Alex Wodak

  • Alex Wodak. Prohibition and its discontents: who really killed Chan and Sukumaran?

    The fall out from Indonesia’s execution of Chan and Sukumaran for drug trafficking continues. In their unprecedented press conference on 3 May, the leaders of the Australian Federal Police argued that under existing laws and guidelines, they were obliged to share intelligence with their Indonesian counterparts. Moreover, under similar conditions in future, the AFP expects that similar decisions will be made. The basic problems are that many young Australians travel to countries that still retain the death penalty for drug trafficking (and some other offences) and prohibition is still the global drug policy. So the execution of Australians and citizens of other nationalities for drug trafficking in future are inevitable.

    As so often happens with tragedies, the search is now on for someone or some organization to blame. The problem is that everyone is responsible while no one is also responsible: this is in reality a system problem.

    The members of the firing squad weren’t really responsible as they were just carrying out orders. The Indonesian police and court officials weren’t really responsible as they were merely implementing laws that their parliament had passed. President Widodo wasn’t really responsible as he was, like any good democratic leader, merely responding to overwhelming popular opinion in his country. Howard and Rudd weren’t responsible either because in their earlier support for the execution of the Bali bombers they reflected overwhelming popular opinion in their country at the time. Abbott and Bishop weren’t responsible as they inherited this mess from their predecessors. And Chan and Sukumaran weren’t really responsible because they were merely pawns of higher-level criminals who managed to evade detection. The seven mules weren’t responsible either because Chan and Sukumaran had coerced them. As is so often the case in drug trafficking cases, the fall guys who got caught and paid the ultimate price came from poor minority families.

    Compounding the tragedy is the ineffectiveness of drug prohibition, now acknowledged with increasing frequency. More than half a dozen retired and now even serving Australian Police Commissioners have conceded that drug law enforcement has minimal impact on the drug market. A year ago, Prime Minister Tony Abbott admitted that the war on drugs is a war we cannot win but nevertheless argued that it is a war we should keep fighting. In June 2011 the Global Commission on Drug Policy, consisting of more than twenty retired world leaders, released a report documenting the failure of drug prohibition and called for a consideration of options. In the last four years, the Global Commission on Drug Policy has recruited more world leaders and issued more reports. Some countries are now starting to reform their drug policy. In April 2016 in New York, a United Nations General Assembly Special Session will consider the growing crisis in global drug policy.

    The seizure of 390 kg of heroin off the coast of Part Macquarie in 1998 did not affect the price or purity of heroin in Australia. Chan and Sukumaran were executed for their role in the attempted trafficking of 8 kg of heroin. What these executions may have done for a time is increase the perception of risk for drug traffickers. That might then get translated into higher prices and greater profits which might in turn convince some wavering wannabe drug trafficker to try their luck. Whatever else drugs might be, they are also a market with buyers and sellers agreeing on a price for a quantity of a commodity. But unlike most markets, drugs are bought and sold in a pyramid market where buyers are also sellers.

    If drug prohibition was to ever be effective anywhere it should be in prisons. Yet drugs are available in most prisons. A few years ago on an international assignment I asked a prisoner in an Indonesian drug prison near Jakarta whether inmates could still obtain drugs. ‘Yes’ he replied, ‘but they are usually more expensive than in the community though sometimes drugs are less expensive inside than outside prisons’.

    So why do we keep fighting a war on drugs when an increasing number of prominent members of the community accept that this is futile?

    Professor Craig Reinarman, a US academic concluded that ‘drugs are richly functional scapegoats. They provide elites with fig leaves to place over unsightly social ills that are endemic to the social system over which they preside. And they provide the public with a restricted aperture of attribution in which only a chemical bogeyman or the lone deviants who ingest it are seen as the cause of a cornucopia of complex problems.’

