Policy Papers I
Alcohol & Public Health Research Unit . 1999. Advice for purchasing strategy on public health issues: reducing drug related harm. Auckland: Alcohol & Public Health Research Unit. [accessed 2 May 2005].
This report recommends funding strategies to the Health Funding Agency (HFA) and evaluates different drug education programmes.
It points out that drug use in New Zealand is not high and did not increase over the 1990s.
Prevention efforts over the last decade have indicated that no one programme can address all aspects of substance abuse, and that effective approaches are those which are collaborative, draw on the experience of community groups, are tailored to the needs of each group, and are designed with input from those groups.
School-based programmes don't generally seem to work, and often use scare tactics and non-credible sources. DARE and Life Education are specifically mentioned as failures. Peer-led programmes are better. Family programmes are promising.
It recommends that the HFA fund programmes that focus on all drugs in an integrated approach, focusing on addressing norms and availability of drugs, and promoting alternative recreation options for youth. Also Maori-based, school-based, community-based programmes and 'fill in the gaps' programmes, such as funding material for dance party goers.
Discusses abstinence vs. harm reduction approaches, arguing that the former is suitable for non-users, but is not the only possible strategy. Reports on strategies that have been used:
- risk factor (identifying risks, from low-self esteem to parental drug abuse, etc) and trying to target those factors;
- social influence (providing information on negative social and psychological effects of drug use, and providing methods to resist the social influences to use drugs, and altering misperceptions about prevalence of use); and
- developmental: focusing on interactions within the family during childhood.
It is acknowledged that no one strategy will eliminate all abuse.
Media approaches can work if integrated into broader, interpersonal strategy. Slogan-based approaches don't work too well ("Just say no!"), nor do scare tactics. Supply reduction has been shown to have had some success in reducing drug use.
Alcohol Drug Association of New Zealand. [2004?] Drug related harm in New Zealand. Christchurch, N.Z.: Alcohol Drug Association of New Zealand. [accessed 3 June 2005].
Discusses the cost to New Zealand society of drug abuse. Economic costs are known only for alcohol and tobacco, and they are in the billions of dollars per year range.
Drink driving is a cause of over 100 deaths per year. Drug use, especially alcohol, is correlated with suicide attempts. Around 25% of workplace injuries are connected to drug use, again mainly alcohol.
Violence is also related to drug abuse. Again, mostly to alcohol, but there is also a connection to methamphetamine. There are also social costs of drug use.
Social tonics are a new trend in drug use. They are promoted as suitable for helping with methamphetamine withdrawal, but are probably of limited use. A sizeable number of young people are using these drugs. No problems with addiction have been noted, but users should be careful of variation between brands that may mean some pills are far stronger than others.
Alcohol Drug Association of New Zealand. 2005. Ecstasy - MDMA. Christchurch, N.Z.: Alcohol Drug Association of New Zealand. [accessed 3 June 2005].
A good short introduction to ecstasy. Provides information on both the positive and negative effects, as well as discussing what is known about the potential long-term effects it may have on mental health. Provides some sensible advice for users on how to reduce harm.
Alcohol Drug Association of New Zealand. 2005. Methamphetamine. Christchurch, N.Z.: Alcohol Drug Association of New Zealand. [accessed 3 June 2005].
A good short introduction to methamphetamine. Provides information on both the positive and negative effects, as well as discussing what is known about the potential long-term effects it may have on mental health.
Allen & Clarke: Policy and Regulatory Specialists Ltd. 2003. Effective drug education for young people: literature review and analysis. Wellington: Ministry of Youth Development.
[accessed 8 February 2006. This link has been updated from the link published in the original bibliography].
Part of a review of best practice in drug and alcohol education. The review aims to improve understanding of the effects of drugs, and of what constitutes effective drug education. It also aims to reduce drug use and enhance uptake of drug education programmes by schools and communities.
This research found that young people's drug use is shaped by "social, cultural and economic contexts". It found that young people with poor relationships with families and others are more at risk of drug-related harm, and that developing their strengths can reduce the risks of harm. Unsurprisingly, drug education that relates to young people's needs is more effective, and providing accurate information about drugs and drug use is a key part of effective drug education.
The research assumes that harm reduction should be the overall objective of any drug education programme, though it notes that this could include abstinence. It does note that there is evidence that abstinence-only programmes don't work. It provides a number of conclusions and recommendations about the most effective means of providing community drug education.
