drugs and regulate the supply of legal drugs such as alcohol and tobacco).</p>
<p>Together, the three pillars form our harm minimisation policy. This has been the long-standing approach to alcohol, tobacco and other drugs in Australia dating back to 1985.</p>
<p>However, the National Drug Strategy does not guide the allocation of funding to the three “pillars”. <a href="theconversation.com/spending-down-on-harm-reduction-for-illicit-drugs-report-15346">In practice</a>, supply reduction receives about two thirds of the funding available for drug responses, demand reduction receives around <a href="http://ndarc.med.unsw.edu.au/news/law-enforcement-takes-lion%E2%80%99s-share-illicit-drug-spend">30%</a> and harm reduction receives just <a href="http://ndarc.med.unsw.edu.au/news/law-enforcement-takes-lion%E2%80%99s-share-illicit-drug-spend">2%</a>.</p>
<h2>The Harm Reduction Innovation Fund</h2>
<p>The proposed fund is a separate investment specifically for harm reduction initiatives, including research and evaluation. Some of the initial ideas put forward by Di Natale (<a href="http://www.theguardian.com/commentisfree/2016/mar/02/richard-di-natale-we-need-to-reclaim-our-courage-and-vision-on-drugs-policy">a former drug and alcohol clinician</a>) include drug checking and safe consumption facilities.</p>
<h3>Drug checking</h3>
<p><a href="http://www.unharm.org/drug_checking">Drug checking</a>, sometimes called pill testing, tests the pharmacological contents of a person’s drugs to allow them to make more informed choices.</p>
<p>Despite the controversy in Australia around drug checking, is not a new idea. Many countries around the world including France, Germany, Spain, the Netherlands, Switzerland, Austria, Belgium, routinely have drug checking facilities available at festivals. In those countries <a href="https://theconversation.com/six-reasons-australia-should-pilot-pill-testing-party-drugs-34073">it has been shown</a> to change the black market, improve the content of illicit drugs and affect people’s choice about whether to use drugs.</p>
<p>There is a lot of support among young people for this policy. Many drug treatment and law enforcement professionals have spoken out <a href="http://www.news.com.au/lifestyle/health/health-problems/why-deaths-wont-stop-the-party-drug-test-kits-gain-popularity-as-festival-overdoses-soar/news-story/a25d6eaf98c2781c327de51bf55aa534">in favour</a> of drug checking as one way to prevent deaths at festivals and dance parties.</p>
<h3>Safe consumption facilities</h3>
<p>Safe consumption rooms allow people to use drugs under the supervision of medical staff. They provide space and some equipment like clean needles but do not provide drugs. Australia only has one safe injecting facility, located in Kings Cross, which has been in operation since 2001.</p>
<p>Evaluation of these facilities in <a href="http://www.health.nsw.gov.au/mhdao/Documents/msic-fr.pdf">Australia</a> and internationally has shown <a href="theconversation.com/safe-injection-facilities-more-than-just-a-place-to-shoot-drugs-36386">significant benefits</a> in reducing overdose deaths and increasing access to treatment.</p>
<p>Again, it is not a radical idea. The <a href="theconversation.com/why-australia-needs-drug-consumption-rooms-53215">first supervised injecting facility</a> opened in Switzerland in 1986 and there are at least 88 established centres across the world.</p>
<p>These facilities have growing <a href="http://www.heraldsun.com.au/leader/north/richmond-traders-change-tune-on-support-for-safe-injecting-room-to-combat-drug-use-on-victoria-st/news-story/b1dc86d6c5cee59ff04dc436e57d88df">support in the community,</a> despite initial reservations from the general public when the first one was opened in Australia 15 years ago.</p>
<h2>What’s the provenance of this policy?</h2>
<p>Historically, Australia has been a world innovator and leader in harm reduction. We were among the first in the world to establish <a href="http://www.avert.org/professionals/hiv-programming/prevention/needle-syringe-programmes">needle and syringe programs</a> in the mid 1980s, a safe injecting facility, random breath testing, and opioid pharmacotherapies like methadone. As a result of the rapid expansion of needle and syringe programs in the 1980s, we have one of the <a href="en.wikipedia.org/wiki/List_of_countries_by_HIV/AIDS_adult_prevalence_rate">lowest rates</a> of HIV in the world.</p>
<p>But we are now lagging behind other countries, with limited investment in harm reduction activities. A specific allocation of funds to develop innovative harm reduction strategies is a welcome proposal.</p>
<p>The proposed strategies from the Greens, however, are not new. There is ample international evidence that they are effective in reducing harms. Some might argue that they are well established and well evaluated enough across the world to implement now.</p>
<h2>Is it good policy?</h2>
