Another drug summit? This time, premier, don’t tick boxes – save lives

Almost five years have passed since I presented my report from the Special Commission of Inquiry into the Drug “Ice”. The evidence I heard during the inquiry was confronting and compelling, revealing that our illicit drug laws and policies were not working and that they fell well short of what the citizens of NSW are entitled to expect.

I found that the alcohol and other drugs (AOD) sector was grossly underfunded, resulting in unacceptable difficulties in accessing treatment for people in need, and an under-strength workforce suffering from exhaustion. Our harm-reduction strategies were inadequate. My report made a raft of recommendations that offered a comprehensive blueprint for reform.

Posters for Brisbane’s first permanent pill-testing site, CheQpoint, in Fortitude Valley. Credit: Courtney Kruk

After an extraordinary delay of more than 2½ years, the then Coalition state government made a welcome infusion of funding (“transfusion” may be a more appropriate word, as the sector remains seriously under-resourced) and accepted many of the recommendations. However, some of the most important were rejected, including that we should decriminalise simple use and possession of illicit drugs, introduce drug-checking (pill-testing) and expand our harm-reduction services, including the outstandingly successful medically supervised injecting centre.

Labor came to power in 2023 on a platform that included holding another drug summit, a clear recognition that more needed to be done. On Wednesday and Thursday this week, that drug summit will be held at Sydney’s International Convention Centre and it is likely to be the last opportunity for many years for urgently needed reform in NSW. This summit will determine whether the Minns government is truly committed to modernising our drug laws and policies or is simply engaging in a box-ticking exercise.

There is no fixed template for the design of a summit. This summit is a far more limited affair than the triumphant 1999 Drug Summit. Instigated by then premier Bob Carr, that summit was designed to tackle head-on what had become a grave drug crisis, including an increase in heroin use and the incidence of HIV and other blood-borne viruses.

Held at Parliament House, it involved suspending all other parliamentary business for five days; unlike the coming summit, every MP was expected to attend, along with invited non-parliamentary delegates. Most delegates had voting rights on resolutions, and voting was by conscience, free of party lines. It resulted in major reforms, all driven by enlightened politics and the crack of the whip of a special minister of state appointed for the purpose.

This heralded one brief, shining moment. Innovative harm-reduction measures were introduced, including expansion of the needle and syringe program, increased availability of naloxone for reversing heroin overdose, and the establishment of a world-leading medically supervised injecting centre that has since saved thousands of lives. New justice initiatives were introduced, including the very successful Magistrate’s Early Referral into Treatment (MERIT) diversionary program. At this point, NSW was regarded as a world leader in drug law and policy. Sadly, it is a mantle that we lost long ago. Our current laws and policies are inadequate to meet the complex challenges we now face.

I heard evidence during my inquiry that NSW has not had a formal AOD policy since the last one expired in 2010. Incredibly, there is still no such policy. During this policy vacuum, the sector became seriously under-resourced and we were ill-equipped to deal with the rapid rise in methamphetamine use from 2011. Today we face the emergence of deadly synthetic opioids such as fentanyl and nitazenes.

There are many reforms that must be addressed this week, which have a firm evidence base – see the ice inquiry’s report and the recently published Evidence Hub for the NSW Drug Summit 2024 prepared by UNSW’s Drug Policy Modelling Program. These reforms include:

• Decriminalisation of use and possession of drugs. This requires a health response rather than criminal prosecution, which causes its own serious harms.
• The important Early Drug Diversion Initiative scheme needs redesigning. It is currently being deployed ineffectively and diversion should occur as a matter of law and not depend on police discretion.
• Drug-checking/pill-testing should be introduced at fixed sites and they should also be available at high-risk venues such as music festivals. Just last week, the CheQpoint pill-testing service in Brisbane detected potentially fatal nitazene in a counterfeit oxycontin pill purchased over the internet. Our youth especially need this protection. “Just say no to drugs” is a completely inadequate policy response.

Far more resources must be allocated to harm reduction, including additional medically supervised injecting locations that will save countless lives (as has been the case with Uniting’s facility at Kings Cross, opened in 2001, which by April 2022 had supervised 1,232,951 injections with no deaths onsite, successfully managed 10,890 overdoses and made 20,420 referrals to health and social services. Each item of reform must be seen as one important component of a holistic policy.

Much to do ... Dan Howard, SC, as commissioner of the ice inquiry in 2019. Credit: Screenshot

Ironically, many of the attendees at the summit this week will be the same indefatigable experts, clinicians, treatment providers and people with lived experience who have provided evidence at, or made submissions to, previous inquiries or inquests. Their voices will certainly be unified in telling the government that they are exhausted at having to repeat, over and over, that the evidence for reform is clear, and that the time for reform is now.

It is doubtful that attendees this week will be asked to make any resolutions, as they were in 1999, since there has been no indication that they will have any formal voting rights on outcomes. Instead, the capable co-chairs, John Brogden and Carmel Tebbutt, have been tasked to “work with attendees to develop and prioritise solutions” and will produce a report by next February or March. There have been many important evidence-based inquiries and inquests in recent years detailing the reforms required, upon which the summit can – and must – build.

The government must finally put in place a comprehensive, integrated, whole-of-government alcohol and other drugs policy that is fit for our times and fully resourced. Its key design elements were provided to the previous Coalition government in January 2020, in recommendations 5 and 6 of my ice inquiry report.

If this 2024 summit fails to introduce the critically needed reforms, it will be remembered as a meaningless talkfest, an unworthy successor of Labor’s triumphant 1999 summit.

Dan Howard presided over the Special Commission of Inquiry into the Drug “Ice” in 2019.