Bellamy, Paul, and Jill McNab. 2003. Methamphetamine ('speed' and 'P') in New Zealand. Background note: information briefing service for members of Parliament; number 2003/05. Wellington, N.Z.: Parliamentary Library.
[available from the Parliamentary Library for Parliamentary staff only].
An overview of the chemistry, effects, legal status, and social and policy issues surrounding methamphetamine in New Zealand. Reports on the prevalence of methamphetamine use from the Drugs in New Zealand surveys [Black, Casswell, and Wyllie, 1993; Field and Casswell, 1999). Notes the rise of use among middle-class professionals, "lower socio-economic Māori populations", university students and in the dance scene. Discusses the neuropharmacology of methamphetamine in simple terms. Explains the risk of death and dependency, and that there is little therapeutic use for methamphetamine. Describes the health risks posed by clandestine laboratories, and the links between methamphetamine and organised crime.
Describes the reclassification of methamphetamine to Class A, pointing out that the Green Party voted against this reclassification. Points out that methamphetamine is only Class B in most countries. Discusses control measures, pointing out the poor results obtained from school programmes, and the importance of law enforcement operations and moves to control precursors. Some treatment programmes have been successful in reducing recidivism.
Bowden, Matt. 2004. Submission of Social Tonics Association of New Zealand to the Health Select Committee on the matter of Misuse of Drugs Amendment Bill (No 3) and the Supplementary Order Paper. [Auckland, N.Z.]: [Social Tonics Association of New Zealand]. [accessed 4 April 2005].
Provides STANZ's submission on proposed amendments to drug legislation in New Zealand. STANZ argues that the current system provides "an unhealthy black/white view" of some recreational drugs. Bowden advocates for evidence-based legislation and a "happy medium" between full criminalisation and a total laissez faire approach. He suggests that criminalisation would only create a black market for legal highs.
'Social tonic' is recommended as the appropriate terminology for BZP/TMFPP-based products.
Bowden argues that the (US) Food and Drug Administration (FDA) ban on BZP is based on a misreading of earlier scientific research that makes BZP seem far more potent than it really is.
The current classification scheme under the Misuse of Drugs Act 1975 has classifications for drugs that pose a very high, high, or moderate risk of harm - but none for drugs that pose a low or minimal level of harm. Social tonics are safe, and are being blamed for hospital visits (not admissions) by users who have also consumed illegal drugs. The sale of pure BZP, which has also caused hospital admissions, is condemned, and it is noted that legislation exists to prevent this. Dr Lynn Theron of Auckland Hospital is quoted as saying that in 2003/4 14 people were admitted having taken social tonics, but all but one had also taken alcohol, and some had taken other drugs.
Relative risks of other drugs, as well as motor vehicle accidents and adverse pharmaceutical events are presented, and claimed to be much higher than that posed by social tonics.
STANZ discusses its Code of Practice, and argues that such a Code is a better option for regulation than placing social tonics in the Misuse of Drugs Act 1975: "[i]t is important from a social responsibility point of view to differentiate legal substances from illegal substances so that the perception is not created that one is an extension of the other." Any legislation to control social tonics should be separate from the Misuse of Drugs Act.
STANZ supports the Guidelines for Safe Dance Parties (Ministry of Health, 1999), including sanctioning members who refuse to adopt the Guidelines (especially providing cold running water).
Brady, Elizabeth. [c1995]. Drugs used for other than medicinal purposes in New Zealand; Drug and alcohol issues pertaining to children and adolescents; vol. IV. [Wellington, N.Z.]: [Specialist Education Services].
Reviews the effects of common recreational drugs. Discusses models of drug use and dependence, and how genetics and family background may play a role. Discusses assessment, treatment and prevention.
Has sections on amphetamines and ecstasy. Amphetamine is a bitter white powder, usually imported. It has some medical uses (treating Parkinson's, obesity, narcolepsy). Moderate users may present as restless, alert, euphoric, suffering from dizziness, headaches, irregular heartbeat or altered sex drive. Heavy users may experience agitation, panic, depression, hallucinations, fainting. Long-term users may experience nutritional problems, sleep loss, permanent anxiety, receding gums, high blood pressure and psychoses. Dependence is possible, withdrawal is difficult and may require medical treatment and ongoing counselling.
