You are on page 1of 119

COMMONWEALTH OF AUSTRALIA

Official Committee Hansard

HOUSE OF
REPRESENTATIVES
STANDING COMMITTEE ON FAMILY AND HUMAN SERVICES

Reference: Impact of illicit drug use on families

TUESDAY, 3 APRIL 2007


SYDNEY

BY AUTHORITY OF THE HOUSE OF REPRESENTATIVES


INTERNET

The Proof and Official Hansard transcripts of Senate committee hear-


ings, some House of Representatives committee hearings and some
joint committee hearings are available on the Internet. Some House of
Representatives committees and some joint committees make avail-
able only Official Hansard transcripts.

The Internet address is: http://www.aph.gov.au/hansard


To search the parliamentary database, go to:
http://parlinfoweb.aph.gov.au
HOUSE OF REPRESENTATIVES
STANDING COMMITTEE ON FAMILY AND HUMAN SERVICES
Tuesday, 3 April 2007

Members: Mrs Bronwyn Bishop (Chair), Mrs Irwin (Deputy Chair), Mr Cadman, Ms Kate Ellis, Mrs Elson,
Mr Fawcett, Ms George, Mrs Markus, Mr Quick and Mr Ticehurst
Members in attendance: Mrs Bronwyn Bishop, Mr Cadman, Ms George, Mrs Irwin and Mrs Markus
Terms of reference for the inquiry:
To inquire into and report on:

How the Australian Government can better address the impact of the importation, production, sale, use and prevention
of illicit drugs on families. The Committee is particularly interested in:
1. the financial, social and personal cost to families who have a member(s) using illicit drugs, including the
impact of drug induced psychoses or other mental disorders;
2. the impact of harm minimisation programs on families; and
3. ways to strengthen families who are coping with a member(s) using illicit drugs.
WITNESSES
BETTS, Mr Ryan, Graduate Student, ONE80TC, Teen Challenge New South Wales ........................... 105
GOULD, Dr Bronwyn, Private capacity ........................................................................................................ 57
MORRIS, Mr Rhett, Chief Executive Officer, ONE80TC, Teen Challenge New South Wales.............. 105
REECE, Dr Albert Stuart, Private capacity.................................................................................................. 25
SHER, Mrs Jennifer Marcia, Trainer, Toughlove Inc.................................................................................... 2
SMITH, Mrs Louise, Representative, Toughlove Inc. .................................................................................... 2
WODAK, Dr Alexander David, President, Australian Drug Law Reform Foundation ............................ 82
Tuesday, 3 April 2007 REPS FHS 1

Committee met at 9.36 am

CHAIR (Mrs Bronwyn Bishop)—I declare open this public hearing of the House of
Representatives Standing Committee on Family and Human Services and its inquiry into the
impact of illicit drug use on families. We have a full program ahead of us today, and we will be
taking evidence from Toughlove New South Wales, Dr Stuart Reece, the Australian Council for
Children and Parenting, the Alcohol and Drug Service and Teen Challenge. We look forward to
hearing interesting presentations and personal perspectives on the impact of illicit drug use on
families.

In the afternoon, an hour has been set aside to provide an opportunity for interested members
of the public to give a short oral statement if they wish, on an informal basis, on how illicit drug
use has impacted on them and/or their families. The public are welcome to observe this hearing,
and a transcript of the evidence gathered today will be available on the committee’s website.
Should anyone want any other particulars, members of the committee staff are present to answer
those.

FAMILY AND HUMAN SERVICES


FHS 2 REPS Tuesday, 3 April 2007

[9.37 am]

SHER, Mrs Jennifer Marcia, Trainer, Toughlove Inc.

SMITH, Mrs Louise, Representative, Toughlove Inc.

Witnesses were then sworn or affirmed—

CHAIR—Welcome. I have had the pleasure of meeting some of your people on previous
occasions, but I wonder if you would like to make an opening statement for us this morning.

Mrs Smith—Thank you. We are here today to lend our voice and support to the parents and
families who live every day with the impact of the behaviours associated with drug abuse. As
parents we believe that our young people have endless potential and are not intrinsically bad.
Unfortunately, due to the influences of our society and the increasing infiltration of drugs into
our communities, our young people have fallen into bad situations.

It is with great delight and gratitude to have been given this opportunity to present to you
today and to participate in this inquiry. The parents of Australia have been sorely neglected in the
whole process of restoring family relationships that have been eroded and destroyed by the illicit
use and distribution of drugs in our communities. We are here also to support the
Commonwealth government Tough on Drugs initiative. We believe that initiative had a budget of
approximately $27 million, yet none of this appears to have been targeted towards the parents
and the main caregivers of these drug addicted young people.

The Toughlove program is a not-for-profit organisation that exists solely to support parents
and families who have adolescents with unacceptable behaviours. We currently receive no
financial funding from the government or the corporate sector to provide this much needed
community service. We survive purely on membership subscriptions, weekly attendance fees,
some fundraising activities and, most of all, the many volunteer hours that our parents kindly
give to the organisation. In order for us to reach those parents and families who would benefit
enormously from the Toughlove self-help approach, there is also great need for national
advertising campaigns to increase awareness of the Toughlove program.

Support is also needed to hold educational and training weekends on a more regular basis, to
help further develop the members and leaders of the program. Currently, these are only held
biannually due to limited personal and financial resources. These training programs have proven
to be motivational, inspirational and an excellent framework for building the organisation.

The financial, social and personal cost to families varies with every situation. The following
examples are true-life situations and experiences that some of our Toughlove parents have faced.
The addicts will steal anything so it can be sold to create funds for their next fix. Parents,
grandparents and siblings have had thousands of dollars stolen from wallets and their goods have
been pawned. Many have become involved with dealers and gangs who blackmail them into
becoming further involved in crime. Extreme physical, verbal and emotional abuse is often
displayed towards family members by the addict, brought on by drug-induced psychoses. This is

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 3

a heart-wrenching and harrowing experience for a parent to endure. Parents have been threatened
with knives, guns and other weapons—their whole being placed at risk. Why? Drugs take over
and it is the drug that the parent is talking to, not the young person. The addict has no social
conscience and no regard for authority figures, and worst of all they often lose the only support
they had: their family.

What is the personal cost? How do you begin to describe the loss of a child through an
overdose? How do you explain to your boss the real cause of why your work is suffering? How
do you cope with the endless sleepless nights, wondering where your child is and if they are
safe, continually feeling fearful about what they are doing to themselves and maybe what they
are doing to you? And what of the impact on the rest of the family, the other siblings and society
in general? How do you cope with the theft, lying and deceit? We are parents and we love our
children. We never want to give up on them.

For the fortunate few who have discovered the Toughlove program, they now have the
strategies to help them cope and to regain control of their homes and their lives. The Toughlove
structured program has given parents new strategies and emotional strength to strive beyond
mere survival. We need to restore our young people as valued members of our families and
society.

I will now talk about harm minimisation. Is it realistic to expect a habitual smoker to stick to
just one cigarette a day? Can an alcoholic restrict themselves to only three drinks a day? The
obvious answer to all of these is no, and it is the same for drug use. Pose this to any parent who
has lived with or is living right now with substance abuse and they will all say the same thing: a
chronic daily user cannot minimise their usage. They become psychologically addicted and need
increasingly larger doses of drugs to achieve the first high.

Needle exchange programs provide health benefits, but what is the real message being
conveyed? That it is okay to use illegal substances? That it is okay to harm or kill yourself? That
it is okay to continue treating the closest people to you like the scum of the earth? That it is okay
to steal, rob and mug?

A serious contradiction is in existence where, on the one hand, the federal government
operates a Tough on Drugs policy, which Toughlove parents wholeheartedly support, and on the
other the government spends thousands of dollars on introducing harm minimisation programs in
our education system. What message is this giving to our young people? How can harm
minimisation possibly be promoted when, at the same time, these drugs are illegal? Our
messages are seriously mixed. Such programs are simply enabling, educating and helping our
young people to get onto the drugs bandwagon. The cycle and impression that drug taking is
cool must be broken.

Further conflict surfaces when young people are readily supplied with Centrelink and
homelessness allowances when in fact they have perfectly good homes with caring parents to
live in. Parents are not consulted. The cost to the government and taxpayer is considerable and
often unnecessary. It is not only a waste of public funds but these allowances are often used to
support drug habits. The antisocial behaviours and crimes committed by drug addicts puts
physical and financial strain on the court system. Many young offenders often end up in jail and
become further schooled and skilled in crime.

FAMILY AND HUMAN SERVICES


FHS 4 REPS Tuesday, 3 April 2007

We support increased and improved access to long-term rehabilitation programs. Our children
are our future. We are now witnessing drug use in children as young as 10 years of age and
increasing experimental usage in teenagers. Adolescents attending school under the influence of
drugs are a big problem. They are often verbally and physically abusive to staff. When truanting,
they are often engaging in a range of criminal activities.

Drug addiction often leads to mental illness, eventually deteriorating into serious mental
illness, psychotic behaviours, schizophrenia and even brain damage. This in turn adds enormous
strain and expense on our already overstretched medical systems.

We support our members on a 24/7 basis with crisis teams available throughout every group in
their local community. We show parents that by changing the way they react to unacceptable
behaviours, they will start to reconnect with their children.

Drugs are being openly sold on the streets, outside schools and most railway stations. This is
doing irreparable damage to our young people. They are the future of our country and without
them we are at risk of losing a whole generation. Imagine the total loss of continuity to our
society?

We have very graphic commercials with regard to tobacco and alcohol. We believe that there
needs to be something similar with regard to drugs. We look forward to answering your
questions and working further with this committee in finding ways to support families and
parents to deal with the impacts of illicit drug use. Parent abuse and the abuse of the home can
no longer be tolerated in Australian society. Addiction is not a one-person issue; it is a family
and community issue that has to be addressed. As it is said, it takes a community to raise a child.
Thank you.

CHAIR—Thank you very much. You have given that statement to us already. We will treat
that as your submission. Would you like to tell us about the sorts of problems that you have to
deal with?

Mrs Smith—From personal experience in my home, we have had to deal with thousands of
dollars, literally, being taken from my wallet—to the point that I have had to lock all my
personal possessions in my bedroom when I am at home. We have had things taken from our
home to be pawned so that they can get enough money to get their next hit. We have had a lot of
parents who have holes in their walls through the mood swings. I am very fortunate that I have a
double brick home, so hitting the wall is going to hurt them more than it hurts my wall. I
personally sustained a needle stick injury with the blood filled syringe as I was going through
my child’s things searching for drugs and drug paraphernalia. That would have been the most
harrowing three months of my life waiting for the end results from that. To me that is totally
unacceptable and unwarranted.

CHAIR—Is this one child in your household?

Mrs Smith—I have four children. The two eldest ones are heavily involved in the drug scene.
They are multiple daily users. One of them was actually dealing from my home. My car was
crashed on several occasions doing drug deliveries. I only found this out afterwards. That is just
my own personal experience. There is so much more out there from our members.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 5

CHAIR—How old was your first child when he started, or did both boys start about the same
time?

Mrs Smith—They were 15 and 13. They were both involved for nine years.

CHAIR—How did it start? Where did it start?

Mrs Smith—It started on a weekend away on our property out west. One of their cousins
introduced them to drugs on a camping expedition and got them drunk at the same time. It was
through a family member.

CHAIR—You said they were on it for nine years. Are they off it now?

Mrs Smith—I am proud to say the last 18 months. My second child approached me for a
phone number for a rehab facility. I provided him with that information. He filled out the form,
got a phone call the next day and was admitted that day.

Mr CADMAN—That is good.

Mrs Smith—He spent 6½ months in that facility. This is a child who would not do anything
unless he wanted to. When he was satisfied that he had met the requirements of where he wanted
to be in his life, he went to a halfway house, which he is now living in. He is attending TAFE, he
is working and he is looking to get his own apartment as we speak. When I asked him how he
was feeling, he said: ‘My mind is clear. I will never, ever go back to that lifestyle again.’ I have
been extremely fortunate that my boys have come out the other end.

Mr CADMAN—Both of them?

Mrs Smith—Both of them. I put it down to the strategies that I learnt at Toughlove: how not
to react to my children and how to react to their unacceptable behaviours. I also think a little bit
of maturity has kicked in as they are now 26 and 24.

CHAIR—What drug were they using?

Mrs Smith—The drug of choice was speed, but it started off with marijuana. I believe that my
son was dealing in anything that anybody was requesting.

CHAIR—He had to get it from someone else, didn’t he?

Mrs Smith—Oh yes. I know exactly where he was getting it from, too.

CHAIR—Did you find that the police were of any help?

Mrs Smith—The police have very limited resources. I told my boys that, if I found any
paraphernalia relating to drugs or drug activities, I would call the police. I had to do that the very
same day that I said it. The police arrived and said, ‘We can’t do anything because it’s for
personal use.’ I said, ‘Yes, I do understand that.’

FAMILY AND HUMAN SERVICES


FHS 6 REPS Tuesday, 3 April 2007

CHAIR—But that is against the law.

Mrs Smith—I know. But there is a law that states that, if the quantity of drugs in someone’s
possession is in the range of so many grams, it is considered to be for personal use.

Mrs MARKUS—It has to be above a certain gram for a person to be charged.

Mrs Smith—Exactly.

Ms GEORGE—I thought that was only for marijuana. Does it apply to other drugs as well?

Mr CADMAN—In New South Wales it applies to heroin.

Ms GEORGE—I stand to be corrected.

Mr CADMAN—I think under 18-year-olds are allowed a larger amount than over
18-year-olds, as I remember it.

Mrs Smith—Yes.

Mrs MARKUS—As a parent, what would you have liked to have seen happen when the
police arrived?

Mrs Smith—They said, ‘Would you like us to wait here while your child packs his things and
we’ll escort him off the premises?’ I said no and that I would deal with it myself because I was
in the Toughlove program and I knew how I could handle it. They were very gracious in offering
to do that. They are very restricted. They have very tight limitations on what they can and cannot
do. In the good old days, if a kid was doing that, they would take them out the back and give
them a good kick up the behind or they would do it in front of their friends to totally embarrass
them. But drug users do not have any conscience these days. They are not embarrassed by
anything that is done to them because they are looking to the next hit. They do not have any
family involvement. They do not want any family involvement. Authority figures are a joke to
them. They will tell you that. If you say, ‘I’m going to call the police,’ their response is, ‘That’s
the funniest thing I’ve heard so far today.’ They just have no conscience.

CHAIR—Do you think that is part of the drug?

Mrs Smith—Yes. As I said, you are talking to the drug, not the child. If you can separate the
two, you can deal with the problem and still love your kid.

Mr CADMAN—Could you give us a little more detail on how that works out in practice?
That is a really interesting concept. It would take you a while to get your head around doing it.

Mrs Smith—It did. For years we were dealing with this situation at home. On the first night
that I arrived at Toughlove, a dear friend of mine was sitting there. I said, ‘I hate my kids’—and
that is a horrible thing for a parent to have to say—because of all the things they were doing, the
associated behaviours, and what it was doing to their siblings. And this dear lady sat there and
went like that—and I am going, ‘Okay; what’s she doing?’—and she said: ‘Kid—behaviour. Kid

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 7

is over here; behaviour is over there.’ And it was like a light bulb moment. I went: ‘I’ve got it. I
have to deal with the behaviour in order to deal with the kid.’

So we put strategies in place at home. We set a stand, our long-term goal; it is an ‘I will not
tolerate’ statement, and mine was: ‘I will not tolerate drugs in my home and my life.’ Each week
we do a little bottom line, and it is like placing one Lego block on top of another, each week, to
get yourself to that goal, your stand. And it can be a simple thing: that, for this week, I will draw
up a set of house rules—‘These are the conditions on which I expect you to live in this house’—
and present it to the child. Of course it is going to be ripped up and there is going to be ranting
and raving. So you produce it again. You stick it on the fridge and on the back of the toilet door;
you stick it wherever you can.

The child will not like the changes that are happening in the home because they can see the
status quo is changing. They are losing control; mum and dad are starting to get control back
again. ‘We don’t like this, so our behaviour’s going to go up a notch or two.’ And it does. Their
behaviour becomes much worse very quickly. But with the support of Toughlove, you are able to
stand strong and be confident that what you are doing is the right thing. And you just soldier on
and eventually that child’s control over you as a person and what goes on in your home starts to
diminish. It is not a quick fix program. It is not going to happen overnight. It has taken us many
years as parents to get to where we are. So do not expect to go to two meetings and find that you
have the answers to everything.

Mrs Sher—It is like a Weight Watchers program, where you have to take small steps and over
a period of time things start changing. The young people actually want those boundaries. It is
just that the parents have been so bullied that they have started being treated like they are the
children and the children are the parents. Over a period of time the parents start realising that
their children’s behaviour and what they are doing is not going to bully them, the parents, into
changing, into the children getting their own way. And then, with time, they change.

Mr CADMAN—I guess a lot of parents in that situation would feel: ‘Am I likely to lose the
child? Is the child going to leave home, go and live on the street and become one of the dregs of
society, totally dependent on drugs, and sink into oblivion?’ The chance of losing your child,
even to the point of death—

Mrs Smith—And that is feasible. We have cases of that. Anna Woods—there was a prime
example. She was not even out of home; she was living at home, and she came to her demise
through using ecstasy. And there are times when children will leave home. They get to a certain
age and they are told that they have rights; they can leave home if they want to; their parents
cannot tell them what to do.

CHAIR—Who tells them that?

Mrs Smith—The school system. They are told in class that at 14 years and nine months they
no longer have to attend school if that is what they wish and their parents can sign off on it.

Mrs Sher—Centrelink as well; if they go and they live away, they get an allowance straight
away. Parents are not consulted at all.

FAMILY AND HUMAN SERVICES


FHS 8 REPS Tuesday, 3 April 2007

Mrs Smith—Some children are actually set up in high-density housing; they have whitegoods
supplied; they have everything supplied to them; they are on an allowance. The parents have not
been consulted. Nobody has bothered to ring and find out if they were actually kicked out of
home. And some of these parents come to us in absolute despair. They do not know what to do.
They have dealt with DOCS, they have dealt with all sorts of organisations, only to be told, ‘We
can’t help you with that.’

Ms GEORGE—A number of my constituents have shared experiences, and I think we have


all heard them. The Salvation Army in the Illawarra has been running a support program for
families for many years and I have assisted in putting submissions to government for funding to
help them at the grassroots level to deal with what are very harrowing experiences.
Disappointingly, for some reason there are not enough resources provided for dealing with the
situations you have described, at the grassroots level. As a parent who has been through this
situation, what is it that government can and should be doing that we are not doing? Having
looked at some of the research regarding detox programs, it appears that unless the person who
is addicted really wants to break the addiction then it does set up this kind of churning effect. We
have heard about that in previous submissions. I am a supporter of long-term rehabilitation
programs like I saw at Odyssey House. From your practical experience, what could government
have done that we did not do to help you through that difficult and harrowing experience that
you are describing?

Mrs Smith—I believe that parent support programs should be more widely advertised. There
is so much out there for the children—detox, rehab, psychiatrists, psychoanalysts, counsellors—

Ms GEORGE—Often they do not have that, or they cannot get access to it.

Mrs Smith—That is right. Sometimes the parent is left standing there saying, ‘What can we
do, where can we go?’ Ninety-nine per cent of the parents who come to our meetings say: ‘This
is our last opportunity. We don’t know what to do after this. We have never heard of you before.’
We have been in Australia for 10 years but to this day we have people come in and say that they
have not heard of us. If we were able to get some funding we could do national advertising and
we could set up more groups around the country. We could get the word out there to parents that
there are support groups that can assist them, that can let them regain control of their lives and
homes and help them get back their personal power as parents. In Toughlove we have the 10
beliefs, which are almost like the 10 commandments. One of them is ‘Parents are people too’. In
the scheme of things, parents lose their identity because the kids rule the roost—but there is so
much out there for the kids.

Ms GEORGE—Beyond the interfamily situation that you have described?

Mrs Smith—Yes.

Ms GEORGE—Beyond that, what would you be looking at? Long-term rehab programs?

Mrs Smith—Absolutely. I personally have come out the other end with a child that has gone
through that program. You are quite right; the child has to be the one who wants to do it. The
organisations will not take a phone call from the parent; they have to talk to the child. The child
has to admit that they have a problem and that they are ready to do something about it.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 9

Ms GEORGE—What do you do in the meantime, before the child makes that conscious
decision?

Mrs Smith—You go to Toughlove!

Ms GEORGE—You seem to be very down on harm minimisation, but is it a question of


helping that child survive through that period until they make the conscious decision to seek
treatment? How should governments respond to that? The drugs are out there.

Mrs Smith—The drugs are definitely out there. The production of drugs really needs to be
cracked down on. From my own experience with my child, I have gathered so much information
in our local area through him telling me who the suppliers are, who the dealers are and what
drug they specialise in. I have passed that information along to the authorities. He knows, and he
was telling me—his mother. And this was when he was in the midst of all this drug activity.
More people in the community must be made aware of how these dealers operate.

Mrs Sher—They are all over the place: at the railway station, at the clubs and outside the
schools and shopping centres. The government could do something about these dealers.
Unfortunately, a lot of the young people themselves become the dealers. That is how they get
them in. There is a whole drug culture out there. The government could do something about
kerbing it. It is so open; you can see these people.

Mrs Smith—I could walk out of this building now and within 10 minutes come back with
some drugs for you.

Mrs Sher—It is just too openly allowed. It is too easy for them; we are enabling them to carry
on.

CHAIR—Do you think we have created a culture by using soft language, talking about harm
minimisation and all these accommodating policies? Have we said it is okay, that it is
acceptable?

Mrs Smith—I think it enables the children to do what they want to do.

CHAIR—How did you save your two other children?

Mrs Smith—The youngest two?

CHAIR—Yes.

Mrs Smith—You put so much time and energy into trying to fix the problems of the oldest
two that you seem to forget that you have another two children there. They are not doing
anything wrong: their schoolwork is fine, their work is fine, their friends are fine and they are
doing everything right. And then one day it just hits you: ‘What about these other kids? I have
forgotten that I have four children.’ I made a conscious decision one day and said: ‘I have put too
much time and too much energy into trying to fix the problem with my two older ones. I am now
going to concentrate on my youngest ones and give them what they have missed out on for the
last few years.’ They have both said to me that they are not the least bit interested in drugs. They

FAMILY AND HUMAN SERVICES


FHS 10 REPS Tuesday, 3 April 2007

witnessed too much at a young age. My daughter was witnessing things at nine and 10 that no
child should have to witness.

CHAIR—Like what?

Mrs Smith—When my son heard me coming he shoved about five kilos of speed at my
daughter and said, ‘Hide this under your jacket, mum’s coming.’

CHAIR—What did she say?

Mrs Smith—She did not think there was anything wrong with that because she was too young
to understand, so she did it. It was only in the last two years that she gave me this information.
When my husband and I used to go out for a night, they would invite their friends over and
would be running up and down the hallway of the house with bongs in their hands in front of my
two youngest children. These kids are just too young to experience things like that. You then
come back to the ‘monkey see, monkey do’ syndrome: they see it happening in the home and
they think it is okay. It is not okay, and she could not understand why we were being so anti
drugs. It was not until she got older and could see the behaviour of the two oldest boys and what
they were doing that she understood. She came to us and actually apologised for not
understanding where we were coming from.

Mrs MARKUS—Louise, how did Toughlove help you to address those kinds of issues? As
you were being supported through the Toughlove program and began to see when you stumbled
or found out that things like that were happening, how did your approach change?

Mrs Smith—I became stronger and more confident within myself as I was putting my bottom
lines into practice each week. We started off in a small way and got bigger and bigger as our
confidence grew and we knew that we could do bigger and better things. It was through the
support of the organisation, the weekly structured meetings. I would get a phone call every week
saying, ‘Hi, how’s your week been going?’ I knew that if I had a crisis I could ring anybody,
particularly the leader of the crisis team of my group, and say, ‘I’ve just had the police here and
they have just carted my son away and taken him off to the mental department at the hospital.’
Parents do not know what to do. They do not know where to turn when all of a sudden the police
turn up and cart their kid off. Now, in return, I am the crisis team leader for my group and it is
not unusual on a Friday or a Saturday night to get phone calls at two and three o’clock in the
morning from other parents who are in the same position I was in. I will not tell them what to do.
I will say to them, ‘What do you think you would like to do in this situation?’

There are other instances of crises in the home: the parent feels that they are being intimidated
or the child has them by the throat up against the wall. If they want to ring the police I will say to
them, ‘Would you like me to be there with you as a support for you when the police are there?’ If
they say yes, I will hop in the car and drive over there and sit with the parent. The police know
about Toughlove, and are quite accepting of the fact that we go in as support people for the
parents and do sit there on occasions. So it is that support system that is absolutely paramount; it
is the backbone of Toughlove. To know that you can ring somebody at any time of the day or
night to talk is a relief. Just having somebody listen sometimes is the biggest relief.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 11

Mrs Sher—When the young people see that there are other people who are interested in them,
who will be there and sometimes come to the home when there is a huge upheaval, it seems to
change their behaviour to a certain extent. In earlier days there used to be very small
communities where aunties and uncles and elders were all involved in the family. Today
everybody is very isolated. So those young people, when they see other people arriving when
there is some kind of upheaval, note the behaviour. Because there is somebody else watching,
not only the immediate family, it changes them.

Mrs MARKUS—You talked about a national campaign, programs and support structures.
What is stopping you from establishing that or extending it? What would you need?

Mrs Sher—Money.

Mrs MARKUS—What would that money provide?

Mrs Sher—It would provide us with the opportunity to set up offices in every capital city,
with administrative staff to man the office.

Mrs MARKUS—Training staff, obviously.

Mrs Sher—Yes. We have a limited number of trainers at the moment because of a lack of
money to run our weekend workshops and a lack of money to train up people, such as myself, to
become trainers like Jenny. We have two in New South Wales, and that is to cover the whole
state of New South Wales.

CHAIR—How many people are involved in Toughlove?

Mrs Smith—Our membership at the moment is approximately 200.

CHAIR—And it is word of mouth?

Mrs Sher—We try and drop leaflets at the police stations, the libraries and the doctors. We do
it all ourselves. We are all volunteers.

CHAIR—Have you ever tried to apply for a grant?

Mrs Smith—We have only just started in the last 18 months, and we are doing it at a low
level. We are trying to get in at local government level. Of course, because we are volunteers we
do not have the time. We are all very busy people with our families and our work, and we do
what we can to try and get in at that level. We have had success in the last 12 months with two or
three small ones.

Mrs Sher—We applied for localised grants. In Wollongong we got a grant. In quite a few
areas we have had a few grants, but not on a large scale.

Mrs Smith—With advertising on a large scale, I think we envisaged that we would like to get
something in every major newspaper. We would like to be able to do postal drops with our

FAMILY AND HUMAN SERVICES


FHS 12 REPS Tuesday, 3 April 2007

information. A billboard would be lovely. It is just that a lot of parents say, ‘I have not heard of
you before.’ We are very limited in what we can do with our personnel and our funding.

Mrs MARKUS—Building that extended support network takes time. You need people
dedicated to it.

CHAIR—How would you say your message differs from the harm minimisation message?

Mrs Sher—As we said before, we believe it is like an alcoholic who has one drink. How can
an alcoholic have one drink? There are various people who can take drugs or take whatever they
take and they are okay, but with young people who take drugs, it does such a lot of harm to their
mental health. We have seen this time after time: a lovely young person becoming somebody
that the parent does not recognise. We want to take the ‘cool’ out of drugs and try and educate
them, before they even come to their teens, so that they know the harm that drugs can do. Some
people who try ecstasy take one and they die. How could you put it into a child’s head that it is
okay to experiment?

Mrs MARKUS—Do you think one of the keys is that you start to say no to behaviour and
you start to set the boundaries?

Mrs Sher—Yes, but some parents find that difficult to do by themselves. They need support
to do it, especially with talking through different ways and strategies of doing it in different
situations.

Mrs Smith—Especially if they have been intimidated by their child and physically,
emotionally and verbally abused. Imagine having a six-foot-something boy standing over you,
intimidating you for money, and you are saying ‘no’, and then all of a sudden he grabs hold of
you and slams you against the wall. I am going to say ‘yes’ so I can get out of the situation.

CHAIR—So what you are saying is: domestic violence has taken on a whole new meaning. It
is no longer just between adult partners but drug-addicted children are performing domestic
violence on their parents.

Mrs Sher—The police are called out regularly for acts between parents and children. Ice is
causing the anger and the very bad behaviour.

Mrs Smith—We have a number of parents in Toughlove who have taken out AVOs against
their children. That does not mean that they have to leave home. They can have an AVO up with
the child still living on the premises, but they have very strict conditions on how they can live
there: lack of intimidation—

CHAIR—Does that help?

Mrs Smith—It has helped in a majority of cases. It might get to the end of the 12 months or
the two years and they have to reappear in court. Of course, they are asked by the magistrate,
‘Do we need to take this off? Have things changed?’ Depending on the situation, the parent can
either extend it or have it come to a stop.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 13

Mrs Sher—We try to keep the young people in the home. It is important to have family that
are together. It is absolutely the last resort for them to leave home. If they do, then the other
parents go along and make sure that they are safe, make sure that they have food, make sure that
they are okay and keep in touch.

CHAIR—What about when keeping a person who is violent and drug-addicted in the home
means that your other children are at risk and they could go the same way? What would you do
then?

Mrs Sher—Then, as I said, other parents would ensure that they have a safe place to stay.
They would leave after a period if they really would not toe the line in the home or if the parent
says, ‘I will not tolerate drugs in my home.’

Ms GEORGE—So the philosophy is keeping the child at home—

Mrs Sher—As long as you can.

Ms GEORGE—in a supportive environment, as long as you can, and dealing with the
boundary situation—

Mrs Sher—Yes, those are the steps. You would take all steps before you would say, ‘Look, if
you are going to have drugs in my home and you are going to behave like this, I’m afraid you’re
going to have to leave.’ You have to have some boundary and mean it. If they do not do that, the
other parents will arrange for a safe place and they will keep in touch and make sure that that
young person is okay—and hopefully will go to rehab. We would try to ensure that they go to
rehab, because once they are out of the house and you are not enabling them to carry on that
behaviour, once they are out there, in a lot of cases they suddenly think, ‘Well, I’m on my own.
I’ll have to do something about it. I will go to rehab. It’s not so great out here.’

Mrs Smith—Toughlove likes to provide a soft spot for the children to fall, and that can only
happen in a family unit. Sometimes it does get to the stage where that soft place is too hard to
provide. Especially if you have been confronted with physical violence on a daily basis, you
have to ask yourself, ‘Am I going to be safe at the end of this day? Am I—and other members of
the family—still going to be alive at the end of this day?’ That is a decision that you have to
make.

Mrs MARKUS—It is a journey, isn’t it, to that decision.

Mrs Smith—It is a hell of a journey.

Mrs MARKUS—There are a whole lot of other boundaries to get to that point.

Mrs Smith—It is a harrowing journey.

Ms GEORGE—While you are going through that harrowing situation, what support is there
in the community for families? Besides your organisation, I am thinking in terms of counsellors
and other people out there you can call on. Is there any support?

FAMILY AND HUMAN SERVICES


FHS 14 REPS Tuesday, 3 April 2007

Mrs Smith—They can take their children to counsellors, and a lot of parents attend
counselling themselves. I am doing a diploma in counselling at the moment, and I would like to
specialise in adolescent addiction to deal with the children and send the parents off to Toughlove.
That is what I want to do, and I think that is how it should be approached: you look after the
children as a psychiatrist, a counsellor, a therapist—whatever you want to call them—and not
leave the parent standing at the door, at the end of the hour, going, ‘I know nothing about what
has happened in there. I do not know what is going on. Can I have some help please?’

In sending them to organisations like ours, there is a double-pronged approach: you are
dealing with the child who has the unacceptable behaviours, and organisations like Toughlove
are giving the parents the strategies to be able to structure their home life to be more beneficial
for both parties.

CHAIR—What do counsellors tell children who are on drugs? What is the official line? Do
they have a line?

