Briefing to the Incoming Parliament - NZ Drug Foundation Policy Briefing 2020 2023
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Briefing to the Incoming Parliament NZ Drug Foundation Policy Briefing 2020 – 2023
The Drug Foundation has been at the
forefront of major alcohol and other
drug debates for over 30 years. We take
the lead in Aotearoa New Zealand,
promoting healthy approaches to
alcohol and other drugs.
Creating solutions
with communities
We work with communities, especially
tangata whenua, to find effective solutions
to drug issues.
Public education, information
and outreach
We create resources and lead projects in
schools and workplaces to reduce alcohol
and drug harm.
Policy development
We advocate for evidence-based policies
and effective treatment services that will
build a healthy society with the least
possible harm from drug use.
www.drugfoundation.org.nz
Tēnā koe
The New Zealand Drug Foundation’s
vision is for an Aotearoa free from
drug harm.
Our mission is to be the catalyst for
people, their communities, service
providers and policy makers to take
action that prevents drug harm.
Like you, we are concerned about the harms drugs There are solutions. There are some relatively easy wins that
cause in New Zealand. could make a big difference, as well as some deeper reform
needed to shift our framework to a health-based approach,
There is some cause to celebrate recent progress: there which has been proven to reduce harmful use and use
has been investment in new treatment approaches, with among young people. We need to overhaul the Misuse of
new funding and renewed energy in this sector. Moves to Drugs Act – making tweaks will not work, as last year’s
legalise drug checking will save lives, as will the new High amendment to encourage police discretion to reduce
Alert early warning system. All of this has been met with convictions for minor drug offences has shown.
wide public support, as we continue to see a mood for
change in how we address drug harm in Aotearoa. We now have flagship reports that all set out excellent
options for Government moving forward: the Health and
However, our dated legislation, the Misuse of Drugs Act Disability System Review (Simpson report); He Ara Oranga,
(1975), ongoing gaps in treatment availability, and the Report of the Government Inquiry into Mental Health
under-investment in prevention, public education and and Addiction; and Whakamaua, the Māori Health Action
early intervention is creating a vicious cycle for people Plan. All these reports recommend providing support earlier,
who use illicit drugs. providing a full range of services to meet different needs
and cultural approaches, reducing inequities, and improving
This year, treatment providers have been reporting
outcomes for young people and Māori.
difficulties meeting an increased demand for their
services due to the effects of Covid-19, which has This briefing sets out our recommendations for putting
amplified an existing shortage. One reported a 300% those reviews into action. We look forward to working
increase in referrals since the nationwide lockdown. with you to reduce drug harm over the next three years
When someone seeks treatment but can’t access it, and beyond!
a window of opportunity is lost to help that person.
People continue to be convicted for minor drug offences.
In 2019/20, 3067 people in total were convicted of
low-level drug offences, and for 1126 people, the drug
conviction was their most serious offence. Of those
convicted, almost half were under 30 years, 71% were Sarah Helm
men and Māori made up 39%. Executive Director
Alcohol continues to be our most harmful drug.
Meanwhile, we are seeing a second wave of harm
from highly toxic synthetic psychoactive substances.
Communities continue to be deeply concerned about
the effects of methamphetamine. MDMA and cannabis
use has risen, while tobacco use has declined.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 01
High-level
recommendations
PRIORIT Y PRIORIT Y
1. Reform our laws to
treat drug use as a
health issue | PAGE. 08
• Replace the Misuse of Drugs Act with a new law
2.
•F
Reduce
inequities
for Māori | PAGE. 14
und a full range of primary mental health and
that treats drug use and possession as a health addiction services led by Māori, for Māori.
issue to reduce drug harm among those that
• Strengthen alcohol regulations and replace
need it, and shift funding to back this up.
criminal sanctions for the use of drugs with
• Remove criminal penalties for growing, using a full range of treatment and detox services
and sharing small quantities of cannabis. – removing discretion from Police.
A large majority of New Zealanders
support decriminalisation.
• Improve our medicinal cannabis system
PRIORIT Y
3.
so products can be made available, and are
affordable. Provide a statutory defence from Strengthen education
prosecution for those who grow plants for and keep young people
their own medical use. in school | PAGE. 16
• Review the Sale and Supply of Alcohol Act
to reduce the huge harm caused by alcohol. • Strengthen the way the health learning area of the
New Zealand curriculum is implemented, to equip
young people with skills to think critically and
make good choices about drug and alcohol use.
• Remove the ability of schools to exclude
students under the age of sixteen, and
implement the recommendations of
the Tomorrow’s Schools review.
02 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nz
PRIORIT Y PRIORIT Y
4. 5.
Invest more effectively
in education, prevention, Develop innovative solutions
harm reduction, and to reduce drug harm in
treatment | PAGE. 18 communities | PAGE. 22
•E
nsure a stepped increase in treatment sector • Respond to methamphetamine harm in
funding to meet demand, including specific communities by investing in community
funding to respond to ongoing challenges responses, reforming punitive drug laws,
from Covid-19. and funding research.
• Fund the development of health approaches • Build safer working environments by requiring
across the whole spectrum of use, not just all workplaces to have impairment policies and
for people experiencing long-term harms enact regulations on how drug testing should
from addiction. (and shouldn’t) be used in the workplace.
• Fund behaviour change messaging to reach • Keep people safely housed by investing in
all users, and implement a full range of alcohol Housing First programmes and funding initiatives
moderation activities (for example as previously to reduce drug harm in temporary housing.
run by the Alcohol Advisory Council).
• Make our roads safer by directing more resources
to roadside testing for alcohol impairment and
rethinking the Land Transport (Drug Driving)
Amendment Bill.
• Respond to ongoing harm from synthetic
cannabinoids by funding the Acute Drug Harm
Community of Practice and reforming drug laws.
• Ensure vulnerable people are not unfairly
evicted from residential tenancies for
using methamphetamine.
• Invest in drug checking to make sure anyone
who needs to can access the service.