<p>The fund is relatively small. The Sydney Medically Supervised Injecting Centre <a href="theconversation.com/why-australia-needs-drug-consumption-rooms-53215">costs</a> around $3 million a year to run, so the fund is unlikely to be able to fully fund many additional centres.</p>
<p>But a targeted fund like this could provide support for research into new strategies to prevent harms and death among people who use alcohol and other drugs, the largest group of which is young people.</p>
<p>We know that most people who <a href="http://www.aihw.gov.au/alcohol-and-other-drugs/ndshs/">use illicit drugs</a> do so infrequently, for a relatively short period of time and then quit. Keeping them safe and alive until they stop should be a high policy priority. </p>
<p>We also know that some of the greatest harms are from the legal drugs, alcohol, tobacco and pharmaceuticals. Policymakers also need to come up with innovative ways to reduce harms for these drugs as well.</p>
<p><em>Is there a policy you want us to check? Contact us at <a href="mailto:checkit@theconversation.edu.au">checkit@theconversation.edu.au</a>.</em></p><img src="https://counter.theconversation.com/content/59666/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nicole Lee works as a consultant to health services to support best practice treatment and policy. She has previously been awarded grants by the Australian Government, NHMRC and other public funding bodies for drug research.</span></em></p>PolicyCheck unpacks the details and history of the Greens’ proposed $10 million Harm Reduction Innovation Fund drug policy.Nicole Lee, Associate Professor at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/406312015-05-13T06:45:15Z2015-05-13T06:45:15ZAwareness campaigns need to target the real victims of ice<figure><img src="https://images.theconversation.com/files/81491/original/image-20150513-25052-m9o97p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Instead, we need to adopt a harm-minimisation approach. </span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-193975568/stock-photo-man-slumped-on-sofa-with-drug-paraphernalia-in-foreground.html?src=2rYBphv_c167L_RK3of-3g-1-4">Monkey Business Images/Shutterstock</a></span></figcaption></figure><p>This week the <a href="http://www.health.gov.au/internet/ministers/publishing.nsf/Content/health-mediarel-yr2015-nash015.htm">federal government launched</a> a television advertising campaign to warn young people and their families about the harms of using crystal methamphetamine, also known as “ice.” The first ad in the A$9 million campaign, depicting ice-fuelled violence in the home and a hospital emergency department, will run for four weeks on television and six weeks online. </p>
<p>The government also set aside <a href="http://www.budget.gov.au/2015-16/content/bp2/html/bp2_expense-14.htm">A$20 million in Tuesday’s budget</a> for ice awareness campaigns over the next two years. This comes as the Commonwealth government prepares its interim <a href="http://www.dpmc.gov.au/taskforces/national-ice-taskforce">National Ice Taskforce</a> report, which aims to develop a collaborative federal-state response to the drug.</p>
<p>But international evidence suggests such “awareness” campaigns are not the most appropriate way to address harmful methamphetamine use. In fact, fear-based approaches can increase stigma which possibly drives people away from, rather than towards, treatment.</p>
<h2>No methamphetamine epidemic</h2>
<p>Australian media outlets and politicians claim we’re facing a nationwide “ice <a href="http://www.abc.net.au/news/2015-05-05/governor-youthie/6446546">epidemic</a>”. But ice is just one – albeit typically very pure – form of methamphetamine and the most up-to-date <a href="http://www.ncbi.nlm.nih.gov/pubmed/25559677">research</a> estimates that the proportion of Australians who have used any type of methamphetamine (ice, “speed” powder) in the previous year has remained relatively stable for at least the last <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">decade</a>.</p>
<p>Nevertheless, the government and media’s continued use of hyperbolic language – in addition to a tendency to ignore and sometimes <a href="http://www.dailytelegraph.com.au/news/nsw/ice-scourge-needs-a-strong-response/story-fni0cx12-1227296149027">dismiss</a> public health experts’ advice on ice – has the potential to incite unnecessary fear and misinform the public about this supposed “<a href="http://www.governmentnews.com.au/2015/04/abbott-goes-cold-on-ice-menace/%22">menace</a>”. </p>
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<figcaption><span class="caption">The government’s TV ad campaign started this week.</span></figcaption>
</figure>
<p>Victorian premier Daniel Andrews, for instance, <a href="http://www.abc.net.au/news/2015-03-05/victoria-unveils-455m-plan-to-tackle-ice-problem/6282258">recently claimed</a> 80,000 Victorians had used the “evil” drug ice in the previous year. ABC Fact Check subsequently <a href="http://www.abc.net.au/news/2015-04-07/ice-users-in-victoria/6346708">investigated</a> the accuracy of this figure and, based on the most recent National Drug Strategy Household <a href="http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=60129549848">Survey</a> (NDSHS) and expert advice, concluded that the statement was not supported by data. </p>
