top of page
Search

Reducing drug harm and targeting organised crime: might 'safe supply' be the answer?

According to wastewater testing results, methamphetamine use has risen by 96% from 2023 to 2024. Addiction services are also reporting a surge in use. Casey Costello, Associate Police Minister and Customs Minister, has recently highlighted that the only way to stop this is to combat the profitability of organised crime in New Zealand (Hanly & Reporter, 2025); however, few effective measures for doing this have been suggested. Such a supply-side focus is unsurprising from the customs minister – trying to reduce illegalised drug supply through drug seizures is a core part of that role, despite the ministry of customs itself reporting that drug seizures have little effect on consumption (Costello, 2025).


Many groups have pointed out that traditional supply-side approaches, such as drug seizures and harsh penalties for suppliers, have little effect on drug consumption. Research suggests that these efforts destabilise drug markets, increasing violence, drug harm, and associated crime (Cano et al., 2024; Grahl Johnstad, 2025; Kral et al., 2025; Werb et al., 2011). It stands to reason that, if there is high demand for a drug and that drug can be sold for a high price, as they can in New Zealand, then organised crime will go to extreme lengths to fill that void and make a tremendous profit. This highlights two key approaches to reducing this use and limiting its associated harm: reducing demand for the drug, and, as Casey Costello has pointed out, reducing the profitability to organised crime in a way that works (i.e. not just drug seizures or harsher penalties).


The illegalised drug trade is exceedingly profitable (Rolles et al., 2012). Estimates of drug use from wastewater testing, coupled with surveys of typical prices paid, estimate the value of New Zealand's illegalised drug markets to be over a billion dollars (The New Zealand Illicit Drug Harm Index 2023, 2024; Wilkins et al., 2024). It is unsurprising that the illegalised trade is so lucrative. Monopolies can be enforced through violence, which would not stand in the legal economy, and black market businesses are free from the profit-restricting regulations that legal industries spend millions to lobby against. The illegality and stigmatisation of people who use drugs exacerbate addiction and make it harder to get help, fuelling higher rates of consumption. Additionally, the inherent violence of drug prohibition towards people who use drugs, both from law enforcement and from those involved in the industry, may cause increased use as well (Grahl Johnstad, 2025). Whilst legal industries such as alcohol or gambling businesses may be heavily penalised for plying their customers with excessive amounts of their products or services, or inducing addiction disorders, illegalised industries are rewarded for such behaviour.


Research has shown that drug seizures do not reduce drug supply (Costello, 2025; Weatherburn & Lind, 1997; Wood et al., 2003), and the illicit supply of drugs exacerbates drug harm through adulteration, dose uncertainty, and a lack of customer care. Drug seizures are associated with increased overdoses (Cano et al., 2024; Kral et al., 2025) and increased drug market violence (Werb et al., 2011), potentially leading to increased, rather than decreased use (Grahl Johnstad, 2025). It is these factors, which prohibition exacerbates and prevents legislation against, that cause the majority of drug-associated harm. With drug seizures being an apparent failure, it is time for new supply-side approaches to combat drug harm, such as safe supply.


Safe supply programs are a supply-side method of reducing drug harm that acts as an alternative to drug seizures, which have negligible efficacy. Safe supply programs involve providing safe, known doses of drugs to the people who use them, reducing the harm of taking the wrong thing, taking the wrong dose, or taking drugs in a more harmful manner. Such programs may take many forms. Here in New Zealand, for example, we have a nationwide opioid substitution program where people who are experiencing addiction to opioids may receive an alternative opioid such as methadone from a pharmacy. Such programs have been shown to be an effective treatment for addiction (MacArthur et al., 2012; Mattick et al., 2009) sure, but they also reduce other types of drug harm by reducing mortality risk (Sordo et al., 2017), reducing HIV transmission in people who inject drugs (MacArthur et al., 2012),  and reducing the risk of legal harm or violence experienced by people who use drugs (Kalicum et al., 2025).


Additionally, always knowing where their next dose is coming from and that it will be in a facility that may provide other healthcare services gives people who may be dependent on drugs much-needed stability. Whilst New Zealand uses methadone or suboxone for opioid substitution therapy, some jurisdictions go directly to the product people are currently using on the street and prescribe them heroin, a practice named 'heroin assisted therapy' (McNair et al., 2023; Smart & Reuter, 2022; Strang et al., 2015). Both methadone substitution and heroin assisted therapy have been shown to reduce drug use, improve retention in therapy, and reduce rates of acquisitive crime (McNair et al., 2023; Smart & Reuter, 2022; Strang et al., 2015).


