2. The inclusion of public health focused restrictions around the sale and supply of these products.

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1 1 May 2013 Committee Secretariat Health Select Committee Parliament Buildings Wellington Submission on the Psychoactive Substances Bill (RPH) serves the Greater Wellington region, through its three District Health Boards: Capital and Coast, Hutt Valley and Wairarapa and is based at the Hutt Valley District Health Board. We work with our community to make it a healthier safer place to live. Our staff include a range of occupations such as: Medical Officers of Health, Public Health Advisors, Health Protection Officers, Public Health Nurses, and Public Health Analysts. In particular RPH focuses on achieving equitable health outcomes for high needs groups such as Māori, Pacific peoples, child and youth, low income families and other vulnerable groups. RPH commend the Health Select Committee on their swift response to concerns about psychoactive substances through the development of the Psychoactive Substances Bill. The sale and use of psychoactive substances in our communities is a growing concern amongst community providers, parents and the police regarding adverse reactions that include psychotic episodes, continuing mental instability and insomnia. Over the past 12 months there has been an increasing number of hospital Emergency Department admissions associated with these substances. It is for these reasons that RPH is in favour of: 1. The main purpose and focus of the Bill which requires evidence of less than low harm through clinical trials before products are approved for use. 2. The inclusion of public health focused restrictions around the sale and supply of these products. We wish to make the following comments on sections covered in the Bill.

2 Part 1 Subpart 1 Preliminary matters (3) Purpose RPH recommends amending the purpose of the Act to read: The purpose of this Act is to promote health and reduce harm through regulating the availability of psychoactive substances in New Zealand. Currently the Bill does not address health or harm reduction explicitly in its purpose. It is important that this aim is at the forefront of the Psychoactive Substances Regulatory Authority (The Authority), policy-makers and politicians minds when making decisions about psychoactive substances. Subpart 2 Interpretation (8) Interpretation It is recommended that the Minister and Ministry responsible for the administration of this Act be nominated in this section as the Minister of Health and the Ministry of Health. This Act has been instigated with the intentions to protect the public from the potential health harms of psychoactive substances. RPH therefore believe this Act should explicitly nominate the responsibility of the Act to be under Minister of Health and the Ministry of Health. Part 2 Subpart 1 Licenses to Import Manufacture and Sell Psychoactive Substances RPH support the implementation of a licensing process to import, sell and manufacture psychoactive substances. Part 2 Subpart 2 Approved products (41) Register of approved products Section 41 should include a subsection relating to information collection and dissemination of unapproved products as well as approved products. There is little information, research or evidence about the effects, toxicology, or composition of these substances. Because of this, it is important that regardless of whether a substance is approved or not, information about it is made available. It would be beneficial to consider whether this may be covered within other legislation for example the Hazardous Substances and New Organisms Act. Part 3 Subpart 1 Control of approved products (46, 47, 48, 49) Age restrictions RPH agrees that the purchase and supply age of psychoactive substances should require an age limit. This imposed age limit should be related to the degree of risk the product poses to younger individuals. The brain continues to develop until the age of 25, while there is currently no research available on the potential harms of psychoactive substances, research has found that products which cause intoxication such as alcohol and drugs pose a risk to

3 adolescent brain development 1. Furthermore, the sale of psychoactive substances to those as young as 18 years old inevitably increases the supply of these substances to all youth attending school as many 18 year olds are still attached to a school community. Other restrictions, prohibitions, and requirements relating to approved products public health regulations included in primary legislation and applied to all products RPH is in support of the public health regulations outlined in sections 50, 51, 54, 55, 56, 57, 58, and 59 which outline health regulations, include health warnings, packaging restrictions, and restrictions around the place of sale. (64) Infringement Offences Section 64 outlines the infringement offences under this Act. RPH recommend legislation considers harsher penalties for offences related to the sale and manufacture of psychoactive substances. While approved products will be of low harm, they are still considered to cause some harm and should be treated with great caution and control. In addition, as the Bill is currently written there is inconsistency between infringements recommended by The Psychoactive Substances Bill and the sale of herbal smoking products under the Smoke-free Environments Act. Part 3 section 46 (1) states A person under the age of 18 years commits an offence if the person buys an approved product, and (3) A person who commits an offence against subsection (1) is liable on conviction to a fine not exceeding $500. This is inconsistent with a similar clause in the Smoke-free Environments Act 1990 section 30 (1) No person may sell a tobacco product or herbal smoking product, or having sold it to a person of any age deliver it or arrange for it to be delivered, to a person younger than 18 years. Section 36 (6A) states Every person who sells a herbal smoking product, or who having sold it delivers it or arranges for it to be delivered, in contravention of section 30 (1) commits an offence and is liable to a fine not exceeding $2,000. The need for there to be consistency between legislation is outlined further in the sections following. Subpart 3 Enforcement (s68) Enforcement Officers Section 68 (1) states that the Authority may appoint enforcement officers to enforce this Act. 1 Odgers. C.L., et al (2008) It is important to prevent early exposure to drugs and alcohol among adolescents/psychological Science, 19 (10): p