<h2>Use and harm</h2>
<p>According to the NDSHS, in 2013 around 2% of the Australian population used any methamphetamine (speed powder, ice or “base”) in the previous 12 months. Only about 16% of these “recent” methamphetamine users reported using the drug once a week or more. </p>
<p>Regardless, using methamphetamine – particularly frequent and heavy use – <a href="http://www.ncbi.nlm.nih.gov/pubmed/18368606">is associated with</a> serious psychological, physical, social and financial harms.</p>
<p>The risk of experiencing such effects is likely to have increased due to the dramatic <a href="http://www.ncbi.nlm.nih.gov/pubmed/25220170">rise in purity</a> of methamphetamine in recent years. The average purity of speed powder and crystal methamphetamine seizures in Victoria increased from 12% to 37% and 21% to 64% respectively in the four years up to 2013. </p>
<p>It’s therefore crucial we that don’t undermine the experiences of individuals, families and communities impacted by the harmful use of the drug. </p>
<p>Rather, we need to accurately define the issue, including the nature and extent of methamphetamine use and related harms in rural and regional areas, to allow the development and implementation of cost-effective, evidence-based and timely responses. </p>
<h2>Awareness campaigns</h2>
<p>Numerous studies have indicated “what works” with regard to public awareness, education and prevention strategies which aim to reduce harms related to licit substances, such as <a href="http://www.tobaccoinaustralia.org.au/14-4-examining-effectiveness-of-public-education-c#x21.">tobacco use</a> and <a href="http://www.aic.gov.au/media_library/publications/tandi_pdf/tandi472.pdf">drink driving</a>. But there is little evidence that similar initiatives targeting illegal drugs are effective. </p>
<p>The limited available research suggests that the well-known, graphic <a href="http://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CB4QFjAA&url=http%3A%2F%2Fwww.montanameth.org%2F&ei=H79JVfmZPOSgmwXBs4CIBA&usg=AFQjCNGsCkgtUZNS9CQJN-mXvwVZocT6zw&bvm=bv.92291466,d.dGY">Montana Meth Project</a> and <a href="http://www.facesofmeth.us/">Faces of Meth</a> advertising campaigns in the United States are costly, ineffective and possibly even counterproductive. </p>
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<figcaption><span class="caption">Faces of Meth campaign.</span></figcaption>
</figure>
<p>The findings of one study suggest that the Montana Meth Project might actually increase acceptability and decrease perceptions of risk relating to using methamphetamine.</p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/20638737%20study">Another</a> noted that:</p>
<blockquote>
<p>“When accounting for a pre-existing downward trend in meth use… [the campaign’s] effects on meth use are statistically indistinguishable from zero.”</p>
</blockquote>
<p>Concerns about the efficacy of such initiatives are reflected in the HIV <a href="http://wsuengdoctors.pbworks.com/w/file/fetch/60398594/Fear%20apeals.pdf">literature</a>, which suggests that fear-based approaches can lead to stigma and poor health outcomes, such as from reduced treatment-seeking.</p>
<h2>Reducing the harms from meth use</h2>
<p>Many of the evidence-based suggestions put forward by leading experts are not – at least currently – politically palatable and are therefore unlikely to be implemented anytime soon. </p>
<p>Extensive international <a href="http://www.druginfo.adf.org.au/topics/supervised-injecting-facilities">research</a>, for example, shows safe-injecting facilities such as the one in Sydney’s Kings Cross can have enormous public health benefits. These include preventing blood-borne virus transmission, freeing-up health-care resources and improving drug treatment pathways. However, we are yet to see a comparable service implemented in any of Australia’s other drug use “hot spots.” </p>
<p>It is also unlikely that Australia will soon follow the lead of nations and jurisdictions that have decriminalised, legalised or “controlled” previously illicit substances. These include Portugal and the United States, with Ecuador’s government <a href="http://panampost.com/rebeca-morla/2015/04/14/ecuador-breaks-the-ice-on-drug-legalization-in-landmark-bill/">currently</a> debating the issue.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/81496/original/image-20150513-20475-qit2e4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">The average purity of speed powder and crystal methamphetamine seizures in Victoria increased in recent years.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-97440071/stock-photo-female-hand-retrieving-drug-packet-our-of-her-blue-jean-pocket-with-copy-space-on-black.html?src=pp-photo-755829-NeJk99chI1rL5pBu_mip7A-7&ws=1">Sylvie Bouchard/Shutterstock</a></span>