Mrs Smith—I do.

CHAIR—When somebody becomes a counsellor, are they taught something? Are you taught
an ideology; are you taught a line? What happens?

Mrs Smith—There are specific drug counsellors who specialise in this.

CHAIR—What are they taught? What is the line they push?

Mrs Smith—I personally confront the child. I am not a person who has a softly, softly
approach. I tell the child straight off that I am there to help them, that if they lie to me I will end
the session then and there, on the spot, and that it is then up to them to call me. I let them know
that I am not going to be intimidated, that I know all the tricks in the trade, that there is nothing
they can say or do to shock me in any given form and that I have seen and heard it all. But you
have to approach each situation differently, because everybody reacts differently to drugs. You
cannot put your personal thoughts onto another person. You have to let them evolve with their
discussion on what they are feeling, where they have got to and how they got there.

CHAIR—Is it true or do they make it up? Do they convince themselves that that is how they
got there?

Mrs Smith—I suppose that, if you tell a lie often enough, you start to believe it. But, having
lived with four teenagers, two of them having been substance abuse addicts, you get very good at
being able to tell when they are on the up and up and when they are—

CHAIR—But there are a lot of counsellors who do not have your experience.

Mrs Smith—Exactly.

CHAIR—They have come out of a nice course somewhere. What does the course tell them?
Is the aim of all counselling to get kids off drugs? Is that the aim?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 15

Mrs Sher—I think they have various philosophies. It is an individual thing.

CHAIR—Government provides money, because our policy is to get people off drugs. Is that
the message that is put out there through counselling?

Mrs Sher—I do not think so.

CHAIR—I can tell you of an example of a parent who came into my office. She found her
child, who had been to a year 10 formal, using marijuana. She took the child off to the
counsellor, who said, ‘Don’t let your mother know about it.’

Mrs Sher—That is what I say: it is very personal.

CHAIR—It is appalling.

Mrs Smith—Exactly. That is the counsellor putting her own personal view on the spin of the
situation, and you do not do that.

Mrs MARKUS—Not all counsellors would do that. I think that would be unfair.

Mrs Sher—No. As I said, it is a personal thing.

Mrs MARKUS—It would be unfair of us to make that statement about all counsellors.

Mrs Sher—Yes; that was a one-off situation.

CHAIR—Was it? I do not know. All I can tell you is that—

Ms GEORGE—You would imagine that in that situation the parent, if they thought the
advice was inappropriate, would raise it with whatever organisation.

Mrs Smith—But the parent is not going to know; the parents are not allowed to know.

Ms GEORGE—I do not claim to be an expert, but I think that the general philosophy of
counsellors assisting children with addictions would be to try to assist them out of the addiction
and to point them in the direction of—

Mrs Sher—Absolutely.

CHAIR—When this happened to that parent, the culture was: ‘Oh, don’t worry about
marijuana; it’s okay. It flushes through the body in three months; don’t worry about it; it doesn’t
hurt it.’

Mrs MARKUS—It does hurt you. That would be a counsellor who is ill-informed, I would
think.

FAMILY AND HUMAN SERVICES


FHS 16 REPS Tuesday, 3 April 2007

Ms GEORGE—Louise, one thing you mentioned in your contribution is that when your child
decided the time was such that he wanted to beat the addiction, you were able to ring and get
into detox virtually the next day. I find the situation with lots of the parents I deal with not like
that. They often tell me of their frustration because Johnnie is at the stage where he wants to get
treatment but no beds are available because of limited supply. Is one of the solutions to expend a
lot more resources in providing detox and rehab?

Mrs Smith—Yes.

Ms GEORGE—Can you expand on that on transcript, please?

Mrs Smith—I was very fortunate that the facility—the number I was given—was out of
Sydney. You are advised, if your child wants to go into detox and rehab, to send them outside
their comfort zone, so I sent him up the coast. I was very fortunate that they had positions
available and he was able to get in straightaway. You are required to go into detox for seven days
before you go into a rehabilitation facility, because they will drug-test you on admission. He
showed up as having marijuana in his system. They said that we had to accept that because it can
take anywhere between 30 and 60 days for marijuana to come out of his system but that he was
not showing positive to any other drugs. They were able to take him. Some children go into
detox and then when it is time for them to transit over to rehab, there is nothing—it comes to a
dead stop—and seven days in detox is not going to do anything; 30 days in rehab is not going to
do anything.

Mrs Sher—It has to be long term. I have found that generally they expect the young person to
ring them and say, ‘I’m ready; I want to go,’ because the parents cannot force them to go
anywhere. And then there is a waiting list, so they wait and in that time, they possibly relapse
and change their mind. So there is nothing—

Ms GEORGE—That is the experience I have come across.

Mrs Sher—Yes; you cannot go in the next day. It just does not work that way.

Mrs Smith—I was just fortunate.

CHAIR—You can schedule them, can’t you?

Mrs Smith—If it can be proven that they are a threat to themselves or to anybody else, yes
they can be scheduled.

Mrs Sher—It is very hard for that to happen though.

Mrs Smith—Particularly in New South Wales. I do not know about other states.

Mrs Sher—Often the mental health team is called in from the hospitals and they generally let
the young person go straight home afterwards. They never keep them.

Ms GEORGE—Do you think there is a psychotic episode?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 17

Mrs Sher—They never keep over, never give them treatment or never advise and there is no
follow-up afterwards. Nothing happens after that, which is really—

CHAIR—It does seem to become apparent that, unless there is long-term rehabilitation
immediately following the detox, it is not going to work.

Mrs Smith—There has to be.

Mrs Sher—They have got to get into a detox too; it is not just about the rehab. There has to
be enough places and then the connection; the link being very strong between the detox and the
rehab so that they cannot fall through and end up back on the merry-go-round again.

Mrs Smith—I was fortunate that my son did not have to go to detox because he was home for
seven days and I had him basically tied to me for seven days. I did not let him out of my sight. I
knew he was not going anywhere. He could not possibly get anything. So when they accepted
him into rehab, he was already detoxed. And that is not pretty.

CHAIR—Would you like to describe it?

Mrs Smith—If you could imagine somebody that cannot sit still, that cannot sleep, that
cannot eat, sweats profusely, twitches, verbal outbreaks, laying down on the floor, kicking,
screaming, hitting anything that comes within reach, that is what you live with for seven days
before they get into rehab.

CHAIR—So you are saying that most of the detox is what we might call ‘cold turkey’?

Mrs Smith—No. Detoxes are very structured in that in extreme cases they will be assisted
with medication to help relieve their symptoms, and that is an ongoing thing for seven days.
Once they leave there and they go into rehab, the rehab facility then deals with their mind. They
have daily counselling sessions. They have group sessions. They have one-on-one sessions. My
son had this every day for 6½ months. Building up his esteem, telling them that, yes, he is a
good person. This is what is really hard. Yes, these kids are good kids. They have just got
themselves involved in such a bad situation, and that is all it comes down to. Our kids are good.
They are born good. They are born innocent individuals. Nobody is born bad, they just get
involved in the wrong situation, with the wrong people at the wrong time and in the wrong place,
and it just spirals out of control from there.

Mrs Sher—We need to have strategies for how to deal with it and to educate parents because
the knowledge has to be there when they are going through those teenage years—to try and
prevent—

CHAIR—If you could spread what you are talking about, would there be better outcomes in
the way it currently works?

Mrs Sher—Definitely.

Mrs Smith—Parents would not wait until the situation was in a crisis. As they started to see
behaviours evolving and they think it is typical teenage behaviour, well, there is a very fine line

FAMILY AND HUMAN SERVICES


FHS 18 REPS Tuesday, 3 April 2007

between typical teenage behaviour and totally unacceptable behaviour. And if those parents
reach that stage and they can come to an organisation like ours before it becomes critical, the
outcome would have been achieved a lot earlier.

Mr CADMAN—How many branches have you got in Sydney?

Mrs Smith—Nine.

Mr CADMAN—Really! You don’t tell too many people about it, do you?

Mrs Sher—That is the problem!

Mr CADMAN—I see your address is Pennant Hills; that is right near where I am but I did not
even know you existed.

Mrs Sher—It is very difficult because we are volunteers. It is run by parents for parents. So
we are mostly working. We have to do pamphlet drops. We have to have information evenings.
We have to do everything within our own—

Mr CADMAN—What would be the average membership of each group?

Mrs Sher—At the moment, it varies between 15 and 20.

Mrs Smith—And given the unacceptable behaviours out there of our teenagers, we should be
having to find premises much bigger than we are in now to cater for the parents who are dealing
with this.

Mrs MARKUS—Where are your groups?

Mrs Sher—In Bondi, Randwick, Wollongong, Thornleigh, Sutherland——

Mrs Smith—Blacktown, Richmond, Roseville, Davidson, Broken Hill.

Mrs Sher—We have calls to our office just about every day—from Gosford, say, or
Newcastle—from people wanting to start a group, but we would have to drive out there, we
would have to organise a weekend workshop and we would have to train the parents how to run
the group.

Mrs Smith—And that is a 12-week process for somebody like Jenny or I; we have to allocate
12 weeks to train the group from scratch through to them being able to be a group standing by
themselves.

Mr CADMAN—I have been reading your stuff; it is very interesting.

Mrs Smith—We think so!

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 19

Mr CADMAN—It is about self-support and families supporting each other when they are
going through hard times. And your philosophy is really interesting, the way you have put it out,
with the stands you are going to make, what you set as a bottom line, and the way you plan and
support to achieve that bottom line, whatever it may be, for a week. I think it is fascinating. It
would be good to have some sort of study done about the results you achieve. How long does a
person normally stay a member of the group? As long as they need to, I suppose.

Mrs Sher—I have been a member for 10 years.

Mrs Smith—I have been a member for five years. I do not need to be there; the reason that I
am still there is because I receive so much from Toughlove—

Mr CADMAN—You want to give a bit back?

Mrs Smith—I want to give back now. I do not need to be there, but I would like to help
parents who come in now—to educate them on where I have been, where I am at now, what I
have learnt and what it has done for me, because I believe so strongly that this group was the
saviour for our family. I truly believe that without the group we would have been minus two
children by now—whether that was through fatality or through the jail system.

Mrs Sher—And that would be if there were harm minimisation and you just said, ‘All right;
do it.’

Mrs Smith—That is right.

Mrs Sher—‘We know you want to do it, so you have to do it, so we’ll be there to make sure
that you don’t die; you just phone us and we’ll do all the things that will protect you.’ But Louise
took a stand, by loving her child and saying, ‘I don’t want you to be on drugs and have this life. I
want you to have a better life. And I am going to help you, but by not tolerating it and making
sure that you are going in the right direction.’

Mrs Smith—The thought of promoting harm minimisation as being more important than
abstinence from drug consumption—

Mrs Sher—and prevention—

Mrs Smith—is not logical to me. To me it is saying, ‘It’s okay if you consume the drugs;
that’s fine. But it is more important to minimise it.’ It is not a logical statement.

Ms GEORGE—I find it hard to believe that parents are actually saying to children, ‘It’s okay
if you take drugs, and we’re just there’—

Mrs Smith—There are some out there.

Ms GEORGE—Well, I would imagine—

Mrs Smith—There are some who supply the drugs to their children. It is a generation thing:
you have one generation which has become involved in drugs; it goes to the next generation—

FAMILY AND HUMAN SERVICES


FHS 20 REPS Tuesday, 3 April 2007

the child has seen the parents use the drugs, and then they start using. Sometimes the parents
supply the drug to the child. Then you get to the third generation, and what have you got?
You’ve got a generation who are stoned 24/7, who will not work—who cannot work—because
of the results of their addiction and what the drugs are doing to their brains. If you have ever
seen an MRI scan of an ice addict’s brain, it is honeycombed—it basically looks like their brain
is being eaten away by the substance.

Ms GEORGE—I guess my response would be to say that we could always find horrendous
and extreme examples, such as the one you are talking about. But, in general, some of the
families that I deal with I think would find your approach workable and practical while others
would say, ‘While ever my child is using, as a parent I want to protect them from a possible
fatality.’ It is a very personal thing which will vary from family to family as to how best to help
in that crisis situation. But what I think we as a society are planning to do is to provide enough
support for the families to be able to deal with the problem as best they can. It may be that they
will go through a period of thinking, ‘I’ll do what I can to prevent harm,’ and then come to the
conclusion that whatever they have done, without setting the boundaries, has not worked. I do
not know because I have not had that experience.

Mrs Smith—When people first turn up to a Toughlove meeting I say to them, ‘Is what you’re
doing working?’

Mrs MARKUS—A good question.

Mrs Smith—And 100 per cent will say no. I say, ‘Well, if it’s not working, we need to
perhaps look at ways of changing the way you’re reacting to the bad behaviours.’ If you start
reacting in a way that is opposite to what you have been doing, the young child will stand there
and go, ‘Whoa, don’t like this; what’s going on; what are mum and dad doing?’ ‘My four
children all had a different name for the organisation Toughlove: one called it ‘easy hate
Toughlove’; another, ‘that wacko cult group’; and another, ‘tough titties’. I cannot remember
what the fourth child called it but they all had different names for Toughlove. From the first
meeting they knew that I was going to Toughlove. They knew what Toughlove was about and
they knew they were in for a rough journey.

CHAIR—I would like to raise another point on harm minimisation, which I think we are
going to explore when we talk with Dr Reece and which I do not think has been addressed at
all—that is, harm minimisation says that its aim is to keep someone alive. These are the same
people who say that smoking kills people. The fact of the matter is that people who take drugs
shorten their lives. They will not live a full life; they will age sooner; their brains are affected.
So, when you are talking about keeping someone alive, it is talking about whether you are going
to give someone the opportunity to live a full life—

Mrs Sher—A better life.

CHAIR—not a shortened life in which they are physically and mentally impaired. I do not
think anyone has started to really discuss what the outcome is of long-term drug use and what it
means in terms of the individual who has been abusing.

Ms GEORGE—But it is all forms, isn’t it—licit and illicit.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 21

Mrs Smith—I know of someone who is in an institution because of long-term marijuana use,
who does not have the motor skills to undo their zipper to use the bathroom. That is a very basic
task that is required in life.

CHAIR—It has taken a long time for there to be an acknowledgement—I think many people
knew it but refused to acknowledge it because it did not suit their paradigm—

Mrs Smith—Denial.

CHAIR—that marijuana is a wicked drug.

Mrs Sher—It sits in the brain cells and attacks the tissues of the brain. It interferes. How can
we give it out and allow that to be used?

CHAIR—We have not tried. We have been told and have had evidence given to us—I have
said this before and will say it again—that the most successful smoking ad has been the one with
the girl with the deformed face with the cancer and the teeth falling out. That could be a picture
of someone who has been on drugs.

Mrs Smith—There is a new ad out in the United States at the moment for meth.

CHAIR—Even for methadone we are starting to hear facts that we have never heard before: it
attacks bones and teeth, and that is why they are prematurely aged and will die. So when we talk
in emotive terms about keeping alive it is something we have to look at longitudinally, as people
who want to use statistics about other substances that are legal do a longitudinal study.

Ms GEORGE—I beg to differ, because we do not live in a perfect world and I think all of us
are realistic enough to accept that. Despite the best efforts to crack down on the drug barons and
the pushers, the drugs are out there and I think everyone’s goal is to try to get young people into
appropriate treatment to assist them to break their habit. An addiction in any form is difficult,
and if it means preventing them from unnecessary loss of life in the process then I do not think
the two are mutually exclusive.

Mrs Smith—You have to look at both ends, I think.

CHAIR—Exactly—and we are only looking at one at the moment.

Mrs Sher—If my child was on heroin and there was nothing I could do, I would not want my
child to die.

CHAIR—Of course you would not.

Mrs Sher—I think both ends have to be looked at.

Mrs Smith—I would rather have my child alive—and sober.

Mr CADMAN—But I think you have to accept that they may put themselves in
circumstances where they may die.

FAMILY AND HUMAN SERVICES


FHS 22 REPS Tuesday, 3 April 2007

Mrs Sher—Yes.

Mrs Smith—And I think every parent who is dealing with or has dealt with this has to accept
the fact that that could be the end result in some cases.

Ms GEORGE—It is tragic.

Mrs Smith—It is not the natural course of things in a family unit that the child dies before the
parents.

CHAIR—There are other problems too. I met a woman recently who told me that her son
who was a heroin addict had overdosed. He was in a motor vehicle and choked on his own
vomit—which is usually the way they die. He was revived sufficiently so that he did not die, but
now he is a quadriplegic and his mother now has to find ways to have him cared for.

Mrs Smith—I think children who are involved in the drug scene have to be allowed to look at
the end results of what drug use can do. I know that laws in the Privacy Act prevent this from
happening, but sometimes the shock culture is needed to bring these kids around, to let them
stand there and say, ‘I don’t want to be there.’

Mrs Sher—But I think in a lot of cases Toughlove also prevents fatalities. We are trying to do
something to prevent it. We are not just saying: ‘All right, you are doing it. We are going to
make sure that you won’t die because when you do it we will make sure there won’t be
infections.’ We try to pull out all stops to see that they do not get worse. We try different things,
and that is what we have to do. We cannot just accept the fact that they are on the drugs and
therefore they get to have methadone or whatever. We still have to fight it and try to do
something about it in the family.

Ms GEORGE—When children come to court for offences related to drug use or to the sale of
drugs, we have toyed with the idea that maybe they have to go into a compulsory program. But,
as we have said earlier, if the child has not come to that realisation, is there an argument for
compulsion?

Mrs Sher—I think there should be compulsory rehabilitation as a sentence.

Mrs Smith—Can it hurt?

Ms GEORGE—Can it hurt? Yes, I am asking you.

Mrs Smith—The facilities will say that the child has to be the one who wants to do it, or that
the addict has to be the one who makes the initial contact. I know in the court system you have
the MERIT program. If there is no physical violence involved with the child in the drug
addiction case, yes, the courts will refer them to the MERIT program. All I can say is this: ‘Give
the kid a chance in rehab; let’s see if it works.’ I was fortunate that it worked the first time. I do
not kid myself there could be a relapse. I accept that. It can take two, three or more times in a
rehab facility for the addict to address their problems, but let us give it a chance. What is there to
lose?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 23

Mr CADMAN—If you follow that logic then the courts’ diversion programs should be aimed
not at counselling but at detox and rehab.

Mrs Smith—I believe so.

Mr CADMAN—Yes, it was a question; I was not making a statement. I was asking for your
opinion.

Mrs Smith—It is the associated behaviours that come from drug use that bring our young
people into the court system. I personally have had my son in court so many times that I am
almost on a first-name basis with the magistrates in Parramatta court, and each time this child
has got off with a fine and a good behaviour bond. Some of the things that he has done are
actually incarceration offences, and he has got off. What is that telling him? As we walked out
the last time, he said, ‘I got off that one pretty easy, didn’t I.’ The court system should have said:
‘We require you to be in a facility for no less than six months to assist you with your issues. If
you leave that facility prior to the six months, your original charges will stick and you will be
brought before the court on those original charges and sentenced.’

Mr CADMAN—I thought that is the way diversion was supposed to work, but it does not
seem to.

Mrs MARKUS—If you cannot get them to rehab and detox, are there other options?
Counselling and so on? What are other options available to parents? Is that what you want or do
you think more narrow, more structured, more direction is better?

Mrs Smith—Rehab and detox might work for some. Counselling may work for others. Drug
facilities where the client goes along perhaps one or two times a week for counselling purposes
and perhaps for medication to assist them to get off the harder drugs that they are on and then
withdrawing that medication works for some. I have witnessed people going along to these
facilities, collecting their medication, not taking it but saving it up and then selling it.

CHAIR—Is there any evidence that counselling alone works?

Mrs Sher—The 12-step program is also very good—the same as Alcoholics Anonymous. It is
very good.

CHAIR—It is a guidance program to get off it? The aim is always to get off it?

Mrs Sher—It gives them the tools and helps them. There are other people with them also
trying to get off it. They have people who sponsor them. Most rehabilitation hospitals have these
meetings, and take their patients to the meetings. They are very good.

Mrs Smith—Yes, they do.

Mrs Sher—They have proven to be very successful. One must pull out all stops. People on
drugs miss appointments and they do not tell the truth when they go to see the counsellor. A
proper rehabilitation program is, in the long term, far more effective.

FAMILY AND HUMAN SERVICES


FHS 24 REPS Tuesday, 3 April 2007

Mrs MARKUS—One which incorporates counselling?

Mrs Smith—Yes, on a daily basis.

Mrs Sher—At Toughlove we have education segments where we bring in counsellors and
other members. We educate parents as well. We also advocate that they go to counsellors,
psychologists and psychiatrists. We do not do it alone. We give them as much information as we
possibly can to help them with the situation.

CHAIR—The good news is that most people do not take drugs, so our policies do work. What
we are looking at here is how we can help families with a member who is recalcitrant—I
suppose that is the term—bring them back into mainstream life.

Mrs Smith—And it can be done.

CHAIR—Thank you very much for coming along this morning.

Mrs Smith—Thank you.

Proceedings suspended from 10.48 am to 11.01 am

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 25

REECE, Dr Albert Stuart, Private capacity

Witness was sworn—

CHAIR—We now resume this hearing of the House of Representatives Standing Committee
on Family and Human Services and our inquiry into the effect of illicit drugs on families. I now
welcome Dr Stuart Reece to give evidence. I can see that you quite obviously want to make an
opening statement and that you are prepared and have got an audiovisual for us, so please go
ahead.

Dr Reece—Thank you very much for having me at your inquiry and for asking me to make
some comments on the subject of harm minimisation and its impact on the Australian
community, particularly families, and particularly in relation to mental illness and the biological
hazards on the body of addiction. I am very interested in that subject. It is something I am very
keen to see Australian research promote at a scientific and molecular level.

I think it is appropriate that I briefly mention my credentials. I know I have been mentioned in
the press a few times, so I would like to run over a few things. My presentation will touch on
some of the research conducted in my clinic which has not yet been published in scientific
journals. I have been advised by senior scientists that publication in Hansard of some of the
graphs would compromise its subsequent publication in science, so I ask for your consideration
on that matter. The submission I have tabled to the committee already is able to be published, but
some of the graphs you will see here have not been published.

I have been a doctor for 25 years; I have five medical degrees and diplomas, including an
earned doctorate in liver transplantation. I was a designated study officer of the Royal Australian
College of General Practitioners in the Queensland faculty on naltrexone in 1998. I have done
1,800 rapid detoxes, which is one of the biggest experiences in this country. I was a naltrexone
pioneer in Queensland. I have only had two hospital admissions out of 1,800 procedures
conducted, which is a world safety record. The Queensland health department have advised that
I personally conducted 8,000 of the 11,000 buprenorphine detoxes in Queensland. I defeated the
cream of the methadone crop in court in a long-running battle with the medical board, so I do
know the science. I was recently appointed as senior lecturer at the University of Queensland for
our original research in addiction toxicology, which I will present briefly today. Most of this is in
the process of publication in the scientific literature.

CHAIR—Let me get this right: you are prepared to show us your graphs in the public
hearing, but you would like the graphs not to be published in the Hansard.

Dr Reece—Some of them. I can indicate to the committee which ones.

CHAIR—Can I have a resolution from the committee that we agree to Dr Reece’s request that
the graphs he indicates will not be included in the Hansard?

Mr CADMAN—That is perfectly reasonable. I so move.

FAMILY AND HUMAN SERVICES


FHS 26 REPS Tuesday, 3 April 2007

CHAIR—It is so resolved.

A PowerPoint presentation was then given—

Dr Reece—One of my patients, who had a 12-month heroin addiction and was treated under a
maintenance paradigm at the big methadone clinic in Brisbane for six years, recently said that he
thought that that was unjust and unfair. Why do patients stay away from treatment in droves?
Most authorities suggest that only 30 per cent of our seriously addicted patients are in treatment.
We have a paradigm of harm minimisation in which about one per cent of our intravenous drug
users in this country are infected with HIV. But 70 per cent or 75 per cent of IV drug users have
hepatitis C, rising to 80 per cent to 85 per cent after six months of use.

One of my main concerns with this issue is the St Petersburg-Moscow effect. This committee
would know that 80 per cent of the world’s heroin is grown in Afghanistan, and that the opium
road leads up through Central Asia and across into the big drug markets of Europe and America.
Recently, that opium road spread up into Russia. In Russia, there was a youth culture
characterised by a lot of sexual activity and intravenous drug use. Within two years, 30 per cent
of those aged 20 or under—including teenagers—who were drug users in the party scene had
HIV.

Ms GEORGE—Where was this?

Dr Reece—Moscow and St Petersburg.

Ms GEORGE—What evidence do you have for that assertion?

Dr Reece—This is based on repeated reports from the leading Russian doctors in addiction
from hospitals there, whom I have met at international meetings. This fits with some of the
concerns from the UN about HIV epidemics around the world, such as those in Russia, eastern
Europe and Africa. I am concerned that this might be happening in Australia also. The harm
minimisation paradigm has limited our HIV incidents in this country, as you know. But in the
Weekend Australian it talked about the fact that there are 1,000 cases expected in this country
this year, whereas not so many years ago—in 1996 or 1997—there were only 100 cases a year.
That is a tenfold increase. What is worrying me very much is that the underlying behaviours that
drive the epidemics have gotten worse under the harm minimisation paradigm. The same paper
talks about the education programs making it worse.

The thing to understand—and this is not just HIV—is that this is an ice driven epidemic. It is
ice, MDMA and ecstasy that drive the romantic, hypersexual behaviour. They provide energy
and cause sleeplessness and provide an important jet propellant for these behaviours. The disease
is called drugs, sex and rock and roll. New cases of HIV in this country have risen dramatically.
There is another side to harm minimisation. My submission to the committee quotes this
paragraph from Dr Wodak, who, as you all know, is the leader of the harm minimisation
movement. He said:

In many countries it is time to move from the first phase of harm reduction—focusing on reducing adverse
consequences—to a second phase which concentrates on reforming an ineffective and harm generating system of global
drug prohibition.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 27

Wodak is Australia’s most vocal drug legalisation proponent. The whole harm minimisation
framework, theory and philosophy have to be suspect when you see those two things coming out
of the one mouth.

Let us look at the dollar cost of harm minimisation to this country. These are estimates, largely
designed from my knowledge of the field. You good folk are in government and you would
obviously have access to exact estimates of the things that I am flagging, so you could work
them out. According to my estimates, there are about 35,000 methadone patients in the country.
Each costs about $3,000 a year. I heard that we use 200 million syringes a year, which at 10c for
the distributed cost would be $20 million. I do not know the number of staff for the ATODS
methadone clinics around the country, but there must be at least 5,000 people employed in the
industry. If their average salary is around $50k, that adds up to $250 million a year. The
associated costs for government departments—because, of course, this is not just an industry; it
is a series of industries—would be, as indicated on this slide, a total annual budget of $500
million and, over three years, $1,500 million.

Now, I want to look at the roots and the fruits of harm minimisation as a philosophy, because
it is my view that it is saying something to our people and they are all getting a message that is
profoundly wrong. This slide shows a tree of death I found on the net. I borrowed the image. You
will notice a young female at the top of that tree in great distress. Our data and other data shows
clearly that women are badly affected by this ‘drugs, sex and rock’n’roll’ cultural disaster that
we have. It is a very old theme. ‘You will not surely die.’ That is what the harm minimalists say:
‘You can do all this. I’ll show you how to get away with it.’ The whole issue, particularly with
the advent of naltrexone implants for narcotic addiction, raises the question in a very forceful
way: in the temptation of youth culture, what is our fundamental attitude to seduction? ‘Just one
taste’—that refers to a taste of heroin. ‘One taste won’t matter.’ Long ago that had severe
consequences. There are these two people. ‘Choices matter.’

I was interested to discover that the actual historical site of Sodom and Gomorrah has recently
been found in Israel. On the bottom right of this slide are pictures of sulphur balls that have been
found there. So consequences matter, and they can destroy a civilisation quickly, as we saw with
yesterday’s tsunami and so on. This slide shows a tree with snakes, which to my mind is a lot of
the stories that you hear from harm minimisation. Methadone, syringe giveaways, injecting
rooms, medical cannabis, heroin trials—all those are catered for by the same people.

But, on the other side of the tree, you have all the downsides, the side effects, which are not
talked about in this culture. It is of extreme concern to me that medical science which is known
and understood overseas is not understood and not talked about and given no airplay whatsoever
in this culture. Harm minimisation—you can measure a lot of these parameters. These are old
slides I made several years ago, charting a lot of these behaviours: this is condoms and the AIDS
risk, charting the parallel between condoms and AIDS deaths. See up there how it says ‘p equals’
something—

Ms GEORGE—Sorry, I do not understand. What are you saying—condom protection and


AIDS deaths are correlated?

Dr Reece—Yes, condom sales and AIDS deaths. I am saying that there is a statistical
association between the two.

FAMILY AND HUMAN SERVICES


FHS 28 REPS Tuesday, 3 April 2007

Ms GEORGE—And what is it?

Dr Reece—I just want to explain to the committee what the ‘p’ figure is. The ‘p’ figure is
probability, a statistical measure of probability. In science, the convention is that less than 0.05 is
significant. So, the smaller the value of p, the more likely it is that there is some association
between them which needs explaining.

Ms GEORGE—Yes, well, could you explain what it is that you are inferring by the
association, please.

Dr Reece—I am suggesting there is a link between condom protection and AIDS deaths. Now,
we all know that an AIDS death in untreated disease takes 12 years after an HIV infection, on
average. But I am suggesting there is an association there and I am suggesting that this was a
marker of the spread of the harm minimisation philosophy around the country and that it
correlated with AIDS deaths, one of the key markers in the paradigm we are trying to control.

Ms GEORGE—So you are suggesting that condom use is not reducing the incidence of HIV?
I do not understand what your point is.

Dr Reece—That data alone does not establish causation and it does not establish
directionality, but it does say there is, statistically, a link. In other words, it does not prove that
condoms do not cause AIDS deaths; it just says there is a statistical association. What I am
saying is that harm minimisation is not just theory; you can measure it.

Then the number of AIDS deaths fell with the introduction of triple therapy—highly active
retroviral therapy. But it was the treatment of HIV that brought the number of deaths down. It
was the treatment. And that is what methadone, buprenorphine and syringes do not do for drug
addiction. They do not treat it. It was not harm minimisation that reduced AIDS deaths. It was
treatment, and that of course is what I am advocating for addiction.

IVDU risk reduction—this is the million syringes distributed, estimated based on data we have
heard. And this shows heroin deaths, figures that are available from the ABS. That is, as you see,
an old graph. It is from 1997, so it is 10 years old. But that shows that the more syringes went up
the more heroin deaths went up. You could say, Ms George, that there was more heroin in the
community and so more syringes went out, but it is also possible—and I will show you the slide
in a minute—that the distribution of syringes trivialised drug use in the community and was one
of the factors that led to more drug use.

Ms GEORGE—Yes, but you have no controlled experimentation which would say to me that,
without the syringes, heroin deaths would not have been higher than they are.

Dr Reece—Yes, that is true.

Ms GEORGE—Anyone can put their own slant on data, can’t they?

Dr Reece—Yes. It is just an association—that is quite true. With methadone risk reduction


there are more methadone deaths and parallel more methadone registrations, which is what you
would expect, because obviously death is a factor of how many people are on it.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 29

Then I asked my patients, ‘Do you feel that the government encourages drug use through
methadone provision, syringe exchange and all the talk in the community about relaxing drug
laws and things?’ Forty per cent of these hardened drug patients said yes, they did think the
government was increasing it. So when you add the three harms we are trying to prevent—
condoms, syringes and methadone—together and compare them with AIDS, heroin and
methadone deaths, you find there is a close relationship. Again, it is just an association; it is not
causation. You can actually plot those significant values there.

The conclusion that I would make—and I did the slides 10 years ago, as you can see—is that
harm minimisation may be a temporary strategy which works for a short term, which is where I
think we are at with our HIV epidemic now. Harm minimisation deliberately avoids addressing
underlying behaviours, which meanwhile grow worse. That is my concern.