    We continue to fight a war on drugs for several reasons. Drug wars are still useful politically. Many politicians still think the transitional costs of changing drug policy are too high. But there are now supporters of drug law reform among politicians of virtually all parties. Law enforcement aimed to reduce the supply of drugs employs many people. The costs of continuing the current failed policy are increasing while the costs of changing policy are declining as more countries move out from the crumbling straightjacket of international drug control.

    Australians who wish to avoid more tragedies like Chan and Sukumaran should support drug law reform and the universal abolition of the death penalty.

    Dr. Alex Wodak AM, President, Australian Drug Law Reform Foundation, Director, Australia21

     

  • Alex Wodak. The toxic combination of illicit drugs and politics: Australia confronts ice

     

    John Ehrlichman, the Watergate conspirator, claimed to have come up with the idea of waging a war on drugs while he was a member of President Nixon’s ‘Committee for the Re-Election of the President’, wonderfully referred to as ‘CREEP’. The aim, Ehrlichman told Nixon, was to ensure that the elderly wealthy white voters who turned out in such large numbers to vote for Nixon in 1968 would turn out again in 1972 on polling day. The plan was to appeal to their contempt for the young, poor and black using illicit drugs as the perfect ‘dog whistle’. Despite the albatross of the Vietnam War hanging around his neck in 1972, Nixon won 49 of the 50 states in a landslide victory. Politicians around the world took note. An electoral magic pudding had just been discovered.

    In the early 1970s, US Congress established a National Commission on Marijuana and Drug Abuse but President Nixon got to appoint most of the members. Nixon stacked the Commission with people he thought would support the sorts of recommendations he wanted. When Nixon heard that the Commission was leaning to recommend ending cannabis prohibition he called in the chair, Raymond Shafer. The Watergate tapes recorded the conversation: Nixon: “You’re enough of a pro to know that for you to come out with something that would run counter to what the Congress feels and what the country feels and what we’re planning to do, would make your Commission just look bad as hell….Keep your Commission in line.” Towards the end of the meeting Nixon advised Shafer that he had not heard yet from the committee that was considering Shafer’s application to become a Federal judge. In the end Nixon rejected the Commission’s recommendations and Shafer did not get the judicial position he had applied for.

    Fast forward to 5 September 1989 when US President George HW Bush addressed his nation on television and held up a bag of crack cocaine from a recent arrest close to the White House. President Bush used the address to announce a major ramping up of the war on drugs but he did not tell his fellow Americans that, on instructions, law enforcement officials had lured the reluctant black crack seller to Lafayette Park, near the White House. President Bush was under considerable pressure at the time as opposition rose to his economic restructuring.

    On 8 April, 2015, Prime Minister Abbott, also under considerable political pressure, announced a new Ice Task Force. Yet not so long ago, in December 2014 the Abbott government had established a new drug advisory body, theAustralian National Advisory Council on Alcohol and Drugs (ANACAD) whose top priority was to come up with effective responses to ice. ANACAD had earlier taken over from the Australian National Council on Drugs.

    For decades drug policy has been a very useful prop for those seeking election or re-election or a boost to sagging opinion polls. But communities around the world are starting to be a lot more discerning about fear-based political machinations involving drugs. In the USA, several different polling organisations  have found that a growing majority now supports regulating ‘marijuana’ (i.e. cannabis). In Australia, support for once controversial but pragmatic interventions like needle syringe programs and supervised injecting facilities continues to slowly climb.

    A few years ago, some retired Australian Police Commissioners started commenting that our drug law enforcement was more effective than previously and about as effective as it ever could be but still the impact on the drug trade was negligible. Now even some serving Police Commissioners have made similar comments.

    The community’s favourite drug intervention is education. But the results of mass and school based education campaigns are pretty modest. The expectations of the community and politicians about the impact of drug education are unrealistic.

    Drug treatment has worthwhile benefits but improvements are usually much slower than the dramatic progress the community wants. But drug treatment in Australia, as in most countries, has a limited capacity, range of options and flexibility. During alcohol prohibition in the USA (1920-33), treatment for people with alcohol problems disappeared. Similarly, drug treatment struggles in countries where drugs are defined primarily as a criminal justice issue. Australia will make very little progress with ice while most people badly wanting help have to wait in a queue for six months as they mostly do now.

