Wastewater Testing and Rataora Trial Informs Enforcement and Treatment

Wastewater Testing and the Rataora Trial, two programmes within Te Ara Oranga, are providing evidence based data regarding illegal drug use in Whangarei.

Te Ara Oranga is an integrated model of Police and Health activity in Northland to reduce methamphetamine demand by enhancing treatment services and increasing our responsiveness.

Up until now, reliable data about the volume of illegal drugs used by the population has been difficult to obtain. Wastewater testing provides an accurate measure of illegal drug consumption that is cost effective, timely and non-intrusive.

When people consume drugs, they are processed by the body into other compounds (metabolites). A mixture of the parent compounds (drug taken) and associated metabolites are excreted and make their way into the wastewater system.

Wastewater testing in Christchurch and Auckland began in December 2016, with testing in Whangarei starting in August 2017. Data is collected from the wastewater facilities for one week every month.

The reports present the results of analysis of wastewater samples for the last four months from the three sites. This testing does not identify individual users or usage rates.

Methamphetamine, MDMA/ecstasy and cocaine were detected in wastewater from all cities. Heroin and α-PVP were not detected in any of the wastewater samples.

“The results indicate a high incidence of methamphetamine in the Whangarei wastewater and confirm the commitment to the Te Ara Oranga partnership between Northland DHB and Police to reduce methamphetamine demand,” noted Superintendent Russell Le Prou, District Commander, Northland.

The collaborative model has been developed in response to increased level of harm from methamphetamine use in Northland communities, to whānau and children. The wastewater results will provide an ongoing baseline of data to inform and measure both treatment and enforcement.

“For example, following an enforcement operation, when methamphetamine is seized, the impact of the seizure will be monitored against the wastewater results.

“If the wastewater shows less usage in the community then it may be one indicator that the targeting of that operation was successful. If no impact is seen it may indicate that further investigation is needed into methamphetamine supply.”

The Screening and Referral to Treatment trial called Rataora compliments the wastewater testing by providing an indication of the number of people who use methamphetamine and come into contact with health or police services.

The trial was implemented within the Whangarei Hospital Emergency Department and the NZ Police Whangarei Custody suite, 24/7 over a one week period.

In the Emergency Department 350 patients were screened for substance use and related issues. 70 people were referred on to specialist services such Mental Health & Addiction, Smoking Cessation, the Alcohol Drug Helpline and Depression Line. A further 12 people were referred to their GP and another six people were given a Brief Intervention by a psychologist or at ED.

Four methamphetamine users were identified during the week of screening. If the screening was to be implemented for an entire year then it might be expected that around 200 methamphetamine users would be identified.

“This is significant as many people don’t come to treatment until their problems are severe or have caused them problems with the law or their mental health,” noted Jenny Freedman, Professional Leader Addictions, Mental Health & Addiction Services, Northland DHB.

“The Emergency Department initiative has the potential to offer people a referral to treatment earlier, before they develop a severe problem.”

This research began with a focus on the use of methamphetamine. But what has been found in ED, and amongst those screened in police custody, is that methamphetamine is commonly used together with cannabis and alcohol.

One outcome of the Rataora trial is the appointment of a full time Whangarei Hospital Emergency Department Screening & Intervention position and the DHB is investigating the possibility of drug testing options for use in a clinical environment.

Employment can support recovery from methamphetamine addiction. As a part of Te Ara Oranga, Northland DHB have employed two Employment Specialists to support people to secure and maintain employment. Out of the 24 people who wished to accept support from Employment Works, in the first three months, a total of nine people have commenced employment.

Activities within the Police methamphetamine team include cold calling suspected users, engaging users with treatment providers and enforcement operations against suppliers of methamphetamine.

“Our staff are actively visiting people who are known methamphetamine users and referring them to the DHB,” said Superintendent Le Prou.

“Police have referred ten people in the last month for treatment. The DHB responds within 24 hours of receiving the referral and meets with the client to assess and offer an appropriate treatment option.”

Click here to view the first four months' results from the Te Ara Oranga Whangarei wastewater programme.(external link)

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