Irene* is waiting nervously for her son Noah’s* drug test result. He’s been struggling with methamphetamine addiction for the past two years, and Irene has watched in anguish as his escalating use has cost him his farm job, his home and most of his friends. The 24-year-old has recently been allowed to live at the family home in the Bay of Plenty on the proviso he gets support and passes regular drug tests.
“I was drug testing him every three days,” Irene says. “He’s been good so far, so about two weeks ago when he was sitting on about three weeks clean, I started dropping the testing back to about once a week, because I thought I could tell by his behaviour.” She looks down at the test he’s just taken, sighing as the result becomes visible. “It’s come up negative, but it’s a very weak negative, so that’s just a big trigger for me.”
Irene is exhausted and her nerves are shot. She has spent countless hours worrying, researching and reaching out to try to find Noah help. It has been a mentally and emotionally exhausting process, with some hit-and-miss results when interacting with various support agencies. She is grateful he is now at home, following her testing rules and attending outpatient clinics through a local addiction service.
Jocelyn*, who lives in the lower North Island, is in a similar situation. Her son Michael* is a multi-substance user, “cocaine, prescription drugs, alcohol” she reports. “My son’s journey with addiction has had a profound impact on our entire whānau. We’ve felt the pain, carried the shame and stigma, and witnessed first-hand how broken and under-resourced our current system is.”
Michael, 23, started doing drugs when he was at high school. “He was using them to escape,” Jocelyn says. “He thought they made him a better person, able to socialise and talk to people. We didn’t realise the escalation, which sounds really naive.”
After five exhausting years, during which Michael had interactions with police, the courts and various addiction services, he is now in a long-term residential treatment facility, paid for by Jocelyn remortgaging her home. “We were lucky to get him in, and without the money, we were desperate, thinking where the hell would we try next?”
As Jocelyn and Irene have discovered, addiction treatment is not a one-size-fits-all model. Trauma, co-existing mental health conditions, cultural identity and family involvement all shape what support works for each individual. While one person may benefit from early intervention and peer support, another may need intensive residential care or trauma-informed counselling. One person may respond best to a kaupapa Māori approach, another may need medical intervention.
Above all, timing matters. There is what’s often called a “golden window” in addiction treatment, when a window of opportunity opens and the time is right for the person affected to do the work required to recover. It’s a tough job to find the right treatment at exactly the right time, from a service that has the criteria and capacity to help.
For families like Jocelyn’s, the only way to guarantee timely treatment is often to pay privately – even if that means re-mortgaging the house. Private insurers such as Southern Cross won’t cover addiction treatment, citing its “different risk profile” compared with other health issues.
Common threads
What Irene and Jocelyn have faced is far from unusual. Throughout the country, thousands of families are in similar turmoil, and the data shows the problem is growing. According to Te Hiringa Mahara, the Mental Health and Wellbeing Commission, almost 45,000 people accessed specialist addiction services in the year to June 2024. That number doesn’t paint a full picture, as it doesn’t account for people receiving support privately or not receiving any support at all. Considering these additional cases, and the climbing rates of substance use, addiction rates in New Zealand are likely to be much higher.
Data from the NZ Drug Foundation shows methamphetamine use is on the rise, climbing 74% between 2020 and 2024, and Massey University reports that almost a third of people using the synthetic stimulant do so daily, or nearly daily. Cocaine use is also rising sharply, up 229% between 2020 and 2024, and 11% of people are now vaping daily.
As for New Zealand’s favourite addictive drug, alcohol, although overall consumption is inching down slowly, more than 700,000 people (16.6%) still drink at levels considered hazardous, and one in 12 adults are reported to binge at least once a week.
Those connecting with addiction services are discovering a sector under strain. The Mental Health and Wellbeing Commission notes wait times for specialist addiction services are below the government target, and the number of referrals being declined by these services is on the rise.
