Wednesday, 21 January 2009

Q & A: Gino Vumbaca

This is the third in a series of Q & A's for people who have some relationship or interest in illicit drugs.

Name: Gino Vumbaca

Role: Executive Director of the Australian National Council on Drugs
Date: January 2009

Gino Vumbaca has one of the hardest jobs in Australia. Although he is part of the core advisory group for drug policy to the Australian government, he also strongly supports Harm Minimisation which sometimes can put him in a precarious position. As we saw with the Inquiry into the Impact of Illicit Drug Use on Families aka The Bishop Report: “The Winnable War on Drugs”, Gino was called in to defend Harm Minimisation against a hostile, heavily biased and trumped up panel of twits led by Bronwyn Bishop. In his typical diplomatic style, Gino stood his ground whilst being bombarded with farcical and ludicrous questions aimed at discrediting Harm Minimisation. Someone as well grounded and knowledgeable as Gino Vumbaca was never going to be an easy target for them and was grossly underestimated.

I have never met Gino but his reputation speaks volumes about the man. Someone who is dedicated to the well being of others and one of Australia’s top experts on drug policy. A tireless and dedicated supporter of a better future for the addicted and society in general. The fact that Gino took the time out of his extremely busy schedule to be part of this Q & A is evidence of his commitment to the drug issue. Read on to get an insight into the personal views of maybe the most important person shaping our drug policy.

NOTE: Gino’s answers are his own personal opinions and not those of the ANCD, its members or the government.

About Gino Vumbaca
Mr Vumbaca has extensive experience in the HIV/AIDS and drug and alcohol fields both in Australia and internationally. He is a Churchill Fellow and has completed a Social Work degree and a Master of Business Administration at the University of Sydney. He has worked as the Manager of HIV/AIDS and related services with the NSW Department of Corrective Services, in a variety of drug and alcohol centres as a counsellor and was responsible for coordinating the establishment of the NSW network of needle and syringe exchange programs for the NSW Health Department. Mr Vumbaca also continues to provide advice on prisons, HIV and drug issues for international organisations such as the UN and WHO.
Source: ANCD


The Australian National Council on Drugs (ANCD) has no official decision making role for our drug policy and is an advisory group only. Do you feel you should this is sufficient?
Yes - it is the role of government (elected) to make decisions for which they can be held accountable to the community - certainly the ANCD has a role to provide independent evidence based advice and to inform public debate and thinking on drug policy but in the end it is governments, on behalf of and taking into account the needs and views of the whole community, that need to make the decisions.

Do you think the public understands what the ANCD actually do and should their profile be raised?
Some of the public will understand and some will not, but I think that the public profile of the ANCD over the last 5 years in particular has been raised considerably - it could always be better but I think many people continue to learn and understand its role. Certainly, the level of government and media requests for advice from the ANCD has increased markedly over the years. In the end however it is not the public knowledge profile of the ANCD that it is most important but rather the quality and timeliness of its advice for the public and policy makers.

Does the press help or hinder your job at the ANCD?
Both, but it helps far more than it hinders. I would say that in the overwhelming majority of cases the media has been good at reporting on ANCD commissioned research and announcements, as well as general drug and alcohol matters of concern, certainly in regard to alcohol policy in recent times the media have been very helpful in raising issues and maintaining pressure for change - reflecting the community view. There are of course media reports that are unhelpful and if I were to single some out it would be those that promote so called 'miracle' cures without checking or reference to any real evidence, and those media reports that imply drug users are somehow not entitled to humane care and support. I also think we don't help the media enough such as being able to provide a single national helpline number that could be listed at the end of every relevant story on drug and alcohol use.

There is now more evidence than ever before that drug addiction is a physical condition and some people are more susceptible to becoming drug addicts than others. Do you think the public understands this?
It is true that there is increasing work being done on the genetic disposition to dependence and I think the public understands this somewhat but many would still see dependence as a matter of personal choice or via a disease model approach - this is not a rejection of the theories and research within the biosciences fields but rather a reflection of the long standing complexity surrounding nature and nurture. Suffice to say, it is an area that requires far more research particularly in Australia.