• Establish a comprehensive package of
drug indicators with a dedicated survey
for drug and alcohol use.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 03
But first – what you
need to know about
drugs in New Zealand
WE HAVE HIGH RATES MOST DRUG USE IS DRUGS CAN CAUSE
OF DRUG USE NOT HARMFUL SERIOUS HARM TO SOME
The drugs that cause most harm While it’s safest not to use For a small group of users, drug use
in New Zealand are alcohol alcohol and other drugs, – whether legal or illegal – can cause
and tobacco. Over 800,000 most people are not harmed significant harm. Harms include
New Zealand adults much, or at all, by their use. illness, injury, addiction and even
drink hazardously.1 death, with the effects borne by
whole communities.
• Almost 1 in 3 New Zealand adults
NEW ZEALAND ADULTS
have a moderate to high risk of
experiencing health and other
82% drank alcohol in the
past year.1
4 out of 5 New Zealand
problems from their current pattern
of substance use – mostly tobacco
(20% of adults) and alcohol (15%
adults who used an illicit drug of adults).3
13% of New Zealand adults in the past year reported
currently smoke tobacco.1 no harmful effects.2 • About 5,000 people die each
year from smoking and second-
hand smoke.4
17%
• Some communities continue
used illicit drugs
in the past year.2 to suffer huge harm from
methamphetamine use, which
can cause hallucinations, erratic
15% used cannabis
in the past year.1
behaviour and psychosis for some
who use heavily or frequently.5
• 1 out of 5 New Zealand adults
drink in a way that risks physical
7
7 out of 8 or mental harm.1
New Zealand
70
adults who used
alcohol in the past
year reported no
8
harmful effects.2
More than 70 deaths have been
connected to synthetic cannabinoids
since mid-2017,6 and many more
New Zealanders have experienced
serious long-lasting health effects.
04 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nz
THE MOST DISADVANTAGED ARE
OFTEN THE WORST AFFECTED
• Mäori, Pacific people and people
living in areas of socio-economic
deprivation are more likely to
experience harm from their own
alcohol or drug use,7 and are most
likely to want help with their drug
use but not receive it.7
THERE IS NOT ENOUGH
HELP AVAILABLE
• Around 50,000 New Zealanders
receive support to reduce their
alcohol or drug use each year,9
but estimates suggest that only
about a third of those who could
benefit from treatment are
accessing it.10
50,000
87 %
• Services are overextended and
underfunded. People often have
to wait until their problems have
become severe before they can
access help.
• When people seek help but
cannot access it, we miss our
window of opportunity to
support them.
of people in prison have
experienced an alcohol or other
drug problem in their lifetime.8
Only third of those who could
benefit from treatment are
accessing it.10
Around 50,000 people want help
to reduce their alcohol or drug
use each year.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 05
CONTINUED
What you need to know
about drugs in New Zealand
COVID-19 HAS IMPACTED MDMA is a Class B drug, harms WHY DO PEOPLE TAKE DRUGS?
BOTH DRUG USE AND to the user are relatively low
TREATMENT SERVICES People use alcohol and other drugs
compared to other substances.
for many reasons, including pleasure
During the countrywide lockdown, Recent reports indicate an increase in and recreation, spiritual discovery,
addiction services reported some the amount of gamma-butyrolactone performance enhancement,
increase in drug use, commonly (GBL) seized by Police and Customs experimentation, peer pressure or
alcohol and cannabis, compounding in 2020.14 This is a central nervous to self-medicate physical problems,
an existing shortage of treatment system depressant that carries emotional pain or trauma.16
places. Some decreases were also significant risks because the
reported, with some clients using threshold to overdose can be
the time to cut down or stop using WHY DO SOME PEOPLE STRUGGLE
a matter of millilitres. WITH DRUGS AND ALCOHOL?
drugs altogether.11
The long-term impacts of Covid-19 The likelihood of harmful use patterns
NOT ALL DRUGS developing depends on a range of
on alcohol and drug use are still ARE CREATED EQUAL
unclear but may be significant: social, cultural and genetic factors.
the psychosocial impacts of major In a study by the Independent Although chemical addiction can
crises can be broad and long term. Scientific Committee on Drugs,15 play a part, more significant factors
which ranked 20 drugs across 16 contributing to substance use
Treatment providers have reported measures of harm, heroin, crack disorders are trauma and abuse,
difficulties meeting an increased cocaine and crystal methamphetamine mental health problems, stress,
demand for their services as already- were deemed worst for individuals poverty, and housing insecurity.
vulnerable people deal with the using them. Alcohol, heroin and
challenges and uncertainty that crack cocaine ranked the worst in
a global pandemic has brought us. terms of impact on society, with
Increased demand for alcohol and alcohol ranked worst overall.
drug services is likely to continue Ecstasy and LSD were ranked
for some years.12 We can prevent among the least damaging.
future negative health outcomes
by strengthening the alcohol and
other drug sector now.
Harm caused by drugs
ILLICIT DRUGS 80
HARM TO USERS (CW 46) HARM TO OTHERS (CW 54)
CURRENTLY OF CONCERN 72
70
Methamphetamine use remains
60
relatively low across the population 55 54
Overall harm score
as a whole, with 1% of the population 50
using it in the past year.1 However,
the harms caused by its sale and 40
use are particularly severe in 33
30 27
some communities. 26
23
20 19
Synthetic cannabinoids remain 20
15 15 14 13
a big focus of concern, with new 11
9 10 9
10 7 7
and dangerous analogues regularly 6
discovered by Customs and Police. 0
Alcohol
Heroin
Crack cocaine
Metamfetamine
Cocaine
Tobacco
Amfetamine
Cannabis
GHB
Benzodiazepine
Ketamine
Methadone
Butane
Khat
Anabolic steroids
Ecstasy
LSD
Buprenorphine
Mushrooms
Seizures by Police and Customs
show a substantial increase in the
quantity of MDMA (ecstasy) seized
in New Zealand in 2019.13 While
Drugs ordered by their overall harm scores.15
06 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nz
WHY DO WE NEED
TO FOCUS ON DRUGS?
Harm from drugs affect
every level of society.