“We’re very fortunate, and in a strong position in New Zealand, in that we have this amazing, professional addiction workforce who know who they are and what they’re doing,” says Sam White, executive director of the Addiction Practitioners’ Association Aotearoa New Zealand. “But at the same time, our sector is having to do some really difficult work and is incredibly stretched. We’re dealing with increasingly complex cases, working with people who are carrying difficulties from their families, their communities and life events. Our workforce is constrained, we are suffering from shortages, and we are suffering from funding issues that have not been kind to us.”
More than a quarter of all those using mental health and addiction services are accessing addiction services. Yet the addiction sector receives only 9.1% of total mental health and addiction funding. The Drug Foundation has long claimed an increase in addiction-sector investment is badly overdue, a call White wholeheartedly agrees with.
“We need more investment in the workforce. We need an ecosystem that is supported, more people doing the mahi and doing different types of treatment. We have large waitlists for inpatient treatments, limited detox beds available and the residential treatment sector is contracting, all caused by funding issues. Resource the sector, resource the services. That is what will help because they are the ones that are close to the community, they’re the ones that get it and get on with it.”
Increased investment in the addiction sector would strengthen the treatments we currently have on offer, White says, and enable expansion into options not used in New Zealand. “We are stifled in the amount of innovation we can offer,” she says. “Things like supervised injecting. We are lagging behind other countries. It is always context-specific and differing countries have different needs and patterns of drug use, but funding to keep up is certainly an issue.”
Her view is echoed by the Drug Foundation. “There are quite a lot of trials happening overseas for substitution or medication-assisted therapy,” says deputy executive director Ben Birks Ang. “It would be good for us to pay attention to what is being learned there and see how that could be applied in New Zealand”.
However, Birks Ang points out there are significant differences between the addiction support we offer in New Zealand and what is available overseas. “People’s perception of addictions treatment is usually based on what they see on American television or movies, where the options are medical treatment or 12-step programmes.
“They think the start of their journey should be residential withdrawal and then residential treatment, without realising all the other options we have here that are less disruptive to their lives. We have had several decades of fantastic kaupapa Māori services and mutual aid communities; they need funding and development focus. We still need security for our residential treatment programmes so they can keep operating and be available to people, but we also need several other options that people can access earlier before requiring inpatient-level care.”
Stigma challenge
The pressure on the addiction sector isn’t just about funding, options and capacity. The deeper challenge is stigma – the judgmental views of addiction that shape how it is regarded and influence whether people actually seek help.
Many in society – the public, healthcare providers, police, employers, friends and family – still consider people with addiction as morally corrupt, incompetent, dangerous, unpredictable, weak and not capable of making decisions. This despite the well-researched, modern-day understanding that addiction is a chronic, relapsing disorder stemming from a combination of biological, psychological and environmental factors, often a response to emotional pain.
Irene admits her attitudes have changed immensely since her experiences with Noah.
“I thought addicts were the scum of society. It wasn’t until the last four weeks when I’ve been to visit Noah at the side of the road, asleep in his car, that I thought, ‘Holy shit, this is my son.’ I judged people, but now I know it can happen to anyone. Noah didn’t get addicted because he chose to. He used the drug and then used it more and more until he was addicted. We need to understand that it starts very, very innocently.”
Jocelyn also admits that throughout her family’s journey, she has had to confront her opinions. “At first, I was absolutely ashamed that my son was choosing this path. I wouldn’t talk about it because if he wasn’t okay that must mean there’s something wrong with me as well.
“But now, I’m sick of this being something I’m holding like a failure. It’s not a failure, it is what it is. Addiction isn’t a choice. It is driven by many, many factors. People don’t choose it, and it’s not something that needs punishment. It’s something that needs support and help.”
Sue Philipson runs Taranaki not-for-profit Families Overcoming Addiction. She is adamant stigma needs to shift for people to receive the support they need.