Ecstasy is “easily manufactured from 3-4 chemicals” and shares “psychoactive and physical effects of LSD”. (Both these statements are highly debatable). It leads to “euphoria, enhanced emotional/mental clarity, enhanced sensual experiences”. It is commonly used by “yuppies and young experimenters”, and not usually mixed with other drugs. The effects last for 6-24 hours (also debatable statements). Research on the long-term effects is inconclusive. There is no research on dependence, but tolerance appears to develop. Psychological dependence is possible, physical dependence unlikely.
The section on amphetamines is generally accurate, and that on ecstasy contains a number of errors or debatable points – obviously reflecting the fact that ecstasy was practically unknown in New Zealand at the time of writing, and little was known about it.
Expert Advisory Committee on Drugs. 2002. Advice to the Minister on Methamphetamine. Wellington, N.Z.: National Drug Policy. [accessed 21 April 2005].
Presents evidence on the risks of harm posed by methamphetamine, and recommends to Ministers that the drug should be re-classified as a Class A substance.
Rationale for reclassification include:
- the increase in stimulant use in the late 1990s,
- an increase in the number of users being hospitalised, or seeking counselling,
- increasing number of arrests for drug offences related to amphetamines, in seizures of drugs, and in clandestine laboratories located.
Recommendations for reducing the amount of methamphetamine a person needs to have in their possession before they can be charged with intent to supply are presented.
Police are likely to face increased violence due to the rise in methamphetamine use, both through gang turf wars, and through individuals being more violent as a result of the drug.
Reviews the chemistry of methamphetamine, the long-term effects, the risk of amphetamine psychosis, the fact that there are few accepted therapeutic uses for the drug. Reports the potential for overdose, which, although low, is real. All cases cited are from overseas, which is interesting as other reports have suggested there have been New Zealand cases. The risks of addiction, and the fact that no known treatment for dependence exists, are described. The increased likelihood of methamphetamine users engaging in unsafe sex is mentioned.
The manufacturing process is described, and the hazardous chemicals produced are named.
Every claim made in this paper is backed up with research evidence. It therefore provides a very good overview of the science behind recent government policy.
Expert Advisory Committee on Drugs. 2003. EACD minutes. Wellington, N.Z.: National Drug Policy. [accessed 14 April 2005].
The minutes from meetings of the Expert Advisory Committee on Drugs, established under the "Misuse of Drugs Amendment Act 2000….to provide expert advice to the Minister of Health regarding drug classification issues." The minutes are high-level and lack detail so aren't discussed further here.
Expert Advisory Committee on Drugs. 2004. Advice to the Minister on benzyl-piperazine IBZP 2004. [Wellington, N.Z.] National Drug Policy. [accessed 13 April 2005].
Provides advice to the Minister of Health on BZP, the main ingredient in social tonics. States that more information on the health effects and prevalence of BZP is needed.
Argues that BZP should not be marketed as a dietary supplement, and regulation, such as sale restrictions, should be considered. Claims that there is no schedule of the Misuse of Drugs Act 1975 into which BZP could be placed. Notes that restricting access to BZP may lead to users seeking more dangerous drugs as a substitute (see the Supplementary Order Paper to the Misuse of Drugs Act 1975 (House of Representatives, 2004). Advertising of social tonics is criticised for not taking into account their impact on younger people.
Notes that BZP has been trialled as an anti-depressant, but has no known human therapeutic use. Notes that users would not use it to an equivalent dose strength as amphetamine, because the side effects become unpleasant at lower doses than this. Notes drug treatment centres are not seeing clients needing help specifically for BZP, though some poly-drug users use it. Notes that the only case of death involving BZP can be attributed to MDMA, not BZP. Also notes anecdotal evidence that it may be problematic in combination with alcohol. Suggests that using BZP may start a pattern of abuse that leads to using harder drugs, but also that the opposite may occur (users may switch from harder drugs to BZP). Notes usage patterns and sales.
Notes there is no evidence of dependence or addiction, but suggests that mild psychological dependence, in order to overcome inhibitions or gain energy, is possible.
This last seems like a very probable, and often under-reported, reason why people develop drug dependencies.
Notes BZP is used as a substitute for illicit drugs due to the cost, risk of conviction, and poor quality of illegal drugs. Notes the Ministry of Health has met with industry, but says industry self-regulation is not recommended as long-term strategy.
Overall, an excellent, if short, piece of work. It seems to identify the status of social tonics in New Zealand society, and the authors are clearly aware of the issues around BZP.