Thinking about Burdens and Harms. Third Annual ACT Alcohol and Other Drugs Sector Conference All Things Being Equal: Exploring the Burdens of Harm Canberra, 24 June 2010. David McDonald Visiting Fellow, National Centre for Epidemiology and Population Health,
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Third Annual ACT Alcohol and Other Drugs Sector Conference
All Things Being Equal: Exploring the Burdens of Harm
Canberra, 24 June 2010
Visiting Fellow, National Centre for Epidemiology and Population Health,
The Australian National University
Consultant in Social Research & Evaluation
Currently illegal drugs
Currently legal drugs
Low availability High availability
[Copyrighted slide removed]
Source: Babor et al. 2009, p. 19.
Article 4. If the World Health Organization finds:
a) That the substance has the capacity to produce
i) 1) A state of dependence, and
2) Central nervous system stimulation or depression, resulting in hallucinations or disturbances in motor function or thinking or behaviour or perception or mood, or
ii) Similar abuse and similar ill effects as a substance in Schedule I, II, III or IV, and
b) That there is sufficient evidence that the substance is being or is likely to be abused so as to constitute a public health and social problem warranting the placing of the substance under international control, the World Health Organization shall communicate to the Commission an assessment of the substance, including the extent or likelihood of abuse, the degree of seriousness of the public health and social problem and the degree of usefulness of the substance in medical therapy, together with recommendations on control measures, if any, that would be appropriate in the light of its assessment.
Source: Nutt et al. 2007, pp. 1047-53.
It is not just the chemical characteristics of the drugs that determine harm, but also how drugs are used, drug interactions, society’s responses to drugs and people who use drugs, etc.
Nonetheless, harm potential should be prominent in informing policy decision-making.
Disability-Adjusted Life Years (DALYs) 2003
(Source: Begg et al. 2007 & presenter’s calculations)
Source: adapted from MacCoun & Reuter 2001.
‘Harm’ is a complex concept
‘Where we sit determines what we see’
Thinking about the ACT’s drug-related burden of harm
The facts and figures on health & social harms
The community’s values and expectations
The sources of drug-related harms
Who in our community bears the drug-related harms
Babor, T et al. 2010, Alcohol: no ordinary commodity - research and public policy, 2nd edn, OUP, Oxford.
Babor, T et al. 2009, Drug policy and the public good, Oxford University Press, Oxford.
Bennett, T & Holloway, K 2009, 'The causal connection between drug misuse and crime', British Journal of Criminology, vol. 49, no. 4, pp. 513-31.
Goldstein, PJ 1985, 'The drugs/violence nexus: a tripartite conceptual framework', Journal of social issues, vol. 15, no. 4, pp. 493-506.
Kendzor, DE et al. 2010, 'Financial strain and smoking cessation among racially/ethnically diverse smokers', American Journal of Public Health, vol. 100, no. 4, pp. 702-6.
Kleiman, MAR 1992, Against excess: drug policy for results, Basic Books, New York, NY.
Kleiman, MAR 2009, When brute force fails: how to have less crime and less punishment, Princeton University Press, Princeton.
MacCoun, R, Reuter, P & Schelling, T 1996, 'Assessing alternative drug control regimes', Journal of Policy Analysis and Management, vol. 15, no. 3, pp. 330-52.
MacCoun, R & Reuter, P 2001, Drug war heresies: learning from other vices, times, and places, Rand Studies in Policy Analysis, Cambridge University Press, Cambridge, UK
McKie, J & Richardson, J 2003, 'The rule of rescue', Social Science and Medicine, vol. 56, no. 12, pp. 2407-19.
Mrazek, PJ & Haggerty, RJ (eds) 1994, Reducing risks for mental disorders: frontiers for prevention intervention research, National Academy Press, Washington DC.
Mugford, S 1991, 'Drug legalization and the 'Goldilocks' problem: thinking about costs and control of drugs', in MB Krauss & EP Lazear (eds), Searching for alternatives: drug-control policies in the United States, Hoover Institution Press, Stanford, Calif.
Mugford, S 1993, 'Harm reduction: does it lead where its proponents imagine?' in N Heather, A Wodak, EE Nadelmann & P O'Hare (eds), Psychoactive drugs and harm reduction: from faith to science, Whurr, London.
National Preventative Health Taskforce, Tobacco Working Group 2009, Tobacco control in Australia: making smoking history, Technical Report No 2, including addendum for October 2008 to June 2009, [Department of Health and Ageing], Canberra, writer: Michelle Scollo.
Nutt, D, King, LA, Saulsbury, W & Blakemore, C 2007, 'Development of a rational scale to assess the harm of drugs of potential misuse', The Lancet, vol. 369, no. 9566, pp. 1047-53.
Roche, AM 1997, 'The shifting sands of alcohol prevention: rethinking population control approaches', Australian and New Zealand Journal of Public Health, vol. 21, no. 6, pp. 621-5 .
Rose, G 1981, 'Strategy of prevention: lessons from cardiovascular disease', British Medical Journal (Clinical Research Ed.), vol. 282, no. 6279, pp. 1847-51.
Rose, G 1992, The Strategy of Preventive Medicine, OUP, Oxford.
Social Research & Evaluation Pty Ltd
1004 Norton Road, Wamboin NSW 2620
Phone: (02) 6238 3706
Mobile: 0416 231 890
Facsimile: (02) 9475 4274
National Centre for Epidemiology & Population Health
The Australian National University
Canberra ACT 0200
Email: [email protected]