Month: February 2010

More of the same…

The Rudd government announced another advertising campaign to ‘confront illicit drug use’ last night. Their media release states that:

Too many young Australians don’t understand the very real and dangerous impacts of taking or using illegal drugs

Their ‘new’ campaign will tackle this perceived lack of knowledge by using graphic images that emphasise the damaging effects drugs have. Young people need to ‘face facts’ about the risks involved in drug use.

I have numerous problems with this announcement.

  1. This is not a new campaign. Howard’s Tough on Drugs campaign has been on the go for many years with the same concepts and ideas.
  2. Social marketing campaigns like this are not informed by credible evidence. The National Drug Research Institute’s Prevention Monograph, a report commissioned by the Department of Health and Ageing themselves, found limited evidence to support the effectiveness of social marketing campaigns in reducing or preventing drug use and associated harms. Some studies even find such campaigns may lead to increased drug use through curiosity or reactance. Their most likely outcome is to have little influence on drug use decisions.
  3. These campaigns seem to be designed more for showing the general voting public that the government is ‘doing something’ about drug use. It seems no accident that this announcement and action comes in an election year.
  4. Assuming that young Australians don’t understand the dangers of drug use is unfair. This assumption should be tested. Research suggests that young people do understand and acknowledge the risks they are taking, yet they still choose to use drugs. Until the government can accept that choosing to use drugs can be a logical, informed decision, they will miss their mark in trying to engage young drug users.
  5. The Department of Health and Ageing needs to learn how to interpret statistics accurately!

Two prevalence estimates are compared across time by the Department to support their action in ‘tackling illicit drug use’. They appear to be drawn from the National Drug Strategy Household Survey series. The first read:

The proportion of recent regular ecstasy users who use weekly or more often has risen from 0.8 per cent in 1998 to 17.3 per cent in 2007.

I traced these figures back to their sources in the NDSHS reports and found that these figures refer to teenagers aged 14 to 19, and that the 1998 estimate was based on such small numbers that the estimate should be used with caution. The second reads:

There is also a disturbing trend in the increased ecstasy use by young females aged between 14-19 which is up from 4.7 per cent in 2004 to 6 per cent in 2007.

The table this comparison is taken from in the NDSHS 2007 report shows the increase is not statistically significant. That is, there is no disturbing trend. It is, in fact, hard to find ‘disturbing trends’ in the NDSHS series. Most drug use estimates are decreasing or steady. Whoever was charged with finding these disturbing trends to fit this media release has capitalised on the fact that most people who read it won’t know its source and how to access and interpret the original data.

I recall the Rudd government talking about its plans to use evidence-based policies on drugs and health issues more generally. This campaign is just more of the same. I guess drug policy misses out again when it comes to evidence-based policy.

This post can also be found on betweenthelines.org.au.

Do drug dogs deter use?

Ecstasy arrest numbers have been rising in the Australian state of New South Wales. While many interpret the rise in the number of ecstasy users arrested as evidence of increased popularity of the drug, it is also a likely consequence of increased policing, especially the use of drug detection dogs at music festivals and clubs.

In 2004, Victoria Police first announced their plans to use drug detection dogs (or sniffer dogs) to assist in the arrests of people in possession of prohibited substances. I was one of a group of people who gathered in a Melbourne pub to discuss the situation with other concerned citizens. Our little group talked about how people might respond to sniffer dogs: would drugs be taken at home before going out? would people who bought from regular dealers before going out turn to unknown dealers once inside the club? would people just have more house parties? We never really considered the question: will people stop taking drugs altogether because they might be slightly more likely to get arrested? We knew that this outcome was far-fetched, even though it was the official argument from police and policy makers.

Fast forward to today: I find myself having coffee with a friend from the original 2004 sniffer-dog group of concerned (clubbing) citizens. Our lives have changed a lot since then. Victoria Police now routinely employ sniffer dogs in their work. They are a feature of the Melbourne clubbing experience and according to my friends, clubbers have adapted. On a recent Melbourne outting of his, he and his partner found broken condoms and film canisters in the toilets. Through conversation, they discovered how clubbers had adapted to the reality of sniffer dogs: by storing their drugs internally in the canisters wrapped in condoms.

My friend’s observation is supported by research conducted in this area in Sydney and Melbourne. Dunn and Degenhardt conclude from their research in Sydney that:

regular ecstasy users do not see detection dogs as an obstacle to their drug use. Future research is necessary to explore in greater depth the experiences that drug users have with detection dogs; the effect detection dogs may have on deterring drug consumption; whether encounters with detection dogs contribute to drug-related harm; and the cost–benefit analysis of this law enforcement exercise.

Given these conclusions, it is not clear what purpose sniffer dogs serve. Superintendent Bingham notes that:

With MDMA, it’s lots of smaller seizures. If we go to a large music festival, we are there to target the dealers, not the users, but obviously the users will get caught up in that.

