Mattersof Substance. october 2017 Volume 28 Issue No.3 www.drugfoundation.org.nz

We should have known

The recent extraordinary spate of 20 deaths linked with synthetic cannabinoid use could have been avoided. The warning signs were there, but who was listening? Contents

FEATURE: TUHOETANGA We should 16 have known FEATURE: ENLIGHTENMENT AT THE COVER: How New Zealand failed END OF THE MAZE to spot the synthetics crisis NZ 02 NEWS

$ 20 COVER 06 STORY 3M

FEATURES Become 14 16 20 22 a member Without warning Tühoetanga Enlightenment at the Public mood swing: An early warning system As Tühoe inch closer to end of the maze Have Asia’s brutal The New Zealand Drug Foundation has could save lives. Rob Zorn mana motuhake – self- World-leading drug policy drug wars hit a nerve? been at the heart of major alcohol and compares a couple of determination – a Drug experts plus an enthusiastic Mangai Balasegaram asks other drug policy debates for over 20 years. international examples Foundation hui in Rüätoki crowd of advocates, whether public outrage During that time, we have demonstrated that might work here. touched on what that politicians, clinicians could mark a turning point a strong commitment to advocating could mean for healthcare. and activists equals hope in Rodrigo Duterte’s bloody policies and practices based on the for change. War on Drugs. best evidence available.

You can help us. A key strength of the Drug Foundation lies in its diverse membership base. As a member of the Drug Foundation, REGULARS you will receive information about major alcohol and other drug policy challenges. Drug history in You can also get involved in our work to New Zealand 28 find solutions to those challenges. 30 32 36 Country model 34 Guest editorial: Viewpoints: Prevention and education: Our membership includes health promoters, Q&A: Lizzie Marvelly 37 Drivers of change Does cannabis really The right message: primary health and community organisations, researchers, students, schools and boards The election left Winston cause 32 deaths each Engaging teens and of trustees, policy makers, and addiction Peters holding all the year in New Zealand? young people treatment agencies and workers. cards, but maybe change The way we count deaths We highlight some work is driven from the is vital, as it determines the that’s under way to help Membership and subscription enquiries backbenches anyway, extent of the government’s young people understand [email protected] writes Emma Espiner. response. We explore the and talk about drugs. or visit our website. way drug deaths are currently recorded. www.drugfoundation.org.nz

matters of substance is published matters of substance invites Brand development/ NZ Drug Foundation by the New Zealand Drug feedback and contributions. graphic design 4th Floor, 265 Wakefield Street Foundation. All rights reserved. If you’re interested in Insight +64 4 801 6644 PO Box 3082, Wellington, Neither this publication nor any contributing a guest editorial [email protected] New Zealand part of it may be reproduced or article, please contact us: www.insightcreative.co.nz p +64 4 801 6303 matters of substance without prior permission of the [email protected] October 2017 Drug Foundation. p +64 4 801 6303 Vol 28 No. 3 ISSN 1177-200X

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@DuncanGarnerNZ Fuel pipeline down - Govt goes ape. Housing crisis - beat up. 20 dead in 8 weeks due to synthetic drugs - sssh we’re announcing new bootcamps ... SEP 18

@AotearoaSam Crisis. Seriously. These are DEATHS - serious issues will be far greater in number. Prohibition is killing kiwis ... SEP 14

@MelindaButtle Name your craft beer! It’s the job your granddad did plus a word you don’t fully understand. Mine is ‘The Boxer’s Contingency’ ... SEP 10 very election, we put together a briefing to the incoming parliament. As we make the final touches to our latest recommendations, @wolfenyc Calling mandatory drug testing of those I’ve been reflecting on what we told them received public benefits “love” is like calling three years ago. police arrest “kindness”. #stoptheharm ... AUG 26 The current government has made some progress towards a more health-focused @philquin By far the biggest addiction cohort in E approach to New Zealand’s drug problem; our new briefing will certainly highlight NZ are middle class wine-swillers, poshly ROSS BELL the areas where progress has been slow hoovering vino on the daily like it’s their last Executive Director and where reform is urgent. on Earth ... AUG 18 But there are two issues where no progress has been made despite a supportive policy environment – opioid @JustSpeakNZ If we can’t control drugs in Aotearoa in overdose prevention and an early warning system for new psychoactive our prisons, we certainly can’t control them outside substances. Both highlight failed implementation by government and its agencies. of prison. - Danny Matene #ajustvote ... JUL 27 Three years ago, we advocated strongly for naloxone – the overdose reversal medicine – to be more widely available. Our advocacy was KEY EVENTS & DATES successful. The Medicines Classification Committee agreed to change the status of naloxone, allowing it to be accessed without prescription as part of an approved overdose pack. This pack could be distributed 27th IFNGO Conference: Understanding Addiction, Treatment, widely through the needle exchange programme, both to people who Prevention and Harm Reduction Policy, Macau inject drugs and to their friends and family. 6-8 NOV 2017 We naively assumed that, the decision having being made, the agencies responsible for implementing it would crack into gear and get it done. This was not the case. Instead, they have given us excuses why it is not their Agents of Change Summit, San Diego, USA agentsofchangesummit.com responsibility and highlighted barriers to implementation that still exist as though it was someone else’s role to remove those barriers. 12–13 FEB 2018 This bureaucratic inertia is agonisingly odd. After all, we are talking about preventing deaths. The same inertia exists in a very stark way with the recent deaths NZ Population Health Congress, Auckland, from synthetic cannabinoids (which our cover story examines in detail). pophealthcongress.org.nz Government agencies had agreed to establish an early warning 18–20 APR 2018 system for psychoactive substances by June this year. This languishes for lack of funding and lack of motivation. We can only imagine whether things would have been different if this warning system had been in place. 12th International Society for the Study of Drug Policy conference, But even without this system, different government agencies Vancouver, Canada, issdp.org

had access to good knowledge about the rapidly changing synthetic 16–18 MAY 2018 cannabinoid black market. For reasons known only to them, they chose not to share this more widely – including to the public. We could very easily find ourselves stuck with the status quo, Australian and New Zealand Addiction Conference, Gold Coast, where agencies with access to good intel continue to sit on it. Australia, addictionaustralia.org.au So when we write our briefing to new politicians, we will talk to them about drug law reform and the urgent need for more 28–29 MAY 2018 resources for prevention, education and treatment. But we will also vigorously challenge those government agencies tasked with Follow us implementation to act with more urgency, especially when it comes Join us online to lifesaving interventions. drugfoundation.org.nz/connect

www.drugfoundation.org.nz 01 News NZ.

of Kiwis want cannabis 03 Drug policy hui 04 Fighting meth 05 Dunne steps reform and support is in Rūātoki in Northland down 65% rising amongst voters $ AL AL N N UR UR ON ON O O FIRST FIRST ATI ATI Z Z N N LAB LAB N N GREE GREE 3M 2016 2017 2016 2017 2016 2017 2016 2017 THE DRUG FOUNDATION NORTHLAND POLICE and “COMPASSION, INNOVATION took its model drug law deep treatment providers are and proportion” were 01 LEGAL CANNABIS LAW BACKING into Tühoe territory in August, working together to put catchphrases for the most REMAINS HIGH with a hui at the remote Te prevention and treatment first, unlikely champion of drug law Rewarewa Marae in Rüätoki. in a new approach to high reform. Under Peter Dunne, Ngäi Tuhoe leader Tamati levels of methamphetamine the National Drug Policy Public support for cannabis Kruger opened the hui, use in the region. began to view drug use as which focused on the Northland DHB and NZ Police first and foremost a health law reform is as strong impacts of our broken drug have been funded $3 million issue as he doggedly pushed law on Mäori, with an eye to to deliver the Te Ara Oranga a reluctant government as ever, a new survey possible solutions. The Drug Methamphetamine Demand towards responsible reform. conducted for the Drug Foundation’s Principal Adviser Reduction Strategy pilot. The Peter Dunne stepped down Gilbert Taurua presented trial, a first for New Zealand, in August after 33 years in Foundation shows. “Whakawätea te Huarahi: will see a range of new referral politics, leaving behind him A model drug law to 2020 and treatment options for a legacy that saw, amongst The Curia Market Research poll shows almost and beyond”. meth users and their whänau, other things, the unlikely while a team of seven pairing of the words ‘sensible’ two-thirds of those surveyed in July 2017 want CAYAD’s Denis O’Reilly spoke about practical initatives being dedicated Police officers and ‘drugs’. cannabis to be either legalised (28 percent) run by Hawke’s Bay CAYAD work to reduce supply. Peter’s contribution will not or decriminalised (37 percent). That’s roughly and how other communities Funding for the programme be forgotten, and while some the same results as last year’s survey, when could also set up their own was made available under wonder what might happen schemes. A community panel the Criminal Proceeds to drug policy reform without 64 percent of respondents were in favour spoke passionately about the (Recovery) Act. him, the fight will go on. of change. Sixty percent of National voters impact of drugs on local want change, with support even higher people, and a political panel amongst supporters of the other parties. was asked the hard questions by MC Toi Kai Räkau Iti. Even more want freer access to medical cannabis, with 78 percent supporting legalising or decriminalising for pain relief. 06 Bottle store owner wants early closing city-wide 02 Seven years on, Treaty claim holds government to account across the city and includes supermarkets and dairies. recommendations to reduce Waitangi. He believes alcohol “Otherwise, it’s not going to alcohol-related harm. supply is actively driving do anything … People will just Mäori Warden David Ratu health inequalities between drive to the supermarket if we says the government had Mäori and non-Mäori. are not open, and there will be more drunk drivers.” a duty to implement the “Every piece of legislation out recommendations, which there has a Treaty clause in it, A PALMERSTON NORTH Mr Dhillon says people often included increasing the except alcohol; except the one bottle store owner is taking return for another round once price of alcohol, raising that has the biggest impact on a stand against binge drinking, they are already intoxicated the drinking age to 20 and does the most damage to calling for the local council and their reasoning is impaired, A NEW CLAIM before the and restricting alcohol my people. That is simply not to require all alcohol retailers so a proposed 10pm closing Waitangi Tribunal accuses the advertising and sponsorship. good enough.” Ratu said he to close at 9pm. time is not good enough. government of breaching the Ratu says the Sale and would take his fight to the Big Barrel director Baldeep Palmerston North District Treaty by not carrying out the Supply of Alcohol Act is not International Court of Justice Dhillon says it will only work Council will consider the draft Law Commission’s 2010 consistent with the Treaty of if necessary. if the rule is enforced right local alcohol policy this month.

02 matters of substance October 17 04 10

03 09

06 90% 01 02 05 07 10 Judge urges Northland community to confront meth use 09 Coroner steps up calls for funding 08 Smokefree 2025? 08 A NORTHLAND judge claims 90 percent of crime in the 2025 region is driven by drug use, primarily methamphetamine, A ROTORUA CORONER has and has urged Northlanders 2065? called for more funding and to confront the problem. better collaboration between Judge Greg Davis says most SMOKEFREE 2025? More like social service and government of the family violence and Smokefree 2065, says Häpai agencies, after the death of a burglary cases he hears are Te Hauora. The public health young man who had severe linked back to meth, which 07 Meth ‘contamination’ submission provider has teamed up with problems with solvent, alcohol drives people to steal to fund University of Otago to develop and other drug use. their drug use and alienates landlords the right to test an action plan, with direct new them from their whänau. properties for meth mid- Maurice Murtagh, 20, had a measures to achieve the 2025 long and tragic involvement He says it will take a brave tenancy and then evict smokefree target, which they with a number of different stand from within the tenants with only seven say is slipping away. support agencies. Residential community, to confront drug days’ notice if testing University of Otago researcher treatment was difficult to use “head on”. “If we don’t, shows traces of the drug. Professor Richard Edwards access because he had no IRD my fear is that it’s going to We believe there are major says New Zealand was once number or formal identification. entrench and ‘normalise’ in THE GOVERNMENT has social justice, human rights, considered a world leader in After months of trying, a bed our communities and make proposed a new set of health and financial tobacco control, but the pace became available the day after it even more difficult for standards on supposed implications to this of change has slowed. he died. generations down the track meth-contaminated amendment and that there’s The proposed new measures Coroner Michael Robb also to actually break away and live properties, which the no scientific evidence behind include a dramatic reduction highlighted the lack of funding a drug and alcohol-free life.” Drug Foundation believes it. We have made a submission in retail outlets selling for compulsory residential He was hopeful the $3 million is a significant breach of to the Local Government tobacco, removing additives, treatment, with only 15 beds Te Ara Oranga meth reduction tenants’ rights and will put and Environment Select reducing nicotine content, in Rotorua to cover the entire project, recently launched by vulnerable people at risk. Committee outlining our increasing the minimum Midland region. He said his Police and Northland District The Residential Tenancies key concerns and calling for purchasing age and increasing finding would not be critical Health Board, could begin Amendment Bill gives further evidence-based debate. tobacco tax. of any one service. to empower change.

