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A crucial new harm-reduction tool for New Zealand

MoS aug 2020 high alert2

A new online harm-reduction tool has been rolled out by Police, Customs and the Ministry of Health, with help from the Drug Foundation.

It’s great to be celebrating yet another step forward in government-supported harm reduction with the launch of High Alert – a national drug early warning system.

What is High Alert?

High Alert collects a broad range of drug-related data and can provide a national alert or warning if a particularly harmful substance is circulating. This is a joint effort led by the National Drug Intelligence Bureau (made up of Police, Customs and the Ministry of Health) and a range of community and government partners that regularly encounter and respond to drug-related harm, including the Drug Foundation.

What is the purpose of early warning systems?

Early warning systems are designed to detect dangerous, new or contaminated substances within the illicit drug market. These systems can work at a range of levels – an early grassroots example occurred way back at Woodstock (1969) with a loudspeaker announcement to “avoid the bad ‘brown acid’”. More formal early warning systems are the government-backed Drug Information and Monitoring System in the Netherlands or the user-generated Pill Report online system. In New Zealand, KnowYourStuffNZ has been providing alerts based on festival testing, which have circulated rapidly and extensively within festival communities.

Early detection of harmful changes in the drug market enables faster and more-effective responses to reduce or prevent drug-related harm. Crucial information – what to look out for, safer dosage, what to do in an overdose – can be quickly shared with those to whom it matters most. People who use drugs can look online and then make more-informed (and often safer) choices around their drug use.

Early warning systems also improve the ability to respond to acute drug-harm incidents. The more emergency responders know about a substance, the more effective the response can be. An example is the case of n-ethylpentylone, a synthetic cathinone detected in New Zealand in 2018, which is a much more dangerous substance than MDMA (which it is normally sold as). People using the drug often did not know what they had taken, and emergency responders where not prepared to support the high levels of psychosis they encountered, nor were they aware of the longer time required for effects to subside compared to other drugs. High Alert would enable knowledge for both the community as well as those responding, hopefully reducing both the incidence and severity of drug-related harm.

How does a decision about an alert get made?

Analysts from the National Drug Intelligence Bureau make an initial assessment based on any data received and recommend one of four actions: alert, notification, article or monitor. Alerts are the highest threshold, involving widespread media reporting and sharing of harm-reduction advice. Alerts are used when there’s a high public health need – such as Fentanyl being found in the opioid supply. Lower-threshold concerns can be monitored, put into an article on High Alert or turned into a notification where information is distributed through partner networks but not to the general public. The decision on which action to take is revised when new information is received and considered by an expert advisory group.

How does High Alert work alongside drug checking and other initiatives?

High Alert gives people wanting to use drugs and those involved in harm reduction a heads up on what to look out for. It’s also a platform that drug-checking organisations can publish information on – another weapon in the harm-reduction arsenal. If new synthetic cannabinoids – which were responsible for over 60 deaths in the past few years within New Zealand – (re)emerge, High Alert will help us to prepare more effectively in our response. Knowing about a specific cannabinoid at the border helps to prepare messaging for the community and medical advice. Once a synthetic cannabinoid is detected within the community, warnings can be shared regionally or nationally, with consistent advice and up-to-date best information.

Using the example of high-potency MDMA found at New Zealand festivals last summer, High Alert would enable earlier warnings over certain pill types and for people to be cautious of or even avoid purchasing before going to the festival. This system allows us to act sooner and hopefully prevent drug-related harm.

How did we get to this point?

The Drug Foundation has been advocating for a national early warning system since 2012, and an early warning system was a key activity named in the National Drug Policy 2015–2020. There were a few false starts with various iterations, but it’s great to see High Alert launch with a strong focus on community partnership and public accessibility. An interesting element of High Alert is the ability for user-generated reports as well as the more news-oriented style for some of the information delivery.

High Alert will continue to develop and refine as new substances are detected and responded to.

Find out more at highalert.org.nz

For email updates go to highalert.org.nz/subscribe-to-updates

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