Let us talk about addiction for a moment. It is established in the medical literature that
addiction railroads the basic circuits which are responsible for pleasure. Outlined in blue is the
limbic system of the brain and the yellow area up there is the segment of the brain which
corresponds to conscience and control of what I want to do. Addiction takes them out.

I was party to a radio interview in Adelaide the other day and they were talking about the
moral dimensions of this behaviour. The point is that in addiction morality is short-circuited and
bypassed by the addictive behaviour, as we were saying earlier. If that area is damaged, it means
we as community need to stand up to protect our young people from themselves, because their
conscience processes are impaired by the process of addiction. Very importantly, it is
established—and there are now dozens of mechanisms—that brain development in utero when
the woman is pregnant, in childhood when the child is growing and in adolescence is damaged
by addiction. Addiction gets in and affects the molecular pathways which are responsible for
brain growth and brain maturation, synapse formation, synapse transition and brain cell growth.
Virtually every process is impacted by addiction.

This committee would be well aware of the psychiatric co-morbidity. There are, again, dozens
of pathways. This is accepted by the leading doctors at the biggest hospitals in America. If you
talk to dentists, they do not see worse teeth than those of drug addicts. There are severe
infections. The committee would be aware of blood-borne infections, but there are many others.
Immunosuppression occurs in all addictions. If you think about the drug case where they are
injecting, they are getting a load of virus straight up their vein and they are knocking out their
immune system at the same time. So it is a double whammy. It is not just the fact that they using
dirty syringes; it is the fact that their immune system is pickled anyway.

The effect of cannabis on lungs is accepted by every major respiratory college in the world. I
do not know if you can see it, but see on the right at the front on the top there is a huge hole and
on the left there are our four big holes in those lungs. When you look at the AP view, there are
these massive holes. Emphysema is an accepted complication of cannabis. This patient is so bad
we are going to report him in the scientific literature, so these two graphs cannot be used. This
patient with see-through lungs is only 55 and also has see-through bones. Bone density is here
on the graph. It is way under the mean. He has see-through bones. That is from cannabis.

CHAIR—Is that also a restricted slide?

FAMILY AND HUMAN SERVICES


FHS 30 REPS Tuesday, 3 April 2007

Dr Reece—Yes. This patient has the same thing from heroin. This is not a restricted slide. His
bone density is way below where it ought to be. This top one is a paper from Boston University
showing that methadone causes osteoporosis. The lower slide shows that cannabis causes
osteoporosis, although that was a mouse study—but it was carefully done. This is interesting.
This shows, again in mice, that bones have adrenaline terminals. Mouse and human physiology
is the same to a large extent. It needs to be disproved now in man to show that it is different,
which I doubt it will be.

This is looking at the adrenalin receptors in bones. Adrenalin receptors are triggered by
stimulants such as amphetamines and cocaine. I can tell you from a clinical perspective that my
addicts get far more fractures than my nonaddicts. This has not been well researched in man, but
it seems likely that stimulant abusers will also be subject to osteoporosis. Addiction kills cells
directly, especially addiction to amphetamines and especially when it is combined with cannabis.
That is accepted. They inhibit cell growth. That is the cellular theory of ageing. If you reduce
cell growth on the one hand and increase cell death on the other, your cells must be ageing.

You would be familiar with photographs such as this one where you can see that the subject of
the photograph is female. You can see the rapid weight loss that was cocaine induced. This photo
is from the London Metropolitan Police Service. Here is another photo of a female subject and
you can see the devastation. It is not just weight loss that you are looking at; there is an ageing
effect which fits with what I just said about the cellular theory of ageing. This photo is from the
Brisbane Youth Service. I think it was cut out of one of our papers up there. You can see that two
of those three patients in the photo are female and you can see that the skin changes and other
changes are all changes caused by ageing. This is another photo of a patient from Perth. Again,
she is female. She went from a size 10 to a size 24 from the age of 19 to the age of 42.

Ms GEORGE—As the result of what?

Dr Reece—As the result of methadone and psychiatric drugs. That is what I am saying:
addiction is neurotoxic. It kills the cells in the brain. Zyprexor, the drug she was given, is
notorious for causing weight gain. This is the kind of treatment we are rolling out across our
country. This photo is of a 44-year-old patient of mine. You will notice the purple hair. Her hair
is purple because its real colour is grey. She has dreadful wrinkles on her face. They are much
worse than those of some of my geriatric patients. She is also not smiling in the photo because
she does not have any real teeth. All of those are signs of ageing. The death rate—this is
NDARC data from Sydney—in addiction is 10 to 100 times control.

CHAIR—Does that mean it is 10 times more likely?

Dr Reece—Yes. The death rate—

Mr CADMAN—Ten to 100 times more likely than normal.

Dr Reece—Yes. It is 10 to 100 times accelerated. That, of course, fits with the theory that
these people are ageing. If you go to the Matthew Talbot Hostel, or any of those St. Vinnie’s
hostels in Brisbane, it is quite obvious, but it has not been studied previously. I am very worried
about it. My key thesis is that I want to see real science at the molecular level done on this

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 31

subject. It is very important because we could understand why normal people age, why they get
hardening of the arteries and why they get cancer. All of that is involved.

Last week the ABS death figures for 2005 were released. This table shows you the cumulative
deaths in Australia from 1997 to 2005—over nine years—from those causes. You will see that
addiction to drugs was at eight, with around 12,000 deaths in that table.

CHAIR—Where it says ‘drugs’, does that mean illicit drugs?

Dr Reece—Largely addictive and illicit drugs—so morphine and pethidine would be


included.

CHAIR—Which are legal but when they are abused it is illegal.

Dr Reece—Yes, and a lot of heroin addicts are using morphine as heroin and are dying a little
bit after the shot. Heroin is diacetyl morphine, so all you have left is morphine in your blood
when it was really heroin if you took it an hour earlier. These are addictive deaths. There were
12,000 deaths from drugs. That is in nine years. There are only 1,400 deaths on that chart from
HIV in the nine years. You know that the resources we give HIV and drugs are quite disparate.
Alcohol had 2,000 deaths. That is deaths from alcohol poisoning. That is not from alcoholism as
a disease or from drunk driving; that is just acute alcohol. That puts it in scale. Remember that
we only lost 500 in Vietnam and yet there are 12,000 deaths—

CHAIR—But what you are saying in your proposal is that, in addition to the people who die
of drugs because of a reaction straightaway to the drug, there could be many people included
who had cancer, a stroke and all those other things because of the drug addiction over years.

Dr Reece—Yes.

CHAIR—When I see a statistic on the television that tells me that 19,000 people die of
smoking related causes a year, is that measuring every person who dies from, say, 10 to 100?

Dr Reece—Yes.

CHAIR—Whatever they identify—it could be emphysema or whatever—has been caused


over a protracted period.

Dr Reece—Yes.

CHAIR—But nowhere that I know of is there any study or research that shows that if you
take addictive drugs you could die over a spectrum of time as a result of having taken those
drugs at any point in time. We have no idea. It could be a figure which is far higher than any of
those figures.

Dr Reece—Yes. You are understanding it exactly. This is the years of potential life lost—the
YPLLs. This has been calculated by ABS. I should say: ABS did not have YPLL data for 2005
available, so the 2005 data is based on the death data for 2005 times the coefficient from the
previous eight years. If you add them up, on that list—and I will talk about the problem of heart

FAMILY AND HUMAN SERVICES


FHS 32 REPS Tuesday, 3 April 2007

attack and cigarettes in a minute—drugs come fifth on the YPLL score. But notice that at third
place is heart attack. I have put ‘heart attack plus arrhythmias’. Doctors have to fill out death
certificates, as you know. Those go to the ABS and are the basis of these reports. If a patient is
dead and they are old and we do not know what caused it, the way it works is: doctors usually
write ‘heart attack’ in the box. If it happens in hospital and they have a post-mortem, there is no
coronary infarct. There is no myocardial death. It is not a heart attack, they are just dead. Their
heart must have beaten out of rhythm, and they died. That is very important, because it means
that what we call heart attacks are not heart attacks.

CHAIR—They are arrhythmia.

Dr Reece—Yes, exactly. I spoke to my cardiologist friend last week and asked, ‘How many of
these are heart attack deaths?’ and he said, ‘30 to 50 per cent.’ That means that what we call
heart attacks and what we say are smoking related deaths may actually be a doubling of the real
number. When you correct the heart attack figure, drugs move to fourth place. Notice that in nine
years, they are responsible for 450,000 years of life lost. And they are lobbing in at No. 4, behind
car crash, suicide and lung cancer, so I am saying that this is a huge issue.

This cuts to Senator Bishop’s issue of the age they die at. I will come to that in a moment.
Here is the slide: YPLLs per cause of death. If you look at the years of life lost per cause of
death, the very first one is methadone. The average age of death is 46 years prior to the mean age
of Australian death, which is about 78. Then car crash is 41.9, then drugs at 41.2. Of course,
methadone is a drug. It is given for drugs. So addiction has the first and the third highest number
of years of life lost directly attributable to toxic deaths only.

CHAIR—Let us get that straight. You are saying that the average life expectancy of a drug
user is 41.

Dr Reece—It is 41 years less than—

CHAIR—Oh, less than. So if the expectancy of life for a male is about 77—

Dr Reece—It would be 42 years off that. Thirty-three or whatever it is. So it is more than half.

Here we have drug deaths by type. Opiates head that list. This is just the death data. You have
got 7,000 for opiates. Methadone is 1,000. That is a lot for a harm minimisation technique. Then
amphetamines is 700. Amphetamines cause a lot of psychosis and cardiac damage, but in terms
of death it is 700 for amphetamines and 7,000 for opiates. It is important to keep those figures in
mind—

CHAIR—That is deaths in one year, in what period of time?

Dr Reece—That is the cumulative deaths over the nine years.

CHAIR—Over the nine years of your study.

Dr Reece—Over the nine years that the detailed ABS figures have been available.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 33

CHAIR—Okay. So it is the ABS series. What is the name of that series?

Dr Reece—I do not know. It is a custom data request that I have been making, every year, to
ABS for years.

CHAIR—Okay. So it is one that you have compiled by asking for their statistics.

Dr Reece—Yes.

CHAIR—Thank you.

Dr Reece—Now if we look at drug YPLL by drug type, this is a year potential life lost. The
total at the bottom is 520,000 over those nine years, with opiates heading the list at 320,000.
Methadone is there at 44,000. The methadone lobby say that they reduce the death rate by three
or fourfold. But that is a figure which needs to be considered and discussed in the public arena.
You have a treatment which is associated with 44,000 years of life lost.

Let us talk about the pathology of addiction for a minute. It is my contention that harm
minimisation in this country is rolled out as drug trivialisation. These are some infections. That
puffy hand at the top left is common in addiction clinics. If you look at the infected leg on the
right, you will see that most of the back of the leg is involved in that boil that has spread. That is
not an ordinary boil. That is the immunosuppression of the patient; the immune system is not
rotten. So an infection gets off in that patient and it goes crazy. There are a number of abscesses.
That is the right armpit of that patient. It has been incised by the local hospital and it has pus
pouring out. That would not happen in a patient who had a normal immune system. Then the
ulcer on that right leg—you can see the footy socks—is deep into the bone.

In my clinic we looked at where the infections were. They were in the teeth and in the skin—
on the far two left columns—and the other one is upper respiratory tract infection and other
infections common in other patients. These addicts are immunosuppressed so they do not get the
normal infections. Then we looked at the severity, and in the ‘moderate to severe’ category the
addicts are much worse. They do not get the common colds that nonaddicts do—in same way
that renal transplant patients do not—but when they do get an infection it is very severe.

In this graph we have looked at the pathology results of 12,000 patients over the previous 12
years in my clinic. If you look at the graph on the top left, you will see that that is a measure of
inflammation, and then the globulin is a measure of inflammation. The globulin:albumin ratio is
on the bottom left. You can see that all of those are higher in the addicts. At the bottom right, it is
difficult to show, but the addicts have a higher lymphocyte count than the nonaddicts—due to
this immune turnover which is occurring because of the immune stimulation that has occurred,
and infection is thought to drive ageing. This is a photo of some of the teeth in my clinic, which
are so bad that even the dentist was shocked.

CHAIR—Can we go back to that slide? Now, that is from taking what?

Dr Reece—Our research is not funded, so our data does not exist in a tight enough form to do
multivariate regression on it to answer your question in detail. My patients are largely heroin
addicts, so it is largely opiates. The point is that the infection is not only shocking around the

FAMILY AND HUMAN SERVICES


FHS 34 REPS Tuesday, 3 April 2007

teeth; it has also ruptured into the face here, so it affects not just the teeth but the local region,
and of course it can seed throughout the body from that site. Most addictions will produce that.

CHAIR—And people do die from dental infection.

Dr Reece—Dental infections that spread. It can spread to the heart valve or the brain and that
is very serious. This graph measures it: teeth out, traumatised teeth, rotten teeth, rotten extracted
teeth. You can see that it is worse in the addicts. In the bottom graph we have charted the
severity and, in each of those severity categories—mild, moderate, severe—you can see that it is
worse in the addicts.

Ms GEORGE—How many people are shown on that graph?

Dr Reece—The sample size is about 400.

Ms GEORGE—Those are people from your clinic, and where do you find the control group?

Dr Reece—They are in my clinic. I see general patients and I see addicts as well—medical
controls.

CHAIR—We hear about big waiting lists for state dental clinics, for people to get access into
state-run services. Would many of the people who are requiring dental treatment be addicts?
Would they add to that list?

Dr Reece—Yes. Some of the dentists—the academic dental units—are very keen to work on
this group. But, of course, we need to control their addiction first, because they will not keep
their appointments, they will not eat right, and their addiction knocks off their stem cells. The
gum line there, where the teeth join, is a zone of active germ warfare. It has intense
immunological activity. If your immune system is not happening, there is no point fixing your
teeth—they are going to rot again. It is also the stem cells. It is the stem cells that keep your
teeth healthy. They talk about being ‘long in the tooth’. That is because the stem cells recede.
Naltrexone will reverse these changes. Naltrexone will control the addiction, it will stimulate the
immune system and it will stimulate the stem cells. So we need to control their addiction and
then get an academic group—a university dental department—to work with us to fix the teeth.

CHAIR—So you are saying that, in addition to blocking any pleasure reaction to taking an
addictive substance—which is what naltrexone says it does—naltrexone can also allow the
immune system to recover?

Dr Reece—Yes.

CHAIR—Are you saying that it is an active ingredient in naltrexone that does that?

Dr Reece—Yes, because opiates suppress the immune system. So if you block the opiates you
kick it up. It is the same with stem cell activity and cell growth. Opiates suppress cell growth. By
blocking out suppression of cell growth you improve cell growth. It is the same with the
cannabis blocker, called rimonabant, that my submission discusses. I will mention that briefly.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 35

CHAIR—This question is a bit out of left field: when older people get pneumonia, doctors
administer morphine to stop the pain but they know the person is dying. Does this also have the
effect of stopping any repair work going on, or is it too late for that?

Dr Reece—It would. And you are right, it is too late. In the last days of your life, it is over.
The battle is lost, so you stage manage it as peacefully and calmly as you can. If I were in that
situation, I would be more than happy to have morphine. That is a palliative use of medicine,
which is different.

This slide shows self-mutilation. This figure refers to psychiatric illness. It would be old news
to this committee that psychiatric illness is a big issue in addiction. What I really want this
committee to understand and what I would love for this committee to help me get out to the
Australian community is that psychiatric illness is predictable based upon what we know of the
biology of these drugs and the damage they do to the brain.

There are dozens of pathways that addiction changes in the brain. The same areas, the same
cells, the same receptors, the same pathways and the same intracellular transduction mechanisms
cause psychotic illness. The limbic system of the brain is involved in memory and mood.
Addiction involves the same receptors, the same pathways, the same dendrite ends and the same
transmitters. Doctors overseas regard this is as ‘case over’. They do not even discuss it. In
Australia, we pretend about the psychosis link and pretend that there is not enough evidence. In
America, at Johns Hopkins Medical School, they know this. We are way behind. Of course, the
community is as confused as our policy makers.

This slide compares cases and conditions. There are more psychiatric cases—more psych
patients—in addict populations than non-addict populations, and addicts have more psych
diseases than the non-addicts.

This is an old graph showing antidepressant subscribing in the community. I had those figures
on my hard drive, so I just popped them in. The committee would know that there is lot of
antidepressant use in Australia.

CHAIR—Do antidepressant drugs also suppress the immune system?

Dr Reece—No. Ms George, this graph shows a statistical association between dental damage
and mental damage. They are associated. No-one knows why. We believe that it is probably
because there is a stem cell defect involved in both, but we have not done the science. We would
love to do the science. One of my main messages to the committee is: please help me to do the
science.

This is patient is only 23 years old but he is 50 per cent grey. It turns out that hair greying is a
stem cell defect. This is in the accepted literature and refers to all patients. At the age of 23
years, this patient is 50 per cent grey. That is one of the first things that triggered my interest in
this area.

Ms GEORGE—I know some people who have gone grey prematurely and who have not been
addicted to drugs.

FAMILY AND HUMAN SERVICES


FHS 36 REPS Tuesday, 3 April 2007

Dr Reece—That is right.

Ms GEORGE—So you take one case and build—

Dr Reece—No. We have done the statistics. This is published and so this is not on a restricted
file.

Ms GEORGE—How many people?

Dr Reece—About 400. This graph shows my medical patients and this one shows my addict
patients with greying at both the temple and the vertex. The alter ratio at the vertex is about six
and at the temple it is only three. So they are much greyer on top. This is what I am saying: they
have a generalised defect in stem cells across their scalps—not just at the temple like me. What I
think is happening is the whole body is growing old. When you go to Matthew Talbert hostel
that is what you see. That has been published in one of the world’s leading dermatology journals.

This slide shows the arteries. You know about hardening of the arteries. We have talked about
stroke and heart attack before. This is a study in mice from the National Institute of Health—one
of the leading labs in the world. The YPE on this slide shows a young rat at 50 days old. If you
give it phenylephrine, which is an amphetamine, stimulant or speed, the stain that you see in this
picture starts to look like the stain in this picture. You can reproduce the old phenotype in the
young rat by giving it speed. I warn you that a heroin addict withdraws three or four times a day.
That is why they have three or four shots a day. They are in withdrawal three or five times a day,
so that happens three or four times a day.

CHAIR—What is it that happens?

Dr Reece—They are hardening their arteries.

CHAIR—What is the causal effect of that?

Dr Reece—Probably adrenalin overdrive from the stimulant use of amphetamines or cocaine.


Heroin and cannabis users go into this hyper-adrenalin state withdrawal three or four times a
day. So, although they are on depressants, three or four times a day their system gets out of
control because of the effect of adrenalin.

This data from Johns Hopkins Medical School is similar. This slide shows their population.
The case on the left is control. The next is cocaine, then HIV and then HIV and cocaine. That
graph is measuring calcium in the coronary arteries, which is hardening of the arteries.

This is the system that I use. There are three schools in Brisbane using this system. I am one;
the others are the PA and Royal Brisbane. This is called the sphygmocor system; this is the world
leading system to measure hardening of the arteries. You have heard about hardening of the
arteries, you know that your arteries get harder as you get older. This is the way you can measure
it. You can calculate a biologic age. In vascular surgery there is an aphorism that you are as old
as your arteries, so by measuring the age of the arteries, we can tell how old patients are.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 37

This is what I was saying before about the female specific damage of this problem. Males are
on the left, females on the right. This is addiction. Gray is the expected age, what you would
expect, blue is the control and red is the addicts. So the male addicts are getting old quicker than
you would expect—this is the best system in the world for measuring biologic age—and there is
the same thing in females. That is the expected age, and in females this affect is much more.
That is 7½ years in females; this is about two years in males.

Then you look at withdrawal. In the males, the withdrawal figure goes up and the female
figure goes right up here. This is nearly 50 years gain in age. This is a restricted slide.

CHAIR—So are you saying that the withdrawing is very damaging in itself?

Dr Reece—Yes.

CHAIR—And that is because of adrenalin?

Dr Reece—Yes, and other things. It is also immunosuppressive.

CHAIR—We suppress the immune system and we have upped the adrenalin—

Dr Reece—And we have turned off the stem cells; we are making their cells old. We are
causing arrhythmias in the heart, and that is very bad.

This is paired data. This is taken when they withdrew. Males are on top, females on the
bottom. These are the same patients studied in addiction and in withdrawal. So this is in
withdrawal, and you can see that in general it drops. These changes are significant. They are the
same patients studied, and you can see there is a significant drop across there and here. These are
P values down here—remember I said less than .05 are significant; they are all highly
significant—and in females the effect is also highly significant.

This is amphetamines. Remember what I said about adrenalin on the blood vessels? Again you
can see on the chart that that is the expected age, that is the age in amphetamine addiction. Down
the bottom I have done a similar thing—the calculated age is on the left and, under
amphetamine, their reference age is on the right.

This is the index of sudden death. This program that I use puts out 100 outputs about what is
happening in your heart, 100 statistics. One of them is blood flow to the conducting tissue that
makes the heart beat regularly. This data shows that in males this is the danger zone; this is
where you are at risk of sudden death in males. In females the sudden death zone intersects the
average! So in this younger group, half of the women are at risk of sudden death. One of my
patients is 23—a scrawny girl with a body mass index of 18, as skinny as a stick—and she is
way down there, at risk of very sudden death. You would never pick it because the traditional
cardiac risk image is the big truckie who eats too many meat pies. That woman is the opposite
and she is at risk of dying like that, thanks to drugs. This is very worrying data.

This is stem cells. We are the first group in the world to measure stem cells in addiction. That
is the normal drop in your major circulating stem cell that occurs with age. In addiction, it looks
like that. That is a very different picture to the message that most Australians hear—‘You can

FAMILY AND HUMAN SERVICES


FHS 38 REPS Tuesday, 3 April 2007

take drugs if you want, it’s really not that bad’, the soft trivialised message. This is terrible. That
is the normal drop in the vascular stem cell. It is the vascular stem cells that heal our arteries. We
have talked about hardening of the arteries; these are the cells that keep those arteries soft and
pliable. They drop, of course, with age when all of your stem cells go off, but look at what
happens to the addicts, in red. The New England Medical Journal says that is the leading
predictor of death, and it is so low it is ridiculous. I urgently want this country to initiate formal
scientific study of these problems. All addictive drugs block cell division. That is quoting the
Dallas Group in Texas, one of the best authorities in the world.

This is a list of the diseases of old age, virtually all of which are described in addiction. Then
there is cancer. This is very damaging data. This study is of mice. It shows fusion of the end of
chromosomes, ring chromosomes and multiple chromosome translocations—double and
quadruple and ring chromosome translocations, which are associated with ageing and cancer. I
showed this data, these slides you are seeing now, to one of the leading cancer research scientists
in the world—

CHAIR—Go back to the previous slide, where you talked about ‘telomeres’. They have been
the subject of news in the last few days. People have identified what proteins make up the
telomerase, which feed cancer cells. Is that right?

Dr Reece—That is very close.

CHAIR—That has been heralded in the media in the last few days as a great breakthrough
and very important. Could you then explain a little more about the importance of those because
we cannot live without them, apparently, either?

Dr Reece—I would love to tell you—it is a great story; it is fascinating. As you know, we
have 46 chromosomes. The ends of them are very important. It is like a family. In any family, we
look after the little ones and the vulnerable ones. It turns out that the ends of our chromosomes
are vulnerable. The reason is that inside every cell we have lots of DNA repair mechanisms.
They repair DNA. If you go shopping and you see a little kid running around, lost, you are going
to ask, ‘Are you okay?’ Our DNA repair mechanisms are like that. If they see the end of a
chromosome flapping in the breeze, they will go over and grab it and try and fix it. They can fix
it in the wrong place. The end, the protection, the covering that is over the chromosome is a very
complicated subject but it is very important.

Let me explain the way it works. The ends of chromosomes cannot be replicated by normal
DNA replication mechanisms that make the proteins that make your body. Therefore, with each
round of cell division, the DNA, the chromosomes, get a bit shorter. It is called the telomeric
theory of ageing. The telomeres get shorter. It is called TTAGGG—that is, thymine, thymine,
adenine, guanine, guanine, guanine. That is the six-fold repeat that goes on lots of times. Mice
have up to 400 Kb of them. People have up to 50 Kb. So mice have long telomeres—the
protecting bit at the end—and we have short ones. Because it gets shorter each time the cell
divides, you can run out of telomere. This can create a crisis in the cell. The DNA cannot divide.
But the ends are vulnerable. They can get repaired but if they get stuck to another chromosome,
the wrong chromosome, this causes cancer. It causes chronic myeloid leukaemia and other
cancers such as breast cancer and brain cancer. This is called the telomeric theory of ageing.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 39

In CML, in chronic myeloid leukaemia, you have a growth, and the Philadelphia chromosome
shows this—the things that make the cell grow—tagged to another chromosome, where it stops
the cell dying. So the cells grow but they never die, whereas normally in the body all the white
cells produced all die. If you stop them dying, that is why there is leukaemia—we need to
control this. That is the genetic fingerprint of cancer—of telomeric damage, which is cancer.

This is terrible data. When I showed this to one of the leading cancer researchers in the world,
who works in Brisbane—we have just put in a NHMRC grant together—he was absolutely
horrified. And yet we are told there is nothing wrong with using cannabis and soft drugs. That
message is not true. This is the telomere.

This is the data on gene toxicity. This is looking at chromosomal translocations. Chromosomal
translocation is a massive genetic damage. It is massive. It is a bit like the Hiroshima bomb. It
did not just tap on the door of a house in Hiroshima; it wiped the place off the map. So this is
measuring chromosomal translocations. The controls you can see there in yellow are saline and
DMSO, standard lab solvent. On the right is Mitomycin C, a cancer drug. It is too toxic to give
to patients so we give it to cells in culture. But three cannabinoids—THC, cannabinol and
cannabidiol—tested in this assay as positive as the positive control.

CHAIR—So you are saying that cannabis destroys chromosomes much worse than other
substances that you have on that—

Dr Reece—Than saline or DMSO, which is standard lab solvent. So cannabis is a very potent
gene toxin and is a huge worry. Yesterday, I saw a kid I had never met before. He was about a
week old, and he had no hips. Dad was a heavy pot smoker and he said, ‘Oh, it just happened.’ I
said, ‘No, it didn’t. This happened because, likely, the cannabis you’re smoking and that you’ve
been smoking throughout pregnancy is a known gene toxin.’

Another of my patients has a five-year-old boy with brain cancer. It is likely the same process.
I was speaking to a bunch of mums in a knitting circle one day and I was talking about this. And
this mum puts up her hand and says, ‘My grandson has got translocation of chromosome 7. He’s
seven years old and he can’t feed himself and he can’t talk. His father is a heavy pot smoker.’

I will talk about this in a moment. This is called the Barker hypothesis of ageing. Just say we
have a young lady sitting here who is pregnant, and she is poisoning her body with all the
poisons she can put into it. That is not doing the little baby developing inside her any good. You
could have me here all day talking about toxicity. You could aggregate all the changes and say
that they are degenerative changes, they are deleterious changes and we’ll call that ‘ageing’. But
think about it. You are all computer literate; you know that ‘garbage in equals garbage out’. Let’s
say I get an egg and a sperm together and they are both damaged—we know that the two
zygotes, the gametes, in addiction are damaged—and we form a zygote, a baby, a lot of times it
will not be viable; it will just die. But if it continues to develop, how can ‘garbage in’ equal ‘It’s
fine, there’s not a problem’ when you are talking about genetic damage on a neutron-bomb
scale? It cannot. If we allow these lies to continue in this country, we are going to have a whole
generation who are going to be like this.

I was talking about sperm. I was saying that some of that other data were from mice, but this
slide shows controlled human sperm. Look carefully at the nuclei of these things. Some of these

FAMILY AND HUMAN SERVICES


FHS 40 REPS Tuesday, 3 April 2007

are tails without heads and heads without tails. And that is a white cell from inflammation in the
prostatic fluid. But this nucleus is not the normal nucleus of a human sperm. And yet this subject
is largely not investigated. The UN advises that there are 180 million cannabis addicts
worldwide—180 million!

I think we have a social responsibility to do the science. We are a first world country; we have
the scientists who can do this. They are bursting at the seams. They have just asked for resources
and they want to get into it.

Sperm makes babies. This is the Barker hypothesis of ageing in utero. The sperm of course are
stem cells and they are stem-cell progeny.

CHAIR—We hear a lot—we certainly did in our inquiry into work-family balance—that as
the average age of women having babies is pushed back the infertility question gets much
greater. Women have a finite number of eggs, which age, and what’s left is probably not as good
as what there was. Are you saying that if a woman uses drugs the ageing process of that finite
number of eggs is accelerated?

Dr Reece—I can say this: our evidence suggests it. Every time I interrogate the hypothesis
that addiction accelerates ageing, I hit paydirt; the test comes up positive. Every cell line that we
study shows evidence of ageing, and I am about to discuss it in cancer. The cell line you are
talking about is that of the ovum. That is a very different stem cell line. They do not divide. Stem
cells in general do not divide. It is their daughter cells that do the division. That is a terribly
important question, but there is no science, and my invitation to you as legislators and
policymakers is: please help us do the science. All we ask for is resources. I have 13 professors
in Brisbane who want to work—

CHAIR—So the answer to my question is: ‘unknown’.

Dr Reece—Unknown, probably because they are not dividing. But in every other cell line that
we have studied the answer seems to be yes. I have seen it in half-a-dozen different tissues now,
so I think the answer is yes, generically.

Ms GEORGE—In regard to this evidence you are presenting to the committee today: have
you had a peer review, an assessment, of your work? Do you publish in medical or scientific
journals?

Dr Reece—Yes. The stuff on teeth has been accepted. It will be out soon in the Australian
Dental Journal. The stuff on hair I showed you has already been published in the Archives of
Dermatology of November last year. That is a leading American journal.

Ms GEORGE—And what about the other, on chromosome links—

Dr Reece—That is not our work. That has already been published; that is in the literature.

Ms GEORGE—So you could send the committee some references to your scientific and
medical publications, and on the peer review and assessment?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 41

Dr Reece—Absolutely.

Ms GEORGE—You can refer us to it.

Dr Reece—You have a lot of data there; you probably have too much—

Ms GEORGE—I am not a scientist, but a sample group of 400 people does not necessarily
tell you very much.

Dr Reece—Four hundred is pretty big for addicts. But you are right—more science needs to
be done.

Ms GEORGE—I need science.

Dr Reece—Yes, more science needs to be done, and that is my invitation: please, please help
us.

This is cervical cancer. As I said, I have medical patients and addict patients. As the top slide
shows, we give them a simple score. For instance, 0.5: I ask them, ‘Have you had an abnormal
Pap smear?’, and if they say, ‘Yes’, that is it. ‘Have you had CIN1?’—that is a precancer of the
cervix 1—2, 3, and that is cancer. So that is how the scoring system works.

If we look at all the ages of our patients—because, obviously, the medical patients are older—
then there is more cancer in the non-addicts, and in the younger women, under 45, where the
ages are the same, there are still more addicts. But in all groups, the addicts have more cancer.
This is what is worrying me: in the addicts it seems to happen 10 years younger. See how that
curve peaks at about 10 years younger than that one? And that curve peaks at about 10 or 20
years younger than this curve? So, not only is your ratio here three times more cervical cancer,
but it is happening 20 years earlier. This effect is also not studied, and I think it needs to be.

This cuts to babies. This is published; you can find this yourselves. I can give you the title and
the authors—it is on PubMed. It was published in 1989. This shows that there is an 11-fold
higher risk of this leukaemia in the babies of cannabis-smoking human mothers. That is why the
sperm stuff is such a worry.

CHAIR—Where is that published?

Dr Reece—In Cancer, volume 63, page 1904, 1989. The Hansard reporter has asked for a
download copy of the slides—so you are welcome to have them. That 11-fold increase in risk
fits with what we are learning. The sperm studies I just showed you were published in 1999.

