Guess: Which is SA's Most Dangerous Drug?

The drugs which kill most South Australians are not peddled down dark alleys. They’re sold by a smiling cashier at the supermarket, corner deli, and your favourite watering hole. Should drugs be categorised by the harm they do, based on evidence and science, or by their popular reputation? Greg Barila has been finding out.

It’s a fiercely contentious and morally-charged question which divides people as surely and precisely as creationism or stem-cell research. 

Are legal drugs more dangerous than drugs which are presently illicit? Is puffing on cigarettes and chugging wine more harmful to your health than an ecstasy pill at a nightclub or the occasional joint with friends at a dinner party?

Around the world, a growing chorus of concerned medical experts and researchers has been questioning the conventional wisdom on the classification of drugs, according to their harm. And their findings have been sobering.

I draw back the black curtain to find the assistant behind the counter in a beanie and cut-off gloves. This is not an ordinary Independent Weekly assignment.

“Do you sell Rush?” I inquire. “Yes, we do,” the assistant says stepping into a back room to fetch an order sheet pinned up on the wall. “It’s for cleaning leather”, he says nodding knowingly, making sure I get the drift. “Yeah, yeah,” I reply.

A hazard warning on the brochure points out that cleaning leather is “a dangerous game” that can change the colour of the leather. What it fails to point out is that Rush is not a leather cleaner, nor is it a nail polish remover or video head cleaner.

Not when you buy it from one of the several sex shops around Adelaide where I find it available for sale, anyway.

Known by several names, including Bolt and Poppers, Rush is part of the amyl nitrite family of drugs and is used primarily among the gay community to enhance sex.

Users sniff the liquid contents of the small bottle to get a rush that relaxes the muscles and can last a couple of minutes.

Also known as isobutyl nitrite, the drug is listed under Schedule 4 of the Therapeutic Goods Act. It is sometimes used to treat cyanide poisoning and angina but is only available legally by prescription.

The price on the bottle ranges between $25 and $40 but the real cost can be two years in prison or a maximum fine of $10,000.

But while the drug can be fatal if swallowed or mixed with other medications such as Viagra, The National Drug and Alcohol Research Centre says the risk of serious injury is “fairly remote” and that “there are no recorded sudden deaths from inhaling nitrites”.

Compare its record with that of widely used legal drugs such as alcohol and tobacco.

About 20 per cent or 300,000 people smoke in SA, while in 2004, 85 per cent of people 14 years and over said they had had a drink in the past 12 months.

According to Drug and Alcohol Services SA, 1280 South Australians will be dead this year alone because of tobacco-related illness.

That’s 25 of your work colleagues every week, three of your friends per day. That’s after they’ve taken up 6240 hospital bed days.

A Burden of Disease report by the SA Health Department, found that between 2001 and 2003, an average 322 people (222 of them male) per year died as a result of harmful 
alcohol consumption.

Car accidents, cirrhosis of the liver and cancer were major causes.
 
As the law stands, South Australians have the freedom to quite literally drink and smoke themselves to death. In 2005 heroin killed 37 people, about 10 times fewer than alcohol but every bit as effective in breaking a parent’s heart.

Statistics like these have prompted scientists around the world to review the way drugs are classified, based on clear and available evidence of their harm. 

In a 2006 report to the House of Commons by a select committee on Science and Technology, researchers slammed the UK’s A, B, C classification system saying it was divorced from rocksolid science and ordered the Government to act, post-haste.

“We have found glaring anomalies in the classification system as it stands and a wide consensus that the current system is not fit for purpose,” the report found.

A study published in The Lancet this year by Professors David Nutt and Colin Blakemore came up with a list of drugs, ranked according to their proven harm, their addictiveness, and the effect of their use on families and communities.

Top of the list was heroin, then cocaine, barbiturates and street methadone. Alcohol came fifth, and tobacco was ninth, more harmful than cannabis, LSD or ecstasy.

Its findings underpin the very debate in SA between outright prohibition and harm minimisation.

“There is no doubt that the simple, tough on drugs, war on drugs approach doesn’t work, produces irrational results, criminalises people when they shouldn’t be criminalised,” Democrats MP Sandra Kanck says.

