‘Ludicrous’ policy will drive addiction services backwards

Threats and forcing people further into poverty will make it harder for those with addiction problems to get help, writes Victoria's Dr Fiona Hutton

Well, you can tell there is an election looming, as politicians run around in ever decreasing circles, tightening the noose on some of New Zealand’s most vulnerable people, including beneficiaries who use drugs. Under National’s proposed policy, beneficiaries who refuse to attend drug rehabilitation sessions face having their benefit halved, with many beneficiaries already facing benefit reductions if they fail or refuse to take a drug test.

All highly concerning, given research demonstrates that forced treatment for those with problematic drug use is not helpful, that coercing into treatment those who are not addicted is unethical, and that the most helpful approaches for those who have problems with their drug use are non-judgemental, harm-reduction services such as needle exchanges. These services can also offer pathways into rehabilitation and other support.

Why not back these approaches with the money promised to ‘get tough’ on drug-using beneficiaries, instead of ploughing it into things we know are ineffective? A holistic approach to health-related issues such as drug use is the most productive; threatening people and forcing them further into poverty will make it harder for those with addiction problems to get help, and will further marginalise an already vulnerable section of society. In another policy announcement, National has said it would boost spending on drug treatment and education, so why not add the money for drug testing beneficiaries to this initiative?

I’m also puzzled (as well as concerned) about the reference to ‘treatment’ for recreational drug users – why is this group seen as in need of treatment? Those who use drugs recreationally (at the weekend, for pleasure and leisure, rather than in a dependent or addicted way) do not need treatment. By definition, their drug use is not a problem, and does little if any harm to the user, those around them or the wider community.

This policy is ludicrous, as well as a waste of tax-payers’ money – do recreational users of drugs like alcohol need ‘treatment’? Those who drink four glasses of wine a week, for example? Of course not, so why do we insist on such punitive measures for those who recreationally use other drugs such as cannabis, ecstasy or amphetamines?

So why are we pandering to punitive populist notions instead of following an evidence-based path toward reducing drug harm among some of our most vulnerable citizens? Oh yes, I forgot, it’s an election year.

Drug testing beneficiaries is not new (although the focus on beneficiaries aged 17-25 and the demand for forced treatment/rehabilitation is). It has been in place since 2012, but its effectiveness remains devoid of evidence. What has the drug-testing regime demonstrated? That all beneficiaries are rabid drug users, squandering the generosity of taxpayers in illicit, seedy dens of iniquity, shoving drugs down their throats at a pace unequalled by anyone else in society? Quite the contrary.

Of 8001 beneficiaries sent for testing in 2012/2013, only 22 failed the test or refused to take it, a rate of 0.27 percent. It appears the state paid around $1 million to a drug-testing company to test beneficiaries who gave clean results.

More recently, 466 beneficiaries failed or refused to take drug tests over the last three years. Going on Ministry of Social Development estimates, that amounts to 466 out of around 32,000 tests a year (some 96,000 in total), a rate of about 0.49 percent.

I can’t help but wonder if these results would be replicated in the wider population?

And, of course, pushing punitive policies such as drug testing falls into the trap of believing the myths about testing. For example, a positive drug test cannot tell whether the person is intoxicated or affected by the drug at the time of the test, just that (in the case of cannabis) they may have taken it in the last two to three weeks. It also cannot tell whether the person is dependent on or addicted to that drug, or the amount of the drug that has been used.

In sum, drug tests are unable to tell whether use of the drug detected would have had any effect on the beneficiary’s ability to search for work or their suitability for a particular job. They are utterly useless in this respect, so why is National proposing to spend a large sum of money intensifying drug testing for this section of the population? Although I’m betting the drug-testing companies are rubbing their hands together with glee at the prospect. 

The evidence also shows that drug-testing regimes increase harm from drug use, as they encourage ‘drug switching’ to illegal and legal drugs that stay in the system for a shorter amount of time or cannot be detected — but are often more harmful drugs. Synthetic cannabis, for example, is one of the drugs popular among those scrutinised in this way, as are other drugs such as ecstasy and amphetamines.

So why are we pandering to punitive populist notions instead of following an evidence-based path toward reducing drug harm among some of our most vulnerable citizens? Oh yes, I forgot, it’s an election year.

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