The latest Croakey article urging governments to intensify their crackdown on illicit tobacco is remarkable not because it presents any genuinely new ideas, but because it demonstrates how difficult it has become for some parts of the public health establishment to acknowledge policy failure when that failure conflicts with deeply held beliefs.
I first became involved in drug policy in the early 1980s when Australia and most other countries were threatened by a very serious HIV epidemic and I was working in the national HIV epicentre near Kings Cross, Sydney. At that time there was no effective treatment and no well proven prevention. Young people were dying in alarming numbers. There were three, relatively small, high-risk groups (men-who-had-sex-with-men; women who sold sex; and people who injected drugs) and a very large population of low-risk people. What we feared most was HIV spreading extensively among low-risk people because that would have involved huge numbers of people and been very difficult, slow and expensive to control. The greatest risk of a generalised HIV epidemic (HIV prevalence >1% among low risk people) was HIV spreading rapidly among and from people who injected drugs. My colleagues and I were determined to prevent that from happening. We wanted: explicit education about HIV of people who injected drugs by their peers using street language; sterile needles and syringes to be distributed and used injecting equipment to be collected; the methadone treatment programme to be rapidly expanded and liberalised; and government funded organisations run by people who inject drugs for people who inject drugs. I wrote 13 submissions to government begging to be allowed to start needle syringe programmes. All were declined or ignored. So we decided to start our own needle and syringe programme even though it was illegal and did so on 12 November 1986. We will celebrate the 40th anniversary of that civil disobedience in NSW Parliament House on 12 November 2026. Within two years, every state and territory had established a needle syringe programme and these were later expanded to scale. HIV prevalence among Australians who injected drugs drugs has remained low. About 90 countries now have needle syringe programmes and a similar number have methadone/buprenorphine treatment programmes. Of course we faced ferocious and protracted resistance. But drug harm reduction wins most of its battles eventually. It was a great disappointment for me to realise that the opposition to needle syringe programmes mainly came from a desire to protect drug prohibition. I then developed a great interest in drug prohibition. Why did it start? Did it work? Were there better ways of managing illegal drugs? I have pursued these and related questions over the last 40 years, reading widely, talking to experts and people who use drugs in many different countries and talking to senior law enforcement officials. In summary, I conclude that drug prohibition is an almost universally futile policy which is usually a successful political strategy until it isn’t.
When I saw the MP Julian Hill saying "We are not going to surrender our policy to criminal gangs!"
I was thinking to myself "well, change the fucking policy!"
Why is it so difficult to change policies in Australia?
Why is it treated like Gods word written in stone?
Is it because the opposition will jump on it and rubb it in big time as a failure?
This policy works, lets keep it. This one does not, lets change it, adjust it, retune it, till it works properly.
Why do we have to wait for a change of government and hope that they will do something about it?
I first became involved in drug policy in the early 1980s when Australia and most other countries were threatened by a very serious HIV epidemic and I was working in the national HIV epicentre near Kings Cross, Sydney. At that time there was no effective treatment and no well proven prevention. Young people were dying in alarming numbers. There were three, relatively small, high-risk groups (men-who-had-sex-with-men; women who sold sex; and people who injected drugs) and a very large population of low-risk people. What we feared most was HIV spreading extensively among low-risk people because that would have involved huge numbers of people and been very difficult, slow and expensive to control. The greatest risk of a generalised HIV epidemic (HIV prevalence >1% among low risk people) was HIV spreading rapidly among and from people who injected drugs. My colleagues and I were determined to prevent that from happening. We wanted: explicit education about HIV of people who injected drugs by their peers using street language; sterile needles and syringes to be distributed and used injecting equipment to be collected; the methadone treatment programme to be rapidly expanded and liberalised; and government funded organisations run by people who inject drugs for people who inject drugs. I wrote 13 submissions to government begging to be allowed to start needle syringe programmes. All were declined or ignored. So we decided to start our own needle and syringe programme even though it was illegal and did so on 12 November 1986. We will celebrate the 40th anniversary of that civil disobedience in NSW Parliament House on 12 November 2026. Within two years, every state and territory had established a needle syringe programme and these were later expanded to scale. HIV prevalence among Australians who injected drugs drugs has remained low. About 90 countries now have needle syringe programmes and a similar number have methadone/buprenorphine treatment programmes. Of course we faced ferocious and protracted resistance. But drug harm reduction wins most of its battles eventually. It was a great disappointment for me to realise that the opposition to needle syringe programmes mainly came from a desire to protect drug prohibition. I then developed a great interest in drug prohibition. Why did it start? Did it work? Were there better ways of managing illegal drugs? I have pursued these and related questions over the last 40 years, reading widely, talking to experts and people who use drugs in many different countries and talking to senior law enforcement officials. In summary, I conclude that drug prohibition is an almost universally futile policy which is usually a successful political strategy until it isn’t.
Oink 🐷 oink 🐷 oink 🐷
Well I never, who wuda thunked that wud 'appen?
Perhaps albo was too interested in beating his own cgt changes?
Are we up to septodown yet? Never been so many abf orificers.
Oh dearie me, maybe a crooked budget n more taxes will our ex pats come home n bring an ocker buddy or two with them???
Ffs!!!@