Stimulant substitution therapies have also been trialled for people who experience cocaine, methamphetamine, or other amphetamine type stimulant addictions (Kalicum et al., 2025; Tardelli et al., 2020). Such programs would typically use a legally prescribed stimulant such as dextroamphetamine, lisdexamfetamine, or methylphenidate (Ritalin) as a substitution for street drugs. To date, only the compassion club model run by the Drug Users Liberation Front (DULF) in Vancouver has provided methamphetamine and cocaine rather than a substitute drug (Kalicum et al., 2025). Stimulant substitution therapies are less researched and less commonly implemented than opioid substitution therapies. Stimulant substitution therapies have been shown to reduce drug use and increase periods of sustained abstinence (Tardelli et al., 2020). The provision of pure methamphetamine and cocaine through the DULF Compassion Club model also resulted in reported improvements in mental, physical, and overall health, reduction in contact with the police and experiences of violence, improved income, reduced reliance on organised crime, reduced drug use, and improved likelihood of using clean/sterile equipment (Kalicum et al., 2025). Unfortunately, the studies of the DULF Compassion Club do not differentiate between people who use stimulants and people who use opioids (there is likely a lot of crossover between the groups); however, these results are promising for the efficacy of such a legal model of stimulant provision for the reduction of drug harm.


Whilst safe supply programs may not always ensure a person experiencing addiction gets past their addiction, they do ensure that everyone who uses them knows precisely what it is that they are consuming, significantly reducing the harm of drug poisonings and overdose (Bowles et al., 2024; Kalicum et al., 2025). Currently, the only people who can access a safe supply in New Zealand are people experiencing addiction to opioids, which is a very small number of people. The majority of people who use opioids, like most drugs, are not addicted and thus, only have access to an unsafe street supply. Not only does this cause greater harm to the person themselves, but it also ensures that, rather than that money going into the health system, as it could with safe supply, it goes directly to funding organised crime. Currently, prohibition forces people who use drugs to fund organised crime in order to acquire a more dangerous supply of drugs. This act puts them at greater risk of violence and harm and leads to considerable instability in their life. Safe supply gives them a choice to purchase drugs from licensed providers instead, taking money away from organised crime, ensuring a safer supply of drugs, and also giving them greater access to health care professionals who can monitor their use and help them to avoid harm. Whilst people who are dependent on opioids have a slight choice here with the option of opioid substitution therapy, people who use methamphetamine, or any other illegalised drug for that matter, have no such choice and thus, are forced to fund organised crime and take greater risks with their drug consumption.


The success of such a safe supply program would depend on the details of how it operates. The simplest method would involve an expansion of the current methadone program whereby people who use methamphetamine, or other drugs, may acquire a safe supply of either an alternative drug that acts similarly (substitution – methylphenidate, dextroamphetamine, methadone) or their drug of choice (methamphetamine, heroin, MDMA), from a pharmacy or other licensed provider. The required regulations and complexities around the program would depend on whether it targeted dependent or non-dependent users, and whether it involved substitution therapy or gave clients the actual drugs that they wished to use. There should likely be different rules for different drugs based on their potential for harm, how people use them, and their addiction potential. Regardless of how a safe supply scheme operates, it should ensure that specially trained practitioners provide harm reduction advice to every client and monitor their use, so that they can offer help and support if the client may be developing a problem. Greater funding for support services should be provided, not because safe supply is likely to increase rates of addiction, but because it will enable people to be put in contact with support services much sooner and thus, preventative services that do not focus on abstinence will need to be developed. These services will focus on resolving underlying issues before an addiction may develop. The Harm Reduction Support Groups run by the Needle Exchange Program are a great example of such a service (https://www.nznep.org.nz/support).


