It’s tough, it’s expensive, but rehab really works
Rehabilitation works. Just ask Sally*, who first injected heroin at the of 15.
By 19, she was injecting four times a day and was working as a prostitute to pay for her habit. This continued until she met a social worker who referred her to a drug rehabilitation clinic.
After a tough battle with a few setbacks, Sally is able to live without heroin, and is now completing her second year of a law degree. And this is all thanks to rehabilitation.
Yet despite the ability of rehabilitation to transform lives, this isn’t the focus of drug treatment strategies.
Just this month the Australian Institute of Health and Welfare reported that only 5.1% of drug treatment episodes in this country principally involved rehabilitation. In prisons, while methadone maintenance programs were offered to all detainees in all jurisdictions, there were very few opportunities for detoxification and rehabilitation.
These statistics are consistent with those published by individual facilities such as the Sydney Medically Supervised Injecting Centre, where 30 per cent of clients receive some form of referral and of these only a small fraction receive referrals to detoxification or rehabilitation programs.
The reason for this is partially ideological but also partially economic - drug rehabilitation is expensive. But it does achieve results. Sweden has the lowest drug use rates in Europe and much of that can be attributed to their emphasis on rehabilitation centres.
We can and should do more here. In NSW the total 2011/12 budget for drug and alcohol services is $161 million, an 8 per cent increase on the previous year - but we still spend more than double this amount on parks and wildlife.
Up to now there has been debate over whether our drug policy should adopt a “zero tolerance” or a “harm minimisation” approach. This is a false dichotomy. Clearly we should always try to minimise harm. Clearly we should not tolerate the supply and use of illegal drugs.
“Harm minimisation” has come to mean that we assume there is, and has always been, some sort of “drug karma” in society as a whole: if one drug falls, another one takes its place.
There is often no suggestion that drug abuse may have become more prevalent in many contemporary societies, and no admission that countries such as Sweden have been able to buck that trend. Harm minimisation has also come to mean that most forms of suggestion or encouragement to kick a drug habit on the part of a health professional is some sort of violation of a person’s right to be addicted.
The harm minimisation approach, despite its claim to a monopoly on compassion, has unpersonalised drug treatment. It seems to be more concerned with statistical ends, like ambulance call outs or syringes in the streets. I have not yet seen a recent study on drug treatment programs that looks at outcomes such as return to meaningful employment or long term mental health.
What we need is a drug policy that realises that while drugs may always be with us, they need not remain as prevalent, and they certainly need not always be a part of an individual’s life. We need an approach to drugs that is perhaps not so “experienced”, and that still believes people addicted to drugs can, with assistance, overcome their habit and live more meaningful lives.
The recent announcement by NSW Attorney-General Greg Smith to establish a 300 rehab bed centre for drug-addicted prisoners is a positive and welcome shift in dealing this with problem. The new centre is part of a broader program that will provide ongoing support through vocational training and further education to assist participants re-settle into the community.
This is exactly the kind of forward thinking NSW needs which serves both the needs of addicts and the greater community at large.
Dealing with drug addiction is not simply about “managing” a “problem” or generating positive statistics as some within the drug treatment lobby believe. Rather, it is about the reality of human experiences, human lives and realising the potential that lies within us all.
Rehabilitation works. Just ask Sally.
*names have been changed to protect the identity of the individuals mentioned
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