Minimising Meth’s Harms – Expert Reaction

A new report recommends several actions to reduce the
harms of methamphetamine use in Aotearoa New Zealand, saying
the evidence is clear that reducing supply alone doesn’t
work.

The report, commissioned by the Helen Clark
Foundation and the New Zealand Drug Foundation, recommends
steps such as rolling out treatment partnership programme Te
Ara Oranga nationally. It also proposes a pilot to test
whether a stimulant substitution treatment model could help
people move away from the harmful impacts of being in
contact with the illicit methamphetamine market.

The
SMC asked experts to comment on this report.

Dr Marta
Rychert, Senior Researcher, Shore & Whāriki Research
Centre, Massey University, comments:

“New Zealand is
among countries with the highest use of methamphetamine
globally, with latest data showing 1.2% of adults have used
methamphetamine in the past year.

“The report is
timely, and offers some practical solutions that could be
implemented in New Zealand, in keeping with the harm
reduction approach advocated by the
authors.

“Proposed solutions range from expanding
existing responses (e.g. expanding access to drug treatment)
to implementing entirely new and innovative solutions. One
of the innovative recommendations is to pilot a substitution
programme where people with methamphetamine use disorder
could legally access alternative substances. Scientific
evidence for this solution is mixed, but the report usefully
puts ideas forward for the public debate and policymakers’
consideration.

“In my view, one of the
recommendations in the report deserves particular attention.
That is to expand Te Ara Oranga programme which has been
piloted in Northland, and recently evaluated. The programme
is a holistic solution involving partnership between the
police, social workers, addiction services, iwi providers
and other agencies. The evaluation of the programme
concluded it was a cost-effective and community-tailored
response. The programme recognises that effective response
needs to support both users and their whānau to quit, as
well as strive to reduce methamphetamine supply operated by
gangs.

“Methamphetamine use and problems are
concentrated in neighbourhoods with higher deprivation
levels. Ultimately, underlying issues in those communities
– such as poverty, housing insecurity, limited employment
and education opportunities – need to be addressed if we
want to tackle the issue long term.”

No conflict
of interest.

Associate Professor Chris Wilkins,
Shore & Whāriki Research Centre, Massey University,
comments:

“I think the report rightly brings meth
back into the spotlight, following much debate about
cannabis as a result of the Referendum. The wastewater
sampling provides clear evidence of both the scale and
geography distribution of use in New Zealand (this has been
really valuable objective data on consumption, confirms what
we found in our surveys and pilot wastewater testing, which
were sometimes greeted with scepticism). There is good
reason to believe NZ Health Survey underestimates use
considerably.

“I would endorse the roll out of the
Te Ara Oranga programme, particularly to Bay of Plenty and
Hawkes Bay where there is high levels of use, but really
throughout the country (there is also evidence of high
levels of meth use on the West Coast and bottom of South
Island). It was great to see the emphasis on the need for
services to be local, including in small towns and rural
areas (our research has long identified the expansion of
meth use and manufacture into rural/regional areas and the
lack of accessible treatment services, users often lack the
resources to travel beyond their home location). Also, I
agree there’s a need to provide a range intensity of
treatment services also with Māori approaches, including
supporting peer to peer support (e.g., Alcoholics
Anonymous). There is opportunity to be innovative and
adaptable with services to attract more people into
treatment and help seeking, and use limited resources
wisely.

“Gangs appear to have played an important
part in the spread of meth and have adopted direct selling
and multi-level peer marketing. Competition over meth
selling between gangs results in violence. There is also a
largely unknown impact on levels of corruption. Gangs
present themselves as economic/social role models in many
communities. Enforcement should focus on gang organised
crime meth trafficking.

“I would urge caution in
adopting some kind of stimulant replacement programme –
the evidence of effectiveness has been mixed and there are
risks with stimulant maintenance including mental health and
addiction, physical health of users, and impact on others
(reasons to believe it has important differences from opioid
substitution).”

No conflict of
interest.

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