Expert Links Substance Abuse, Mental Health & Justice System
Expert says New Zealand could lead world by learning from overseas harm reduction approaches
“Your prison rates are second only to those of the US. Ten percent of your prison population are incarcerated for drug offences. If you crack down on drug users in the ways currently being proposed you are going to see that number increase dramatically.
“When we treat people with substance use problems as less than human we deny them the help they need to return to being productive members of society. If we want to help people and return to happier societies, we need to change the way we look at drugs and addiction.
“Tough love and war on drugs approaches only make people feel less connected and more likely to use drugs.
“Evidence also shows boot camps for young people simply do not work.
“New Zealand has an opportunity to be world leaders in dealing with substance use. Please don't become just another failed statistic.”
Evidence shows social approaches that are compassionate and seek to reduce harm lower rates of crime, substance use and homelessness – and have enormous benefits for society, the Cutting Edge addiction conference was told today in Wellington.
Dr Seema Clifasefi, Co-director of the Harm Reduction Research and Treatment Center in the Department of Psychiatry and Behavioral Sciences at the University of Washington-Harborview Medical Center in Seattle, said there is an inextricable link between substance use, mental health and involvement with the criminal justice system.
“When we take a war on drugs approach we actually wage war on race and poverty, targeting the most marginalised. We literally lock them into punitive Catch 22 systems that they cannot get out of, and that has bad results for everybody,” she said.
Dr Clifasefi spoke about some of the harm reduction strategies that have been used in Seattle with great success.
One of these has been a Housing First approach which seeks to provide immediate, permanent, supportive housing to individuals experiencing homelessness without preconditions such as sobriety or treatment attendance. In other words, Housing First aims to resolve the immediate crisis of homelessness and then work with people where they are at (both physically and psychologically) rather than imposing strict standards they are not yet able to meet.
“It’s about listening and getting them the help they need – not what we think they need. It’s about giving them autonomy in decisions over their own lives,” she said.
In Seattle Housing First has reduced alcohol related harm, substance use and social costs associated with things like jail, hospitals and emergency departments – and Dr Clifasefi says it is cited most frequently by residents as, “the thing that saved their lives.” Her research has shown a Housing First approach used with just 75 individuals saved tax payers more than 4 million dollars in its first year of operation.
The Law Enforcement Assisted Diversion (LEAD) programme, which diverts low level drug offenders and sex workers out of jail and into harm reduction services, is another innovative Seattle programme that has reduced recidivism and social costs while also being associated with people’s connection to housing, employment and income/benefit services.
Dr Clifasefi, who received her PhD from Victoria University in Wellington and married a Kiwi, says the same principles that have worked in Seattle and elsewhere could work just as well in New Zealand.
“My experience is that you have a very social justice oriented society here, and a lot less bureaucracy than we have in the United States. New Zealand seems to embrace the idea of harm reduction as a strategy on both a policy and individual level.
“Your National Drug Policy has harm reduction as a stated goal, and that’s heartening. You could easily adopt a Housing First policy for your growing homeless population and implement more diversion programmes to reduce disparities in your criminal justice system.
“I think if New Zealand looks at the research and evidence base from other harm reduction models, including decriminalisation of drug use as Portugal has done, you could be world leaders in addressing addiction.
“When we approach issues such as substance use in ways that minimise harm and promote health and wellbeing, we create happier, healthier communities and everyone in society wins.”