    Although drug problems are found across the economic and social spectrum, they are more common in severely disadvantaged populations. Also, countries with greater inequality, like Australia, seem to have worse illicit drug problems. Support for reducing inequality in Australia and other countries is growing with the case so far made largely on the grounds of improving the economy. But a fair case can also be made that less inequality would reduce some of our social problems including illicit drug use.

    The $64 million question that has not been asked about ice is why the drug market started providing this drug in the first place. For me the answer seems clear. Drug prohibition encourages more dangerous drugs to replace less dangerous drugs just as bush cannabis morphed into skunk and then Spice, powder amphetamine morphed into ice and ecstasy morphed into related but much more dangerous compounds.

    We haven’t got there yet but Australia is slowly moving to acknowledge that it’s not so much illicit drugs that are dangerous as having a drug market that is completely unregulated. Economic forces ensure a vibrant drug black market while political forces till now have precluded a pragmatic arrangement. In the short term, political forces usually dominate but in the long term, economic forces prevail.

     

    Dr Alex Wodak AM, President, Australian Drug Law Reform Foundation, Board Member, Australia21

  • Alex Wodak. Why is illicit drug use considered evil?

    It seems self-evident to many that the use of illicit drugs is evil. But why? When pressed, the most common response to this question is that illicit drug use is evil because it is against the law. So the next question is ‘why is the use of certain drugs illegal?’ State parliaments in Australia started banning the use of certain drugs even before Federation. In the last half century, Australia signed and ratified three international drug treaties (1961, 1971, 1988) which required domestic parliaments to pass laws imposing criminal sanctions on people who use or traffic drugs.

    In the late 19th century, opium became the first drug banned in Australia.  But opium was initially only prohibited if it was smoked. At that time, Chinese people on the goldfields were the only people in Australia smoking opium. The majority of Australians at that time had access to edible opium which remained lawful and taxed until it was prohibited in 1906. Edible opium is said to have remained readily available after the 1906 ban but the Commonwealth lost an annual income of £ 60,000.  Was opium smoking acceptable before it was banned and evil afterwards? Likewise, was edible opium acceptable until 1906 but did it only become evil afterwards?

    Australia was represented at the 1925 Geneva Convention on Opium and Other Drugs which agreed to ban the non-medical use of the opium, coca and cannabis plants and drugs derived from them. Accordingly, the Commonwealth Government banned the importation of cannabis in 1926 and requested the states to pass legislation banning cannabis. Victoria (1928), South Australia (1934), NSW (1935), Queensland (1937), Western Australia (1950) and Tasmania (1959) complied. If cannabis use in Australia is now evil, when did it become so? Was it evil when Prime Minister Tony Abbott, Communications Minister Malcolm Turnbull and former Prime Minister Julia Gillard used cannabis in their youth to become relaxed and comfortable? Was it evil when US Presidents Bill Clinton, George W Bush and Barack Obama used cannabis in their youth?

    Following international pressure, believed to have originated in the USA, Australia banned the production and importation of heroin in May 1953. Existing heroin stocks could be used medicinally till exhausted but could not be replenished. The decision to ban medicinal heroin was criticised at the time by the then Director General of the Commonwealth Department of Health, the Presidents of several Royal Colleges (Surgeons, Physicians and Obstetricians andGynaecologists) and the President of the British Medical Association (before the Australian Medical Association was established). So if the use of heroin is now evil, was it already evil when used medicinally before 1953 or did it only become so when used recreationally after it was prohibited?

    If the use of illicit drugs is not intrinsically evil, then we have to ask why their sale and purchase is evil?  The use of illicit drugs might well be unwise, even recklessly unwise, without such use constituting evil. Most members of the community will need little convincing that the injection into a vein of an unsterile powder of uncertain constituents and strength bought from a stranger is extremely unwise. But is it evil?

