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Keynote Address - Drug & Alcohol Strategy Conference

Published: Thu 4 May 2017 02:09 PM
Hon Peter Dunne
Associate Minister of Health
4 May 2017 Speech
Keynote Address – 8th Australasian Drug and Alcohol Strategy Conference
Te Papa, Wellington
Good afternoon everyone.
It gives me great pleasure to be here to talk about our shared interest in influencing attitudes towards alcohol and drug use. It is an honour and a privilege to be asked to give one of the keynote speeches.
I also look forward to taking your questions afterwards.
Drug policy in New Zealand is an ongoing balancing act. And because the tightrope tends to move, it is vitally important for us to keep checking whether we have our balance right.
Because we need to cover overseas as well as local experiences, today’s speech is going to be a rather rapid fly-by view of both international and local drug policy.
Recently, I had the good fortune to be in Vienna to take part in the 60th session of the United Nations Commission on Narcotic Drugs. It was one of the most constructive and encouraging international events that I have attended.
I was delighted to express New Zealand’s support for the work of the Commission and the UN’s Office on Drugs and Crime.
Over the last few years of attending such meetings, I have seen welcome signs of an increasing shift internationally towards a health focus on drugs, rather than drugs being treated as primarily a law and order issue.
This has profound implications for how we treat drug users. It means drug use disorders should be treated in the health system. So people with these disorders need access to essential medicines, including controlled drugs, but we need to minimise the risk that these drugs will be diverted or misused.
It also means people need continued support for recovery through their rehabilitation and reintegration into everyday life. We all know health is more than just the absence of ill health, or treatment of it.
A truly health-focused drug policy has to include building resilience and responding to the reasons why people use drugs. And it has to respond in a balanced way to the harm associated with drugs.
While there is still a long way to go in some instances, it is generally encouraging to see this happening more and more. Yes, a number of countries still impose the death penalty for drug offences – and a small minority condone the barbaric extra-judicial killing of drug users and dealers.
New Zealand will always stand firm in opposing that.
But on the whole, drug policies the world over tend to take a wider frame of reference and look for a proportionate response to drug-related harms.
I will just focus for a moment on what this means to us in New Zealand. We have seen a shift away from a relatively narrow punitive approach to drugs to a more balanced view.
You can see this shift in our national drug policies. New Zealand’s National Drug Policy balances three complementary elements. These strategies – problem limitation, demand reduction, and supply control – have been part of all the drug policies that we have had.
The goal, however, has changed and become more broadly health-focused. While the previous policy had a harm minimisation goal, the current one explicitly aims to promote and protect health and wellbeing as well as aiming to minimise alcohol and drug-related harm.
That may sound straightforward, but there are several questions worth raising about that goal. For one thing, how much do we know about alcohol and drug-related harm in New Zealand?
It is all very well to talk about effects on individuals and the community. These are very real, and we all see the weekly media articles about them. But we do not have accurate measurements of the size of the problem.
We have a New Zealand Drug Harm Index which gives us some indication, but we know that the drugs being used and the way they are being used are changing. So the index has to be a living, changing document.
Knowing about the harm is one thing, but knowing when we have minimised is more complex. And whose health and wellbeing are we promoting and protecting?
The easy answer is to say ‘everyone’s’. But is everyone getting the same degree of protection and promotion?
These questions are not easy to answer. But we know that our health services, enforcement services and others working together to strike the right balance of education, support and enforcement is the best way to address them.
It requires a people-centred approach where a range of agencies – health, police, correctional services, social services and others – work together to respond to individual, family, and community needs.
As a small country, we know the value of working together. We do not usually have the resources to get things done other than by cooperating with each other.
As the leader of a party which has a confidence and supply agreement with the government, I also have a particular appreciation of the need to work collegially and find common ground in order to make progress.
But it is not always the norm in other, larger countries, where achieving inter-agency co-operation is in itself a challenge. Our agencies cooperate with each other via an interagency committee on drugs, tasked with the challenge of achieving the objectives of the National Drug Policy.
In the area of interagency cooperation, New Zealand has seen particularly encouraging collaboration between Police and Health at local, regional and national levels.
During my attendance at the UN this year, I had the opportunity for a bilateral meeting with the Portuguese delegation. The Portuguese approach of putting the health system front and centre when drug use is an issue is admirable and something to aspire to.
Unfortunately, whenever Portugal is mentioned, the focus is often solely on the tolerance they apply to low-level use of drugs, while overlooking the other side of the story about possession and cultivation remaining illegal, and the very strong use of mandatory assessment and treatment programmes in place for all drug use.
