NDRI symposium, Melbourne, 6/5/11

Researchers from the National Drug Research Institute are presenting a selection of our current research and discussions of future directions for alcohol and other drug research. The symposium will be hosted by Turning Point Alcohol and Drug Centre, 54-62 Gertrude St, Fitzroy. Yes, I’m involved… see final title on the program. My talk will start at around 12:30pm… I could be your entertainment while you eat your lunch 😉

It’s happening on Friday 6 May, 2011, 10.00am-1.00pm

RSVP to (08) 9266 1600 or ndri@curtin.edu.au by Friday 29 April, 2011

PROGRAM

The role of the Institute in informing effective policy and practice – Steve Allsop

Informing alcohol policy: the role of quality evidence in informing and measuring the impact of policy – Steve Allsop

Exploring social contexts of alcohol and other drug use: Using mixed methods to inform alcohol and other drug policy – David Moore

Starting early: prevention & early intervention – Anna Stearne

Closing the gap: reducing alcohol and other drug-related harm among Indigenous Australians – Dennis Gray & Ted Wilkes

Drugs and the internet: risks and opportunities – Monica Barratt

Off the grid

Social media tools have become major parts of how I live my life, but I also believe that there are times when you need to protect yourself from new information and create a special space with a singular aim: full immersion in the PhD thesis – the writing-up and production of arguments and stories woven through introduction, methods, results and discussion. Envisioning the whole story requires all of my concentration and commitment.

I am about to step into an intense writing period of 2 months. To achieve this, I am going ‘off the grid’. This will be my last Web 2.0 offering until March. It will be a small achievement to see a two month gap in my Facebook activity when I resurface. More crucially, I’m looking forward to handing over a full draft of the thesis to my supervisors!

If you do email/message/comment, I will read and respond in March. I look forward to a more solid engagement with everyone post thesis submission.

Thanks to everyone for their support and patience.

Monica

Youtube cherry popping

My Youtube cherry has been officially popped. I’m sure my technique will improve with practice 😉

Curtin has launched a new marketing campaign called Make Tomorrow Better. It showcases Curtin staff in 1 minute videos describing how they ‘make tomorrow better’ and includes the following short performance…

It was a little difficult talking about how my research directly affects people, because I’ve not had a chance yet to present conclusions and implications that can be acted upon. But this experience has given me ideas about video-blogging in 2011 after thesis is submitted.

Australian Drugs Conference 2010

Today I attended Day 1 of the Australian Drug Conference 2010. The conference focus was ‘Public health and harm reduction’. I certainly felt at home in this environment: where public health, human rights, harm reduction, law reform and the involvement of people who use drugs in policy and practice were emphasised.

We have had some recent successes in Australia that were celebrated today: including the NSW state government’s decision to lift the trial status of Sydney’s supervised injecting centre. Other innovative harm reduction measures, such as peer-administered naloxone to prevent death from heroin overdose (Chicago, and in many other parts of the world), the ‘unsupervised’ provision of buprenorphine-naloxone substitution therapy (USA, France) and the decriminalisation of illicit drugs for personal use (Portugal), are yet to find acceptance in Australia despite positive results in other parts of the world.

I was particularly interested in the session called I found it online. Johnboy Davidson (Enlighten Harm Reduction) spoke about the proposed internet filter and what it might mean for online harm reduction, Cameron Francis (Dovetail) discussed the challenges of responding to new or emerging drugs using mephedrone as an example, and Stephen Bright (Peninsula Health) provided an overview of so-called legal highs and the law in Australia.

Some of the messages I took from this session include:

  • The censorship laws as they stand today could be applied to websites hosted in Australia, but generally at not enforced. Even so, websites disseminating instructions on safer injecting could be taken down if the laws about refused classification were actually enforced.
  • We need a workable early warning system to detect new and emerging drugs quickly. None of our current systems are quick enough to help people who use drugs and the people who work with them better understand new drugs: ways of reducing harm, specific risks, etc.
  • New drugs are quick to arise and quick to disappear – in part this is due to the legal roundabout whereby new ‘legal highs’ are marketed/used in Australia, then they are discovered by law enforcement, analogue laws are used/enforced, and the cycle begins again. (Or markets are driven by trends in larger countries like the UK, where the UK enacts legislation to ban the new substance, which precipates another new substances, and we begin again…).
  • Legislative approaches to controlling emerging drugs should be examined carefully. Are drug laws themselves fuelling the problem on both the demand and the supply side?

