E-Substance July 2008

3 July 2008

Welcome

Dear reader,

Welcome to the July issue of the New Zealand Drug Foundation's monthly e-newsletter - e-Substance!

Next week 8 New Zealand NGO delegates, led by the Drug Foundation, join 300 colleagues from around the world at the Beyond 2008 forum in Vienna. The forum will be the final part of the global consultation of NGOs involved in responding to drug related problems. The New Zealand delegation will jointly present findings from the regional consultation with our Australian colleagues. We'll let you know what happened in Vienna on our return.

This month we bring you three special features: reflections from two New Zealanders who attended the Barcelona International Harm Reduction Conference; the launch of the Drug Foundation's new volatile substances guide for retailers; and a story on the government's recent announcement to review liquor licensing. We cover two news items: The Drug Harm Index and a story on Aussie alcopop tax.

We hope you will find these stories interesting and useful. We welcome your feedback - please email editor@drugfoundation.org.nz.

Thank you for your continued interest in our work!

 

IHRA Conference in Barcelona - an interview with Gerard Vaughan and Bruce Atmore

In May, two New Zealand representatives attended the 19th International Harm Reduction Association's conference in Barcelona. This annual event has become the main meeting point for all those interested in harm reduction around the world, and the beautiful Catalonian city welcomed some 1300 delegates. We chatted with ALAC's Gerard Vaughan and the Ministry of Health's Bruce Atmore to find out their thoughts on the event itself, and what lessons they bring back to New Zealand.

Gerard Vaughan, Chief Executive, ALAC

So what did you think of the conference?
It was a mind-expanding experience. It was a combination of things - some of them were personal, some were just the dynamic of 1300 people from 90 different countries. It's a pretty interesting and dynamic mix because you really do come across a really broad spectrum of views.

I have not been exposed to some of the views that people were promoting, such as the views of the consumers of drugs - outside my comfort zone and how I saw the world, particularly the people who were advocating that the only harm from drug use is the safety around use. I found it quite challenging because that is not the framework I work from personally.

Coming from the alcohol sector, it would have been quite different for you being around the drugs issues?
It was actually. The network of international harm reduction has grown from efforts to reduce spread of AIDS and infectious diseases related to drug use. So in some way, I should have been quite prepared for some of those paradigms.

Alcohol has had quite a different history, being a legalised product in most countries for a long time. Internationally, there is an increasing interest in alcohol as people are looking at the population-level harm. There was a very interesting paper from Switzerland where they had cracked down on marijuana use - so they did see a reduction in marijuana, but at the same time they saw a real increase in binge-drinking. And I think that is where the connection between alcohol and illicit drugs lies. I saw some movies on consumption rooms and that is something I found quite challenging - watching a movie of someone coming in and being assisted to shoot up.

What lessons would you take away for New Zealand?
There were a couple of things that got me thinking as a result of the conference. One is where the alcohol fits in the harm minimisation paradigm. With alcohol, its not being drunk that's the problem, it's drinking to get drunk - the effect.

It's all about the individual choice and freedom and how much the environment shapes you, and how much you regulate the environment - limiting the individual choice. The harm reduction movement advocates that the criminal framework around drugs creates a lot of the problems.

What I have learned is that New Zealand does not have the same problems that a lot of other countries do, to the same extent. I think that is mainly because of the Customs border control - we have been quite successful at keeping the product out even compared to Australia, who have very real problems.

On the world stage, it reinforced for me the growing awareness for a number of countries who are starting to realise that alcohol is a big problem for them - quite a range of countries, including Africa, India, not so much from Asia.

Has your perception of alcohol changed as a result of viewing it in the wider context of drugs?
Yes I think, from the population point of view, alcohol is a much bigger problem than drugs. With drug use, the difference is the public fear around drug use, driven particularly by the fear of infectious diseases. I've come away from the conference realising that some of it is not so black and white. I am not promoting legalisation of drugs at all, but I can actually understand some of the arguments.

Some of the Muslim Middle-Eastern countries presented at the conference have the opposite problem: alcohol is illegal according to Koran, so they have a greater acceptance of drug use.

Do you think that harm minimisation is the approach that New Zealand should be taking?
I see harm minimisation as a continuum, and it is really just how and at what point you have an intervention. To what extend should the individual freedoms be limited by law? You may get two people working within the harm minimisation framework who vigorously disagree with each other.

I think the emerging area, perhaps not discussed so much at the conference, is to understand why people are seeking to become intoxicated and use drugs. Some of the issues may be different for different groups. People from different cultures often lead quite similar lifestyles, and there may be some benefits at looking at ways other countries are dealing with these populations, looking at common approaches.