    In 1895, Oscar Wilde received a 2-year prison sentence with hard labour for sodomy. Alan Turing, who had contributed substantially to the Allied defeat of the Nazis in WW II and the development of computers, was found by a British court in 1952 to have had sex with another man. Turing committed suicide rather than face the consequences. Homosexuality was considered a crime when Wilde and Turing were alive although it has since been removed from the criminal code.  Same gender marriage is now lawful in the UK. Did Wilde and Turing commit evil acts even though today the same acts are no longer considered a crime? Queen Elizabeth has apologised for the way Turing was treated. It is not just the law and the community which has changed its view about the nature of homosexuality. In 1973, the American Psychiatric Association reclassified homosexuality as a lifestyle rather than a disease.

    A vigorous international debate about the effectiveness of drug law enforcement is now growing. Senior drug law enforcement figures now increasingly acknowledge the futility of efforts to restrict the availability of illicit drugs. But the real debate we should be having is about the fairness and justice of laws which criminalise the use of certain drugs (but not other drugs which create much more harm).

    In 2008, (then) Father Peter Norden noted that the gospel said ‘When I was hungry, you gave me to eat, when I was naked you clothed me, when I was in prison you visited me.’ Norden argued that “Jesus today would have included another couple of phrases, perhaps, ‘When you were mentally ill, you walked with me, when you were addicted, you stood by me. ‘ Not that you walked away from me or sat in judgement of me”. (http://www.abc.net.au/radionational/programs/encounter/faith-and-the-fix/3174376#transcript) Walking away from and judging people struggling with drug problems worked well politically for decades. But it has been a disaster for many people who use drugs, their families and communities. This doesn’t even begin to describe its impact on countries which have been the source of illicit drugs or through which such drugs have been transited.

    Whether or not our current drug laws are effective, or whether alternative policies might be less ineffective are important questions. But the most fundamental question we should be asking ourselves is whether our drug laws are fair and just.

    Dr Alex Wodak AM is President, Australian Drug Law Reform Foundation.

  • Alex Wodak. Reducing the demand for illicit drugs

    At his Congressional confirmation hearing in January 2001, the then Secretary of Defense-designate Donald Rumsfeld was asked whether US drug problems were best attacked by reducing demand or targeting drug supplies. Rumsfeld said that he believed that illicit drug use was “overwhelmingly a demand problem”. He added, “If demand persists, it’s going to find ways to get what it wants” and “if it isn’t from Colombia, it’s going to be from someplace else.” This might have been an unconventional view 14 years ago but it’s becoming a mainstream perspective these days.

    The conventional view is that young people make bad choices about illicit drugs because of an information deficit. Tell young people how bad illicit drugs are, so Conventional Wisdom asserts, and they won’t touch the stuff. Unfortunately, the experience of evaluating decades of educational mass and school-based campaigns is that, at best, modest and temporary benefits are achieved. But some studies have found that educational interventions often achieve no benefits or even increased drug use and problems. Community and therefore political expectations, are stubbornly unrealistic. In the various National Drug Strategy Household Surveys conducted for the Commonwealth Department of Health and Ageing every three years, the community always notionally allocates the lion’s share of government expenditure to drug education. Drug education is clearly the community panacea for drug problems.

    My personal journey thinking about these issues started after I spent an evening in a shooting gallery in Williamsburg, Brooklyn, New York City, in October 1987 while looking at HIV among people who inject drugs in Europe and North America. ‘Shooting galleries’, common in much of the USA, are derelict houses where people can bring drugs secreted on their person and hire (used) needles and syringes for a few hours to inject with. Shooting galleries helped to spread HIV extensively in the USA. The local police are usually paid to ignore shooting galleries.

