Hard News: What would a harm reduction strategy look like now?
25 Responses
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In this paper, the author, Toby Seddon, argues we should embrace those online markets and include them as part of a overall new way of agile regulations (I paraphrase).
I think these sites are really quite useful ( as you've written about recently too, Russell), and should be seen as critical to innovative harm reduction.
[By the way, I can flick people a copy of Seddon's full paper, or check out his blog here: https://tobyseddon.wordpress.com/]
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It all comes down to education - reduce the harm before it happens
Some open, honest and credible literature that clearly points out in lay terms what a user can experience from the substances they choose to take, plus the pros and cons of the substance in question
Training for those on the frontline on how to help those that find themselves in trouble - that includes paramedics, ambulance staff etc.
Training for the police on how to deal with those on substances and empathy training - I guess they might already get some of this?
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I simply wanted to smash the TV screen I was that frustrated at Lisa's constant attempts at putting words into Matt's mouth.
Shocking performance IMHO
Aint particularly a massive fan of Matt but why ridicule someone that is actually trying to find an answer to the problem and seems on the surface to be thinking outside the square which is probably whats needed yes?
I thought he handled it very well considering the traps they tried to lay and you could see him laughing inwardly in places.
Peter Dunn needs to wake the hell up. I've always supported him but his recent 'If your'e wanting to legalise then you must be a rabid weed hoon' statements have lost my vote for ever.
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The best harm reduction strategy has to start with legalising cannabis. Ignoring this truth has caused most of our problems.
Education programs have to be evidence based to be credible and trusted. If the truth about cannabis isn't told, all other information becomes suspect.
The continued prohibition of well-researched and relatively harmless cannabis has led to the proliferation of synthetic products. That they were for sale in shops made them appear safe to young people. Many of these products exhibited nasty short term effects and all have unknown long-term outcomes.
Legislative approval of these other substances, and calling them "legal highs", looked like cynical profiteering, at the expense of cannabis users, by everyone involved. That they were subsequently, effectively banned has only made matters worse, as you rightly pointed out on The Nation, Russell.
Any national drug strategy which doesn't include legal cannabis is a waste of time and doomed to fail. -
http://psychoactives.health.govt.nz/industry/how-get-product-approved
Alcohol products certainly wouldn't get approval under the testing regime.
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Alfie, in reply to
Any national drug strategy which doesn't include legal cannabis is a waste of time and doomed to fail.
Hear hear!
Matt Bowden's optimistically named 'drug safety testing' site sounds like there might be even an element of public good involved. But that's not necessarily the reality.
Coincidentally we ran into an old friend last week who previously acted as a human guinea pig for Bowden's legal highs. The intelligent, high functioning and personable guy we knew a few years ago is now a complete mess. He has regular seizures, his marriage and his life have pretty much fallen apart. While MB's products may not be the only factor in his downfall, he certainly attributes a good deal of the blame to those chemicals.
Campbell Live (remember that show?) has highlighted the addictive nature of synthetics better than most media. And I've yet to see/read a single good report about synthetics. As drugs go, they're down there at the evil end of the bucket.
What's the chance of a crowdfunded campaign succeeding in having good old cannabis approved via the Psychoactive Substances Act? It's less harmful than any of the chemical substitutes, and the 'fatal' dose has been estimated at about 30 kilos... from a height of ten metres.
And a plea to the media. Could we stop calling these drugs "synthetic cannabis" please? They're chemicals with no connection whatsoever to cannabis.
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what would a harm reduction strategy look like now? Not in five or 10 years, but now?
What actions would a harm reduction approach prescribe?
Can I clarify the parameters of the question? Are you talking about a strategy that the government could follow right now, given that they had already bought into harm reduction, or a strategy that advocates for harm reduction would use to convince people of it's necessity?
Presuming the first one, are you limiting the meaning of strategy to discussion of what to do about new drugs or is it open to the most obvious ideas of decriminalization of existing drugs? Which harms can be considered? Just the harm from the taking the drugs? Or the harm of police persecution, criminal records?
Should partygoers be able to safely test their pills before popping them?