“The heart of addiction treatment needs to be that people with addiction are seen as people who need healing. They’re not seen as somebody who is a weak person, or a bad person, or a broken person. Families need to understand this, too.
We’ve felt the pain, carried the shame and stigma, and witnessed first-hand how broken and under-resourced our current system is.
“I meet family members who are confronted with an addiction for the first time, and they’ll have that lack of understanding; they’ll be thinking, ‘Why can’t he just put it down? I have a couple of wines and don’t have a problem, so why does he?’
“When you start educating families that addiction is very often a coping strategy, a response to trauma, they can get on board with that. Generally, they’re really pleased to hear there’s actually a reason behind the behaviours.
“I’ve lost count of the number of times I’ve said to families over the years, ‘Nobody wakes up one day and says, ‘What am I going to do with my life? I know what, I’ll become a drug addict’ or ‘let’s be an alcoholic.’ Nobody makes that choice.”
Erin ONeill, founder of Brave Hearts NZ/Manawa Kaha Aotearoa, a nationwide organisation providing support and education to families affected by substance abuse, says more stigma is attached to addiction than to mental health illnesses. “With mental health, money has been put into it and I think we’ve broken through the stigma barrier. But with addiction, we haven’t even begun to break through.”
ONeill cites a recent study carried out by Brave Hearts with the Bethlehem Tertiary Institute that surveyed more than 700 families with a family member who’d experienced addiction. It found two of the most predominant emotional responses from families to their predicament were shame (47%) and embarrassment (45%).
These emotions drive families to close ranks and isolate, rather than seek assistance. “Family members don’t want to believe that this is really happening,” ONeill says. “And if it is happening, at first, all they’re thinking is, ‘How can we stop the neighbours from finding out?’
“It’s the same old, same old. How can we break through that stigma? How can we make people want to reach out for support?”
Stigma kills
“Stigma kills people,” says Suzy Morrison, a clinical supervisor with more than 30 years’ experience working in addiction and recovery settings. “It stops people from reaching out for help. We know the numbers accessing services is high, but what about all those people who are not seeking support? People don’t understand the impact that stigma has on people, and I’m not being dramatic when I say stigma is killing people.”
Morrison’s view is backed by the Drug Foundation’s latest “Drug Overdoses” report, showing almost three New Zealanders die each week from preventable drug overdoses – twice the number of people who die by drowning.
“That’s hundreds of families and loved ones suffering unimaginable grief and our current system is woefully ill-equipped and underfunded to prevent harm and to adequately respond to it,” executive director Sarah Helm said on the report’s release.
Morrison has lived experience of addiction and long-term recovery. She, too, says shifting stigma is key to improving outcomes.
“Addiction causes a massive disconnect, and the only way through that is to reconnect, and that’s got to be done warmly and kindly. By the time people have been in active addiction for a while and got to the point where the shit has seriously hit the fan, then they’re going to be full of guilt, shame, fear, anxiety and panic, as are their whānau. They need a society that cares and doesn’t judge, and services that are warm and open.”
The practitioners association’s Sam White agrees stigma is a huge issue. “We know it’s there all the time. We’re the biggest advocates against it, but it’s almost like it’s such a big issue to get past, you just forge on. You address it where you can.
“Again, it comes down to resourcing the sector. Resource the workforce – our workforce is gold. They’re the ones who can destigmatise it because many have walked this path, and they are the best advocates, along with families that have travelled through it. They’re out there doing amazing things with families, helping people with addiction turn their lives around and become amazing contributors to society.”
This is what mothers like Irene and Jocelyn are hoping desperately for – that their sons overcome addiction, like countless others have, and rise up to meet their potential.
“He is a beautiful, intelligent, kind and lovely young man who I believe could really make a difference in the world,” Jocelyn says of Michael. “I want him to be able to come out and live a healthy life where he feels good about himself and knows that, actually, who he is is okay. He is okay. He just has to be himself and be okay with who he is, because he’s amazing.”
Names marked with an * have been changed.