Delamere Speech: Guidelines For Cannabis, Alcohol
Speech: Launch Of The Guideline For The Recognition, Assessment And Treatment Of Alcohol And Cannabis Abuse In Primary Care
Hon Tuariki Delamere, Associate Health Minister
[Mihi to dignitaries present] The Director General of Health, Mason Durie and the National Health Committee, representatives from the Royal New Zealand College of General Practitioners, the Goodfellow Unit, the Wellington School of Medicine, the Alcohol Advisory Council, the Wellington IPA, the Salvation Army Bridge programme, and relevant staff from the Ministry of Health
If we really want a healthy and wealthy population, then following these guidelines, the last of three produced by the National Health Committee, will be an excellent way to get one.
At present we spent more than $6 billion every year on our health system, and yet, as these guidelines point out, it has been estimated that alcohol abuse alone costs us somewhere between $1 - $4 billion a year.
It sounds so easy to fix, doesn't it? We drink less, we smoke less - whether it's tobacco or cannabis - and we become healthier, we enjoy our lives and relationships much more and we don't have to spend so much money fixing up problems we don't have to have or that are not inevitable.
So why doesn't it happen?
Take drinking. Heavy consumption of alcohol is widespread in New Zealand. More than one New Zealander in six drinks above the generally accepted safe level. I repeat: more than one in every six!
Problem drinkers (that is regular weekly consumption of over 21 drinks per week for men and 14 for women, or more than 6 drinks at any one time for men or 4 for women) are a far larger group than those who are dependent or alcoholic.
Problem drinkers place themselves and those close to them at risk of harm both physically and psychologically.
Young people are of particular concern because patterns of problematic drinking can be established early and are difficult to break later.
Further the binge drinking behaviour of many young people places them at risk of sexually transmitted diseases and unwanted pregnancies. Cannabis use is also common among this group and is often used in combination with alcohol and can compound its effects.
Here are a few figures to illustrate why we think these guidelines are so necessary.
About 80% of kiwis visit their GP every 12 months. But somewhere between 65 - 80% of patients with alcohol-related problems are not detected by their GP.
These guidelines aim to change that.
Because so many people visit a doctor at some stage, primary care provides an ideal opportunity to raise questions about drinking behaviour and for the practitioner, be it a doctor or practice nurse, to encourage moderation.
Advice from a health professional is an effective way of reducing consumption.
But it is not just a matter of doctors and practice nurses taking responsibility for their patients welfare. The patients themselves must expect to be asked about their drinking patterns, should see the visit as an opportunity to check up on and take responsibility for their own behaviour.
They should also feel able to approach their primary care provider about the mental problems of depression and anxiety - the subject of the two former NHC primary care guidelines.
I've talked about alcohol, mainly, but these guidelines relate also to cannabis abuse - something I know a little about.
I am particularly concerned about its long-term effect on the young. There are complicated phrases about the physical and psychological effects of long-term use of cannabis on dope smokers - but they can be boiled down into one phrase "It makes you even dopier."
Ladies and gentlemen, I commend the work of the National Health Committee and its research workers in producing these guidelines. I am sure they will make a valuable contribution to the improved health of New Zealanders and I have great pleasure in officially launching them.