Well that's a bit impractical unless we're talking about giving them all chemistry degrees and access to testing kit suites. But they could at least have an "official" record of what is known about the testing that has already been done and the known consequences in the wild, and very strict laws about the detail that has to be on the packaging. It's going to be a large (but not impractically so), sparse database, though, if we have to treat combinations as separate drugs. It sounds like something a government department could probably manage. Eventually it would start delivering robust information on the most popular individual chemicals and combinations. For anything really bad it should deliver it fast.
A mobile capable website and/or app would be a handy thing for people puzzling over a box of something barely known. If they were forced to have individual codes, and maybe barcodes to make it even easier for scanning, then it would be that much more likely to be used. This already exists for foods in the supermarket, I can't see why it couldn't work for a legal product. This would also mean it would be a lot easier to trace any bad batches back to the source. I think it would probably put a huge handbrake on the dumping of any crappy stocks.
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And I've yet to see/read a single good report about synthetics. As drugs go, they're down there at the evil end of the bucket.
Well you don't tend to get news about people not having some terrible thing happen to them on synthetic cannabis. You don't get interviews of Peter Dunne at a rave with kids dancing happily around him. I know of plenty of people who have had experiences they liked on them. Usually, they still said that if it were legal, they'd prefer cannabis to cannibomimetics. But there are some advantages to synthetics even in the effects. Some of them are reported not to have the typical vacant day-after feeling that cannabis has. But the most commonly reported advantage is that you're less likely to get busted. And yes, there's quite a lot of reports of horrible side effects.
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BenWilson, in reply to
It’s less harmful than any of the chemical substitutes, and the ‘fatal’ dose has been estimated at about 30 kilos… from a height of ten metres.
I'm pretty sure I'd survive being hit by 30 kilos of cannabis even from 10m. I'd raise my hands into Hallelujah position and let it rain.
ETA: Actually I'd like to be the very first volunteer to test that.
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Russell Brown, in reply to
Legislative approval of these other substances, and calling them “legal highs”, looked like cynical profiteering, at the expense of cannabis users, by everyone involved. That they were subsequently, effectively banned has only made matters worse, as you rightly pointed out on The Nation, Russell.
It's important to recognise what actually went on here. These products were banned and banned and banned and banned. Peter Dunne would put out press releases saying how many he'd banned that week. Eventually, it became clear that this just wasn't working. Enter the Psychoactive Substances Act.
The problem was, it now seems clear, that by that point, the best candidates for product regulation had already been banned in the whack-a-mole years. THse for sale when the Act was passed were much less desirable. But still, the PSA radically reduced the number of products available and the number of outlets that could sell them. It wasn't an opening up of the market, it was a sharp curtailing.
Well, that's one of the things that went wrong with the Act ...
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Russell Brown, in reply to
Should partygoers be able to safely test their pills before popping them?
Well that’s a bit impractical unless we’re talking about giving them all chemistry degrees and access to testing kit suites.
I mean testing services at dance parties and festivals. It would help, even with retail testing kits.
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BenWilson, in reply to
It would help, even with retail testing kits.
What kind of things can they test for? I guess you're meaning this for illegal drugs. Legal drugs should have been tested in the factory and list the ingredients on the packaging, like they do in the chemist, and in foods.
In which case you're also kind of answering my first question about who you're talking about pursuing harm reduction. If it's illegal drugs, it's not going to be the government, presumably?
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I think it's about time to face the fact that the psychoactive substances act is a complete failure, except in one sense. I have always held that the act was never supposed to work, and the regulatory regime was simply a chimera designed to allow bulk banning of legal highs whilst erecting impossible barriers to legal market entry. About all we can take away from this failed piece of legislation is the philosophical volte-face of thinking about a legislative framework built upon regulation rather than prohibition, and from there start again.
I question even the desirability of allowing legal highs into the market place, at least in the way we currently sell them. I would have thought that all the empirical evidence now points to the reality that buying traditional illegal drugs from a criminal network with raw market signals to provide decent products and not kill it's customers (combined, perhaps, with less strict policing) is actually a safer and better option for society than dairies flogging off to children and the mentally ill all sorts of synthetic concoctions made by ruthless profit-driven legal high manufacturers in Thailand. Better new Nikes for community pot dealers in Northland than Ferraris for legal high drug lords in Thailand.
