Greg Denham Greg Denham November 2010November 2010

Law Enforcement and Harm Law Enforcement and Harm ReductionReduction

Harm Minimisation includes activities in three major areas:

•Supply reduction

•Demand reduction

•Harm reduction

Role of Police in drug harm minimisationRole of Police in drug harm minimisation

The Police approach to drugs in the community is The Police approach to drugs in the community is based on the principle of harm minimisation. based on the principle of harm minimisation.

Police are an active participant in the National Drug Police are an active participant in the National Drug Strategic Plan and as such contribute to reducing Strategic Plan and as such contribute to reducing drug harm through activities designed to reduce the drug harm through activities designed to reduce the supply of, demand for and harm caused by drug supply of, demand for and harm caused by drug use.use.

Supply Reduction:Supply Reduction: Inter-agency operations - Customs - AFPInter-agency operations - Customs - AFP

Major Drug Investigation DivisionMajor Drug Investigation Division

Regional Initiatives - targeted street Regional Initiatives - targeted street

operations operations

General DutiesGeneral Duties

Demand Reduction:Demand Reduction:

Drug Diversion/Cannabis CautioningDrug Diversion/Cannabis Cautioning

school and community educationschool and community education

referrals to Alcohol & other Drug referrals to Alcohol & other Drug

agencies/treatment servicesagencies/treatment services

Court programsCourt programs

Harm Reduction:Harm Reduction:

Response to Overdose PolicyResponse to Overdose Policy

Needle and Syringe Program PolicyNeedle and Syringe Program Policy

Safe searching - needle stick injuriesSafe searching - needle stick injuries

Monitoring of drug affected prisonersMonitoring of drug affected prisoners

OST in CustodyOST in Custody

Policy ResponsePolicy ResponsePolicy ResponsePolicy Response

1.Members are not to conduct unwarranted 1.Members are not to conduct unwarranted

patrols or person checks within the patrols or person checks within the

vicinity of NSPs unless there are vicinity of NSPs unless there are

exceptional circumstances.exceptional circumstances.

Victoria Police ManualVictoria Police Manual

Policy ResponsePolicy ResponsePolicy ResponsePolicy Response

2.When attending the scene of a non-fatal 2.When attending the scene of a non-fatal

drug overdose, members are asked to drug overdose, members are asked to

consider the community interest and not consider the community interest and not

to pursue minor possession and use to pursue minor possession and use

charges. charges.

Victoria Police ManualVictoria Police Manual

Law Enforcement Issues:Law Enforcement Issues:

Police actions can be one of the strongest Police actions can be one of the strongest determinants of whether a person uses harm determinants of whether a person uses harm reduction services or not.reduction services or not.

Policing actions can be counter productive to Policing actions can be counter productive to harm reduction programs and increase the HIV harm reduction programs and increase the HIV risks to individuals and the general community. risks to individuals and the general community.

Police support for harm reduction approaches Police support for harm reduction approaches is critical in facilitating ‘enabling is critical in facilitating ‘enabling environments’. environments’.

..

To develop and maintain a To develop and maintain a supportive and supportive and enabling enabling environmentenvironment for harm for harm reduction approaches.reduction approaches.

Goal of Law Enforcement and Harm Goal of Law Enforcement and Harm Reduction:Reduction:

‘‘Police can be the best friend - or Police can be the best friend - or the worst enemy - of harm the worst enemy - of harm reduction’reduction’

‘‘Harm reduction cannot - and will Harm reduction cannot - and will not - work without the active not - work without the active participation and support from participation and support from police’.police’.

..

Courts:Courts:

The C.I.S.P. and C.R.E.D.I.T Programs The C.I.S.P. and C.R.E.D.I.T Programs seeks to provide early intervention and seeks to provide early intervention and access to drug treatment, accommodation access to drug treatment, accommodation and material aid and support, as required, and material aid and support, as required, to facilitate the needs of the defendant.to facilitate the needs of the defendant.

C.R.E.D.I.T also seeks to enhance the C.R.E.D.I.T also seeks to enhance the likelihood of a defendant being granted likelihood of a defendant being granted bail and then successfully completing the bail and then successfully completing the bail period. bail period.