Over the last 10 years science has gone through a whole revolution—like the silicon chip or
the horse and cart—and the techniques of science today have not been applied to the hugely
important questions, especially as we have virtually 200 million cannabis addicts in the world.
My case to the committee today is that this needs to be done urgently and it needs to be linked
with appropriate community education programs.

FAMILY AND HUMAN SERVICES


FHS 42 REPS Tuesday, 3 April 2007

Addicts cannot sleep—all chemical addicts cannot sleep. See the little mouse on the top right?
It has a derangement of its sleeping system. It is called circadian system derangement. Like any
chemical addiction, the last thing that will be right will be the sleeping system. The death rate is
very high; the body size is lower and the body weight looks small. All the organs are low, the
muscles are thin and wasted, as happens in the old, and the immune profile is different—like old.
The whole circadian thing is a big issue in our patients.

Turning to addiction and grief, this committee would know, having listened to as many
testimonies as you have, that there is a huge psychosocial dimension to addiction. It is not all
science. One of my patients said this to me a few days ago: ‘I feel really bad because I have
stuffed up my life.’ Drugs were just the smokescreen. This grief, this heartache, this heartbreak is
a huge factor with addiction and a primary cause of relapse—they cannot cope with stress other
than getting blotted out. In the old days they would go out and get drunk; these days they have
other stuff. The management of grief in addiction is a huge issue. Personally, I do not believe
that you can challenge and defeat addiction in the long-term until you start to deal with this.

A child prodigy in America wrote this poem, which I think is completely gorgeous. It is called
‘Compassion’ and goes, ‘Do not repair, do not scorn and do not wipe my tears. Just taste them,
and they will dry up on their own.’ I have met only one person in the world who knows what a
diapason is. It is the bottom chord, the bottom stop, on an organ which sets the whole tone and
flavour. This little girl—she is 12 years old now—writes, ‘The diapason of disobedience is an
unreadable sphere; only the electricity of love recognises and cures the sin.’ The cause of grief is
love; the cure for grief, I think, is love in eternity. So in my clinic we speak the language of truth,
the language of science and the language of the heart—well, we try to, as best we can. And I
think Australia needs to start doing this to its kids because I do not believe that the kids of this
country are being told the truth.

The molecular pathways that need investigating I can detail and outline for you, if you like,
but I do not think this is the time or the place for that. The organ systems that have been involved
include all those ones that we have mentioned. When I say that addiction damages cell growth,
the cells we are talking about are largely stem cells because they are the ones that do the
growing. We need to study man; the mouse is the major experimental model. But it is a two-way
street. I am not just advocating for more research into addiction. If we understood why addicts
grow older faster I am sure we would learn something about why everyone ages. Obviously, we
would learn something about hardening of the arteries, and new ways to investigate arterial
sclerosis, osteoporosis, dementia and even cancer. In other words, this is providing potentially a
new way to understand and investigate all these things from a scientific point of view.

Obviously, this needs a dedicated research institute or a virtual institute. I have mentioned $50
million in my submission to the committee. I will tell you how this is done, by way of
background. One study of three pairs of postdoctoral fellows, which is about the size of a small
group in America doing research, on an average salary of $70,000 is $420,000 a year. On-costs
are about $30,000. Consumables are about $150,000. That is $600,000 annually for the study. If
there are 24 studies—and I will show you the list in a moment—over three years that is $43
million. It is quite small compared with the budget for harm minimisation. This slide shows the
lists of the studies of our research team in Brisbane. You have the list in your slides. They are the
extras. These are the 30 professors in Brisbane I have been in touch with, most of them recently,
who are keen to help me do good science that can be published.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 43

Point 3 of the committee’s terms of reference refers to the action plan—what can be done
next—and this is how I see an action plan. The trial is ongoing in Perth, as this committee has
heard. I was appointed by the RACGP to go and investigate that clinic back in 1998, and my
views on that clinic have not changed since that time. As investigating officer for the RACGP
Queensland, I thought the clinic needed to be replicated. I said that in my first letter to the
college when I reported back, and I still think that. It can be done in a research way. If we need
more research, that can be rolled out across the country, across the nation, as demonstration
clinics to create more options for these affected patients. Clearly, that needs to be supported
psychosocially.

We need the Addiction Research Centre of Excellence. It turns out that these questions are
being avoided globally by the research community due to the sort of soft drugs toxicology
approach that we have had, the sort of common myth. If Australia sets up this centre, which I am
arguing for, then we would lead the world in this area and I think we should. We have leaders in
Brisbane who just need to be galvanised with some funding to do the science we all want to do.

I have not talked much about rimonabant. I have a slide on that and I will come back to it in a
moment. I will talk a little more about education programs. I am worried about the information
systems in this country. As I said, 2005 finished nearly 18 months ago and we have just been
given the death data. I have been told that the YPLL data is three to six months away. That
means it is nearly two years. Why can’t we have our data back? The NCIS, the National
Coroners Information System, at Monash in Melbourne, have a very good turnaround for the
data on Victorian drug deaths—it is fantastic; it is one of the best in the country—but the same
school gives us a very poor service on our national data when that is where the data is housed.
So that needs to be looked at. Obviously we need to have the data at our fingertips so we can
make informed decisions.

I am worried about the statistics that come out from the National Centre in HIV Epidemiology
and Clinical Research. I have been getting their publications every three months for more than
10 years. Each month they tell me that there were about 100 new HIV infections in the previous
year, but a few days ago in the paper—and you have a copy in your folders—they said they were
expecting 1,000 this year. So I do not know what is going on with that and there is no way I can
really find out.

Now consider naltrexone. Naltrexone is an opiate blocker. It will reverse the effects on tissue
growth in all those cells. Most of those results have been examined and published, particularly
by the group in Pittsburgh. This is some old data of ours where we compared implants with
tablets—implants are at the top and tablets are at the bottom of the slide. We are very keen for
our patients to work. As you can see, it makes a huge difference to their outcomes. Social
support is very important and sport is important. Sport helps the brain regenerate. There are
dozens of mechanisms in the brain where physical activity and intellectual stimulation help the
brain recover. I think intensive sporting programs should be mandatory in every drug rehab
program in the country, just like in boarding school. Sport helps the brain get over this
devastating damage.

Because I am out of town today, I have been reading some basic science journals. One article
says that we should expect to see damage in the synapse—that is, where the nerve cells talk to
each other. The article says that the nerve cells talk to each other between the cells—not even

FAMILY AND HUMAN SERVICES


FHS 44 REPS Tuesday, 3 April 2007

where the synapse is but the glutamate. The transmitters leak out on the axons, between cells,
and of course glutamate is affected by all these addictive drugs. So not only is there damage in
the synapse but extrasynaptic trafficking information flow will also be disrupted by addiction.
Sport will reverse all this, so sport is a really big one. In the rehabs I have been exposed to it has
been underemphasised.

It is no secret that NA and all the spiritual programs have a big effect. This is a slide from
Perth. Professor Hulse may have told you that naltrexone interferes with the use of all other
drugs. I mentioned rimonabant a few minutes ago. This is the cannabis blocker. It is coming
from France to Australia probably next year. It is presently released in eight countries. It has
been marketed for weight reduction and tobacco addiction. If you type SR141716A into the
National Library of Medicine’s PubMed website, you will find a huge amount of literature.
There is intensive research on rimonabant. It was the first cannabis blocker identifier and it is
now being brought to market. But there are also studies that I have seen presented at the leading
cannabis conferences internationally that say that it interrupts cocaine, amphetamine, opiate,
gambling and food addiction and maybe cannabis addiction itself.

I know of good schools in this country that ask me: ‘Where can I find good web resources to
teach our kids on the subject of drugs?’ I have listed a few here. The good websites need to be
made available. We need to upscale our information program in this country, we need to start
getting some of this information out there and we need to do the obvious things that you would
do such as web based, interactive information programs.

What I have done here is look at the quality of cannabis education on our government
websites. I have gone to each of the state government websites and typed in ‘cannabis’, as you
would if you were a school student doing a project on cannabis. I have listed four, two, two and
zero for each of the states. They are the number of pages in their cannabis brochure. New South
Wales is the winner, with four pages. Three of the states had nothing on their internal websites.
In the US, if you do the same exercise at drugabuse.gov, which is the American site, you get 32
pages. I do not think that we are doing the best things to get the information out.

I will not go through this data in detail—it is in your slides, but it shows that cannabis is bad
for you. They did some education in America and in one year they got the cannabis use rate
down among teenagers by 21 per cent—just with effective public education. That is fantastic. I
do not believe that harm reduction supporters tell the truth to the community. I do not think that
we should minimise the truth. In general, we need to give the truth a voice. We need to give it
legs.

In your handout, there is an outline of the talk. On page 2 of your folder, there is an email
from Trevor Grice, who is a world author. He has been in the Frankfurt Book Fair. He is an
educator in this area. He is discussing in that email in that blue part at the top a major turnaround
in what we know about drugs globally. If you turn the page, I have some detailed sections about
drug death statistics year by year, which we have been tracking with the ABS for many years.
After that page, you will see the data that I have mentioned about stem cell defects and
hardening of the arteries.

I have something that someone sent me a few days ago—obviously, I have an interest in this
area. It is titled, ‘Truckie chronicles his own death by making a video of his decline.’ On page 2,

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 45

I have highlighted the fact that his father thought there was a 70- to 80-year-old man on the
inside of his 34-year-old body. My data now proves that for the first time in the world.

Ms GEORGE—What is the significance of the email subject, ‘The Jews are never going
quietly again’?

Dr Reece—No. That is an email that someone sent me which I sent out. It is the blue bit at the
top that I am referring to. That is from Trevor Grice.

Ms GEORGE—Can you explain that?

Dr Reece—Trevor Grice is the world authority. He has published a book called The Great
Brain Robbery. He is from New Zealand, and wrote that with an educator. That book came out
seven or eight years ago. It is updated continually. It is marketed around the world and he is in
touch with the best people from all around the world. In the email, he talks about the big change
in Britain—as you know, cannabis was down regulated in Britain. Yet the authorities and some
of the leading people who opposed that down regulation have now come out and said: ‘I’m
sorry, but you were right.’ We have seen it through cannabis psychosis and other things. There is
a big intellectual change happening now in the UK. That tells that story, along with what is
happening around the world. That is a very tight email. It says a lot—the blue bit. Just white out
or ignore the black bit. You do not need to see that at all; that is irrelevant. The blue bit is what is
of interest.

Ms GEORGE—So why is this in our folder?

Dr Reece—Because I printed out the whole email.

Ms GEORGE—So it has no bearing on—

Dr Reece—Please, put a big mark through it. If I had had weeks, you would have a beautiful
gilt-edged thing.

Ms GEORGE—Okay.

Mr CADMAN—Why is this Swedish system working?

CHAIR—Can you take a seat at the table now, Dr Reece. I do not know about you, but I
might be suffering from information overload. That was a fantastic presentation. You certainly
show that you have an extraordinary knowledge of the subject. There are some questions that I
have asked along the way that show that I am very interested in this theory that addiction hastens
ageing. It seems to open up a whole new area of inquiry which has not been investigated before
and which is important. My colleague, Mr Cadman, just asked a question that also occurred to
me. Could you answer his question about the Swedish model? Does it reflect any of that
information that you have given us here today?

Dr Reece—You will see that the Swedish model was mentioned on the education slide. I
believe they have done a fantastic job.

FAMILY AND HUMAN SERVICES


FHS 46 REPS Tuesday, 3 April 2007

CHAIR—So that we all have the background, why don’t you tell us about the position in
Sweden—how they liberalised, how they changed their minds and what has happened?

Dr Reece—Sweden is known globally as having a very liberal culture on most issues—I think
we all know that. So back in the mid-sixties—I think it was 1966—they decriminalised heroin
and it became widely available. But what happened subsequently was that the situation
exploded. In the following year, as I understand it—in 1967—they had to repeal the laws and,
instead of having the softest laws in Europe, they had the most stringent. What happened
subsequent to that—and it has obviously been a work in progress—is that the subject I am
discussing today, the toxicology of addiction, is taught in every subject in school. It is integrated
into maths, social studies, reading and English. That is on the education slide, which I can find
for you, if you like. It talks about integrating it into their school subjects, providing information
on websites, which are informative—including the photos I have shown—and about it being
interactive so the kids can get involved.

Trevor Grice from New Zealand has been negotiating with the American ambassador in New
Zealand and, I understand, some diplomatic people in the US. He would like to set up an
ANZAS type treaty for research between Australia, New Zealand and America. They have some
very good epidemiological researchers in New Zealand. They are the ones who study all this
stuff at the population level. That is how it is. He has interactive websites which are great. There
are cartoons, factories, chemicals in the brain—it is heaps of fun for the kids, but they learn it
and get the message. You saw the slide I presented from America. Their success against cannabis
just in one year, with widespread public education, is absolutely legendary, of course, and
deservedly so.

Mr CADMAN—But there must be more than an education program. There must be other
elements to the Swedish—

Dr Reece—It is an ethic in their community, and the schools are reflecting, I think, that this is
dangerous: ‘Don’t go there; we went that way; we tried hard and it went terribly wrong and blew
up in our face.’

Mr CADMAN—So do the rest of us have to crash before we come back to this?

Dr Reece—That is what I am worrying about now, particularly with HIV seeming to be taking
off. In Uganda they pulled up when 50 per cent of their adults were HIV positive. At what point
do we do a reality check? Every scientist I show this to—as you can see, they are the top
cardiologists, the top neurologists, the top brain researchers and the top cancer researchers in
Brisbane and not just Brisbane but Dallas and Los Angeles as well. You will see in your folders
that you have input on the project you are referring to from the world leaders—the leading
addiction toxicologist in Dallas and one of the leading ageing guys in Louisiana at the NIH NIA.

CHAIR—Can we go back to the hypothesis you had right at the beginning, of the connection
between HIV and drug taking. There seems to be no doubt about it: HIV is again on the increase
in Australia. There also seems to be an agreed position that the Grim Reaper campaign was
successful. It literally scared the living daylights out of people and into behaving in a way that
did not put themselves at risk—or made them less at risk. But that was a long time ago. We have
a whole generation of people who have grown up since that campaign and who would never

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 47

have heard of it and never seen it. Therefore, they would not have the memory of that message.
That could be one reason why it is on the rise again. If we go back to that campaign, there were
two things that stood out. One was that it was directed at the whole community. It did not
highlight that it was prevalent in this country in one genus of people, shall we say. It also
stressed the don’t-share-needles aspect, because it was seen that that was an avenue where HIV
could go from—from the homosexual group into the heterosexual community—and therefore it
was given much importance. That is my memory of what happened. So the needle exchange
program was introduced as a preventive measure for that, and it seems to have been successful.
But we seem to have gone on from there and to have grown that program of exchange into the
whole of the drug issue itself being no longer connected to the HIV question. So I was a bit
confused about you putting such emphasis on the growth of HIV and the needle exchange
program. Can you explain that to me?

Dr Reece—The terms of reference of your committee relate to harm minimisation within drug
abuse.

CHAIR—That is right.

Dr Reece—Conceptually it would be nice to confine discussion just to addiction—to the sort


of toxicology that I was mainly talking about—but because of HIV there is an overlap. I have
slides about sexual health, too, which do not give us a terribly good report card in that area.
What I am saying is that HIV was the justification for harm minimisation. You cannot discuss
harm minimisation and not allude to that. That is why it exists. So if that is appearing to escape
again—if we have an outbreak of HIV—in the post-education era, because the paper reported
and we have known for years that education is making this problem worse, where do you go? It
is important to remember that as a justification.

The reason for talking about syringe exchange is that I am simply trying to get it out of the
theoretical area, where I have got my view and you have got yours, into the measurable,
quantifiable area and study what can be studied. We can study deaths, we can study needles, and
we can study methadone. There are not many objective handles we have on the drug epidemic.

Ms GEORGE—But what you cannot tell us is what the incidence of HIV would be in the
absence of the needle exchange program and in the absence of condom use, can you? It could be
far worse, presumably.

Dr Reece—No, I cannot. But I am not arguing with the necessity. To be quite honest—

Ms GEORGE—I just found the correlation between condom use and the higher incidence of
HIV a bit mind-blowing. I am not quite sure what it was you were trying to tell us in that slide.

CHAIR—I think it was actually extraneous to what we are talking about.

Ms GEORGE—It was clear on the overhead.

Dr Reece—Ms George, my blood runs cold when I get a patient come in to see me and he
says: ‘I have just come out of jail, I’ve got HIV and I shared my syringe with hundreds of
people.’

FAMILY AND HUMAN SERVICES


FHS 48 REPS Tuesday, 3 April 2007

Ms GEORGE—Possibly contracted in jail.

Dr Reece—I don’t know. My blood runs cold.

Ms GEORGE—Sure. So would mine.

Dr Reece—I have got a patient sitting in front of me. I do not deny that the pragmatic thing to
do back in 1986 was what was done. What I am saying is: at what point do we draw rein? Two
things happened. Firstly, we applied the harm minimisation methods. But look at Australia in
2007 compared to 1987. The youth culture today is unrecognisable to what it was then.

Ms GEORGE—Yes.

Dr Reece—Can you see what I am saying? I am saying that harm minimisation protected and
sheltered our community—we have about a one per cent HIV infection rate, or whatever it is.
We have bought ourselves time, but the underlying behaviours are off the charts. I have got
slides here for warts and herpes. Those figures are terrible. We have some of the highest
incidences of those in the world. Warts got out of control. Herpes got out of control. Is HIV
getting out of control? I do not want to fiddle while Rome burns. If we have bought ourselves
time, what have we done with that time? It is what happened in Moscow and St Petersburg and it
can happen here. It happened with warts, herpes and hep C.

CHAIR—That was all a bit quick. It was very quick to go from needle exchange to Moscow
and St Petersburg. Basically I think what you are saying is that by the introduction of that
program and stopping the spread of AIDS we have brought ourselves into a false sense of
security, but that what was engendered underneath was a behavioural pattern which has got out
of control, which is potentially enormously harmful for the community at large.

Dr Reece—Yes, and the parameters we have now are quantifying that and we need to look at
that. The only reason I have brought them up is to quantify. It is very difficult to quantify all of
this. We have TV reports which are essentially anecdotal. We do not have that many measures.

CHAIR—Let me ask you this question. We are going to hear this afternoon from Dr Wodak. I
have read his submission and we will be able to question him on it. I was stunned when I read it,
because I really did expect him to dissemble more. But he is in your face. He is a pro drug
legaliser. It is in black and white.

Dr Reece—That is right. He has said it in lots of places. He is also the prime mover behind
harm minimisation. I am saying: if you looked at those—

Ms GEORGE—Can I intervene here? In the absence of Dr Wodak, I think that is a very


provocative statement that the chair has made. I have read his submission and I think what he
has consistently argued for is heroin trials. That is quite different to—

CHAIR—No. He goes much further than that. He talks about going the next step.

Ms GEORGE—Dr Wodak should be here. I do not think we should be talking about—

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 49

CHAIR—He is going to be here and will be able to answer it. I am saying: when we have
harm minimisation, which means so many different things to different people, and harm
reduction, some people see it as legitimate to have the aim of bringing people off drugs and have
a tough on drugs policy—which is the government’s policy—to reduce the supply of drugs and
reduce the number of people who go on them. That is the aim and that is called harm
minimisation to them because they want to reduce the harm to kids. We heard about Toughlove.
Of course people want to reduce the harm, but to other people this is the first step to the
legalisation of drugs. The Greens have come out and said it. How then do we run a policy that is
not one of mixed messages? How do we have a policy that is understood by young people unless
we start to tell them the things that will happen to them if they indulge? At the moment they
think popping pills is just fine, you can wash them down with whatever you like and dance all
night and that is the end of it. How do we go about devising a policy that lets people know what
the consequences are of what they do? On education to date, the Institute of Health and Welfare
tells us that only two per cent of people do not use drugs because of education, so it is virtually
meaningless. What do we do? What sort of programs do we run?

Dr Reece—Without the truth, you are going to get nowhere. You are all parents; you have
done this with your own kids. You have explained what you want them to do and you have done
your best to help them along the right way and to encourage it. You have to speak the truth with
compassion. That is what you have to do. And you have to be consistent. The kids in the
community have got the mixed message loud and clear that drugs are not that bad. I think you
could take the Swedish approach. You can say: ‘Hang on, psychosis is out of control. Jails are
full of all this stuff.’ New medical treatments are becoming available. There is Rimonabant,
implants and other new things. We have a new peril and whole communities are being decimated
by it. Harm minimisation runs under the scientific construct, the banner headline which is never
stated, that drugs really are not that bad: ‘give all the heroin users Narcan if they overdose; drugs
aren’t that bad.’ That is not true.

Ms GEORGE—I have never heard anyone suggest that. Of the exponents I know in the harm
minimisation area, I have never heard one of them say, ‘Drugs aren’t bad.’

Dr Reece—Yes, but that is the message that kids—

Mrs IRWIN—Might I just interrupt? I am the deputy chair of the committee. I have just come
from a function, so unfortunately I could not be here when you made your opening statement.
Would you say that you support policies that save someone’s life? We have to have policies in
place to save our young ones.

Dr Reece—Yes.

Mrs IRWIN—So what policies? I am sorry, Chair. I will most probably have to read the
Hansard. Do you support methadone, because it has been proven to save people’s lives?

Mrs MARKUS—It also kills people.

Dr Reece—We have had 957 methadone deaths in this country since 1997, when the ABS
started having details. I think methadone needs to be brought to account and I think there is no

FAMILY AND HUMAN SERVICES


FHS 50 REPS Tuesday, 3 April 2007

question that the methadone industry in general is not brought to account anywhere in the
country. There is no question of that.

Ms GEORGE—But do you see methadone treatment as the preferable alternative to young


people staying on heroin with all the associated legal—

Dr Reece—Nearly anything is preferable to drugs, but now new treatments are becoming
available. I am a doctor, so I speak from my medical background. It is no secret—everybody
knows it—that all that medicine has had to offer for almost forever has been methadone. That is
what treatment was. There is no question that that is one of the factors in our low HIV rate. That
has a role but, at this point, the way the establishment thinks is that methadone not only has a
role but is the be-all and end-all. In fact, a lot of people I know refer to it as vitamin M. It is the
end of treatment, not the beginning. Some people have suggested that it forms a step in
stabilising people to get them out of the culture, to get them out of the viruses and bring them
back to some kind of reality. It has a valuable use. Basically, in my clinic I use a lot of
buprenorphine.

Ms GEORGE—Isn’t it part of the harm minimisation strategy to try to assist those people
who are addicted to very severe drugs like heroin to use the methadone program? I am not
arguing that people ought to be parked on it—there are too many people parked on it—but that
other pharmacotherapies should be used.

Dr Reece—I would agree with that position. Exactly—there are far too many people parked
on it.

Mrs MARKUS—One of the challenges of the methadone program is that it is being used as a
way for people to detox, or to be stabilised and then reduce, but the other issues, the behavioural
issues and the social issues, are not being addressed. In many cases—not all—that is not
happening, so the underlying behaviour, the pattern, the lifestyle continue. Again, I would agree
with Ms George that they get parked on it, and that does not take them to a place where they can
have a healthy lifestyle. We have seen some of the health impacts of that.

Dr Reece—Their own figures show that 70 per cent of methadone patients also have to be on
benzodiazepines—valium, xanax, that sort of thing—which are devastating. This stuff all causes
gross weight gain. You would probably be aware that one of Australia’s leading health crises is
our aging population and the other one is our weight gaining population. I have a problem when
the methadone industry stand up, fly the flag, and say, ‘We put our patient in the nursing home;
he is still on methadone after 30 years’. That is success? Why doesn’t anyone ask: is he in the
nursing home 20 years too soon because of methadone? Why doesn’t anyone ask: do his other
associated pathologies have anything to do with the treatment he was given? I am not arguing
that that was not better than heroin, but it is this parking thing. Where the methadone becomes
an end, I have a problem.

Ms GEORGE—But isn’t it part of the problem that the only opiate suppressant that I know,
naltrexone, is not yet at the stage where it can be made widely available through the implants
and there is still a lot of research that needs to be done in terms of its efficacy. Once it gets on to
the market, people will have a range of different alternative treatments in trying to break their
addictions.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 51

CHAIR—There is a whole industry out there of people making money out of methadone who
do not want to see an alternative.

Dr Reece—Yes.

Mrs IRWIN—There is also an industry out there making lots of money out of naltrexone
implants, too.

Dr Reece—No, that is not right. I can’t accept that. But Ms George, to your point, naltrexone
was synthesised in 1963, 43 years ago. It was first used clinically in 1973. It is a middle-aged
drug, by any call. Everyone who has investigated the Perth program is impressed with their
outcomes.

Ms GEORGE—Including me.

Dr Reece—I am not saying there is not more research you could do. I would love to use those
implants and do research—I would just love to. I think it is something we should do. But if I am
right, we do not just have, as Mrs Bishop said, AIDS increasing again; we have it increasing
again in a post-education era. She is right. We have not re-run the grim reaper campaign, or
whatever, in its 2007 incarnation; that is true. But if we are at a cusp—we lost the hepatitis C
battle, we lost the warts and herpes battles, we are losing the Chlamydia battle—do we do what
Uganda did, and wait till 50 per cent of us have HIV before we say, ‘Maybe we should do
something different’? Yes, they have more research, but why does it have to wait in Perth?

Ms GEORGE—So what is your solution to that problem? That is what I don’t understand.
You tell us what the problems are—and the rising incidence is of concern to everybody. But
what else should we do? You are not in favour of needle exchange?

Dr Reece—I just explained to you, ma’am. When my patient comes out of jail with that story,
I am devastated. I am saying, if you want more research, we exist in a real world. This is not a
theoretical discussion. There is stuff happening out there that we all want to stop. If you want
more research, fine.

Ms GEORGE—No, I am asking you what your solution is to that problem.

Dr Reece—Roll out the research in Perth around the capital cities in appropriately
credentialed clinics to complete the research and deliver service at the process. We know enough
now to say, ‘This is safe. We used them in Queensland. One of the big problems we have in
Queensland is that they come from Perth. So we have a logistic problem. When the patient needs
the next implant, they can’t have one. We have to do buprenorphine and it all gets terribly
complicated and you have to book a flight to Perth.

Ms GEORGE—I see.

Dr Reece—That would fix the logistical problem, it would fix the crisis dimension—HIV is
taking off; they have had the education, they are not listening. It would fix service delivery
issues, it would fix research issues and it would do what Australia needs done, which is to get on

FAMILY AND HUMAN SERVICES


FHS 52 REPS Tuesday, 3 April 2007

with the job and provide an option. A lot of my patients are just bored with taking drugs and they
cannot get off them. So that is a big part of it.

The other thing is to work with the company with rimonabant and do the things I said in my
suggestion: get the cannabis blocker here; roll it out. You guys are the policy makers. You are the
rule makers. Put all the roadblocks aside. This research is crying to be done. Let’s do it. Let’s
make it a priority. Let’s put it on the front foot. Let’s go for it.

CHAIR—So you are saying that, with naltrexone, more research can be done on it while it is
actually being used—that there has been a sufficient amount done that has declared it to be safe
and therefore it can be used.

Dr Reece—Yes.

CHAIR—And you are saying that, with the cannabis blocker, there has been sufficient
research to allow the TGA to approve that and for it to be used here in Australia and for more
research to done as well—yes?

Dr Reece—Your comments about naltrexone I would agree with. If they want more research,
there is no reason why that research has to be confined to Perth. There are good professors in
other cities, especially Sydney. We all know Sydney has—

Ms GEORGE—I thought they were doing the first trial ever under the auspices of the
National Health and Medical Research Council?

Dr Reece—Yes, they are.

Mrs IRWIN—I think Westmead Hospital as well.

Dr Reece—No, because John Curry is in Melbourne now. He is a professor in Melbourne; he


has moved. But all these issues can be dealt with. There is no reason to limit the activity to Perth.
Everyone knows there is a drug crisis in Carlton and a drug crisis in Cabramatta, so why is the
research being done just in Perth, particularly if we have this other crisis looming? So I think it
can be rolled out. I think education needs to be ramped up. What is going on is Australia is that
we almost have a propaganda of silence, a cover-up of silence. That can be ended forthwith by
appropriate education programs. Why don’t we have fabulous websites, where kids can play
with things like cartoon characters, learn about it and have fun? Why don’t we do that? Why
don’t we write to every principal in the country so that they all know where there are good
websites, so they all know where the reliable data is, and fix the disgrace I just showed you? The
states have zero, two or four pages of cannabis information on their websites. The US have 32.
There is no reason to allow that to continue.

CHAIR—But the first thing is that there are a whole lot of people out there who are actually
pro cannabis. They want it legalised. They want to be able to use it. We as a government have a
policy that says we are tough on drugs but we want zero tolerance, which includes the use of
harm minimisation in the way I described it earlier, by protecting kids and keeping them alive
while you are getting them off it. But the aim is to get them off drugs and return them to normal
life, not say, ‘Well, the war on drugs has failed; therefore, we’ve got to legalise all drugs.’ It has

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 53

not failed at all. Most people do not take them. It is more successful than many of the other laws
we pass. But, unless we can overcome the voice that says, ‘Drugs are okay and they’re here and
you’ve just got to learn to live with them,’ we will never get a proper roll-out of a policy that
says ‘this is bad’. We got the roll-out of an HIV campaign because we all agreed HIV had to be
stopped. We have a strong antismoking campaign because there is a big body of opinion that it
adversely affects people’s lives. But with this we have a whole body of people putting their
hands up and saying, ‘No, drugs are okay.’ So how do we beat them?

Dr Reece—There are two points in answer to your question. The first thing is that we can
only start from where we are; we have got nowhere else to start from. Thank God we are not
where Uganda were when they got the message. Second, it has to be, like you said, as it was
with cigarettes and HIV: everybody knew. It is a tsunami. Everybody—

CHAIR—But there was an agreement that this was bad.

Dr Reece—Yes, I know. That is right.

CHAIR—There is no agreement here. There is a body of people who want drugs and say it
publicly. They say, ‘It’s okay; you’ve all got to learn to live with it.’

Mrs IRWIN—Have you looked at studies overseas and what other countries are doing, like
Switzerland?

Dr Reece—Yes. I have been to 16 international conferences.

Mrs IRWIN—They have got some excellent programs in place.

CHAIR—Sweden.

Dr Reece—Chair, the answer to your question is partly this: in this country, there are no basic
science experts doing research. There is no-one reading this and publishing this in that context.
There are a lot of people spilling a lot of ink on a lot of parchment to say there is nothing wrong
with drugs. No-one is applying the science. The government spent $20 million—

Mrs IRWIN—Well, that is what I think we would like: scientific evidence.

Dr Reece—That is what I am arguing for. The government spent $20 million on stem cells in
Brisbane, $200 million on stem cells in Melbourne and $3,000 million on depression nationally.
The government has the ability, through generating the right science, to change all this and, in
fact, deal with this issue that you are talking about, this establishment view. It is not the ordinary
bloke in the street who thinks that. The ordinary bloke in the street in Cabramatta or Kings Cross
is worried sick. It is the experts. My message to government is that there are no real experts in
this country. So I just do not want you to make someone a professor of whatever wherever; I
want you to create an industry where a young person has a future by doing that science, and we
could lead the world.

Think about it. Why am I so motivated? It is very simple: I have kids. The oldest is 18. One
day I will have grandkids. And if my kids do not get consumed by the addiction epidemic, the

FAMILY AND HUMAN SERVICES


FHS 54 REPS Tuesday, 3 April 2007

grandkids will. The only way to protect my children is to protect their friends. The only way to
protect their friends is to protect all the kids, and the only way to do that is to tell the truth. And
if I tell the truth, I may as well tell it globally. It is like cigarettes and the lung cancer thing:
when everybody knows the facts there is no debate. The only reason we are even having this
discussion is because there are no experts in this country who understand that science. That is a
disgrace which your government has the ability to correct, and must do so urgently because
some of those studies indicate so much. You are talking about the effect of drugs on ageing—you
could study that. You hardly need cash. Get a bunch of mice, six cages, cannabis, alcohol,
opiates, cocaine, amphetamines and the controls, and see who dies first.

