Motions

Hon PETER DUNNE (Associate Minister of Health) Link to this

I move, That, pursuant to section 4A of the Misuse of Drugs Act 1975, this House approve the Misuse of Drugs (Classification of Ketamine) Order 2009, and the Misuse of Drugs (Presumption of Supply—Ketamine) Order 2009, made under section 4 of that Act. These orders demonstrate the Government’s commitment to prevent and reduce the harm associated with drug use in New Zealand. I am pleased that after considering these orders, the Health Committee has recommended that they should be approved. The Health Committee has worked hard in its consideration of these orders, in a short time frame. I thank all members of the committee for their valuable work.

Ketamine is a short-acting, dissociative anaesthetic, currently listed as a prescription medicine in schedule 1 of the Medicines Regulations 1984. It is commonly and legitimately used by veterinarians, primarily as an anaesthetic agent, and is becoming increasingly used in human surgery and palliative care. However, ketamine is also gaining popularity as a drug used illegally, for non-legitimate purposes. When used in this manner, ketamine can induce potent hallucinogenic effects, including out-of-body - type experiences, whereby the user feels numbness and detachment from themselves and others around them.

The Expert Advisory Committee on Drugs has assessed this substance and noted that its recreational use can induce schizophrenia-like symptoms in healthy adults, and that there is growing anecdotal evidence of physical and psychological symptoms of ketamine dependence amongst recreational users. Taking this into account, the Expert Advisory Committee on Drugs provided advice that ketamine poses a moderate risk of harm and should be appropriately classified as a class C4 drug in schedule 3, Part 4 of the Misuse of Drugs Act 1975. The Expert Advisory Committee on Drugs further recommended that the presumption for the supply of ketamine be set at 10 grams whether or not it was contained in a substance, preparation, or mixture. This means that anyone found in possession of 10 grams or more of ketamine will be presumed to be in possession of the substance for the purposes of supply, unless it is proven otherwise.

As the Minister in charge of the National Drug Policy, I believe that the classification of drugs should be based on expert medical and scientific advice. To this end, I accept completely and commend to the House the recommendations of the Expert Advisory Committee on Drugs that ketamine be scheduled as a class C4 controlled drug and that the presumption of supply for this substance be set at 10 grams whether or not it is contained in a substance, a preparation, or a mixture. The classification of ketamine as a class C4 controlled drug will not remove the availability of ketamine for legitimate use by health professionals, by veterinarians, and by researchers who hold a controlled drug licence. But the classification will increase regulatory controls, and increase police and customs enforcement powers to control the importation and diversion of ketamine for illegal purposes.

As the synthesis of ketamine is complex, this is not a drug that criminals can manufacture in New Zealand. Rather, those who use ketamine for non-legitimate purposes are generally able to obtain the substance only from the theft of legitimate medical and veterinary stocks. Therefore, real gains to control the harmful, non-legitimate use of ketamine can be made by mandating for the safer storage of the substance, in the same manner as other controlled drugs that are also medicines are stored, such as morphine. That is what this classification will achieve.

In regard to the proposed presumption of supply of ketamine, I acknowledge that concerns have been raised in the past that presuming any quantity of a substance to be available for supply may be in breach of one’s right to the presumption of innocence. For this reason, I support the Law Commission’s review of this matter within the wider review that is under way into the Misuse of Drugs Act, and I will take very seriously the Law Commission’s recommendations in regard to the presumption of supply.

However, we also have responsibilities under the current legislation, and that legislation mandates that should a specific presumption of supply, such as 10 grams in the case of ketamine, not be set, then a default quantity of 56 grams will take effect. Members will surely agree that for a substance deemed by the experts to pose a moderate risk of harm, possession of that particular quantity of ketamine would be excessive. Should the House agree to this motion, I will direct the Ministry of Health to consult further with affected parties before setting an enactment date for the classification, which will be brought into force with separate commencement orders. This consultation is necessary to ensure that hospitals, veterinarians, and other legitimate users of ketamine, such as researchers, are given enough time to prepare for the changing requirements in relation to the storage of the substance.

These orders are necessary to limit the dangerous non-medical use of ketamine without compromising legitimate access to the substance by medical and veterinary professionals. They will send a message throughout the country that the harmful use of drugs is not acceptable and will not be condoned by this Government. I therefore commend these orders to the House.

Hon RUTH DYSON (Labour—Port Hills) Link to this

I start by acknowledging the Associate Minister of Health Peter Dunne and thanking him for his comments in praise of the Health Committee and its consideration of this issue. The only puzzle I have is what triggered the referral of such items to a select committee, rather than the Associate Minister being able to sign them off directly. That is an issue that the select committee is yet to receive advice on. It is not a criticism; it is just an interesting difference in process. I also acknowledge the Associate Minister and congratulate him, because I understand that earlier this week he was a recipient of a very distinguished award, which acknowledged his support of philanthropy in New Zealand. I think that that is a matter of pride. We will all share in his glow from that award. I think it was well deserved. The other recipients are very highly regarded people. Peter Dunne now joins that list, and I congratulate him on that.

