Dr. Garrett McGovern:

First, the stigma associated with heroin use is far greater than that associated with any other drug I can think of. It is slowly being matched by crack cocaine, probably, although not so much with powder cocaine. I work with those people every day, as does Senator Ruane. Many people were afraid to come for treatment back in the day. We did not have opiate substitution treatment services and we did not have naloxone until recently. When talking about stigma, some commentators have called it a form of drug apartheid whereby some drugs are treated differently from others.

I have never known a drug quite like heroin in terms of the way the people who use that drug are talked about by other people, who know very little about the drug and very little about the communities in which those people live. When I started working in the late 1990s there were people who would not come to the clinic because it was in the neighbourhood in which they lived. They asked me if there was another way they could see me because they did not want to come through the front door as many of the people who lived close to them did not know they were using that drug. That is a horrible thing. One is trying to help somebody with a health problem, yet the person is shying away from treatment. Looking at the statistics there are probably almost 12,000 people on opiate substitution treatment. It is climbing a little. There are probably a lot of people, and I have met them, who would not go to a treatment clinic because of the stigma associated with the labelling of that disease.

I will not mention it in this room but we know what all that language is. When we are talking about stigma relating to drug use, we are really talking about stigma relating to specific drugs and that drug is different from other drugs. I would not say it is a developing problem but crack cocaine is a problem in many marginalised communities now. We are late to the table with Naloxone. We could have a whole debate about the way it should be wheeled out. We should take a very low-threshold approach to Naloxone. I am against the idea that it is on prescription and is given by a doctor. I do not think there is any evidence whatsoever that Naloxone is misused. It should be low-threshold because it can save people's lives. It can save them immediately.