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Q Station buildings

Being sequestered at an abandoned quarantine station in Manly provided the perfect location for some deep thinking about drug policy research as Samuel Andrews reports

The 10th International Society for the Study of Drug Policy (ISSDP) annual conference was held in Sydney this May. The conference had 160 delegates from 34 countries and was held at Q Station - the exotic old quarantine area just out of Manly. With stunning harbour views and temperatures above 22 degrees each of the three days it was a great place to talk all things drug policy. Researchers, academics, students and policy makers presented and participated in discussions on UNGASS, best practice in treatment, harm reduction, images of people who use drugs, enforcement, cryptomarkets, policy, psychoactive substances, Hepatitis C, medicinal cannabis, programme evaluation and overdose prevention.

The conference opened with Professor Louisa Degenhardt, an epidemiologist, discussing the Global Burden of Disease study. Through calculating the years of life lost and the years lived with disability the health impact of a behaviour or condition can be estimated. This study has improved the way it looks at drugs over time and shows that substance use has a significant health burden, from more direct areas like injury to its longer term impact through cancer, worsening of other health issues and dependence. While this study only includes physical harm and has a high threshold for data inclusion, it appeals to a wide range of people and disciplines and presents very solid evidence around the need to see drug use as a health issue and invest in treatment and prevention.

The true pleasure of this conference came in the highly analytical approach to drug policy that is often absent. Rather than just a description of drug use prevalence, availability, and a summary of interventions in different regions - presenters were asking foundational questions, feeding back from in-depth evaluations with key learnings, and aiming to re-direct and improve best practice and models of care.

This was particularly clear in the fantastic panels I attended ‘perspectives on policy’ and ‘substance use normalisation’. The first provided an insightful critique around how we talk about harm and addiction. The harm someone experiences from substance use is often directly linked to a diagnosable psychological experience of addiction, yet we know the harm actually comes from the drug and how it is used, not the diagnosable condition in and of itself. While this may just seem like a thought exercise, placing the causal link between addiction and harm (rather than heavy, sustained substance use and harm) has big implications. This framework has arguably led to predominantly abstinence based treatment programmes being funded rather than harm reduction or minimisation services. The goal is to ‘cure’ the addiction rather than stop the harm (which can be from addiction but not always) whereas treatment like opiate substitution can be highly effective, more achievable and have minimal harm.

The second panel had Fiona Measham, one of the original authors of the drug normalisation thesis (1994) alongside four people presenting on how they have applied this concept, how it has morphed and its current limitations. Panellists showed the flexibility in how we begin initial analysis of drug issue with this framework beginning with societal attitudes rather than individualistic models of deviance.

Having the space to challenge some of these fundamental assumptions is truly important to enable development and progress, especially in an interdisciplinary field. As Professor Scott Burris outlined; researchers of drug policy must be vigilant to maintain the integrity and rigor of academic process, providing analysis not just description.

Samuel Andrews is the Drug Foundation’s Policy and Information Officer. At the conference he presented a paper on his Honours research: "Prescription drug misuse: a university-led harm reduction approach".

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