As the Associate Minister said in his introductory comments, the reclassification of ketamine is not directly comparable to the way that other drugs have been considered by this House. Ketamine is a drug that is legally used, but not for recreational purposes. It is a drug that is used by vets, but over recent times it has become more prevalent as a recreational drug in New Zealand. The habit has been imported, in particular from Asia. It is very commonly used as a recreational drug in Asia, particularly in Hong Kong. This drug has some serious consequences. Its use does not cause serious health effects, but it can do enough to have a person admitted to hospital and treated. Although those health impacts are not permanent, long-lasting, or significant, the Health Committee nevertheless looked at these orders, the Misuse of Drugs (Classification of Ketamine) Order 2009 and the Misuse of Drugs (Presumption of Supply—Ketamine) Order 2009, and decided that approving them was an appropriate step to take.

One of the more concerning aspects that we were made aware of was that people who use this drug recreationally have a feeling of disassociation with the objects, people, and activities around them, which can be quite dangerous. They literally are not aware of their connection to activities that are going on around them. Obviously, that can put them in very vulnerable or dangerous situations, rather than it being a case of the drug itself causing some physical effects.

Another consideration that the Health Committee examined in its process of looking at these recommendations was on the advice it received from the Expert Advisory Committee on Drugs, particularly in terms of understanding how the process the advisory committee had followed led it to the conclusion that ketamine needed to be reclassified. The proposed classification of ketamine as a class C4 controlled drug would allow the police and other enforcement agencies greater powers and it would increase deterrent penalties. Obviously, one would be able to be convicted for importing ketamine, unless it was for the purpose for which it is originally intended—that is, as I mentioned earlier, for use by a vet. The classification also considers manufacturing ketamine, supplying it to a person up to the age of 18, and selling or offering to supply it to a person 18 years or over, which would incur a maximum penalty of up to 8 years’ imprisonment. So this is not being considered as a light measure. Further penalties would include up to 7 years’ imprisonment for conspiracy to commit such an offence, and up to 3 months’ imprisonment or a fine of $500, or both, for possession in breach of section 7 of the Misuse of Drugs Act.

I think it is a rare moment in this Parliament—which perhaps has not been seen before in the life of this term—when the Associate Minister, who is from United Future, moves a resolution that Labour supports, and I am sure that will be followed by National supporting it. I think that both the Green Party and the ACT Party will support it. If the member representing the Māori Party takes a call in this debate and supports it, there would be a break-out of agreement, and perhaps we might consider having the House rise early at that point—

Dr PAUL HUTCHISON (National—Hunua) Link to this

Thank you for the opportunity to speak on this motion on the Misuse of Drugs (Classification of Ketamine) Order 2009 and the Misuse of Drugs (Presumption of Supply—Ketamine) Order 2009.

The Health Committee considered this matter and, as other members of this House do, its members feel strongly that it is appropriate to classify the drug accordingly. I note that there are currently no requirements for ketamine to be held securely, and that quantities of the drug have recently been stolen from hospital trolleys. Ketamine has potentially harmful effects. It can induce symptoms similar to schizophrenia in healthy adults. There is growing anecdotal evidence of physical and psychological symptoms of ketamine dependence amongst recreational users. Therefore it is highly appropriate that ketamine is scheduled accordingly as a class C4 controlled drug. I, too, commend this motion to the House.

HONE HARAWIRA (Māori Party—Te Tai Tokerau) Link to this

Tēnā koe. When this notice motion came up for classification of ketamine under the Misuse of Drugs Act, I was hoping that maybe ketamine was a chemical agent used in cigarettes, effectively making tobacco an illegal drug. That would have been a great idea, supported by the Māori Party and all other parties in the House, as well as overseas, where, a couple of years ago, the Commons Science and Technology Committee of the UK Parliament called for a major rethink on the classification of alcohol and tobacco, based on the fact that together they account for 90 percent of all drug-related deaths in the UK, and are among the top ten most dangerous substances in society. Its report was backed up by research in The Lancet and the British Medical Journal in 2007 that said that, based on physical harm, dependence, and social harm, alcohol and tobacco were ranked among the top 10 most dangerous substances—higher, indeed, than both cannabis and Ecstasy. But when I read the motion, I see that ketamine is something different from tobacco—something altogether milder and way less dangerous—but reclassification of ketamine as a controlled drug will now mean that general practitioners, district health boards, and vets, etc., will have to put it under lock and key, and track and record its use, which is what the sector has been after for some time, so we will support the motion.