www.drugfoundation.org.nz 03 News

World. 07 09 01 03 UK Police commissioner calls for change to drug laws

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IT SEEMS the UK Police do not all agree with their government’s drug prohibition stance, with at least one local force choosing compassionate 01 UN JOINS CALL FOR DECRIMINALISATION alternatives to prosecution. Ron Hogg, Durham and 04 New plan to In a joint release aimed at ending Darlington’s Labour Police, reduce Iran’s health care discrimination, the Crime and Victims’ drug trade Commissioner, organised a United Nations has joined the symposium last month to start World Health Organization in urging talking about the alternatives member states to review and repeal to criminalising drug users. “punitive” drug laws with “proven” Five years ago, Mr Hogg and his Chief Constable, Mike negative health outcomes. Barton, decided not to target people growing cannabis Previously limiting its calls to health and for personal use, stating IRAN IS moving to tackle evidence-based solutions, in 2016, the drug possession charges were its drug crisis. Alongside nations voted to maintain a criminal not their priority. Since then, a new Bill under way in approach to drugs, despite strong opposition they have set up a number its parliament to stop the 05 Hangovers of alternatives including execution of low-level drug ok here from some countries. However, Secretary- safe injecting facilities traffickers, a proposal has General António Guterres has now called and a diversion scheme been drafted to distribute for a more treatment-focused approach. to address the root causes diluted drugs (mainly of offending. Both have methadone) to people Mr Guterres was Prime Minister of Portugal been proven effective. with an addiction problem. when the country first decriminalised drugs He has called for the Meanwhile, Police have and says he understands from personal government to hold a intensified their campaign experience how prevention and treatment fundamental review of against large-scale drug the country’s drug policy. can generate positive results. trafficking. Iranian Police claim THE MUSIC business can drug production in Afghanistan have unfriendly hours and has surged since the US-led a permissive attitude to booze invasion in 2001, and last year, – so now one London firm 02 Harm-reduction workers unite against synthetics ban the UN said Iran has one of is allowing its staff to take the worst addiction crises in hangover sick days. They can with critics saying it will be and a coalition of leading the world. even send notice of their a logistical nightmare and harm-reduction organisations Officials say the aim is to condition via WhatsApp. a waste of resources while has been formed to try and sever the relationship between actually allowing more stop it being passed. The CEO of Dice, a music drug users and traffickers. harmful drugs to be sold ticketing app based in The group is calling for Iran’s Drug Control Shoreditch, defends the move on the street. harm-reduction approaches Organisation says there by pointing out some of the The Drugs, Poisons and like pill testing to replace the are now 2.8 million “regular” best deals in the industry Controlled Substances current tactics of increased drug users in the strictly happen after a gig. “We trust A PROPOSED blanket ban on Miscellaneous Amendment law enforcement measures conservative country. Official each other and want people synthetic drugs in Australia Bill 2017 is being debated in such as sniffer dogs and figures estimate there are to be open if they’re out late has been widely condemned, the upper house of Parliament, greater search powers. 220,000 to 250,000 traffickers. experiencing live music.”

04 matters of substance October 17 03 05

10 War on Drugs hits home for Duterte 04

10 THE WAR on Drugs just got personal for Philippines President Rodrigo Duterte, with his son implicated in a major drugs bust – as outrage continues over suspected Police killings and door-to-door drug tests in Manila’s poorest neighbourhoods. 02 Paolo Duterte, Vice Mayor of Davao and son of the man responsible for the country’s 08 increasingly violent War on 06 Collateral 08 Seven days Drugs, has denied links to damage of drug policy a $125 million narcotics 07 Pot’s legal, talks in shipment. A senate inquiry but young Cape Town has raised allegations that he people aren’t helped ease the entry of the smoking more drugs into Manila’s port, with questions about ties to a criminal syndicate and even a “dragon-like” tattoo with secret digits on his back. The Philippine leader has HUMAN RIGHTS activists repeatedly said he would have condemned morphine resign if critics could prove overregulation in Latin INTERNATIONAL EXPERTS any members of his family America, claiming patients say South Africa is likely to were involved in corruption. living in the poorest countries EARLY SIGNS show young prioritise health and human in the Americas have become people are not smoking more rights, as its government collateral damage in the cannabis since it was legalised considers changes to the 09 Ecstasy trials a “breakthrough” War on Drugs. in Washington State, nor have national drug policy. for soldiers Colombian human rights treatment admissions While a High Court bid to organisation Dejusticia increased, according to the legalise cannabis continues in users with intense feelings of recently released a report Institute for Public Policy. Pretoria, several international euphoria. It also reduces fear about drug policy in eight Under Initiative 502, the experts were brought in to and gives users a deep sense Latin American countries. state’s legal-pot law, the speak at a recent Drug Policy of love and acceptance of Researchers highlighted many Washington State Institute Week conference in Cape themselves and others – examples of regulatory barriers for Public Policy is required Town. Human rights activist the perfect conditions for that block access to essential to conduct regular cost- and Global Commission on trauma therapy, says MDMA pain relief medications, benefit analyses on issues Drug Policy member Anand WITH RECENT wars pushing researcher Rick Doblin. including limiting who can ranging from drugged-driving Grover, who was instrumental post-traumatic stress disorder prescribe or handle morphine, to prenatal use of marijuana. in having homosexuality laws “If you were to design the (PTSD) within the American perfect drug to treat PTSD, as well as the amount or The latest report was limited repealed in India, was one of military to “epidemic levels”, MDMA would be it,” says length of prescriptions. to a few specifics including the speakers. a new therapy being trialled Doblin, who raised the money The report says regulations the degree of youth and adult Organiser Shaun Shelly said by the Food and Drug in Argentina are so onerous use, treatment admissions 2017 is an important year for for early trials himself. Initial Administration has been that many pharmacies choose and criminal convictions. drug policy in South Africa, tests showed the risks to be hailed as a “breakthrough” for not to stock morphine, while It said the only change was as the National Drug Master much less than previously patients living in rural or increased adult use, in regions Plan and several other drug soldiers and others – ecstasy. thought, and after recent impoverished areas are unable that were already known to plans are due to be released Ecstasy’s appeal has always human trials, Veterans Affairs to access medication at all. have higher sales. before the end of the year. been its unique ability to flood is cautiously welcoming it.

www.drugfoundation.org.nz 05 Cover Story

We should have known The recent extraordinary spate of 20 deaths linked with synthetic cannabinoid use could have been avoided. Russell Brown talked with those willing to go on the record about how we got here.

RUSSELL BROWN

06 matters of substance October 17 www.drugfoundation.org.nz 07 Cover Story

Peter Dunne

...once the situation arose where effectively everything was banned, I think they said, well, that’s the problem resolved.

PETER DUNNE

n 21 July, when ––––– 2014 changes, there was a prevailing the Police and the All of that was wrong or irrelevant. feeling that we had sorted the problem. Chief Coroner’s At the time of writing, nearly two “There was a certain dishonesty there. office released months after the original headline, another I fought to maintain the integrity of the a statement that Police statement has revealed that at least Psychoactive Substances Act. The National seven deaths in 20 recent deaths are likely to be associated Party fought to get psychoactive substances Auckland so far with synthetic cannabinoid use and that off the shelves, and they weren’t too fussed O the chemical implicated in most cases is about the integrity or otherwise of the Act. that month appeared “to be linked to the use of AMB-FUBINACA – something the Police “So once the situation arose where synthetic cannabis”, the news seemed have had at least good reason to suspect effectively everything was banned, I think to come out of nowhere. since June, when a major Customs seizure they said, well, that’s the problem resolved. The statement was quickly followed was made. So to that extent, you could say that was by a New Zealand Herald report revealing Incident clusters have spread beyond taking the eye off the ball or just assuming that the city’s St John ambulance service Auckland, in keeping with the “zombie that it had all just passed by. was attending to as many as 20 people outbreak” pattern observed in other “I continued doing my work, but it a day suffering “life-threatening effects” countries, and the St John ambulance was in an environment where, as far as from using “synnies”. At the same time, service has attended to around 700 cases the National Party was concerned, and in social media was dotted with accounts since mid-June. particular the leadership of the National from members of the public who had The harsh truth is that the crisis did not Party, that had all been resolved. It was off stepped in to call for emergency aid after come out of nowhere. It was developing the shelves, and we’d dealt with it. ‘Yeah, finding street people in Auckland CBD even before the 2014 amendment to the yeah, you can get your Act in place, but behaving bizarrely and suddenly Psychoactive Substances Act took all frankly that doesn’t matter. The stuff’s off collapsing unconscious. synthetic cannabinoid products off retail the shelves, and that’s all that counts’.” Public health officials fretted that shelves. And for a range of reasons, almost ––––– New Zealand streets might finally have no one saw it happening or, in some cases, In April 2015, I visited ESR for a follow-up seen the arrival of the powerful synthetic did not wish to see. interview about the results for a party pill opioid fentanyl. The original joint ––––– we’d had the agency test for a Matters of statement had indicated “the possibility “I wouldn’t say we took our eye off the Substance story. As I spoke to two ESR that some products can also be laced with ball,” says Peter Dunne, the Associate scientists, another story emerged. other unknown chemicals”, and a senior Health Minister who drafted the Dunne had recently assured news officer at the Avondale Police station Psychoactive Substances Act and fronted media that Police had told him there was told the press of test results “which the critical amendment in the midst of only a “comparatively small” underground show things like fly spray and weed an election campaign. “I think that more market in synthetic cannabis products, killer” in illicit synnies. what happened was that, as a result of the trading in products stockpiled from the

08 matters of substance October 17 We had a very new one last week. It was in our data library, so we could identify [it] that way, but we could not find any published data in scientific published papers. It takes ages for them to catch up.

JENNY SIBLEY

old legal regime. But what the scientists Then a communications flurry began. anything in that time. You could have said about recent testing of products seized Dunne himself wrote to debate the a fit, you could stop breathing – and then by the Police and Customs painted a very conclusions in the post. But the evidence wake up.” different picture of synthetic cannabinoids. seemed undeniable. The market in At no point did Tania or any of her “There are significantly more,” ESR synthetic cannabinoids had not ceased fellow users know the contents of what forensic analyst Hannah Partington told when they left retail shelves the year they were buying, but they were able to me, “and it’s not consistent. They change.” before. It was not trading in leftover stock, tell that some “strains” would be stronger “It’s new ones,” confirmed senior and it seemed to be increasingly filled than others. forensic scientist Jenny Sibley. “We had with entirely new chemicals. “There was no name for all the strains a very new one last week. It was in our ––––– you could get – it was just synthetic data library, so we could identify [it] that Tania never even saw a blip in supply. cannabis – but you could smell the way, but we could not find any published A 27-year-old Mäori woman from West difference in the strains. Some would data in scientific published papers. It takes Auckland, three months in recovery when smell like methylated spirits – the stronger ages for them to catch up.” I spoke to her, she began using synthetic the smell, the stronger it was. But there Both agreed that a recent large Customs cannabis in 2014, right at the end of the was a crushed pill that was in the stuff seizure of JWH-018, one of the original years during which the products had been sometimes too, and you could see that “legal highs” banned by the Minister in sold in shops. through the leaf. That was more like a November 2012, was an exception. Of 10 She started, she thinks, “because ‘body stone’, but it wouldn’t knock you synthetic cannabinoids identified and two marijuana was hard to get at the time. unconscious unless you smoked more provisionally identified, only three had It went pretty much dry around here. So we than three or four cones.” ever been issued with interim product thought it was easier just to go to the shop At one point, Tania was spending $500 approvals – and thus could plausibly be – because it was legal at the time.” a week on synnies “and I didn’t always have “leftovers” from the period of regulated And then the market went underground. $500 coming in”. She lost weight, “and my sale under the Psychoactive Substances “When it was banned from the shops, it kids just didn’t like me on it”. Act’s interim regime. Five of the 12 were was already being sold on the streets, so we “Some people, it would just affect entirely new. knew people who knew where to get it from.” them by putting them to sleep. But my Synthetic cannabinoids were a separate Her brother, her 57-year-old mother mother was smoking it too, and it would issue to the main Matters of Substance and the father of her children also started make her have seizures, but she’d wake story, so I posted that part on my own using. “No one else in my family would up thinking she was all right and have website. On the day it was published, an touch it.” more. I used to say to her, you don’t know ESR communications manager emailed to “It changed people a lot. You wouldn’t what strain you’ve got, so just be careful ask if the test report noted in my “excellent be able to do anything. You’d get knocked with it. Because even one puff would make post” could be shared with the Ministry of out then want more when you woke up. It her look paralysed and she’d start talking Health and Police. puts you to sleep, and you don’t remember to herself.”

www.drugfoundation.org.nz 09 Cover Story

Zavier Skilling leading protest organiser Jade Stirling and other supporters up on to the Bay Hill in 2014. The group were showing their opposition to legal highs being sold in Timaru dairies.

