Dear Colleagues
Thanks for the responses to date to the Compulsory Treatment concept.
Just to clarify my call for debate in which I recognised that there are
problems with compulsory treatment along with the advantages:
1. I am not against the concept of tolerance rooms and I can understand
parents supervising their children's drug taking at home. The concern is
the legal vulnerability of parents doing this in Queensland where the
law is draconian, and their ability to provide the medical help should
it be necessary. This vulnerability is more so for friends and good
meaning people providing such facilities. Until we have guaranteed
quality control of the injecting drugs used (only possible through legal
regulated supply) this approach will continue to put good meaning
parents and friends at considerable risk. At some time we are going to
have a death in a tolerance room or home and police will have no option
but to take the actions which is their duty.
2. Due to international economics and politics, and the fear of
politicians of ballot box backlash, the likelihood of legal, safe,
supportive T Rooms is unlikely.
3. Compulsory treatment is being considered by New Zealand - we were to
have a paper at this year's Winter School by the person working on the
issue, but he became ill and the project was suspended. The Chairman on
ANCD also proposed that compulsory treatment at a public meeting I
attended recently. I saw compulsory treatment in Manilla where drug use
was not an offence, but treatment was compulsory. The facility I
visited had a large professional team of doctors, social workers and
other health workers who claimed they were getting good results.
4. The reference to compulsory education by one reply to Drug Watch is
interesting. I wonder what level of literacy Australia would have if we
didn't have compulsory education. I am also aware of some innovative
alternative education programmes that are also claiming better results
for those being forced back into education by Youth Training legislation
and who don't respond well to the traditional education system.
5. We already pick up drunks and take them to a form of compulsory
treatment called assessment and referral process. Drug Courts are an
option of compulsory gaol or compulsory treatment. Queensland law is
that if caught in possession of a dangerous drug the maximum penalty is
25 years, and maximum of 2 years for possession of a "thing" other than
a hypodermic needle, connected to the administration, consumption or
smoking of a dangerous drug. Better they are picked up for treatment
than have to face criminal action.
6. We certainly have had success at Logan House with those who choose
treatment as an option to gaol - not much room for choice really. The
choice is compulsory gaol or compulsory treatment. Relapse and return to
treatment is a feature of chronic dependence.
7. Queensland Corrective Services have endorsed a recommendation for
first offenders to have the option of treatment - given the choice, it
is compulsory treatment or compulsory imprisonment for those convicted.
8. The study cited by Brian McConnell needs to be taken into account.
However, we need to ask whether the problem is the compulsion or the
treatment model used. There is ample evidence of clients having to adapt
to treatment models, rather than designing treatment for client needs.
Also, the adoption of Motivational Interviewing by psychologists etc.
implies that motivation to treatment can be achieved. We have received
funding for the assessment and motivation to treatment of prisoners
prior to release. Hopefully this program will increase those moving into
treatment.
9. It is reasonable to argue that given the opportunity and support, a
percentage of those detoxed in compulsory treatment will take the
opportunity to continue. What that percentage would be is dependent on
why they are using, what treatment modes are on offer, attitudes of
treatment staff, etc., etc. Certainly, innovation and new treatment
approaches will be needed.
10. Legal T-Rooms would be of great benefit to those who use them,
especially if they provided a quality controlled regulated injecting
drugs and legal safe guards and safety provisions for staff and users.
But not every user will attend these facilities. Similarly with using at
home - we have numerous calls from parents crying out for forced
interventions for their missing youngsters. As we know at least one
father went as far as "kidnapping" his daughter.
In conclusion, compulsory treatment has many models and advantages. The
measure of success depends on the expectations of outcomes of a program.
We are fortunate to be seeing a range of treatment options emerging,
especially in the pharmacotherapies. At least it will enable an
intervention to occur to enlighten the users of treatment options,
assess the bio-psycho-social needs of the clients, and can involve the
family and friends in the treatment process. Relapse and return to
treatment should not be seen as a failure.
What I am advocating is consideration and debate of the issue. Thanks
for your thoughts, and I look forward to hearing more pros and cons on
the issue of how to make compulsory treatment work. No doubt there will
also be arguments as why it ought not be considered.
Bob
--
The Alcohol and Drug Foundation - Queensland is a community based
charity
committed to the reduction of harm associated with alcohol, tobacco and
other drugs.
The Foundation may be contacted on +61 7 3832 3798 (International) or 07
3832 3798 within Australia. Fax +61 3832 2527 (International); 07 3832
2527
(Australia).
Home Page <www.adfq.org>
Foundation Services include: Outpatient Alcohol and Other Drugs
Counselling
Service; Logan House Drug Rehabilitation Centre; Interlock Employee
Assistant Program; Pre-Release Treatment Assessment Program;
Publications -
Drugs in Society, Health Wise, Drug Watch, Queensland Directory of Drug
Agencies; the Winter School in the Sun; the Queensland Drug Forum; and
DARTS Community Development Programs.
Chief Executive Officer:
Bob Aldred
Telephone +61 7 3832 3798 or 0411 51 6154
Email: <[log in to unmask]>
--
The Alcohol and Drug Foundation - Queensland is a community based
charity committed to the reduction of harm associated with alcohol,
tobacco and other drugs.
The Foundation may be contacted on +61 7 3832 3798 (International) or 07
3832 3798 within Australia. Fax +61 3832 2527 (International); 07 3832
2527 (Australia).
Home Page <www.adfq.org>
Foundation Services include: Outpatient Alcohol and Other Drugs
Counselling Service; Logan House Drug Rehabilitation Centre; Interlock
Employee Assistant Program; Pre-Release Treatment Assessment Program;
Publications - Drugs in Society, Health Wise, Drug Watch, Queensland
Directory of Drug Agencies; the Winter School in the Sun; the Queensland
Drug Forum; and DARTS Community Development Programs.
Chief Executive Officer:
Bob Aldred
Telephone +61 7 3832 3798 or 0411 51 6154
Email: <[log in to unmask]>
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