Illicit drug monitoring offers plenty of evidence – but where’s the action?

Australia’s wastewater drug monitoring program illustrates the scale of the country’s illicit drugs problem, but policy responses are lagging. A government advisory panel could help spur action, John Coyne writes.

In 2016, one of Australia’s senior law enforcement officials confided in me his belief that the National Wastewater Drug Monitoring Program would revolutionise the way we think about illicit drug consumption in our communities. He was more than a little worried that this program would reveal that Australia’s illicit drug demand and supply reduction activities were not working and the drug problem was worsening.

Over the last two years, the program has tested wastewater sites across Australia using a scientifically-modelled methodology to establish an evidence-based quantitative understanding of our national illicit drug use patterns. Last week the Australian Criminal Intelligence Commission released a sixth report on their National Wastewater Program.

Understandably, this report generated some media attention (see here, here and here), but policy discourse has been limited. Although it’s early days, it’s not clear how the program’s five previous reports have been used by government policy and decision-makers. For some reason, despite the program’s findings, as well as their scientific validity and reliability, policy responses have been slow to materialise.

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In terms of good news, there has been a 9.5 per cent decline in the total estimated annual weight of heroin use in Australia over the last two years. Other government reports, such as the ACIC Illicit Drug Data Report, also indicate that heroin supply has been stable over recent years. Without further data it’s hard to hypothesise whether this reflects a reduction in drug users or a change in user preferences. However, it would appear from this evidence that, to date, the troubling trend of increased heroin use in the US has not been replicated in Australia.

While Australia may have dodged the US heroin epidemic, the use of synthetic opioid fentanyl has increased. The data seems to indicate lower daily variations which suggests consistent use. This is the second report to highlight Australians are increasingly using synthetic opioids.

The latest deaths of young people at music festivals have sparked an overdue public debate on drug harm reduction, zero tolerance of drug use, and pill testing (see here, here, here and here). While this debate has raged the latest wastewater report reveals a 7 per cent decline in the estimated weight of MDMA consumed over the last two years.

During the same time, the number and MDMA detections in terms of weight and importations at Australia’s borders has increased. Arguably, this could be a case of law enforcement having an impact on availability but does not give us any indication of how this is impacting MDMA user choices.

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In contrast with heroin and MDMA, the use of cocaine appears to have increased significantly. The ACIC reports that the estimated weight of cocaine consumed annually in Australia has increased by 34 per cent. There is evidence to suggest that domestic user preferences may have much to do with this change, but the global oversupply of cocaine could also be responsible for pushing more of the drug onto the Australian market. And there has been plenty of evidence to suggest that Mexican organised crime groups have sought to supply the Australian market.

It would also appear that despite law enforcement’s significant efforts methylamphetamine – also known as ‘ice’ – remains Australia’s most used drug in terms of weight. Worse still, despite all of the public discourse and demand reduction efforts, including marketing and education, ice consumption by weight has increased by 17 per cent over the last two years.

Without even diving into the reports’ details on geographic user patterns, it’s self-evident that the National Wastewater Program offers policymakers plenty of evidence for new policy decisions.

Let’s for a moment consider our most pressing illicit drug challenge: ice.

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On the 6 December 2015, Australia’s National Ice Task Force released its final report to the Prime Minister. Then on the 15 December 2015, the National Ice Strategy 2015 was released and was later modified in December 2017.

The evaluation report for phase seven of the national drugs campaign, released on 21 May 2018, states that ‘there was also little evidence for any campaign impact on attitudes to drugs at this stage’. And all the while drug use has increased, despite record seizures.

One option for government here is to consider bringing together a federal wastewater response advisory panel. The panel could draw membership from the law enforcement, health, academia and community sectors, and use the results of the wastewater reports to perform three key roles.

Firstly, it could provide independent advice to the Department of Prime Minister and Cabinet on the implications from wastewater monitoring program results on existing policies, strategies, and task forces. Secondly, the panel could use the program results to identify new supply and demand reduction and harm minimisation strategies to recommend to government. Finally, the panel could provide government with independent advice on gaps in their understanding of Australia’s illicit drug use challenge.