You made a presentation at the conference, how did it go?
It was a panel discussion. What really struck me is that the approach we are taking in New Zealand looking at the whole of our population - we are looking at why we are drinking - big picture, long term stuff. All the other countries are looking at particular interventions on particular issues, such as the night-time economy or music festivals. They are really well-thought through plans with a targeted audience. There are no really any other countries, apart from Australia, who are starting to look at their drinking culture, that are taking the same approach as us. So we can learn from those countries on the particular approaches they are taking.

Bruce Atmore, Senior Analyst, Ministry of Health

So what was your general impression of the conference?
Although there were a number of presentations that had no direct relevance in the New Zealand context – as different countries have different issues to grapple with – I think the conference represented a great opportunity to learn about increasing coverage and effectiveness of harm reduction policies and practices around the world. New Zealand needs to be in the loop and it was a privilege to have the opportunity to attend.

It was appropriate for Barcelona to host the conference as the Catalan and Spanish governments have recently recognised the levels of drug problems and rates of infectious diseases in their communities and embarked on quite rapid implementation of harm reduction programmes to address the issues on a number of levels. These include free and comprehensive needle exchange provision, extending opioid substitution programmes, and opening supervised injecting facilities in Madrid and Barcelona, and alcohol and drug treatment facilities in many prisons. Spanish practitioners actually won awards at the conference for what they have achieved in a short space of time, and it was very uplifting.

What sort of problems did they focus on at the conference?
For me, the overarching theme at the conference was the “Three HR’s” – harm reduction, human rights and health rights – and the difficulties in somehow joining those up. What the conference highlighted for me was that harm reduction is now the accepted orthodoxy. HR initiatives are clearly good for public health – they save lives, are cost-effective and keep in mind human rights objectives.

Is this relevant for New Zealand?
Yes, New Zealand has a commitment to harm reduction as part of our National Drug Policy. For example, we were the first country in the world to have a comprehensive national needle exchange, so we should be proud of that.

Were there any particular presentations that stood out for you?
There was an address by an UN Special Rapporteur Paul Hunt (ed. Hunt is originally from New Zealand) on the rights to health. He called for the drug policies around the world to be reshaped to encompass human rights, not just law and order, as drug users are often marginalised and face discrimination. This year is the 60th anniversary of the UN Declaration of Human Rights, which upholds principles of equality, non-discrimination and rights to the highest attainable standard of healthcare.

Do you think the problem with human rights is more relevant to developing countries?
Yes, it was evident that the right to good healthcare and human rights is more of a challenge in some developing countries. It can also sometimes be a matter of ideologies, for example a “zero-tolerance” approach to drugs and drug users in some jurisdictions often works against users gaining access to good services and instead they often face punitive sanctions, such as imprisonment.

So how does incorporation of harm reduction manifest itself in the New Zealand drug policy?
The conference showed me that New Zealand is not far off the mark in terms of international harm reduction practices, for example, our needle exchange programme, methadone maintenance and new prison treatment facilities. Some delegates also commented that we may be leading the way in our approach to regulating lower risk restricted substances and they saw this as a harm reduction measure. Here, BZP was recently determined to constitute a moderate risk and was classified as a Class C drug, but the restricted substances framework remains and we are working towards better regulation around these.

One of the emerging areas in drug policy is looking at people’s motivation to take drugs. What is your opinion on that?
I would say that the acknowledgement that people do take drugs has been, and is difficult for some people. People have always taken drugs and probably always will - whether it is tobacco, alcohol, illegal and other drugs, such as caffeine even. Full prohibition of illegal drugs has not worked well and one reason may be that we don’t really understand the motivations. If we can address some of the motivations, the underlaying causes, it will help us to prevent and control drug use the best we can, focusing on harm minimisation to keep people safer.

Gerard Vaughan from ALAC said he was challenged by the people promoting legalisation of drugs, such as heroin. How did you find that?
Yes, there was a wide spectrum of opinion expressed. First of all, I think it is important to distinguish between legalisation and regulation of drugs, and while there was robust debate, I think there were a lot more people advocating for regulation. I don’t support legalisation of drugs and leaving it to a commercialised environment and I didn’t sense many people at the conference supported that approach. While of course there were differing views, what most seemed to be advocating for was access without sanction for people who are dependent users, including the extension of maintenance and substitution programmes.

Mr Atmore encouraged New Zealand's alcohol and drug practitioners to attend the next IHRA conference, which will be held in Bangkok on April 19-23, 2009.

