AMA challenges substance abuse report's illicit drugs recommendations

Dr Yong said the AMA supports many of the 128 recommendations regarding alcohol and tobacco issues, but has grave concerns about the Report's recommendations on illicit drugs.

"We support the introduction of graphic warnings on cigarette packages, subsidising of nicotine patches and building community support for smoking bans in all public places," Dr Yong said.

"We also support moves to include cigarette-style warnings on alcohol packaging, and to explore changes to alcohol taxation based on alcohol content."

Dr Yong said the Report errs on the conservative side in regard to illicit drugs.

"The Report appears to be biased against methadone maintenance for the treatment of opioid dependency," Dr Yong said.

"The report gives more credibility to treatments, including naltrexone, which have a lesser evidence base than methadone.

"According to ADCA (Alcohol and other Drugs Council of Australia) methadone maintenance treatment has been clearly demonstrated to reduce illicit opiate use. It has been more successful than other options including:  no-treatment; drug-free treatment; placebo medication; or detoxification in clinically controlled trials.  It is the most cost-effective treatment for opioid dependence available in Australia.

"The Report focuses strongly on abstinence.  Evidence shows this is not a reasonable outcome for conditions like opioid dependency, which tend to follow a chronic relapse pattern.

"The AMA supports the discussion of abstinence within the spectrum of treatment options.

"The report seems to replace harm minimisation with harm prevention but there is little explanation as to what is meant by this change in direction.

"The AMA is concerned that this change in direction is a push towards the concept of zero tolerance.

"The public health implications of such a dramatic shift in national policy would be catastrophic. 

"Under this philosophy we will see an in the spread of blood borne diseases and an increase in drug related crime and drug related deaths.

"Zero tolerance or it neo-euphemism "harm prevention" is something the AMA believes the Australian community should be very wary of embracing as the sole answer to illicit drug use in the community.

"The zero tolerance option will never be the panacea for all the community's drug problems," Dr Yong said.

Dr Yong is a psychiatrist who specialises in adolescent health issues.

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                   Judith Tokley    (02) 6270 5471 / (0408) 824 306