Some of my thoughts on these issues are that:

  • The internet facilitates and accelerates the process of new drugs emerging, but the internet is not the causal factor, and suppressing access to drug related information on the internet (as would happen under the proposed internet filter) will not necessarily reduce this facilitation. The consequences of the internet filter for drug users and drug markets needs some more careful thought: one scenario is that seasoned drug and internet users will still be able to find and share information in a clandestine fashion (using virtual private networks or peer-to-peer traffic) but the novice user casually searching google for information will not have access to important information for drug harm reduction. Yet, they will definitely still have access to websites selling ‘legal highs’ because these can keep changing their name/location as required…
  • People really need to look at the demand side of emerging drugs: addressing only supply will never change the desire to use drugs. We should ask the hard questions, like: ‘Is spending money/time reducing supply/purity of MDMA pills necessarily a good thing for public health?’ If we find that people displaced from ecstasy use decide to use emerging and mainly unknown drugs as substitutes, should we not reconsider the wisdom of this?

Thanks to everyone I chatted to today and I hope you all enjoy tomorrow’s sessions!

A guide for the undecided Australian voter

With 3 days to a federal Australian election, many voters appear to be fed up with politics and don’t know whether to vote in Julia or Tony. It seems to me that many people have one or two core issues that sway them one way or the other.

I recommend a couple of tools that helped me situate my own views with the views of our political parties. My method takes a more holistic view using a self-assessment of one’s own political beliefs and comparing those to the political parties on offer.

Political compass

I recommend spending 10 minutes completing the political compass test. This test goes beyond the left-right economic continuum by also including an authoritarian vs libertarian social continuum. You end up positioning your views on the following quadrant:

Once you have done the test, how do your results compare with the Australian political parties? Have you noticed how closer Labor and Liberal actually are in their views of how things should work? Read more here.

The Liberal Democratic Party has their own version of this test, which includes some of the other minor parties on the political compass.

Becoming an educated voter

Now you have a better idea of which party represents your views best, get educated about how to make your vote count.

There are so many myths about Australia’s preferential voting system. One big myth is that a vote for the Greens is a vote for Labor. Or that voting for any minor party is a ‘wasted’ vote.

It is actually very easy for Liberal leaning voters to vote Green-Liberal. Just vote 1 Green, 2 Liberal, and number all other boxes in the house of representatives. Then, vote below the line in the senate. To help you do this, head to Below The Line. This site allows you to customise your senate ticket so you can print it off, take it into the voting booth and copy the numbers onto your senate ballot paper.

But, didn’t the Greens do a deal with Labor on preferences? Yes, they did, but these deals only matter if people vote above the line in the senate. Voting above the line means you trust your preferred party to allocate your vote to them first and their preferred parties next, should party 1 not get enough votes for a senate seat or have some left over.

I’d rather vote below the line and determine exactly where my preferences go. OK, it takes a little longer, but this is democracy, right? We should be happy we have this opportunity to vote for Shooters and Fishers party, if we chose to!

This election, for example, I am taking great pride in being able to put Stephen Conroy (Labor Senator) last on my senate ticket. This man has pushed for the internet filter and has labelled anyone against the filter as advocates of child porn. He’s the sort of politician I want out of politics. So I am using my democratic right to ensure my vote doesn’t assist the continuation of Conroy in parliament.

So, to summarise:

1. Work out which party best represents your view of the world

Recommended tool: the political compass

2. Ensure you understand how to best use your vote!

Recommended tool: vote below the line

Happy voting!

