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Law Enforcement and Harm Reduction. Greg Denham November 2010. Harm Minimisation includes activities in three major areas: Supply reduction Demand reduction Harm reduction. Role of Police in drug harm minimisation
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Law Enforcement and Harm Reduction Greg Denham November 2010
Harm Minimisation includes activities in three major areas: • Supply reduction • Demand reduction • Harm reduction
Role of Police in drug harm minimisation The Police approach to drugs in the community is based on the principle of harm minimisation. Police are an active participant in the National Drug Strategic Plan and as such contribute to reducing drug harm through activities designed to reduce the supply of, demand for and harm caused by drug use.
Supply Reduction: Inter-agency operations - Customs - AFP Major Drug Investigation Division Regional Initiatives - targeted street operations General Duties
Demand Reduction: Drug Diversion/Cannabis Cautioning school and community education referrals to Alcohol & other Drug agencies/treatment services Court programs
Harm Reduction: Response to Overdose Policy Needle and Syringe Program Policy Safe searching - needle stick injuries Monitoring of drug affected prisoners OST in Custody
Policy Response 1.Members are not to conduct unwarranted patrols or person checks within the vicinity of NSPs unless there are exceptional circumstances. Victoria Police Manual
Policy Response 2.When attending the scene of a non-fatal drug overdose, members are asked to consider the community interest and not to pursue minor possession and use charges. Victoria Police Manual
Law Enforcement Issues: Police actions can be one of the strongest determinants of whether a person uses harm reduction services or not. Policing actions can be counter productive to harm reduction programs and increase the HIV risks to individuals and the general community. Police support for harm reduction approaches is critical in facilitating ‘enabling environments’. .
To develop and maintain a supportive and enabling environment for harm reduction approaches. Goal of Law Enforcement and Harm Reduction:
‘Police can be the best friend - or the worst enemy - of harm reduction’ ‘Harm reduction cannot - and will not - work without the active participation and support from police’. .
Courts: The C.I.S.P. and C.R.E.D.I.T Programs seeks to provide early intervention and access to drug treatment, accommodation and material aid and support, as required, to facilitate the needs of the defendant. C.R.E.D.I.T also seeks to enhance the likelihood of a defendant being granted bail and then successfully completing the bail period. .
OBJECTIVES Provide access to accommodation, welfare, legal and other community supports. Provide clients and the Court with monitoring and support of clients on the program for a period of 3-4 months. Minimise harm to the client and the community by addressing the issues related to substance abuse. Provide early treatment and access to drug treatment/rehabilitation programs. Reduce risk of re-offending.
. • Reduction in the number of defendants remanded due to a lack of accommodation or treatment/support in the community. • Long term reduction in involvement of defendants in the criminal justice system. • Successful placement of defendants in drug treatment/rehabilitative programs. • Successful completion of bail by defendants who would otherwise be remanded in custody.
WHO IS ELIGIBLE FOR THESE PROGRAMS? . • Any defendant eligible. • For those seeking bail, to be admitted to a period of bail they may be referred to the C.R.E.D.I.T/Bail Support Program for assessment.
The range of services provided to clients on bail (C.R.E.D.I.T) has included the following: • Assessment, treatment & support plan, support & monitoring whilst on bail & follow up (up to 4 months). • Case management, court reports, brokered treatment through COATS for access to drug treatment services including: Detox & rehabilitation programs; drug & alcohol counselling. .
Referral to short term crisis accommodation. • Passport photos for identification & medical purposes. • Referral to pharmacotherapies. • Referral to outreach services for clients requiring intensive support. .
Referral to employment programs for training/employment assistance. Travel cards, food vouchers and access to material aid, payments where required and court date reminders/diaries. .
Opiate Substitution in Prisons: • National Methadone Policy 1997 • Prisoners special client group • Pose a risk to themselves and health and safety of community upon release • Recommended that specific assessment criteria & processes be established to improve access to methadone treatment in prisons for prisoners to: • Continue their community Rx in prison. • Commence Rx in prison for those who are: • Using illicit opioids • At high risk to heroin relapse upon release .
Victorian Prisons Program Aims to: • Reduce drug use among prisoners • Reduce transmission of BBV’s • Prevent/reduce overdose deaths in prison & upon release to community • Reduce drug related recidivism upon release Objectives • Improve pharmacotherapy access to prisoners: • Prescribed community methadone & buprenorphine across the system • Using illicit opioids in prison • At risk to heroin relapse upon release • Minimise standover & diversion of these treatments
Malaysia The HIV epidemic in Malaysia has largely been driven by ongoing transmission from and amongst injecting drug users. In order to contain and subsequently reverse the trend of the escalating infections in the country, prevention measures that have been proven to be effective have been implemented, these include needle exchange and methadone maintenance programs. In 2005 a National Task Force on Harm Reduction, made up of representatives from the National Anti-Drugs Agency, Ministry of Health, Royal Malaysian Police, Prisons Department, academics and representatives of NGOs, acted in a steering and guidance capacity. In January 2006 the publication of the ‘Needle and Syringe Exchange Program Pilot Project - Standard Operating Policy’ was released.
Malaysia These guidelines recognized the important role that police would play in facilitating the effective conduct of needle exchange programs. Police are specifically mentioned as an agency that will be required to develop specific guidelines for local police operations: ‘3.1.4. The success of this exchange model will also largely depend on the local police operations. Local policies and National Guidelines for police will have to be developed to assist in this pilot project’ The ‘National Guideline for Police on NSEP’ have also been developed and endorsed by the Malaysian Royal Police (PDRM).
Malaysia These guidelines recognized the important role that police would play in facilitating the effective conduct of needle exchange programs. Police are specifically mentioned as an agency that will be required to develop specific guidelines for local police operations: ‘3.1.4. The success of this exchange model will also largely depend on the local police operations. Local policies and National Guidelines for police will have to be developed to assist in this pilot project’ The ‘The Malaysian Needle and Syringe Exchange Program Guidelines for Police’ were subsequently developed and endorsed by the Malaysian Royal Police (PDRM).
‘Police Discretion’ ‘There is the need for police to consider the operation of Needle and Syringe Exchange Programs (NSEPs) when carrying out their duties in the areas where these programs are situated. Without restricting their day to day duties and obligations, police should be mindful not to carry out unwarranted patrols in the vicinity of NSEPs that might discourage injecting drug users from attending.’ Malaysia
Malaysia In 2006, the Malaysian Prisons Department agreed to implement a MMT program and a pilot project was introduced in Pengkalan Chepa Prison in April 2008 with 50 prisoners participating. This MMT program was accredited by the Health Ministry of Malaysia with the support of Malaysian AIDS Council. Treatment consisted of regular methadone dosing and individual counseling sessions. A week prior to their release, the prisoners on the MMT are treated at government hospitals or clinics and they may continue their MMT post release at the same hospital or clinic. The program is claimed as a success because it relies heavily on collaboration and inter-agency cooperation as well as the involvement of civil society and inmates’ families.
‘Harm reduction is not an obstacle in reaching the goal of a drug-free world. Drug control authorities need not fear a rise in drug use simply because people are taking steps to protect themselves from HIV and reduce their drug dependency.’ Michel Sidibé .
The End Thank You greg.denham@nych.org.au