I have long felt that pursuing sick and disabled people for inconsequential cannabis use related to their ailments is both imprudent and a poor use of Police resources – formal Police guidelines for such situations would be a welcome development.
An excellent example of positive collaboration between Police and the Ministry of Health is illustrated in a new approach to reducing demand for methamphetamine.
Police and the Ministry of Health developed the approach together last year. The idea for this new approach grew from Operation Daydream. It began as what you might call a standard operation in the sense that police arrested a number of people who were supplying methamphetamine.
However, it departed from standard practice when it came to users identified during the operation. Rather than prosecute, police contacted them to discuss their issues and offer referrals to treatment services. This proved to be a positive and productive approach.
The users engaged with officers, and gave them some insights into the reasons that they were using methamphetamine. What they then did with the information was set up a public meeting with some users and some members of the community who had never set eyes on methamphetamine.
Getting these two groups of people together was a powerful experience for all concerned. Even something as simple as talking to each other can make a positive difference to people’s lives. So we are building on this initiative.
The current pilot programme brings together police, health and community efforts to respond to the needs of a particular area and its people – in this case, Northland. That will in itself be a positive thing that brings people together.
It also represents a shift in attitudes, with a district health board partnering with local police and community organisations to improve outcomes for people in the area.
Innovation also happens centrally of course.
The unique part of New Zealand’s response to the issue of new psychoactive substances is of course our Psychoactive Substances Act.
I have a history with this Act as the Minister responsible for its introduction. Prior to the Act, we had a losing battle on our hands with new psychoactives. This was because new substances were emerging in the market too quickly for us to establish the level of risk that they posed.
This system meant that users of new psychoactives were consuming drugs that were not fully understood, and risking all sorts of harm to themselves and others.
Previously, New Zealand faced precisely the same problem as other jurisdictions. We had a range of unknown substances, posing unknown risks.
The existing controls were based on the old world of well-known and well understood substances. For the old drugs, the risks could be judged, and they could be scheduled in our Misuse of Drugs Act with the appropriate controls.
But that approach depends on the substances being understood. The government could legislate based on the risk of a substance, but it had to know the risk first.
For something like cocaine, where we can draw a picture of the molecule, and identify risks and medicinal uses in detail, that approach works well.
For the new psychoactive substances, that approach simply did not work. By the time it had been identified, investigated and legislated against, the original substance could be replaced by 10 new ones.
Instead, New Zealand’s response was to reverse the onus of proof. Under the new legislation, licences must be obtained by people or businesses who wish to import, research, manufacture, wholesale and retail psychoactive substances and products.
The Act also restricts the sale of these products, when approved, to people aged 18 years and older. That is an apparently simple change, but a world-leading solution that has effectively reduced the level of harm to users of new psychoactives.
The Act was amended in May 2014 to prohibit animal testing data being used for the purpose of product approval.
At this time the necessary tests cannot be done using entirely non-animal methods. I do not see this situation changing for the foreseeable future. I am advised it will likely be at least 5 years before any applications for product approval are received, as they must wait for non-animal test methods to be validated.
Once this happens, we will have the flexibility with our psychoactive substances legislation to fully control the window of opportunity. At that time our innovative policy approach will fully come into effect.
The work we are doing now on new psychoactive substances is bringing to bear expertise from both within and outside government to develop an early warning system that will help identify and respond to emerging drugs. Early warning systems were a popular topic at the Commission on Narcotic Drugs meeting.
As you may recall, I spoke about having seen an increasing international shift from a law and order focus to a broader focus on health. One thing that particularly stood out from the Commission’s discussions was alternative approaches to the possession of drugs.
My colleagues in Vienna agreed there are many ways in which the system can send a message that illegal drugs are unacceptable – and that these ways do not always need to involve criminalisation. We can take these ideas forward in developing options for further minimising harm within our National Drug Policy framework.
As I said to begin with, New Zealand’s drug policy continues to be a balancing act.
This year agencies will check the initial agreed actions in the National Drug Policy, to ensure we keep on striking the right balance. To change attitudes and minimise the harm that can come from the use of alcohol and other drugs, we must stay open to new ideas and new frames of reference.
I have said many times that the principles of compassion, innovation and proportion underpin our national drug policy. Consistent with that theme we need to be constantly open to alternative approaches and ways of doing things, always so long as robust pharmacological, clinical, and criminological evidence is there to back up the positions we take.
I hope this conference builds on existing efforts to change thinking and behaviour towards alcohol and drug use and I wish you all a rewarding and productive time here in Wellington.
Thank you.

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