Politicians are often labelled as being “soft on drugs” when they suggest that a “tough on drugs” policy is not the answer. Do these types of politic stunts make your job harder?
I don't think they make it easier - many people in the sector are rightly tired of this type of rhetoric although to be fair it is often others that attach such labels rather than politicians. The reality is that Australia has a balanced and pragmatic drug policy and has done so for many years. It should not be about being soft or tough it should be about being effective. However, we should not underestimate the power of language at times. The recent proposal by the NSW Opposition for a greater focus on rehabilitation of prisoners was met with positive coverage and this is encouraging for many of us that have been advocating for an end to increasing incarceration as an answer to the problems of drug use and associated harms.

Australia appears to be following the US and placing more emphasis on religion in politics. Do you feel this effects our drug policy?
Not that I am aware of - I think it would be fair to say that faith based services have a long history in providing services for disadvantaged groups, but they also compete for their funding with all other services. People representing faith based services also sit on advisory bodies at times, again this is a reflection of their role in providing treatment and other services. I don't think anyone should ever be appointed to a position of influence on drug policy (or any public health policy) as a result of their religious beliefs.

Does religion have any place in drug policy or treatment?
see above

The US is infamous for it’s drug policy and opposition to Harm Reduction. Though the US has about 10 times the number of HIV/AIDS sufferers amongst injecting drug users compared to Australia, only recently has federal funding been allowed for needle exchange programs. Is this a sign that Harm Minimisation is becoming more accepted in the US?
I am not sure about the level of acceptance in the USA - it is certainly encouraging that pragmatic and humane responses taken here over the past 20 years are starting to also gain greater traction in the USA - it is unfortunate that so many people have had to suffer in the interim. President Elect Obama has made some statements in the recent past that would seem to signal a change in approach, but I guess time will tell.

Bronwyn Bishop chaired an enquiry into illicit drugs last year and produced a report called “The Winnable War on Drugs” which you were asked to participate in. Do you think Harm Minimisation was unfairly criticised?
Yes - I think the report fell into the trap of arguing about language and ideology rather than evidence and that, in my opinion, is something that Australians are generally wary of and sceptical towards. A lot of people understand that drug users are people just like them with real lives, families and friends and they deserve to be the primary focus rather than used as a proxy in a battle of ideologies.

John Howard wanted to remove Harm Minimisation as Australia’s primary drug strategy and implement a policy of Zero Tolerance. Do you think most Australians understand what Harm Minimisation really is?
I am not sure that the premise of the question is accurate but I understand that is a perception for some - as to public understanding of HM, I think it could be a lot better. There is confusion at times between harm minimisation and harm reduction - but again we can get too caught up in arguing about language when it is the quality and effectiveness of the responses to drug use issues that needs to be debated.

South Australia recently banned drug paraphernalia and rejected a call to test MDMA for Post Traumatic Stress Disorder. Is this a good move in your opinion?
I think that in reality these decisions often sit at the margin of what constitutes effective drug policy. I am not aware of the evidence underpinning these policy decisions so don't feel in a position to comment further.

Are anti-drug advertisements using scare tactics effective?
I know some people will disagree but they can be - the ANCD has assisted in many campaigns for Governments and the goal has been effectiveness via thorough research and focus testing of concepts with the target audience, be they young people or parents. I understand that some people believe that somewhat dispassionate information on drug use is the most effective approach but I think that is not supported by what target audiences say and fell, it also seems to be undermined somewhat by the campaigns associated with anti-smoking which have been very effective and haven't shied away from showing people some of the graphic consequences of smoking. The issue is not so much scare campaigns but effective campaigns that need to be supported by a range of other strategies (as we also see with anti-smoking which includes a range of public policy changes) and the need for campaigns to be ongoing so they can evolve and develop even more sophisticated approaches to inform and educate the public.

Kevin Rudd said in an interview that his policies would be evidenced based if he won the election. Do you think this will encompass our drug policy?
The ANCD has had the privilege of meeting with the Prime Minister and many of his senior cabinet colleagues, including the Deputy Prime Minister and Health Minister and have no doubt that evidence based policies will include drug policy.