I guess "What would a harm reduction strategy look like now" would be accepting our bright new regulatory regime didn't work, and is now dedicated to producing absurd outcomes, where whole herds of elephants in the room are ignored and vast amounts of money is being spent to negotiate a deliberately broken Byzantine regulatory regime in pursuit of an utopian fantasy - a "healthy' high. And then apply the philosophical change that underpinned the psychoactive substances act - a legislative framework built upon regulation rather than prohibition, and shift to regarding drug use primarily as a public health issue tather than a criminal justice one - to the the place of all the old-school stuff like cocaine, heroin, marijuana, MDMA and so on.
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Russell Brown, in reply to
One small blessing of the Psychoactive Substances Act is in its penalty provisions.
Possession remains illegal, but incurs only a $500 "infringement fee". (Labour's Iain Lees-Galloway unsuccessfully argued for a zero penalty.) Even possession of large quantities for supply incurs a maximum two years imprisonment.
By contrast, drugs listed under the Misuse of Drugs Act (or their analogues, which is an open question) still incur much heavier penalties – even though they may be demonstrably less harmful. Yes, it is a silly and irrational situation.
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The audience they play to is the same one that is baying for the blood of the two Australians in Bali, who will never even try to consider that drugs should possibly be considered a medical rather than a legal issue.
The human race has sought out mind altering substances since time began and that will probably never change, in fact, as life gets harder it will almost certainly increase.
The game Dunne and co are playing is nothing short of whack a mole with synthetic cannabinoids as fast as you get rid of one another will pop up in a slightly different form. -
Only a quarter of people who submitted their purchases for testing actually had what they thought they had.
Anecdotally, I would assume close to 100% of my dak-smoking friends are actually smoking dak.
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why is it that the media in general [&the political class] are unable to have an honest indepth cost/benefit discourse about drug policy - we know - talking actual evidence here - that psychoactives like weed ,pure MDMA ,psilocybin & mescaline are far less dangerous than alchohol. What a pitiful state of affairs that we seem unable to shake off or even honestly address/discuss the abomination gifted to us {by way of the UN conventions} by Anslinger & Nixon - both racist arch-conservative bigots. I can think of no other important area of public policy where silence rules to such a degree. But then I s`pose 80 years of criminalisation,stigma,propaganda & scapegoating aren`t exactly a great pathway to rational thought.
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Tom Semmens, in reply to
why is it that the media in general [&the political class] are unable to have an honest indepth cost/benefit discourse about drug policy
I think you'll find that amongst the elites in the media and political class there is (in private) a general appetite for sane drug reform. But the police, who would see a lot of money vanish from the police budget and into health one, have a vested interest in keeping drugs as a criminal justice issue and a quick skim of the paper instructs us as to who opposes local stores selling LEGAL highs - the deepest opposition to drug reform comes from the middle and lower class Joe and Jane Sixpack with two kids at school. These classes are largely uncritical consumers of (apparently) unpolitical government information, and they've been subjected to decades of the most hysterical anti-drug propaganda imaginable from people they trust. For Joe and Jane, drugs are simply the stuff of degenerate behaviour.
So you've now got a situation where there is a complete disconnect between expert opinion and popular sentiment. The chattering classes can talk about drug reform all they like. It is God fearing families in Papakura and Winton who will die in a ditch to prevent it.
You can fix this two ways. One is the Sue Bradford section 59 approach, which is to use an elite consensus to ram a change down peoples throats, or you can work with the government and the medical profession to lay the groundwork for the publics acceptance of the need to replace our broken drug laws.
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BenWilson, in reply to
You can fix this two ways. One is the Sue Bradford section 59 approach, which is to use an elite consensus to ram a change down peoples throats, or you can work with the government and the medical profession to lay the groundwork for the publics acceptance of the need to replace our broken drug laws.
The first way isn't going to happen. That was extremely divisive even though it was really quite a tiny change, and elite consensus came down to not wanting to be the one who said horsewhipping kids was OK. But we're talking about meaningful change, and there are plenty of people who think there's nothing wrong with drug dealers and even drug takers languishing in prison and the police being able to pretty much search anyone anytime just by invoking the merest suspicion you have drugs. I don't think class analysis is worth a bar of shit here, but of course you are always going to raise it. There are illegal drugs for poor and rich alike, all banned. The one that's not banned is also something consumed by all classes. Even the homeless.
