Can addiction services cope with drug law change?

The Government has made mental health and addiction a priority for its first Wellbeing Budget, due later this month. Laura Walters reports on experts' reservations about whether it will go far enough.

As the Government plans to effectively decriminalise the personal use of all illicit drugs through directed police discretion, those working in the addiction sector are sceptical about whether the Wellbeing Budget will deliver what’s needed to address the influx of clients.

The Misuse of Drugs Amendment Bill is the Government’s initial response to the nationwide drug epidemic.

Jacinda Ardern and her Government have promised to take a health approach to drug addiction, rather than treating it as a criminal justice issue.

“The changes create a presumption from prosecution to non-prosecution for all drugs, and for all users, and we think that's too far.”

When the country learned 50 people had died from using synthetics, then-Acting Prime Minister Winston Peters kicked the response into gear. Almost a year on, the first major legislative change to the way the country deals with illicit drug possession and use is on its way through Parliament.

Many believe a change can’t come soon enough. A full reform of New Zealand drug law, including repealing and replacing the Misuse of Drugs Act with a law administered by the Ministry of Health, was recommended by the Law Commission in 2011.

Since then, many have continued to advocate for widespread drug reform, but are supporting the current legislation as a step in the right direction.

New Zealand's drug epidemic

On Wednesday, Coronial Services said the number of confirmed deaths from synthetics had risen to nine, plus 54 cases where the cause of death was suspected to be synthetics, and a further 20 deaths where synthetics contributed to the death, but was not the direct cause. That takes the death toll to 83.

Meanwhile, results from the first nationwide wastewater testing programme have found the average weekly use of the detected drugs has an estimated street value of $9.6 million. This is estimated to generate about $500 million in criminal profit annually.

Methamphetamine is the most commonly detected illicit drug, with about 16 kilograms consumed on average each week, across the country. Police say this translates to more than $20m in social harm per week, and more than $1 billion a year. The wastewater testing does not extend to the chemicals used in synthetics, or cannabis.

De facto decriminalisation 

The Misuse of Drugs Bill is a de facto decriminalisation of personal possession and use.

National Party drug reform spokesperson Paula Bennett is critical of the bill, saying this type of change should not happen without thoughtful discussion and debate – a position Police Association head Chris Cahill supports.

Meanwhile, Ardern denies the legislation – should it pass in its current form – is effectively decriminalising all drugs regulated under the Misuse of Drugs Act.

While the issue of possession remained within the Misuse of Drugs Act, and police had the power to prosecute when there was a public interest, they would do so, she said.

But experts who spoke to the Health Select Committee on Wednesday all said the way the law was written meant it was difficult to think of a scenario where possession for personal use – rather than possession for supply for personal gain – would result in a prosecution if police were to follow the current direction in the proposed legislation.

Police Association head Chris Cahill said the wording of one of two key clauses essentially directed police not to prosecute, which he referred to as “compulsory discretion”.

The bill categorises the two main chemicals used in synthetics as Class A drugs, joining the likes of meth, heroin and cocaine, and ups the penalties for those supplying and manufacturing those drugs to recognise the harm caused to communities.

Chris Cahill says the Police Association doesn't have a specific view of whether drugs should be decriminalised or not, but decisions like this needed a proper public debate, followed by good legislation and resources for enforcement. Photo: Lynn Grieveson

Meanwhile, it tells police a prosecution should not be brought in the case of possession for personal use unless there is a public interest. When considering whether a prosecution is necessary, they should consider whether a health-centred or therapeutic approach would be more beneficial.

Law Society representative, and prosecutor, Chris Macklin said he could not think of an example where a sound case could be made for prosecution being more beneficial than treatment, when looking solely at possession and personal use.

Meanwhile, the Police Association’s Cahill said he understood the reason for the proposed law but believed this went too far.

“The changes create a presumption from prosecution to non-prosecution for all drugs, and for all users, and we think that's too far.”

He said a robust debate was needed before essentially halting prosecutions for the possession of all drugs for personal use, and he pointed to the referendum on cannabis legalisation in 2020.

However, the difference between the way the two issues had been approached could be explained by the urgency of the synthetics issue, and the need to immediately reduce harm in communities.

Legalisation of cannabis, meanwhile, was more of a discussion around New Zealand values, and was less urgent in terms of social harm, and pressures on the health and criminal justice systems.

Law no good if services don't exist

The committee heard over half of synthetics users were living rough; the majority are unemployed, and over half are Māori.

Many were using harmful drugs, knowing the effect, in order to escape their difficult realities.

Experts painted a picture of users being some of the most vulnerable Kiwis, and said wraparound services including housing and mental health and addiction treatment were needed if the country was truly going to address the issue.

However, addiction services are already under pressure, and the law change was expected to add to that strain.

Sam McBride from the Royal Australian and New Zealand College of Psychiatrists said psychiatrists were anxious about the ability to meet demand. Resources were already under strain, and while services existed, they would need to upscale their workforce and presence across the country.

To add to the issue, there was no requirement in the current bill for services to be available before police could make a referral.

"Referral to health services are great, if those health services exist."

In some rural areas – where rates of drug use and addiction were high – there was a lack of services, which called into question the workability of the law.

If police referred people to health services, but treatment wasn’t available and there was no follow-through, harm would continue, and trust in police’s ability to make discretionary decisions would be eroded.

The Police Association's Cahill pointed to a case in Kawerau where this happened.

“Referral to health services are great, if those health services exist,” Drug Foundation executive director Ross Bell said.

“It’s kind of pointless in making claims around wanting to treat drugs as a health issue, and doing some tinkering around a drug law, without backing that up with resources, intervention, education and treatment.”

In order to meet expected demand, Bell estimated the alcohol and drug treatment services budget needed to double – that’s a further $150 million.

The Government has made mental health and addiction a priority in its first Wellbeing Budget, to be delivered at the end of the month.

A massive spend in this area is expected in order to implement recommendations from the Inquiry into Mental Health and Addiction.

However, there was scepticism from many in the room on Wednesday, as to whether the Budget would be able to not only meet current demand, but improve the way the country dealt with the growing number of people who needed these services.

There are clearly big expectations on the Wellbeing Budget, from many sectors, and Bell said he was “really nervous" the Government wouldn’t meet expectations. "And if they don't they will face criticism quite widely, and quite correctly," he said.

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