Embracing interactivity and openness: Drugs 2.0

Last Friday, I had the pleasure of attending a presentation by Ray Stephens of Moreland Hall. Ray spoke about ‘Using Web 2.0 to engage with clients and reduce drug-related harm’.

Web 2.0 is an interactive, immersive network where participants consume and create content and connections. Young people, arguably the target group of much alcohol and other drug ‘interventions’, are primarily using the internet to source health information. Online networks facilitated through web 2.0 allow people to collaborate, gather and distribution information. Illicit drug use is no exception to this trend!

Ray argues that web 2.0 is where alcohol and other drug treatment services need to be focusing their attention if they want to capture the attention of the majority of young people who already use these online networks to discussion drug use.

The examples of online engagement in the AOD field that Ray reviewed were websites with comment facilities (like Somazone), websites that host multiple blogs (like Between the Lines) and Moreland Hall’s website Bluebelly, which is pushing the boundaries in its use of wiki articles and forthcoming feature film.

From the audience, we discovered the innovative work currently underway at the Burnet Institute using Facebook. The Queer as F**k project follows the lives of 5 fictional gay men who live together in a share house in Melbourne. The characters have their own facebook pages and interact together on the site. The main action occurs in short film clip episodes uploaded to youtube and disseminated through the facebook page. Health and social issues are introduced through the films and online interaction.

Chris Raine, founder of Hello Sunday Morning was also in the audience and had a chat to me after the show. HSM is a collective of bloggers who have taken 3, 6 or 12 months off drinking to examine why they drink and develop a new relationship with alcohol. Hello Sunday Morning uses similar logic to Queer as F**k: people who follow the experience of these individuals and interact with them will be engaged and more open to learning and experimenting with their own behaviour change. The difference is that the HSM people are real, whereas the Queer as F**k characters are fictional. There is something particularly appealing about HSM bloggers being real.

Alongside the importance of using web 2.0 to engage with people about drug issues, Ray also argued for the opening up of AOD workplaces to web 2.0. How can people who work in this field become familiar with web 2.0 when much of it is blocked by our organisation’s firewalls? How can innovation be stimulated in organisations where facebook, youtube and twitter are seen as not work related?

Ray ended his presentation with a great list of 10 reasons why we should embrace web 2.0 in the AOD field:

1. Source of information
2. Brand awareness, credibility
3. Networking and partnership development
4. Provide treatment to people we will never see
5. It’s engaging (and fun?)
6. Encourage opportunities for users to have a voice
7. Extend your staff’s working hours
8. Free (…ish)
9. ‘They’ are already using it
10. It’s not going away

What I love about this list is that it reads so much like why people should embrace the harm reduction approach to drug use. Essentially, people are using web 2.0 and it isn’t going anywhere, so we need to learn how to use it wisely and well, instead of the zero tolerance approach of ignoring it in the hope that it might be a passing phase. Hopefully more alcohol and other drug agencies will modernise their social media policies and embrace interactivity and openness through web 2.0. All they have to lose is their fear 🙂

* Thanks Ray for starting this conversation. Let’s continue it!

Mephedrone / 4-MMC

‘Meow’ trance victim! A deadly designer drug dubbed Britain’s new ecstasy has sent a man into a psychotic “trance-like” state in the first known case in Melbourne.

When I read this on the front page of the mX (11/3/2010), I knew the moral panic had officially begun. Since then Australia has seen an hour-long ‘investigation’ into the new ‘killer drug’ mephedrone on A Current Affair, with another investigation by Steve Cannane due to air on ABC’s Lateline tonight.

Firstly, what exactly is mephedrone or 4-MMC? And why are people talking about a drug called ‘meow meow’ and ‘plant food’? According to a selection of key information compiled at Bluelight, the full name for this drug is 4-Methylmethcathinone or 4-MMC. The ‘meow meow’ may refer to MM-CAT, another shortening of MethylMethCAThinone. While Australian law prohibits cathinones and any cathinone analogues, including mephedrone, the UK is in the midst of a political struggle to schedule and ban 4-MMC which is currently a legal substance, although it must be marketed as not for human consumption to get around standard regulations of consumable products.

