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Help for synthetic high users

Captain Michael Douglas of Addictions Services

6 May | 2014

People power, particularly the power of provincial New Zealand communities, has surely come to the fore as the Government responded to public pressure—amplified through the media—to immediately ban all psychoactive substances such as synthetic cannabis.

When the Psychoactive Substances Act 2013 passed into law in July last year, it meant ‘legal high’ products would be required to go through clinical testing before being approved for sale—making manufacturers responsible for the safety of what they were supplying. As an interim measure, the law change reduced the number of products from around 300 to 41, with those products remaining on shop shelves regarded as ‘not problematic’ according to Associate Health Minister Peter Dunne. It also greatly reduced the number of places where synthetic drugs could be purchased, taking them out of the likes of corner dairies and leaving just 150 outlets around New Zealand.

But with no testing regime in place and evidence that the remaining products were causing harm, the Government responded to public pressure. On 27 April, Mr Dunne unexpectedly announced that all synthetic drugs would be removed from sale within two weeks until they could be proven to be low-risk.

The Government’s decision was a surprise for Helen Archer, Programme Coordinator at The Salvation Army’s Christchurch Addiction Services. Along with other members of staff and representatives of the wider Salvation Army in the city, Helen had joined one of many rallies against ‘legal highs’ held around the country on 5 April.

After the rallies, Helen decided to launch a support group for families of synthetic cannabis users. This came after she spoke with parents experiencing fear and hopelessness because they could see their children in trouble but couldn’t persuade them to get help.

She says the new whanau support group will provide education, with visiting expert speakers, but will also be a space for people to share their stories and receive support from others who understand what they’re going through. ‘We want to upskill people so they can provide support for their family members. We want to help reduce the risk of their children becoming homeless, because they’ve burned all their bridges. We want to reduce the likelihood of children needing emergency psychiatric services, and we want to reduce the risk of suicides.’ Despite the ban, the group will still go ahead. ‘For as long as there’s a need, we’ll run it,’ says Helen.

With news of the ban, Christchurch Addiction Services also prepared contingency plans in anticipation of increased demand for treatment services, looking at a priority system on a case-by-case basis for those presenting for treatment. They have been working with Community and Alcohol Drug Services (CADS) on a generic response to support GPs who, along with Police and Accident and Emergency (A&E) Departments, are most likely to see the first impact of people in acute withdrawal.

The attraction of legal highs has been that while they have been relatively easy to purchase, they are hard to drug test for, meaning people felt they could still keep using without putting their jobs or training at risk. But they can also be far more potent than cannabis. Users don’t just consume to chill out, but in some cases to totally escape from reality. Salvation Army Addiction Services staff have noted that in many cases, coming off synthetic drugs is difficult, and not dissimilar to coming off other substances such as methamphetamine (‘P’). Those in detox typically experience hot and cold sweats, agitation, anxiety, paranoia, racing thoughts, sleep deprivation and loss of appetite. One client at Christchurch Addiction Services was still in acute withdrawal three weeks after he last used, says Helen.

When people are coming off alcohol, it often requires a medical detox intervention, but in most cases Addiction Services offers what is known as ‘a social detox’ to those coming off synthetic cannabis—a similar regime used by those coming off methamphetamines and other substances. This includes providing a safe, low-stimulus environment, rest, exercise, fluids, small frequent meals and regular monitoring. In some cases, medication may also be needed.

Major Mike Douglas is director of The Salvation Army’s Auckland Addiction Services, which covers Auckland City, Manukau and Waitakere. In the 12 months from March 2013, the service has had 267 clients who attended the day and residential programme for an average of eight weeks or more. Of these, 13 had synthetic cannabis as their primary substance of use. A further 155 had a primary dependency on alcohol, and 56 on methamphetamine. Forty-one per cent were poly-drug users, with many of these using synthetics alongside other drugs, but not as their primary substance.

‘Three groups of people are likely to be affected by the removal of synthetic drugs from shop shelves,’ says Mike. ‘Recreational users may shift to cannabis or alcohol; those with a primary dependency on synthetics may turn to the black market, which has no controls; and a smaller group may approach treatment providers for help.’

He says it’s a misnomer that the media is reporting what has happened as ‘a ban’. ‘It’s not a ban; it’s about revoking the licence of those products that have had interim approval. These products will now need to be scientifically proven to be a low risk of harm to people using them.'

Mike has mixed feelings about the Government's decision, describing it as ‘social policy by media’ at a time when New Zealand was attempting to regulate the environment. Around the world, and with large sales online, there is a growing need for a workable global response to psychoactive substances. With so much money to be made by manufacturer, importers and outlets, safe policing of such a lucrative industry will be no easy task. All governments need to give urgent attention to this dilemma.

While Mike would dearly love to see no market at all for such products, he is realistic about their existence. ‘As a Salvationist, of course I don’t want it, but we do operate in the real world in Addiction Services. We know that prohibition doesn’t work, so we work toward harm minimisation where people can have a quality of life and function safely in society.’

Mike has the greatest sympathy for those fighting personal battles against synthetic cannabis, and urges people to seek help from The Salvation Army. But he also has a message for the New Zealand Government: ‘The legal high of preference in this country is still alcohol,’ he says, ‘and that causes far more carnage: road deaths, hospital admissions, domestic violence. My guess would be that this carnage outstrips synthetic cannabis by hundreds to one. But the Government doesn’t seem to want to address that.’

For access The Salvation Army’s help (for those 18 years and over), go to www.salvationarmy.org.nz/addictions or phone 0800 530 000.

Addiction Services can also provide contact details for specialised youth treatment providers in your area.