</figcaption>
</figure>
<p>As many have said before, drug policies in Australia need to ubiquitously incorporate the proven approach of harm-minimisation. </p>
<p>Although our <a href="http://www.nationaldrugstrategy.gov.au/internet/drugstrategy/publishing.nsf/Content/national-drug-strategic-framework-lp">National Drug Strategic Framework</a> is underpinned by this principle, failure to adopt evidence-based techniques that reduce drug-related harms, such as more safe-injecting facilities and <a href="https://ndarc.med.unsw.edu.au/resource/prison-based-syringe-exchange-review-international-research-and-program-development">prison-based needle exchanges</a>, indicates a discrepancy between policy and practice. </p>
<p>Because people will choose to engage in drug use (both licit and illicit) regardless of the policies and programs in place, we need to encourage them to do so as safely as possible. We also must continue to inform the public about options for managing drug-related consequences and appropriate and available means for professional support, such as telephone and internet counselling <a href="http://www.health.vic.gov.au/aod/directline.htm">DirectLine</a> and <a href="https://www.counsellingonline.org.au/">Counselling Online</a>. </p>
<p>Addressing barriers to drug treatment and ensuring that such services are adequately resourced is vital to meeting the needs of methamphetamine and other drug users at the “pointy end” of the spectrum. </p>
<p>But providing targeted and relevant harm reduction education and ensuring that support is available to individuals who aren’t yet ready – or who <a href="http://www.ncbi.nlm.nih.gov/pubmed/23867050">don’t see a need</a> – to use drug treatment is just as important for preventing the transition to more harmful use patterns.</p><img src="https://counter.theconversation.com/content/40631/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Brendan Quinn has worked on research projects funded by the National Health and Medical Research Council to study methamphetamine use and related issues.</span></em></p><p class="fine-print"><em><span>Paul Dietze has received funding from the National Health and Medical Research Council, the Australian Research Council, the Commonwealth Department of Health and Ageing and the National Drug Law Enforcement Research Fund to study methamphetamine use and harms.</span></em></p>International evidence suggests “awareness” campaigns are not the best way to address harmful methamphetamine use. Fear-based approaches can increase stigma and drive people from treatment.Brendan Quinn, Research Officer (drug and alcohol epidemiology), Burnet InstitutePaul Dietze, Head of Alcohol and other Drug Research, Centre for Population Health; Burnet Principal for Alcohol, other drugs and harm reduction, Burnet InstituteLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/161692013-07-19T04:33:24Z2013-07-19T04:33:24ZCory Monteith, addiction and the search for better endings<figure><img src="https://images.theconversation.com/files/27691/original/mvhphhfp-1374128534.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In the aftermath of Glee star Cory Monteith's death, a lot of media attention has focused on his 'troubled life' and 'dark past'.</span> <span class="attribution"><span class="source">EPA/MIKE NELSON</span></span></figcaption></figure><p>Public attitudes towards drugs are shaped by many things, including high-profile celebrity encounters with drugs and addiction. One unfortunate example of this involves popular Canadian actor Cory Monteith, who was found <a href="http://www.theage.com.au/entertainment/tv-and-radio/glee-star-cory-monteith-died-of-heroin-and-alcohol-overdose-coroner-says-20130717-2q2wi.html">dead in a Vancouver hotel</a> last weekend, with a combination of heroin and alcohol in his body. </p>
<p>Monteith played a high-school football jock-cum-choirboy on the popular <a href="http://www.imdb.com/title/tt1327801/">television program Glee</a>. His character embodied, exposed and challenged the narrow subject positions and stereotypes that adolescents often face in high school. </p>
<p>In death, Monteith continues to expose narrow subject positions and stereotypes, this time pertaining to drugs.</p>
<p>When Monteith’s death was announced, it was met by an immediate outpouring of public grief. As fans and media sought an explanation for what had taken place, <a href="http://www.nydailynews.com/entertainment/tv-movies/director-montieth-final-film-actor-started-article-1.1399306">most of the attention</a> focused on Monteith’s “troubled life” and “dark past”.</p>
<h2>Why the trouble?</h2>
<p>Although he had <a href="http://www.parade.com/celebrity/2011/06/cory-monteith-glee.html">previously admitted</a> to substance use and attended rehab, colleagues believed Monteith had stopped taking drugs. Josh C. Waller, who directed a film Monteith completed before his death said, “I never would have suspected anything was wrong.”</p>
