Addiction is an important part of our Terms of Reference. We focused on addiction issues as they relate to alcohol and other drugs but heard about, and recognise, the harms caused by other forms of addiction, such as gambling, pornography and e-addictions. Addiction is intimately linked, through social determinants of health such as discrimination, isolation, poverty, trauma and stigma, with poor mental health outcomes. Over 70% of people who attend addiction services have co-existing mental health conditions, and over 50% of mental health service users are estimated to have co-existing substance abuse problems.189
We heard many stories across New Zealand about the harms caused by a wide range of addictions. While we acknowledge that every form of addiction is harmful, we chose to focus more broadly on the harmful use of alcohol and other drugs because of their significant, multifaceted impacts, not only on an individual now and into the future, but also on communities, families, and whānau.
We know young people are particularly vulnerable to harms from alcohol and other drugs and that harmful use is significantly implicated in crime – around 60% of community-based offenders have an identified alcohol or other drug need and 87% of prisoners have experienced an alcohol or other drug problem over their lifetime.190 We also know that people suffering from addiction often have poor long-term physical health and die at a much younger age. Young people who use alcohol and drugs early have adverse outcomes due to their still-developing brains and the lifelong dependency that early use can precipitate.
New Zealand has taken steps towards a stronger health-based approach to alcohol and other drugs, but the evidence suggests a much bolder approach is required to minimise the harms associated with alcohol and other drugs.
In this chapter, we identify a pathway for improving New Zealand’s approach to addressing alcohol and other drug challenges. Our recommendations require a shift in the national mindset away from stigmatising addiction towards viewing addiction as a health issue that requires care and support for effective management. These issues are not unique to New Zealand – they are challenges all countries face.
189 FC Todd. 2010. Te Ariari o te Oranga: The assessment and management of people with co-existing mental health and substance use problems. Wellington: Ministry of Health. www.health.govt.nz/publication/te-ariari-o-te-oranga-assessment-and-management-people-co-existing-mentalhealth-and-drug-problems(external link).
190 D Indig, G Gear and K Wilhelm. 2016. Comorbid Substance Use Disorders and Mental Health Disorders among New Zealand Prisoners. Wellington: Department of Corrections. www.corrections.govt.nz/resources/research_and_statistics/comorbid_substance_use_disorders_and_mental_health_disorders_among_new_zealand_prisoners.html.(external link)