Health Research – Major report recommends safer drug laws to combat rising harms

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Source: NZ Drug Foundation Te Puna Whakaiti Pāmamae Kai Whakapiri

A major new report proposes evidence-based reform to New Zealand’s drug laws in response to growing drug harm that the Drug Foundation says will worsen without action.  ref. https://drugfoundation.org.nz/topics/policy-and-advocacy/safer-drug-laws?mc_cid=91522b36a3&mc_eid=19a223383c )

Safer drug laws for Aotearoa New Zealand, released by the Foundation at Parliament this morning on the 50th anniversary of the Misuse of Drugs Act 1975, examines the impact of New Zealand’s drug laws and the growing evidence of law reform efforts overseas.

Executive Director Sarah Helm says the law has been a major driver of harm while outlawing interventions that could help.

“The evidence shows that our drug laws have exacerbated addiction, overdose, deaths and criminalisation,” she says.

“In the past 12-18 months alone, we have seen methamphetamine and cocaine use double, new potent substances enter the drug supply, communities overrun with drug harm, and 3,000 New Zealanders criminalised for cannabis consumption.”

“Our drug laws are unsafe and the status quo is untenable – things are only going to get worse if we fail to act. We do not want to end up with the kinds of drug issues being seen in North America.”

“It is hard to see how any of the MPs who ushered in the Misuse of Drugs Act fifty years ago would consider what’s transpired since to be anything but a colossal failure,” Helm says.

The report paints a grim picture of the law’s impact:

  • Drug-related deaths have risen steadily, reaching nearly three fatal overdoses every week in 2024
  • Chronic harms such as substance use disorder have increased, with services under increasing strain
  • The global illicit drug supply has become more volatile and toxic
  • Māori have faced disproportionately severe impacts, accounting for more than half of those imprisoned for drug offences in 2023 and suffering a fatal overdose rate twice that of non-Māori.

The report pulls together evidence from a wide range of law reform models and harm reduction interventions implemented internationally, including 34 countries and 36 sub-jurisdictions that have decriminalised cannabis use, and 22 countries that have decriminalised all drug use.

Helm says that after careful consideration of the evidence, decriminalisation of drug use, coupled with significant investment in health and harm reduction services, has the clearest evidence of success – offering a reduction in problematic use in particular.

“Portugal’s two decades of experience of decriminalisation is compelling,” she says.

“Overdose deaths fell dramatically, HIV transmission rates plummeted, and the burden on the criminal justice system was eased, all without an increase in drug use. Portugal now has one of the lowest rates of drug-related deaths in the EU.”

A poll commissioned by the Drug Foundation in 2022 found that 61% of New Zealanders supported ‘removing penalties for drug use and putting in place more support for education and treatment’. 68% supported ‘rewriting the Misuse of Drugs Act and putting in place a health-based approach’.

Helm says a big factor in Portugal’s success was that decriminalisation was coupled with substantial investment in health support and harm reduction.

“Our report is very clear that any law reform efforts must be coupled with significant investment in support, including ringfenced funding for services designed and delivered by Māori, who have experience the greatest harm from our current laws,” she says.

The report also recommends a new regulatory framework that would empower a health agency to licence harm reduction interventions (such as overdose prevention centres, safer utensils and more flexible drug checking).

“At the moment the law prevents us from implementing many life-saving overdose and harm reduction measures that would reduce social and health costs upstream. We shouldn’t have to go through a lengthy legislative process each time we want to put common sense life-saving measures in place.”

“We need a responsive and flexible regime that gives an appropriate health agency the power to monitor the evidence and make decisions at arms-length, with clear goals to improve health outcomes.”

The report suggests that a similar framework could be used to enable future regulation of lower-risk substances where there is growing harm or new evidence.

It shows that regulated access to cannabis can work, but design matters.

“The evidence was clear that commercial models don’t work,” says Helm. “They are successful at displacing the illicit market, but overall drive up health harms.”

“Not-for-profit models implemented in Malta, Uruguay, and more recently Germany, have been shown to displace the illicit market without introducing some of the less desirable outcomes we’ve seen from more commercialised legal models in North America.”

“For other lower-risk substances, the evidence for regulated supply doesn’t yet exist, so we have stopped short of recommending this, but we recommend shifting to a more flexible legal framework that would allow us to assess emerging evidence on a case-by-case basis. What may seem out of the question now might change in the future with a rapidly changing illicit drug market, and having options to respond will be important.”

Helm says that no one has all the answers to drug harm, but the report pulls together the latest evidence of what has been shown to work.

“The reforms we suggest are not about liberalisation – in fact they offer the opposite: regulation, safety and control,” she says.

“We are realistic – we don’t expect these recommendations to be picked up from day one, but we hope that they help inform decision-makers and are the start of a conversation. Everyone can see that the status quo is completely untenable – we need to do things differently.”

“We are really pleased to have the Cross-Party Mental Health and Addictions Wellbeing Group receiving the report today.”

The report was developed with the generous support of the Michael and Suzanne Borrin Foundation.

