Labor Senators note that medical experts, drug and alcohol treatment agencies, social and health policy experts, and community services organisations all oppose the Bill.
Expert advice
The following organisations with expertise and experience – among many others – have urged the Senate not to support the Bill, on the grounds that it does not have an evidence base and will be ineffective and counterproductive.
The Network of Alcohol and Other Drugs Agencies said:
NADA believes that the Bill’s proposed drug testing regime is not supported by the current evidence. For example, the New Zealand government’s drug testing trial among welfare recipients as a pre-employment condition returned a detection rate in that population much lower than the proportion of the population estimated to be using illicit drugs in New Zealand as a whole.
Dr Kate Seear, Professor Suzanne Fraser, Professor David Moore and Associate Professor kylie valentine said:
As senior researchers with longstanding expertise in social policy issues relating to alcohol and other drug use, our assessment is that the bill is poorly conceived and counterproductive...
… a recent analysis of submissions to the Committees exploring the 2017 and 2018 bills, Professor Alison Ritter (Director of the Drug Policy Modelling Program at the University of New South Wales) observed that 98% of submissions by organisations and individuals opposed the bills. The remaining submissions were from the Department itself.
The Western Australian Network of Alcohol and other Drug Agencies said:
Expert consensus, as demonstrated through a multitude of submissions to the previous two inquiries on the topic, indicate significant concern that the trial will:
not address the underlying causes of unemployment and disadvantage;
fail to provide an appropriate referral pathway to specialist treatment and support; and
result in a range of unintended consequences, further risking the health and wellbeing of vulnerable people.
The Royal Australian and New Zealand College of Psychiatrists said:
The RANZCP considers that the proposed drug testing program lacks an evidential basis…
…punitive or coercive addiction treatment methods, such the proposed program, are less successful in meeting treatment goals than rewards.
The RANZCP therefore believes that the proposed program is ill-founded and lacks evidence and on that basis should not proceed in the event that it causes further harm to an already vulnerable population of Australians.
The Ted Noffs Foundation said:
We strongly condemn the proposed drug testing trial…for the following reasons:
Similar trials overseas have proven ineffective
The lack of available treatment to meet the mutual obligation requirements stipulated in the Bill
The risk of enhancing income and employment disparities for the target demographic
The risk of net-widening, increased criminal activity and homelessness for the target demographic
The federal government has re-introduced this legislation despite vocal opposition from experts in medicine, law enforcement, and social services…
The Explanatory Memorandum states that “Where treatment is not immediately available, recipients [who return a positive drug test] will be required to take appropriate action such as being on a waiting list [for treatment]”. Current waiting lists for public treatment facilities can be up to six months long. Placing recipients onto these lists will only add to the burden on the sector.
Rather than facilitate access, as the Minister claims, this trial will further complicate pathways to treatment…
Further, we are concerned that this Bill will encourage criminal activity in a vulnerable population.
The Queensland Council of Social Service and Queensland Network of Alcohol and Other Drug Agencies said:
An expert review of a Canadian Government drug testing trial proposal in Ontario published in the International Journal of Drug Policy found that such a program could increase crime, health problems and be legally challenged as a violation of human right.
The Royal Australian College of Physicians said:
Our reasons for strongly opposing this drug testing trial:
This proposed drug testing trial fails to recognise the nature of drug addiction. Addiction is a health issue with complex biological, psychological and social underpinnings; it is not a personal choice. Repeated drug or alcohol use leads to structural and functional brain changes that challenge an addicted person’s self-control and interfere with their ability to resist intense urges to take drugs. In addition, recurring instances of relapse are inherent to the nature of addiction.
These is no evidence that this drug testing trial will work, on the contrary, there is evidence that it could do harm. For example, there is a real concern that people could shift their choice of drug to one that isn't being tested for, which in some cases might be more dangerous, for example synthetic cannabis or synthetic opioids such as Fentanyl. Another significant risk is that individuals suffering from substance use disorder may divert their drug use toward prescription drugs which may or may not have been prescribed to them directly and this is a significant concern given that, after tobacco and alcohol, prescription drugs cause the highest numbers of drug related deaths in Australia.
The Government has not provided enough information about the tests it plans to use for these trials. It is worth noting that immunoassays have a number of shortcomings, especially around false positive and false negative test results. For example, many psychiatric drugs including anti-psychotics and antidepressants can cause false positive immunoassay results for amphetamines in particular. These psychiatric drugs are commonly prescribed so individuals subject to these drug tests could have a positive immunoassay result despite not having used illicit drugs. It would therefore be incredibly unfair to subject them income management for 24 months or to charge them for a retest for a false positive caused by a prescribed medication.