 

Drug Foundation launches Volatile Substance Guide for retailers

Last week we launched our new guide for retailers on managing the sale of volatile substances.

Volatile substances, such as aerosols and solvents (spray paints, glues, gases), are sold at hardware stores, paint merchants, supermarkets, dairies and service stations. Aside from their legitimate household use, they can also be a means of intoxication.

"Tackling volatile substance abuse is a difficult task because these products have legitimate household uses," said Drug Foundation Executive Director Ross Bell, speaking at the launch. "But it's an important issue to face, because deaths can result from inhalant use in the first time, 50th time or 100th time user. Working alongside sellers of these products is one key way of reducing solvent abuse harm in our communities."

Associate Health Minister Jim Anderton said, "The misuse of volatile substances led to six tragic deaths between 2003 and 2004 which obviously had a profound effect on the family, friends and communities who knew the deceased. I very much welcome the development of a guide such as this. I believe it will give retailers the tools they need to act in a more informed way when it comes to the sale of volatile substances in their communities. This can only be a good thing."

"This resource is practical and fills the current need for a consistent nationwide guide for retailers when it comes to the sale of volatile substances. It is something that retailers can easily choose to adopt so that they can play their role in tackling this difficult issue," said Ross Bell.

Check out the Volatile Substance Guide here www.volatilesubstances.co.nz. And visit our YouTube channel for clips of the launch.

 

Long-awaited liquor laws review gets a kick start from PM

New Zealand's twenty-year-old liquor licensing laws are set to be reviewed when the government introduces its "booze bill" to Parliament next month.

Prime Minister Helen Clark has confirmed that the government is giving the previously delayed review of alcohol laws a kick start, and as part of that it will review the Sale of Liquor Act 1989. Her announcement has been welcomed by those involved in alcohol policy, including the Drug Foundation, ALAC and Alcohol Healthwatch.

Prime Minister said the "booze bill" would look at the number of liquor outlets in an area, their size and location, hours of operation and proximity to other premises like schools. It would also require licensing authorities to give effect to local strategies set by councils. Associate Justice Minister Lianne Dalziel, who is working on the Bill, said there was also a provision on prohibiting alcohol to minors, to tackle the problem of liquor stores selling to under-18s.

Issues presented in Manurewa MP George Hawkins' Sale of Liquor (Objections to Applications) Amendment bill would be incorporated into the more substantial government bill as it may progress the proposed changes through Parliament quicker, Ms Dalziel said. Mr Hawkins called for measures to restrict liquor licensing by considering the impact on the communities involved. He introduced his original member's bill after three homicides took place in South Auckland in the last few weeks, including the liquor store owner Navtej Singh.

Drug Foundation's Ross Bell said the Prime Minister's concern about liquor outlets has been shared by many New Zealand communities. "Communities need to be given a stronger voice in how liquor licenses are granted. This includes when licenses are applied for and renewed, and more importantly when councils make big decisions about planning for alcohol in the community."

Improving liquor licensing laws, restricting the presently-liberal marketing practices and keeping a lid on the cheap prices of booze would help with turning around New Zealand's poor drinking culture. ALAC's Chief Executive Gerard Vaughan communities needed to have a say in the number and location of liquor outlets in their area. "This is the strong message we have been getting from communities throughout the country," he said. "There is a lot of frustration out there and things need to change."

The Hawkins Bill passed its first hurdle last night, with 113 MPs supporting it through its first reading and referring it to the social services select committee to hear public submissions.

 

News

New Drug Harm Index released

The Drug Harm Index caused a stir last week in the media with headlines screaming "$1.3b drugs bill we're all paying".

Commissioned by the Police, economic analysis agency Business and Economic Research Limited (BERL) developed a model measuring the social harms produced by the illicit drugs. Their model suggests illicit drug use caused an estimated $1.31 billion of social costs - with stimulants accounting for 42 percent ($546 million), cannabis 33% ($431 billion) and opioids 35% ($326 million). The full report is here (pdf).

One commentator in the blogshere said of the index, "The primary problem with the methodology of the NZDHI is the inclusion of the costs of prohibition into overall social harm costs of illicit drugs. Inclusion of these figures is simply a feedback loop of self-justification. The state deems certain drugs illicit because they are harmful, and a State agency deems these drugs harmful because (in large part) they are illicit. I could, according to this "logic", spend $500,000 protecting my house from being attacked by pterodactyls, and then conclude that pterodactyls are extremely "harmful" because of the enormous cost of protection against them."