Last year, Kanck was flayed by elements of the media after she suggested one of the best things that could be done for victims of the Eyre Peninsula bushfires was to make legal MDMA (ecstasy) available to help them through their trauma. 

Despite the populist uproar, she insists there is evidence to support the idea. 

“We’ve got to have an honest, rational, scientific debate and not one based on morals.

“There are so many substances that are used in one way, industrially, domestically, medically that can be used as a mind-altering drug, we’ve just got such double standards about it” she told the Independent Weekly

“We glorify alcohol. We have wine pages, we have wine magazines, we have booze buses in the sense of young people hopping on a bus on a Saturday night doing pub crawls, and 
we say that’s ok.”

Dr David Caldicott is a researcher at the Royal Adelaide Hospital and an advocate of pill testing at rave parties and harm minimisation.

“This is every bit as serious a public health problem as the AIDS epidemic of the ’80s and we’re not treating it in a scientific way,” Dr Caldicott says.

He explains that properly applied real science does not argue, ‘Don’t have sex’. Instead it says, ‘Use a condom’.

“What we aren’t having is what we had in 1985 – a rational debate on drugs policy. We’ve got these strange rhetorical statements like, ‘Pill testing sends the wrong message’. “That’s not science.

“Politicians in Europe serve science and serve public health, whereas here, unfortunately, public health, as far as illicit policy is concerned, is being used as a political football to be kicked around by politicians, the most verbal of which are clearly uninformed.” 

Family First’s Dennis Hood does not doubt the potential harm of all drugs, whether you buy them under or over the counter. He is worried by the scourge of alcohol and cigarettes.
“In the case of alcohol, our policy has been to restrict alcohol advertising until after 9pm at 
night and also to raise the drinking age (from 18) to 20.”

Hood says he supports the evidence-based classification of drugs but is wary of the dangers of suggesting currently illicit drugs are any safer than alcohol and tobacco.

“When I hear a claim made that these drugs are more dangerous because the statistics show that more people are harmed by them than by illicit drugs, it just ignores one of the main reasons which is that they’re more widely used. So then to lead to the conclusion that alcohol is more dangerous than heroin is just ridiculous.

“That debate has been done, it is clear that the illicit drugs are illicit in Australia because there’s good reason, because the science on those drugs is clear.” 

Ian Horne is general manager of the SA Australian Hotels Association, a sector, it’s fair to say, that would have plenty to lose from a downturn in alcohol sales. As Slim Dusty sang, pubs are lonely, morbid and dreary places without grog.

But Horne says the industry is already acutely aware of the huge responsibility that comes with selling legal drugs.

“By all means have a study. But we already know that alcohol when abused, and quite separately tobacco, has a negative effect on the community.

“That’s why alcohol, compared to most legal products is so heavily regulated.

“They don’t regulate breakfast cereals or soft drinks to the same extent they do alcohol.

“Having said that, it’s hard to defend tobacco consumption in any circumstances, other than to say it’s an individual’s right to do what they like.”

For its part, the government says it’s concerned about the problem and is doing much to curb harms, using instruments both sharp and blunt, such as legislation and providing counselling services and substitution treatment for opioid addiction.

Substance Abuse Minister Gail Gago points to bans on fruit flavoured cigarettes, and smoking bans in cars with children and in pubs, clubs, and the casino from November.

And regarding illicit drugs, Gago says the government’s three-pronged plan of attack involves cracking down on supply, helping users abstain from further use, and reducing harm.

These are worthy measures, but the question burns like a lit cigarette.

As long as science takes second place to morality and emotion, will the existing approach do less good than harm?

It’s a question that SA is struggling to answer, and it may be that no one single answer will satisfy every anti-drug campaigner, legislator, or – dare it be said – the crowd watching the footy at the pub on a Saturday afternoon.

● For more information on drug addiction contact ADIS (Alcohol and Drug Information Services, located at Payneham) on 1300 13 13 40 (24hours a day) or on the web
This story was first published in Adelaide's The Independent Weekly, July 21, 2007