Mrs IRWIN—Dr Reece, I think we have some excellent people in this country who explore
this area.

Dr Reece—I am talking about basic science and research.

Mrs IRWIN—And do an excellent job.

Dr Reece—I have never seen one reference to any of the leading science journals in any of the
writings, and I have read everything Wodak wrote after 1999, when I wrote my review on
naltrexone and furnished it to the Australian—

Mrs IRWIN—I have a great admiration for Dr Alex Wodak. He has saved so many lives and
helped a lot of people get off their addiction. I gather that you are a Brisbane physician
specialising in detoxification using naltrexone implants. I have also been to the Perth clinic. A
number of years ago we had a clinic that opened in Speed Street, of all names, Liverpool, in my
electorate. I was very impressed with it. It had to close down because of two deaths there, which
was very sad. How many deaths, that you are aware of, have there been of people who have
taken naltrexone or who have had naltrexone implants?

Dr Reece—That is an extraordinary question. Have you asked the same thing of the
methadone doctors?

Mrs IRWIN—Yes, we have. But I just want to get something on the public record from you,
seeing that you specialise in detoxification using naltrexone implants.

CHAIR—I think he specialises in a bit more than that. We have just had a very long
presentation on his work.

Mrs IRWIN—I just have this question on naltrexone because I am concerned about it.

Dr Reece—I find your question highly offensive. If Dr Wodak were here and I said, ‘Dr
Wodak, how many of your ex-methadone patients have died?’ do you think he would give a
quantifiable answer?

Mrs IRWIN—I think you would find that Dr Wodak would give an honest answer. Once his
submission is up on the website I recommend that you read it because it is an excellent
submission. I have no more questions.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 55

Ms GEORGE—We heard evidence before when we investigated naltrexone. I think you have
to commend this committee for giving the push along to get the research done on naltrexone,
which came out of one of our earlier inquiries. But there seems to be evidence that there is a
higher probability of death amongst people who resume their heroin habit after treatment with
the implants. It may be the same level of potential deaths as there would be from other drugs, I
do not know. Is there anything particular about that argument that you would like the committee
to be aware of? I have heard it raised that the likelihood of sudden deaths is higher once a person
stops using naltrexone implants compared to methadone and other pharmacotherapies. Is there
any substance to that?

Dr Reece—I am sure you would know of the recent paper in the Medical Journal of Australia
by Wayne Hall and Louisa Degenhart. That is a shocking paper. It verges on scientific fraud.
They went down to the NCIS at Monash in Melbourne and they asked all the cases from the
database I mentioned to you whether they had had naltrexone. They had five cases and they
reported to the Medical Journal. Only one of them may have had an active implant, but it also
had cocaine and phenobarb in the system, which could well have been toxic. Pretty much the
only drug which would not have helped speed the death along was naltrexone. So they had one
case and they misinterpreted it. To my eye the units used in that study and reported in the paper
seem wrong. We have always spoken about nanograms per ml of naltrexone. The units in that
paper were wrong. In fact, one author of that paper, Degenhart, is at NDARC. The second
author, Wayne Hall, is not a clinician. He is at the University of Queensland in Brisbane where I
am. I do not recognise the third author. None of them was a doctor. None of them has worked in
the area. It was a breathtaking article but there is no evidence about that. If you ask Dr Wodak—

Ms GEORGE—I will ask him, yes.

Dr Reece—Ask Dr Wodak this question on my behalf: if you have a methadone patient who is
struggling with drug use, what would you do? And the answer is restart him on methadone or put
his dose up. If I have a patient who is struggling on naltrexone, what would I do? I would
reimplant them or give them more implants. It is the same answer. It is not a comment on the
treatment. My problem in Brisbane is that the logistics make it difficult and that is what your
committee can help enormously with.

CHAIR—Dr Reece, thank you for giving us what was an enormously detailed presentation.
As I said earlier, the amount of information that you presented to us is almost information
overload. However, I think I am correct in saying that what you are asking of the committee is
that there be proper scientific studies on the effect of illegal drugs and what they do to the body
in the long term. We have adopted this policy for both alcohol and smoking, which are two legal
products. There is no scientific work being done on the long-term impact of illegal drugs on the
body. When you say 9,000 people died from illicit drugs in the nine years that you have been
taking the ABS stats, you are talking about people who took an overdose or whatever and died.
There could be a lot of people who died prematurely. You showed figures indicating that people
could have a life expectancy of 46 if they have been drug addicts and so on, which is hugely
important and has not been looked at anywhere that I am aware of and certainly you are aware
of. You would like that research to be done.

You would also like studies to be done on naltrexone, not just in Perth with the single grant it
has but across the other states, and for that analysis to be properly done and published

FAMILY AND HUMAN SERVICES


FHS 56 REPS Tuesday, 3 April 2007

contemporaneously with the implants being made. The third thing you want is work done on the
drug that would stop the effect of cannabis. The fourth thing is that we need to have a rollout of
an advertising campaign that is going to warn people what actually happens to their brain and
other parts of their body if they take illicit drugs. Is that a fair summary of what you have had to
say for us today?

Dr Reece—It certainly is.

CHAIR—I thank you very much for coming and for sharing that information with us. There
are slides that you have indicated to us that you do not want published. Could you just recheck
that with us so that we do not put them in the Hansard.

Dr Reece—Can I send you a DVD with the edited ones on?

CHAIR—That would be just fine. We thank you very much for coming and I take it that if we
need additional information from you that you will be quite ready to talk to us further.

Dr Reece—Of course.

CHAIR—Thank you very much for being with us.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 57

[12.44 pm]

GOULD, Dr Bronwyn, Private capacity

Witness was then sworn—

CHAIR—Welcome, Dr Bronwyn Gould. Do you have anything to say about the capacity in
which you are appearing today?

Dr Gould—I am the Chair of the Australian Council for Children and Parenting, but my
understanding is that the capacity in which I appear before the committee is that of a clinician
with diverse experiences involving children, young people and vulnerable people spanning 30
years.

CHAIR—We would be delighted if you would like to make an opening statement to the
committee.

Dr Gould—If the committee is happy, I will make a brief opening statement of about 10
minutes. Then feel free to ask anything, because I am not quite sure which direction you need the
extra input in where I can be of use. Thank you for the opportunity of being here. I am not here
as an academic or as a drug and alcohol professional or in fact as a researcher. I am here because
I have been working with kids and young people in a clinical role for 25 years in my clinical
practice, which means that I have seen the longitudinal spectrum of kids growing up. I have also
established and run a medical service for homeless women in a drop-in centre in Darlinghurst. I
have been working there for six years, and should have been there this morning. I am familiar
with children and young people in non-clinical ordinary settings as well through my role as a
Guide leader. I work on health and ethical issues with Rotary Youth. I am familiar with some of
the research and I understand the layers of complexity. I understand that alcohol falls outside the
terms of reference of this inquiry, but much of what I can say would apply to alcohol if one were
to extrapolate. I have read the transcripts online. I have read the submissions up there as of last
Sunday. I hope that I can add value rather than simply duplicate what you have already heard.

The first thing that I would like to talk about is that my experience suggests that mind-altering
drug use falls on a continuum. That is the finding of the Manly group as well. It ranges from
non-users, to experimental users, to regular users, through to what I would call problematic
users, who are the people that we would all call addicts. Regular users often float beneath the
horizon because they manage so well to cope in their ordinary day-to-day life. It is amazing how
many of those people are out there. It is not until the wheels start to fall off or relationships
wobble or they run out of money for cocaine that they present for treatment.

The impact and interventions for people needed at any stage of this trajectory are quite
different. What you might use for somebody who is an experimental user to help dissuade them
from continuing is quite different from what you would need in terms of resources and input to
work with somebody who had a problematic issue. There are some really well-known points
where there is much higher motivation for change in problematic users, and one of those is

FAMILY AND HUMAN SERVICES


FHS 58 REPS Tuesday, 3 April 2007

pregnancy. That presents a real opportunity to promote change in a longstanding way. It does not
always work, but it helps.

Turning to prevention, we are a society that reaches for a quick fix, and we wonder why our
kids and young people follow that philosophy. We use antibiotics, we use cold and flu tablets
when we have the flu, women of a certain age like hormones to help control our temperature—
we are used to using things to help change us. That is not a justification for using illicit
substances or mind-altering drugs, but it helps us understand part of the backdrop that kids can
grow up with. There is some really good research emerging. There is a paper which I will leave
here. It is badly printed. It is from this week’s Lancet. It is called Interventions to reduce harm
associated with adolescent substance abuse. It is an international paper put together by people
from Melbourne, America and Canada. It looks at the global issues. It is a lovely view of the
different stages of use.

What they talk about in there is that there are four main reasons for starting use, and that is the
bit we want to turn off. The really important bit is to turn off the starting. The four main bits that
they use really conform with what I have noticed in my clinical practice. The first group, and the
main group, are people trying to conform to norms—the peer group stuff. If a norm of a society
in the back lanes of Woolloomooloo is that everybody smokes dope, starting to smoke dope in
the back lanes of Woolloomooloo is part of conforming to a norm. If you are in an environment
where the norm is to drink or the norm is to go skateboarding, it is different, and that is the part
where social influences and legal sanctions can actually have some impact in slowing down the
starting rate.

The next main group that they describe are those of youth culture trying to individuate
identity. That really covers off the drugs that I call the drugs of experience, which can be called
all those other words that we do not use—but the ecstasy and the experiential dancing all night
and feeling amazing rushes fall within that category. That is a harder group.

The most difficult groups to work out how to prevent their starting are the groups who are
driven by escaping distress. Those groups of people whose motivation for starting to use drugs is
to escape distress are the groups that have even more long-term and harmful problems than the
other groups. They are often the people who have longstanding difficulties arising from
childhood and neglect and child maltreatment issues. I will give you quick examples from my
ordinary practice. There are two different ways and two interactions. The first one was with a
young man who was in his early 20s who I had looked after since I had diagnosed the pregnancy.
He was a kind of nervous chap, but a lovely young man who was artistic. He came in on a
Monday morning feeling unwell, with a whole range of problems. His dad had died and he was
wondering whether he had high blood pressure. We had bit of a chat and in the space of a
standard consultation I discovered that he had used ecstasy for the first time at the weekend. He
was able to instantly understand and we could put in appropriate education: ‘Yes, it might have
felt great at the time, but how did you feel on Sunday and how do you feel now? And these are
the other things about it.’ He has not used and will not use again, and it is very clear.

On the other hand there was one of my very vulnerable, high-needs, high-cost young people
who I saw for the department in New South Wales. She had endured 13 years of every sort of
abuse at the hands of all members of her family—both parents and siblings—before she was
taken into the care of the state, and that care was not very containing and life was very difficult.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 59

We were seeing her quite regularly and she was a very, very unwell little lass. She used to sit and
shake, and sometimes crawl under the desk in the surgery and just rock and say, ‘I need to be
safe.’ Then at the end of the consultation off she would go again with her worker. She rang me
one afternoon and said, ‘Dr Bronwyn, I’ve found something that really works.’ It was one of
those moments you never forget. I asked her what it was. ‘Oh, it’s better than counselling,’ she
said. ‘I don’t feel all shaky.’ It was obvious what it was: heroin. Somebody had given it to her.
She said, ‘And it lasts for a really long time—all afternoon.’ So she just had a patch of four
hours of feeling what she saw as being normal, something we had not been able to offer her any
other way. Of course, her path was quite different for a number of years, but she is now married
and mothering and drug free, and it is fine. But the two different people needed completely
different approaches to their initiating drug use.

I recognise that there is a real role for a high-profile campaign to increase awareness of the
substances and their risks as one part—I stress, one part—of a sophisticated change management
strategy. I think there are several areas we need to be really careful about before we embark on
something like that that would make us feel we were doing the right thing. My belief is that
children and young people believe and adopt ideas and practices suggested by their peers, their
magazines, Home and Away, Neighbours, Desperate Housewives, by whatever their current
identity is, or ideas that they have arrived at themselves that they believe through the process of
their own decision making. And they are much more likely to act on and incorporate that into
their way of being than preaching from grown-ups, especially from parents, which is often a
turn-off. There is also the danger of a loss of credibility. If we say, ‘You will get this, this, this,
this and this,’ and all around them they have got friends—if they are in that sort of a group—
who seem to not have their limbs falling off and whose brains are not fried, then what we are
telling them based on research does not resonate with their lived experience, and we could lose
credibility. So that needs to be addressed in part of the campaign.

Parents need a lot of help in these sorts of campaigns to help them understand how to work
with their children and young people, especially children and young people who have early signs
of anxiety disorders or anything like that, so that those children can be helped to find other ways
to deal with how they feel and other ways to make decisions before they are old enough to be
exposed to drugs and other things.

Obviously, any strategy that improves the healthy development of kids from day one onwards,
and includes social development as well, is actually part of prevention of drug use. But that is
easier said than done. There is a real role for alternative mood management and emotional health
strategies to be rolled out throughout schools in a really careful, well-thought out way. And part
of that would be drug education.

I turn now to a program that I am not involved with and have no income from—that is a
declaration. There is an innovative program in its infancy being designed by the group at
CRUfAD, which is the anxiety disorders unit, and they are particularly interested in web
dissemination of teaching and treatment. This is called Climateschools. They have done some
pilots and they have actually demonstrated a change in binge drinking in girls in schools. That
was very early days, but it is web delivered so it is inexpensive to run throughout schools in the
country. There are people that are involved: Professor Gavin Andrews, whom you may or may
not know. He is overseas at the moment but he would be the sort of person who would be happy

FAMILY AND HUMAN SERVICES


FHS 60 REPS Tuesday, 3 April 2007

to talk about how it would all hang together as part of a stepped program running over four or
five years. It is remarkably inexpensive.

CHAIR—What is the aim of it?

Dr Gould—The aim is to help young people to learn to make better decisions, to understand
mood states, arousal, depression, decision making and how to manage it, drugs and drug use and
alcohol and alcohol use. It is a series of modules.

CHAIR—With what aim once they have assimilated and got all that information?

Dr Gould—To prevent.

CHAIR—To prevent?

Dr Gould—Absolutely.

CHAIR—That was the word you left out.

Dr Gould—That is an assumption I am making. I am absolutely sorry. It is to stop them using.

CHAIR—With so much of the stuff we have, we seem to forget that word.

Dr Gould—I have got it all written down here.

CHAIR—Could we have a look at those?

Dr Gould—It is about preventing it. You would not even call it ‘harm minimisation’. You
would call it ‘prevention’.

CHAIR—Good word.

Dr Gould—How does that sound?

CHAIR—It sounds terrific.

Dr Gould—I think it is really important that children who have identified mental health
difficulties receive proper mental health treatment at the time people start to notice it, not when
they go off the rails, and that helps to prevent their risky use of substances to manage their own
emotions. What often happens is that because we have scarce resources, the resources and
services go to the people at the acute end rather than the severe end and there is a real difference
between acuteness and severeness. The kids that are acting up, the kids that are spray painting,
get a lot more attention—and they need it—than the child who has quietly got a crippling
anxiety disorder, and they are both equally unwell. That has a huge role in prevention of mental
illness and in turn drug use. The constant dilemma though is that it is always acute more than
severe. Headspace is another Commonwealth initiative that is a really interesting and one that
might help prevent a lot of drug use over time. Are you familiar with headspace?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 61

CHAIR—No.

Dr Gould—I found out about it last week in one of my medical journals and it is a really
interesting project with the Division of General Practitioners.

Mrs MARKUS—Is it federally funded?

Dr Gould—Yes, it is federally funded. They have one-stop shops with mental health, GPs,
drug and alcohol and all of those sorts of things under the one roof so young people can go in
and broach it in an environment where they know somebody is not going to fall off the chair. If I
went, ‘Oh my god!’ when somebody told me they used ecstasy or that they were thinking of
using it, I would not hear again. It is really important that the professionals are trained to
understand to be absolutely neutral and unshockable but helpful. But young people often know
when they are having difficulties.

CHAIR—So in being helpful, what are they meant to do?

Dr Gould—Direct them to something more appropriate. It depends on the situation and the
person.

CHAIR—If somebody comes in and says to you, ‘I’m thinking of taking ecstasy,’ how are
you going to be helpful?

Dr Gould—We will sit down and talk about why they want to take ecstasy. It has happened.
And then we talk about why, what they think is going to happen. Then we look it up, we go
through it together, we look at the downside. Then they make a guided decision not to. The
young person is the person making the decision. If I say, ‘Don’t be so ridiculous,’ I become like
their parent. I have been known to do that to my children. But if I can guide somebody
through—

CHAIR—But if you say, ‘It’s your decision, dear, it’s probably okay,’ then you are condoning
it.

Dr Gould—No, you do not say it is probably okay. You guide them through. You say:
‘There’s this and there’s this and there’s this and there’s this. And what’s that, look, and what’s
that, look, and have you weighed this up and have you weighed this up? Now look at all of that
together’—

CHAIR—Do you say, ‘By the way, it’s illegal’?

Dr Gould—Yes. We say, ‘If you want to do law you might have a record and if you want to
do medicine you will have a record that could stop you.’ That is not a big driver for a 13-year-
old; it is a much bigger driver for a 20-year-old. But then you can help people to make a guided
decision. It is very easy. Mostly they come in to talk to you about that in advance, hoping to be
dissuaded anyway. That is quite all right.

The choice of drugs is the other key issue that worries me. We were taught when I was a
student that people tended to choose the drug of recreation that matched their mental disorder. So

FAMILY AND HUMAN SERVICES


FHS 62 REPS Tuesday, 3 April 2007

people with high anxiety states chose heroin, opiates and downers; people with other illnesses
chose the uppers.

CHAIR—What other words can we use except ‘recreational’, because that condones it.

Dr Gould—Mind altering? Experience changing?

CHAIR—Mind destroying?

Dr Gould—Yes, but then if you have somebody who is sitting next to you who is one of the
top advertising executives in the country who uses cocaine every week and his mind is okay, and
they do not see the others, it is really hard.

CHAIR—He does not get to meet the top advertising executives snorting cocaine either.

Dr Gould—You would be amazed. You would be amazed how many people managed to
moderately misuse—

CHAIR—No, I said the kid who has come to you for advice is not going to meet him.

Dr Gould—No.

CHAIR—He is going to meet peer pressure in the street for what is readily available at
school.

Dr Gould—That is right, and the child chooses based on price.

CHAIR—So we talk about recreation drugs—it is cheap.

Dr Gould—The choice of drugs is based on price and availability. In the old days, people
almost chose, except the young ones who were really poor, to inhale and then they moved up.
Speed was always cheap. When people who have anxiety disorders—and anxiety disorders are
not just somebody having a panic attack; they are really crippling, disabling illnesses—and post-
traumatic stress and a whole lot of other legacies from childhood stuff, if they take heroin,
valium, alcohol, they all feel a whole lot better very quickly. It is only a very short fix, and it can
be become very addictive.

However, if they take the uppers, the stimulants, they can become much more unwell very,
very quickly. With the heroin drought, we are noticing in the clinic in Darlinghurst a lot more
aggression, a lot more agitation and a lot more irrationality where people are shooting not for
pharmacological effect but by what they can put in their arm.

CHAIR—Heroin is now regarded as being dirty, unattractive, and nasty people do it—

Dr Gould—Ice is dirty too.

CHAIR—whereas popping a pill—

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 63

Dr Gould—Pills are ‘clean’.

CHAIR—But if they are going to shoot ice—perhaps they do not have to, though; they can
take it in other ways.

Dr Gould—My group of ladies are habitual shooters, so they shoot it. It is very difficult. They
are becoming much sicker than otherwise.

CHAIR—Have you been attacked?

Dr Gould—Once.

CHAIR—Have any of your nurses or other staff been attacked?

Dr Gould—Once, and it was a moment that reinforced a lesson. I have a belief that most
aggression—not with ice—is based in fear, and this particular lady—

CHAIR—I am talking about ice.

Dr Gould—No, this was a heroin person. She went for me with a knife.

CHAIR—But none of your ice people have attacked you yet?

Dr Gould—No. I have seen ice people very, very violent, but not in the clinic, thankfully.

Ms GEORGE—What surprised me when we went to the naltrexone clinic on a visit to Perth


was that some of the people who were addicted were on buprenorphine, which was available in a
capsule, were taking the capsule and putting it into the syringe and injecting it.

Dr Gould—They put anything in it.

Ms GEORGE—So there must be something about the buzz of—

Dr Gould—It is about the injection. After a while you learn that the good feeling you get is
the needle and the rush, rather than the substance. That is what happened with Normison when
heroin first became really difficult. A lot of people were sucking the Normison out of the
capsules and then injecting it. If they missed, they had the most horrendous ulcers; it was just
awful.

I think the committee has heard a lot from parents who have children with mental health
disorders and drug and alcohol things, and that is a huge problem. When you have caring,
committed parents you are halfway to fixing it. It is one that needs a lot of attention. Given the
hats I wear, I thought I should talk from the point of view of children who have parents who
have substance problems. Parental drug use while a baby is in utero has an impact on kids in the
long term. In the short term, parental drug use has an impact on kids in terms of neglect, in terms
of failure to be able to parent adequately, in terms of attachment—in terms of everything.

FAMILY AND HUMAN SERVICES


FHS 64 REPS Tuesday, 3 April 2007

CHAIR—Would you approve of a program where, when a mother is pregnant—and you said
that that can be a point to get them off it—doctors and nurses feed the mother methadone? So the
baby is born addicted to methadone.

Dr Gould—I do not know enough about the science—

CHAIR—It is happening.

Dr Gould—but my teaching was that it is really dangerous for the foetus to undergo
withdrawal. That was what I was taught when I was a medical student and when I was doing
paediatrics at postgraduate level—that the foetus underwent withdrawal as well and that could
really—

CHAIR—It has to go through withdrawal when it is born.

Dr Gould—Exactly. But undergoing withdrawal while you are trying to grow and develop
can actually kill the foetus, because it has seizures. It may have changed since then. The role of
methadone as I see it—and it is not the way it is always used—is that it is an important circuit-
breaker. Methadone is a really important circuit-breaker to help contain some of the drug-
seeking behaviours but then it has to be backed up by really good, intense psychotherapy and
work with people. If somebody sees their drug and alcohol counsellor once a fortnight and picks
up their methadone every day, I do not think that is optimum treatment. It is cheaper but it is not
optimum. In the first month, I would have somebody see their drug and alcohol counsellor for an
hour three times in the first week, because that is the only way to get ahead of it. Then you can
get people stable, taper them and get life changes happening as well. Lots of people try to pull
themselves off methadone near the end and jump too early, and very little long-term, useful
counselling is freely available. People manage to find the money for their drugs but not for their
counselling, but that is just a matter of choice.

CHAIR—Do you have a handle on the cost of the provision of all those services, more
particularly whether or not there are enough of them? The more it spreads, the more the demand
is, and there is just not enough to go around.

Dr Gould—I do not know the numbers; they must be huge. But if we can effectively stem the
tide of people coming in at that end of the system, if we can effectively really turn down the
number of kids who are developing drug use problems, we could then work on the other end.
There are a number of ways you can put stuff at the other end that will help. Services that we
would use to help eight-year-old children of substance-using mums would be the same sorts of
services that would be really appropriate for kids with mental health issues as preventative
services. But, yes, the cost is enormous.

CHAIR—We know that 94 children were killed in New South Wales, and I think it was 97 in
Queensland and something similar in Western Australia—

Dr Gould—I was one of the reviewers of the children’s commission on child deaths.

CHAIR—Could you talk to us about those child deaths? Could you tell us how they died?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 65

Dr Gould—No; I did that seven years ago.

CHAIR—All right. This was last year.

Dr Gould—I do not think that there were 94 in New South Wales who died as a result of
parental drug use.

CHAIR—No, these were children who died as a result of being returned to their parents.

Dr Gould—And the parents were substance misusing. Was that the Ombudsman’s report?

CHAIR—I want to see a disaggregation of how they were killed and to know the background
of those parents, because certainly some of them were killed by their drug-taking parents as a
result of drug taking.

Mrs IRWIN—I think some of them were the result of alcohol abuse as well.

Dr Gould—When I read the transcript I saw that figure and I took the liberty of chasing up
the children’s commission data and the Ombudsman’s data for the reviewable deaths but I was
not sure what year you were talking about. I am happy to undertake to chase up that information,
disaggregate it into groups and find out whether or not there were systemic failures.

CHAIR—I just find the idea of children being returned to parents who kill them appalling.

Dr Gould—It is very hard to sort out which parents will never be able to provide a safe and
nurturing environment for their children—and to sort that out really early and deal with it—and
which parents can get it close to right with a lot of help. To monitor them over time, with the
kids foremost in our minds, is a really expensive but interesting task.

CHAIR—We took some evidence yesterday in Fairfield that struck me as very valuable
evidence. It was the idea of targeting communities at risk, not individuals.

Dr Gould—So that it is normal to go and have help?

CHAIR—Not selecting them out of the community but choosing a whole community at risk
and then putting in networking programs to prevent them from falling foul.

Dr Gould—Is this the children of drug-using parents or is this children in general?

CHAIR—These are communities where the children are at risk because of drug use—and a
whole lot of other things too.

Dr Gould—Yes, I understand exactly what you mean.

CHAIR—It is aimed at stopping the children from thinking that this could be their way out.
The likelihood of a child of a drug addict becoming a drug addict is really quite high. But, going

FAMILY AND HUMAN SERVICES


FHS 66 REPS Tuesday, 3 April 2007

back to the reasons why they start, the Australian Institute of Health and Welfare says that
curiosity is the biggest reason and that peer pressure is the second biggest reason.

Dr Gould—It is all part of that first one. In this Lancet study, curiosity and peer pressure
would both be in that first category. That is the main group and that is the group that you can
help with education.

CHAIR—They are identified here as separate groups. The third biggest reason is to do
something exciting. Quite low down, at eight per cent, is a traumatic experience. It is a very at-
risk group.

Dr Gould—That is your problem group long term and this is your other group.

CHAIR—Yes, and this group needs to be targeted and could be found in a community at risk.

Dr Gould—It is very important to work with mums who have lost their babies to drugs too—
mums whose babies have been removed. You often find that women will talk about it. Some of
my clients who have had tubal ligation after a number of pregnancies say that it is really hard.
One lady who was really cross said, ‘It’s all your fault.’ I asked, ‘What is my fault?’ and she said,
‘I cannot get help anymore because I cannot get pregnant.’ The other thing that women can
learn—and this is not your average woman; this is women in very difficult situations—is that
you get access to services if you are pregnant, that people care about you, but that when your
child is removed people stop helping you.

CHAIR—But the child is then just a commercial commodity.

Dr Gould—No.

CHAIR—Yes. You get money when the child is with you.

Dr Gould—When your child is removed because you are unable to be a mum, the services to
help you improve your life go too—they disappear. It is really important to work with those
mums, after they have relinquished their children or have had their children removed by the
services, to help them develop safer, more secure lives because they are going to get pregnant
again.

CHAIR—Yes.

Dr Gould—They will, and they are low on the list because of the lack of resources. It is a
really important one. I forget about them at times.

CHAIR—But it is a relatively small percentage.

Dr Gould—Absolutely—but very important.

CHAIR—It is small but very important and we need services for them because they are
individuals and they matter and they are still our responsibility. But we do not want to cloud the
big problems that we have to attack by thinking this is the only problem, because it is not.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 67

Dr Gould—Absolutely, because you have this group here, in my mind. You have all of the
ordinary kids, the Bobbsey Twins kids, and then in amongst the Bobbsey Twins kids one kid in
10 has an identifiable mental illness. Fewer than one in 10 of those kids with a mental illness,
which is about 20 per cent, get treatment.

CHAIR—Is this new?

Dr Gould—They are Australian statistics.

CHAIR—Did children always have mental illness or is this new—or don’t we know?

Dr Gould—We do not know. We have only just started to measure them properly. In this
group here we need to target those kids as well to stop them getting into that cycle.

Mrs MARKUS—So is that one in five with a mental illness that could be chronic or are they
likely to have an episode of anxiety or depression?

Dr Gould—No, it is chronic. It is identifiable and sustained. It is not somebody having a


week of conduct disorder.

CHAIR—If somebody is born and there is a limb missing, you notice. But do we know
whether there are some people born where there is something missing in a connection in the
brain? We do not know.

Dr Gould—We do not know. It is genes and it is environment and it is the interplay. The early
environment helps to establish the links in the brain. It is such a series of circles and bubbles. A
chaotic, difficult early environment—for example, being the child of a drug-using parent who is
not well supported and is not coping—in and of itself can create identifiable clinical illness in
the child.

CHAIR—Being born to an addicted parent—

Dr Gould—That is a bad start.

CHAIR—and having to go through withdrawal as a baby is not going to make you a really
great prospect.

Dr Gould—Then that compounds, as life is chaotic and unpredictable as well. It really


interferes with your regulation.

Mrs IRWIN—You were talking about the four main reasons for starting. I think number three
was distress. You told that lovely story about that young lady—I gathered you had been seeing
her for many years—who was a heroin user.

Dr Gould—She became an anything user.

Mrs IRWIN—That is right. She has now had children and is drug free. What assisted her to
get off heroin?

FAMILY AND HUMAN SERVICES


FHS 68 REPS Tuesday, 3 April 2007

Dr Gould—I do not know and she does not know—and what has made her such a good mum,
I do not know. When she last came in to see me it was social. She came in from Western Sydney.
She had these two little kids and she was just the perfect mum.

Mrs IRWIN—So you do not know if she was on methadone or whatever to assist?

Dr Gould—No.

CHAIR—She was never on methadone?

Dr Gould—No. But I do not think we would take that as a stat. For fear of identifying her,
that is all. There were some cultural issues, and she was married very quickly.

Mrs IRWIN—What type of education programs would you like to see targeting our young
people?

Dr Gould—The key skills that young people need—and I know that some of the studies show
that simply giving kids information will only delay drug use by a year—is to know how to make
informed decisions and how to do their research. Even little kids can learn that in primary school
now—how to do their research, how to look things up and then how to make decisions. So the
education would be around structured, balanced decision making. Identifying strengths and
weaknesses and then presenting a whole range of information, especially the downside of drugs,
is really important. Young people need to hear from people like themselves who have gone pear
shaped—people that they can identify with.

CHAIR—This is why we need a big campaign.

Dr Gould—Back in the HIV days—the grim reaper days—which I lived through and worked
through, one of the things we needed to say to kids was: ‘What is it going to take to get you to
use a condom?’ You would say all those standard things in the medical consultation. They used
to say, ‘When somebody like me gets AIDS.’ The most powerful thing one of our local schools
did was have a young person just like them who had AIDS who went in and talked about having
AIDS and how she had caught it. That sealed that message for them. To do the same thing
around drug use with somebody out the other end who has done okay but has mucked up a great
slice of their life would be really useful. We all learn by stories.

CHAIR—The smoking campaign seems to have been judged as successful, but it was not
until—at the risk of sounding boring—we saw that image of the girl looking ugly, with the
horrible face and the hair falling out.

Dr Gould—That’s right. Cocaine sores are a really pretty sight!

CHAIR—Exactly. We saw some images here today. They were pretty gross.

Dr Gould—I know, and they are really great images to use, but that is only part of the suite. A
lot of things have happened about smoking, and images were the icing on the cake.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 69

CHAIR—There has been a whole campaign. There has been acceptance that it is bad, which
we have not got with drugs. As long as we have got people saying that drugs are okay, we have
got a big problem.

Mrs IRWIN—You were also stating earlier, Bronwyn, that you run a homeless centre for
women. I gather that these women would be drug free?

Dr Gould—No, it is a drop-in centre run by Mission Australia, and I run the clinic in there. I
started the ‘doctor on the Tuesday morning’ session. And they are not drug free.

Mrs IRWIN—Where would a woman or a young girl—I suppose I should say a man or a
young boy as well—turn if they have been kicked out of the family home and have no family
support? There is no refuge around, really, that they could turn to, is there?

Dr Gould—It is very difficult. What age group are we talking about?

Mrs IRWIN—From 14 years of age to, say, 20.