Improving the way we respond
to drug and alcohol issues will
$1.8b
help fix many of the big issues
facing New Zealand today.
SOCIETAL COST
Drug use costs New Zealand
$1.8 billion each year in
health, social and economic
11,561
harms.21 If you include alcohol
as well, this figure leaps to
$6.5 billion.22
PRISONS
½
11,561 people have gone to
prison in the past 10 years
for drug offences.17
MENTAL HEALTH
More than half the people
FAMILY VIOLENCE using mental health services
are likely to have substance
Alcohol is clearly linked with
use problems as well.20
child maltreatment and
Among adults with
inter-partner violence.18
problematic substance use,
10%
27% experience some form of
anxiety and 30% experience
some form of depression.3
POVERTY
11%
10% (of those who have ever used
drugs) reported drug use had
affected their financial position.2 JOBS AND
EDUCATION
47%
11% (of those who have ever
used drugs) reported harmful
MĀORI effects on opportunities for
INEQUITY work/study/employment.2
Māori make up about
47% of those in prison
for drug offences.19 HOMELESSNESS
Substance misuse can increase
the chance of becoming and
remaining homeless.23
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 07
PRIORITY 1:
Reform our laws to treat
drug use as a health issue
5
We all want a happier, healthier, For some, particularly Mäori,
more equal New Zealand. a criminal record (and even a
prison sentence) can be the result
Unfortunately, New Zealand’s
of a prosecution for a relatively
current drug law stands in the way.
minor offence, such as possession
The Misuse of Drugs Act 1975 of a drug utensil.
(MoDA) criminalises those who
struggle with their drug use rather
than supporting them. Every year,
THE SOLUTION IS TO TREAT OUR 5 GOALS FOR
DRUG USE AS A HEALTH AND
thousands more New Zealanders SOCIAL ISSUE A NEW DRUG LAW
are left with a conviction that
impacts on mental health, The vast majority of people who use
livelihoods, relationships, drugs do so without causing harm
1
to themselves or others. Prosecuting Minimise the harms caused
travel, housing and education. by drug use, particularly for
them can have a far-reaching negative
The assumption made in our
young people
impact on their lives but has limited
45-year-old legislation is that or no effect on their drug use. The
legal sanctions will be a deterrent
to use. And yet, our drug use rates
remain high.
minority who do struggle with their
drug use need support, compassion
and access to treatment.
2 Respect
human rights
We can learn from international
“Most research has pointed
towards imprisonment
having a weak but
examples such as Portugal, which
implemented a health approach to
drug use in 2001. It decriminalised
3 Safer communities with
less drug-related crime
variable general deterrent the use of all drugs and invested
effect, but deterrence may
be even less effective for
heavily in prevention, treatment
and harm reduction. Despite fears
at the time, harmful drug use in
4 Promote equity
for Māori
people whose offending Portugal has fallen, and drug harms,
is related to drug use.”24 including overdose deaths, have
reduced dramatically.26 5 Be cost-effective and
evidence-based
Legal penalties compound harms for The Misuse of Drugs Act needs
the people who are most impacted by to be replaced with a modern,
drug harm. Prohibition discriminates fit-for-purpose drug law that treats
against Mäori and Pasifika, who drug use and possession as a health
together account for more than and social issue. Commercial supply
half of all cannabis convictions in and trafficking of drugs would
Aotearoa.25 Convictions also fall remain illegal.
disproportionately to young people.
08 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzWhakawātea
te Huarahi
A model drug law
to 2020 and beyond Check out our model drug law
Whakawātea te Huarahi for full
details on our law reform proposal:
nzdrug.org/2017-pathway
'TWEAKING’ THE MISUSE OF Though it is too early to fully assess A NEW LAW WOULD ADDRESS
DRUGS ACT HASN’T WORKED the impact of the law change, in the MANY INJUSTICES AND
10 months following the amendment, INCONSISTENCIES
A new amendment to MoDA, passed
in August 2019, means Police may the number of people facing court In replacing the MoDA 1975 we could
only prosecute for possession and action for drug possession decreased achieve these things:
use of drugs if it is required in the only slightly. Meanwhile, the total
number of proceedings (including • Remove discrimination against Māori
public interest. They must determine
whether a health-centred or warnings) brought against people Our current law leaves discretion
therapeutic approach would be for low-level drug offences went up.27 in the hands of Police as to whether
more beneficial to the public It’s clear this minor fix of MoDA is to prosecute for drug possession,
interest than a prosecution. not sufficient. We need a complete resulting in worse outcomes for
overhaul of our outdated drug laws to Mäori. Removing criminal penalties
The amendment was introduced as
bring them into line with international for drug use entirely would lead
a stop-gap ‘fix’ of MoDA in response
best practice and ensure no one is ever to better outcomes.
to the synthetics crisis, and it sent
a clear signal that the Government prosecuted for drug use or possession. • Reassess levels at which possession
intends to treat drug use as a health of drugs is presumed to be for the
and social issue. purposes of supply
Overhauling the Misuse of Levels at which a person found
Drugs Act would put into effect with a drug is presumed to be in
recommendations from the possession for the purposes of
supply are currently set low in
Mental Health and Addiction
MoDA. Supply charges carry a
Inquiry,28 the Safe and Effective
greater penalty than possession
Justice Advisory Group,29
alone. This means that people who
the conclusions of the Law are addicted to a substance or use
Commission’s 2011 legislative heavily for other reasons can receive
review,30 and the current National a conviction for supply, resulting
Drug Policy.31 It would also be the in long periods of imprisonment.
most effective way to support the
wellbeing of all our communities.
