Ele Morrison from AIVL outlines the extreme impact of criminalisation on the lives of people who use drugs. This presentation was given at the AFAO National HIV Forum, 17 October 2014.

1. DRUG USE AND THE ENABLING
ENVIRONMENT
AFAO National HIV Forum
October, 2014

2. The Enabling Environment
 Criminalisation of drug use and current drug
policy has extreme impact on people who use
drugs and their access to health, legal and
social services.

3. Social determinants of
health
 Drug use and health issues usually focus on
individual behaviours and individual risk
practices.
 Although individual practices play a role,
research has shown social determinants were
among the most significant predictors of
needle sharing behaviour in Vancouver
(Strathdee, 1997).

4. Social factors
 For example, social factors that negatively
affect health outcomes for PUD include:
 poverty
 Homelessness
 Poor access to services
 Stigma and discrimination
 Incarceration

5. Complexity
 The discourse often doesn’t look at
complexity of the role of the environment
and individual knowledge and behaviour:
 For example, injecting is itself often defined
as a high risk behaviour.
 Injecting drug use can be low risk given the
right factors.
 Different factors for different issues – BBV
transmission, overdose, type of drug, social
setting.

6. Structural Violence
 Stigma and discrimination and
criminalisation and illegality can be described
as structural violence.
 Systemic ways in which social structures and
institutions can harm people.
 Contribute to stress, shame, external
discrimination and self-discrimination that
comes from viewing oneself as unequal or
unworthy.

7. Criminalisation
 Leads to:
 Stigma and discrimination
 Creates a criminal class
 Inflates cost of substances, leading to greater risks
and disadvantage in pursuit of money to pay
 Makes people vulnerable to police attention and
discretionary powers
 Drives people away from family and community
 Drives people away from health, education and
support services

8. continued
 Increases risky injecting and drug use practices
 Increases intervention such as child protection
 Results in people being unable to get or maintain
employment
 Leads to poverty and social exclusion
 Increases vulnerability to human rights abuses and
inhumane treatment
 Results in people handing over power, rights and
dignity in exchange for access to basic, or even
substandard services

9. Current Environment
 Australian legal and social environment is
currently extremely frightening.
 Australian policy environment is currently
extremely frightening.
 Australian environment for community
organisations is currently ………

10. International Environment
 Australian environment is important in the
international context.
 Australian support for and promotion of harm
reduction coming to an end.
 Effects of this are already being felt by PUD
and PUD organisations in the region.

11. What we need
 Actual real commitments to the involvement
of PUD in responses to PUD.
 Actual resourcing.
 Willingness to start talking about drug policy
reform.