Talking of Taboos: How brave philanthropy can save lives

By: John Ryan   |   CEO, Penington Institute   |

Philanthropy has a long history of stepping up to support the projects and causes that are unable to secure popular or government support; issues made unpopular due to stigma or believed to be just too hard. In 2012, this very publication devoted an issue to ‘brave philanthropy’, the kind that takes risks and tests bold, innovative solutions. A decade on, the need for brave philanthropic investment is as urgent as ever.

With philanthropy, just like other kinds of investment, there is a direct relationship between risk and return. When the approach is underpinned by vision and strategy, risk becomes a tool and philanthropy has the potential to catalyse meaningful, lasting change. Conversely, we sometimes persevere with funnelling resources toward an approach that is considered ‘safe,’ even when the dividends have been consistently low or even non-existent.

The prevailing stance on drugs is a prime example. Evidence tells us that prohibition and the ‘war on drugs’ is unwinnable. Since its launch fifty years ago, the law enforcement approach has not only failed utterly to achieve its objectives – Drugs today are more readily available and more powerful than ever before – it has undermined health and security, and has chalked up an unfathomable human toll along the way.

By pushing drug use underground, these policies have ensured drugs and their obscene profits remain firmly in the hands of criminal networks, who create ever-more potent substances and aggressively pursue new markets. A 2017 report from the think tank Global Financial Integrity estimated global profits from the illegal drug market had a total value of $USD1.6 to 2.2 trillion. 

In the face of so much failure, there is a growing appetite for change. Many are now pursuing initiatives based on a harm reduction philosophy. This approach involves policies and practices aimed at minimising the negative health, social and legal impacts of drug use, drug policies and drug laws. Harm reduction is grounded in evidence, with an emphasis on effective regulation and human rights. Its interventions prioritise positive change without judgement, coercion or discrimination, and without demanding that people stop using drugs as a precondition of support.

International Overdose Awareness Day (IOAD), held every year on August 31, is one such initiative. Starting out as a grassroots event in Melbourne in 2001, IOAD aims to end overdose and reduce the stigma for those affected. It has now grown into a Global Day of Action recognised by hundreds of organisations in dozens of countries around the world. Just last year, a proclamation from US President Jo Biden designated Overdose Awareness Day an official US National Day.

Penington Institute has been the coordinator of IOAD since 2012. We have been honoured and touched by the global response, which includes thousands of individual tributes from people who have been personally impacted by overdose.

Unfortunately, IOAD and other harm reduction projects have struggled to find the high-level support they need. The public show of allegiance at the community level has not been matched by material support from the philanthropic sector. 

Why are philanthropists so hesitant to embrace harm reduction?

A short answer is that stigma, which surrounds these issues, results in widespread and intractable misconceptions. First among these is the image of the type of person affected by drug use. It is often assumed that people who experience an overdose belong to a dangerous subculture of illicit drug use, taking frightening drugs in dark alleyways. 

But this stereotype is wrong. Illicit drugs like heroin and methamphetamine certainly play a part, but the overdose crisis in Australia is currently being driven by prescription drugs. Someone who overdoses is just as likely to be an older person taking prescription opioids and benzodiazepines for chronic arthritis.

Another misconception exists around scale. Since 2014, overdose deaths have outnumbered the road toll, and the margin is widening every year. It is the second or third leading cause of death for people in their 20s, 30s and 40s and a significant cause of death for Australians of all ages.

Overdose is not a niche issue.

Many of those who are captured in the statistics do not have a pattern of problematic drug use; they simply misjudged, on one occasion, how much to take of a given drug. Alternatively, they may have combined multiple drugs in amounts that would have been safe in isolation, such as alcohol and prescription benzodiazepines.

More than once, potential funders have vouchsafed their concerns to me directly. They worry that if they were to openly support Penington Institute, others would assume that drug use was an issue in their own family. In other words, they are fearful of the very stigma that IOAD was designed to combat.

Addressing the stigma around overdose needs to be recognised as a collective responsibility for our entire society. If we can find the courage raise our voices, we have a real opportunity to curb drug related harms and end the overdose crisis that is currently gripping much of the world. Without that courage, I fear we will always see our efforts fall just short of the impact we are striving for, and people will continue to die completely avoidable deaths.

A not-for-profit organisation, Penington Institute’s mission is to support cost-effective approaches that maximise community health and safety in relation to drugs. Frank and fiercely independent, we connect lived experience with research to improve the management of drugs through community engagement and knowledge sharing.

Aug. 26, 2022

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