• Ensure that programmes
intended to reduce drug harm
can be legally undertaken
An example would be drug
consumption spaces such as those
available in Australia and Canada,
which help to reduce overdose
and death.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 09PRIORITY 1: CONTINUED
Reform our laws to treat
drug use as a health issue
• Reclassify scheduled drugs to • Remove criminal penalties for use WE RECOMMEND:
ensure consistency and fairness or possession of a drug utensil
Drugs are supposed to be scheduled The Ministry of Health was Replace the Misuse of Drugs Act
in accordance with the level of poised to do this several years with a new law that treats drug use
danger they pose to the person using ago, with broad political support, and possession as a health issue
them, but the classification system but was delayed. to ensure that:
no longer accords with what we • discretion is no longer exercised
know about the harms caused by • Create consistency between the
Psychoactive Substances Act to Māori disadvantage, because
different drugs – including alcohol
and the Misuse of Drugs Act no one ever receives a criminal
and tobacco.
conviction for use of drugs
We currently have two parallel
• Review the penalty regime for drug regimes, neither of which achieve
• those who need treatment are
offences to reflect that many of what they set out to do. One single
able to access it
those who deal, do so to support Act could regulate low-harm • programmes to reduce drug harm
their own use substances for sale while continuing can be legally undertaken
Excessively long sentences - up to provide sanctions for trafficking • drugs are classified consistently
to life in prison for supply of more harmful drugs. according to their risk to the user,
methamphetamine - do nothing with penalties that are proportional
to deter offending, and are not to other offences.
proportional to sentences handed
down for other crimes. Therapeutic
pathways for those who need
them should be included in
any penalty regime.
10 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzNew Zealanders’ support
for cannabis law reform
33%
NEITHER
67%
PRO-REFORM
(35% legislation,
32% decriminalisaton)
Source: NZ Drug Foundation, 201832
WHAT’S NEXT MEDICINAL CANNABIS PATIENTS
FOR CANNABIS? NEED URGENT ACCESS TO PRODUCTS
WE RECOMMEND: WE RECOMMEND: Therefore, patients suffering severe
and debilitating conditions
• Remove criminal penalties • Align our product standards continue to use illegally sourced
for growing, using and more closely with our lead products and live in fear of the
sharing small quantities of export and import destinations law. Illegally grown plants
cannabis. A large majority to bring more products to continue to be destroyed and
of New Zealanders support market quickly. medicine confiscated.
decriminalisation. • Remove equity barriers It should become easier to produce
created by high prices by medicines here and to import them
subsidising products. – but so far, no new products have
At the recent referendum,
• Provide a statutory defence been approved. Those that remain
New Zealanders narrowly voted
from prosecution for those available are expensive and
against passing into law a very
who grow plants for their inaccessible for most people.
specific piece of legislation that
would have allowed cannabis or another’s medicinal use. One just solution would be to
to be sold in licensed stores. • Fund education and prescribing provide a statutory defence from
The Bill would have enhanced information for doctors. prosecution for those who grow
public health and social • Down-classify CBD products plants for their own or another’s
justice outcomes, so this from prescription medicines medicinal use, with a medical
was disappointing. to reduce prices and make certificate. This could come with
products more available. a five-year sunset clause to tide
Support for cannabis law reform
patients over until products are
has grown by 20% in the past
legally available.
three years alone33 and will In 2017, the Government
continue to increase. The vast introduced legislation to develop Cannabidiol (CBD) products,
majority of New Zealanders a medicinal cannabis industry in which are prescription medicines,
support either legalisation New Zealand and make products should be reclassified to match
or decriminalisation of more accessible. Regulations to other jurisdictions where they are
cannabis, giving a clear support the Act came into force treated as pharmacy-only products
mandate for law reform. on 1 April 2020. or even dietary supplements.
The problems of prohibition have However, products remain Other essential measures include
not gone away, and Government inaccessible by the vast majority removing pricing barriers,
needs to find a response. In the of New Zealanders who need for example, by subsidising
Australian Capital Territory, a them. The cost is excessive products, ensuring ACC adopts
recent law change means that because products are not an official protocol about what
using cannabis or growing a subsidised. Although cannabis- it will fund and when; and
small amount incurs no criminal based medicines can now be streamlining support from WINZ
penalties. A similar model could prescribed by a doctor, many so beneficiaries do not have to pay
work here as a first step. won’t prescribe due to a lack for expensive medications upfront.
of training and understanding
of prescribing protocols.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 11PRIORITY 1: CONTINUED
Reform our laws to treat
drug use as a health issue
IT’S TIME TO
TACKLE ALCOHOL
WE RECOMMEND: Alcohol is cheap, heavily promoted, We also need to invest more into
and easy to buy. Alcohol harm understanding the scale of FASD in
• Review the Sale and Supply is one of our biggest preventable this country and building capacity
of Alcohol Act in line with the public health disasters. to respond to it. There is still no
2010 Law Commission review. good data on the prevalence of
A 2010 Law Commission Review
FASD in New Zealand, although
• Update and fully implement the characterised our alcohol laws as
the Ministry of Health estimates
action plan Taking Action on the “unbridled commercialisation
as many as 3% of births may be
Fetal Alcohol Spectrum Disorder: of alcohol”.35 The Commission put
affected, at an annual cost of
2016–2019.39 – for example forward a comprehensive suite of
much as $450 million.36 Many
by investing more into research proposals, warning that “picking
other gaps remain to fill from
and support. and choosing among the various
the Government’s 2016–19 action
• Fund behaviour change elements … will lessen the power
plan, which has now lapsed.
messaging to reach all users, of the package to reduce harm”.35
and implement a full range of This is exactly what happened.
alcohol moderation activities We have made progress on a few
(for example as previously run isolated issues, but a comprehensive
by the Alcohol Advisory Council.
“Alcohol is regulated
overhaul of our laws has not yet
taken place, and alcohol harm
but is widely available
remains sky high. and used in our
society. It isn’t seen
Critical policy solutions proposed
by the Law Commission to reduce
as a drug and our
the harm caused by alcohol include regulation approaches
raising the purchase age to 20, to it are inconsistent
stricter rules around licensing and fail to deal with
and opening hours, imposing the harm it produces.”
excise taxes to raise prices and
URUKI! TURUKI!
T
an end to alcohol advertising, FINAL REPORT OF THE SAFE
sponsorship and promotions AND EFFECTIVE JUSTICE
ADVISORY GROUP29
that increase consumption.