Dr Gould—There are places. There is a whole range of refuges around. But that is the sort of
place you start off in, and then you try to get the department or the various agencies helping
somebody get houses—especially to help the young ones, to get them out of the crisis very
quickly.

Mrs IRWIN—The problem that I am experiencing in my area is that we can get them housing
but they have to be drug free. But they need to be on some treatment before we can get them into
a safe place to take them on their road to recovery.

Dr Gould—And a lot of the services are package selling. They look very good; each service
looks fabulous. But when you try to get a mix, to match somebody, it is really very hard. ‘Yes,
you are young, you are homeless, yes, you’ve got no parents, but—woops!—you’re not drug
free,’ or ‘Yes, you’re drug using but, no, you’re 14½ and you’ve got to be over 16 to be here,’ or
‘You’re not pregnant,’ or ‘You don’t have—

Mrs IRWIN—You mean, have a dual diagnosis?

Dr Gould—Exactly. And 60 per cent of the kids have what we call a ‘dual diagnosis’, so they
just use that to exclude kids if they have behaved badly.

CHAIR—It is a wonder it is not higher than 60 per cent, quite frankly! When you start
fooling around with your brain, you get sick.

Dr Gould—One of the things we really need to do is for mums with children and who are still
drug using who are flagging that they want to stop. I think they need to be assessed really
carefully. There is the Hearth Tool. Have you talked to the Hearth Tool people?

CHAIR—No, I do not think so.

FAMILY AND HUMAN SERVICES


FHS 70 REPS Tuesday, 3 April 2007

Dr Gould—The Hearth Tool is an instrument; it is really exciting. In my capacity with ACAP,


we gave it an award for child protection. It has been developed by the Wesley Mission, I think—
one of those in WA. There is an acceptance that we cannot remove all the children from all the
women who use drugs. There are not enough foster care places to do that. That is just—

CHAIR—That raises the other question of completely—

Dr Gould—Adoption?

CHAIR—Adoption off; it doesn’t happen.

Dr Gould—No: I have had four adopted out of my cohort in the last 3½ years; it happens.
But—

CHAIR—That is minute.

Dr Gould—Absolutely. So, given that we have a situation where there are not enough places
for all of these kids—

CHAIR—And some of the foster carers are not too hot, either.

Dr Gould—My discreet way of saying that is: the state does not always make for a great
parent.

CHAIR—We have 21,000 children out there.

Dr Gould—Oh, yes; I know.

Mrs MARKUS—The state is not necessarily the better parent to keep going.

Dr Gould—Exactly. Dorothy Scott describes the state as a parent with an empty breast and a
hard nipple, and I think that is a really beautiful description of the state as a parent. Given that,
the Hearth Tool developers knew they had to work out a way around it. So they assess, with a
focus on the child, the impact of the parent’s drug use on their parenting abilities because, with
supports, not all parents who use drugs are incapable of being adequate. Then they have a
program that works from that, focusing on the family’s future health, of which the mum’s drug
use, or abstinence, is a part. And they work towards maintaining a safe place for the kids. It is
really excellent. Rather than going in and saying, ‘You must stop or the child will go,’ and then
nobody stops, or they give clean urine and have their smoke the day after and they have beaten
the urine test, this is actually collaborative, a working together. It has a lot of promise. It is going
to be rolled out in New South Wales shortly, and it is a really interesting program to look at.

But, if you think about it in another way, if you have a mother who is managing—she has
tapered her methadone down, she is really trying to get there; she is really trying to learn to read,
she is really trying to learn to do her sums to balance the books; she has no family support—
there is just the community around her.

CHAIR—But we are going right back to that stat: that is very much a minority case.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 71

Dr Gould—No.

CHAIR—There are very small numbers like that.

Dr Gould—No. What are the numbers for drug affected mums with kids? Lots.

CHAIR—No, the one you just described, who cannot read, cannot write.

Dr Gould—All right—poor social skills, no education beyond year 7.

CHAIR—That is different.

Dr Gould—Sorry, Chair, but to be a young mum to be struggling out with your kid to go to
your drug and alcohol worker appointment, your Centrelink appointment, your mental health
worker appointment—

CHAIR—My heart goes out to the child.

Dr Gould—Exactly. I am on the child’s side in this equation. In order to make it even


approach something better—given that we cannot stop this mother using because she is starting
to use because she is already there, and headstream prevention stuff is really important—this
child needs to be able to grow up in a way that means they are less likely to start using
themselves. So co-location of services is an excellent idea, based around the needs of the family,
especially those of the child, and quality child care. Quality child care has really good
documented benefits for these kids, as have good school environments and good community
engagement. They help the kids survive if they have to be in that situation. But it is not ideal; it
is awful.

CHAIR—The child does not have many prospects, does it?

Dr Gould—I do not have, off the top of my head, the numbers of kids born to drug-using
mums in Australia at the moment. But you might, or do you want me to hunt that one up?

CHAIR—The only stat we have is that, of 5,000 children born in Perth in a maternity
hospital, seven per cent were born to drug-using parents.

Mrs MARKUS—If you could get those statistics I would certainly be interested in them.

Dr Gould—I will see what I can find. I will find that, and the unravelling of the children. I
think the other thing that really matters for me is that services be available to the people who
need them the most, not the people who squeak the most. I think that applies across counselling
and drug and alcohol services for all of those in most need and for parents and families. I think
that is a really important one.

CHAIR—As there are no further questions, thank you very much, Dr Gould. Thank you for
telling us about the care and help that you give to people who need it. We pray that a lot of it will
be successful.

FAMILY AND HUMAN SERVICES


FHS 72 REPS Tuesday, 3 April 2007

Dr Gould—Good luck. And I will get those figures for you. Thank you.

CHAIR—Thank you.

Proceedings suspended from 1.29 pm to 1.54 pm

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 73

CHAIR—We will now resume the hearing. We will move to our session of community
statements. We think it is very interesting for people to be able to arrive and have their say. They
can say their full name or their Christian name if they want. They can tell their story. We find
that this is very useful. We will call the first person with a community statement. I know that
somebody has to get home for babysitting purposes, so we might start with you. It is lovely to
have you with us, Susan.

Susan—I put in a public submission. I want to make a better impact than the written word in
black and white can provide. I feel like I have been through hell and back. My partner, my
children’s father, developed many addictions. As time went on, I found out about more and more
of them. I felt very stupid and very naive for not realising. It was an extremely difficult time. He
had an addiction to cannabis and bourbon, developed a gambling habit, had an anger
management problem and developed a whole lot of psychological issues. It seemed like the
entire sky was falling in on my life. I fell pregnant with my second child. My first one was about
15 months old or so. I fell pregnant with my boy. The level of aggression that was being shown
towards me began to be shown towards my daughter—my eldest child. At that point, I needed to
run, and I could not run fast enough. I was being hunted. I had my boy. We went through lots of
the processes that exist for children. Throughout that time, I tried to find assistance for my
partner. There was nothing out there. Everyone said that the only solution was private hospitals
that run detox centres. We were living at the poverty line and that was not an option. It was not
something that we could choose; it was not there for us.

He did not believe that he had a problem—that was another issue. He also believed that he
was a victim, and still to this day believes that he is a victim. He does not see that taking drugs is
a problem at all. Because of this, my children effectively do not have a father. He has not had
access to them for five years. My son is now six and my daughter is eight. That has come about
because of the processes in place. We have been through family law. The end result of that was
that he had to have supervised contact. He does not believe that he should have to have
supervised contact, so therefore forfeits his rights, obligations and responsibilities
simultaneously with regard to accessing the children.

During that period, the worst time was the last month of the pregnancy with my son. It was the
first time in my life that I have not been able to earn money. I physically could not work. I had
had a difficult pregnancy. I was extremely heavy and absolutely exhausted. Somehow, I came on
the radar of different community groups within the local area that I live in. People were showing
up at the door with boxes of food.

CHAIR—They helped you.

Susan—They did. They came from nowhere. My boy was born in September. I went back to
work a week after he was born. I used to rock his capsule under the desk while I was doing data
entry. Wow, what a life! But I was working again and I had money again and that meant that I
could pay the rent. There had been all the horrible things that looked like they were happening. I
was looking at a refuge in the week I went into labour with him—on that afternoon, in fact. It
was a horrible, horrible period.

FAMILY AND HUMAN SERVICES


FHS 74 REPS Tuesday, 3 April 2007

Those people from the community groups helped me and, from that, I felt that I needed to give
back to the community. As the years go by, every 12 months I am a little bit stronger and better
off financially and the kids are a little bit bigger and can do a bit more for themselves. I give
back by being involved in the community. I joined a service club; I do fundraising. I am in
people’s faces about everything these days! It is the little people—the communities, the
neighbours—pulling together that changes things. It is not everybody waving a magic wand,
there is a new law and we have to follow it. People not caring anymore—that is where it has
broken down.

I have a really strong opinion now on injecting rooms and legal tolerances of marijuana use
and things like this. Before, where I did not care, I did not have an opinion; now I have an
opinion. I am very much against anything that is going to bring that into people’s houses and the
trauma that goes with it. It is not just that somebody takes drugs; they develop all these other
things around them that just go out of control.

My boy was born in September and by Christmas that year we were back on our feet. We were
not doing great but we were back on our feet and I was earning some money and looking after
my family. People knocked on the door two days before Christmas with boxes of toys for my
kids. There are so many good people out there who want to help and they cannot help. You hear
about volunteer organisations that are falling by the wayside all the time because they cannot get
the official approval of bureaucratic departments like DOCS, basically. My mother actually
reported me to DOCS in the hope that DOCS could see that I was a mother with children at risk,
and they were not interested in helping her or me or my children.

CHAIR—What did they do?

Susan—Nothing. They said that it fell outside of their area or whatever it was. They just said,
‘There is no problem with the mother, therefore the children are okay.’ There were lots of
problems with me. I was totally on the edge of everything, and I know I was. But there was no
help out there.

CHAIR—There was no official help.

Susan—No.

CHAIR—What came to you was from your community and your neighbours.

Susan—Yes, it was just good people. I am just so thankful for them. They did not change my
life; they probably enhanced my life. As I said, I hope the little things I do help someone else. It
is just such a horrible, horrible experience to go through. For me, my family initially and still
almost at this day say, ‘You chose your bed; you lie in it.’ So I was cut off from them. My
partner’s parents had passed away about three years before from cancer, so there was no family
there. I believe that if his family had been alive and giving him support the situation would never
have got to where it is now. But he was on his own and I was on my own. I was fighting for my
kids, for the survival of my kids, and with the horrible level of violence that had entered into my
life that I had never experienced before.

CHAIR—And it was not there before he started taking drugs; is that it?

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 75

Susan—I met him—we used to be on the school bus and we used to kick each other in the
shins, because that is what you did when you were 12. Over many years, we were on, we were
off, we were on, we were off. I lost both of my grandfathers within about two months of each
other. I had flown overseas for the funeral of one and I had come back to where I was living at
the time, and my uncle called me and said, ‘Pop’s kidneys have failed; we think you’d better
come,’ so I hopped back onto a plane and came back and watched my surrogate father die,
effectively.

I was in an extremely vulnerable state when I met up with my partner again. I knew that he
was taking drugs. I believed that it was a weakness of character, that he had fallen into drugs
because he did not have anybody around him; he did not have support. You can talk yourself into
so many things.

CHAIR—You thought you could reform him.

Susan—I thought I could help him. I thought I could give him the strength and the reason not
to, but in fact it was hidden from me. He had said that he was drug free and he was not. I had no
idea about the gambling; that came out later on—you can subpoena information for the Family
Court, and I subpoenaed all the places he had gone to for assistance, all these different
counselling services he had been to. I had no idea. I knew he had a drinking problem that had got
worse and worse. That was how he was dealing with the world. I did not know that the drugs
were back. I did not know that he was putting all the money through the machines. I just had no
idea.

CHAIR—So, do you feel now that you have got yourself back together and you are an active
part of your community?

Susan—Absolutely. I do not think I can ever repay the debt, the goodness that was shown to
me at the time when I was at my lowest—never.

CHAIR—And the father of your children—he’s just not going to be able to make it?

Susan—I have not had any contact with him. Touch wood it stays that way. I just do not want
that disaster back in my life. I do not know what will happen to him. I do not know, because he
has this severe anger management problem which he will not get assistance for, because he sees
himself as a victim and believes that the world owes him a living. I cannot see anything
changing for him. He is happy to live with no housing, in dirt, just living off other people, being
a parasite. That is how I see it—and he is happy with that lifestyle. I want good things for my
kids. I want my kids educated. I want them to have options in life. I do not want any of this
horrible what they tell me is a cycle to affect the next generation.

CHAIR—Yes. So you are going to fight tooth and nail to make sure they get a real
opportunity.

Susan—Absolutely. My kids are very important. They are the future. They are our
scientists—and they will be! I am determined.

CHAIR—It is very good of you to come and tell us your story.

FAMILY AND HUMAN SERVICES


FHS 76 REPS Tuesday, 3 April 2007

Susan—No worries.

CHAIR—Would anybody like to ask Susan anything?

Mr CADMAN—No, that was great.

Mrs MARKUS—No, I am fine.

CHAIR—Susan, I think that is a very impressive story and I think you have shown a great
deal of courage in coming to tell us. And you are right: when you tell it, it is different from the
written word on the page.

Susan—Absolutely.

CHAIR—And I wish you every success with your life and your kids.

Susan—Thank you.

CHAIR—We will hear from Reverend Bill Crews next.

Rev. Crews—I am sorry I did not prepare a submission but life was just too busy. I first got
involved with young people with drug problems in 1970. I was at the Wayside Chapel in Kings
Cross. I remember going to a meeting with Ted Noffs about drugs. There were a whole lot of
people there and Ted was saying how he had started and it was just him. Over 35 years I have
been involved with a whole lot of things at the Wayside Chapel.

I have seen a lot of young people die from heroin overdoses, to the point where it just got
terrible. I remember one batch of heroin coming in and people were dead everywhere. It took
days to bury them all. At that point we thought that education was the answer. The New South
Wales government set up a drug and alcohol authority and I was put on it. Out of that I wrote a
lot of programs for what became the Life Education Centres, which are all over the place. I
wrote a lot of those early programs. We honestly thought that education was the way. We had
hundreds of kids coming. Whole schools would come. Then we set up the caravans and got them
going.

CHAIR—They are still going—they are good.

Mrs MARKUS—They are still going?

Rev. Crews—Yes.

Mrs IRWIN—Do they still have the make-believe giraffe?

Rev. Crews—Harold, yes. Harold is there.

CHAIR—You can see that we have all been in the caravan!

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 77

Rev. Crews—Harold was my idea. I went to Chicago and saw the Robert Crown Centre over
there. We looked at what they were doing. So I tried all of that. Then I went to Ashfield in 1986 I
think it was. We set up a group for parents and families of addicts who had died. That was one of
the most traumatic times of my life. Every week we were at day one. Every week it was like the
week before had not happened. There would be a new mother, father, brother or sister coming in
every week. By that time I do not know how many hundreds of people I had buried.

For a long time I had gone along thinking: ‘We’ll get rid of the problem. We’ll actually get rid
of the problem.’ What I did not ever look at was how the problem started. Well, I did—we tried
to do that with education. I remember walking up Williams Street with my son when he was
three. There was a big sign for Vincents powders. He looked at me—he was three years old—
and said, ‘Vincents make you feel better, you know, Dad.’ He had learned at three that, if you
feel bad, you can take a drug and you will feel better. It did not take long to realise that that is an
attitude that is imbued right in our very culture.

I was caught up with the affair in Griffith—with Trimboli and all of those people and Don
Mackay. We were caught up in all of that. Then we learned about how the marijuana was
shipped to us. I began to realise how much endemic corruption in society you can never wipe
out. It is there. You learned in those days never to trust people. The money that can be made in
this business is so huge. It is almost impossible to find people who cannot be corrupted by it.

It was a real shock to me to realise that some of the best drug importation rings the world has
ever seen were comprised of New South Wales policemen under Murray Riley. The very people
who we had set up to protect us actually got corrupted by that. It was very difficult not to see
that happen. So over time I began to realise that probably the best thing we could do was
minimise the damage done while people were involved with drugs.

After all this time, I have got no idea why people get on to drugs or why they get off. I can say
some get on because of low self-esteem and want to feel better. Others get on because they have
got such high self-esteem and such high self-worth they feel they can experiment and get away
with it. For other people, for other reasons, they get off almost because it is fashionable.

One of the problems is the drug keeps morphing into other sorts of drugs so that the whole
issue starts to change. One of the reasons we are actually getting somewhere with cigarettes is
because cigarettes have always been cigarettes. But it will start off being heroin and then it will
be something else and then it will be something else so it is very difficult. And with all the rehab
programs I have seen, probably a third of people get better, a third get worse and a third stay the
same. It is like this lady said before: it is the caring of the people in the program that actually
works.

In the end, I began to see all drugs in a way like alcohol. We really need to treat it as a health
issue and work on that. The idea that somehow we will wipe out the drug problem forever by
using the police or something, just will not work. In the whole 35 years, almost every few years
there will be: well, we will toughen up. And so things get tougher, tougher, and tougher. But they
always get worse. We get tougher and we get worse. I began to realise that it is like the people
who talk about Christianity and say, ‘Christianity is a fine idea. It’s just never been tried.’ And
people seem to think all we have to do is try harder and we will work it out. But what I have
found is that every time people try harder, it actually gets worse anyway.

FAMILY AND HUMAN SERVICES


FHS 78 REPS Tuesday, 3 April 2007

CHAIR—You are not saying that about Christianity, I hope.

Rev. Crews—In a sense. You know what I mean. But that has been my concern through the
whole thing. Every time we have talked about tightening up, we have actually made the problem
worse. The thing I have found is that one of the dangers of using rehabilitated people to go and
talk to kids about drug problems is that they show that you can experiment with drugs and get
away with it. That is the whole issue I have found. I find that is a very powerful argument.

The way we deal with the drug problem as individuals seems to come from our innermost
being and we do not really want to learn from the experience of others because we have all got
an opinion. It really was cataclysmic for me to give up a puritanical approach, but my experience
was that it just did not work. I do not really know why. It is almost like drug use is a fashion.
They will get onto it and they will drop it because of the same sort of fashion. And all the rehab
centres will say, ‘Well, it’s because we have done this and we’ve done that and we’ve done the
other.’ But I have never really seen a lot of evidence to show that. It is almost like fashion. I just
wanted to share that with you. I get worried about these sorts of things because I have a bit to do
with the injecting room. I had a bit to do with promoting it, getting it started and all of that and I
feel it has done its job, which is to keep people alive for long enough so we can begin to work
out how to get them off it. And that is really all I wanted to say.

CHAIR—It sounds like you have been involved in the worst part of it for a long time and you
have lost hope.

Rev. Crews—No, I do not think I have lost hope.

CHAIR—Because the statistics say we are making progress and when we tighten up, it does
not get worse; it gets better.

Rev. Crews—I wonder about that because, when we look at the amount of heroin that is being
produced in Afghanistan at the moment and the destruction that it is causing in former Eastern
European countries, I think that is where the money is and we will begin to see it move down.

CHAIR—There is certainly a lot of money in it, and those people who would like to have
some of it would love it to be legal too.

Rev. Crews—The best way I can answer that is to tell you about a young addict who came to
me one day and said, ‘I have to get off it; I need police protection,’ because of blah, blah and
blah. I rang Cec Abbott, who was the commissioner at the time, and he said that you have to talk
with Detective So-and-so. I organised for Detective So-and-so to protect this woman, and then I
found out that that Detective So-and-so was the one who was giving her the drugs anyway. I find
that issue all along the way.

CHAIR—We have gone onto another issue, haven’t we, and that is corruption in New South
Wales? It has a long history.

Rev. Crews—But it is everywhere.

CHAIR—I think that is a bit of damnation. There are some very good people around as well.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 79

Rev. Crews—I think there are too.

CHAIR—I think Mick Keelty is doing a very good job.

Rev. Crews—I agree. The problem is that, every now and then, it will be claimed that a group
is incorruptible, but, after a while, one of them will inevitably be arrested. That is what I have
found. I am not trying to be negative at all, because I think we always have to have this battle
between the people who are idealists and those who are a bit more realistic. You have to have
that fight all the time. I do not think I have given up, because I am always looking for new
approaches in education to do this.

CHAIR—Do not give up.

Rev. Crews—No. But we need to hear some of the voices on harm minimisation, because that
approach has saved a lot of lives.

CHAIR—It depends on what it means. It means different things to different people. Thank
you for coming and talking with us today.

Rev. Crews—Thank you.

CHAIR—Welcome, Mr Trimmingham.

Mr Trimmingham—Thank you, members of the committee. In the brief time that I have, I
would like to make a plea for more time. I am the CEO and founder of Family Drug Support.
Although we are a very small and not very well funded organisation, I believe that we probably
provide more support to families of drug users than any other organisation in Australia. We take
25,000 calls a year on our helpline. We have 3,000 to 4,000 people attend our courses and
groups. We get tens of thousands of hits on our website. We have 2,000 members and 200
brilliant volunteers. I was very disappointed and a bit surprised that we were not invited to give a
more formal and lengthier presentation. I would ask the committee to consider hearing from
us—

CHAIR—We have a submission from you—

Mr Trimmingham—You have a written submission.

CHAIR—which has certainly been taken heed of.

Mr Trimmingham—Good. Thank you. In the brief time I have left, I want to make a couple
of points. Today it has been frustrating to hear discussion about zero tolerance versus harm
minimisation. This is an ongoing debate, and in the middle of it all are families who are suffering
and who are dealing with issues of shame, stigma and isolation. This debate does nothing to help
them. What we want is recognition that families are able to support drug users if they themselves
are given support. We believe very strongly that treatment works and that, over time, people can
recover from the worst problems—although, inevitably, that involves a long haul. There are no
formulas for success. There are no quick fixes.

FAMILY AND HUMAN SERVICES


FHS 80 REPS Tuesday, 3 April 2007

I have a story to tell you about a woman who came to see me. She was a doctor and in her late
40s. At the age of 15 she got involved with a 23-year-old man who introduced her to heroin. For
14 years she struggled with a heroin addiction. She went to prison. She tried many forms of
treatment. She had children taken away from her. She had many broken relationships. She woke
up one morning and thought to herself, ‘I would like to go to university.’ On that day she
enrolled in TAFE to do a high school certificate, and she also enrolled in a methadone program.
She graduated from medicine 8½ years later, and that was the day she took her last dose of
methadone.

In the time before that, in the 14 years, she could have died at any time. She had suffered
many overdoses. She could have ended up in prison. Anything could have happened to her. She
made a decision one day, and our experience is that most times when people turn themselves
around it comes from a moment like that—of enlightenment and of a desire for a better life. I
can tell you many other stories similar to that. There was a 17-year-old girl who had been using
drugs on the streets of Kings Cross, every drug possible. She realised she was pregnant. At 17
she stopped using all drugs, despite the fact that her boyfriend then overdosed and died, despite
the fact that she lived in a community of drug users. She is Aboriginal. She is now a health
worker; she is fully qualified. We know that not everybody who gets pregnant gets off drugs—
quite the opposite in fact—but she did. We can never predict when people are going to turn
things around.

I want to finish by saying that families do not support, condone or want to push drugs. That
would be the last thing any family who has been affected would ever want to do. We support
prevention programs, education programs, and we support treatment particularly. We think there
should be more treatment available. What we need is a larger toolkit. What works for some
people does not work for all people. Instead of saying that this is good and this is bad and this
one works and this one does not work, we should test and evaluate all treatment programs and
make a place for them. It is an absolute lie to suggest that people who support harm
minimisation support drug use. I can attest to that from the many, many thousands of families
that I speak to.

CHAIR—Some people do want to see legalised drugs.

Mr Trimmingham—Certainly not families affected.

CHAIR—The Greens want to legalise drugs.

Mr Trimmingham—Look, legalisation is another debate, and maybe it is a debate we have to


have.

CHAIR—It is not a debate; it is not on.

Mr Trimmingham—Anyway, I am not here to debate; I am here to talk for families. It is not


true that families want their kids to use drugs. When we have drug-using kids, we want to get
them off drugs. But the fact is that it is a long haul for many families, and in the meantime—my
son, one kilometre away from where an injecting room now stands, died of an overdose. We do
not know whether he would have ever used that room, because it was not there then. What we do
know is that, if he had made that extra one-kilometre journey, he would still be alive; he would

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 81

not have died that night anyway. And that is the point of harm minimisation: it is not that we
support the fact that our kids are out there using drugs and using clean needles; it is the fact that
it buys us that time. When someone dies, there is no comeback. It is not incompatible to have
zero tolerance for drugs and support harm minimisation. I can attest to that myself.

CHAIR—Thank you very much. As we have nobody else, that completes our community
statements, which were very beneficial. Thank you very much for coming and giving those
statements. We will now move back onto the agenda.

FAMILY AND HUMAN SERVICES


FHS 82 REPS Tuesday, 3 April 2007

[2.28 pm]

WODAK, Dr Alexander David, President, Australian Drug Law Reform Foundation

CHAIR—Welcome. Do you wish to make any additional comments regarding the capacity in
which you appear today?

Dr Wodak—Good afternoon. I am representing the Australian Drug Law Reform Foundation,


of which I have been the president for some years. It is an umbrella organisation, which also
includes the Australian Parliamentary Group for Drug Law Reform, whose members are
parliamentarians at Commonwealth, state and local levels and who all support drug law reform.

CHAIR—As I understand it, the submission we have got from you is for the alcohol and drug
service. Is that right?

Dr Wodak—No, it is from the Australian Drug Law Reform Foundation.

CHAIR—That is not what it says on your documentation. There seems to be some confusion.

Dr Wodak—It was sent from my work address. That might account for the confusion.

CHAIR—What is the alcohol and drug service?

Dr Wodak—I am the director of the alcohol and drug service at St Vincent’s hospital.

CHAIR—The submission has come in in the name of the alcohol and drug service, and you
signed it in the other description you gave.

Dr Wodak—My apologies.

Ms GEORGE—I am sorry, Madam Chair. My submission clearly says—

Mrs IRWIN—Mine too.

Ms GEORGE—at the end ‘Dr Wodak, president of the Australian—

CHAIR—Yes, that is what I said. That is the way he signed it.

Mrs IRWIN—Australian Drug Law Reform Foundation.

CHAIR—That is what I said. That is the way it has been signed.

Mrs IRWIN—Thank you, Chair.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 83

CHAIR—The submission is in the name of the alcohol and drug service, but it is signed by
Dr Wodak using that description.

Witness was then affirmed—

CHAIR—We have received quite a lengthy submission from you. Would you like to make an
opening statement?

Dr Wodak—I would. Thank you very much. Mood-altering drugs have been used by people
in virtually all countries throughout history. Anyone who believes that this entrenched pattern
over thousands of years can be simply and suddenly ended by government fiat is naive in the
extreme. From time to time, countries prohibit certain drugs. Alcohol was illegal in the USA
from 1920 to 1933. Opium for eating was taxed and legal in Australia until 1906 and was then
banned. Heroin was prohibited in Australia in 1953. Before 1953, heroin could be lawfully
prescribed by doctors in Australia. There is no pharmacological or public health logic to the
classification of some drugs as legal and others as illegal. These decisions about declaring
different drugs in different countries to be illegal or legal at different times have all been
arbitrary historical accidents more influenced by politics than logic or science.

While there is a strong demand for a drug, a source will always emerge. If there is no legal
source, illegal sources will emerge. Suppliers of illegal drugs compensate for the risk of getting
caught and punished by increasing the price of the drug. Higher prices increase the profits made.
The higher the risk of getting caught and the more severe the punishment, the higher the price
and the higher the profit. The higher the profit, the more people who are attracted to becoming
drug traffickers and the greater the quantity of drugs available for sale. This is the Achilles heel
of drug prohibition. What has often happened in drug prohibitions is that dangerous drugs were
driven out by even more dangerous drugs. In Asia over the last half century, anti-opium policies
have had pro-heroin effects. During alcohol prohibition in the United States, beer disappeared
and was replaced by wine and spirits. In Australia in the last seven years, amphetamines have
taken over during the heroin shortage.

Whatever we may think about drugs, they are markets with buyers and sellers just like real
estate or ballpoint pens or any other commodity. Access Economics estimated in 1997 that the
market for mood altering drugs in Australia was worth $29 billion a year. Drugs that we call
illicit accounted in 1997 for $7 billion of that $29 billion total. These days, since the fall of the
Berlin Wall, few are now brave enough to attempt to defy powerful market forces. Only North
Korea, Cuba and drug war warriors still believe that they can ignore powerful market forces.
Everyone else knows that sooner or later it is inevitable that a heavy price will be paid for trying
to ignore powerful market forces.

Harm reduction, a widely and possibly often wilfully misunderstood term, is a simple concept.
It means that we focus primarily on reducing the adverse consequences of drugs, such as deaths,
disease, crime and corruption. The alternative to harm reduction is use reduction, as in the war
against drugs. In use reduction, we focus primarily on reducing drug consumption, whatever the
impact on deaths, disease, crime and corruption. The most important point about harm reduction
is that the scientific debate about harm reduction is now over. Harm reduction is recognised
widely to be effective, safe and cost effective.

FAMILY AND HUMAN SERVICES


FHS 84 REPS Tuesday, 3 April 2007

Five Labor and three coalition governments, in Tasmania, Queensland and the Northern
Territory, adopted harm minimisation as our official national drug policy in April 1985. Every
state and every territory government since then, whatever its political hue, has adopted and
implemented harm minimisation. The current federal government, despite its public stance,
sensibly but unfortunately discreetly, continues harm reduction in several forms, including a $10
million a year enhancement of state-territory needle syringe programs, generous funding to
support HIV prevention among injecting drug users in Asia, vigorously carrying the torch for
harm reduction in debates within the UN system and by diverting drug-using offenders from the
criminal justice to the drug treatment system. Needle syringe programs in Australia from 1988 to
2000, according to a Commonwealth department of health commissioned study, by 2000
prevented 25,000 HIV infections and saved up to $7.7 billion, while by 2010 needle syringe
programs will prevent 4½ thousand deaths from AIDS. If this committee wants to scrap harm
reduction in this country, you will have to take personal responsibility for the HIV epidemic that
Australia then has to have.

There is growing realisation that relying on drug law enforcement, Customs, police, courts and
prisons to control illicit drugs in the last several decades has not worked, is not working and can
never work. In the decades of global drug prohibition, drug production and consumption has
soared around world. It is now a global $US322 billion a year industry, of which 26 to 58 per
cent may be profit. Drug problems have got worse and worse over the decades. Governments
have spent more and more taxpayers’ money. This is a typically high-taxing, big government
approach. Many fiscal conservatives, such as the Nobel prize winning economist Professor
Milton Friedman, condemn these futile attempts to arrest and imprison our way out of our drug
problems.

What we have to do is redefine drugs as primarily a health and social issue, with funding for
health and social interventions raised to the level enjoyed by drug law enforcement. Criticism of
harm reduction and drug law reform may be clever politics in the short term, but the war against
drugs has been an expensive way of making a bad problem worse. If drugs are treated primarily
as a public health problem, as suggested recently by Justice Don Stewart, deaths, disease, crime
and corruption will fall, and I expect that drug consumption will also fall once the huge profits of
the industry are removed. In the current system, criminals and corrupt police control the drug
market. Regulating this market mainly using public health measures is the least worst way of
responding to these drugs.

There are two ways of responding to difficult problems in our community such as illicit drug
use. One way is to stress the community’s condemnation of the rejected behaviour—in this case,
the consumption of prohibited substances—but place less emphasis on the actual outcomes of
the prohibition. The other way is to focus on reducing the harms of the rejected behaviour—in
this case, trying to reduce those deaths, disease, crime and corruption, investing in what science
shows us works while respecting the human rights of all of our citizens, including those citizens
who still choose to use prohibited drugs.