Photo credit: Fairfax Media NZ / Timaru Herald

Tania says her mother suffered head “I had one friend ask, ‘Do you know injuries several times during seizures. I was only smoking it if it’s my stuff that’s killing everybody?’” She says the effects were stronger Tania and her mother eventually quit if synthetics use was accompanied by because everyone else was by making sure there was never any in alcohol or other drugs. smoking it... Who’s using it? the house. She’s happy to be getting better. “That stuff is pretty wicked when Pretty much the whole of “I was only smoking it because everyone you’re on P. I’ve tried it, and it makes you Henderson that has a drug else was smoking it.” really zombie-looking, you can’t handle Use is still widespread in her community, any facial expressions. It’s ugly. I videoed problem, and from Wellington she says. myself to see what I was like on it with up to the Far North. “Who’s using it? Pretty much the whole the crack, and it made me want to stop. of Henderson that has a drug problem, and “Mixing alcohol with it is also a big TANIA from Wellington up to the Far North.” no-no, I think. It can make you vomit ––––– after the seizures. Sometimes I’d be put Henderson-Massey Local Board member to bed and not even know what had and Unitec lecturer Paula Bold-Wilson happened. I’d just wake up and think led a campaign to get synthetic cannabis ‘How did I get here?’” products off the shelves in West Auckland Supply usually came through the in 2014, when she worked at the equivalent of tinny houses, and the sellers Waitemata Community Law Centre. were generally in their 30s or 40s. Some She’s deeply disappointed by what may have had gang connections, others happened after the ban. were simply dealing to support their “At the time we were campaigning, own use. we were trying to raise awareness of “They don’t care how much they’re how many people were still extremely putting in it and what it’s doing to the sick afterwards and that actually the buyers, because the buyers in the end government had a responsibility to tidy up are making their own choices by buying the mess of those who’d become addicted it and taking it. So that’s what I guess through those products being legal in our makes the dealer so proud of making it community. But they left the community – because [they’re] making a buck and to tidy up the mess really.” they’re getting what they want.” Bold-Wilson says the campaigners This year’s flurry of media reports “always knew that the synthetics would about deaths did not go unnoticed, go underground. We were pretty realistic she says. about that. It’s similar to P, it’s going to be

10 matters of substance October 17 sold. But you have to do education stuff, you have to raise awareness around the AMB-FUBINACA is an Quite clearly, people risks of smoking this product.” She says another thing hasn’t changed example of the emerging class aren’t mixing it right... There since the ban: who’s suffering. of ‘ultrapotent’ synthetic does seem to be a complete “What was really upsetting during the cannabinoids and poses a ignorance in terms of what selling of those products was that, at the public health concern. the dosage should be... end of the day, it was Mäori being hurt by them. And that’s even more relevant today. NEW ENGLAND JOURNAL OF MEDICINE KEVAN WALSH Our people are selling to our people.” ––––– It wasn’t only officialdom that didn’t see the crisis developing. KnowYourStuffNZ’s Wendy Allison, who spent last summer testing drugs on demand at festivals and parties, says no synthetic cannabis was presented to her team for testing, and no cannabinoids were found in any other form. Wellington Hospital toxicologist Dr Paul Quigley notes that hospital EDs in some regions have seen no synthetics- related presentations since 2014. Robert Steenhuisen, Auckland Regional Manager of Community Alcohol and Drug Services (CADS), says his service is seeing markedly fewer presentations related to synthetic cannabinoid use this year than when they were legally sold – but also that it’s seeing a different kind of user. these analyses is consistent with strong what the dosage should be, and that’s In 2013, users generally only had a depressant effects that account for the not surprising because there really is problem with the one drug – now, their ‘zombielike’ behaviour reported in this no information given out. This is not use is likely to be mixed in with other mass intoxication. AMB-FUBINACA a product that we can recall ... this is drugs, such as depressants. is an example of the emerging class of something prepared in people’s backyards All this is in keeping with the ‘ultrapotent’ synthetic cannabinoids in terms of putting out plant material and experience in other countries, where and poses a public health concern. adding the chemical to it.” synthetic cannabinoid use is concentrated Collaboration among clinical laboratory The sheer potency of AMB-FUBINACA among the marginalised and dispossessed. staff, health professionals, and law warrants emphasis. Posters to “psychonaut” These are not recreational drug users. enforcement agencies facilitated the forums on the internet describe strongly The Auckland crisis was also identical timely identification of the compound effective vaporised doses of as little as 100 to outbreaks elsewhere in the world at and allowed health authorities to take micrograms – that’s the potency of LSD. the same time. The week before the news appropriate action.” And it means that a kilogram of AMB- broke in New Zealand, Police in Fort So why, when Police and doctors a year FUBINACA – US$2,500 from a Chinese Wayne, Indiana, reported 20 overdoses before in New York had worked together to factory – contains at least 10,000 doses. in 24 hours, attributed to a bad batch of identify the culprit chemical, was everyone ––––– “spice”. The week before, there were 150 in the dark in New Zealand? Then-Minister There were some indications of what overdoses – many requiring intensive Dunne was clearly unimpressed, telling was going on. The Illicit Drug Monitoring care admission – in Lancaster County, reporters that his office had had “less than Survey (IDMS) conducted by Massey Pennsylvania, where the director of a couple of hours’ notice” of the police and University’s SHORE Centre picked up the emergency services speculated that coroners’ joint statement. “There’s been shift to the black market. The most recent “some bad K2 has hit the street”. no contact with my office at all on this. IDMS report, published in April this year, Few, if any, of these cases involved We need to be working together on this.” notes a decline in the use and availability adulterants, and one chemical in particular It fell, again, to ESR to release accurate of synthetic cannabinoids since the 2014 was implicated: AMB-FUBINACA. information about the drug involved retail ban (notably among users of party An article published this year in New and, subsequently, the really bad news: drugs such as MDMA) but also an increase England Journal of Medicine described the dosing in synthetic cannabis in in strength. how researchers studying the so-called New Zealand was between 10 and 30 The results of that survey only go up “zombie outbreak” identified the chemical times higher than that identified in the to 2015 – it’s no kind of early warning first in products seized by Police and then benchmark Brooklyn case. system – but the survey’s director, – after working backwards to determine “Quite clearly, people aren’t mixing it Dr Chris Wilkins, says the reported what its metabolites would be – in the right,” ESR Forensic Chemistry Manager increase in potency “seems consistent blood of users. It concluded: “The potency Kevan Walsh told RNZ. “There does seem with the problems we’ve been having of the synthetic cannabinoid identified in to be a complete ignorance in terms of recently. The black market products were

www.drugfoundation.org.nz 11 Cover Story

quite a bit more powerful than what had “Part of the problem with drug policy the development, implementation and previously been around under the in this country is that they’ve got no ongoing maintenance of the system”. Psychoactive Substances Act.” research so they don’t know what’s going A question about what research and Users tended to be younger people on. That’s becoming more and more clear information on the problem is currently in more deprived parts of Auckland. to me. So they tend to rely on the media being gathered was deflected to district “They’re definitely not ecstasy users – and synthetic cannabinoids was a classic health boards, “as the responses are or party drug users and maybe not even example of that.” being led by them”. The Auckland methamphetamine users.” He compares it to SHORE’s experience District Health Board refused to make IDMS and its partner survey NZADUM in tracking the methamphetamine market. any comment or to allow its specialists (New Zealand Arrestee Drug Use Monitoring) “In the last couple of years, we were to be interviewed. also picked up a decline in both the use picking up all this increased meth use – One potential partner in an EWS, and availability of natural cannabis. Some frequency of use, availability, lower prices. Associate Director of Auckland users liked synthetic products because they In 2014, people were sceptical, but as the University’s Centre for Addiction Research allowed the passing of workplace drug seizures went up to massive amounts, it Dr David Newcombe, is happy to talk. tests, Wilkins says, but that doesn’t explain demonstrated the value of this sort of “It’s not a real thing,” he says of the why overall availability of natural cannabis research. But when it came to the last one, nascent EWS. “Information is being would decline. they just didn’t want to release it. collected. ESR collects information about “One explanation might be that the “We were too successful. You end up the samples they are sent, albeit within people previously involved in cultivating reporting something that people don’t the restraints of coronial inquests and cannabis have moved to synthetic want to hear.” that sort of stuff. Ambulance officers also cannabinoids because they’re much ––––– collect information. But the issue is what easier to produce. You don’t have to The spate of headlines in July was they do with that information, where that cultivate them for four months and then followed by news reports that progress information is sent to for some sort of have a chance of the Police swooping in. towards the early warning system (EWS) decision around what we do with it. The fact that natural cannabis availability promised two years ago in Dunne’s “I’m often asked whether an early is declining indicates it’s coming from National Drug Policy would be expedited. warning system would have prevented the supply side, so someone previously The bad news: there’s no specific budget these deaths, and that’s a really difficult involved in producing natural cannabis for that either. question to answer. It possibly could doesn’t do it any more.” A Ministry of Health response to have informed agencies better if they’d We won’t be able to find out more questions from Matters of Substance says had that information.” from the two surveys: funding for them “some funding” for a “scoping project” He notes that, on the day we speak, (largely from the Police budget) was has been received from the 2016 Proceeds he has only learned of the updated death cancelled recently. Wilkins admits of Crime funding round and the Ministry toll of the synthetics epidemic from he finds that frustrating. is still “pursuing funding to support news reports.

12 matters of substance October 17 Part of the problem The reason that well-to-do with drug policy in this white kids don’t have the country is that they’ve got same level of problematic no research so they don’t drug use as poor homeless know what’s going on. That’s brown people is that they becoming more and more have access to better drugs. clear to me. So they tend to rely on the media... WENDY ALLISON

CHRIS WILKINS

Newcombe says model EWS systems overdoses in North America or the people was amended, so did perceptions of (“the European one is the gold standard”) in Northern Ireland dependent on the a problem. So would a functioning also provide information to users. But prescription medicine pregablin or Psychoactive Substances Act have does the nature of this class of drugs – hooked on Valium in Scotland (where saved lives? unbranded, apparently undifferentiated, fake street Valium has become a major “I don’t know, because you can’t critically dependent on dose, even within – and deadly – problem). always be confident about these things a batch – pose a particular problem for an Those drugs, say Allison, “all have when you look back,” says Dunne. EWS? Synthetic cannabinoid users are something in common, and what they “But I would say with a fair measure a far more disconnected group than have in common is that they’re cheap to of confidence that, had the Psychoactive middle-class party kids who want to produce, they tend to be addictive and they Substances Act been operating as know what’s in their pills. come with associated problems. I call them intended, we wouldn’t have had a black The Ministry answered this question drugs of the poor. They’re accessible to market. We’d have had a much clearer with a single word: “No.” Newcombe marginalised communities. The reason that sense of what was becoming available acknowledges the challenge but believes well-to-do white kids don’t have the same – and anything that was as risky as this even a warning about a particularly potent level of problematic drug use as poor stuff is at the moment would have been batch could be useful. homeless brown people is that they have detected long before it got anywhere near Wendy Allison notes that, since testing access to better drugs.” the public.” strips that spot fentanyl disguised as other Overseas research has found that But even that’s not an easy conclusion. drugs have become available in North there is another group gravitating towards The blanket-ban amendment to the Act America, they are being used by homeless synthetic cannabinoids – the very young, did reduce overall use of synthetic people where they have been distributed. who lack the money for and access to cannabis products – but it drastically “You actually have to put some effort “better” drugs. At least one case currently increased the level of harm to remaining into getting the information out there,” before the coroner involves a schoolchild, users. None of this is easy. she says. “But if you do go out and offer and Matters of Substance has spoken to Doing the right thing will require good them the service – and they’re not required intermediate children aware of slightly knowledge of exactly what the problems to go into a Police station and risk getting older peers who are using. Perhaps are. And the thing that should worry us busted – they probably will take it up.” problems there will prompt more all is that we not only don’t know enough, There is a deeper issue here, one concerted action. we are in danger of knowing even less beyond whatever new drug has come The suffering of marginalised than we did. down the pike, and that’s underlying people doesn’t make headlines the way social conditions. The people affected by the pains of middle-class people do. Russell Brown is an Auckland-based journalist synthetic cannabis here are marginalised, When middle-class users dropped away and publisher of publicaddress.net. like many of those dying from fentanyl after the Psychoactive Substances Act

www.drugfoundation.org.nz 13 Short Feature

Photo credit: Scott Simpson, flickr.com

Without warning

he complete The two small bags were tested using Unlike some other absence of product gas chromatography-mass spectrometry. ingredient listings The results for the sample from Auckland jurisdictions, New Zealand or labelling of new show that two identifiable substances had has little in the way of a synthetic drugs been sprayed on the plant matter. These drug early warning system being sold on the were pFFP and AMB-FUBINACA (also T black market means known as FUB-AMB). The former is a for emerging substances no one knows piperazine derivative listed as a class C exactly what is contained in each product drug with known psychedelic properties. and usage trends. Such a being flogged on street corners. Is the It is the ultrapotent AMB-FUBINACA tool may well have saved drug in one packet the same as the last? that has been linked to drug deaths and Is potency consistent within a batch? life-threatening conditions, both in lives in recent times. Are any adulterants added? What are the New Zealand and overseas. Rob Zorn summarises effects? What is a low-risk dose? Knowing In the Wellington sample, a different the answer to these questions can mean chemical was found: synthetic cannabinoid the issues and looks at a the difference between life and death. 5F-ADB. This powerful chemical has been couple of existing systems Samples obtained by VICE NZ in linked to deaths in Japan, and hospital Auckland and the Drug Foundation in admissions for extreme mental tension we could emulate. Wellington, then tested by the Institute of and anxiety in many countries. Environmental Science and Research (ESR) The problem is not only with the in September, show more than one smokeable synthetic drugs. Testing hazardous substance is circulating under carried out by the Drug Foundation the discredited term ‘synthetic cannabis’. and KnowYourStuffNZ at festivals last Names are important, so while it’s true summer indicated that drugs often these new products act on the cannabinoid contained substances other than what system in the body, they are hugely the person thought they were buying. different chemicals with very little As manufacture of new psychoactive ROB relation to natural cannabis or early drugs proliferates and an ever-evolving ZORN synthetic variations like Kronic. black market constantly reinvents itself,

