7 May 06 Harming
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Our
capacity to imagine dire outcomes is infinite. From the
creaking of the house in the dead of night evoking vivid
images of an approaching intruder, to a delayed arrival
bringing fears of dreadful traffic accidents, we commonly
imagine the worst.
As
Mark Twain put it: “In my life I’ve experienced many
horrible things, some of which actually happened”!
And
that is the reality - most of the bad things that we imagine
could happen don’t, while conversely, of course, some bad
things that we could never in our wildest dreams have
imagined, like the September 11th terrorist attacks
or the 2004 Tsunami, do occur.
This
fear of risks and threats also affects governments. In that
case, the scale can be massive: the potential threat of a Year
2K computer ‘meltdown’ and the risk of a bird flue
pandemic, caused governments around the globe to panic and
throw billions of taxpayers dollars at strategies to minimize
the perceived risk.
But
the real challenge for governments - that have a seemingly
bottomless purse for public displays of ‘caring’ - is to
find an appropriate balance in their desire to protect
citizens from adverse events.
The
problem is that governments are prone to regulate and spend in
order to prove that they are addressing a perceived problem,
even if what they are doing turns out to be doing more harm
than good. And therein lies another problem: once a course of
action to minimize a perceived risk has been implemented,
there is little appetite for changing that course of action
even if it proves not to be working as well as expected.
That
certainly appears to be the case with regard to the
government’s strategy of “harm minimisation” in relation
to potential risks affecting young people. Harm minimisation,
or harm reduction as it is also called, is the strategy that
has been adopted in New Zealand to educate our young people
about the potential danger of engaging in risky behaviours
such as drug use and sexual activity.
Harm
minimisation is based on the premise that if people are taught
the safest possible way to undertake a risky behaviour, then
the harm that they will experience will be reduced. The
problem with this approach is that, not only does it send a
message to our young people that
dangerous activities and risky behaviours are acceptable, but
it also teaches
youngsters who have had no previous interest in such matters,
how to engage in them!
For
example, in our primary schools, the Health and Physical
Well-being curriculum teaches our nine-year-olds about
managing risks in “sexual decisions and drug use”, at age
ten, they are taught about harm minimisation in relation to
“the use of drugs and sexual activity”, and by age eleven,
the children are being taught “safe sexual practices and
drug use”.
Further,
curriculum resources include materials published by the
Community Alcohol and Drug Services in conjunction with the
Waitemata District Health Board, which contains explicit
information on drug use such as “LSD
tripping with good friends usually creates a much better time
than doing it alone”, when using cocaine “avoid using the
same injection site when having several blasts in the same
night, to reduce vein damage. Getting advice and filters (to
remove impurities) from your local needle exchange is also
advisable”, and when using Nitrous Oxide “inhaling the gas
using balloons reduces the risk of potentially fatal lung
damage from NOS pressure as well as the risks associated with
cold gas”.
This
week’s NZCPD Guest Commentator is former
Member of Parliament Pauline
Gardiner, Chief
Executive of Welltrust, a
secondary school alcohol and drug support service. Pauline questions
whether this strategy is working: “if
Harm Minimisation, which has been the only approach for the
past 20 years, is working so well - why are we one of the
highest drug-using nations in the world?” (Click here
to view Pauline’s article>>>)
Last
year, Wellington Coroner Garry Evans, following his
investigation into the deaths of six young people from
substance abuse, called for a change away from the present
‘harm minimisation’ approach. He said
the Government's national drug policy should focus on
preventing the harm caused to young people by using drugs,
rather than trying to minimise it. He also said that talk of
"safe choices" by children and young people was
inappropriate.
In
response, the Public Health Association defended harm
minimisation stating that it is recognised internationally as
the most effective way of addressing drug-related harm.
This
debate has now spilled over into another area of risk
affecting young people, that of “self harm”, where someone
deliberately mutilates themselves. A UK based paediatrician,
Dr Charles Essex (who previously worked for Plunket in
Auckland) in an article published in the NZ Doctor has
suggested that young people be given advice on the best ways
to cut themselves: “One approach, therefore, is to advise
safe self-cutting – using clean blades instead of glass or
rusty metal cans, advising where to cut so as not to damage
underlying tendons or arteries…”
While
there appears to be no plans at present to teach children and
young people about this sort of deviant activity, it does
serve to illustrate just how inappropriate the strategy of
harm minimisation really is. It is like advising parents to
show their young children exactly how to get the lids off
dangerous chemicals, and then telling them not to do it,
instead of warning them so strongly about the risks and
dangers that they would never dream of experimenting for fear
of the consequences.
The
poll this week asks
whether you agree with the Wellington
Coroner Garry Evans, that the
Government's national drug policy should focus on preventing
the harm caused to young people by using drugs, rather than
trying to minimise it?To take part in our online poll
>>>
Your comments and contributions are welcome. Send your comments here
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Opinions expressed are those of the contributors, and do not
necessarily reflect those of the editorial staff.