Harm reduction and drug law reform are steadily gathering national and international support.
Support for zero tolerance and a war against drugs approach is steadily declining. What we need
now is to find ways so that good policy can also be good politics.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 85

CHAIR—We have your submission, which you put in in advance. I have to say, Dr Wodak, I
was amazed by it—absolutely amazed. I had been used to you dissembling more—when I read
things like:

… the Commonwealth Government has publicly supported a War Against Drugs approach since 1997. The War Against
Drugs is marketed in Australia under a ‘Tough on Drugs’ label. Perhaps this is because focus groups disliked the ‘War
Against Drugs’ label.

You go on then to say:

… the Prime Minister said in 2002 that “the path to success does not lie in giving in to the drug barons; it does not lie in
giving in to the harm minimisation philosophy.”

That is a Hansard quote from the Hon. John Howard. You say:

Support and criticism of harm minimisation today is a division within, rather than between, … parties …

Your whole submission is couched in those terms, telling everybody else that you are right and
they are wrong. But you also reveal yourself to be a proponent of drug legalisation. You are pro
drug. I would like you to deny it if you are not. Are you pro the legalisation of drugs?

Dr Wodak—I have come along here as a medical practitioner with specialist qualifications. I
have 25 years of working, running a public and private clinical practice in alcohol and drugs. I
have published over 230 scientific articles.

CHAIR—I am aware of all that. Yes or no?

Dr Wodak—I helped to establish the National Drug and Alcohol Research Centre. I am
regularly used as a consultant by the World Health Organisation and UN AIDS and recently by
the World Bank. I think I have some expertise to offer.

CHAIR—I just want an answer to my question—yes or no. Are you pro the legalisation of
drugs?

Dr Wodak—My view is that people who try to throw mud—

CHAIR—It is not mud; it is a simple question.

Dr Wodak—and make ad hominem attacks are basically saying that they do not have any
arguments. I think I have a lot of expertise to offer this committee. I have travelled to 30 or 40
countries which I have worked in on official business. I think I have some expertise. I think what
we should more profitably do is spend time talking about evidence. I am very happy to talk
about evidence.

CHAIR—I just want to know where you are coming from. Are you pro drugs being
legalised—yes or no? That is simple.

Mrs IRWIN—Chair, I do not think Dr Wodak is on trial here.

FAMILY AND HUMAN SERVICES


FHS 86 REPS Tuesday, 3 April 2007

CHAIR—Excuse me; I just want an answer to my question.

Mrs IRWIN—He has been good enough to come before this inquiry today and put in an
excellent submission.

CHAIR—Excuse me. The Prime Minister has been attacked in this. The government’s policy,
the bona fides have been attacked. I simply want an answer to my question: are you pro the
legalisation of drugs or not—yes or no?

Dr Wodak—I will tell you exactly what I am. I have been paid a salary, courtesy of the
taxpayer, since 1982 to reduce the harm from drugs.

CHAIR—Are you pro legalisation of drugs?

Dr Wodak—I am answering your question, if you will give me time. I am paid a salary by the
taxpayer to reduce the harm from drugs—alcohol, tobacco, prescription and illicit drugs. I have
been doing that since 1 July 1982. I work very hard to do that, and I believe I have been
successful in doing that. I do not have a view that drugs are either good or bad, but I certainly
have a view that harm resulting from drugs is bad and I do everything I can to try to reduce it—
at the individual level, the family level and the community level.

CHAIR—So you will not answer the question.

Dr Wodak—I have answered the question.

CHAIR—No, you have not. You have not told me whether you are against or pro legalisation
of drugs. From reading your submission, you tell me you are pro drugs.

Dr Wodak—My view is that this committee should stick to talking about evidence. If you
want to talk about personalities, I will infer from that that you do not have an argument for your
views.

Ms GEORGE—Could I just follow up—

CHAIR—Yes, you can in a moment.

Mrs IRWIN—As deputy chair, I would like to have the second question after you, Chair.

CHAIR—That is fine. If you would like it after Ms George, you can have that, or you can
have it before Ms George.

Mrs IRWIN—I would like to have it before Ms George, Chair.

CHAIR—You can have it before Ms George. The point is that we are inquiring into the effect
of illicit drugs. The government’s policy is zero tolerance. The government’s policy is the
prevention of taking drugs. There are a body of people in this community who want to legalise
drugs. The Greens have come out and said that they are pro legalising drugs. I want to know
whether or not a person like you, who is taking my taxpayer dollars, as well as others in high

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 87

positions with a voice of authority, is pro legalising drugs. It is a legitimate question for this
reason: if we are to have a total policy and advertising campaign, as we have had against
smoking and AIDS, there has to be a consensus in the community that that is a good thing to do.
If we have an influential body of people such as you, who put out a different point of view from
the government’s while taking the government’s dollar and is pro legalisation of drugs, the
community is entitled to know that, to see whether or not we can have a campaign that will be
supported by everybody. It is a perfectly legitimate question, and you can sling slings and arrows
if you like, but that is my view.

Dr Wodak—The paramount drug policy making body in this country is the Ministerial
Council on Drug Strategy.

CHAIR—No, it is not. It is the federal government, because it controls what drugs come in
and out of this country.

Dr Wodak—The Ministerial Council on Drug Strategy believe that they are the paramount
official national drug policy making body in this country, and they say so on their website. If you
care to look up their website, you will see that. If you tell the Ministerial Council on Drug
Strategy that they are not the paramount official—

CHAIR—They are subject to the Commonwealth. You can have the next question, Mrs Irwin.

Mrs IRWIN—Dr Wodak—

Dr Wodak—Excuse me; just before you do that, can I just make the point: it is all very well
to say that the government has this policy or that policy but, as I said, the government—

CHAIR—You choose to ignore it.

Dr Wodak—No. I say that the government is saying one thing and doing another thing or, as
you say in politics, walking both sides of the street.

CHAIR—I do not accept that about the Prime Minister, who has been very clear in what he
says—and the last time I looked he was the Prime Minister of this country.

Dr Wodak—Do you believe that there is a $10 million enhancement to needle syringe
programs a year from the Commonwealth to the states?

CHAIR—Yes, I do and that has got to do with the HIV policy, which was very successful and
came out of that large campaign we had with—

Dr Wodak—And that is harm reduction.

CHAIR—When we discussed harm reduction earlier—I do not know if you were present—
we discussed that it meant different things to different people. That is precisely why I asked you
the question: does it mean to you that the next step is legalisation of drugs? Julia has got the
question.

FAMILY AND HUMAN SERVICES


FHS 88 REPS Tuesday, 3 April 2007

Dr Wodak—I would like to answer that question.

CHAIR—It was not a question.

Mrs IRWIN—It sounded like a question, Chair.

Dr Wodak—Rather than have a drug like cannabis controlled by criminals and corrupt police,
which happens under the current system where we have an industry twice the size of the
Australian wine industry controlled by criminals and corrupt police, I think there is a strong case
to be had for taxing and regulating the cannabis industry, and I have said that in my submission.

CHAIR—Exactly. It is very important for us to know that you are pro the legalisation of
drugs so that we can see where you are coming from.

Dr Wodak—This is a shallow argument and if I can just help to educate you on this—

CHAIR—Thank you very much, I can find my education elsewhere. Julia has a question.

Mrs IRWIN—Dr Wodak, I think it was Greiner who supported a heroin trial along with Kate
Carnell.

Dr Wodak—Yes, that is correct.

Mrs IRWIN—I just want to get back to what the Chair was actually—

CHAIR—And George Soros is providing money.

Mrs IRWIN—saying regarding zero tolerance and this government’s Tough on Drugs policy.
What I would like on the public record is an answer to this: what would be the effect on our
health system and the community if all harm minimisation measures were withdrawn—if we
fully adopt a zero tolerance policy? What would happen to our country and our young ones?

Dr Wodak—Well, it would devastate the health system and even more serious than that we
could expect that HIV would increase.

CHAIR—It already is.

Dr Wodak—We have the example of the United States which is explicitly and very
consistently against harm reduction. It is a very powerful country, and the United States had 14.7
new AIDS cases per hundred thousand Americans in the year 2003. We had 1.2 new AIDS cases
per hundred thousand in the same year. The United States, with a population of 300 million only
hands out 25 million needles and syringes a year. With a population of 20 million, we hand out
32 million needles and syringes a year. So I think we could expect to see the number of HIV
cases rise, the number of AIDS cases and deaths rise, and we would have a number of other ill
effects.

We practise harm reduction in Australia, not just for illegal drugs but also for legal drugs. For
example, the Commonwealth required all flour in Australia, from 1991, in a mandatory way, to

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 89

be fortified with thiamine—a vitamin B—and the result of that was the virtual disappearance of
a particular kind of brain damage called the Wernicke-Korsakoff syndrome. We used to see
several cases a week at St Vincent’s Hospital in Sydney. We might now see one or two cases a
year. This is a devastating illness which has disappeared thanks to the fortification of flour. We
accepted that we would like to reduce excessive harmful and hazardous drinking. We do that as
best we can. As a last line of defence we fortified flour with thiamine and, therefore,
substantially removed this cause of death and destruction.

Ms GEORGE—I preface my remarks by saying, as a member of this committee, I come


along not as an expert in the field but to hear different perspectives on the issue, and more
importantly, to look at strategies that can better handle a growing problem in our community.
And I believe that anyone that appears before the committee, Madam Chair, should be treated
with courtesy and civility even though we may not necessarily agree with one another.

Mrs IRWIN—Hear, hear!

Ms GEORGE—Having said that, can I just say that part of the problem that I find in the
discourse is that these positions are somehow seen as mutually exclusive. I am tough on drugs
and the drug barons, and if law enforcement can get all those people, well and good. I also
accept your point that corruption is endemic in this industry and that young kids often fall off the
rails. So my view would be that I would want programs that minimise the harm to them and treat
these young people; I would not want to have them sent off to prison as the first recourse but put
into proper rehab programs.

Part of my concern about the situation as it exists now is that I see a lot of people even in my
community who have been on methadone for donkey’s years. For want of a better term, I see
them as being parked there, with no follow-up to try and get them off methadone, which I
understand from my readings is as addictive as heroin. Certainly it is a kind of stabilising force
in the interim, but I think too often there is no move on from that interim solution to the next
attempt at trying to get rid of their addiction.

In terms of the pharmacotherapies that are there, I do not understand why we have not
invested more money into something like naltrexone, which I have seen in the implant program
over in WA. Also, while I have got the call, I would like to ask you, Dr Wodak, to explain
something you said which does not quite conform with my understanding. You queried the
connection between cannabis use and severe drug induced psychosis. Some of the research that I
have been looking at lately seems to suggest to me as a layperson that there is quite a correlation
between mental health problems and drug taking, including now—according to the stuff that I
have read—cannabis. I have heard the argument that if you support harm minimisation you are
soft on drugs, so the discourse, as you said earlier, is not terribly helpful. But you might just
comment on those three things: why we are not looking at alternative pharmacotherapies, the
methadone issue, and the correlation between cannabis and mental health problems.

Dr Wodak—Thank you for the questions and I appreciate the sentiments, especially your
support for a civility of discussion. It is a difficult area of a difficult discussion and I think it is
very important that we try to avoid the personalities and polemics and focus just on the
arguments and the evidence. I share your uneasiness with the way the debate is polarised. My
view is that it should not be polarised. Promotion of abstinence is, for me, a natural and

FAMILY AND HUMAN SERVICES


FHS 90 REPS Tuesday, 3 April 2007

inevitable part of harm reduction. In some ways it is the most complete form of harm reduction
if I can manage to get a patient to be abstinent. I work very hard to try and help patients who are
aiming for abstinence to become abstinent. It is not easy, but I try my best. But there are times
when we have to accept the situation as less than ideal and where that utopian goal for that
patient is, for the time being, unreachable. In those cases we aim for harm reduction, for
reducing the damage, reducing the harm. So I share your view and, to me, this is in some ways a
nonsensical debate.

Let me turn to your three substantive questions. New South Wales has had about 50,000
individuals in methadone treatment since it was first introduced in Australia in 1970 and there
are something like 16,000 people on methadone in New South Wales today—methadone and its
related drug, buprenorphine. So that means about 34,000 people have got off methadone. I can
assure you that the doctors in my own practice, in our clinic, and doctors who I work with do not
keep anybody on methadone longer than they want to stay on it themselves. Sometimes people
will come to us in a chaotic state, saying they want to jump off methadone today or tomorrow.
Where we think that is unwise and inappropriate and possibly dangerous we will explain that to
the patient, but we are unable to compel people to stay on methadone even if we want to. If
somebody wants to come off methadone they can.

Yes, it is difficult but if somebody sits down with their doctor and works out that they want to
come off methadone over three or six months and plans it, it is possible. It happens every day
and that cannot be overemphasised. I do not think people park on methadone. Most people are
off methadone within a few years. A minority stay on methadone forever. I used to be of the
view that people should have two years on methadone and then when those two years were up—
because of the shortage of places for methadone—someone else should get that place.

What changed my view was going to New York City in 1987 and talking to the person who
then coordinated methadone for New York City. I put the view to him that you have put to me
now and asked what he thought. He said that one of the patients on methadone in New York City
was an internationally renowned film director who went all over the world making films. Every
time he came back to New York City and tried to stay off methadone he relapsed back onto
heroin. He managed quite easily when he was in Argentina, Spain, Portugal or somewhere but
when he came back to New York City he just simply could not stay off heroin. He tried six times
doing that and the sixth time he decided that it was unfair to him, his wife, his family and so he
stayed on methadone. And I see patients in exactly that situation who are terrified of coming off
methadone.

Turning to the question of naltrexone, many years ago when the first prospect of naltrexone
coming to Australia was being considered, I approached the pharmaceutical company and asked
them—implored them—to bring naltrexone into the country. Why did I do that? Because I
believe in choice for drug users. The more options that drug users have to help themselves, their
families and their communities by reducing their drug use and their problems, the better.
Naltrexone was introduced ultimately and we know a lot more about naltrexone now than we did
then and we now know, scientifically, that the way it has been used up till now has not been
helpful. We know that when naltrexone is given to people, only four per cent are still taking it
after six months. The problem with naltrexone is not that it does not work; it is a very effective
drug. The problem is that people do not take the drug. Compliance is very poor.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 91

Ms GEORGE—Is that not overcome by an implant?

Dr Wodak—It may be overcome by an implant but as yet we have not had sufficient research
to confirm that categorically. Since the thalidomide disaster of a few decades ago, doctors,
myself included, have become extremely conservative, and I make no apology for that. The
guiding principle in medicine for all new pharmaceutical products is that they are ineffective,
unsafe and cost ineffective until proven otherwise. So as far as I am concerned, until a strong
case can be made that naltrexone implants are effective, safe and cost effective, I will continue to
assume the reverse.

In relation to cannabis and psychosis, it is an important question. I think the views reflected in
the submission are widely held. Two propositions are generally made: firstly that cannabis, when
taken by people who have no history of mental illness, can develop a psychosis. The second
proposition is that people with an established history of psychosis or severe mental illness can be
adversely affected by taking cannabis. I think the majority view on both questions is that the first
question is negative, that is, that the cannabis probably does not precipitate severe mental illness
in people who have not been previously mentally ill. But there is probably now a majority in
favour of the second proposition.

Let me say two things about this question. The first is that, in medicine, we commonly argue
about the toxicity of drugs for decades before we work out what is really going on. We are still
arguing about the toxicity of alcohol and, to a lesser extent, tobacco. There is still argument
about whether alcohol does or does not protect people from heart disease. The debate still goes
on. The debate may continue for some decades about cannabis and psychosis.

However, an even more important question for me is not whether cannabis causes this amount
of harm or that amount of harm but, rather, how we reduce that harm. What I fail to understand
is why cannabis psychosis, if it does occur, is better managed with cannabis distributed by
criminals and corrupt police than by some taxed and regulated form of distribution where we
would at least have some form of control over its distribution. We could at least put warning
signs on it—for example, that Jennie George thinks that cannabis causes psychosis or the
minister for health thinks it causes psychosis or something.

CHAIR—Disgusting.

Dr Wodak—Alternatively, we could put help-seeking behaviour on the packets, as we do with


tobacco. If a drug like tobacco, which causes 19,000 deaths a year in Australia, is available for
legal and regulated sale—something that I support—then it seems to me that a drug like
cannabis, which does not cause any deaths—

CHAIR—Rubbish.

Dr Wodak—would be better managed by taxation and regulation. But I particularly


appreciate your remarks about civility.

CHAIR—Ten years ago I remember making a strong statement in the Senate that, if you were
really a pro-drug person and wanted to legalise illegal drugs, what you would do is mix them up

FAMILY AND HUMAN SERVICES


FHS 92 REPS Tuesday, 3 April 2007

with legal drugs and say they are all the same and then argue that, because you can handle this
one by regulation, ergo you can handle the rest. That is exactly what you have done today.

We can look at the question of deaths. We had some very good scientific evidence this
morning—not rhetoric but evidence. We looked at the question of the 19,000 people who die
annually from implications of smoking. That is over their whole lifetime. When we look at the
deaths recorded from the use of illegal drugs, it is merely sudden death from the drug then and
there, not the deterioration and the dreadful things that happen to the body over the full lifetime.
That is never counted, nor is it counted in with other statistics that we get—that is, the number of
people who are killed in hospitals by misadventure and negligence, which is 15,000 a year. So
we need to get that into perspective.

But to simply say that we have lost it because there are still drugs there would be a good
reason to abolish all laws. We have laws against murder and it still happens. We have laws
against speeding and it still happens. We have laws against burglary and it still happens. But we
do not fail, because most people do not do it, and neither do most people take illicit drugs. But
there is certainly a body of people who think it is people’s right to take drugs if they wish. There
are people overseas, like Mr George Soros—do you know Mr Soros?

Dr Wodak—I do, actually.

CHAIR—Mr Soros I think was the man who was going to provide the $10,000 to Kate
Carnell for the drug trial in Canberra. That was rejected, wasn’t it?

Dr Wodak—I have met Mr Soros twice and I am proud to have done that. I do not know what
people have against Mr Soros. I do not know whether it is because he is Hungarian or whether it
is because he is Jewish—

CHAIR—or because he is an arms dealer.

Dr Wodak—or whether it is because he is the second most successful investor of all time
after Warren Buffett—

CHAIR—And arms dealer.

Dr Wodak—I do not know. But I do know that he has given away $US500 million a year for
the last five or 10 years and I think on that score he is worthy of considerable praise. But if I
could—

CHAIR—But he has also given a lot of money for—‘I believe the global war on drugs has
failed and is causing more harm than drug abuse itself.’ That was a Soros funded letter to Kofi
Annan.

Dr Wodak—If I could go back to the point I made earlier, I think that ad hominem attacks
simply add to the case that I am making—that people who support the war against drugs and are
critical of harm reduction really do not have a case to answer, so all they are reduced to doing is
slinging mud. That might be fair game in politics, but it is not—

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 93

CHAIR—I do not think that is a response. What I am saying to you is that I think, when we
are having this discussion, the community at large is entitled to know what you stand for.

Dr Wodak—I have told you. I stand—

CHAIR—For the legalisation of drugs, and it is important.

Dr Wodak—No. I stand for the—

CHAIR—And you are associated with people who would like to overturn the United Nations
resolution on illicit drugs. Is that true or not true?

Dr Wodak—Well, as per the evidence I have given in these documents, the United Nations
themselves say that there is room for the possibility of changing the international drug treaties
and, as they say themselves—the quote is in there—

CHAIR—But they have not done it and they abide by the resolution that says it should stay
illegal.

Dr Wodak—If I could go back to an earlier point that you made about whether drug laws are
like murder laws and should be—

CHAIR—Burglary.

Dr Wodak—Burglary, okay. There are generally considered, in—

CHAIR—Speeding.

Dr Wodak—In jurisprudence—not my field—crimes are classified into two categories: mala


in se and mala prohibita. Laws on crimes which are ‘mala in se’—bad in themselves—are very
consistent between countries and very consistent over time. They are the laws against homicide,
assault, bank robbery and so forth. They are generally not controversial, and they generally also
have the advantage that witnesses are present when the crime is committed.

CHAIR—To the contrary: those things differ from jurisdiction to jurisdiction, as well you
know.

Dr Wodak—Mala prohibita laws, against things like homosexuality or off-course betting—or,


in this case, drugs—tend to be controversial—

CHAIR—Speeding; not wearing seatbelts—

Dr Wodak—No, they are mala in se laws. Mala prohibita laws tend to have no witnesses and
tend to be mired in controversy.

FAMILY AND HUMAN SERVICES


FHS 94 REPS Tuesday, 3 April 2007

CHAIR—People are entitled to know, since you are funded by the taxpayer, what it is you
aim to do. So could you tell me what the main objective of the Australian Drug Law Reform
Foundation is? What is its main objective?

Dr Wodak—The main objective of the Australian Drug Law Reform Foundation is to try and
reduce the harm that drugs cause in Australia—

CHAIR—By what means?

Dr Wodak—By redefining this issue as primarily a health and social issue, and thereby
raising the funding for health and social interventions to the levels of law enforcement. If I could
encapsulate it, that would be it in a sentence.

CHAIR—So it is more of the legalising of drugs. Okay, I do not think I have any more
questions.

Dr Wodak—If I could just respond to that: the term ‘legalisation’ is a very vague term and, I
think, an unhelpful term—

CHAIR—It means we do not have laws prohibiting it—it would no longer be illicit; it would
be licit.

Dr Wodak—Perhaps, Chair, I could suggest that you might take Jennie George’s suggestion
about civility to heart, and let me finish the sentence—

CHAIR—I do not think we should let civility get in the way of letting people know—

Dr Wodak—and let me finish—

CHAIR—what it is you stand for—

Dr Wodak—Let me finish—

CHAIR—when you are taking the taxpayer’s dollar.

Dr Wodak—Let me finish the sentence that I had started, which is that drugs like alcohol are
legal, but that really does not help us very much to understand how they are controlled by the
community.

CHAIR—Yes it does.

Dr Wodak—They are controlled by taxation and regulation. Tobacco—

CHAIR—Precisely what I said to you in the beginning.

Dr Wodak—Tobacco is—

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 95

CHAIR—If you want to get your agenda up, you mix them all up together.

Dr Wodak—Tobacco is controlled by taxation and regulation, and I think cannabis should


also be controlled by taxation and regulation. Methadone, for example, as Jennie George was
talking about before, is controlled by prescription.

CHAIR—I think it is important we know and have the answer to that question. I have no
more questions of you, thank you.

Dr Wodak—Thank you.

Mrs IRWIN—I have a few questions.

CHAIR—Yes?

Mrs IRWIN—I will definitely not interrogate you, Dr Wodak. I want to go to your
submission. Bear with me; I think it was under the title, ‘The impact of harm minimisation
programs on families’, and it was on page 8 of your submission, page 48 of our notes here,
where you state:

Licit drugs should be included in any serious inquiry about drugs as they are not excluded by MCDS, the paramount
drug policy making body in Australia.

I am going to admit something: I would not have a clue what MCDS is. Could you tell me what
it is, and your understanding of the attitude of MCDS to harm reduction?

Dr Wodak—Certainly. MCDS is the Ministerial Council on Drug Strategy. It comprises the


nine health ministers—

Mrs IRWIN—Right.

Dr Wodak—the eight police ministers and the federal justice minister, there being no federal
police minister. It meets once or twice a year. Every four or five years since it was established in
1985 it has reviewed Australia’s National Drug Strategy. On each occasion that it has reviewed
Australia’s National Drug Strategy, it has declared that Australia should retain harm
minimisation. It did so on the last occasion, in 2004; that is on its current website. It defines
‘harm minimisation’ as consisting of supply reduction, demand reduction and harm reduction.

Mrs IRWIN—Okay. I have one last question. I understand that you travel widely. I was in
Switzerland about four years ago when we were doing the last inquiry on illicit and licit drugs,
and they hold you in high regard from your visits there, but I believe you have also worked in
Asia. I wanted to ask you, from your personal experience, about the attitudes of these countries
to harm reduction.

Dr Wodak—Certainly. Thank you. Switzerland went through a very difficult period in the
1980s and early 1990s due to the breaking-up of the Yugoslav republic and the Soviet Union. A
large number of criminals from the former Yugoslavia and the former Soviet Union found their
way to the richest country in Europe and got involved in the drug trade. The drug trade in

FAMILY AND HUMAN SERVICES


FHS 96 REPS Tuesday, 3 April 2007

Switzerland expanded considerably due to the activities of these new drug traffickers. Things
were really very difficult in Switzerland. Having visited that country many times during that
period, I noticed the effects myself. The Swiss authorities were alarmed by the developments. It
was very common for women walking near railway stations in any of the big cities to have their
handbags snatched. Crime was out of control. Drug overdose deaths were rising. HIV among
injecting drug users was out of control. The country was really in a mess.

Switzerland did what many countries do in those circumstances; they expanded the resources
available to the police drug squads and they increased the severity of penalties—they had a kind
of war against drugs. What they found was that things got worse. So then they allocated even
more resources to the police drug squads and further increased the severity of penalties. Things
got worse. They did this several times.

Then, in the early 1990s, they became very despondent about the lack of success they were
having and so they turned to the international harm reduction fraternity, of which I am part, for
advice, and the harm reduction advocates gave the kind of advice that I am giving now—that is,
that Switzerland should take a harm reduction, drug law reform approach. That advice was
taken. I was present in Geneva in 1997 when the then President of Switzerland, Ruth Dreyfus,
the first ever woman president of Switzerland—a Jewish woman at that—opened our
international harm reduction conference. She said what I have just relayed to you now, and she
said that she had accepted the invitation to speak at this international conference to express her
gratitude to the people from all over the world who had provided this advice, because it was the
right advice. Once that advice was taken, overdose deaths started falling, crime started falling,
HIV came under control, and the Swiss were very happy with that.

Last year, in the distinguished medical journal the Lancet, a paper by Nordt estimated what
had happened in the city of Zurich in the period 1990 to 2002. During that time they put a lot of
money into establishing and expanding the methadone program in Zurich. They estimated that in
1990 there were 850 Zurich residents who started using heroin for the first time and, by 2002,
that number was down to 150, an 82 per cent reduction in the number of new heroin users—so
850 in 1990; 150 in 2002.

Not only was there a reduction in the number of new heroin users but there was also a
substantial reduction in crime and in heroin seizures because the market for heroin had collapsed
because the former heroin users were now on the methadone program. So that has really been
the experience of Switzerland and it is not just people’s strong feelings. This is backed by
evidence.

In my other travels I have worked in countries in Asia as far west as Iran, where I have been
three times, to as far east as Mongolia. I was in Iran twice with the World Health Organisation
and once at the invitation of the Iranian authorities. In Mongolia I was also with WHO. I have
been in virtually every country in between. What has been very gratifying in the last five years
has been the extraordinary increase in support for harm reduction at an official level.

Last September, the Prime Minister of Taiwan, while I was visiting Taipei, asked to see me
and asked for my opinions in a very civil manner for over half an hour. I am generally treated
with respect and tolerance when I travel, I am pleased to say. But the really pleasing thing is to
see that country after country in Asia—China, Vietnam, Malaysia and Indonesia—are all

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 97

adopting harm reduction. Indonesia was the first country in Asia to start a methadone program in
its prison system and Taiwan is the second country to do that. I am not sure that they have started
yet but they are certainly committed to do it. I am proud to say that Australia is doing an
extraordinary amount to encourage the uptake of harm reduction at the official level, and
Minister Downer is, I am sure, personally supportive of this. AusAID is very much involved and
has my grateful and heartfelt gratitude for what it is doing. Apart from at that official level, there
is an army of Australian consultants engaged across Asia in helping our colleagues in other
countries implement harm reduction. It is a very important way in which we are helping other
countries in our region.

Mr CADMAN—I am interested in your comment on the failure of the federal government’s


program and the success of the subterranean program. You said that the policy actually being
implemented was harm minimisation and that it was successful. Statistics from the UN Office of
Drug Control and Crime Prevention for 2004 show that of the OECD countries Australia has the
highest cumulative average of illicit drug users. Switzerland, which you uphold as following our
example, probably has about half that number, and Sweden has about half that again. So I cannot
understand your logic. There is the failure on the one hand of a superficial program and the real
program is harm minimisation. Why has it been so unsuccessful?

Dr Wodak—Australia spends very little of the money that is expended by Commonwealth


and state governments in response to the problem of illicit drugs.

Mr CADMAN—So is it just a matter of the quantity of money?

Dr Wodak—It is part of it. We spend very little on harm reduction. About one per cent of the
total allocation goes to harm reduction. But I hope I made it clear, and I apologise if there was
any confusion, that those four things that I said the federal government is doing, which are
supportive of harm reduction and contradictory to zero tolerance, have my full support: the $10
million to the states and territories for the needle and syringe programs; the support for—

Mr CADMAN—But didn’t you say that the policy adopted throughout Australia is harm
minimisation, and the Ministerial Council supports that and so that is really the policy that is
adopted. It appears on these figures here to be a complete failure.

Dr Wodak—Thank you for the question. It is an important question. This really goes to the
heart of why people like me do support harm reduction. All figures have to be looked at on face
value and—

Mr CADMAN—It is a UN figure.

Dr Wodak—Can I just go into that a bit more. These figures have to be gone into. We have to
also look at what figures are likely to be more reliable and less reliable. The problem that we
have is that, when drug use is estimated in climates of severe repression such as that which exists
in countries like Sweden, people are much more likely to attempt to deny their drug use even to
someone who is coming around and asking them than they would be in a country like Australia.

Mr CADMAN—So you are questioning the method of the survey?

FAMILY AND HUMAN SERVICES


FHS 98 REPS Tuesday, 3 April 2007

Dr Wodak—No, I am not questioning the method. I think it is a simple, basic fact that, if
people are responding to a survey in a climate where there is severe repression and a possibility
of severe punishment, they are much more likely to deny their drug use. A second and even more
important point is that people like me are much more focused on things that really matter. What
really matters is whether somebody is dead or alive, whether somebody has HIV or does not
have HIV—

Mr CADMAN—But those results are very poor—you must admit that.

Dr Wodak—whether a crime has occurred or has not occurred and whether corruption exists.
Those to me are far more important than whether somebody is—

Mr CADMAN—But you said that the emphasis from the Commonwealth perhaps in those
areas was laudable but that insufficient emphasis is given to other places. You are saying that the
policing process now is important?

Dr Wodak—What I am saying is that I think it is much more important that we focus our
attention on things that really—

Mr CADMAN—I would like to see Australia at the bottom of that list, not at the top.

Dr Wodak—I agree.

Mrs IRWIN—Where does this list come from?

Dr Wodak—I agree, but, Mr Cadman, I think it is even more important to look at things that
really matter—that is, whether people are alive or dead. What you may not know is that deaths in
Sweden from drug overdoses have been rising steadily for many years and are amongst the
highest on a per capita basis in Europe. For me that is—

CHAIR—Where is the evidence of that?

Dr Wodak—That is from the EMCDDA—the European Monitoring Centre for Drugs and
Drug Addiction—which is based in Lisbon.

CHAIR—It has not come our way. I have some criticism of some stats you used by a Swedish
professor. They are criticising you, but I am not aware of those criticisms of the Swedish.

Mrs IRWIN—I have a question on those statistics that Alan has just given us. I would like to
go into that. Actually, that is an attachment to the Kings Cross injecting room case for closure. I
am just wanting to know if that is true. They have not said where they got them from.

Mr CADMAN—The doctor has just quoted figures without any authority. I am quoting on
authority. I do not care if—

Mrs IRWIN—I am just saying that I—

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 99

Mr CADMAN—I do not care about the source, as long as the authority is correct—and it is
the United Nations figure. Do you dispute that?

Mrs IRWIN—I would just like to check—

Mr CADMAN—You will need to show me that it is wrong if you are going to dispute it.

Dr Wodak—Mr Cadman, if I had known in advance that I was going to be asked that
question I would most happily have brought along a recent annual report of the European
Monitoring Centre for Drugs and Drug Addiction. I can assure you that what I have said is
correct.

Mrs IRWIN—You might want to take that on notice and get back to us. That would be great.

Dr Wodak—I would certainly be happy to do that.