14 matters of substance October 17 University’s SHORE researchers and the new synthetic cannabinoid was around. Perhaps the first thing Drug Foundation. As reported elsewhere To be honest, we just don’t know what would be to put a centrally in this issue, without a dedicated budget, happened to those people because we progress is likely to be slow (see the cover haven’t seen the forensic pathology.” co-ordinated interim process feature “We should have know”). So it seems an early warning system in place where DHBs, Centre for Addiction Research for New Zealand remains an urgent but Customs, Police and other Associate Director David Newcombe overdue priority. Perhaps the first thing believes it is too early to say what such would be to put a centrally co-ordinated agencies could at least a system might look like. Apparently, interim process in place where, DHBs, share what information we already collect a lot of good data. Customs, Police and other agencies could How to share it is the issue, but he says they do have. That’s not at least share what information they do getting a system like the Welsh WEDINOS currently happening. have. That’s not currently happening. (see sidebar) in place here probably isn’t likely in the near future. As Drug Foundation Director Ross Bell Newcombe says it’s really hard to said in a 26 July media release, “Regrettably, it’s vital the New Zealand health system know for sure whether having this system the situation with dangerous substances is prepared for wave after wave of new already in place would have helped circulating … is likely to be repeated. and dangerous substances. mitigate the recent epidemic. We shouldn’t be caught out again.” Accurate information is crucial for “It’s about whether the border control Unless we get cracking on an early medical professionals and first responders. agencies we hope might feed into this warning system of our own, we may What substances are in this stuff? How do system might have picked up that this well be. we treat people who’ve taken it? Getting samples tested by ESR then sharing the information with hospitals and emergency departments needs to happen as fast as Two existing early warning systems possible. And when something highly dangerous is circulating, credible messages EU Early Warning System these substances, allowing for efficient need to hit the streets. The EU Early Warning System, operated dissemination of critical information to The Drug Foundation began calling for by the European Monitoring Centre for Drugs Police, coroners, Customs, health providers a drug early warning system in New Zealand and Drug Addiction since 2005, is probably and so on. The data collected is also stored in 2012. An early warning system is the most comprehensive in existence but in a searchable database, ensuring that designed to detect and publish information works at a relatively high level. emerging knowledge about new drugs is about currently circulating drugs so people easily accessible. can make informed decisions before taking It’s a network of European early warning them. When a highly dangerous substance mechanisms that collect and share Welsh Emerging Drugs and Identification is detected, protocols are in place to issue information on new drugs, and the of Novel Substances (WEDINOS) products found in member states that alerts. These can be rapidly and widely WEDINOS emerged in 2009 following contain those drugs. shared, to help people avoid anything that an increase in emergency department is dangerous and save lives. Each member state has what are called the presentations in Wales, where those A few jurisdictions around the world National Focal Points (NFPs) and Europol presenting had taken unknown drugs. are already doing this in various ways – National Units (ENUs). NFPs have a public A team of clinicians devised an informal at a relatively high level in Europe and health focus and collect data around trends mechanism whereby samples of unidentified at more popular levels in Wales and in drug availability, emergence, usage drugs provided by patients were tested Australia (see sidebar). patterns and addiction. They draw and profiled. information from a variety of sources, There is no reason why we couldn’t In 2013, Public Health Wales expanded including the media and existing forensic also do this here. In fact, the National Drug the project to a national framework. early warning systems. Policy (2015–2020) specifically endorses It now also collects data on users’ a multi-agency early warning system to ENUs have a law enforcement focus and experiences and drug trend information “monitor emerging trends and inform collect data on things like the supply of from a wider collection of sentinel both enforcement and harm reduction new psychoactive substances, controlled monitoring hubs. Information about strategies”. The Ministry of Health has drugs found in new products and the emerging substances and pragmatic contracted the University of Auckland’s involvement of organised crime in harm-reduction advice are then disseminated Centre for Addiction Research to manufacture or marketing. to the whole population via its website, investigate what data is currently being Combined, these agencies act as central media releases, publications and other gathered that could contribute to an co-ordination points for a two-way flow means. Samples and data can be submitted early warning system, and how it could of information between individuals and by any person or organisation in Wales. be shared. organisations at a national level, and the Recently, one of the WEDINOS pilot clinicians, That work is already underway, and wider European network. Emergency Department Consultant Dr David the next step will be to develop a prototype The benefit of this model is that it connects Caldicott, has replicated the system, known with intended key players including the wide range of people concerned with as ACTINOS, in Australia’s Capital Territory. Customs, Police, emergency services, the Ministry of Health, ESR, Massey

www.drugfoundation.org.nz 15 Feature

Tame Iti Tūhoetanga

In August, Nga¯i Tu¯hoe and the Drug Foundation invited experts and community leaders to come together in Ru¯a¯toki to declare war on drug dependence. Don Rowe was there to capture what happened.

DON ROWE

Photo credit: Hillena Parsons

16 matters of substance October 17 Tamati Kruger, Tu¯hoe spokesman and leader

One of the diseases of colonisation is distrust...

TAMATI KRUGER

Photo credit: Hillena Parsons

ou know you’re homes the bodies of Tühoe’s chiefs, but whenua, joining them in shared purpose, on a marae by the death is here too in the Anzac Memorial cleansing a space for conversation and laughter. Contagious, Hall on site. Death is a part of life for discussion. Tühoe icon Tame Iti is tangata unreserved laughter, Ngäi Tühoe, as it is in all Mäori culture. whenua here, and his feet created paths brought up from So is ‘Tühoe time’ we were told. in the dew as he gave his whaikörero the belly. Laughter “The pöwhiri will start a little late, OK? inside the wharenui. irrespective of Tühoe time. Kia ora.” After a häkari of tea and filled rolls Y As the manuhiri gathered outside, to lift the tapu inside the historic Anzac circumstance. Laughter in the face of historic tragedy. familiar faces cropped up. Tamati Coffey Memorial Hall, Tühoe spokesman and In the shadow of Te Urewera, Rüätoki’s and his partner, campaigning for the leader Tamati Kruger spoke first. Te Rewarewa Marae holds particular Labour party in Waiariki; Denis O’Reilly, “One of the diseases of colonisation is significance for Ngäi Tühoe – in these a Päkehä Black Power member and social distrust,” he began. “Distrust of ourselves, mountains, the prophet Rua Kënana was activist; gold-toothed Rex Timu, president distrust of our concepts, distrust of mana, arrested on a charge of offering ‘moral of the Hawke’s Bay Mongrel Mob. More of tapu, of Tühoetanga.” resistance’ to constables who had tried would arrive later in the day – Mäori Party “But we need those values, because to arrest him months earlier for the illicit leader Te Ururoa Flavell to debate Richard when we know what it means to be a good sale of alcohol. Kënana was pardoned Gillies from the Greens. Tühoe, then we can identify the opposite, posthumously only last month, 90 years “I’m here because of meth, because of the vices. We are now declaring war on after his death. The community he founded suicide … all our problems,” Timu told me dependence. Drugs are a dependency as at Maungapöhatu, the sacred mountain after a warm greeting. Timu has a claim much as the benefit is a dependency on of Tühoe, never recovered. Archaic, lodged with the Waitangi Tribunal arguing the Crown. For 100 years, we have been prohibitionist drug laws have continued racist government policy is the reason so presented with solutions by the Crown, to disrupt and disestablish tangata whenua many Mäori are addicted to and none of them have worked because ever since. methamphetamine. After banning the use it’s a broken system. We need to not And so, as Tühoe inch ever closer to of the drug in his chapter, he claimed user just realise that but to create a new mana motuhake – self-determination – rates had dropped by 70 percent. understanding because what is broken we’re here for a hui. As the sun rose higher and the day got doesn’t work.” “There’s a tangi today, we’re a little hotter, the mist lifted above the mountains As with many indigenous peoples, worried about the turnout,” I was told and dissipated from the fields surrounding a history of mistreatment at the hands on arrival. the marae. The laughter disappeared of the Crown has left Tühoe particularly Ten minutes from Täneatua, the marae too when the wavering karanga drifted vulnerable to the ravages of drug and sits on a flat plain between Te Urewera across the marae ätea and out through alcohol abuse. In the 19th century, the and the Whakatäne River. Te Tapuwae, the waharoa. Karanga is said to weave a Crown confiscated their most fertile land the urupä at Ötenuku Marae to the south, connection between manuhiri and tangata – a band that also provided the only access

www.drugfoundation.org.nz 17 Feature

Denis O’Reilly

...don’t worry about legality. We’re talking about harm reduction.

DENIS O’REILLY

to the sea. What followed was more will prepare ourselves for the battle that on the ground and in the trenches, reform than 100 years of war, deprivation and lies ahead.” starts with a system that’s compassionate injustice. Famine in the 1890s alone And Tühoe have allies already, even rather than punitive. killed nearly a quarter of the population. if their motives are politically motivated. “Healing starts with the hapü, because In 2013, Kruger as chief negotiator agreed Tamati Coffey stuck around for nearly nobody can talk to your family like you to an historic Treaty settlement in the area two hours longer than intended, another can,” affirmed Nikapuru Takuta of Tühoe of $170 million, which was brought into casualty of Tühoe time, and addressed the Hauora. “Because we love our babies, eh? law in 2014. Tühoe also received an hui as both a candidate and a Mäori man. We love them.” apology from Treaty Negotiations Minister “When I was born, it was illegal to be Tühoe Hauora is a Tühoe-operated Chris Finlayson, citing the Crown’s me. It was illegal to be gay. Now, in 2017, health service provider, which provides “unjust and excessive behaviour and the I’m married, and my partner is standing four-day tikanga programmes to bring burden carried by generations of Tühoe right over there. That signals to me it’s wayward Tühoe back into the fold, often who suffer greatly and carry the pain of possible to shift our thinking. This gives after referral from the Department of their ancestors”. me hope for drug reform, and if I’m in Corrections. Through relearning their It was an important milestone in the Parliament, I will do everything I can to Tühoetanga, they reclaim their identity quest for self-determination. But it was make it happen.” – a critical component in the war on only the beginning of Tühoe’s battle, as Speaker Denis O’Reilly, a self-described addiction. And in that way, they are Tamati Kruger continued. ‘resultant’ and Black Power life member, grounded in connection and love. “I believe that we no longer have knows a thing or two about the machinations “It’s about the power of aroha,” Whitiaira battles with the Crown, only skirmishes,” of Parliament, having rubbed shoulders Timutimu, Mäori Responsiveness Advisor said Kruger. “We’ll probably have more with Prime Minister Rob Muldoon at the and Police representative, concurred. skirmishes, and some wars here and there, height of his power. He argued that what But as the rain rolled in after lunch, but the big fight is over. However, it has matters in these conversations isn’t the the temperature dropped and it got dark been replaced by a more serious battle, legal status or current societal attitude inside the hall. These talking points, the which is the battle with ourselves.” towards drugs, but what communities do same themes, over and over. It’s no longer “We’re dealing with at least two about them in terms of outreach, support about convincing an audience, rather generations of Tühoe who are dependent and rehabilitation programmes. disseminating the message. and addicted and loyal to the system. It is “If you remember, the good Lord “We’ve gotta radicalise the way we going to be the most tragic war that Tühoe turned water into wine – the guy was a think,” Tame Iti told me over a cup of has ever engaged in. It will be a great drug manufacturer,” he joked. “So don’t fish chowder. “The things that have been cleanout. It will be a change of structure. worry about legality. We’re talking about implemented by government policies are There will be things that are unlearned harm reduction.” not working. They’re too dogmatic in their and undone. There will be things that And for members of the community approach. So first and foremost, we have will be learned and restored. And so we panel, representatives of the organisations to radicalise ourselves and radicalise our

18 matters of substance October 17 Whitiaira Timutimu, Ma¯ori Responsiveness Advisor Te Ururoa Flavell, Ma¯ori Party leader and Police representative

All photos credit: Hillena Parsons realities. There are many aspects of space of Tümatauenga. The rituals, the remission – they’re escalating, particularly Tühoetanga that can help to make this voice of the women, are for you to be able in regards to methamphetamine. work. It’s a belief, it’s a lifestyle, it’s a to walk into the space. Then our hands “What I see is destruction left, right 24/7 thing. This isn’t a Tühoe festival, reach out to each other. This identity, and centre,” he said. “It’s getting bigger it’s not a three-day thing. You breathe in, Tühoetanga, is like an armour.” and worse and harder to break, and I’m you breathe out, you’re Tühoe. It’s more Because Tühoe are the iwi closest struggling to say what we should do.” than lip service. to autonomy, inching ever closer to total, There was one person present who “There are many addictions, it’s not legislated mana motuhake, they are in a did know what to do. Parehuia Mafi of just alcohol. Our children get addicted, unique position to attempt new models E Tü Whänau stood up during a Q and A, my kids can see the yellow arches before of healthcare. Programmes like Tühoe the final speaker and the only wahine I can. The symbolism is very strong. Hauora, grassroots initiatives grounded in the room to challenge the politicians He sees that, and he’s thinking about the in Tühoetanga, directly combat the directly. She spoke of losing her brother chips and the little toy and the burger. social problems that open a community to drugs at just 22, of how she’d worked “We need to replace that symbolism. to drug-related harms, and may provide for change, of how nothing had changed. Tühoe needs to make people think of a the best model forward for Mäori the Of how it could change, but only from home, a job, a future.” country over. Iti believes in leading from the ground up. That symbol is Te Urewera, now its the front. “What gives us sharp elbows is our own legal entity under the governance of “I’m not here to tell other iwi what mana motuhake,” she said. “What gives Ngäi Tühoe. The mountains and rivers and to do,” he said. “We just need to set an us leverage is our inalienable connection lakes that make up Te Urewera are Tühoe’s example. We need to be the beacon that to our people. You politicians have to Jerusalem. As Kennedy Warne, founding people can see. But the government know we’re coming for you. And you will editor of New Zealand Geographic, was needs to remove the booby traps, the listen so that there are no more lives lost.” told by one local, “The Egyptians had their landmines, because we become victims And with that, the hui came to end. pyramids. The Mayans had their temples. of that. It’s been happening for 170 years. But as Tamati Kruger had made clear, the We have Te Urewera.” The Tühoe ancestor There needs to be a change in attitude.” real battle is truly just beginning, and it Pötiki-Tiketike was born of the mountains But the response from the one sitting will be in their hearts and in their rohe and the mist, and Tühoe claim descendancy MP in attendance, Mäori Party leader that it is won or lost. But as history has in a very literal sense. And as tangata Te Ururoa Flavell, was more one of shown us, Ngäi Tühoe are used to facing whenua, their fortunes are tied directly frustration and consternation. After 12 down the odds, no matter how long it to the mountains. years in Parliament under both Labour takes or who stands on the other side. “You energise here,” Tame said. and National governments, he has an “It’s the positivity. It’s home, and it’s intimate understanding of the realities Don Rowe is an Auckland-based journalist where the heart is. Every time we of political action. And after all that time, on the staff of The Spinoff. welcome the manuhiri, we’re in the the problems are far from being in

www.drugfoundation.org.nz 19 feature

Enlightenment at the end of the maze

Our Through the Maze symposium in July was a starting point for change. Bringing together world-leading drug policy experts with an enthusiastic crowd of community advocates, policy makers, politicians, clinicians and social justice activists under Parliament’s democratic roof caused a real stir.

