A New National Drug Policy for New Zealand: Discussion Document

A New National Drug Policy for New Zealand

Discussion document

Citation: Ministry of Health. 2013. A New National Drug Policy for New Zealand: Discussion document. Wellington: Ministry of Health.

Published in December 2013
by theMinistry of Health
PO Box 5013, Wellington 6145, New Zealand

ISBN978-0-478-41579-7 (online)
HP 5780

This document is available at www.health.govt.nz

This work is licensed under the Creative Commons Attribution 4.0 International licence. In essence, you are free to: share ie, copy and redistribute the material in any medium or format; adapt ie, remix, transform and build upon the material. You must give appropriate credit, provide a link to the licence and indicate if changes were made.

Contents

Introduction

How you can help

Scope of the discussion

What’s the timeline?

How to share your views with us

Background

The purpose behind the policy

Alcohol and drug use in New Zealand

How the National Drug Policy works

A new policy, a new direction

Keeping what works, and making it better

References

Appendix: List of questions

List of Figures

Figure 1:The three pillars of the National Drug Policy

Figure 2:Traditional National Drug Policy focus: preventing and reducing harm among people who use alcohol and other drugs

Figure 3:Broadened National Drug Policy focus: preventing and reducing harm among families, communities and society

A New National Drug Policy for New Zealand: Discussion document1

Introduction

We are asking for your help to shape our next National Drug Policy, which sets outthe Government’s approach for tobacco, alcohol, and illegal and other drugs. For simplicity, we will refer to all these substances as ‘alcohol and other drugs’ throughout this document. These substances have different legal status and are controlled by different legislation, but all have the potential to cause harm to users and to society.

Many different government and non-government groups have a role in preventing and reducing the harm alcohol and other drugs can cause. The National Drug Policy brings together these activities, guides decision-makingacross government and communities and sets priorities. In the past, priority areas have included certain groups, such as young people, Māori and Pacific people, and certain substances, such as methamphetamine.

There have been two previous National Drug Policies in New Zealand. The mostrecent one has now expired, and needs replacing. We want it to include a revised view of ‘harm’ that captures the problems alcohol and other drugs can cause to people other than the user. We also think it should address the priorities of everyone working in the area, including law enforcement officers, educators, social workers and health professionals. The policy should reflect the way that we now work, and be flexible enough to meet future trends. To achieve this, we need to better understand the issues that people think are important.

How you can help

We want to hear your view on what a better policy for alcohol and other drugs might look like. Throughout this document, we ask some questions to guide discussion (you’ll find them throughout the document, and collated in the Appendix below), but you can tell us about other ideas or concerns you might have as well.

Scope of the discussion

We won’t be changing the laws on alcohol, tobacco, drugs or medicines as part of this process. This means that legal issues like changes to drug offences and penalties or the banning of tobacco will not be considered as part of this discussion. We can’t act on submissions asking us to do these things, but we will consider how our laws can support the goals of the policy once it’s up and running.

What’s the timeline?

We are having the discussion now, before the draft policy is written, because we want to use your experience to shape the policy from the outset. When the discussion period finishes, we will analyse everyone’s feedback and provide it to Government with recommendations for the new policy.

This discussion process will be open from Monday 16 December 2013 through Friday 28February 2014. We want the new policy to be ready in June 2014. To do this, we will need to work quickly once the discussion period closes. We don’t think it will be possible to consult with everyone again after February 2014, but we will continue to talk with groups that represent those who use drugs as well as people who know about research, treatment, education and enforcement.

How to share your views with us

You can share your views by emailing or posting your feedback to us at the following address:

NDP Discussion

Sector and Services Policy

Policy Business Unit

Ministry of Health

PO Box 5013
Wellington 6145

Background

The purpose behind the policy

1.We care about alcohol and other drugs because as well as causing harm to individuals, they can impact on families and communities as a whole. Looking closely, we see that these substances contribute to many of the broad social issues that New Zealanders are concerned about. For example, we see evidence of alcohol and drug misuse when looking at our high rates of imprisonment, domestic violence cases, lack of educational achievement and our comparatively high rate of youth suicide.

2.Up to 70percent of injured people who turn up to our emergency departments on weekends are there because of alcohol (Jones et al 2009; Humphrey et al 2003). As well as harming themselves, these people impact on the waiting time of others who need hospital services. Additionally, 22percent of all injury claims made to ACC are alcohol-related (Minister for ACC 2010). Drinking alcohol affects our longer term health as well. It is linked to a range of health conditions, such as alcoholic liver disease, some cancers and cardiovascular diseases. Alcohol use can also impact on existing health conditions such as diabetes and mental health conditions (Alcohol Advisory Council 2012).

