Today marks the 6th International Harm Reduction Day, a day focussed on promoting evidence based public health policy, practices and human rights.
Established over 30 years ago, the New Zealand Needle Exchange Programme is one of New Zealand’s most successful public health programmes. Last year the programme distributed 3.75 million needles. Internationally, HIV prevalence amongst people who inject drugs is 13%, in New Zealand it is just 0.2% largely due to the early introduction of needle exchange.
HIV and AIDs posed a major public health challenge in the 1980’s, and the fear of the potential impact of HIV was a key driver in the development of the needle exchange programme. Today, people who use drugs face different challenges. Over the last two years New Zealand has seen a public health crisis develop, a crisis that has led to 80 deaths from the use of synthetics. These deaths were largely preventable and the fact they have happened should provide a major impetus for changes to our drug laws and policies.
Today in New Zealand we have seen changing needs and patterns amongst people who inject drugs. The use of opiates continues but we are also seeing methamphetamine and steroid injection. Whilst HIV has been less prevalent amongst the injecting community, Hepatitis C is a key concern but with the new treatments a cure is now available. “People who inject drugs bear the burden of Hepatitis C and the new treatments are a game changer for our community. As people who inject drugs often don’t access mainstream health services we have partnered with a range of health providers to bring services into the needle exchanges. As a peer led and peer based service, need a space where our community feels safe” says Kathryn Leafe, Executive Director.
“Harm reduction is not about condoning drug use, rather it is about meeting people where they are at and recognising that people will use drugs. Harm reduction is about keeping people safe and helping them to reduce the risks to themselves and others” says Kathryn Leafe, Executive Director.
Harm reduction is a proven intervention, with a solid evidence base that demonstrates its effectiveness. Yet harm reduction services both at home and abroad are often under developed and under-funded. Just last week 329 organisations signed a joint letter calling on governments and world leaders for a coordinated health and human rights based response as well as an increase investment in harm reduction.
The New Zealand Parliament is currently discussing amendments to the Misuse of Drugs Act 1975 in response to the synthetic Crisis and last week the Health Select Committee heard a number of oral submissions. This debate has drawn significant media attention. However, as is often the case judgements of ‘morality’ about people who use drugs and tougher penalties have gained greater visibility. Yes, we do need effective criminal justice and policing in response to organised crime but we must also assist those who use drugs. Drugs, drug use and drug dependency often have a disproportionate impact on those in our community who are marginalised, poor, have experienced trauma, are socially or economically disadvantaged, our young people, our Maori and rainbow communities. The appropriate response is a health and not a crime based one. “The criminalisation of drugs and drug use presents a barrier to effective health-based approaches – it can stop someone seeking help” says Kathryn.
We applaud the proposed move towards the introduction of police discretion and the presumption against charging people for possession for individual use. However, what we really need is a fundamental overhaul of the Misuse of Drugs Act to ensure it is fit for purpose and provides the framework for a truly health-based approach.
New Zealand as a country has proved itself to be highly innovative in harm reduction with the early introduction of needle exchange but we urgently need to re-capture this pioneering spirit and innovate once more. Increased investment is needed in harm reduction services to expand and build on established programmes whilst also expanding our portfolio of interventions beyond needle exchange and OST. Drug checking, naloxone provision, overdose prevention, supervised consumption and low threshold services are all urgently needed.
Kathryn Leafe, Executive Director - firstname.lastname@example.org,nz