Trials by their nature need to be representative of the broader context so that valid conclusions can be drawn and findings generalised. Having trials exclusively conducted in regions with higher risk of substance use issues and dependent on the availability of treatment services as well as the capability to administer the other components of the Bill will not accurately test the feasibility or effectiveness of the proposed measures, nor will the results be able to inform any nationwide roll-out.
The proposed drug testing trial would not only be expensive but population drug testing is an unreliable way of identifying those who have substance use problems. There are distinct differences between recreational and dependent drug users. Drug testing will not be able to distinguish between those who have clinically significant drug problems and recreational drug users who don’t meet DSM criteria for substance use disorder and do not require treatment services.
Referral to treatment services of all of those who test positive will be a waste of scarce resources and will impact on services which are already stretched beyond their capacity – potentially impacting on those people who are already waiting and motivated to engage in treatment voluntarily.
We do not believe the $10 million Treatment Fund proposed by the Government is an adequate measure to address these issues in the trial sites as it is a one-off funding commitment which does not provide sustained funding and will therefore have workforce implications in the longer term.
Access to quality treatment, delivered by a suitably trained workforce, is fundamental for anyone struggling with addiction, and this should be the major priority for policy development and investment in this area. Key organisations in the health and welfare sector including the RACP have called for a boost of at least $1 billion per year to address unmet demand for Alcohol and Other Drug treatment services. Doctors having to monitor and report on their patient’s adherence to their mandatory treatment could negatively affect the patient-doctor relationship and trust, which are critical to successful drug and alcohol recovery...
Instead of pursuing this, at best ineffective and at worst directly harmful, drug testing trial, we call on the Australian Government to appropriately invest in alcohol and drug treatment services and a suitably trained workforce, and work with experts in the field of addiction medicine to develop evidence-based policy and plans that will effectively address drug and alcohol dependence in the community and support people on the path back to health and employment.
St Vincent’s Health Australia said:
We urge the Senate not to support this bill…
We note the Government’s comments in the media that they have been engaging with stakeholders from the health, alcohol and other drug, and welfare sectors. However this engagement occurred after the policy was announced and no policy changes have been made of substance to reflect the widespread and unanimous concerns of these sectors.
The Kirby Institute said:
There is no evidence that any of the proposed measures will directly achieve outcomes associated with reductions in alcohol or other drug use or related harms.
The Australian Medical Association said:
The Australian Medical Association (AMA) continues to have concerns about the proposal to drug test welfare recipients…
Substance dependence or addiction is primarily a health problem, and that those affected must be treated in the same way as other patients with serious health conditions…
Referring individuals who test positive to treatment will increase demand on these services, resulting in less capacity to assist those individuals who are actively seeking treatment (independent of the trial).
Anglicare Australia said:
The Bill is not based on evidence. It is an expensive measure that will neither reduce drug dependence and addiction or help people find work. It simply appears to be an ideological attack on our social safety net…
This policy, which is deaf to international experience where similar policies have consumed significant resources and failed, is subject to a consensus of criticism from a range of experts across the alcohol and other drug (AOD) and employment services sectors, It should be disbanded.
The Australian Council of Social Service said:
ACOSS is unaware of any evidence to show drug testing of income support recipients helps to address addiction or employment outcomes…
The Australian Government’s own Australian National Council on Drugs looked into the evidence around drug testing in 2013 and strongly opposed drug testing income support recipients. It found:
“There is no evidence that drug testing welfare beneficiaries will have any positive effects for those individuals or for society, and some evidence indicating such a practice could have high social and economic costs. In addition, there would be serious ethical and legal problems in implementing such a program in Australia. Drug testing of welfare beneficiaries ought not be considered.”…
The Australian Medical Association’s former president Michael Gannon said:
“…this policy is mean, unfair, and totally unnecessary, especially when there are so many positive things the Government could be doing in the health and social policy sectors.”
The Human Rights Commission also urged the Senate not to pass the Bill.
Labor Senators note that in evidence given by the Department of Social Services and Services Australia it was revealed staff are not yet receiving specific training or preparation to deal with clients who will have to undergo drug testing. This raises concerns for the safety and security of staff and clients.
The General Manager, Participation and Disability Division, Services Australia, said in regard to specific staff training to deal with clients requiring drug testing:
I can point out that, of course, we have been considering it, and there have been a lot of internal discussions about how we prepare our staff for these situations, just as we prepare them for any situation dealing with people coming into our service centres. This has certainly been a consideration, but training has not yet been rolled out to those staff.
Recommendations
Labor Senators call on the Senate to listen to the overwhelming consensus of experts and oppose the Bill.
Recommendation
Labor Senators recommend that the Bill not be passed.
Senator Malarndirri McCarthy