CHAIR—I am going to go to Louise Markus who can perhaps tell us later about Kirsten
Kalls, who criticised the work that you did and a report that you gave where you admitted that
you had made mistakes with regard to your statistics. I think that, when we do ask you to justify
the stats that you give, it is a valid thing to ask for.

Mrs MARKUS—I have a couple of comments and then some questions. I understand that it
is important to you that people are alive and not dead. I think all of us would agree. None of us
want to see any life lost, whether it be in the mother’s womb or beyond that. I think too that in
much of the evidence that has already been presented—and some of it is very anecdotal and not
necessarily empirically based; you have already alluded to this in talking about families—there
is more than just the person. I will refer to them as persons. I think sometimes we call the person
‘the addict’. I think that, to place value on them as individuals, we should identify them as
people who use illicit drugs.

But there is more than that person involved. There is family; there are children, parents,
grandparents. There is a whole context of people who are impacted by this. That person is not
necessarily going to an isolated room and engaging in their illicit drug use and then coming out
and not impacting in a negative way, in a harmful way, on the rest of the people that they are in a
relationship with.

I will move on to some questions. Firstly, methadone programs—and I worked with many
families over a 25-year period before I stepped into this job. You have talked about some people
who have come off methadone. But, in my experience and from some of the anecdotal evidence
that has been provided, there are some clinics where individuals on methadone, when they want
to come off, find it extremely difficult and there is not necessarily the help available. And, in
some instances, wherever they are receiving the methadone or whoever is prescribing it—and
this is in the evidence presented by people who work with people who are using methadone—the
individual using methadone is not helped to reduce their use. There are many instances where
people are on methadone for long periods of time and where the support structures and other
kinds of assistance that would be most beneficial to changing some of the behavioural and
psychological impacts on them, and maybe the broader relationships that they are engaged in,
are not provided. So you could make a comment on that.

FAMILY AND HUMAN SERVICES


FHS 100 REPS Tuesday, 3 April 2007

Secondly, naltrexone—some of the evidence that has been presented indicates that naltrexone
is most effective when there is ongoing, very regular support and where, again, all the broader
issues are addressed, where it is not just about an implant or a pill but where a whole lot of other
support structures are in place. You might like to comment on that.

A third point is that you talked about two types of laws—forgive me for not being able to
repeat what you said. Are you inferring that when people engage in the use of illicit drugs there
are no witnesses? I suppose, from what I have seen over the years, there are children and adults
and grandparents that have viewed and observed behaviour that I am sure none of us here would
really want as a part of our families. We do not live in a perfect world, so we have to work with
that. Could you comment or respond to those questions?

Dr Wodak—Thank you for the question and the tone of your question as well. I am very
happy to answer those questions. I agree with your opening remarks about the need to always
see the problem of illicit drug use, and licit drug use too, for that matter, in a broad context and
not just a narrow context of the individual who has the problem, because almost invariably
others are involved and others often suffer grievously over this problem. We see, unfortunately,
in my hospital, a steady stream of people damaged by alcohol, tobacco, prescription and illicit
drugs and, to me, one death is no less tragic than the other. We lost a 37-year-old man from
alcohol just a couple of weeks ago—a fine man. It is always difficult.

Turning to your questions on methadone: I am not sure whether you are aware that
methadone, despite the controversy that rages in this country and some other countries, is now
very well accepted internationally and it has been included by the World Health Organisation in
the essential drugs list. In fact, Australians prepared the—

Mrs MARKUS—I am not asking about whether it is accepted internationally; I am talking


about—

Dr Wodak—The support needed.

Mrs MARKUS—the fact that there are many people in our communities who remain on
methadone for a long period of time and that the opportunities and the availability of choice and
options for them to step down from that do not appear to be always present.

Dr Wodak—The reason I am saying what I started off saying is that it leads up to the answer
to your question. So methadone has been included on the essential drugs list of the World Health
Organisation, which is a very important step, recognising the strength of the scientific arguments
for benefit and the weakness of the arguments that it causes great damage. It has also been
endorsed in a joint statement by the World Health Organisation, UNAIDS and the United
Nations Office on Drugs and Crime. Both of those, its inclusion on the essential drugs list and
that joint endorsement, were in the year 2005. That really means that we are dealing with a
serious treatment.

The problem that you have just talked about—and I share a lot of the sentiments you
expressed—is that methadone is grossly underfunded. Buildings where methadone work goes on
are often squalid. The great Australian sport of cost-shifting between Commonwealth and

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 101

state-territory levels of government is applied with great vigour on both sides, I am sorry to say.
The result of it is that methadone facilities and clinics are usually run on the smell of an oily rag.

CHAIR—There are millions of bucks in it—people making profits out of it.

Dr Wodak—If I can go back to evidence. The system is grossly underfunded and that really is
the core problem. I could not agree more with your remarks, Mrs Markus, about the need to
support people going through any kind of drug treatment, not just naltrexone but methadone as
well. People generally start using heroin at the age of 17 or 18. They first come to methadone at
the age of 26. In those seven or eight years, they have often lost the chance to have a proper
education, they have lost contact with their families, their careers are wrecked, they are often
deeply in debt, their children are in a mess, their relationships are in a mess and you cannot put
that right just in a matter of days or weeks or even months; it takes years. You need staff to help
work with those patients to help them. Probably one of the most helpful things we can do for
someone struggling with a drug problem is to help them get a job and we try to do all of those
things with the resources that we have available.

If you drew the conclusion that naltrexone works much better when effective support is given,
that is really true of every medical condition. If we are looking after a diabetic with insulin, it is
not simply a matter of handing a person the insulin; we have to talk to them about their diet and
their way of life and their exercise and all the rest of it.

In answer to your last question about mala prohibita—and I am sorry if I did not explain that
well enough to you before—I was trying to say that there are types of laws that are called ‘mala
prohibita’ bad because they are prohibited—

CHAIR—We have been that way; I am sure she understood.

Dr Wodak—The problem with all of these kinds of laws is that the lack of witnesses is a real
problem for prosecution. Often police, under these circumstances when required to police mala
prohibita laws, bend the rules and bend the rules of evidence sometimes quite seriously, and this
is often where corrupt practices take place. So, yes, drug use is often witnessed but, in terms of
police prosecution, it is difficult to get somebody who can testify.

Mrs MARKUS—Do you know the number of deaths in Australia from methadone?

Dr Wodak—I do not know anywhere where it is estimated. It would not be hard to find that
out.

CHAIR—Perhaps you could take it on notice.

Dr Wodak—I am certainly happy to do that.

Mrs MARKUS—One of the points that I would like to make is that we talk about deaths
from heroin, but there are deaths from methadone and I think it is important to get that on the
public record.

Dr Wodak—It is a more complicated question to answer than you might think.

FAMILY AND HUMAN SERVICES


FHS 102 REPS Tuesday, 3 April 2007

Mrs MARKUS—I am not saying that it is simple. All these issues are complex, but I am just
saying that it needs to be on the public record.

Dr Wodak—Very often, when death occurs and methadone is found, there are often many
other drugs present and it is very hard to determine the extent to which methadone contributed to
the death.

Mrs MARKUS—So, if somebody uses heroin, are they likely to be using other drugs as well?

Dr Wodak—Yes, they are, and there is considerable overlap between the use of heroin and
particularly alcohol—that is very common. We did a study about 20 years ago at my hospital of
150 consecutive heroin overdoses in about 1985 and we excluded anyone where there was any
suggestion that alcohol might be implicated. We took blood or urine or gastric samples and
analysed them for morphine and other drugs, and the second most common drug after heroin was
alcohol. I can remember with astonishment the results of that study. The average alcohol
concentration was 0.17—in other words, more than three times the legal blood-alcohol level for
driving—and the maximum was 0.49. And we thought we had excluded everyone where there
was any hint of alcohol. So alcohol is very significant.

Mrs MARKUS—Do you know the statistics for deaths of children from methadone that has
been given to them by their parents? I am not saying that that does not happen with heroin, but
the point I am endeavouring to make is that, if you do not address the underlying behaviour and
you do not really work to bring change in people’s lives, the death and damage and harm will
continue. While there is a process for people making decisions about what they are ready to do at
what point in time and they need to be supported to make those steps towards change and
hopefully a drug-free lifestyle—and not everybody will make those choices—I think it is
important that our goal is not the lowest common denominator but should be to encourage
people to reach their full potential as much as possible and make all the choices along the way to
be drug free.

Dr Wodak—I could not agree more with most of what you said. Carrying out these things is
very difficult. You are often dealing with people who have been sexually abused in childhood,
who have had all sorts of problems during their growing-up period—

CHAIR—We have already established that that is a small percentage of people who are users.

Dr Wodak—and trying to help these people is very difficult. That is all the more reason why
drug treatment needs to be properly funded. There are various estimates of funding levels for
drug treatment, but they are very low. What we do have is cost-benefit estimates, admittedly for
cocaine users in the United States, which are that, for a $1 investment in cocoa plant eradication,
there is a 15c benefit; for a $1 investment in interdicting cocaine between South and North
America, there is a 32c benefit; for US Customs and police, there is a 52c benefit; and for
cocaine drug treatment, there is a $7.46 benefit. Despite that, the United States government
allocates seven per cent to drug treatment and 93 per cent to drug law enforcement. The
imbalance in Australia might not be quite as bad, but it is still very bad. If we had more money
for methadone clinics we would be able to do all the things that you want to do and that I want to
do.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 103

Mrs MARKUS—I would support more money for methadone clinics, but only if they went
towards reduction.

Mrs IRWIN—I wonder whether I can ask two questions, Madam Chair, because we did keep
Dr Stewart two hours and I think he was only down for an hour.

CHAIR—You were not here. We allocated time.

Mrs IRWIN—I was just informed of that by Ms George. I arrived here at about a quarter past
12. I have a question that Ms George wants me to ask, because she had to go, and I have one I
want to ask on my own behalf. Dr Wodak, do you support a continuing role for drug law
enforcement?

Dr Wodak—Of course I do. We need to have drug law enforcement. A Wodak government
would certainly maintain a role for drug law enforcement.

Mrs IRWIN—I will give you a membership form for the Labor Party shortly.

CHAIR—The Labor Party would probably have you; I do not know whether we would.

Dr Wodak—I wish drug law enforcement every success in its difficult but futile task.

Mrs IRWIN—You were talking earlier about naltrexone and when it was first introduced into
Australia. I think you stated that you believe people should have choice. Have we done any
studies into the effectiveness of naltrexone treatments? I think you said also that you had some
concerns about not enough research having been done into it. Is there research going into
naltrexone?

Dr Wodak—Yes, research is going on in that area. All drug research is difficult and it is
unfortunate that not all but most of the research on naltrexone that has been done in Australia has
been by people who are great enthusiasts for it but who have some difficulty establishing
objectivity and credibility—and that is a real problem. But other research has been carried out by
people of impeccable reputation; that research to date has been very disappointing. The research
has been done in three phrases. The first phase gave people naltrexone and then watched them
over a period of months. We found the result from that was dismal. That is the result I quoted
where at six months four per cent were still taking the drug. That study was carried out by
Professor Saunders in Brisbane.

Then there was a phase of research where the treatment was initiated by rapid opiate
detoxification or ultra-rapid opiate detoxification. That was sometimes done with a general
anaesthetic and sometimes done with heavy sedation. We found that to be very expensive and
also that it did not increase effectiveness. In both cases we found that the death rate from people
engaged in naltrexone was about six or eight times higher than we had expected it to be.

CHAIR—Where are those figures?

Dr Wodak—They are published in the NEPOD studies. That was a program of 13—

FAMILY AND HUMAN SERVICES


FHS 104 REPS Tuesday, 3 April 2007

Mr CADMAN—You are a practitioner in methadone and you do not know their figures? That
is strange.

Dr Wodak—No.

CHAIR—I find it odd too that you know statistics about naltrexone but not about methadone.

Dr Wodak—NEPOD was a collection of 13 different research studies that were coordinated


by the national drug and alcohol research centre. One or two of those studies included
naltrexone.

CHAIR—Yes, I think we have seen those.

Mrs IRWIN—Naltrexone is in its early stages. We had a private clinic in my electorate that
was charging between $3,000 and $10,000 and I think there were two deaths there.
Unfortunately, they were not followed up. I think they were using naltrexone plus heroin. But
my ears pricked up when you said that research was being done. The member for Hughes spoke
in the federal parliament in support of this clinic, after first seeing it many years ago. About six
months ago, I spoke with a Vietnamese lady who went on naltrexone and is now on an IVF
program because she does not seem to be able to carry a child to term. I just wondered whether
she miscarries because of the naltrexone treatment that she was on.

CHAIR—I think it is the drugs she took before she went on to IVF.

Dr Wodak—I cannot answer that.

Mrs IRWIN—I am just wondering. I think it is good that research into naltrexone is still
going on.

Dr Wodak—Naltrexone implant research is being carried out in Los Angeles, in the United
States, by Walter Ling and his colleagues, which I think is high-quality research. I await the
findings from that research with an open mind. I have heard of the design that is being presented
and I think the findings, whatever they are, will be well worth listening to. It may work and, if it
does, we have an additional treatment option.

Mrs IRWIN—That is fantastic.

Dr Wodak—That is good.

Mrs IRWIN—It will help save a number of lives.

CHAIR—Thank you for attending. It has been most illuminating.

Dr Wodak—My pleasure.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 105

[3.45 pm]

BETTS, Mr Ryan, Graduate Student, ONE80TC, Teen Challenge New South Wales

MORRIS, Mr Rhett, Chief Executive Officer, ONE80TC, Teen Challenge New South Wales

Witnesses were then sworn or affirmed—

CHAIR—I do apologise that you have been kept waiting. We are grateful to you for joining
us. You may like to make an opening statement, but before you do I note that you have given us
a very good pack of information. Is it the wish of the committee that the three-page statement
entitled ‘An impact of illicit drug use on families’ be accepted and published as a submission?
There being no objection, it is so ordered. The rest we will accept as an exhibit. Would you like
to make an opening statement?

Mr Morris—Thank you. Teen Challenge has organisations right around Australia and we
have existed in Australia for some 40 years. The only state of Australia that we are not
represented in at the moment is Tasmania, and we are excited to announce that Tasmania will be
coming online within the next 18 months. We have just located a facility and we are moving
towards that.

I will make a few statements with regard to the three questions that the committee are looking
at and, in that, the financial, social and personal cost to families who have a member using illicit
drugs, including the impact of drug-induced psychosis or other mental disorders. We firmly
believe that the cost to families is enormous, and financially they have often been impacted by
theft as the person involved attempts to fund his or her habit. Consequently, families are often
left with large amounts of debt. They struggle to repay medical and legal costs, outstanding debts
accumulated by the person involved in the using. In fact, a lot of borrowing takes place. The
classic character trait of anybody involved in drugs is that they are a class A manipulator.

Socially, the families often feel the effects of an issue that can be interpreted only as ‘modern
day lepers’. Addiction in our society is a subject that is often swept under the carpet. Families of
users often feel isolated and are left wondering what role they played in the initial use or what
led to that person having to use drugs in the first place. There is a lot of guilt involved.

Finally, in relationships the addictive cycle leads to a breakdown in trust and communication
between family members. As the habit intensifies, we see drug-induced psychosis come into
play. Family members are not trained in or aware of how to deal with the erratic and often
violent nature that stems from such drug-induced psychosis. Family life moves from incredible
highs to incredible lows with basically threats of violence and self-harm between those times.

I have asked Ryan here today because he is currently a staff member with us but he has also
gone through the residential program that we are talking about today, and so in a moment I am
going to ask Ryan to speak to that.

FAMILY AND HUMAN SERVICES


FHS 106 REPS Tuesday, 3 April 2007

With regard to the impact of harm minimisation programs on families, we deal with literally
hundreds of families and we have dealt with thousands of families over 40 years. I am yet to see
an auntie, uncle, mother, father, daughter, child—any family member—want anything but a
complete 180 degree turnaround for a young person involved in a destructive lifestyle. Harm
minimisation does not deal with the issue but only medicates a symptom. We believe that, if we
can address the issue and tackle the problem at the original cause—things like family
breakdown, fatherlessness, abuse and neglect—and teach these young people the skills necessary
to deal with disappointment in their lives, we will give them a real chance at a positive future
rather than a future of monitored substance abuse.

Finally, on ways to strengthen families who are coping with a member using illicit drugs, I
think the first step must definitely be a campaign to create a positive environment for families to
come out. A few years ago it was not such a positive thing to talk about depression. Yet with
good government support, organisations like beyondblue and a few famous people we have
made depression quite a topical subject that is quite openly received in the media. I think we
need to be doing the same thing with addictive behaviours.

CHAIR—I don’t think Britney Spears helps, though, do you?

Mr Morris—No, I do not think she helps us at all. I think in America rehabilitation is


something that needs to be on your CV to get you your next movie!

Mrs MARKUS—It will be on the public record.

Mr Morris—I think we need to lose this tag of modern-day lepers and, instead, start to
promote the courage that it takes for a young person to admit that they have a problem and that
they are seeking help. Often our centres are full of young people who have hit rock bottom as
there was no encouragement to seek earlier intervention in their drug use. They feel trapped by a
combination of their life-controlling issue and society’s opinion that: ‘You got yourself into it,
mate. Well, you can get yourself out of it.’

Over the years we have noticed that often it is not only the young person who requires
counselling and support and a breakthrough but also the family involved. The first step is
carefully guided reconciliation between the young person involved and the family members and
the building of trust. Often, substance abuse can be generational. If you can find the family
member who is prepared to break with generational tradition and decide to turn it all around,
then you have not only affected that person’s life but you have set up future generations for
success. You will hear Ryan’s story today, and he is a prime example of breaking with
generational tradition.

More rehab and training centres need to encourage family members to play an active role in
the person’s retraining or rehabilitation. This is often a process which is overlooked. I do not
believe it is overlooked because of ignorance by the other fine centres around Australia that are
doing such great work. I think it is overlooked because of the simple cost factor. You need extra
staff members not only to be able to deal with the issues of the young people you have in the
centres—and Teen Challenge has, as of today, some 350 young people—but also to deal with
their family members. We just do not have the funding to be able to do that. We will, though, and
we are endeavouring to get there.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 107

With regard to single mothers who have small children and are involved with life-controlling
issues, we are very passionate about this, particularly in our Sydney office. We are just about to
launch a program to set up a facility that caters specifically for young mothers who are
struggling with life-controlling issues and who have kids. We believe that more centres need to
be prepared to run programs and build purpose-built facilities that cater for embracing the
opportunity to care for both mother and child, rather than having them face the trauma of
separation. As the mother seeks help with her substance abuse issues, we believe we can also
give great solid instruction for these mums to be great parents.

CHAIR—That is not always going to be possible, is it?

Mr Morris—It is not always going to be possible, but I think, if it was all about making sure
we were a hundred per cent successful every time, Teen Challenge probably would have stopped
39 years ago. Our history is dotted, unfortunately, with lost causes, but if it is just for the one
then it is all worth it.

Our final statement is that, obviously, all of this needs to be conducted in an environment of
professional care in order to be able to achieve the best result for any of our students. And if this
is okay we can listen now to Ryan’s story and hear where he has come from.

CHAIR—Yes.

Mr Betts—Dad left home when I was five years old. He left my mother alone with the kids—
at that time, me and my brother. He was arrested at Sydney airport not long after—he was
bringing heroin into the country. Our stepfather was a very violent and very abusive alcoholic.
He used to beat us and mum. She ended up having two more kids with him—my two sisters.
Growing up in that environment, fatherless and then with this father figure that was so abusive
and carried on the way that he did, meant that we grew up with a lot of issues. We grew up bitter,
hurt and aggressive, with a lot of walls and with no identity. Just before I went into the training
centre we were fighting with the people in the units next door. It was all over drugs and
everything else. One ended up having his throat cut, there were shots fired and all sorts of things.
That is just how it was, and that is how we grew up, seeing all those sorts of things.

As Rhett was saying, it is generational. I ended up going down the same road. A lot of our
family members are in jail and many others have died. Along the way, I have also seen a lot of
my friends die. Two of my friends committed suicide just before I went into the program, and
others were in jail. I remember thinking to myself at the time about the way that I was living. My
girlfriend was a prostitute and on drugs, and she had a little girl. The way that I was living was
as though a baton had been handed down from one generation to another, and I thought it had to
stop. So I ended up in Teen Challenge.

I lacked identity and understanding of what it meant to be a real man. I thought the way that I
was living—all violent and everything else—was about manhood, but it was not. I had no role
model. I had nothing like that. This is where the program steps in and deals with issues of
neglect, abuse, rejection and, of course, addiction. It takes you down a separate path, but it is the
path before that that brings you to addiction and that is the path that Teen Challenge, One80TC,
deals with—abuse and all sorts of things like that. Not everyone has been abused. A lot of people
just try drugs and end up addicts, but there is always something lacking in a person’s heart when

FAMILY AND HUMAN SERVICES


FHS 108 REPS Tuesday, 3 April 2007

they have to reach out and take drugs. That is where the program steps in. Of course we deal
with addiction, but we mainly deal with the heart and the cause behind taking drugs in the first
place.

I have been out of TC for two years. I bought a house when I finished the program. I am in the
process of buying a second house. I am renovating the house that I have already bought because
I am a carpenter. We are looking at buying a third house by this time next year. I will not stop. I
want to get as far away as possible from where I was. I work for TC now. I work very closely
with a lot of the boys and help out with renovations there. I also like to speak at functions like
this. My life has completely turned around, but the girl that I was living with at the time—

CHAIR—What happened to her?

Mr Betts—I have stayed friends with her for a long time. She is still on the street. She is
living somewhere here in the Cross. She rings me every now and then. DOCS has her little girl.
She has just faced sentencing and is on parole at the moment. But she is still in crime. This is
where we need ministries like Teen Challenge. Her daughter does not even know her mother.
That little girl is five years old. She is in the exact same position I was in 20 years ago. I see her
little girl. She is just an innocent little girl.

CHAIR—Where is she? Has she been fostered? What has happened to her?

Mr Betts—DOCS took her. Annie is the name of the girl that I was with. She ended up with
Annie’s parents. Annie is not allowed to see her little girl. The little girl loves her mum to
absolute bits. She is turning into a terror and is already in front of a psychiatrist and all that sort
of stuff. She is five years old.

Mr Morris—In New South Wales there are 1,000 babies born every year to a drug-affected
parent.

CHAIR—Thank you. We were looking for that figure.

Mr CADMAN—We have heard from all the experts and you tell us the facts.

CHAIR—We have had all the experts but they could not give us the numbers!

Mrs MARKUS—That is an awful figure.

Mr Morris—Yes.

CHAIR—I am sorry. I interrupted your story, Ryan. What happened to your brother and your
two half-sisters?

Mr Betts—One of my sisters has just finished school.

Mr CADMAN—I know your sister, don’t I?

Mr Betts—I think you know my brother as well.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 109

Mr CADMAN—She is a wonderful young woman.

Mr Betts—She is beautiful.

Mr CADMAN—I have only realised just now who you are.

Mr Betts—One of the sisters is all right. I worry about her. It is what she does not say that
worries me. She appears as though everything is together. Do you know what I mean? We call it
denial; however, my sisters were a lot younger when everything was happening. My step-dad
ended up leaving home, although we lived just down the road from him. The girls did not see the
violence in the house that my brother and I saw while we were growing up. My brother is the
complete opposite to me. He never touched drugs. He never touched alcohol or anything like
that. Without invading his privacy or confidentiality, I see the path that he has gone down. I say
to him: ‘Joel, you never hit the bottom like I did in that sense. You’ve always aimed for the top,
but it doesn’t mean that your heart is not broken. We saw the same things. One reached out to the
bottle and one reached out to success. One hit drugs and one went for women and that sort of
lifestyle.’ But if you get behind his outward appearance, his heart is just as broken.

CHAIR—But he coped in that way?

Mr Betts—In a way—

CHAIR—You are never going to be able to take away the heartbreak, are you?

Mr Betts—No, that is right. But still, he lacks identity and he lacks all sorts of things like that.
He has just gotten older; he has not—do you know what I mean? It is all still there.

CHAIR—And, of the two sisters, one has just finished school and one—

Mr Betts—One is still in school. She cries on my shoulder all the time. She has such a broken
little heart. The way I see it is that, if I did not do this program, I was affecting my immediate
family. My sisters and my brother had to come and see me in courts or being arrested or all sorts
of things like that, so that affected my immediate family. I was affected by a person who was
exactly like me once, when he did not have a family. But, if I had had a family or my kids—like
I said, the baton just passed on. We are going down the same path and we are raising up four
more people into our world who are just as messed up, hurt and abused and everything else.

CHAIR—You have not married or had children or anything at this stage?

Mr Betts—No, I am waiting just to find the right girl. I cannot wait to get married and have
kids, to be honest.

CHAIR—Has your brother married? Does he have children?

Mr Betts—No, he has not been married either yet. He is 27 years old, but he has had a
girlfriend for a while now. He is plodding along. He is getting there. I was listening to an
argument before about legalising drugs and all the rest. I have to say that I think you would be
crazy to say you can go for your life—

FAMILY AND HUMAN SERVICES


FHS 110 REPS Tuesday, 3 April 2007

CHAIR—Absolutely.

Mr Betts—and to get heroin or cannabis or anything like that as common as alcohol or


cigarettes.

CHAIR—It is ridiculous. In fact, it is evil.

Mr Betts—Load the gun and hand it to them: ‘There you go.’

Mr Morris—We announced it to our boys—when the Greens were talking about that in the
state parliament—in one of our training sessions with all our students there. I do not think I have
ever seen a bigger uproar than them objecting to the talk of legalising ice. You come out, and we
will show you our boys and girls, and we will talk to you about legalising ice. It is just—

CHAIR—I would not mind coming out to visit you, actually.

Mr Morris—We would love to have you.

CHAIR—Could we do that?

Mr Morris—Absolutely.

Mrs MARKUS—It would be good for us all to go—

Mr CADMAN—There is another place that I spoke to you about yesterday that we could visit
at the same time.

CHAIR—Yes.

Mr CADMAN—We were talking about Mercy Ministry, which is similar to your program but
in a different part. It is up at Castle Hill. It is for girls.

Mr Morris—Yes.

Mrs MARKUS—Can I go back to this methadone thing, because I struggle so much with that
actually being more of a problem than a solution. Do you think that for guys who are on one of
the methadone programs or whatever, it is almost impossible or hard for you to get them into the
program?

Mr Morris—I think the truth behind the methadone program is that, if you really ask them
honestly whether they want to be on it or not, the fact is that they do not. If you can offer them
an alternative where they do not need to be on it and still get a result, they will jump at it every
time.

Mrs MARKUS—It is good for you to make that point.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 111

Mr Morris—In the first three days of this week, we received nearly 270 phone calls for help.
Most of those were from solicitors, lawyers and legal teams with young people who are in
prisons. I have been in Parramatta prison. I have seen the line-up of some hundred inmates
getting their methadone drinks. All we can say is that we put them through the detox so that their
health is right; we bring them in and we run them through our program. Methadone is just as
dangerous as ice.

CHAIR—That is a statement and a half!

Mrs MARKUS—I agree.

Mr Morris—It is.

Mrs MARKUS—What concerns me is that attitude of, ‘Let’s keep them just alive’; whereas
that is the lowest. No-one wants to see anybody die, but placing value on individuals, on
humans, on families and on our society is about believing for the best—

Mr Morris—That is right.

Mrs MARKUS—and it is about setting the goalposts and then aiming to get there. That is
how I view it.

Mr Morris—I have four little children and if one of my children were involved—and God
willing, that is not going to happen—I would fight with everything I had to see them free and not
sustaining a monitored drug program. I think 40 years of evidence shows that we can bring a
person in, love them, care for them, help rebuild their lives, give them the skills, give them a job,
get them physically fit, deal with the issues of their life and have trained counsellors and
psychologists on site that can work through those issues. You can actually see a breakthrough in
people’s lives.

Mrs MARKUS—One of the gentlemen this morning, Dr Reece, gave evidence about physical
activity like sport being very critical to particularly physical regeneration, the immune system
and so on. What do you do at TC for that?

Mr Morris—Most of the guys and girls that come in are incredibly underweight just because
of the nature of the lifestyle they have led during their addictive behaviour. On average you
could have a guy that normally weighs 80 or 90 kilograms weighing anywhere between 40 and
50 kilograms. We run a program where we bring in proper, trained health trainers to come in
each week. But again it is a holistic approach—things like weights, touch football and an eating
program. But you can also start to make—particularly with weights and boys—that a bit of an
addictive behaviour and so you have even got to monitor that as well. We have noticed that most
of our best counselling occurs in the middle of a touch football competition when a punch-up
breaks out and you can pull the boys apart and you can deal with the issue on the spot. ‘Why is
that flicking your switch? Why is that making you angry?’ We find sport is a big part—for self-
esteem as well.

We have been approached by the Sydney Swans to talk to them and their players about how to
work that exact issue through. We have all seen in the recent things that have taken place that

FAMILY AND HUMAN SERVICES


FHS 112 REPS Tuesday, 3 April 2007

success in sport does not qualify you as a person. That is not going to be called an addictive
behaviour.

CHAIR—I think that player’s father—Cousins, is that the name—deserves a medal. He had
the courage to come forward and say, ‘We’ve got a problem here and we have just got to deal
with it.’

Mr Morris—That is what we were talking about earlier. There is not enough of it and not
enough parents who feel confident; they feel ashamed that their young person has got involved
in it.

CHAIR—But there is no reason why you cannot still feel ashamed and say, ‘But I’ve got to
deal with it.’

Mr Morris—That is right. That is exactly right.

CHAIR—There is nothing wrong with the shame but you have to be able to say, ‘We’ve got
to deal with that.’ I think that was a really good move and it shows that Rugby League is
behaving better than AFL.

Mr Morris—There are certainly some challenges, that is for sure.

CHAIR—We would very much like to come and visit you and have a look. I think we can
arrange to come and see you and the sort of programs that you have.

Mr Morris—We would like to have you.

Mrs MARKUS—The new program that you are about to start with the mums and children, is
that happening somewhere else?

Mr Morris—Absolutely. We have a policy that you do not run a male and female program on
the same site. It is a recipe for disaster. It will be occurring though within a kilometre of the
other site and we are currently looking at a couple of blocks of land as we speak. There are a lot
of dual services that can be offered to the boys and the girls. It is just cost efficient to run it that
way. But there is no interaction whatsoever; you do not need broken people getting together.

CHAIR—No. They are both vulnerable; wrong decisions are made.

Mr Morris—Homogenous style programs are the most successful programs.

CHAIR—That is interesting.

Mrs MARKUS—Has the program with the mums and children been trialled somewhere else?

Mr Morris—Yes, there is a centre in Sydney called Jarrah House.

Mrs MARKUS—I know Jarrah House. It has a very good reputation.

FAMILY AND HUMAN SERVICES


Tuesday, 3 April 2007 REPS FHS 113

Mr Morris—Yes. We have partnered with them in getting advice on how to build a place and
we have had tours of their facility. It is quite a specific-built facility that you need to look at.
They run an excellent program. The difference between them and us—there are a lot of
differences but this is the main one—is that they run a six-week program and we will be looking
at a 12-month residential program. We strongly believe that if you have been in a lifestyle of
drugs for six, seven or eight years, it is going to take more than six weeks—

Mrs MARKUS—Definitely!

Mr Morris—to regain your life. But, in saying that, it is a great stepping-stone, and this is
where Jarrah House sees us getting involved, in that they could be there for six weeks and then
come to us for the remainder.

CHAIR—Thank you very much for coming, and, Ryan, thank you very much for sharing
your personal experience with us. Susan came and gave her personal story at lunchtime. When
someone tells their own story, face to face, it has an impact. Thank you very much for sharing
with us. Thank you for your attendance today and thank you very much to the Hansard reporter.

Mr Betts—No worries.

Resolved (on motion by Mrs Markus):

That this committee authorises publication, including publication on the parliamentary database, of the transcript of the
evidence given before it at public hearing this day.

Committee adjourned at 4.11 pm

FAMILY AND HUMAN SERVICES