The discussion was vigorous and questions The Drug Foundation sends out a big thank Here are some snippets from our were many. By the end of two days under you to our host Associate Health Minister Through the Maze: Healthy Drug Law the Beehive’s staggered roof, there was a Hon. Peter Dunne, the stellar line-up of symposium in July. All the speakers’ palpable sense of optimism that change is speakers and panellists and everyone who presentations are available on our imminently possible. Even if people didn’t joined in, both in person and via the You Tube channel, while The Spinoff has reach a neat agreement on what this may trending #drugmaze17 tag. A special published a great selection of articles and look like, there was much common ground thanks to our fabulous chairperson Alison videos on thespinoff.co.nz. Or find all the to continue building on. Mau and media partner The Spinoff. news coverage on our website.

POLICY MAKERS

As many of you will know, I am a strong In 2011, when we had over 7,000 supporter of the Portuguese approach arrests in Washington State for to drug regulation. It manages to balance simple possession of cannabis, 120 tolerance for low-risk use with clear legal in 2013 is victory enough. Using our and health-focused boundaries. Police officers, our prosecutors, our judges, our jails, our prisons for cannabis is a huge waste of public safety resources. We have much bigger fish to fry, as President Obama said. Our early health and safety Hon. Peter Dunne outcomes are good. We have not Associate Health Minister seen youth use go up, we have not youtu.be/a8LqqsAOt_I seen an increase in auto accident fatalities associated with this.

Tough criminal prohibitions around cannabis, it’s a failure! Prime Minister Trudeau was absolutely clear there were two things that he kept talking about over and over again: minimising harms to young people and taking the illegal market out of the cannabis business.

Hon. Anne McLellan (Canada) Alison Holcomb Former Deputy Prime Minister, Health Minister Author of and campaign director for Washington youtu.be/mPhv0zqKgV8 State cannabis legalisation law youtu.be/VmMVJSTzgy0

20 matters of substance October 17 RESEARCHERS OUR MODEL FOR CHANGE

So because we have a system that is In the end, our proposal comes down chronically underfunded, as a result of to what would you want for your child, the way we perceive drug use, we have partner or grandchild if they were ended up with a system that is inflexible struggling with drug use? Would you to changes to drug use patterns. This is choose a compassionate law that focuses what the changes in meth use have on getting them well, or would you choose taught us. These were pretty sudden prosecution, punishment and a criminal changes in the way people use meth, record? I hope in 20 years’ time we will and our treatment services weren’t be looking back on today and be laughing prepared to deal with them. Not only about the old fashioned ideas we had on do our treatment services receive just Nicole Lee drugs in the same way that today we 20 percent of the drug funding, they’re Adjunct Professor, National Drug Research laugh at the idea that mixed flatting is Institute, Curtin University; Director, 360Edge only funded at half the need that is out youtu.be/ubqUznbvYlE something that is outrageous. there, so we are continuing to implicitly punish people who use drugs.

ADVOCATES

Drug law reform is long overdue. It’s necessary in order to address discriminatory legal responses to Māori and because of the way the current law is applied and enforced against Māori Kali Mercier as a particular demographic in the Drug Foundation’s Senior Advocacy and Policy Adviser youtu.be/R9E5YMhVBsY New Zealand population. Drug law reform must involve Māori and must address our needs. But not just our TREATMENT PROVIDERS needs, also our tikanga, our custom lore, who we are, our ways of thinking, Khylee Quince Governments do find it hard, for better being and doing. Senior Lecturer, Law School, AUT or worse, to actively do things. Maybe youtu.be/GfkDjldaQqc we can ask them to not stop us from doing things. It might make it easier for them, and it means we’ve got to have our ducks lined up and be able to do Policies made here in Wellington it ourselves. This will help us keep our have a measurable impact on families local community engaged. like ours, communities like mine, electorates like mine. And I want to make sure that that stuff’s done right. Every solution needs to be tailored, and it needs to be tailored by us, for us, for our communities. I want to see things that work. I want to see that these things will reduce harm on kids, reduce harm on communities. I don’t Kiri Allan want to tout around politically palatable Labour Party East Coast candidate popular catchphrases because it feels Marianne Jauncey good. I want real solutions. Medical Director, Uniting Medically Supervised Injecting Centre, Sydney youtu.be/DUjtbN07HG8

www.drugfoundation.org.nz 21 Feature

Duterte protest NYC

Photo credit: Vocal-NY Public mood Have Asia’s brutal swing: drug wars hit a nerve?

An erosion of human rights enables the brutal approach to drug policy taken in some Asian countries, says Mangai Balasegaram, but recent teen deaths in the Philippines have sparked massive public outrage, and she asks if this could mark a turning point in President Rodrigo Duterte’s bloody War on Drugs. MANGAI BALASEGARAM

22 matters of substance October 17 t 8.45pm on 16 August, Kian delos All of you who are into Santos was gunned down in a dark, drugs, you sons of bitches, dead-end corner in I will really kill you. the Manila suburb A of Caloocan. He was PRESIDENT RODRIGO DUTERTE yet another statistic in a bloody drug war in the Philippines that has left about 7,000 dead. In the preceding week, 90 people had been killed. There are believed to This death of delos Santos was different. He was just 17, and CCTV footage be almost 900 people on conflicted with the account from Police, death row for drugs in that this was “nanlaban”, a common Malaysia, Indonesia, justification for killing, meaning he Thailand and Pakistan, resisted arrest and tried to fire back. Witnesses told local media that and many hundreds more in a defenceless delos Santos was beaten China, Iran and Vietnam. and dragged from near his home to where he was found dead, curled in the foetal HARM REDUCTION INTERNATIONAL position, with bullet wounds in his ear and back. The last words of the high school student went viral: “Please stop! Please stop! I have a test tomorrow!” Stories of a responsible, caring teenager who got up at 5.30am to help run the family store cast further doubt on Police claims. The tragedy hit a raw nerve. It shook a public largely supportive of the deadly anti-drug crusade unleashed by President Rodrigo Duterte, who took office in June last year promising, “All of you who are into drugs, you sons of bitches, I will really kill you.” Gloria Lai, Asia’s Regional Director for the drug-related crimes. For some, the penalty As the carnage in the streets mounted, International Drug Policy Consortium, says is life. A 2015 report by Harm Reduction Duterte remained defiant. He has dismissed this is reflected in the penalties for drug International noted: “There are believed protests by international human rights offences, systematic compulsory detention to be almost 900 people on death row for groups and described innocent victims of people who use drugs classified as drugs in Malaysia, Indonesia, Thailand as “collateral damage”. “rehabilitation”, high levels of incarceration, and Pakistan, and many hundreds more When, last year, former Justice grave human rights abuses and some of in China, Iran and Vietnam.” the highest rates of HIV and hepatitis C Secretary Senator Leila de Lima quizzed “Shoot them” the Chief of Police about all the dead amongst people who inject drugs. “Shoot them because we indeed are suspects having resisted arrest, she was She pointed out there were also in a narcotics emergency position now.” promptly charged with involvement extrajudicial killings in Thailand’s 2003 This instruction to Police last July on drug in the drug trade and put behind bars. War on Drugs. A government inquiry later traffickers was not from Duterte but from Suspects are always killed in gun found half the 3,000 people killed had Indonesia’s President Joko Widodo, who battles with the Police. Senior Police no connection with drugs. “But the pace, has taken a hard line on drugs since taking officers have told Reuters they are scale and duration of the killings in the office in 2014, refusing clemency for offered US$200 for every drug suspect Philippines far outstrips the 2003 atrocities death-row drug convicts. or “troublemaker” killed. in Thailand,” she said. The United Nations estimates that There are concerns that Indonesia Punishment and prison nearly half a million people are held is heading in the same direction as the The bloodbath on the Philippines annually in compulsory drug detention Philippines. In July, the country’s new streets may be exceptional, but across centres in Asia for “rehabilitation”. drug czar, Budi Waseso, praised Duterte. the region, drug wars, brutality and Human Rights Watch has documented “We have our own laws,” he told Reuters. drug-related executions are not. Drug use abuse, torture, physical and sexual “I have to say, though, that Duterte’s policy is often seen as a moral failure, a social violence and forced labour in centres shows he is taking care of his citizens.” evil, a crime against society deserving in Cambodia, China, Laos and Vietnam. “We’ve seen more killings,” confirmed harsh punishment. In Indonesia, Malaysia, Myanmar, human rights lawyer Ricky Gunawan, In general, Asia has some of the most the Philippines and Thailand, 40–70 adding that the Police recently said they punitive and repressive drug policies. percent of people in jail are there for had shot 40 drug dealers in the first half

www.drugfoundation.org.nz 23 Feature

Methadone maintenance programmes have Professor Dr Adeeba Kamarulzaman, Dean of Medicine expanded rapidly in Vietnam at the University of Malaya

The illegal drug problem should not be reduced to a political or criminal issue. It is a humanitarian concern that affects all of us.

CARDINAL LUIS TAGLE

Photo credit: MMT Vietnam of the year. “There is not a lot of criticism for one year? I don’t think so.” But if measures such as needle exchange and about it.” picked up at a Police raid on a club and methadone programmes. The attitude towards drug users, tested positive for drugs, he said, they In Malaysia, skyrocketing HIV rates he said, was very negative. could be sent for mandatory treatment. among drug users drove the government There have also been more arrests, He said academics, not law to look beyond its punitive policies. raids, forced urine tests, detention and enforcement, should lead the nation’s What also helped was a report prepared imprisonment. Drug users were now response to drugs. “Our drug policy is by Professor Dr Adeeba Kamarulzaman, required to report to Police or face charges. developed by moral ideology. It is not now Dean of Medicine at the University The country is “regressing”, said Edo scientific or evidence-based.” of Malaya, who had recently returned Agustian, National Coordinator of the Cambodia also launched a drugs from Melbourne. Indonesian Drug Users Network (PKNI). crackdown at the start of this year, “We went knocking on doors of He said methadone clinics were being with increased arrests and detentions agencies [dealing with] drug use or HIV … asked to disclose details on clients. in congested prisons, as in Indonesia, Ultimately we went to the highest political “We are worried what they are planning disrupting outreach work for HIV leadership who gave us the go-ahead to to do with that data,” he said. prevention. Critics have said the move, pilot a methadone programme. The nod Human rights abuses have risen which followed a state visit from Duterte, to do a needle exchange programme came sharply, according to a report by the was a distraction from political issues. as a complete surprise.” Indonesian Coalition for Drug Policy In northern Thailand, the authorities In 2015, almost 100,000 injecting drug Reform based on research from nine major cited drugs as the reason behind two users were accessing needle exchange cities. Almost all respondents said they extrajudicial killings and house raids programmes. As a result, HIV infections had been extorted for money or sexual on the Lahu ethnic minority. Human among drug users are now very low. favours, abused or even tortured. Some rights activists have been demanding The “Cure and Care” clinics provide free, described blindfolded beatings, being burnt the truth on the killing of one confidential, voluntary treatment, offering with cigarettes, electrocutions and rape. 17-year-old Lahu activist. counselling, check-ups and methadone to Outreach work is now more difficult. nearly 130,000 people. A study last year “The community are afraid,” said Agustian. A shift towards harm reduction found the rate of relapse among detainees “How can we reduce the HIV epidemic Asia’s harsh drug policies stand in released from government drug detention if people don’t feel safe to access stark contrast to the move elsewhere centres was almost 10-fold higher than health providers?” towards decriminalisation, legalisation among those treated at the clinics. Treatment needs to be voluntary, and medical cannabis. But explosive Vietnam is also shifting away from Agustian said. HIV epidemics among drug users have its compulsory drug detention centres, “They may have a good position, a good begun forcing a shift towards a public known as “06 centres”, which have been salary … and use drugs occasionally, once health approach, and several countries criticised for human rights abuses and a month. Do you think they need treatment have begun adopting harm-reduction have been called “labour camps” because