If we genuinely wish to put a dent in organised crime in New Zealand, then safe supply is the answer. By providing people who use drugs with a choice between funding organised crime and violence and being sold risky substances, or funding healthcare services and accessing a safer supply, you give people the autonomy to make an ethical and moral decision around their drug use. The average person does not wish to participate in crime or drug-associated violence; however, the prohibition of drug use has forced people to be participants in an industry that they are against. Prior to prohibition, people were happy to work with enforcement as they were usually victims of the situation and nothing else; however, the prohibition of people who use drugs forces them to be complicit in an industry, and thus, they are less willing to help with enforcement.


As well as taking money away from organised crime, ensuring a safer drug supply, reducing experiences of violence, and providing more lifestyle stability, a safe supply scheme would give greater healthcare access to a highly marginalised population. Currently, it is tough to reach people who are experiencing drug harm before serious harm has occurred. Whilst needle exchange services and drug checking have increased the ability to reach such people, such services are still only used by a tiny proportion of people who use drugs in New Zealand. This regular access to healthcare professionals can ensure that providers can check in with their clients to ensure that they are not developing addiction or moving towards more harmful drug use practices. Specially trained staff can advise clients on harm reduction practices at each visit, just as occurs when clients attend a drug checking clinic, and safe supply venues would provide ideal bases for other programs, such as shifting people who inject towards smoking, which is of less harm (Whelan, 2025).


Whilst this article outlines numerous benefits to the development of safe supply programs in New Zealand, there would of course be several hurdles to overcome, one of which would be the gut reaction of 'what the fuck do you mean you want to provide [illegalised] drugs to people?'. There are likely to be significant concerns around the potential for such a program to increase drug use, to cause more harm, or for pharmacies or other providers to become targets of theft. Not only would such a change require substantive legislative change, but it would also require a psychological shift, too – not just in the way we approach people who use drugs, but also in the way we approach our own drug use. A safe supply system would need to be implemented in a step-wise manner with rigorous ongoing research and constant adaptation as we learn more about the new system.


Concern over the increased use resulting from the implementation of harm reduction measures is almost always the first counterpoint raised. Here in New Zealand, concerns were raised about condoning and increasing drug use during the debate around the implementation of the needle exchange program and the legalisation of drug checking. Both programs have reduced drug-associated harm in New Zealand, and there has been no evidence to suggest that either has caused any significant increase in drug use. Research shows that safe supply programs reduce drug use and harm among people who use them (Kalicum et al., 2024, 2025; McNair et al., 2023; Nyx & Kalicum, 2024; Tardelli et al., 2020) and that reduced barriers to access and a focus on client autonomy can improve outcomes (Bowles et al., 2024; Kourounis et al., 2016). Further trials will be needed to fully determine if a safe supply system for non-dependent users will change levels of drug use and, far more importantly, levels of drug harm. It is important to remember here that prohibition does not by any means result in a complete lack of, nor even a minimal amount of, drug use. Under the current framework of drug prohibition, use of almost all drugs is rapidly increasing, with methamphetamine use itself increasing by 96% from 2023 to 2024 (National Drugs in Wastewater Testing Programme - Quarter 1, 2025, n.d.). When the current framework has such a small impact on consumption that use could almost double in the space of a year despite no significant change in how we treat drug use, there is clearly ample wiggle room to try something new.


An increase in pharmacies and other potential providers holding large quantities of illegalised drugs may come with an increased risk of theft for such organisations. Whilst currently many of these organisations already hold a variety of drugs on hand that may be used for non-medical purposes, such as opioids, these are likely to be at much lower amounts than would be required for a safe supply program. Additionally, removing the most significant funding source of organised crime in New Zealand would likely lead to many groups quickly seeking alternative forms of crime to compensate for this – a phenomenon observed with the lifting of alcohol prohibition in the USA ("Prohibition Profits Transformed the Mob," n.d.). Robbing the safe supply providers that destroyed their business would be the likely first port of call. Holistic support services would need to be put in place to ensure that those left behind from these organisations have work opportunities that enable them to integrate into society without resorting to other forms of crime. The Project Employment Program (PEP), implemented by Prime Minister Muldoon in the 1980s, is a prime example of an effective program that could aid this. Providers of a safe supply program are likely to be at increased risk of theft, and funds should be earmarked to help cover the additional security services required by these organisations. This could easily be funded by the billions of dollars currently wasted on drug seizures and the imprisonment of people involved in the illegalised drug trade, which increases drug harm and drug use (leading to an even larger spend on healthcare services). Postal services could also be an option to limit the heightened security requirements of multiple outlets. The time taken for drugs to arrive would also reduce the potential for impulsive purchasing; however, this would come with other concerns, such as ensuring parcels do not go missing or get stolen and ensuring that clients still receive some form of two-way conversation with a healthcare practitioner around their drug use. Organisations should be offered the opportunity to opt in or out of such a service, and the training and implementation of specialist services, with specialist health practitioners and security services, should be investigated. It is unlikely that a typical provider would require a greater amount of security than a local bank outlet in the long term.