3.Over half of all crimes committed in New Zealand, including homicides, are carried out by people under the influence of alcohol or drugs. In one-third of family violence assaults, the offender had drunk alcohol prior to committing the offence (New Zealand Police 2009). Similarly, in 2012 on the roads, driver alcohol or drug use contributed to 82 fatal traffic crashes, 338 serious injury crashes and 941 minor injury crashes (Ministry of Transport, personal communication, 2013).

4.Alcohol and other drug use has an impact on children. We know that drinking alcohol while pregnant can lead to fetal alcohol spectrum disorder, and that smoking while pregnant is associated with childhood obesity, behavioural problems and respiratory infection. The Government’s White Paper for Vulnerable Children (New Zealand Government 2012b) reported Child, Youth and Family concerns about alcohol or drug use in 71percent of mothers whose children came into contact with that service under the age of two.

5.Early use of alcohol and other drugs is a key risk factor for poor life outcomes, such as learning and behavioural difficulties, mental and physical health, and poor educational achievement and employability (The Green Paper for Vulnerable Children: New Zealand Government 2012a). Use of tobacco, alcohol or drugs before the age of 12 is a key risk factor for future criminal offending (Ministry of Justice 2008).

6.If we are able to reduce the amount of alcohol and other drugs that New Zealanders use, we can expect to see increases in our productivity, benefits to our health and reductions in rates of crime. This is especially true for young people.

Alcohol and drug use in New Zealand

7.Alcohol is the drug that we use most; 80percent of us drink it regularly. However, we are starting to drink less; this is especially true among young people aged 15–17 years. The proportion of young people who had drunk alcohol in the past year fell from 75percent in 2006/2007 to 59percent in 2011/2012 (Ministry of Health 2013). On average, it is estimated that New Zealanders aged 15 years or older drink the equivalent of 9.12 litres of pure alcohol each year. This is comparable to Australia (9.89 litres) but is well above the global average of 6.13litres (WHO 2011).

8.Drugs of serious concern overseas, such as heroin and cocaine, are not used by many New Zealanders (under 1percent), but we do have high rates of cannabis use compared with other countries. Nearly half of all adults have tried cannabis at some point in their lives, and an estimated 14.6percent have used it within the past year (Ministry of Health 2010).

9.Methamphetamine is our most problematic illegal drug. Not many of us use it (recent data suggests around 0.9percent of the population have used it or a similar substance in the previous year: Department of Prime Minister and Cabinet 2012), but those who do are at risk of becoming dependent on it or suffering problems such as psychosis. There have been some high-profile incidents in which those under the influence of methamphetamine have hurt others.

10.Another area of concern in New Zealand and around the world is the rise in the popularity of new psychoactive substances, such as those found in party pills. We donot currently have concrete figures on how many people use these substances, but dataare being collected and will be published in 2014. New legislation has been passed that restricts the sale of these products until they can be proven to be low risk.

11.We have made good progress with tobacco, but not for all groups. The number of smokers in New Zealand has dropped steadily over the past 30 years. In 1976, the rate of daily smoking among New Zealanders aged 15 years and over was 35.6percent. Today, it is about 17percent.Unfortunately,less progress has been made on Māori smoking rates since 2007: 38percent of the adult Māori population still smoke daily. Pacific peoples are also overrepresented in smoking statistics: 23percentare daily smokers (Ministry of Health 2012).

How the National Drug Policy works

12.As we have mentioned, there is a whole range of issues relating to alcohol and drug use in New Zealand. The National Drug Policy is a way of ensuring that everyone whose work involves these issues takes consistent action in addressing them. The Ministry of Health only focuses on one part of the story. Many other government agencies, like New Zealand Customs and the Police, have other important roles, and community organisations also play a vital part.

13.Since 1998, our policy has been founded on the principle of harm minimisation. This approach tries to improve social, economic and health outcomes for individuals, communities and the population at large, through a range of programmes and actions. These include controlling the supply of alcohol and other drugs, encouraging people not to use these substances and helping those who do use them. This approach is very similar to that of other countries, including the United Kingdom, Australia and many in the European Union.

14.Figure 1 below explains the three key types of activity undertaken under the National Drug Policy. These are what we call the ‘pillars’ of the policy: supply control, demand reduction and problem limitation.

Figure 1: The three pillars of the National Drug Policy

A new policy, a new direction

15.In the past, the policy has largely focused on interventions for people who use alcohol and other drugs. This has been important for preventing alcohol and drug use and improving the outlook for those who do use them. It has also had a good effect for the wider community. However, we think we can do better. We want the new policy to expand its definition of harm to place a greater emphasis on the harm that alcohol and other drugs cause to people other than those who use them. Figures 2 and 3 below indicatewhere we have focused our efforts in the past and where we wish to do so in the future.