24 matters of substance October 17 draft, which still has to go through the Lower House, will be amended. We need to support the Thus, even in Asian nations embracing harm reduction, considerable challenges slowly growing number of and barriers remain. There are still voices joining the outcry problems with the Police and plenty against the War on Drugs. of arrests and a lack of political and public support. In Malaysia and Vietnam, SPOKESPERSON FROM NO BOX PHILIPPINES compulsory drug detention centres continue despite the evidence that voluntary treatment gets better results. Stop wasting human lives Around the time delos Santos was killed, two other teens were also found dead. Carl Arnaiz, 19, was shot controversially, and Reynaldo de Guzman, 14, was found in a creek with 30 stab wounds and his face wrapped in packaging spokesperson, who did not wish to tape, a hideous hallmark of the drug be named. Nobox staff have tightened murders. Both bodies bore signs of torture. security. “Given the current environment The teen deaths triggered a public … it’s difficult for anyone to not feel some outcry. Thousands joined protests. kind of fear.” Politicians called for an inquiry. Church Could the teens’ deaths mark a turning leaders spoke out. point in the drug war? Duterte, who has “We knock on the consciences of those enjoyed high ratings, has since softened his who kill even the helpless … to stop tone. But he recently said that the killings wasting human lives,” Archbishop of – which number more than that from any of labour treatment such as processing Manila Cardinal Luis Tagle said in a global terror attack – would continue. The cashew nuts. Some 06 centres are statement. “The illegal drug problem drug war is a central issue for Duterte, who transforming to voluntary centres, should not be reduced to a political has admitted to using the drug fentanyl. or criminal issue. It is a humanitarian and conditions have improved. In the big picture, a nation’s approach concern that affects all of us.” The rhetoric that drugs are a “social to drugs often reflects its state of human The archbishop has called for church evil” is less widespread now. Instead, rights. As drug users are often at the bells to toll every night around 8pm in said a local leader of a community bottom rung of society, they face the protest, saying, “We cannot allow the initiative, “We hear more and more worst human rights abuses. destruction of lives to become normal. often that drug addiction is a disease The Philippines has a long history We cannot govern the nation by killing.” that needs treatment, especially at higher of extrajudicial killings, with activists, “Ever since the recent deaths of the levels [of government].” journalists and communists killed in teenagers – Kian, Carl and Reynaldo – we Following a successful pilot study, previous administrations. have seen a lot of activity and sentiment methadone maintenance programmes have “The difference now is that it’s now from people who realise that these deaths expanded rapidly, and in 2014, they were more widespread to target not just activists are precisely because of how the War on being offered at 127 clinics in 38 provinces. but ordinary people,” said Carlos Conde, Drugs has been carried out thus far,” said Disturbingly, Vietnam saw a slight Philippines researcher from Human Rights a spokesperson from No Box, which provides increase in arrests after Duterte intensified Watch, adding the country has long had community services and advocates reform his drug war. a “serious breakdown in its criminal of drug policies and laws. In Myanmar, a drug law review offers justice system, so impunity and lack “We need to support the slowly hope of a change to the current strict of accountability persist”. growing number of voices joining the Much depends on the vagaries of drug policies. “The new draft law that outcry against the War on Drugs … and to was sent to Parliament proposed to stop political rulers and how they choose to open up the space for honest conversations approach drugs. Nevertheless, there are sending drug users to jail and instead about drugs and the people who use them, deep, long cracks on Asia’s hardline provide them with treatment, which is which has always been missing.” approach to drugs. indeed a big positive change,” said Tom The discomfort around discussing Kramer from Transnational Institute’s drugs is rooted in a “deep-seated stigma” Mangai Balasegaram writes extensively on Myanmar programme. that is “taught to us from the very health and drug use. She won the 2000 Media However, under the current draft, beginning” through education or the Award from Harm Reduction International drug possession is still criminalised. media. “If there’s anything ‘positive’ for reporting on drug use and was featured in “Only drug use itself – detected, for about what’s happening it is that people a UNAIDS book on Asian leaders in HIV/AIDS instance, via a urine test – will not lead are willing to talk about this now and for her work leading AIDS journalism in to a jail term but to treatment, which explore other ways that aren’t so negative Malaysia in the 1990s. would be compulsory.” It is hoped the or … cost so many lives,” said the

www.drugfoundation.org.nz 25 Opinion

Photo credit: Garry Knight, flickr.com

On addiction and the politics of compassion

ental health is I am writing these words to you in early September during notably on the agenda this election the lead-up to the New Zealand General Election. During (and hopefully the short space of time between when I was asked to write post-election). this opinion piece and when I started putting pen to paper, Given our suicide M rate now sits at a two of my friends committed suicide and another nearly heart-breaking 606 overdosed. She woke up cold and alone in her lounge with people in the last year, this focus is long overdue. Faced with the loss of my friends music blaring at 4am, surprised she had woken up at all. and the overdose too, it has made me realise we need to have a very public and brave conversation about mental health – and of course addiction. As is often the case, the two cannot be divorced from each other. Labour has promised to throw $48 million at mental health, and leader CHLOE Jacinda Ardern is tentatively thinking KING about decriminalising cannabis. National

26 matters of substance October 17 has committed $40 million to funding handle, so sitting sober with these addiction services, which would have been The opposite of addiction emotions was incredibly painful – brilliant if this funding wasn’t attached to is connection. Dehumanising, but I survived it. their draconian new crackdown on drugs One of the clinicians told me while and gangs policy announced by Police isolating and eroding the I was there, “There is rarely anyone who Minister Paula Bennett. The terminology human rights of those deeply comes through here who isn’t suffering used in the policy/package title alone involved in drugs isn’t going from trauma and PTSD.” echoes that of the failed War on Drugs, to solve the problem – it Those of us who have addiction issues and it will further criminalise those generally come from hard lives and a lot with addiction issues. In particular, never has. of pain. I wish wider society (including the crackdown is focused on meth and, people like Paula Bennett) would as journalist Russell Brown points out, acknowledge this. “The package … includes a proposed However, the belief goes that if you new charge of ‘wilful contamination’, increase the pain of those with addiction which [is] a doubling-down on the ‘meth through, for example, punitive drug contamination’ boondoggle and represents polices, those with substance abuse issues another way of criminalising people with can be shamed and coerced into stopping. drug problems.” In reality, this erroneous strategy only To compound things, during a press heavier and heavier. It was a combination criminalizes, stigmatizes, and further conference that followed announcement of trying to get through long, hard and lowly isolates those with addiction, further of the package, Paula Bennett said some paid hospitality shifts while managing the entrenching addiction and the impacts gang members had “fewer human rights” depression that often comes when you are within wider culture and communities. than others. Her comments were poor and struggling to find decent work. In Puna, I spent nights drinking coffee widely condemned. But last year, there was a sudden uptick and talking to other people in the house, Tommy Wilson, Executive Director in my drinking, which was brought on and everyone had a story. Some had been of Te Tuinga Whänau Support Services because I was sexually assaulted. I started using for decades, some had only been in Tauranga, put it well when he told the drinking daily to beat back flashbacks and using for a short time, some had lost New Zealand Herald last month that the trauma that I had zero skills to cope with. everything and some were doing current system of criminalising people My drinking quickly became everything they could to hold on to needed to change. unmanageable, and I became desperately what they had left. Notably, most of the “[We don’t need] task forces of police depressed. I started seriously worrying women there were survivors of intimate coming in,” he said. “The secret is to about my health and, if I am honest, my partner violence or rape or both. reconnect them.” life. I got help. I contacted Mahi Marumaru, Puna has a powerful model of recovery The opposite of addiction is connection. which is a peer support addiction and through which people with addiction Dehumanising, isolating and eroding the recovery counselling service offering human rights of those deeply involved in one-on-one counselling in your own home. and trauma can come and rest and aim drugs isn’t going to solve the problem – it Given my level of drinking and depression, for a bit of healing while in a supportive never has. However, National’s punitive my peer support worker suggested I go environment that doesn’t cut you off approach speaks to a wider culture within into addiction respite care, which seemed socially. We weren’t told how to live our Aotearoa, which sees those with addiction a bit excessive to me at the time. But later lives, but we were taught the skills needed as criminals who should be shamed and I relented. I was exhausted, I looked like to maybe live them a little better, bolder coerced into abstinence. shit and I was desperate for help. and braver. However, in Aotearoa, we have strong On a Tuesday morning, my peer Wider society teaches that people and robust (though underfunded) models support worker drove me to Puna like me who are struggling with substances of addiction and recovery that serve not Whakataa, and during my two weeks there, do not deserve help. I made bad decisions only as pathways to wellness but also as I found it a house of aroha, compassion and therefore should be punished for my models of resistance against stigmatisation and learning. It was the first time in my life bad behaviour. These types of pervasive and dehumanisation towards those with I could be honest about how serious my narratives are deeply harmful and are often addiction. These models are based on drinking had become. The level of care written into governmental drug policy. compassion and aroha with peer support within Puna is incredible. You get your They put barriers in place for people who strongly at the core. own room, a chef cooks your meals each actively want help, and they also happen I know all this because I have substance night and the care is 24/7. There is always to be untrue. abuse problems, and as I type these words, a clinician or peer support worker directly Like anyone else struggling with I am six weeks out of a community house on hand to whom you can talk day or addiction, I deserve to be treated with called Puna Whakataa, which is a short- night. They don’t lecture you, they don’t dignity, compassion and aroha. term respite for people with addiction. shame you, they listen to you. Interestingly, alcohol (the drug that does Two times a day, there are classes Chloe Ann-King is a writer and community the most harm in society) has been left out that teach tools to manage cravings for activist who also advocates for hospitality of the new crackdown, though it’s long booze and drugs as well as tools to cope workers and those on welfare. She is currently been my choice of poison. with uncomfortable and tender emotions. training to become a peer support worker in I’ve been a binge drinker since I was I have spent a lot of my life pouring addiction and recovery. young, but in recent years, my drinking got alcohol onto the emotions I couldn’t

www.drugfoundation.org.nz 27 Drug history in new zealand

REDMER YSKA

28 matters of substance October 17 ARTICLE 06

Our cheery, white-coated pharmacists, Committee member and legendarily however, then turned heroin into a runaway punitive Oakley Hospital Superintendent Revenge suburban sensation. What made it acceptable Dr Pat Savage called it “a horrible was the fact that it was readily prescribed indictment of the Gadarene swine-like of the in the form of sweet cough mixture, behaviour of modern youth”. Young users a sure-fire cure for the pesky common cold. were frequently scruffy with long unkempt And boy, did the Baby Boomer parents’ hair, unwashed bodies and living in dirty Hastings generation take to it. By 1947, so much conditions, he claimed. ‘linctus heroin’ was flying out the pharmacy The fatalities didn’t end there. door that a United Nations committee Between May 1972 and 1973, the Incubus publicly demanded that our government authorities recorded 15 deaths, all of the explain. We were said to be among the people in their 20s and mainly in world’s “highest” users of heroin per head Auckland. Without exception, these of population. deaths were caused by overdoses of Redmer Yska traces Chastened officials got out their pharmaceutical opioids, either legally clipboards: “Detailed investigation New Zealand’s history obtained from doctors or sourced in a number of centres and follow up from pharmacy break-ins. of heroin. work with the prescribers … led to an The ‘demand’ side of the equation assessment that not less than 50 persons was now taking shape, and apprentice in New Zealand were dependent on heroin Who knew? In 2014, the do-it-yourself from the cough linctuses which had been users queued in droves to buy the heroin brewed up in local kitchens was prescribed to them.” high-quality Southeast Asia heroin honoured in a glossy volume promoting So out of control were prescribing supplied by the ‘Mr Asia’ syndicate after Kiwi inventions “that changed the world”. rules and systems that the Director of the the mid-1970s. Until the perpetrators were The book, No. 8 Rewired, hailed Public Health Division told his minister: eventually caught, that is. And it is at this ‘homebake’ as the equivalent of pavlova, “Unless sufficient and competent staff are point that the homebake story began. jet boats and electronic petrol pumps: a appointed I cannot take responsibility for As No. 8 Rewired recalls: “By 1979 “bloke-in-a-shed response to New Zealand’s the control of dangerous drugs.” heroin was much more available in isolation”. Authors Jon Bridges and David Officials meanwhile learned to their New Zealand … then the police strangled Downs argue, “Just because it’s illegal, alarm that a group of intravenous opioid the flow … as the 1980s dawned the heroin doesn’t mean it isn’t a classic.” users had emerged in the heartland. addicts were starved of what they needed, The long, mostly hidden and quietly A shopkeeper, a Chinese market gardener and their necessity gave birth to a weird swoony story of the Kiwi relationship and two nurses in Hawke’s Bay were later antipodean bastard – homebake.” with heroin (diamorphine), whether identified as the founding cohort. Health Two Aucklanders with heroin pharmaceutically pure or freshly baked officials imaginatively described them as addictions and a rough knowledge of by local chefs, has rarely, if ever, enjoyed the “Hastings Incubus” (an incubus is an chemistry dug out old university texts. this kind of positive attention. Early last old medieval term for an evil spirit). They concocted a basic recipe for century, local newspapers like Truth A 1970 Health Department report into transforming over-the-counter codeine dubbed heroin “the sleep of death”, illicit drug use noted its manifestation in tablets into sticky morphine that could telling of “dope derelicts”, the hapless the late 1940s: “There is good reason to then be converted into heroin. victims of the “lure of the poppy”. believe that this group initiated in this It stayed secret: the phenomenon of Take this, from 1925: “A drug addict, country the intravenous use of opium crazed people (with long unkempt hair?) and is the hard core of infection of other Thomas Bilcliff, took his last dose of leaping out of cars and clearing pharmacy narcotics abusers.” heroin in Auckland the other day when shelves of codeine seemed to go unnoticed. Officials grappled with what they saw he exceeded his capacity for the drug For a while. In January 1983 came the as the dark handiwork of the ‘incubus’. and never awoke from his last dreamlike first ‘homebake lab’ bust. Over the next In 1968, a 17-year-old died after injecting sleep … he was visited in his room in three years, as 90 more labs were himself in a grotty Grafton flat. More the Waitemata Hotel by … a young man unearthed, our invention was even said deaths followed. The tragedies drew only of 21 summers. It is stated that the first to have crossed the Tasman. It is now muted headlines – but behind the scenes, certified as a Kiwi classic. Really? greeting Bilcliff gave his friend was, health and law enforcement authorities No. 8 Rewired deserves the last word. ‘Have you any dope?’… Bilcliff thereupon were tearing their hair out. helping himself to another dose, and The fatalities occurred just as a “Nowadays it’s not so popular. Codeine is falling fast asleep, passed into the high-powered Drug Dependency and a lot harder to come by since a crackdown Great Unknown.” Drug Abuse Committee sat in Wellington in availability of the standard ingredients The word was out. The 1927 to examine the local pick-up of global in 2010 – well, a very Kiwi-style of Dangerous Drugs Act soon placed drug culture, especially LSD and cannabis, crackdown where you can still buy them, stringent curbs on doctors prescribing linked to the 1960s counterculture. but you have to answer some very probing heroin to people like Bilcliff, though writer Midway through 1968, a telex marked questions first. Iris Wilkinson, herself addicted to heroin, “urgent and confidential” flew between “And the NZ drug scene has another noted in 1932 that doctors were often Auckland’s CIB boss and the shocked and arguably worse scourge to deal conned. It was the vigilant chemists of committee. It talked of an outbreak of with – ‘P’ (otherwise known as New Zealand who were holding “the injecting activity involving “literally methamphetamine). At least we didn’t narcotic habit in check”. hundreds of people in Auckland”. invent that one.”

