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Understanding the Ice Epidemic: A Public Defender's Perspective on Drug Policy

This presentation by Dr. Alex Wodak at the 2008 Public Defenders Conference explores the complexities of the “ice” epidemic and the historical context of global drug policies. Key topics include the effectiveness of current strategies, the evolution of drug laws, and the socio-economic dynamics surrounding methamphetamine use. Wodak advocates for a shift from punitive measures to health-oriented interventions, highlighting the need for increased funding for treatment and the importance of addressing stigma and political barriers.

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Understanding the Ice Epidemic: A Public Defender's Perspective on Drug Policy

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  1. The Ice Epidemic Public Defenders Conference Taronga Park Zoo, 16 March 2008 Dr. Alex Wodak, St. Vincent’s Hospital awodak@stvincents.com.au

  2. Topics: • How did we get here? • Is it working? • Why doesn’t it work? • What is ‘ice’? • What should we do about ice? • What do we do? • What stops us doing what we should do? • Conclusion

  3. How did we get here? • 1909 First Opium Commission, Shanghai • The Hague 1912, Geneva 1925 • Single Convention 1961 • Psychotropic Substances Convention 1971 • Trafficking Convention 1988 • UN organisations: CND, UNODC, INCB

  4. How did we get here? 2 • USA major force adoption, expansion, maintenance global drug prohibition • War Against Drugs 1971 huge political success RM Nixon • Copied around world

  5. How did we get here? 3 • Australia represented 1925 Geneva • 1953 Australia banned heroin • 1960s US troops R&R leave Vietnam • 1985 adoption ‘harm minimisation’ • 1997 adoption ‘Tough on Drugs’ • 2000 heroin shortage – increasing amphetamine

  6. Is it working? ‘Drug prohibition is a joke inspired by religion designed to enrich criminals and terrorists in the name of promoting morality. It is working, except for promoting morality’

  7. Is it working? 2 • Outcomes -  • Cultivation, production, consumption • Range types drugs – ‘iron law of prohibition’ • Adverse consequences also  • Deaths • Disease • Crime • Corruption

  8. Is it working? 3 • Serious collateral damage • Narco countries • Narco terrorism • Expensive • Customs • Police • Courts • Prisons

  9. Why doesn’t it work? • $ US 322 Billion global turnover • Arms > drugs > oil & gas • Profit 26-58 % turnover • 1 kg Heroin $1K source, $300 K destination • Law of Supply and Demand • Economics, politics in opposition • Intuitive vs. counter-intuitive

  10. What is ‘ice’? • In the beginning: amphetamine • ATS increase in Asia 1990s • Amphetamine to methamphetamine • MTA to ‘ice’: cocaine to ‘crack’ • Salts, bases • Advantages inhalation vapour • Popular MSM, then heterosexual

  11. What should we do about ice? • Treat primarily health, social problem • Increase funding health, social interventions • RAND 1993 return $ US 1.00 cocaine • 17 ¢ coca plant eradication • 32 ¢ interdiction • 52 ¢ customs, police • $ 7.46 treatment cocaine drug users

  12. What do we do? • 93% resources to drug law enforcement • 7% drug treatment • Stimulant Treatment Programme NSW 2006, 2 sites • Core = psycho social interventions • Engage, motivational enhancement, CBT, narrative, contingency contracting • Attract, retain, benefit

  13. Dex Substitution Treatment • Like methadone treatment, NRT • Small minority treatment refractory • Oral, legal, slow acting, supervised vs. injecting, illegal, fast acting • No sustained release dexamphetamine Australia • Research: UK, USA, Australia • More research needed

  14. What stops us doing what we should do? • Politics • Funding • Stigma • ‘It’s their own fault’ • Deontology vs. Consequentialism

  15. Conclusion: • ‘Ice’ product ‘War Against Drugs’ – iron law prohibition • Australia badly affected • Good results: health, social interventions, inexpensive • Terrible results: drug law enforcement • Politics sustains failed, futile approach • Problems ‘mala prohibita’ laws

  16. ‘if something cannot go on forever, it will stop’ Herb Stein ‘The main difference between genius and stupidity is that there are limits to genius’

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