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New report calls for overhaul to methamphetamine approach

4 Sep 2022
This article was published 18 months ago. Content may no longer be relevant.

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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ENDS

Notes to editors:

  • Minimising the Harms from Methamphetamine was jointly commissioned by the NZ Drug Foundation and the Helen Clark Foundation. It is co-authored by Philippa Yasbek, Kali Mercier, Dr Hinemoa Elder MNZM, Dr Rose Crossin, and Prof Michael Baker MNZM.
  • About 40,000 people use methamphetamine each year, but less than a quarter of this group use methamphetamine monthly or more often. This means most people who use methamphetamine don’t experience addiction. Methamphetamine harm is, however, concentrated in some communities.
  • Our punitive approach has seen more than 12,000 people convicted of a methamphetamine offence in the last five years, with almost 4,000 of those people sentenced to prison. Despite this, methamphetamine use hasn’t significantly decreased across this period.
  • Māori are severely disproportionately affected by current approached to methamphetamine. Māori make up 48% of those convicted for drug possession (of all drugs) and 62% of those sentenced to prison.
  • Te Ara Oranga, piloted in Northland since 2016 and now expanding to the Eastern Bay of Plenty, is a comprehensive social-wellbeing intervention designed to address all aspects of the harmful consequences of methamphetamine use for users, whānau and community. It does this through partnerships between agencies (Police and Health), iwi, NGOs and other service providers. The combined response addresses both supply and demand, and includes targeted enforcement, treatment for individuals and whānau, community education and health promotion work. It also includes destigmatisation approaches, such as bringing peer support workers into emergency wards to help doctors better understand patients.

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