12 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzTHE PSYCHOACTIVE SUBSTANCES ACT 2013 CLEAN SLATE LEGISLATION
IS STILL NOT WORKING IS TOO NARROW
WE RECOMMEND: The Act was created on the WE RECOMMEND:
understanding that a regulated
• Review the Act to help it work market is much safer than an • Review the ‘clean slate’
as it was originally intended, unregulated black market where scheme to conceal the
allowing low-harm substances profit is the only motive. In a black convictions of those who
to be strictly regulated. market, products are not tested, have been prosecuted for
and no one is accountable if a low-level drug offences,
• Alternatively, incorporate
product causes harm or even death. even if they went to prison.
the regulation of low-harm
substances into a new Misuse Unfortunately, the legislation
of Drugs Act – it makes sense was passed very quickly, with A person’s previous convictions
to treat all substances under limited public education about are automatically concealed
one piece of legislation. its purpose. Some communities from the records where they
panicked, and a political decision have had no convictions for the
was made to insert a clause past seven years. The scheme
When the Act was passed, new banning animal testing of any does not apply to those who
substances were being produced so new drugs. This rendered the have been to jail.37
quickly there wasn’t time to make Act unworkable, and no products
each illegal before the next was have been approved for sale. This means that the 7,093
developed. Thousands of untested people who have been convicted
products were legally on sale, and Tragically, more than 70 and sentenced to prison
no one knew their health effects. New Zealanders have died for low-level drug offences
using unregulated synthetic in the past decade do not
The Act made all psychoactive psychoactive substances since qualify.38 A drug conviction
substances illegal by default. mid-20 17.6 There’s a compelling can negatively impact lives
However, if a substance could be argument that regulating low-risk and livelihoods in a way that
proven to pose no more than a low substances would steer many is completely out of proportion
risk of harm, it could be approved people away from serious harm to the original ‘crime’.
for sale under strict regulations. by nudging them towards products
that are known to be safer.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 13PRIORITY 2:
Healthy futures for Māori
The NZ Drug Foundation supports Substance use for Māori and Pākehā, 2019/20
Māori communities to respond to
100%
the disproportionate harm caused Māori Pākehā
to them by both drugs and our
drug laws. We work alongside 80%
communities to reduce drug harm
and support initiatives that help 60%
individuals and whānau struggling
with drug use. 40%
MĀORI NEED EQUITY IN 20%
DRUG-RELATED HEALTH AREAS
Mäori continue to disproportionately 0%
feel the burden of drug and Current Past-year Hazardous Past-year
alcohol harm. smokers drinkers drinkers cannabis users
Mäori are 2.8 times more likely Source: 2019/20 New Zealand Health Survey1
to use tobacco and 2.2 times more
likely to use cannabis than non-Mäori.
The disparity is greater in women for Long-term solutions to these Building the workforce will require
both substances.1 disparities are set out in Whakamaua, long-term investment and focus.
Mäori and non-Mäori have similar the Mäori Health Action Plan,39 Ensuring Mäori lead the development
drinking rates, but Mäori are 1.8 times which recommends: and implementation of the action plan
more likely than non-Mäori to drink process is absolutely essential.
• increasing access to and choice
hazardously (in a way that may of kaupapa Mäori primary mental
cause harm).1 health and addiction services
• increasing the capacity and
capability of the Mäori health sector
• expanding access to rongoä Mäori
• increasing provider innovation to
develop and spread effective kaupapa
Mäori and whänau-centred services.
14 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzWHARE TUKUTUKU
As part of a collaboration with Te Rau Ora, we’re helping to develop an approach
to workforce development to improve Mäori health outcomes and reduce disparities
through an integrated model of prevention. Whare Tukutuku will develop and deliver
an addiction workforce development programme for frontline workers, and
establishing a national addiction leadership group.
The programme aims to support AOD services to develop early interventions in
collaboration with Mäori whänau to increase the range of interventions available.
REFORM OUR DRUG LAWS Leaving discretion in the hands of WE RECOMMEND:
TO BENEFIT MĀORI AND Police will never provide a solution
ADDRESS RACISM for the disproportionate number of • Implement the Health and Disability
Unacceptably, our current drug law Mäori entering the criminal justice System Review recommendation
produces hugely disproportionate system on drugs charges. We need to to set up a separate Māori
imprisonment and conviction rates overhaul the outdated Misuse of Drugs health authority.41
for Mäori. The result for many can Act, and remove all criminal penalties
• Implement the actions relating to
be endless cycles of reconviction. for low-level drug offences. For this
drugs and alcohol from
to be a success, Mäori need to be
• Mäori make up 49% of those Whakamaua, the Māori Health
partners in the development and
convicted for drug offences.17 Action Plan, especially by funding
implementation of that law.
• Among cannabis users, a full range of primary mental
Mäori are three times more health and addiction services,
likely than non-Mäori to be STRENGTHEN ALCOHOL LAWS led by Māori, for Māori.
arrested and convicted for The Law Commission review of our • Follow the recommendations of
cannabis-related offences.40 alcohol laws in 2010 recommended He Ara Oranga, and take a stricter
a suite of changes to reduce the harm regulatory approach to the sale and
Recent changes to the Misuse of Drugs supply of alcohol. Replace criminal
alcohol causes in our communities,
Act have reduced overall convictions sanctions for the use of controlled
including raising the purchase age
slightly, but the proportion of Mäori drugs with a full range of treatment
to 20, imposing excise taxes to
receiving court actions for low-level and detox services.
raise prices and an end to alcohol
drug offences remains significantly
advertising.35 Most of these were
higher than it is for non-Mäori.27
never implemented.