So I guess we're looking at the second way. Like we have been as long as I've been alive, with some very small progress having been made in all that time in terms of harm reduction, and a neverending stream of new prohibitions.
Which is why, I guess, that Russell is asking the question. It's actually hard, at this time, to even envisage what moving toward sanity would look like, it's so far away in the rear view mirror. Indeed the framing of the question begs what I see as half the problem. You frame it as harm reduction, and you're already saying that harm is the most important thing. But no one takes drugs because they're not harmful. They take them to enjoy. And that side of things is past the horizon behind us on all except everyone's favourite little hypocrisy, alcohol. You're setting up a framework that fundamentally does not even grasp the reason for the taking of drugs, built right into it. How sane can it ever be?
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Indeed the framing of the question begs what I see as half the problem.
Very true. The first thing we need to do is to stop using the language of prohibition. To speak of “harm reduction” is to be colonised in the head by the War on Drugs. Nobody talks about “harm reduction” when discussing mountain-climbing, rugby or fishing (all potentially deadly past-times). Harm is not inevitable in these activities, and this is the same with recreational substance use.
We need to talk about promoting safety not “harm reduction”.
From an actual tactical perspective, here is what I think would work:
1. Get rid of National and Act and Dunne out of government, they are hopeless and have no grasp of science.
2. It has to be Labour / Greens who do this.
3. Legalise cannabis (NB: not decriminalise) and put some resources into researching the impacts on health, crime etc. Actual metrics, not doctrinaire opinion, will validate the case for legalised cannabis.
4. Once we have established that (like homosexual law reform, prostitution law reform, and same-sex marriage) the bloody sky has not, will not, and will never fall in, the next step is to decriminalise Ecstasy. The metrics from Ecstasy decriminalisation will likely include an massive reduction in alcohol-related crime (i.e. massive validation), at which point we can start to decriminalise psilocybin, LSD, mescalin et al.
5. As appropriate, transfer funding from law enforcement / healthcare related to War on Drugs policies into research and education initiatives (with a strong emphasis on metrics that measure the actual impact of the law reforms).
6. None of this is to say we should have an unregulated market. Freedom to use does not require an unfettered freedom of access to purchase, we need to be sensible about distribution and promotion. The nicotine model of availability in every dairy/supermarket/service station is a huge problem, and we can avoid this quite easily with proper regulation.
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mark taslov, in reply to
The first thing we need to do is to stop using the language of prohibition. To speak of “harm reduction” is to be colonised in the head by the War on Drugs.
Great suggestions Mikaere. I’m not politically minded enough to discredit the process you outlined. From my limited perspective your process doesn’t strike me as being at odds with the way things could roll. However your post was food for thought and so I’d like to air a couple.
“Colonised in the head” is perfect, and as a phrase it’s worth expounding upon. Our heads have been colonized, our bodies have been colonized and our land and property have been colonized in this war.
However I hit a bit of a roadblock at your 3rd point, perhaps in only that I’d like to know more about the reasoning behind that, this would be helpful, for me at least.
As an agriculturalist from an agricultural country I tend to look at things from the ground up. For my purposes I think I’d also like to make a distinction between raw products, value added products (processed) and synthetics. My thoughts are specifically related to raw products, entailing life of whatever variety, from Cannabis to Erythroxylaceae, from Echinopsis pachanoi to Lophophora williamsii, including and not limited to Copelandia,Galerina, Gymnopilus, Inocybe, Mycena, Panaeolus, Pholiotina, Pluteus, and Psilocybe.
1. In terms of seed/ spore distribution, the significant harm to the cultivator and distributor at this point is arrest and incarceration; paranoia induced stressed, confiscation of property and fines.
2. In terms of actually growing these plants the significant harm to the cultivator and distributor at this point is arrest and incarceration; paranoia induced stressed, confiscation of property and fines. Though there is the remote chance of a member of the public feeling the effects upon inhaling a whole plantation’s worth of dust in season; that’s a bridge better left to cross once, and only if, it’s built. Even then a court could rule for glasshouses in such a scenario. As far as I can ascertain it is not illegal to grow mistletoe, holly, Jerusalem cherry, yew, Ivy, Wintergreen, Manzanita and other plants that have been shown to be demonstrably more harmful. There are problems but plant cultivation is not significant amongst them.