A report was published in the medical journal, The Lancet, where psychiatrists who specialise in addiction and legal/police officials with medical expertise were asked to rank the most dangerous 20 drugs. The factors used were physical harm to the user, addictive potential of the drug and the drug's overall impact on society. Cannabis, LSD and ecstasy didn’t even make the top 10, alcohol came in at number 5 and tobacco came number 9. Should this effect how the government approaches the rating of drugs?
It is an interesting approach - there of course is still a level of subjectivity within the approach but it does seem to be a way of promoting greater public awareness and debate on drug and alcohol issues.

Should the drinking age be raised to 21?
There is evidence that in some countries there have been some benefits from a higher drinking age but I think in Australia we have problems with underage drinking despite there being a legal limit in place and I would be wary of placing so many more people in illegal situations, particularly given the associated problems that could cause - it is the culture and patterns of alcohol consumption that need to be addressed. Alcohol is available and consumed by many here and we need to be wiser and more aware of the potential consequences of alcohol misuse, particularly for young people.

Should well known sportsmen and sportswomen be tested for non performance enhancing drugs?
This is not an area of expertise for me but if testing regimes are to be in place they need to be done within the context of a comprehensive program that also provides assistance and addresses alcohol misuse.

Do you have any first hand experience with someone you know being addicted to drugs?
Yes - both personally and professionally

Methadone is just as addictive as heroin and some people argue that methadone simply replaces one addiction for another. Do you have an opinion on this?
Methadone and other pharmacotherpies allow people to get some control back over their lives. The evidence is quite clear on their effectiveness. It is a legitimate treatment that deserves support.

Some members of Drug Free Australia (DFA) say ex addicts especially those on medication like methadone don’t have a place discussing addiction treatment. Are they correct.
I am not aware of that comment specifically but I think we should all be very careful about trying to exclude people from a debate. It should be the merit of the argument that determines its worth not the opinion of mine or others on the person that delivers the argument.

Australia was to have a heroin trial but it was vetoed by John Howard because it “sent the wrong message about drugs”. Was he right?
This was a decision made by the government of the day - I am unclear as to how the impact of the messages that could have be sent by its introduction were assessed and decided. Trend data from the National Drug Strategy Household Survey shows increasing support for controversial programs such as injecting rooms and prescription programs. As I said earlier the final judgement that balances the evidence and community wishes rest with the government of the day, as it should.

Other Opiate Maintenance Treatments(OMT) are in use or on trial in Europe, Canada and the U.K and have great success. Should other forms of OMT be trailed in Australia like slow release oral morphine, injectible hydromorphone, dihydrocodeine and prescription heroin?
Evidence from these programs should be assessed and inform policy debate and thinking in Australia. We should never be afraid to look at options and alternatives.

Finally, if you were Prime Minister Gino Vumbaca and you could change one law relating to illicit drugs or drug treatment, what would it be?
No restrictions for treatment, that is, when someone wants help they should be assessed and have the best treatment made available to them without delay. Seeking treatment is a significant and somewhat scary step for many people to take and it should be met with positive professional assistance as quickly as possible.

Q and A: Kerry Wolf - Certified Methadone Advocate (USA)
Q and A: Dr. James Rowe - Lecturer at RMIT, School of Global Studies, Social Science & Planning
Q and A: Sandra Kanck - Former South Australian MLC. South Australia spokesperson for Families and Friends for Drug Law Reform (FFDLR)
Q and A: Tony Trimingham - Chief Executive Officer, Family Drug Support


Jaz said...

An addiction treatment center is staffed by knowlegable professionals who have been trained to work with individuals who have been dealing with long-term addictive disorders. Problems like these are difficult to overcome, but with the right therapy and a good dose of encouragement, recovery is possible.

Reginald Lee said...

I have experienced Mr Vumbacas' personal policy/views 1st hand whilst a client of the Lifestyle Unit at Long Bay Gaol! I'm sorry but my opinion is that until you have experienced the degrading soul destoying processes that we as addicts have had to live to survive! You can't possibly write compassionate policy that affects the outcome of peoples rehabilitation. You are not the right person for the job Gino!

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Terry Wright said...

Thanks Reginald.
Sorry to disagree but I think Gino Vumbaca
 is an excellent choice for his current role as Executive Director of the Australian National Council on Drugs.

Maybe you could elaborate more on the situation?