Of particular concern is the increase
As emphasised more recently in
in the total number of proceedings
the Mental Health and Addiction
(including warnings) for Mäori – from
Inquiry report He Ara Oranga,28
1,350 in the 10 months before the law
we are well overdue for a thorough
change to 1,537 for the same period
overhaul of our alcohol laws, and
after the law change.27 In other words,
this would particularly benefit Mäori
we’re seeing more involvement with
(see page 12 for more on this).
the criminal justice system in total,
even though fewer of those actions
result in a conviction in court.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 15PRIORITY 3:
Strengthen education
and keep young
people in school
Strengthening health education The Government has recently WE NEED TO KEEP
would have lifelong benefits. appointed new ‘wellbeing curriculum YOUNG PEOPLE IN SCHOOL
leads’, which is an excellent step. FOR AS LONG AS POSSIBLE
Schools are required to equip students
Focus now must be on providing The Statement of National Education
with self-management skills and
sufficient training for the new leads and Learning Priorities (NELP)45
knowledge about alcohol and drugs.
and directing extra funding towards puts learners at the centre of how
This is best done as part of the health
workforce and resource development. education is provided, and requires
curriculum by teaching young people
schools to ensure ‘barrier free access’
to think critically and gain the skills
TŪTURU to learning.
needed to understand themselves and
make sense of the world around them. Unfortunately, alcohol and drug use
remains one of the most common
Although this is part of the
reasons to be excluded or expelled
New Zealand curriculum, two-thirds
from school. The harm caused by
of year 8 students are below the
exclusion, expulsion and suspension
expected achievement level for these
is usually far greater than the
skills.42 We need to help young people
consequences of drug and alcohol
catch up with core learning so they
use itself.
are prepared for a world where
alcohol and other drugs exist. Schools are a major protective factor
for reducing alcohol and drug harm
Tüturu is a school-wide and improving overall life outcomes,
HEALTH AND EDUCATION
NEED TO WORK TOGETHER approach led by the Drug yet our current school management
Foundation that helps to reduce structure places discretion around
Schools help young people form drug and alcohol-related harm expulsions and exclusions in the
values and build knowledge and and keep students in school. hands of boards of trustees. These
skills to prepare them for the modern are often underequipped to make
Different sectors work together
world. They teach them to think evidence-based decisions on behalf
to improve the wellbeing of
critically about their wellbeing so of students with multiple issues.
their students and develop
that they make the best decisions
their critical thinking. An Excluding young people from school
for themselves and are able to seek
independent evaluation of for drug or alcohol use prioritises the
support should they need it. Schools
the project, co-created with needs of the school before the needs
need support to increase the focus on
11 schools and five health of the learner and impedes access to
wellbeing in their curriculum and to
providers, found Tüturu helped education, missing the objectives of
work in a more integrated way with
to change how schools deal the NELP. We need to help schools
health services.43
with alcohol and other drugs fully implement these new national
by changing the focus from education and learning priorities so
punitive to pastoral.44 students can be kept in school.
16 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzWe recommend removing the power WE RECOMMEND:
TWO EXAMPLES OF APPROACHES
to exclude students under the age of THAT HAVE BEEN DEVELOPED
sixteen from school, and encouraging • Strengthen implementation of
schools instead to find more evidence- the health learning area of the
based techniques to develop a positive New Zealand curriculum, with
culture in the school. It is also training for the new ‘wellbeing
essential that dispute resolution leads’ curriculum and extra
be made easier for families, as funding towards workforce and
recommended by the Tomorrow’s resource development.
Schools review.46 This would help
• Use evaluated approaches,
ensure more young people stay in
such as Tūturu to develop whole-
school for longer.
• Unfold – a challenge-based school approaches that shift the
initiative for young people focus from punitive to pastoral.
TARGETING PEER CROWDS offering healthy alternatives • Invest more funding into youth
to drinking. Multiple agencies
services that can work in
While many young people are doing have worked together to figure
out how to engage a particular partnership with schools.
well, many risk factors cluster in
group of young people, help • Remove the power to exclude
smaller (but identifiable) groupings of
them feel like they belong in students under the age of sixteen
young people. The Drug Foundation
the community and build their from school.
works together with a number of other aspirations for a healthy and
organisations and agencies to engage • Implement the recommendations
successful life.
some of these peer groupings and of the Tomorrow’s Schools review.
identify approaches that improve • Fund initiatives based on the
their wellbeing. cross-sector Peer Crowd Projects.
The projects were independently
evaluated this year and were found to
be effective, with the evaluator stating,
“The Peer Crowd Projects are an
excellent example of how multiple-
partner, cross-sector projects can • 360-empathy tool – an
operate successfully, and is arguably immersive video experience that
an unusual case in the New Zealand uses virtual reality technology
public sector, given the large to help professionals put
collection of government and themselves in the shoes of young
people. Two-month follow-ups
community agencies working
found 88% of participants
together in a unified way.”47
in a workshop using the tool
had changed their practice
to improve their engagement
with young people as a result.
Photo credit: Tobil, pexels.com
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 17PRIORITY 4:
Invest more effectively in
prevention, harm reduction
and treatment
People should be able to access Of the 8.9% – or roughly 100,000 people who are at risk of problematic
a full range of evidence-based people – who experience severe substance use but experiencing only
support options for drug and symptoms, only around half receive mild (or no) symptoms.
alcohol use at the time they alcohol or other drug support each
More investment is needed to reach
year,3 meaning that even for people
need them. all users. Additionally, the alcohol
who are struggling, our services fall
moderation campaign has been
Unfortunately, this vision is far from well short of what is needed.
neglected for many years. The results
the current reality. People face long
are evident in the high levels of harm
waiting lists and struggle to access
WE NEED A FOCUS ON we still experience from alcohol.
the support they need.
BEHAVIOUR CHANGE Shifting to a health approach means
The Drug Foundation is the only reorienting funds from justice towards
LET’S INTERVENE EARLIER organisation working to develop prevention as well as treatment.