4 Currently the Ministry of Health appoints Smoke-free Enforcement Officers to carry out duties enforcing the regulations of the Smoke-free Environments Act. As the appointed enforcement officers are likely to require a similar skill set to the current Smoke-free Enforcement Offices, RPH recommend the Authority considers appointing Smoke-free Enforcement Officers to enforce regulations under the Psychoactive Substances Bill. This would ensure consistency is granted between varying New Zealand legislation. Subpart 5 Other matters (85) Relationship with other Enactments RPH have a general concern for the potential conflict between this Bill and the Smoke-free Environments Act It is recommended that the Select Committee seek advice from officials regarding sections of the Bill which may be similar to the Smoke-free Environments Act, for example the Control of Approved Substances section regarding fines mentioned above. Schedule 1 - Transitional Provision RPH disagrees with the transitional provision recommendation in Schedule 1 and instead recommend that the sale of all, psychoactive products are discontinued until they have been fully approved by the Authority. Schedule 1 of the Bill allows the Psychoactive Substances Regulatory Authority to at any time, recall a product if it is considered more than low risk, however this a reactive step rather than a preventative approach. Health risks will continue to cause concern until the Bill comes into full effect if unapproved products remain available for purchase during the transitional period. Other matters not mentioned in the Bill Marketing and Sponsorship RPH recommend the inclusion of a third point to section 53, prohibiting the promotion of approved products through sponsorship. This section of the Bill outlines restrictions and requirements relating to advertising approved products, however as it is written there are no restrictions to the promotion of products through sponsorship. Sponsorship is used as a vehicle to embed brands and products into subcultures and accounts for a large proportion of brand and product marketing that targets youth, for example alcohol brands sold in New Zealand are increasingly being marketed via sponsorship of music, clubs and sporting events 2. RPH would recommend harmonising this Bill with the Smoke-free Environments Act 1990 in regards to section 25 and 25A. This will effectively nullify the use of events as sponsorship opportunities. An example of this would be the following: Section 53 (3).An approved product brand cannot be used to provide sponsorship in any form. 2 Hill and Casswell 2001: Bucahnan. D. R., and J. Lev. (1989) Beer and fast cars: How brewers target blue-collar youth through motor sport sponsorships. Washington, D.C: AAA Foundation for Traffic Safety, Rekva, D. (2000) Counteracting sports marketing by the drinks industry. P in Global Alcohol Policy Advocacy Conference. Syracuse, NY.

5 Sponsorship includes the organisation, promotion, financial contribution or other type of contribution to any of the following (a) events (b) a person, team or group (c) an object, vehicle or craft (d) an animal or organism (e) agreements for exclusive sale rights It is prohibited for a brand to associate any of the above through all or any part of the company or product name, trademark, words, logos, colours, shapes, sounds, smells or other elements used with the purpose of advertising the product. Conclusion Finally, we strongly support the implementation of this Bill. This will provide a significant countermeasure to address the widespread concerns around the safety of these products. We are happy to provide further advice or clarification on any points raised in our submission. The contact point for this submission is: Nadia Freeman Public Health Advisor Community Action on Drugs (CAYAD) Phone: or (reception) nadia.freeman@huttvalleydhb.org.nz Kind Regards Dr Stephen Palmer Medical Officer of Health Peter Gush Service Manager