Williams Poto: Substance Addiction (Compulsory Assessment and Treatment) Bill — First ReadingText is incorporated into the Bound VolumeWilliams Poto: Substance Addiction (Compulsory Assessment and Treatment) Bill — First Reading[Sitting date: 15 March 2016. Volume:712;Page:9707. Text is incorporated into the Bound Volume.]POTO WILLIAMS (Labour—Christchurch East): Tēnā koe Mr Deputy Speaker. Thank you. It is a great opportunity to be able to speak on this bill which as Dr David Clark has said we are supporting to the select committee. The intent of the bill is positive but there are certainly some questions that I as a member of the Health Committee am very keen for the select committee to investigate.There is no denying that when somebody has relinquished their liberty and also when they are provided treatment potentially without their consent there is a fine balance that needs to be struck between their rights as an individual our rights as a community to safety and their rights to not be harmed. It is a balance that we need to get right and there are some questions that need to be answered in my mind before we can actually get to a point where I am comfortable that this is the right way to track down and support people with severe substance addictions.There is no denying that the Alcoholism and Drug Addiction Act is outdated. In 1966 I do not think that many of the substances that are being consumed now or the ways that they are being consumed would have even been heard of. In my earlier days I recall being quite taken aback when people were consuming glue by sniffing. It was called sniffing but these days young people are huffing all manner of substances that were not conceived of in 1966 when the Act first came into effect. Also society has changed in its attitude to the use of some substances so there is no doubt that we need to update the legislation.As I pick up on the point that Dr David Clark made we currently detain about 74 people with severe substance addiction. The estimation is that this will go up to around 200 under this legislation but we do not know for sure and we cannot know for sure until we have tested out several things. One of the things that we need to test out is the assessment on which someone will actually come within the purview of this legislation. If we are talking about the assessment as will be defined within the legislation it will be based on three criteria: the severity of the substance abuse the risk to that individual from significant harm and whether they have refused treatment.Here is where the concept of compulsion comes into the discussion. Anecdotally I know from work that I have done in the past where I have worked with groups who were compelled to attend various sessions—in this regard I am talking about young people who might have been compelled to go to groups held by the Department of Corrections as part of their probation conditions. Anecdotally it is thought that compulsion is a really important part of the compliance to a treatment and the success of the treatment programme. But that is anecdotally and unfortunately it does not appear that we have the evidence that compulsion is a proven pathway to ensuring that someone who is compelled to do a treatment programme is actually successful at getting through that programme and has a successful result.Here I want to add that the experience of mental health consumers in this regard has not been entirely positive. Mental health consumers will want to I am sure contribute and submit to this bill because of their previous experiences. In that regard I am referring to what may have happened in the past around the electroconvulsive therapy which for mental health consumers was something that they were compelled to do and in many instances was very detrimental to their ongoing mental health. So there is a cautionary tale in that. In discussion with organisations such as the Citizens Advice Bureau the treatment will be residential and it will require us to change our way of working with people with addictions due to the provision of wet houses.A wet house is a place where you can safely use a substance until such time that you can wean yourself off that substance because if you have a serious substance addiction you cannot go cold turkey—it is very dangerous to do that. This is a change in the way we would treat people with addictions. In my view it is actually an option that could be open to a whole lot of other people who have substance abuse not just the most at risk of severe harm. It is a method that is used overseas; it is not something that we use here but it is certainly something that the Health Committee could look at as an option for treatment for people with other levels of substance addiction.This bill also tends not to include the co-morbidities that go along with someone who has a serious substance addiction. Here I am talking about mental illness talking about family violence sexual abuse and other social harms. We cannot see this person in isolation—only around their addiction. We have to actually review the whole environment that this person lives within. Neither can we actually then discharge somebody back into an environment that is completely unsafe because that will mean that they are then triggered by whatever is in their environment and we potentially will not get a successful treatment option for that person. I am hoping that the select committeewill be able within the purview of this legislation to ask questions of health officials about what is going to be provided for somebody post-treatment so that they can have a successful reintegration back into the community.I want to refer to the regulatory impact statement. There is a reference to not including the criterion of significant harm to others within the bill. I just want to quote from the regulatory impact statement. It says: “Existing legislation directed at child protection family violence and other criminal behaviour is available to deal with situations where behaviour arising from the substance addiction results in a risk of serious harm of others.” It concerns me that serious harm to others is not part of this legislation.I want to refer to the Mental Health (Compulsory Assessment and Treatment) Act 1992 where serious harm to others is part of that legislation. For me I am concerned that for someone who is under a compulsory treatment order and is mentally unwell there is a component of risk to others within their assessment. However somebody who has a serious substance abuse addiction does not have serious harm to others as part of their assessment. I think we are missing an opportunity here to ensure that things such as children who are in homes where methamphetamine is being manufactured for example are not a significant risk to that child or that young person. It is my belief that the Health Committee should examine this as something that we should include in the legislation.There is much more that I could say but in conclusion I just want to talk about the Code of Health and Disability Consumers’ Rights because there are elements of this legislation that are in breach of this code of rights. The right to freedom from discrimination coercion harassment and exploitation—the coercion aspect of right No. 2 does come into play here. Right No. 6 the right to be fully informed is about when somebody does have a compulsory treatment order imposed upon them and they are not completely informed. Right No. 7 the right to make an informed choice—there is also an aspect of not being fully informed and being able to give your permission. And right No. 10 is the right to complain. I understand the district inspector service will be part of this legislation and hopefully anyone who is ordered to have treatment as part of this legislation actually has the option to complain. On that note I commend the bill to the House. Thank you.