For all intents and purposes the chief harm in either of these steps is criminalization.
Obviously the question would be, what becomes of these products once they have been harvested?
Legalise cannabis
I’m going to go out on a limb here, bastardise this word ‘legalise’, and claim that cannabis is already legalised, albeit legalised for the black market, in as much as it is addressed and restricted by legislation, the reality doesn’t eliminate cannabis from the market. Governments sitting on this legislation should be in no doubt that:
A) It remains on *the market* (albeit not the white side of the market).
B) It forces all would-be purchasers to procure the product from criminals.
C) This increases crime.If seed/ spore distribution and cultivation were decriminalised what changes might we be likely to see? Would harm be reduced/ or safety promoted, or would this change have any impact whatsoever with regards to harm? The trends that may emerge from such a sea change could provide priceless data in terms of paving the way forward. At the least I’d be hesitant about forecasting any significant increase in harm from such a step.
Given that New Zealand is run as an experiment – at least to the extent that it lacks much in the way of long term precedent (legal or otherwise) – I think rather than hypothesising ad infinitum, six steps ahead of ourselves, like nervy lab techs, we’d be best served by actually taking tangible coherent steps; the first being eliminating all references to seed/spore distribution and plant cultivation from our penal code. I venture that this might be a reasonable alternative to your 3rd step, though in doing so I would concurrently implement your step 5:
5. As appropriate, transfer funding from law enforcement / healthcare related to War on Drugs policies into research and education initiatives (with a strong emphasis on metrics that measure the actual impact of the law reforms).
Once these steps have been implemented, then our Government could continue to adapt and adjust according to *our* (their) abilities, taking into account all forms (direct or otherwise) of harm reduction with a longterm goal of minimising drug related cases clogging up the justice system amongst other potentially positive outcomes, done so with a large does of pragmatism, but I’m reluctant to suggest anything that would get too far ahead of the current game, because doing so or having done so would seem to be half the problem at this stage.
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mark taslov, in reply to
I guess another question would be:
None of this is to say we should have an unregulated market. Freedom to use does not require an unfettered freedom of access to purchase, we need to be sensible about distribution and promotion. The nicotine model of availability in every dairy/supermarket/service station is a huge problem
Is it really? For whom? It is certainly a problem for the buyer who has to ask for a menu at every purchase, but I’ll assume that the problem to which you refer is that declining smoking rates are not declining fast enough?
Hesitantly I’d assert that the availability of tobacco products online or the illegality of selling electronic nicotine refills over the counter in New Zealand are arguably far bigger problems than the availability of tobacco every dairy/supermarket/service station.
In 6, with insufficient detail, I’m assuming that you are promoting the transfer from one cartel to another, from the black to the white. Looking at this servo tobacco menu I notice that vast majority of the brands are foreign and looking at a RYO tobacco pouch I find no mention of the chemicals, ingredients or process. I have no easy way of ascertaining whether high nitrogen content fertilizer was used in cultivation. Without the branding I’m not sufficiently educated to visually identify a higher burley tobacco – a factor which may result in higher TSNA levels. Basically as a tobacco user, in terms of what I’m actually inhaling, I’m in as dark a place as I could possibly be, and that has nothing to do with the availability.
Basically, with the TPPA looming, I’m skeptical about any proposal of a regulated cannabis market that doesn’t also venture to account for developing a domestically-sustaining industry.
For personal use I’d like to see this precedent carried over:
Here in New Zealand you can buy tobacco seed, grow the stuff, and, if you want to, smoke it quite lawfully. You may not lawfully sell it, barter it or give it away. The same regulations govern brewing, wine making and the distilling of alcoholic beverages. If you live elsewhere check your local legislation to ensure that you comply.
Industrially we have this type of precedent to develop upon:
In 2005 the Government approved regulations to allow the commercial cultivation of hemp (cannabis sativa) in New Zealand. Hemp farmers still need to apply to the Ministry of Health for a permit to cultivate, deal, breed, import or sell seed, and must pay a fee of NZ$500 per license, but no longer need to call their crop an experiment.