<p>This notion – that something must have been wrong for Monteith to have taken drugs – has appeared elsewhere. In Rolling Stone magazine, <a href="http://www.rollingstone.com/movies/news/glee-gone-wild-writer-remembers-cory-monteith-20130715">Erik Hedegaard described him</a> as a “guy with an unhappy past that bedeviled him to the end”.</p>
<p>In The Age, Ben Pobjie’s article <a href="http://www.theage.com.au/entertainment/box-seat/why-cory-monteith-deserved-a-happier-ending-20130715-2pzmf.html">Why Cory Monteith deserved a happier ending</a> lamented:</p>
<blockquote>
<p>Sadly, [his Glee character] Finn and Cory were not the same person … in real life it’s never as easy as on TV – and that as well as we knew Finn, we didn’t ever know Cory. </p>
</blockquote>
<p>Unfortunately, these well-meaning attempts to understand Monteith’s drug use, addiction and death are deeply problematic. Especially the assumption that people who use drugs and develop addictions are fundamentally troubled and dysfunctional.</p>
<p>This simplistic narrative is often compounded when high-profile celebrities such as Monteith, or Heath Ledger and Amy Winehouse before him, die alone. The idea of popular celebrities meeting a lonely demise conjures up notions of tragedy, isolation and despair. </p>
<p>In so doing, it reinforces the idea that drug use leading to overdose must always be accompanied by deep-seated trauma. It’s a neat explanation for these sudden deaths but one that should trouble us.</p>
<p>Although drug use and overdose may sometimes be preceded by psychological pain, it isn’t always so. People who take drugs <a href="http://www.ashgate.com/isbn/9781409408390">form a very diverse population</a>. </p>
<p>Importantly, not all drug users or even addicts <a href="http://www.tandfonline.com/doi/abs/10.1080/09581591003653132#preview">experience themselves</a> as sick, dysfunctional or troubled. Indeed, the “troubled addict” is a narrow stereotype that has parallels with those Monteith’s character both embodied and resisted in Glee.</p>
<h2>Not inevitable</h2>
<p>Of more concern though, is the notion of the “troubled” addict because it lends an air of inevitability to fatal overdoses. We need to challenge this.</p>
<p>Monteith’s death has been characterised by the coroner’s service and others as just a “sad and tragic accident”. To speak in this way is to imply that nothing could have been done to prevent it. </p>
<p>The reality is that overdoses are the product of a <a href="http://uhri.cfenet.ubc.ca/images/Documents/dsiv2013.pdf">complex constellation of factors</a> including laws that prohibit drug use, the lack of treatment options for people who want help for their substance use, and the absence of medically-supervised consumption facilities that play an important role in preventing fatal overdoses. </p>
<p><a href="http://edition.cnn.com/2012/11/15/health/deadly-dose-jackson-rummler">CNN recently reported</a> that an overdose death occurs every 19 minutes in the United States. According to Australian <a href="http://theconversation.com/how-to-reduce-opioid-overdose-deaths-in-australia-10197">harm-reduction expert Alex Wodak</a>, medically-supervised drug consumption facilities are an important way to minimise risks and prevent such deaths, but the idea struggles to gain political support. </p>
<p>It just so happens that Canadians have been <a href="http://www.thestar.com/news/gta/2013/07/10/ontario_rejects_torontos_call_for_supervised_drug_injection_site.html">engaged in vigorous debate</a> about the need for such facilities in recent weeks. </p>
<p>Many in favour of a harm-reduction approach have called for a facility in Toronto. It would be the second one in Canada but proponents continue to face resistance. </p>
<p>Cory Monteith was just 31 years old when he died. There can be no doubt that he “deserved a happier ending” as Pobjie suggests. But perhaps a more important question might be whether his death could have been avoided altogether.</p>
<p>Simplistic accounts do little to help us understand the complexity of drug use and the overdose phenomenon. And they divert attention from practical measures that could reduce the harms associated with drug use. </p><img src="https://counter.theconversation.com/content/16169/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kate Seear works for the National Drug Research Institute, which receives core funding from the Australian Government Department of Health and Ageing. </span></em></p>Public attitudes towards drugs are shaped by many things, including high-profile celebrity encounters with drugs and addiction. One unfortunate example of this involves popular Canadian actor Cory Monteith…Kate Seear, Research Fellow in the Social Studies of Addiction Concepts program at the National Drug Research Institute, Curtin UniversityLicensed as Creative Commons – attribution, no derivatives.