..

OBJECTIVES OBJECTIVES Provide access to accommodation, welfare, legal and Provide access to accommodation, welfare, legal and

other community supports.other community supports.

Provide clients and the Court with monitoring and Provide clients and the Court with monitoring and support of clients on the program for a period of 3-4 support of clients on the program for a period of 3-4 months.months.

Minimise harm to the client and the community by Minimise harm to the client and the community by addressing the issues related to substance abuse.addressing the issues related to substance abuse.

Provide early treatment and access to drug Provide early treatment and access to drug treatment/rehabilitation programs.treatment/rehabilitation programs.

Reduce risk of re-offending.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?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 The range of services provided to clients on bail (C.R.E.D.I.T) has included the bail (C.R.E.D.I.T) has included the following:following:

Assessment, treatment & support plan, Assessment, treatment & support plan, support & monitoring whilst on bail & support & monitoring whilst on bail & follow up (up to 4 months).follow up (up to 4 months).

Case management, court reports, Case management, court reports, brokered treatment through COATS for brokered treatment through COATS for access to drug treatment services access to drug treatment services including: Detox & rehabilitation including: Detox & rehabilitation programs; drug & alcohol counselling.programs; drug & alcohol counselling.

..

Referral to short term crisis Referral to short term crisis accommodation.accommodation.

Passport photos for identification & medical Passport photos for identification & medical purposes.purposes.

Referral to pharmacotherapies.Referral to pharmacotherapies.

Referral to outreach services for clients Referral to outreach services for clients requiring intensive support.requiring intensive support.

..

Referral to employment programs for Referral to employment programs for training/employment assistance.training/employment assistance.

Travel cards, food vouchers and access Travel cards, food vouchers and access to material aid, payments where to material aid, payments where required and court date required and court date reminders/diaries.reminders/diaries.

..

Opiate Substitution in Prisons:Opiate Substitution in Prisons:

National Methadone Policy 1997National Methadone Policy 1997

Prisoners special client group Prisoners special client group Pose a risk to themselves and health and safety of community Pose a risk to themselves and health and safety of community

upon release upon release

Recommended that specific assessment criteria & processes be Recommended that specific assessment criteria & processes be established to improve access to methadone treatment in prisons established to improve access to methadone treatment in prisons for prisoners to:for prisoners to:

Continue their community Rx in prison. Continue their community Rx in prison. Commence Rx in prison for those who are:Commence Rx in prison for those who are:

Using illicit opioids Using illicit opioids At high risk to heroin relapse upon releaseAt high risk to heroin relapse upon release

..

Victorian Prisons Victorian Prisons ProgramProgramAims to:Aims to:

Reduce drug use among prisoners Reduce drug use among prisoners Reduce transmission of BBV’s Reduce transmission of BBV’s Prevent/reduce overdose deaths in prison & upon Prevent/reduce overdose deaths in prison & upon

release to communityrelease to community Reduce drug related recidivism upon release Reduce drug related recidivism upon release

ObjectivesObjectives Improve pharmacotherapy access to prisoners: Improve pharmacotherapy access to prisoners:

Prescribed community methadone & buprenorphine Prescribed community methadone & buprenorphine across the system across the system

Using illicit opioids in prison Using illicit opioids in prison At risk to heroin relapse upon releaseAt risk to heroin relapse upon release

Minimise standover & diversion of these treatmentsMinimise standover & diversion of these treatments

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).

Malaysia

‘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

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.

Malaysia

‘‘Harm reduction is not an obstacle in Harm reduction is not an obstacle in reaching the goal of a drug-free reaching the goal of a drug-free world. Drug control authorities need world. Drug control authorities need not fear a rise in drug use simply not fear a rise in drug use simply because people are taking steps to because people are taking steps to protect themselves from HIV and protect themselves from HIV and reduce their drug dependency.’reduce their drug dependency.’

Michel SidibéMichel Sidibé

..

Thank You

greg.denham@nych.org.au

The End