To the Editor: Threatened with a surge of Athenian, one-eyed jingoism regarding Australian drug policy that the recent conference report by Ritter et al1 might have elicited, we offer a warning.

Australia has achieved much to be proud of with its harm-reduction policies in recent decades. As Ritter et al attest, Australian researchers and practitioners are “leading the way” in generating political and community support for greater harm-reduction efforts. However, the implementation of real harm-reduction measures can hardly be described as “Olympian” under the current administration. Real Australian successes in the area of harm reduction have arguably occurred despite federal and state policy rather than because of it. Individual positions taken by clinicians such as Dr Alex Wodak, in the face of severe opposition and at times intimidation, account for much of this success. The sad reality is that the “Tough on drugs” approach currently pursued in Australia seems doomed to soon fuse with the Americans’ globally denounced “War on drugs”.

Real harm reduction can hardly be said to have been given a “fair go” in the past decade, with 85% of the total drugs budget in Australia committed to law enforcement — the paltry remainder split between research and treatment.2 While harm reduction strategies have been widely implemented in response to the problems associated with injecting drug use, such strategies have not been nearly as popular in our responses to other types of drug use. Harm reduction is yet to be embraced as an effective response to the problems associated with the so-called “party drugs”, despite mounting evidence of its efficacy in Europe.

Any premature triumphalism on the subject of harm reduction ought to be eschewed. Australia’s recent heritage is quietly being betrayed at a federal level. A little-publicised federal report recently called for a move away from harm minimisation and harm reduction.3 This is despite evidence indicating that functional drug use is emerging as “normal” rather than deviant behaviour among many Australians. 4 Clearly, we must redouble our efforts to ensure that harm reduction becomes a central part of Australia’s public policy stance.

In an era in which it often seems easier to succumb to the whims of our larger neighbours than to resist them, it becomes even more important that doctors and health professionals, and particularly the younger generation of researchers, stand firm. We are, after all, standing on the shoulders of giants.

In reply: Caldicott and Duff raise a very important question: is the federal government intending to soon terminate Australia’s national drug policy of harm minimisation? This view can be supported by numerous and recent unambiguous speeches by senior government ministers, including the Prime Minister. The government would like Australians to believe that it is implacably opposed to a harm-minimisation approach to illicit drugs.

However, a different view appears when federal government funding allocations are examined. For example, the government allocated $215 million to the Illicit Drug Diversion Initiative over 4 years (in addition to a previous allocation of $221 million).1 The intention of this Initiative is to divert selected drug offenders from the criminal justice system to drug treatment. These efforts are, in our view, highly commendable, reducing the use of expensive and largely ineffective custodial punishment and increasing the use of less expensive and more effective drug treatment. They are, however, irreconcilable with a “zero tolerance” or “Tough on drugs” approach to illicit drugs. Another example is AusAID’s recent leadership in the introduction of harm-reduction measures to control HIV epidemics among injecting drug users in Asia.

It is also worth noting that the Ministerial Council on Drug Strategy (Australia’s paramount official drug policy-making body since 1985) has repeatedly and recently endorsed a national drug policy of harm minimisation.

The present federal government, unlike its predecessor, frequently and stridently attacks emotionally charged symbols of harm reduction, such as the proposed prescription heroin trial or the Medically Supervised Injecting Centre in Sydney. However, as the allocation of substantial funding to the Illicit Drug Diversion Initiative demonstrates, in most respects it is very much a case of business as usual.