As the Mental Health and Addiction health and policy approaches
Inquiry report He Ara Oranga28 to prevent harm for the million
recommends, we need to focus more
on healthy approaches to drugs and
alcohol for the whole population, and
provide support options well before
Anxiety, depression and/or somatic symptoms among people
an individual starts to experience
at moderate to high risk of problematic substance use
serious problems. This is more
effective and more compassionate
50
Percentage of people at moderate to high risk of
– not to mention cheaper - than
waiting to be the ambulance at
the bottom of the cliff. 40
problematic substance use (%)
1.2 million New Zealanders are
estimated to be at moderate to high 30
risk of problematic substance use,
according to the New Zealand Health
20
Survey, yet nearly half of those will
experience no clear symptoms to
indicate they may be at risk.3 When 10
we start the conversation when people
are struggling, we miss most of the
0
people we are trying to reach. No Mild Moderate Severe
symptoms symptoms symptoms symptoms
(scoresWE CAN MAKE A REAL INVESTMENT SHOULD BE
IMPACT BY TARGETING SPREAD ACROSS THESE AREAS:
ALL LEVELS OF USE
Prevention and education
He Ara Oranga recommended
increasing the range of mental These appraoches help people
health and addiction services who do choose to use drugs
to target people at all levels to start later in life, use less
of need.28 To be most effective, frequently and experience
we need targeted approaches less harm.
for each group shown in the
diagram below, from those who Harm reduction
don’t use drugs at all to those This includes information
who are severely dependent. and tools that reduce the risk
of drug harm, for example,
providing sterile injecting
equipment, drug checking at
festivals or shorter opening
NO CURRENT RECREATIONAL HAZARDOUS MILD MODERATE/SEVERE hours for alcohol retailers.
USE USE USE DEPENDENCE DEPENDENCE
We'd particularly like to see
new funding going into innovative
MEDICAL new community programmes and
ASSISTANCE,
INTENSIVE services targeting people using
PROGRAMME drugs or alcohol who would not
normally identify themselves as
COMMUNITY-LEVEL SUPPORT,
COUNSELLING, SUPPORTED needing assistance.
WITHDRAWAL, RESPITE CARE
Treatment
BRIEF INTERVENTION, Effective treatment means a
HARM REDUCTION
range of options to suit different
people – from peer support,
HARM MINIMISATION, iwi-based initiatives and
SELF-MANAGEMENT AND SELF-CARE one-on-one counselling to more
intensive methods like detox
EVIDENCED-BASED INFORMATION
or residential treatment.
AND AWARENESS RAISING
Source: National Committee for Addiction Treatment (NCAT), Shaping the Sector.48
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 19PRIORITY 4: CONTINUED
Invest more effectively in
prevention, harm reduction
and treatment
INCREASED FUNDING HAS BEEN WE RECOMMEND:
WELCOME, BUT SIGNIFICANT
CHALLENGES CONTINUE
• Ensure a stepped increase in
The funding increase allocated in treatment sector funding to meet
2019’s Budget has ensured some demand, including specific funding
of the existing services that were to respond to ongoing challenges
in danger of collapse are now more brought by Covid-19.
sustainable. The funding increase • Fund the development of health
also made it possible to scale up new approaches that prevent and
approaches to treatment that had been reduce harm across the whole
piloted within some well-established spectrum of use, not just for
services and primary care providers. people experiencing long-term
This includes a number of new beds harms from addiction.
in addiction treatment facilities,
• Build the capacity of communities
managed withdrawal services,
and frontline providers in health and
and peer support.
social services to support people
Despite these welcome investments, who use drugs. This should include
there are still large holes in treatment funding of whānau-led approaches
provision across the country, and and kaupapa Māori services.
extremely long waiting lists in some • Continue funding alcohol and
areas. Many service providers have yet other drug components of the
to see any improvements in funding. psychosocial response from
People who seek treatment do not Covid-19 (Best Bubble and
always get it. This can mean a window Credible Voices).
of opportunity is lost to support • Fund behaviour change messaging
that person, sometimes forever. to reach all users, and implement
Covid-19 has added a new urgency to a full range of alcohol moderation
these existing issues, putting stress on activities (for example as previously
existing services as people deal with run by the Alcohol Advisory Council.
ongoing job and housing insecurity
and mental health challenges caused
by the pandemic.
20 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzBEST BUBBLE AND
CREDIBLE VOICES CAMPAIGNS
These two campaigns, begun
by the NZ Drug Foundation during
the Covid-19 lockdown, reached
millions of people across the
whole spectrum of alcohol and
drug use with information on
coping with life in a ‘bubble’.
Best Bubble targeted the
general population to encourage
New Zealanders to re-evaluate
their relationship with substances
(primarily alcohol) and use new,
healthy ways to cope.
https://www.bestbubble.co.nz
Credible Voices targeted people
who use alcohol and other drugs
to help them prevent or reduce
drug harm.
Credible Voices – online
Best Bubble campaign posters
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 21PRIORITY 5:
Reduce drug harm in
communities and respond
to emerging challenges
Although not using drugs at
all is the best option, this is not RESPOND TO METHAMPHETAMINE
a realistic reflection of society. HARM IN COMMUNITIES
Inevitably, people will take drugs, Most people who seek help
sometimes in harmful ways. WE RECOMMEND:
for methamphetamine use
For those who do, our focus is • Fund regular, in-depth have already been using for
on preventing and reducing the research into patterns of 5–10 years49. We do not have
harm they experience. methamphetamine use in a good overall picture of what
New Zealand. methamphetamine use looks like
We proactively identify emerging
for individuals in New Zealand
issues across New Zealand, design • Support home withdrawal
before that point. This would
innovative solutions and assist and invest in programmes
help us reach people earlier and
communities to implement them. that focus on community
prevent problems escalating.
These are some pressing issues responses and peer support.
we are working on. • Reform drug laws to treat We know that 1% of
methamphetamine use as New Zealanders consumed
a health issue and ensure amphetamines (including
people are not put off seeking methamphetamine) in the
help due to fear of the law. past year and that rates have
increased slightly from 0.7%
• Set up a cross-sector response
five years ago.1 We also know
that includes a focus on
that around half of people who
treatment, law reform and
used stimulants (including
other issues relating to
methamphetamine) use them
methamphetamine (such as
1–2 times a year.2
'contamination’ in houses).
However, we do not regularly
collect data on who is using
methamphetamine, how often
and how much, and what harms
they experience. We need to
understand more about the first
years of methamphetamine use,
before problems become severe,
so that we can personalise health
advice and services better.