Report overview:

Chapters:

·       Chapter I (Misuse of Drugs Act 1975 in action) uses national data sources to examine drug use, harm and justice responses that have occurred under the Misuse of Drugs Act, including:

o   prevalence of substance use

o   health statistics (fatal overdose, poisonings, and substance use disorders)

o   criminal justice measures (convictions and charges)

o   illicit market measures (drug seizures, availability, and price)

o   limited social indicators

·       Chapter II (Law Commission review of Misuse of Drugs Act 1975) reexamines the 2011 Law Commission review.

·       Chapter III (Achieving hauora: Aspirations of people affected by current drug laws) presents original research undertaken with communities at risk of drug harm in Aotearoa New Zealand, including a large survey and a series of workshops.

·       Chapter IV (Alternative options for drug control – lessons from other countries) presents an overview of evidence from jurisdictions that have attempted drug law reform and considers lessons for law reform in Aotearoa New Zealand.

·       Chapter V (Te Tiriti o Waitangi and drug law reform) discusses the impacts of the Misuse of Drugs Act on Māori and identifies lessons from other jurisdictions.

Proposed principles to guide drug law reform:

1.     Reduce social impacts of drug harm on all New Zealanders

2.    Reduce acute harms, such as overdose, and chronic harms, such as substance use disorder.

3.    Reduce the impact of criminalisation, especially among communities disproportionately affected by it, and reduce the scale and profits of the illicit market.

4.    Ensure people who use drugs can access health support and harm reduction information free from fear of prosecution, stigma, or discrimination.

5.    Enable appropriate access for all New Zealanders to therapeutic drugs that can benefit their health.

6.    Uphold te Tiriti o Waitangi and ensure Māori leadership and resourcing in policy development and service provision.

7.     Prioritise the health and social outcomes of regulation, and prevent excessive corporate influence on regulatory settings.

Recommendations for safer drug laws:

1.               Decriminalise drug use as a foundation for change

i.   Decriminalise personal possession and use of drugs, including utensils.

ii.   Refocus enforcement away from policing use and possession offences and towards tackling supply and improving compliance with any new regulatory systems.

iii. Ensure that any regulatory changes are accompanied by monitoring of health and social outcomes.

iv. Put in place broad protections for people who seek help in the event of a drug overdose or acute substance harm, e.g., through Overdose Good Samaritan clauses.

v.  Apply a clean slate to previous possession/use offences.

vi. Ensure pathways to regulated systems and away from illicit markets remain open for those impacted by criminalisation. This includes transition from illegal economy to legal supply.

vii.  Decriminalise cultivation of a small number of cannabis plants for personal use.

2.              Redirect resources to health in an equitable way

i.    Substantially increase the provision of harm reduction, prevention, early intervention, and substance use disorder (SUD)  treatment services.

ii.     Increase access to specialist treatment interventions for people whose SUD drives their offending. These interventions must focus on reducing reoffending by addressing SUD within the context of criminal behaviour, rather than relying on imprisonment.

3.              Establish harm reduction as responsive public health infrastructure

i.    Set clear goals to improve health outcomes and reduce drug harm in any new legislation.

ii.   Enable more harm reduction and overdose prevention measures immediately, such as overdose prevention centres, safer utensils provisions, and a more diversified and flexible drug checking regime.

iii. Ensure legislation enables ongoing adaptation and development of harm reduction and overdose prevention measures that are responsive to emerging risks and needs. Empower an appropriate health agency with discretionary powers and establish a rapidly responsive licensing system for harm reduction interventions.

iv. Ensure legislation enables treatment and prescribing for people with substance dependence to evolve with changing drug supply issues, in line with international best clinical practice guidance, in all appropriate settings.

v.   Enable professional facilitation of psychedelic assisted therapies, including beyond medicalised settings. Prioritise participant safety by putting in place strict product quality controls, and workforce regulation.

4.              Enable responsible regulation of lower-harm substances

i.    Replace the drug classification system with a more flexible legal framework that grants an appropriate health agency the power to review emerging evidence and strictly regulate lower-risk substances for adults on a case-by-case basis, based on expert advice. Expert advice must meaningfully include the contribution of people with lived experience and ensure the rights of Māori are upheld.

ii.   Regulate legal supply of cannabis through this framework via a non-commercial model, such as not-for-profit associations.

iii. Utilise regulatory measures to limit harms of any regulated substance, such as:

·       age restrictions, price and potency controls, warning signs, and requirements to provide harm reduction and help information;

·       limits on product appeal and availability;

·       bans or restrictions on advertising of products and suppliers;

·       measures to prevent influence of commercial groups on public policy or messaging.

iv. Amend the Psychoactive Substances Act and harmonise it with the new regulatory regime.

5.              Uphold te Tiriti and protecting taonga

i.    Ringfence part of the increased funding for harm reduction and SUD treatment for Māori to empower and resource whānau, hapū, and iwi to roll out appropriate interventions as they determine.

ii.   Ensure Māori are able to exercise tino rangatiratanga over taonga fungi that are currently listed as prohibited plants under the Misuse of Drugs Act.

MIL OSI

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