www.drugfoundation.org.nz 29 Guest Editorial

Drivers of change

he Cabinet table The dramatic advances in tobacco Whakawa¯tea te Huarahi is where the power control – from plain packaging to major is, right? We often increases in excise tax – may have needed roughly translates to a hear that cry from the imprimatur of Cabinet Ministers, fresh start or a new politicians eager to but they had their genesis in the minds pathway to drug reform. grasp government, of backbench Mäori Party MPs Hone T and we hear them Harawira and Tariana Turia. It’s the New Zealand Drug lament that they Now, I write at a time when our can achieve nothing while sitting in new government hasn’t yet been formed, Foundation’s ideal model, Opposition. That is largely true on which will probably have changed by but what hope is there economic matters – indeed, under MMP, the time this is published – but that a Finance Minister can veto an Opposition really confirms my point. We need not that this is the direction measure if it’s deemed too pricey (which necessarily look to Cabinet for creative law makers will take in really means whenever they want). and lasting solutions on drug reform. our new Parliament? But social change is different. It’s That may be a good thing given the a stark but seldom recognised fact that conservative influence likely to be wielded Emma Espiner examines significant social change in New Zealand on the new government, and we’ll address the prospects. has often been driven by backbench MPs, that more closely later. But first the bad often from minor parties. Former Labour news. The diversity of parties and voices MP Tim Barnett never made Cabinet, but that has helped generate social change he did drive and pass profound change under MMP has taken a body blow at on prostitution law reform. He also drove the 2017 election. the civil union changes, which were United Future is gone. Few tears extended into marriage equality by his will perhaps be shed over that. But gone Labour colleague Louisa Wall. In the with it is Peter Dunne, one of the more minor parties, the force for social change thoughtful and knowledgeable Ministers has been just as great. Green MP Sue in the drug reform space in many years. Bradford’s Bill effectively banned the Yes, it took him a while to get there, EMMA ESPINER smacking of children. David Seymour but he was starting to show genuine from ACT has championed the assisted progressive leadership towards more dying Bill, which, while not yet successful, compassionate and evidence-based has put the issue back on the agenda. drug law.

30 matters of substance October 17 The Mäori Party is gone too and with expected to influence policy in this area, QUOTES OF SUBSTANCE it the only independent Mäori voice in is an old-school hardliner on drug issues. Parliament – surely a loss in the debate He’s talked about outlawing gangs on drug issues, which disproportionately (“scumbag low-life gangsters”) and impact iwi Mäori. The Mäori Party had lowering the age of criminal responsibility shown itself willing to engage with to 12. He’s been quoted as offering this a harm-reduction lens, especially in solution to those who sell drugs: “Take challenging punitive and racist laws. these drug dealers off the streets, put them Their primary concern was the in jail and eliminate them.” disproportionate numbers of whänau Now admittedly, this is the rhetoric Mäori with their potential limited by and we are yet to see the policy. The tone drug use, abuse and incarceration. is not encouraging – although it is not all Then consider those who weren’t bleak. New Zealand First has something Can I ask you a booted out of Parliament but never made of a penchant for referenda – remember it in. The Opportunities Party did the unsuccessful 1998 poll on compulsory very massive question – genuinely present opportunities. TOP super? – and now there’s the current it’s a big one... There’s received 48,000 votes, but because of our policy to vote on the abolition of the obviously a lot of pressure curious MMP rules, those people don’t Mäori seats and reducing the number growing in areas about have representation (it’s five times the of MPs to 99. number of votes ACT got, which retains It would be a rich irony if Mr Peters legalising drugs and a presence through the Epsom bolthole). could be persuaded to hold a referendum things like that. What While Gareth Morgan and Sean Plunket on legalisation or decriminalisation of are your individual provided lots not to like by trolling social cannabis. If that were to happen, the polls media users, when it came to drug use, commissioned by the Drug Foundation opinions on that? their ideas had plenty of merit. TOP’s through Curia Market Research since 2016 PRINCE WILLIAM shows more curiosity drug policy was one of the most detailed, suggest Mr Peters would then become the about legalising drugs than most considered and aligned to Whakawätea te unlikely face of cannabis legalisation in leaders in all the monarchies under Huarahi out of any of the parties vying for New Zealand. the Windsor’s family reign. our votes. They are long odds clearly. So who Politics, like nature, abhors a vacuum. else can we bet on to drive change? With these seats empty, the power is Potential champions concentrated. The two major parties hold Not only will this more than 80 percent of the vote. And then During the 2017 Parliamentary Drug trial fail to reduce drugs, Law Symposium, Kiritapu Allan and there’s the guy who holds very few cards it will increase crime – but they’re all aces. New Zealand First Chlöe Swarbrick spoke persuasively leader Winston Peters is the power broker about the need for reform. Both will and drive social division. yet again. As I write this, memories turn be in Parliament. Kiri could have If Parliament wants to back to the interminable coalition haggling influence – and even a Ministerial reduce the social harms position in a Labour-led administration of 1996. But as for New Zealand First’s of drug and alcohol vision on social policy, perhaps that goes – and shows promise as a law maker back even further, to a time the nostalgia with her legal background. addiction, it should spend politician is so fond of: the 1960s and 1970s. Chlöe has a supportive caucus on the money on proven, drug law reform. The Green Party policy The influence of New Zealand First makes recreational use and cultivation of frontline treatment No matter which way the coin lands, cannabis legal – and Julie Anne Genter’s services that work. New Zealand First will have significant medicinal cannabis bill is left to fight DR MARIANNE JAUNCEY, Medical influence over the agenda of any new another day in the new Parliament. Director of Uniting Supervised Injection government. Predicting what New Zealand As for the Labour leader, Jacinda Room in Kings Cross, added her voice First will do is something of a fool’s Ardern wants to increase the use of drug to more than 1,000 doctors, nurses, errand. On the campaign trail, policies courts and also funding for mental health addiction specialists and allied health from the party’s website, faithfully trotted but has been reluctant to say what position professionals publicly condemning plans out by its MPs, were then violently she would take on legalising cannabis to drug test welfare recipients. disputed by the leader, so specifics are even in a conscience vote. hard to come by. Bill English similarly is aggressively But we get the tone. Shane Jones, cautious on these issues, as befits a who may hold a Ministerial warrant again, self-confessed social conservative. has talked tough on the meth trade and Leadership from the top then isn’t told us during the election campaign going to happen in the new Parliament. that he would have liked to “drop a nuke” We look again to the backbenchers for on a Whangarei anti-violence gang event. change – their voices are fewer this time, Ron Mark, who has a strong interest but they are voices that urgently need to in Police and Corrections so could be be heard.

www.drugfoundation.org.nz 31 Viewpoints Cannabis causes 32 deaths each year in New Zealand... Really?

The way we count deaths is vital, as it $3.9 million, it was considered a All drug use has a risk of can directly determine the extent of worthwhile investment. Government can the government’s response to prevent use this metric to set policy priorities. harm, which can include further fatalities. However, when we look at drug-related death. This is often used When a death occurs, the time, deaths, it all gets a bit more complex. location and cause are recorded on a The Ministry of Health’s 2016 Drug Harm in scare campaigns and death certificate, which is then entered Index recorded an estimated 75 deaths as a mechanism for into the national database. If the death per year. The cost of these deaths to is unexpected or the person who died society was calculated at $600 million. discouraging use – but is under 25, a coroner will investigate. Half of that relates to the social cost how frequently does death A forensic pathologist will provide a from premature death and the other half more definitive cause of death and to years of life lived in disability. While occur? Well, it’s much more determine whether it was suicide. this seems like a fairly simple formula, complex than it sounds, Over time, we can compare between further interrogation shows it’s not causes and prioritise resources to reduce so straightforward. with a lot of variation in avoidable deaths across the population. Of those 75 deaths, 32 were attributed For example, fencing pools became to cannabis (this number is from 2012, definition. This Viewpoints mandatory after a high number of children due to delays in releasing coronial data, will argue either side of the drowned in their backyards. Similarly, free and does not include the recent deaths screening for breast cancer (mammograms) from synthetic cannabinoids). Many question: Does cannabis was made available for women over 45 people found this number jarring – how cause 32 deaths each year to enable earlier detection and better could cannabis account for nearly half treatment outcomes for this risk group. the drug-related deaths in New Zealand in New Zealand? Funding is targeted, rather than universal, when you cannot have a toxic overdose to reduce injury and fatalities. from using it? The answer is in how The government’s ‘willingness to pay’ drug-related deaths are defined, coded to avoid a death was infamously set at and allocated to substances. It’s a collusion $3.9 million by the Transport Agency between technical systems, common in 2012. This number was developed as definitions, physiological aspects and a guide for roading projects such as philosophical underpinnings, which pedestrian crossings – if it was expected makes this number contentious and to save at least one life and cost less than open to legitimate challenge.

32 matters of substance October 17 a to considering accidents. isfound Ifsomeone Contributing problematic causeisalso when it’sso abettercomparison. understanding of what adrug-related deathis, and amphetamines canshut thebody down In contrast, anoverdose of opioidsor or physical harmisunlikely, while poisoning mostly comes from heavy long-termuseandis Cannabis doescauseharm, buttheharm and inaccurate. drugs were amore direct causeismisleading were course, butconflating deaths where drugs bemeasuredOther harmsshouldalso of criteria usedtocountdrug-related deaths. overdose shouldbetheonly definitionor drug priorities. andsubsequent policy Toxic This cause No –cannabisanditsderivatives donot this systemisintentionallybroad.Itcaninclude The wayadrug-relateddeathisdefinedunder use andharmexperienced. when considering harmful illicit and MDMA)aredeemedtobethemost (including cocaine,methamphetamine Cannabis andamphetamine-typestimulants Office onDrugsandCrime(UNODC). based onrankingsusedbytheUnited Nations and stimulants, 10toopioids amphetamine-type different drugtypes–32 by The is responsiblefor32deaths peryear. cannabis According tothe2016HarmIndex,yes–

traffic accident, drug useisassumed to

death isunheard of. have drugs intheirsystem atthetimeof the MinistryofHealthwereallocatedto

THE CASE THE CASE

75 overall drug-related deathsrecorded one to hallucinogens. This allocation was was allocation one tohallucinogens.This

cause death. This more closely our matches FOR AGAINST number distorts theharmprofilenumber distorts of the

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to bothcannabisand deaths were from illicitdrugs, like heroin, UNODC datatellsustheonly opioid-based suggests thefigure iscloserto38annually. in Only of validitythe lack inthiswhole dataset. demonstratessedative-related deathsfurther The massive under-reporting onopioidand distinctions ornuance tobebuilt in. does notcurrently allowfor any cause ortoxic effect, asthecodingsystem to distinguish between particularly contributing around what thenumber meansand It’s essential toprovide significant information society, thisnumber becomeseven lessuseful. less toxic usedin orpotentpsychoactives consider thatcannabisisactually oneof the different levels of impairment. And when we ‘over’ A room of peoplecouldallbetechnically actually agood indicatorof behaviour. know to beyond adoubt. Different peoplerespond have different substances. a way to main this numberwasdistributedbetweenthe Because onedeathcaninvolvemultipledrugs, a contributingcauseofdeath. on thedeathcertificateasunderlyingand/or deaths peryearwhereillicitdrugswererecorded was fittedintothisformula,whichmeasured75 The rateofdrug-relateddeathsinNewZealand used where considers is toxic overdose,accidentswhensomeone

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legal ve tied backtothewillingnesspayformula. of theissue,allowingforaresponsethatcanbe for By usingcontributingcauseasthemeasure of afatalheartattack. factors areconsideredtobecontributingcauses significantly. Inthesameway,generallifestyle would to methamphetamine use,wewouldexpectthat attack threeyearsafterstoppingtheir as caused bycontinuedmethamphetamineuse linked tolong-termuse.Takeheartdamage cause anacutetoxicoverdose,thereisharm the drug $1.8 billioncostthatisattributed toillicit prioritise policiestoaddress thesubstantial extracted. This isessential aswedevelop and or death substance may have contributed toeach be systemweuseshould reporting Whichever reducing heavy useover alongperiod. treatment focus actually needstobearound time,by usingtoomuch inashort when our deaths suggests thatcannabisharmiscaused drugs combined. What’s more, thefocus on from priorities. Current figures imply thatharm related deathsto others isthatitdistorts The problem with falsely comparing cannabis- cannabis lookmore harmful thanitreally is. this the in pharmaceuticals were not even considered much New but The numberofcannabisdeathsisreflective

the data, which dramatically underplays an be attributedtothecauseofdeath,asit

underlying causesandhowthedatawas very clearabout howmuch aspecific

cannabis deaths,wegetasenseofthescope

harm causedbycannabis.Whileitcannot number of deathsandrelated harmfor actually heroin isvery uncommonin group of substances. Inturn, thismakes

use inNewZealand every year. Zealand –pharmaceuticalsare cannabis isalmostequaltoallother example. Ifsomeonediedfromaheart

more widely used. Despitethat, – includingtimeframes, contributing have increasedtheriskofheartattack www.drugfoundation .org.nz 33 Country model

taggered by the size and visibility of the problem and seemingly out of options, Swiss authorities sat down with S community and civil society workers to find a solution that sought to manage drug problems rather than declare war on them.