Clearly if MDMA dealers are not being caught, then the stated aim of employing sniffer dogs (to catch dealers) has not been met so far. Even most users would not get caught, given that they will either hide more effectively, choose different venues like house parties over large music events, or buy drugs inside the venues rather than from a known dealer.

So, we return to examining the media mentions of drug busts assisted by sniffer dogs. There, I believe, we find our answer. Sniffer dogs assist police in making more arrests, and these arrests become newsworthy for the general public, who in turn believe the police are doing ‘something’ about ‘drugs’.

Unfortunately, a small number of people have become casualities of the increased policing policies. In 2009, a 17-year-old girl attending the Big Day Out overdosed after consuming all of her drugs:

as she waited in line because she was frightened that she would be searched on entry

Although this response is unusual, any death like this is tragic. It is especially tragic when increased policing at events is sold as an effective deterrent to drug use, when there is no evidence to suggest this is the case.

Censoring online drug discussion

Over the last decade, Australians who use psychostimulant drugs have been increasingly using the internet to access drug-related information. This behaviour is occurring as part of a wider trend towards using always-available information (through wireless internet and internet-enabled notebooks and mobile phones) to ‘google’ just about any topic of interest. The difference with drug-related information is that there has traditionally been barriers in place around the distribution of detailed information about illicit drugs in public spaces. While barriers do exist for Australian-hosted websites containing content that could be refused classification by Australian censors, currently these rules cannot be enforced for overseas-hosted websites. Within this context, drug users have taken the opportunity to openly and anonymously share drug-related information and make connections with others with similar histories and interest in drugs.

The public, open nature of many websites that host discussion about illicit drugs has both opportunities and challenges. Allowing open discussion about taboo topics runs the risk of enabling information to disseminate freely that may be inaccurate and risky to those who choose to follow it. Discussions about drugs may glorify their use or not provide enough cautionary advice. On the other hand, open discussion also enables balanced information and strong warnings in an environment where users can ask questions free of the fear of being identified as a drug user. The public nature of these discussions helps with their monitoring by health professionals and law enforcement agencies; a benefit that cannot be said about interactions that occur privately.

Most Australian drug users now live in a context where internet use is embedded in their everyday lives. Over the next 5 years, this embeddedness will only increase. Access to vast amounts of drug-related information online changes the landscape of drug policy. Young adults who are the target of drug prevention campaigns are less likely to believe exaggerated or unrealistic warnings about drugs when they have the ability to easily and quickly check the veracity of such claims. The denial of the benefits and pleasures of drug use cannot continue for the same reason: it is too easy to find contrary information elsewhere. To gain credibility with drug users, the government will need to acknowledge the reality of drug use: its benefits and risks. Doing this while still sending a message that resonates with the rest of the population will be a formidable (if not impossible) task in the present climate fuelled by misrepresentation of all drug users as ‘addicts’ or ‘junkies’.

A key challenge to monitoring and intervening in online drug discussion over the next 5 years is how the Australian internet filter the Labor Party is planning to introduce in 2011 will affect this context of open public information. Should the filter be applied in its current form, websites hosting detailed instructions regarding drug taking would be refused classification and Australian ISPs will be directed to block such sites if hosted overseas. Should this happen, such material will be unavailable to Australians unless they use proxy connections to connect to the material through overseas-hosted hubs.

It is unclear how Australian drug users will react to this development. One of the major benefits of public online drug discussion is the ability of authorities to watch and react to the information posted. Drug users who lose access to drug information websites may use easily-available tools to set up new websites that bypass the filter through virtual private networks and secure http sites. Peer-to-peer traffic will also remain unmonitored. Should drug discussion move exclusively to these domains, it will become more clandestine and, consequently, harder for officials to track and respond to.

While the presence of detailed information that instructs people how to use a drug may encourage its use, a significant proportion of people will use a drug anyway, with or without instructions. Given that most instructional information about drug use available online is aimed at assisting users refine techniques of use to reduce possible harms, making this information harder to get forces drug users to rely more heavily upon their (offline) social networks for this instruction. The potential for inaccurate information exists in both online and offline information sources. Should these forms of information become banned in the online public domain, they will be harder to monitor and harder to critique. It will be critical to monitor such developments before, during and after the introduction of ISP-level filtering proposed by the federal government.

While there has been significant protest against the proposed internet censorship plans, these have mainly been among the internet-savvy proportion of the Australian population. The debate is yet to be known and understood by the average voter. In truth, the protection of drug user rights to free information and a chance to reduce the harms of their use may not sit well with the average voter either. However, what about fiction that contains detailed information about drug taking? Video games which simulate drug taking? Will Underbelly be taken off air? Quite possibly. How the debate plays out in the next month or so when the legislation is tabled in parliament will be critical to the future of public, open, online drug discussion in Australia.

More on the language needed for the #nocleanfeed campaign to reach a wider audience here