For those who have studied the history of new drug panics, this treatment has a familiar ring to it. Like MDMA (‘ecstasy’), methamphetamine (‘ice’), and GHB (‘fantasy’) before it, 4-MMC (also with the classy so-called street name ‘meow meow’) is a menacing danger that needs to be stopped using the legal system. 4-MMC has been marketed as plant food, like other ‘new’ drugs that have made headlines in the last decade that were labelled research chemicals and incense to avoid regulations associated with food and drugs.

What has become obvious to observers in this case in Australia is that as supply reduction measures tighten and actually influence drug markets for known illegal drugs like MDMA, demand for MDMA is left unmet. It is not surprising that new synthetic drugs are created, manufactured and marketed to meet this demand. While Australia’s analogue laws mean that most new synthetic drugs are likely to be illegal, it still takes time for the police and customs to determine this – and in that time, new drugs enter the market. We will always be playing catch-up. The question I ask is whether we do more harm by perpetuating new and less studied drugs, one after another, than we would do if we regulated the supply of known drugs, even with their harms.

Furthermore, having a sharp divide between illegal and legal drugs can provide people with a false sense of security when they believe a drug is ‘legal’. Pharmaceutical drugs, ‘legal highs’ and other drugs on the margins of legality such as new analogue drugs may be perceived as less dangerous than known illicit drugs. This misplaced sense of security may be stronger among people who don’t take illicit drugs and who haven’t been exposed to them, because they are more likely to actually believe the scare campaigns in the public discourse. For example, posters warn Australians against using ecstasy or speed due it being made in ‘backyard labs’, yet this image contrasts with the imagined pristine lab in a pharmaceutical company or the scientific lab where a drug like 4-MMC/mephedrone could be made. This is surely an unintended consequence of singling out cannabis, ecstasy and methamphetamine in anti-drug campaigns, and an unintended consequence of prohibition itself.

The situation with mephedrone is a little different in the UK, where there are no analogue laws and the drug is freely available although this is likely to change as the UK government looks to include mephedrone in Schedule B. Max Pemberton from the Guardian wrote an article entitled “I took mephedrone and I liked it”, where he said:

I do not doubt that mephedrone will be made illegal, and this is probably a very sensible course of action if we want people to be as risk averse as possible. But what must be appreciated is that as soon as it is, it’s only a matter of time before another substance appears, creating the same problems all over again.

Professor David Nutt, who was sacked from the UK drug advisory board last year for speaking his mind about the inconsistency of drug scheduling in the UK, believes that regulating mephedrone alongside MDMA would be safer than imposing the current system of prohibition.

I urge the UK and Australia to consider not only the situation of this new entrant, 4-MMC/Mephedrone, but to the other new synthetic drugs that have been in its place and will be in its place should our system of prohibition remain the same. Let’s look carefully at the whole system, rather than running around after ourselves over and over again when history repeats itself.

Process vs content

So far, my posts to Drugs, Internet, Society have focused on drug-related issues I find interesting and important. I also want to write about the research process. This is the first of a series of posts more orientated towards process than content.

Why bother discussing process? Because how we come to know something is as important as what we claim to know (perhaps more important). The validity of a person’s knowledge claim is difficult to assess without understanding the argument or the methods used by that person to arrive at their conclusions.

While this may seem obvious, people accept knowledge claims everyday without having access to the process that informed those claims. We may be trusting an expert, we may not have access to the processes behind the claim, we may not have the expertise to critique those processes and/or we may not have the time to do so.

Drug policy discussions in the public sphere are an area fraught with knowledge claims that require critical analysis. It is therefore important for you, as readers of this blog, to read about at least some of the processes I participate in when I ‘do research’.* This is the aim of the ‘process’ category of posts that I’ve just started today.

* These posts are, of course, my own account and reflection upon research processes. This is a discourse in itself that cannot provide an unbiased account (or mirror) of my research.

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.