New Zealand’s approach to methamphetamine needs a
thorough overhaul, with existing policies failing the
community and causing significant harm, a new report
shows.
Minimising the Harms from
Methamphetamine, jointly commissioned by the NZ Drug
Foundation and the Helen Clark Foundation, takes a
comprehensive look at methamphetamine harm in Aotearoa and
proposes a suite of new health-based solutions backed by
local and international evidence.
“Many people think
methamphetamine addiction is an intractable problem, but it
is our policy settings that are wrong,” says NZ Drug
Foundation Executive Director, Sarah Helm. “We need to
stop repeating the same mistakes and hit reset. This paper
shows us that there is a huge amount we could be doing to
reduce harm if we shift our focus and look at the
evidence.”
Lead author of the report, Philippa
Yasbek, says the solutions proposed are backed by evidence,
but require proper resourcing and a genuine policy shift
away from locking people up and towards a health-based
approach.
“Programmes like Te Ara Oranga in
Northland have already shown what a successful local
approach to methamphetamine can look like with the whole
community on board – we need to apply that right across
the country,” says Yasbek.
A recent evaluation of Te
Ara Oranga showed that it reduced post-referral offending by
34% and had a return on investment of between $3 and $7 per
dollar spent.
The report also recommends piloting a
new Stimulant Substitution Therapy treatment for people who
are unable to completely abstain from methamphetamine after
other treatment attempts.
“Treatment doesn’t
always result in lifelong abstinence, but it can lead to
significantly reduced use and harm,” says
Yasbek.
“At the moment, people who can’t abstain
are sent back into the black market, and as a result
experience a range of harms and the potential to spiral back
into addiction. Our proposed pilot would look at whether a
Stimulant Substitution Therapy model could stop this from
happening, like Opioid Substitution Therapy has been proven
to do,” she says.
The pilot would build on recent
work in Canada, decades-old work in Switzerland, and local
Opioid Substitution Therapy that has proved highly effective
in Aotearoa. The pilot would be tightly monitored and would
be limited to people with prolonged regular use who have
been through treatment at least twice and are unable to
completely abstain.
The report also digs into the
complex reasons some people use methamphetamine, including
unmet health needs in some cases.
“There’s
evidence that untreated ADHD can cause people to
self-medicate on stimulants like methamphetamine that can
have a calming effect, similar to the medications they would
be prescribed if they were properly treated,” says
Yasbek.
“ADHD is under-diagnosed in New Zealand. We
need to do much better at improving pathways to diagnosis
and treatment, and we also need to better understand the
link between ADHD and methamphetamine use.”
Other
changes recommended in the report include developing more
kaupapa Māori treatment and support options, a greater
focus on harm reduction, and removal of criminal penalties
for methamphetamine use.
Co-author of the report,
Professor Michael Baker, says New Zealand will only tackle
drug harms if we shift to treating drug use as a health
issue.
“Aotearoa has a history of taking innovative,
courageous, and world-leading approaches to reducing drug
harm. We did it decades ago with the Needle Exchange
Programme, we’ve done it recently with legalised drug
checking, and we can do it with methamphetamine,” he
says.
“A large majority of New Zealanders now agree
that we need to treat drug use as a health issue, and the
solutions we’ve put forward in this paper show what we
need to be doing instead of the same old failed
approaches,” says Baker.
Recent polling by the NZ
Drug Foundation has found that 68% of New Zealanders support
replacing the country’s 1975 Misuse of Drugs Act with a
health-based
approach.
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