The four pillars Switzerland’s national drug policy, introduced in the 1990s, comprises four pillars: prevention, therapy, harm reduction and prohibition. Though experimental and radical, results spoke for themselves, and Population: the Swiss public voted the approach into law in 2008. The number of drug users in treatment rose dramatically. By 2004, drug-related deaths 8.5m had reduced by 50 percent and deaths related to HIV and hepatitis by 90 percent. Effective approaches under the four pillars included needle exchange programmes, medically supervised injecting rooms and free substance-checking at festivals. Possession of up to 10 grams of heroin was decriminalised in 2013. The model’s seemingly contradictory components are one of its strengths, allowing for different approaches under a shared vision. Prohibition conforms to international drug treaties, while other pillars allow for emerging harm- reduction initiatives.

Heroin-assisted treatment (HAT) Switzerland introduced HAT in 1995, Cheese, chocolate, watches – and now more than 70 percent of Swiss people addicted to opiates are in substitution therapy. Those for whom and heroin-assisted treatment methadone and other therapies don’t work receive prescribed heroin. Within a year, it was noted that HAT participants carried out 55 percent fewer vehicle thefts and 80 percent fewer muggings and burglaries. The numbers Switzerland of drug dependent people dying fell dramatically, and a third of those By the 1990s, Switzerland had the highest injecting drug receiving welfare found jobs. and HIV infection rates in Europe. Its first attempt to Why does HAT work? Rather than patients asking for increasing contain the problem was to declare Platzpitz Park in amounts of free heroin as may be expected, Zurich as somewhere heroin users could inject free from once they have gained some stability and returned to reality, they seek to start reducing arrest. Up to 3,000 users visited ‘Needle Park’ daily, and it their daily doses. People rediscover quickly became a cesspit of misery, crime, filth and death. themselves and other meaningful aspects of life. The average patient spends three

34 matters of substance October 17 years on the programme, and by the end DEATHS DUE TO DRUG USE IN SWITZERLAND FROM 1974 TO 2004 of that time, only 15 percent are still 450 taking heroin daily. 400 It disrupts the drug-selling pyramid. Deaths due to drugs 350 Deaths due to AIDS among People with heroin dependency no longer people who are presumably infected by injecting drugs cut what they’ve bought with harmful 300 powders and on-sell it to finance their 250 own drug use. This also helps reduce 200 initiations to heroin use. 150 The clandestine rituals and ‘us versus them’ 100 culture around heroin use, attractive to 50 some, has disappeared, further reducing 0 new initiations. 1974 1976 1975 1978 1979 1977 1997 1991 1981 1987 1995 1993 1985 1992 1983 1982 1994 2001 1999 1989 1998 1984 1996 1986 1988 1990 1980 2003 2002 2004 2000

Is this relevant to New Zealand? http://beckleyfoundation.org/wp-content/uploads/2016/04/paper_18.pdf While the particulars of the HAT programme may not apply to New Zealand, COMPARISON OF HEROIN USE IN DEATHS DUE TO DRUG USE AND AIDS AMONG the principles of public health programmes VARIOUS COUNTRIES DRUG USERS FROM 1985-1999 like this are relevant. The seemingly radical Switzerland Australia 450 1.0 idea of making heroin supply more accessible 400 in prescribed circumstances, combined 0.8 350 with health and social interventions, 300 0.6 has led to big health gains in Switzerland. 250 0.4 This includes reduction in overall use. 200 The same principles behind HAT can be 0.2 150 used to find solutions to problematic 0.0 100 methamphetamine use here. England Italy 50 1.0 0 1997 1991 1987 1995 1993 1985 1992 1994 1999 1989 1998 1996 1986 0.8 1988 1990 Deaths due to drugs Deaths due to AIDS among drug addicts 0.6 Since Switzerland introduced its programme in the Incidence of heroin use per 1,000 population heroin Incidence of 0.4 mid-1990s, deaths due to drug use and deaths due to AIDs among drug users have declined steadily. 0.2 Source: Swiss Federal Office of Public Health 0.0 http://www.tdpf.org.uk/blog/heroin-assisted-treatment- 1980 1990 2000 1980 1990 2000 switzerland-successfully-regulating-supply-and-use-high-risk-0 Year The consumption room is http://beckleyfoundation.org/wp-content/uploads/2016/04/paper_18.pdf the best tool I have to ensure public safety in Bern. MANUEL WILLI, BERN CHIEF OF POLICE

We had to change francs daily cost per perspective and introduce HAT recipient the notion of public health. 35 We extended a friendly hand heroin distribution of HAT recipients are to drug addicts and brought 23 centres (including two 25% women them out of the shadows. in prisons) RUTH DREIFUSS, SWISS PRESIDENT AND francs daily cost to INTERIOR MINISTER 1993–2002 people receiving HAT 44 arrest, try and convict 1,500 at any one time drug users

Prescription isn’t an new cases of heroin years average stay on addiction yearly, alternative to stopping your >150 3 the HAT programme down from 850 drug use. It is – for many – number of people on the a path to it. of HAT recipients >15% HAT programme who JOHANN HARI, AUTHOR OF CHASING THE SCREAM: >15% now have HIV relapse into daily use THE FIRST AND LAST DAYS OF THE WAR ON DRUGS.

www.drugfoundation.org.nz 35 Prevention & education

DID YOU KNOW: METHAMPHETAMINE While no use is safest, use these videos to explore the facts before discussing options.

but Some Methamphetamine people will is a stimulant that Did you know that… start using can be found in Methamphetamine use Methamphetamine many forms. The right message: is very uncommon in to help deal New Zealand. Only with things. 0.6% of secondary school students have reported ever using Meth, and half of those had only However used it once. it can be Engaging teens and young people highly addictive and expensive

HOW IT WORKS

It speeds up the body, and affects the reward pathway in the brain.

This pathway uses dopamine to make a person feel good when they are doing things like eating, having fun, or hanging out with friends. These feelings don’t last, and are usually followed by a nasty comedown with cravings for more. Meth forces the release of dopamine in the brain, to create feelings of pleasure and confidence. Methamphetamine can change how your brain Using Meth in large experiences things amounts or for Physical signs of Methamphetamine like excitement, a long time may use include enlarged pupils, itchy affect your decision- lead to paranoia, skin, increased energy, making, attention, hallucinations, and AND appetite loss learning and memory aggressive or violent behaviour.

ALSO being hyperactive, and very talkative.

Sharing equipment also increases chances of infection.

Want to find support for a So. Stop and think…. young person in New Zealand? Call the alcohol and drug • Is this me? helpline on 0800 787 797 • How is my use affecting the people around me? • And remember, always look out for your mates. Funded by Counties Manukau Health

drugfoundation.org.nz/didyouknow Honest conversations about drugs

issing study or limited understanding of how to make Problems with alcohol or other drugs usually work, fights, changes and what support was available. start early in life. Research tells us that half blackouts, risky sex Many young people thought that a person of all New Zealanders with a substance and relationship their age could just stop drinking if they dependence were already dependent by difficulties are some wanted to. the time they were 19. “It became clear that the young people of the problems We also know that three in 10 students are New Zealand most in need of support for alcohol were likely to have already tried alcohol by the M teenagers and the least aware of what they could do to time they are 13. By 17 years, seven out young adults experience from alcohol. make changes and why someone could of 10 students will be currently drinking. According to a study carried out last year, need a support service,” Ben says. “That’s the most high-risk young drinkers take these particularly worrying, because if a person This means that having an early, calm and things for granted. They believe experiencing doesn’t believe they have a problem, it’s open conversation about alcohol and other some problems from alcohol consumption very difficult to help them address it.” drugs could make all the difference to is normal at their age and that only ‘older’ With funding from the Health a young person’s future. It gives them people have a problem with drinking. Promotion Agency (HPA), the group has confidence that, if something comes up, The study was carried out by US social been running a series of workshops to they can talk to you about it. change group Rescue Agency, who worked identify which messages would best The Drug Foundation has expanded the with a group of New Zealand health and resonate with teenagers and young adults popular Did You Know? series, which help social support organisations, led by the nationwide, particularly those most at risk. adults talk to young people about alcohol AoD Provider Collaborative, to identify The project is being supported by and other drugs. A new methamphetamine teenage and young adult ‘peer crowds’ a specialist advisory group with video and poster have been released, with in New Zealand with similar interests, representatives from public health, the synthetic drug resources due out later attitudes, lifestyles and behaviours. alcohol and other drug sector, the Drug this month. The Did You Know? series The research is being used to inform Foundation, Home Care Medical and HPA. was commissioned and directed by the a range of youth-focused projects. Ultimately, says Ben, they hope to develop AOD Provider Collaborative (supported by The Drug Foundation’s National Youth a person-centred intervention system for Odyssey), the New Zealand Drug Foundation Services Advisor Ben Birks-Ang says the teenagers and young adults, using clear and and Counties Manukau District Health Board. peer crowds study confirmed that young consistent messages to help young people It was developed by Mohawk Media using people were not engaging with health identify early when alcohol is causing characters created by Möca, and all messages about alcohol. Even if problems problems and then easily make changes resources are freely available from the from drinking were identified, there was themselves or seek out support. Drug Foundation website.

36 matters of substance October 17 Q & A

the other board members have, so I wanted to me that affluence acts as a kind of buffer to be very sure I’d be a valuable addition. from the negative connotations around We know that young people are highly drug use. I believe that the system does likely to use drugs (77 percent of young currently treat people from different groups Kiwis have used illegal drugs by the age differently, there is not one rule for all, of 25), and we see too many young people and that unfairness is one of the things being harmed as a result of drug use, that has led me to advocate for change. ranging from employment issues to Q Do you bring a feminist lens to your convictions, right through to serious analysis? What does this add? physical and mental harm. Over the past few years, my thinking around substance A I bring a feminist lens to most things use has changed rapidly, and it’s clear to in life, as anyone who knows me can me that our existing frameworks aren’t testify to! In this case, my feminist lens is working. In the end, I joined the board particularly intersectional. While young because I believe that the War on Drugs men seem to bear the brunt of the negative has failed abysmally and that we need to publicity surrounding drug use, it’s drastically update our approach. I see the generally young, poor, brown men who Drug Foundation as being a key driver of are demonised the most. Young mothers that important change. using drugs also fare particularly badly in the public conversation – especially if they Q What change would you like to see? too are poor and brown. I believe that the A I would like for us to reorient our discussion needs to go much deeper than thinking around substance use so that it’s it currently does. We need to ask questions a health issue rather than a justice issue. like: Why are people using drugs? What’s Punitive policies demonstrably do not going on in their lives that may be leading work, and while the issue of drug use them to become dependent on substances? is seen in a criminal context, it’s very What is the bigger picture? – and most Lizzie difficult to have an open discussion about importantly: How can we help and the issue. I hope that we’ll see significant support them? legislative change over the next decade. We also need to demand answers from the justice system. When Mäori are Marvelly Q How has growing up in Rotorua, then convicted of crimes at a higher rate than working as a musician and now in the Päkehä for the same offences, we have Nga¯ti Whakaue media shaped your views? some serious work to do. When Mäori A When I was a young person in Rotorua, are over-represented in our prison cannabis (or weed, as we called it) was population, we need to be asking some fairly common, and the vast majority of probing questions. my peers experimented at some point Q How do you stay calm/focused in a sea The Drug Foundation’s during their teens. Party pills (“legal of rage (especially online)? newest board member highs”) were also popular, but less so than weed. Alcohol was obviously the A I’ve got better at handling online abuse brings rich experience most common drug and has remained so and rage over the last year or so, but it still from the worlds of music, in every context I’ve witnessed. When I remains an exhausting part of my everyday received a scholarship to go to boarding existence. I think the main thing I can take media and social change. school in Auckland, the drug use I away from living in a reality in which me encountered was markedly different, sharing an opinion generates such an Lizzie is a musician, editor, and many of my peers took MDMA most intense backlash is that I’m having an NZ Herald columnist and weekends. I knew quite a lot of people impact. Standing up against sexism, racism who experimented with LSD during my and other forms of discrimination and inspiration for a generation university years, and during my time in the injustice has never been easy, but the of women. Q&A posed music industry, both here in New Zealand stakes are so high that I see it as my and overseas, I was surrounded by cocaine. responsibility to keep rocking the boat. a few questions to her The differences between these situations Q Apart from a public health approach stand out quite markedly to me. to drugs, is there anything else While a number of youth in Rotorua were New Zealanders should be getting demonised for smoking weed, MDMA use fired up about? Q Why did you become a member of the among Auckland private school students A How long have you got? Kidding. Drug Foundation board? was barely mentioned. Cocaine use in the Personally, I’m fired up about our horrific A I decided to join the board mainly entertainment industry was glamorous and sexual violence rates, the stubborn pay because of my passion to empower normal. The double standards continue to gap and the fact that thousands of Kiwi young people. My decision only came this day. children are growing up in poverty. It’s after thinking about whether I was the It’s fair to say that, for my generation, drug time for us to face up to the tough issues right candidate and what I could do to use is largely normalised, with most of us to make our wonderful little country help. I don’t have the kind of background having experimented while young. It seems a better place.

www.drugfoundation.org.nz 37 Whakawātea te Huarahi A model drug law to 2020 and beyond

Whakawātea te Huarahi means clearing the pathway forward. But our model drug law is just a beginning. We’re talking deep, lasting change.

Do you want to be a catalyst for change? Here’s what you can do:

1 Let us know what you think at http://nzdrug.org/drug-law-2020

2 Have your organisation endorse the model drug law

3 Host a discussion

4 Talk to your MP about why this is important

5 Write to the editor of your local newspaper