    The Williamsburg area, now gentrified, was then clearly extremely dangerous. Abandoned cars rested propped on bricks on the side of the road. Many tenement buildings were derelict and lay empty after a fire. We gathered in a basement room carpeted with filth and broken glass. We had brought candles, as there was no electricity in the building. The front door of the house was missing. I watched aghast as four Hispanic people injected speedballs of heroin and cocaine for several hours.  I could not stop wondering why these two men and two women were so ridiculously indifferent to their health. I wondered why they made so little effort to avoid HIV? I established that they knew some people who had injected drugs and had AIDS, including some who had died of AIDS. But I was then instructed to stop asking further questions. I realized that these four people had lost all hope of decent housing, healthcare, education and employment. Not just for themselves but also for their children and grandchildren. Given the inevitability of a bleak future for them and their families and friends, enjoying a few hours of intense pleasure made some sense after all.

    In 2009, Richard Wilkinson and Kate Pickett published ‘The Spirit Level: Why Equality is Better for Everyone’. This influential book argued that many important public health and social outcomes were worse in countries with high levels of inequality, such as the USA and Australia, and better in countries with lower levels of inequality, such as Japan and Scandinavia. Illicit drug use was one of the issues that they included in their studies. This book has its critics but overall, the reception has been quite positive. My 1987 experience in Williamsburg, Brooklyn seemed to fit their theory like a glove.

    Last October I was invited to give some talks on harm reduction in Japan. I was struck by the fact that after a quarter century of economic stagnation, average unemployment was still only 3.1%  in Japan while after almost a quarter century of uninterrupted growth, average unemployment in Australia was more than double. Youth unemployment in both countries would have been several multiples of average unemployment. Heroin use is almost unknown in Japan but continues to be a significant problem in Australia. Amphetamine use in Japan is also tiny compared to Australia.

    In 2011, I was asked to give a presentation on demand reduction to the Global Commission on Drug Policy in Geneva. I argued that the results of conventional attempts to reduce drug use and problems through education were disappointing. The Chair of the Commission, Fernando Henrique Cardoso, who had been the President of Brazil from 1995- 2003, did not seem impressed by my negative assessment of demand reduction. Cardoso, a hero in Brazil for conquering hyperinflation in the 1990s, asked me what I would do to reduce the demand for drugs. I replied that his slaying of Brazilian hyperinflation had done more to reduce the demand for drugs than all the conventional drug education in the world. Although he did not seem to like that answer either, many clinicians and researchers around the world do accept that higher levels of illicit drugs use and problems are very likely if severe social and economic disadvantage is common.

    The conclusion seems inescapable to me: if we in Australia want lower levels of illicit drugs use and problems, we will have to reduce our high level of inequality. This may seem counter-intuitive to some but there are many examples of dangerous health conditions being conquered as much by improved social conditions as by powerful medical treatments. In the USA, with improved social conditions the prevalence of TB fell by more than two thirds in the early decades of the twentieth century before the advent of antibiotics.

    Dr Alex Wodak AM

    Emeritus Consultant, St Vincent’s Hospital, Darlinghurst, NSW 2010

     

     

     

     

     

     

     

  • Alex Wodak. The current imbalance between public and private interests. 

    The public interest, meaning ‘the welfare or wellbeing of the general public’, has always competed with private interests. Furthermore, public and private interests will always be in competition. What is so unusual about the current tension is the extreme imbalance: these days, private interests almost always get what they want. The policy domination by huge companies and extremely wealthy individuals has severe adverse consequences for the community in areas such as health, social cohesion and the economy. The current extreme imbalance between private and public interests is now not merely an Australian phenomenon but is also international. Examples of this policy imbalance abound in Australia and include mining, alcohol, fast food, transport, taxation and gambling.

    The increasing dominance of private over public interests coincides with an increasing inequality of income and wealth. Inequality in Australia waxed and waned over the years with low levels reached in the 1970s. Inequality then began increasing in Australia, growing under Labor and Coalition governments. Inequality increased to even higher levels in the United States where the imbalance of private and public interests is even more evident and has had striking political repercussions.