In terms of education:
5. As appropriate, transfer funding from law enforcement / healthcare related to War on Drugs policies into research and education initiatives (with a strong emphasis on metrics that measure the actual impact of the law reforms).
Most notable about this paragraph is its brevity. Education, as if just typing the word is an answer in itself. Ideally, with the amount of drugs on the market (including those currently legal), and the vast amount of information available, one could suggest that a government issued (flying) licence (acquired in much the same way as driving licence – by passing a theory examination drawn from the most recent drug-code) would be the only way to adequately ensure the users had sufficient awareness. No doubt our Government would love this kind of income generation. Pragmatically something like that would flounder at the obvious hurdles, but this should give some sense of the extent of the education required.
Education is the most important part of the exercise and arguably needs to be the first stage in the process, regardless of the legality of any of these products, education reduces harm. What we are seeing from the majority of elected representative currently could be dismissed as constituting the opposite of education.
As a user of drugs, legal or otherwise, I contend that the Government is doing the barest minimum to provide a full and comprehensive education as to the harms, effects, benefits, processes and manufacture of the drugs I’m consuming. If they are providing this information they are doing the barest minimum to publicise this provision.
As an omnivore, I contend that the Government is likewise doing the barest minimum to provide a full and comprehensive education as to the harms, effects, benefits, processes and manufacture of the food/drink I’m consuming. If they are providing this information they are likewise doing the barest minimum to publicise this provision.
Education is easily glossed over, just ask Peter Francis Dunne, he is as big an obstacle to responsible education as you’re ever likely to encounter. That’s his legacy.
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Russell Brown, in reply to
We need to talk about promoting safety not “harm reduction”.
I think the message settled on "harm reduction" as a consequence of the recognition that there is no perfect safety. Indeed, it's a good thing that the legislation says "a low risk of harm" rather than "safe". Even caffeine isn't "safe". But I do get your point about a more positive framing.
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Russell Brown, in reply to
None of this is to say we should have an unregulated market. Freedom to use does not require an unfettered freedom of access to purchase, we need to be sensible about distribution and promotion.
For the same reason that the British parliament passed the Adulteration of Tea Act in 1776. Products should contain what it says on the label, and especially should not contain anything that poses a serious risk of harm.
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"harm reduction' is so 1980's. It takes me back to the good old days when Bob Hawke and co used to fund injecting drug users conferences at the Melbourne Sheraton - complete with in house dealer.
These cliches mask the huge intrusion upon human rights that criminalisation of people's right to do to themselves as they wish by way of drug legislation, is.
By playing the silly game of pretending that all this intrusive sticky-beaking of citizens is somehow for people's own good.
The actual cause and effect mechanism of harm reduction/minimisation is never clearly articulated, because any rigorous examination of drug policy and its attendant legislation would reveal that this arcane set of rules exists chiefly as an employment scheme for holier than thou drongos of the school prefect archetype, as well as being a funding vehicle for a huge range of self appointed do-gooders desperate to get their particular dime store psychology franchise up and running.In return the political class gets sufficient power to smash any individual considered problematic. For example the dotcom raid could never have occurred without the general public's apathetic acceptance of law enforcements 'right' to go anywhere do anything - that acceptance was created by years of comic book imagery about 'the evil pusherman'.
Further, the political class' willing obeisance to law enforcement even though blind freddie can see these laws are unjust, unworkable and illogical, leaves law enforcement who are alleged to be objective, feeling obligated to the politicians.
Without anti drug laws the numbers of police could shrink by at least 40% and that means a shitload less middle and senior managers as well as less wooden tops.Hence the alacrity with which the police adhere to every KeyCorp whim.
Best of all pollies get a law enforcement machine with priorities that are the twin furphies of drugs and terrorism which doesn't have the time nor the resources to be nosing around politicians or their obliging lobbyists, much less the lobbysts' employers - even if they did have the motivation to do so.Messing around re-litigating obscure elements on the fringes of this injustice won't change anything. It will create a public awareness that the media approves of a construct that is by far the most egregious example of failed 20th century social engineering ever inflicted upon kiwis.
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