Apparently this ketamine—also known as “special K” and “vitamin K”—is not widely used, but the experts tell us that there may be a rise in recreational use, with some speculation that its use is growing amongst young people. But in truth, the evidence is fairly limited, and it makes us wonder what all the fuss is about—only two customs seizures at the border, two or three cases of low-level harm each year, and no deaths at all. It reminds me of the debate about party pills a couple of years ago. That was the same thing—a big hullabaloo about nothing. There were no deaths, no crime, no nothing, yet we banned that, too.

Ketamine is hardly worth a mention in comparison to tobacco, which kills more than 5,000 New Zealanders every year—more, in fact, than any other single product or disease in Aotearoa. Those deaths are preventable. Tobacco is a known cause of lung, bladder, mouth, pancreatic, kidney, and stomach cancer, and is linked to significant causes of heart disease, emphysema, and other respiratory diseases known to society. We will support this motion, but we urge Associate Minister of Health the Hon Peter Dunne to seriously consider alcohol and tobacco use as also worthy of review. Tēnā koe.

Hon DAMIEN O’CONNOR (Labour) Link to this

I am led to believe that the Associate Minister of Health the Hon Peter Dunne, who moved this motion in the House, should be congratulated on an award that was made last night. I am not quite sure what it was, but I am sure that he received something. I have been informed of that by my colleagues.

Labour will, of course, support this motion to approve the Misuse of Drugs (Classification of Ketamine) Order 2009 and the Misuse of Drugs (Presumption of Supply—Ketamine) Order 2009. How could any party object to the wiser use of a drug that potentially could be misused by young people in this country? It is important to specify, as previous speakers have done, the harm that is currently caused in this country by ketamine. That harm is at a very low level at this point. So I applaud the Associate Minister for moving this motion, which is clearly making the case that prevention is better than cure. If we had done this with other drugs, this country would be a whole lot better off. The previous speaker made reference to both nicotine and alcohol. If we were starting from a different place, I am sure we would have a similar amendment to regulations and legislation.

When I read through the effects on recreational users of this drug, ketamine, I see that it delivers a short duration of hallucinogenic effects—as, I guess, a very good cup of coffee might do. I am not trying to make light of it, but I think we do have to keep certain things in mind. It is usually snorted as a powder, so I guess some people might pretend they are having cocaine. Well, if they stick to this drug, it might be a good alternative way to get their hits.

It is a sad reality that young people and older people resort to drug use, and that no matter what we block, or make illegal, smart people around the world will come up with a new kind of drug. This drug, to be fair, is used at higher levels in Asian countries. That is why I think it is very fair for the Associate Minister and the whole House to assume that its prevalence could increase in this country. I think it is logical that we put in place some provisions that secure its storage. Vets and pharmacists will have to protect their supplies so it cannot be lifted easily, and there will be some penalties for illegal supply.

Let us look at those changes and at what will happen when we have reclassified the drug. There are some fairly severe penalties here, and that leads to a question that, I am sure, will be asked by many intelligent young people. As was said earlier, the effects of the use of this drug are not that severe. They are short term. In emergency departments across this country there have been, in the last year, two or three cases of hospitalisation through ketamine misuse, but there have been hundreds of cases of alcohol misuse.

In supporting this motion, I challenge to the Government to take up the package of recommendations from the Law Commission on alcohol use. When doctors, specialists, and nurses tell us every week that hundreds of people are in emergency departments because of alcohol misuse, the careful considerations of the Law Commission must be taken up by the Associate Minister and his colleagues in Cabinet. The Government should bring to this House comprehensive proposals and legislation that address alcohol-related harm.

We will look like a bunch of idiots and, I have to say, like a bunch hypocrites if we do not move on alcohol, which affects thousands of people every weekend, when we bring to this House a perfectly sound, reasonable proposition to reclassify ketamine, which puts two to three people each year into emergency departments. So let us be consistent. We have moved on tobacco, and I applaud the Government for that. I think it was a good move, but we have yet to see just how committed this Government really is to reducing the harm caused by alcohol.

The penalties in the case of ketamine are very severe. Supplying this drug to anyone under the age of 18 years carries a maximum penalty of up to 8 years’ imprisonment. That is a severe penalty for a drug that puts two to three people into the emergency department each year, and I again compare that with alcohol. Let us get real here. Let us take the bull by the horns and take the opportunity to address drug harm in this country. It is upon this Minister and all Ministers to bring comprehensive recommendations back to the House.

Labour supports this reclassification on the basis that we want to reduce harm from the misuse of any drug in New Zealand. We think that this is a good move at this time, and we will be supporting it.