    The health of Australians improved dramatically during the 20th century. For example, average life expectancy increased from about 45 years in 1900 to over 75 years in 2000. About 25 of the additional 30 years of life expectancy resulted from improvements in public health while advances in clinical medicine only added five additional years. Yet in Australia, 98 per cent of health expenditure funds clinical services with only 2 per cent allocated to prevention. In the first half of the 20th century, improved sewerage and drains substantially reduced deaths and disease. In the second half, the decline in smoking, improved diet and increased exercise were major factors improving health. Tobacco control has been a rare victory for a public interest David over a corporate Goliath. Yet in 2014, the federal government blocked the implementation of a national agreement to alert consumers to the potential health risks of some foods. Some powerful food producers were the only beneficiaries.

    The fate of the proposed Resource Super Profits Tax (RSPT) is another example of the recent dominance of private over public interests. In 2010, the federal government proposed the RSPT, modelled on the well-regarded Petroleum Resource Rent Tax levied on the off shore petroleum extraction industry, after accepting a recommendation from a review of Australia’s tax system. A distinguished committee chaired by a highly regarded Secretary of Treasury had carried out this review. Vociferous criticism from the mining industry including an effective advertising campaign followed, and after the deposition of the Prime Minister by the Deputy Prime Minister a heavily watered down and ineffective Minerals Resource Rent Tax (MRRT) replaced the RSPT. The then government contributed to its own problems through its political incompetence. Once again, powerful private interests got their way and the community lost.

    One of the common links in these examples is the development of monopoly, or near monopoly, arrangements used to generate vast wealth and thereby political power sufficient to extract huge economic rents.

    Taxation arrangements in Australia in recent decades including the abolition or reduction of inheritance taxes, capital gains taxes, private income and company tax, and generous concessions for superannuation and negative gearing, have benefited the wealthier members of the community and large companies.

    The coming to power of Thatcher in the UK and Reagan in the USA and the fall of communism in the USSR and its satellites increased support for the view that private economic interests are inherently more efficient than publicly owned enterprises.

    The replacement in China of a central command economy by a free market system which lifted hundreds of millions of people from poverty over the following decades seemed to exemplify the benefits of a free market economy with minimal restrictions for large companies and wealthy individuals. In the United States, major economists including Paul Krugman, Joseph Stiglitz and Jeffrey Sachs have warned that the currently high levels of inequality have corrupted the political system and there is increasing concern that with a radically extreme Republican Party often prepared to disregard the national interest the United States may have become ungovernable — surely a warning for Australia.

    What is to be done? The first step for those concerned by the increasing dominance of private and corporate interests over the public good is to articulate their views.

    Could a Public Interest Commission maintain a better balance in the future?  First some difficult questions would have to be answered. How will the public interest be defined and measured? Where will successful examples of a Public Interest Commission be drawn from? How will issues be selected and enquiries be conducted?

    And finally, what sort of Australia do its citizens want — an individualist Australia with marked inequalities, poor public services, choked roads and shrinking taxation on the American model, or a more collective and more equal Australia with less poverty, better public services but more taxation similar to the Scandinavian countries and Japan?

    A political correction to the current imbalance can only occur if Australians start to debate their values and visions. The political class can only do so much. Extensive polling shows that a majority of Australians want improved public services and are prepared to pay higher taxes to fund them. However, if large numbers of Australians want to see a different country emerge, they have to be prepared to work for these changes starting at the community level.

    Dr Alex Wodak AM, a physician, was Director of the Alcohol and Drug Service at St Vincent’s Hospital, Sydney from 1982 until he retired in 2012. His major retirement project is drug law reform.  Together with colleagues, Dr Wodak started Australia’s first needle syringe program and supervised injecting facility when both were pre-legal. He was also involved in establishing the National Drug and Alcohol Research Centre, the Australian Society of HIV Medicine and the NSW Users AIDS Association, an organisation for and by people who use drugs.  He is a Director of Australia21.

    This article is one of a series published by Australia 21 on the subject ‘Who speaks for and protects the public interest in Australia?’  For other articles published, see www.australia21.org.au.