A health-based approach to alcohol and other drugs

With decriminalisation coming into effect in the ACT in late 2023, there’s a lot of talk about a ‘health-based approach’ to drugs.

But what does this mean, and how does it differ from criminalisation?

Here we explore the health-based approach, and what’s changing in the ACT.

You can read more about the difference between decriminalisation and legalisation in our article on Drug law reform.

What’s happening in the ACT with decriminalisation?

From October 28, 2023, penalties for possessing small amounts of illegal drugs in the ACT will be reduced.¹

If someone is caught with a small amount of illegal drugs, they may be given an offence notice by police.

You can find out what a ‘small amount’ is for each drug on the ACT Government website.

An offence notice requires a person to either pay a $100 fine or attend an assessment and harm reduction session. They might also be referred to treatment if it’s appropriate.

Police can still arrest someone and require them to appear in court. But instead of facing imprisonment, they’ll have to pay a maximum $160 fine.

These changes don’t make selling or dealing drugs legal or reduce the penalties for doing so. Drug driving also remains illegal.¹

What is a health-based approach to drugs?

This approach recognises that harms related to alcohol and other drug use are a health issue, rather than a criminal issue.

It seeks to prevent and reduce these harms by:

• regulating the supply, accessibility, and advertising of substances (for example, alcohol or tobacco)
• delivering alcohol and other drug education programs, particularly to young people
• providing services for those who use substances, such as drug checking, or medically supervised injecting rooms
• improving access to treatment and support
• addressing stigma and discrimination towards those who use substances.²

The health-based approach recognises that alcohol and other drug use is complex, and not all use is harmful.

It doesn’t view substance use as a moral issue or failing.³

This approach recognises that many things can increase the chances someone may use, or experience harm from, substances.

For an individual, this can include:

• their genetics
• experiences of discrimination
• mental ill health
• socio-economic background and employment status
• experiences of trauma
• level of community connection and support.^4-8

Social and environmental influences can include:

• exposure to marketing and advertising (for example, of alcohol products)
• accessibility of substances
• cultural attitudes or expectations around using substances
• barriers to accessing support.^{7, 9}

Criminalisation of drugs causes harm

Strategies for addressing drug use have mainly focused on criminalisation. But, this approach has many negative effects for individuals and communities.

Criminalisation is where some form of punishment is put in place to try to deter people from using drugs.

The types of measures vary globally, with some countries implementing the death penalty for drug trafficking or use.¹⁰

Despite record seizures, arrests and spending on law enforcement in Australia, use of illegal drugs continues.¹¹

In Australia in 2019, an increase in recent use was reported for several drugs, including:

• cannabis
• cocaine
• MDMA
• hallucinogens (such as psychedelics)
• ketamine.¹²

And internationally, 296 million people used drugs in 2021 – a 23% increase over the previous ten years.¹³

Impact of a criminal record

Contact with the criminal justice system, or having a criminal record for drug possession, can lead to other harms. These include:

• barriers to getting a job, impacting financial stability
• barriers to accessing housing and treatment
• overall negative impacts on relationships, health and wellbeing.^{14, 15}

Young people with a criminal record also face higher rates of poverty and drug use issues. This then increases the likelihood of future contact with the justice system, creating a cycle.¹⁶

Other harms

The criminalisation of drugs disproportionally impacts:

• lower socio-economic people
• non-white communities
• First Nations peoples.^{14, 15}

Criminalisation also comes with a hefty public sector price tag. In Australia, law enforcement costs related to cannabis came to $2.4 billion in 2015-16.¹⁷ By removing penalties, through decriminalisation, police resources can be freed up to pursue other criminal activity.

Stigma

The illegal status of drugs also leads to stigma towards people who use drugs.¹⁵

Stigma is where a person or group of people are seen as ‘other’, and involves the judgement, labelling, and stereotyping of difference.

The World Health Organization has ranked illicit drug dependence as the most stigmatised health condition globally, with alcohol dependence listed at number four.¹⁸

In 2014, Australians said they were generally more comfortable around people experiencing alcohol dependence than a person experiencing heroin dependence.¹⁹

Stigma often leads to:

• people avoiding treatment, support or other services
• feelings of shame, anger, rejection, worthlessness and hopelessness
• worse overall wellbeing.^{15, 20}

A health-based approach to alcohol and other drugs can help address this stigma.