The challenge will be how the index is used by policy makers - ideally it should inform good policy making and allow agencies ask whether New Zealand is investing in the right harm reduction interventions. Alison Ritter, from Australia's Drug Policy Modelling Programme has recently published a good overview of ways drug harm indices might benefit policy makers (pdf).

Some in the media didn't report the index very accurately or seek independent comment on its value. You might be interested to watch this critique of the media's coverage of the index and drug issues more broadly, featuring recently retired MP Nandor Tanczos, Police Association President Greg O'Connor and the Drug Foundation's Ross Bell.

 

Aussies' binge-drinking under Federal Government's scrutiny

Australia is currently looking at several measures in an effort to tame its binge-drinking culture.

The new Rudd government has already raised the excise on alcopops in an effort to target teen drinking. While the increased tax revenue is already flowing into the government's pockets, the supporting legislation is yet to be passed through the Senate. The government has a year in which to pass it, according to Australia's parliamentary conventions, but if the Senate vetoes the tax it is unclear how the consumers would be reimbursed. Family First Senator Steve Fielding threatened to block the legislation, urging the government to introduce alcohol warning labels as well.

Another controversial measure being introduced is Australia's revised drinking guidelines. According to media reports of the draft guidelines, having more than four standard drinks a day constitutes a binge. "That means that if a man is sharing a bottle with his wife and takes a slightly larger share, that he's had a binge," said Paul Haber, the medical director of Drug Health Services Addiction Medicine at Sydney's Royal Prince Alfred Hospital.

Former health minister Tony Abbott said Australia was now in a "moral panic" about alcohol and accused the Federal Government of ignoring illicit drugs. But the current Health Minister Nicola Roxon said that when Mr Abbott was minister, "he did almost nothing to tackle the harm caused by binge drinking."

In New Zealand, the Associate Health Minister Damien O'Connor said our government was not looking at changing its guidelines of six drinks for men and four for women in a single session.

Last week Prime Minister Rudd also announced that the Federal Government is not going to lift legal minimum purchase age from 18 to 21 years. The change was one of the possible options put forward by health groups in order to tackle binge drinking.

"We have no plans for changes on that score," Rudd told Parliament. "We will, however, have much more to say, much more to say on the whole question of dealing with the challenge of binge drinking."

Rudd has confirmed that beer and wine would remain exempt from the 70 per cent hike applied to alcopops.

Our August Matters of Substance will take a close look at the action on alcohol underway in Australia.

 

Website of the month

DrugInfo Clearinghouse

Want to know the nuts and bolts of most legal and illegal drugs? Perhaps you need to find some information on energy drinks? Then this Australian website is a very good place to visit. DrugInfo Clearinghouse is a service of the Australian Drug Foundation that aims to prevent drug problems and reduce drug-related harms in Australia. The website contains a wealth of information on drugs, their effects and treatment options. There is a wealth of fact sheets across subjects such from ‘club drugs' to ‘harm minimisation'. It also breaks the information on drugs down by specific social groups like young people, women and parents. The homepage provides updates of the latest Australian news on drugs and alcohol issues and contains a list of the upcoming industry events. Check it out at www.druginfo.adf.org.au.

 

 

Upcoming events

Cutting Edge, September 4-6, Christchurch
This year's theme is Life and Death as it relates to addiction and addiction treatment. The conference will provide the sector with an annual update on cutting edge research and development, as well as a focus and a sense of national identity. Cutting Edge has previously been centered around clinical-focused treatment presentations; however this year there is strong encouragement for public health-focused presentations.

Australian Professional Society on Alcohol and other Drugs Conference, November 23-26, Sydney
APSAD 2008 will feature an exciting program of international and national keynote speakers who will focus on new treatment prevention and policy approaches to the drug and alcohol field. A broad range of papers will be presented from renowned national and international experts in the latest cutting-edge drug and alcohol research. The conference will feature a range of clinical workshops/master classes to enhance skills acquisition and knowledge transfer.

Australian Therapeutic Communities Association Conference, September 9-11, Byron Bay
"Advancing the Therapeutic Community Approach". International guest speakers for this year's annual conference are Dr. George De Leon and Dr. Nancy Jainchill. In addition to plenary sessions Dr. De Leon and Dr. Jainchill will also conduct interactive workshops focusing on professional practice in standard and modified TC's and correctional settings.

For more events - and to submit your event - visit www.drugfoundation.org.nz/events

Job vacancies

For more vacancies - and to submit your vacancy, visit www.drugfoundation.org.nz/jobs.