Kiwis addicted to methamphetamine could be given a substitute drug to help get their lives back on track if recommendations from a new report are acted upon.
The Helen Clark Foundation and NZ Drug Foundation report out today recommended setting up a pilot programme that would give either a substitute stimulant or controlled doses of meth to those having extra trouble escaping their addiction.
These would be given under supervision and only in limited circumstances, such as to people who've remained addicted after two rounds of traditional treatment.
The report's lead author Philippa Yasbek said the programme would be based on data from New Zealand, Switzerland, and Canada.
And - similar to opioid and tobacco addictions - the treatment could reduce cravings and allow people to get away from the crime and "toxic" situations associated with meth's illegal supply, she said.
"It may be helpful for people, who have been through treatment and reduced their use but are not completely able to abstain," she said.
It comes as meth has grown into the nation's most feared and stigmatised drug over the past 20 years, the report said.
While only around 1.2 per cent or 40,000 New Zealanders use methamphetamine each year, according to the New Zealand Health Survey, the report said the number could be an underestimate and belies the outsized social and health harms it causes.
Meth has had an especially severe impact on poorer communities with wastewater testing showing the highest per capita usage in rural towns in Northland, Bay of Plenty, and Hawkes Bay.
In one example in the Bay of Plenty's Kawerau in 2019, police identified 600 people out of a population of 6000 using the drug, the report said.
Māori are also using and being "criminalised" for meth use at a higher rate than non-Māori.
These problems are being fuelled by the fact large profits can be made selling meth.
That has led criminals to aggressively distribute and market it, "using many of the same tactics as the alcohol industry, such as freebies, discounts, and targeted advertising", the report said.
In 2019, the Herald reported that meth inflicts an estimated $500 million of social damage a year.
Some addicts said they spent up to $1000 a week. Tests on wastewater suggested Kiwis spent $1.4m on meth every day.
While traditional efforts to combat illicit drugs focused on stamping out supply networks and punishing users, the report said these tactics alone had been shown to have failed both in Aotearoa New Zealand and abroad.
That's why the report authors recommended starting the pilot programme.
"We need to increase the focus on innovative, and proven, ways to reduce demand," it said.
"We also need to help people who experience methamphetamine addiction to extricate themselves from a toxic illicit market.
"People who are addicted often become trapped by debt and turn to dealing or other crime to support their own use."
Rotorua resident Kharl WiRepa recently told the Herald about his on-and-off addiction with meth that lasted about 10 years, during which time he lost his job as a fashion stylist and ended up getting stabbed.
"People talk about the housing crisis in Rotorua but that's not our crisis,'' he said.
"Our crisis is the methamphetamine crisis."
He said he understood how the idea of the pilot programme could work in some cases where people are not able to kick their habits.
"If another drug can work to help people stay off the actual meth itself, it is a positive outcome," he said.
However, he said the best outcome was to kick all addictions, noting he moved into drinking alcohol and smoking marijuana in periods where he gave up meth.
"Changing the addiction didn't make anything better, although alcohol is less harmful than methamphetamine allegedly - I just became a heavy addict to that," he said.
"My behaviour wasn't methamphetamine behaviour, but I still lived a life of addiction."
"The best thing is to encourage people to live a healthy life and not seek any drugs whatsover."
The pilot programme was only one among a slew of recommendations in the report, however.
Others included rolling out a more comprehensive national treatment programme that particularly made services available in areas of highest demand, such as small towns in the Bay of Plenty, Northland, and Hawke's Bay.
That would be supplemented by culturally appropriate support for Māori and other groups and improved treatment and diagnosis for people suffering from Attention Deficit Hyperactivity Disorder due to the condition being a risk factor for meth use.
Former Prime Minister and chair of the Global Commission on Drug Policy Helen Clark pointed to the successful Te Ara Oranga The Path to Wellbeing meth treatment programme unveiled in Northland in 2016.
It had been operating in Northland as a trial partnership between police and health agencies, iwi, non-government groups and other services.
It mixes prevention, treatment, and peer leadership that includes aspects such as bringing peer support workers into emergency hospital wards to help doctors better understand patients.
"Expanding Te Ara Oranga nationally is a no brainer. It has been found to reduce offending by 34 per cent and is estimated to return up to $7 on each dollar invested," Clark said.
"We must do what works instead of just trying the same tired old approaches. We must focus relentlessly on harm minimisation rather than just locking people into a cycle of addiction and incarceration."