22 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzCREATE SAFER WORKING
ENVIRONMENTS
Heavy methamphetamine use WE RECOMMEND: At best, urine tests can only
also has very specific withdrawal confirm if someone used a
patterns. Damage to the cognitive • Enact regulations on how drug substance within a certain
area of the brain can mean people testing should (and shouldn’t) timeframe. The tests are also
have a reduced ability to control be used in the workplace expensive, invade employee
their emotions and actions and to better balance safety privacy, and can reduce the
predict outcomes for up to a year. requirements with the need likelihood that employees
This can make it particularly to protect workers’ rights. will disclose health and safety
hard not to relapse. Treatment concerns early.
• Invest in the development of
services need support (and
technology or approaches to Good workplace drug and
funding) to adjust their delivery
measure impairment. alcohol polices can improve the
to ensure they fit around
• Require all workplaces to have relationship between employer and
typical withdrawal patterns
impairment policies. Provide employees, helping people feel safe
for methamphetamine and
better guidance for workplaces to raise issues as early as possible.
can support people in the
about best practice. These policies should focus on
longer term.
reducing impairment, which urine
People can also withdraw tests don’t measure.
successfully at home with the Over-reliance on urine drug testing
In alignment with the Business
right support – something as in the workplace, primarily for
Leaders’ Health and Safety Forum,
simple as self-management cannabis, has created a deceptive
the Drug Foundation works with
guidance all the way through reassurance that health and safety
employers to help them explore
to home detox clinical teams. issues related to impairment are
their current workplace culture and
Providing more support for being addressed. In fact, urine
identify ways to minimise the risk
home withdrawal will also tests do not measure impairment
of impairment in the workplace.
help free up residential beds. and only test for a narrow range
of substances.
To support long-term recovery in
the community, we recommend
investing in community responses
and one:one peer support.50
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 23PRIORITY 5: CONTINUED
Reduce drug harm in
communities and respond
to emerging challenges
KEEP PEOPLE
SAFELY HOUSED
Transitional housing use and acute drug harm are common Confusion around methamphetamine
in transitional housing, and reducing ‘contamination’ from use continues to
WE RECOMMEND: harms can be challenging. affect vulnerable people.
• Expand Housing First to all By building a strong workforce In January 2021 a new amendment
regions so all people have focused on helping this cohort of to the Residential Tenancies Act
access to accommodation people and by committing adequate comes into force that allows
and help to maintain it. long-term funding to wrap-around regulations to be developed to set
• Fund initiatives that reduce services, we can reduce harm in out maximum acceptable levels for
temporary housing. methamphetamine ‘contamination’
drug harm in temporary housing.
from use and manufacture.
Methamphetamine ‘contamination’ This law began its life before the
Covid-19 showed us we can safely 2018 report of the PM’s Chief Science
WE RECOMMEND: Advisor52 on methamphetamine
house everyone. Having a safe
place can give people the space was released. That report found
• Ensure new regulations (due to
they need to address the trauma no scientific basis for the assertion
be drafted in 2021) are framed that you could contaminate a
and insecurity that is so often the
so people are not unfairly evicted house by using methamphetamine
cause of serious drug and alcohol
from residential tenancies for (as opposed to manufacturing
problems.
using methamphetamine. it). To our knowledge, no other
Housing First programmes are • Ensure cross-agency countries have standards for
an excellent way to address the consistency in how standards methamphetamine contamination
underlying causes of homelessness around methamphetamine caused by use of the drug alone.
and help people stay in safe ‘contamination’ from use are
accommodation in the long term. applied to vulnerable people.
The programme currently only • Clarify rules for industry in the
“There are no published
exists in certain regions and can’t
face of ongoing confusion in (or robust, unpublished)
be accessed by homeless youth,51 data relating to health
relation to real estate processes
so extending its reach should be
and insurance claims. risks of residing in a
a priority.
dwelling formerly used
The number of people in temporary only for smoking
accommodation rose rapidly in
methamphetamine.”
2020 following the first Covid-19
PRIME MINISTER’S CHIEF SCIENCE ADVISOR52
lockdown. High levels of substance
24 Briefing to the Incoming Parliament | December 2020 www.drugfoundation.org.nzRESPOND TO ONGOING CONCERNS
WITH SYNTHETIC CANNABINOIDS
Ideally, this amendment would More than 70 deaths have been
WE RECOMMEND:
never have been passed. At the connected to synthetic cannabinoids
very least, we must ensure that new • Fund the workstreams identified since mid-2017 and many more
regulations currently being drafted set by the Acute Drug Harm New Zealanders have experienced
limits for methamphetamine residue Community of Practice, so that serious long-lasting health effects.6
that to follow the science, not the they can continue to develop While we appear to be past the
hype. This will ensure that fewer evidence-based solutions to peak of the crisis, there is some
tenants are harmed by the actions of acute drug harm. concern a second wave may
fearful landlords and a drug testing
• Build capacity to respond to emerge. Anecdotal reports since
industry reliant on stoking this fear.
emerging harms, including Covid-19 began point to increased
Clear and consistent guidance is accessible drug checking clusters of people presenting
also needed for industries including services, self-checking options in need of medical attention
real estate, insurance and drug (such as swabs that test for from use of synthetics. Harmful
checking companies, because the fentanyl), and easy access synthetics have recently been
new regulations will only provide to naloxone. found in several regions.56
rules around rental accommodation. • Legalise cannabis, and get The Acute Drug Harm Community
More widely, agencies including the Psychoactive Substances of Practice, established by the Drug
WINZ, Oranga Tamariki and Police Act working as it should, Foundation, engages a wide range
need a consistent approach to to ensure people have access of organisations and agencies to
methamphetamine use, focused to safer substances. share learnings and develop their
on wellbeing. The new regulations capacity to respond to acute drug
will be designed to cover rental harm. They develop public health
housing, and using their approach messaging, provide resources to
in other situations could lead upskill the workforce, and focus
to unintended consequences. on preparing New Zealand to
Establishing a cross-agency respond to potential future crises
working group to avoid this (from fentanyl, for example).
would be a sensible approach.
www.drugfoundation.org.nz Briefing to the Incoming Parliament | December 2020 25You can also read