Figure 2: Traditional National Drug Policy focus: preventing and reducing harm among people who use alcohol and other drugs

Figure 3: Broadened National Drug Policy focus: preventing and reducing harm among families, communities and society

Keeping what works, and making it better

16.The new policy will maintain the principle of harm minimisation and the three pillarsof supply control, demand reduction and problem limitation. There are no additional pillars to add, and none that we could do without. We believe the current structure is aligned well with what other countries do and is still fit for purpose to reduce harm in New Zealand.

17.However, because we are expanding our view of the types of harm we wish to prevent and address, the manner in which we undertake activities across the three pillars will change. We think this approach will better align the policy with recent legislation such as the Sale and Supply of Alcohol Act 2012 and other key programmes and result areas, including:

• support for vulnerable children
• Drivers of Crime and actions for alcohol and drugs
• the Prime Minister’s Youth Mental Health Project
• welfare reform
• boosting skills and employment.

18.We won’t duplicate or sacrifice programs that are working well. For example, tobacco initiatives are already guided by a clear strategy and a defined action plan. Smoking cessation is a government priority area, and well-developed actions have been defined for the next five years. The Government has a clear strategic vision for New Zealand to be smokefree by 2025. Our National Drug Policy needs to accommodate this initiative.

19.Government agencies and others who deliver alcohol and other drug services are already working together, but we could do better. If we expand the types of harm we wish to address, those of us working for the Government will need to consider how we might work smarter and avoid duplication. We also need to consider how we can best support those working in the field. We would like to hear about how you think we should be doing this, and what our priorities should be. You can help us by answering these questions.

• What should we call our policy? Is the National Drug Policy still a good name?
• Where should we focus our efforts relating to supply control, demand reduction and problem limitation? Should these efforts be consistent or differ depending on the drug or substance?
• Alcohol and other drugs can cause harm to people who don’t use them, such as whānau and friends. In what ways could our policy support your community to reduce this harm?

Outcomes and action plans

20.We want the new policy to be focused on outcomes. We think that instead of just talking about specific substances or certain ways of doing things, we should also be talking about ideal outcomes for communities and people. For example, we may wish to focus on reducing the amount of time it takes for people to receive treatment. We could put a greater focus on reducing people’s access to cannabis. We could try to reduce the number of young people being excluded from school for alcohol and other drug offences or we could make better use of all three pillars to address volatile substance use.

21.If we are focusing on outcomes, we think action plans will be important. We want the main policy to clearly state the longer term outcomes we are aiming for. The action plans should then deal with what is achievable in the short to medium term, and provide the detail needed to make it happen. A recent example of this approach is Tackling Methamphetamine: An Action Plan (Department of Prime Minister and Cabinet 2009). We would like to hear your views as to whether you think it would be useful to extend this focus to other areas of the policy.

• What outcomes should the National Drug Policy aim for?
• What issues should our first action plans try to tackle?

Measuring results

22.To see how we’re doing in terms of outcomes and action plans, we think we’ll need performance measures and targets so we can know if our new approach is working. Having such targets could allow us to evaluate actions across the areas of supply control, demand reduction and problem limitation more thoroughly. Reviewing them might also allow for a more responsive allocation of resources across the policy to ensure that the interventions bringing the greatest benefits are the ones getting the most attention.

23.On the other hand, there are drawbacks to performance measures and targets. Sometimes they are unable to capture the unique nature of situations that lead to a goal not being met. They can also reduce innovation, by encouraging providers to use only tried and true methods to meet their obligations under a particular performance measure.

24.For these reasons, we need to approach this issue carefully. You can help us by answering these questions.

• Should the policy contain performance targets?
• What things to do you think we should measure to see if things are working?

Doing the right things

25.The Government is committed to reducing costs while also improving frontline services in all areas. With this in mind, we need to ensure that our spending on reducing harm from alcohol and drugs is well aligned with other strategies, and gives us the best possible return on our investment.

26.We are interested in your thoughts about how we can best make use of the resources we have available to achieve the objective of the National Drug Policy. In particular:

• How will we know if we are allocating the right balance of resources to each of the areas of supply control, demand reduction and problem limitation/treatment? What should we be looking for?
• What would you like to know about how well the different approaches taken under the policy are working?
• If you are someone who delivers alcohol or other drug services, what have you seen working well in your community to reduce alcohol and other drug-related harm?
• If you are a provider of alcohol or other drug services, do you think there is a way government could better work with you or support you through non-financial means?

Making sure we’re not interfering too much

27.If our policy is to be successful it needs to be consistently applied throughout New Zealand. We need to strike the right balance between an adaptable policy – action plans that allow for community solutions to community problems – and a prescriptive approach that ensures no one is left behind or treated unfairly.