The key takeaways from NSW drug summit's Sydney hearings

Earlier this week, several hundred politicians, policy experts, police, health professionals, and people with lived experience of drug use packed into Sydney's International Convention Centre to discuss drug-related harm in New South Wales.

The two-day summit followed similar conferences in Griffith and Lismore in October.

The summit will result in a final report in early 2025 with the government yet to make any commitments on the basis of the summit.

Here are some of the key points from this week's summit.

Calls for decriminalisation are louder than ever, but the government is holding off

Calls for the decriminalisation of drug use and possession were front and centre of the summit, despite Premier Chris Minns firmly ruling out any such reform in the months prior.

Annie Madden of Harm Reduction Australia, said in the opening address that the full decriminalisation of small amounts of drugs for personal purposes needed to "be firmly on the table".

"Why? Because it is the right and just thing to do."

However, the tone shifted with the stances of the speakers. 

The inclusion of Portland Mayor Ted Wheeler as the summit's "international perspective" was met with criticism.

Earlier this year, Mr Wheeler repealed laws decriminalising the possession of small amounts of illicit drugs in the US state of Oregon, declaring the health system had been overwhelmed and that drug-related crime had exploded due to the legislation.

His testimony was soon cited by NSW Health Minister Ryan Park as he reaffirmed the government's decision not to consider decriminalisation measures in its current term.

"Until I'm confident that people can access services in a way that allows them to get off drugs in a timely manner, then I think there are other issues aside from decriminalisation that we need to focus on," Mr Park said.

The minister's remarks, however, were not enough to dissuade speakers from knuckling down on calls for change. 

The following day, former ice inquiry commissioner Dan Howard received a standing ovation after rubbishing claims that NSW could endure a similar fate to Oregon.

"Portland is a false equivalent to here, because the nature of our drug problem in NSW and Sydney is very different to that of Portland," he said.

"If our politicians reject decriminalisation on the basis of Portland, then it will, with the greatest respect, be a comfortable political cop-out, and a lost opportunity."

Pill-testing and other reforms could be on the cards

While the government was steadfast in rejecting decriminalisation calls, the prospect of reforming drug-checking laws appeared more palatable to Mr Park.

"This is something that we are willing and open to engaging with the sector on. I've been doing that, I've been reading about pill testing, I've been looking at what's happening in places like the ACT," Mr Park said.

Among those calling for pill testing was former premier Bob Carr, the Labor statesman who oversaw the first NSW drug summit in 1999.

"It's better to live with that harm minimisation than deal with the news that your son or daughter has died from an impure substance," he told the ABC.

Drug checking was one of many measures touched upon by Alison Ritter from the University of New South Wales' Drug Policy Modelling Program, as she highlighted the types of reform that could be adopted to minimise and prevent drug-related harm.

Professor Ritter noted the government's capacity to enact "no-cost options", such as altering the law around medically supervised injecting centres.

Current law allows for the operation of a single medically supervised injecting centre in the state, but Professor Ritter proposed altering this act to allow local communities the right to decide if they want a medically supervised injecting centre.

"This would not cost the government anything," she said.

The Uniting Medically Supervised Injecting Centre in Darlinghurst has been in operation since 2001, having managed more than 11,000 overdoses without a single fatality.

Other speakers passionately advocated for a increased funding for alcohol and drug treatment facilities, prevention and intervention programs and peer workforce services.

While the government refrained from announcing any new measures, Mr Park emphasised the importance of continuing and improving funding for health programs.

"We've already been investing very recently, hundreds of millions of dollars into targeted services. Despite that, I think it will require continued focus going forward," he said.

Illicit drug contents are 'more unpredictable' than ever before

Providing powerful ammunition to the case for drug-checking, Amy Peacock of NDARC's sobering assessment of the issue faced by NSW in 2024 spoke to the unprecedented potency of new drugs on the market.

"The landscape around drug use is evolving, it's rapidly changing, it's complex, and it's dynamic. It's not the same as it was 20, 10, or even five years ago," she said.

While the 1999 summit occurred following a sharp rise in heroin use and related harms, the rate of drug-related harms in the lead-up to the 2024 summit has been largely stable.

The greater cause for concern, Professor Peacock said, was the increasing diversity of drug forms and administration. 

Stimulants such as MDMA are being sold in higher-purity forms, while novel psychoactive drugs like nitazenes are becoming increasingly common.

According to Professor Peacock, such drugs were often synthetically produced, purchased as counterfeit medicines, and mixed with other substances, making them potentially hundreds of times more potent than drugs such as heroin.

"In NSW we are seeing increasing clusters of overdoses related to these drugs," she said.

"The contents of illicit drugs are more unpredictable than ever before."

First Nations people over-impacted (and under-included)

Over the course of the Sydney leg of the summit, the consideration of First Nations people in harm minimisation and prevention strategies was a feature of discussion.

The topic first came to the fore during a panel discussion of keynote speakers.

"I'm feeling acutely aware that I'm sitting here as a white person amongst white people here," University of Sydney's Maree Teesson said when asked about topic.

It was soon brought to the co-chair's attention by a crowd member that the panel lacked any Indigenous participants, following which Professor Doyle was called to the stage.

The interaction seemed representative of how Professor Doyle and his peers experienced the summit in its entirety.

"We feel that we haven't been included in the way we should have in this summit," he said on behalf of a discussion group dedicated to the issue of 'equity, respect and inclusion'.

The group proposed a summit pertaining to issues disproportionately affecting First Nations people, as well as a government drug strategy specific to First Nations people.

Balance between portfolios key to successful strategy

In addressing the summit, Mr Minns acknowledged the complexity of drug strategy and managing drug-related harms.

"Drugs are a health issue. They're also a justice issue. They're a police issue. They can be a child protection and social services issue. They are an education issue," he said.

However, much was made over the two-day summit of the fact that less than two per cent of drug health expenditure is spent on harm prevention.

"Prevention is not only important because it improves wellbeing, but it is also cost-effective," Professor Teesson said.

"We clearly need stronger investment in prevention and early intervention."