What happened in Wairarapa could happen again

Drug Foundation executive director Sarah Helm discusses recent fentanyl overdoses in Wairarapa and how we can help prevent overdoses in future.

More than 80,000. In 2021 alone, that's how many people are estimated by the CDC to have died in North America from opioid overdoses. 

Last weekend, over a 48-hour period, 12 people were hospitalised in New Zealand from overdoses of fentanyl, a potent opioid used for pain relief in healthcare settings. Thankfully, all survived. But things could have played out very differently. 

These people, ranging in ages between 31-71, likely didn't know they were taking fentanyl. There’s no way to tell a drug contains fentanyl just by looking at it. They believed they were taking cocaine or meth. 

We tested the drug in our offices with our colleagues from KnowYourStuffNZ, and head of the National Drug Intelligence Bureau and High Alert, Blair Macdonald.  

We ran multiple tests, and they all said the same thing. We then sent the samples off to ESR, who ran more thorough testing. They confirmed the sample was fentanyl.  

It was reported that those hospitalised responded well to being given naloxone, a lifesaving opioid overdose reversal treatment. Unfortunately, naloxone isn’t widely available in New Zealand.  

This is important. A fentanyl overdose can happen incredibly rapidly. The time is takes for an ambulance to arrive can be too long. Overseas naloxone and fentanyl test strips are being freely distributed to people who use drugs, loved ones and community members. First responders are equipped with it. 

In NZ some ambulances and hospitals have it.  

It is literally nothing short of a miracle that there have been no fatalities in the Wairarapa outbreak. 

Our State of the Nation report 2022 (PDF, 2.8 MB), which details drug use in Aotearoa, showed that opioid overdoses already kill about 46 people in the country every year that naloxone could prevent. 

Until now, New Zealand has largely avoided the terrible opioid issues that are rife in America.   

The relative calm that New Zealand has experienced on this front is unlikely to last. It is only a matter of time until more opiates and overdoses hit our shores.  

The Foundation has long argued that country should be doing far more to stop drug overdoses and deaths. Naloxone is a vital tool for preventing overdose deaths.  

It is available in two forms – via ampules or nasal spray. Red tape gets in the way of either of them being given out freely. 

Ampules are funded, available to many medical staff, but not permitted to be distributed to people who use drugs without a hard-to-get prescription. 

The nasal sprays are available over the counter without prescription but are not funded. A two pack of naloxone nasal inhalers cost $92, making it completely beyond reach for those who use drugs or their loved ones. 

Nyxoid naloxone nasal spray

How to keep people safer 

Actions we can take right now to prevent unnecessary harm include increasing the availability of overdose-reversing medicine naloxone and updating the law.  

The Drug Foundation would like to see all first responders equipped with naloxone - police, all ambulances and fire fighters. If any of these staff turn up to a situation where someone has overdosed on opioids, having naloxone readily available could be the difference between someone living or dying. This week the Drug Foundation equipped Wairarapa police cars with naloxone and training to prevent further overdoses. 

But because a fentanyl overdose can be so rapid, we need the community of people who use drugs to also have it on hand and not have to wait for an ambulance. We either need nasal spray funded or the ampule distributed without prescription. The nasal spray is preferred by many people, and the Foundation has been giving it out at our pilot sites, needle exchanges in Nelson and Palmerston North.  

Law reform needed 

At present, criminalisation of people who use drugs is preventing me from being able to do my job and prevent overdoses. My week was spent thinking of how to get the message about this fentanyl incident to the people who use methamphetamine and cocaine in Wairarapa. The law drives people who use drugs underground, making it virtually impossible to resolve an issue like this. 

Overseas, in the US, their punitive drug laws have fuelled the opioid crisis and hundreds of thousands of fatalities. Here in NZ, our drug laws were written in the seventies and closely modelled on theirs.  

We need new drug laws that put health and harm reduction at the forefront and are fit for the modern world.  

We also need to increase funding for harm reduction and overdose prevention. Our recent polling showed huge public support for these measures. 

New Zealand has acted to prevent needless death before, and we can do it again 

During the height of the AIDS epidemic in the 1980s, New Zealand launched the Needle Exchange Programme. People who use drugs can access new needles and syringes, helping keep them safer from blood-borne diseases. At the time, it was a world-leading harm reduction initiative. We are now lagging on new harm reduction measures that are seeing tremendous success overseas.  

Canada has worked to act innovatively to shake the ‘war on drugs’ thinking that has gotten in the way. Portugal has had decriminalisation for two decades now. This is not new thinking. It is proven and robust.