Practical considerations aside, many people may object to a safe supply program based on an ethical or moral argument that they do not wish the New Zealand government (and by extension the public) to be complicit in the sale of non-medical drugs. What this argument fails to acknowledge, however, is that by failing to oppose the current state of prohibition, we are already complicit in maintaining the status quo of prohibition and all of the drug policy harm that comes along with it. By refusing to provide people who use drugs with any viable ethical and moral source of their drugs, we are taking the option away from them. People who use drugs are unable to access drugs without breaking the law, funding organised crime, or causing themselves greater harm through accessing an adulterated drug supply. By refusing to change this 50-year-old law, we are complicit in the current harm that prohibition perpetrates, the increase in drug use, the increase in violence, and the increase in organised crime that it permits. If we wish to make a change in any of these things, we must make a radical change and move towards a system of safe supply before it gets out of hand.


References:

Bowles, J., Nyx, E., Kalicum, J., & Kerr, T. (2024). Qualitative findings from North America’s first drug compassion club. PLOS ONE, 19(12), e0315804. https://doi.org/10.1371/journal.pone.0315804


Cano, M., Timmons, P., Hooten, M., Sweeney, K., & Oh, S. (2024). A scoping review of law enforcement drug seizures and overdose mortality in the United States. International Journal of Drug Policy, 124, 104321. https://doi.org/10.1016/j.drugpo.2024.104321


Costello, C. (2025). Ministerial Advisory Group on Transnational, Serious and Organised Crime March Report (No. TSOC-MAG 25/01). Ministerial Advisory Group - TSOC. https://www.customs.govt.nz/media/dogok1g2/tsoc-mag-25-01-march-report-combatting-tsoc.pdf


Grahl Johnstad, P. (2025). Does drug criminalization increase harmful drug use? A scoping review of underlying mechanisms. Drug Science, Policy and Law, 11, 20503245251348260. https://doi.org/10.1177/20503245251348260


Hanly, L., & reporter, P. (2025, June 14). Deep dive into New Zealand’s growing meth crisis. RNZ. https://www.rnz.co.nz/news/national/564155/deep-dive-into-new-zealand-s-growing-meth-crisis


Kalicum, J., Nyx, E., Kennedy, M. C., & Kerr, T. (2024). The impact of an unsanctioned compassion club on non-fatal overdose. International Journal of Drug Policy, 131, 104330. https://doi.org/10.1016/j.drugpo.2024.104330


Kalicum, J., Nyx, E., Kennedy, M. C., & Kerr, T. (2025). Perceived impacts of North Americas first de-medicalized safer supply program. Substance Abuse Treatment, Prevention, and Policy, 20(1), 11. https://doi.org/10.1186/s13011-025-00642-0


Kourounis, G., Richards, B. D. W., Kyprianou, E., Symeonidou, E., Malliori, M.-M., & Samartzis, L. (2016). Opioid substitution therapy: Lowering the treatment thresholds. Drug and Alcohol Dependence, 161, 1–8. https://doi.org/10.1016/j.drugalcdep.2015.12.021


Kral, A. H., Humphrey, J. L., Schwab, C., Lambdin, B. H., & Ray, B. (2025). Law Enforcement Drug Seizures and Opioid-Involved Overdose Mortality. JAMA Network Open, 8(3), e251158. https://doi.org/10.1001/jamanetworkopen.2025.1158


MacArthur, G. J., Minozzi, S., Martin, N., Vickerman, P., Deren, S., Bruneau, J., Degenhardt, L., & Hickman, M. (2012). Opiate substitution treatment and HIV transmission in people who inject drugs: Systematic review and meta-analysis. BMJ, 345(oct03 3), e5945–e5945. https://doi.org/10.1136/bmj.e5945


Mattick, R. P., Breen, C., Kimber, J., & Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews, 3. https://doi.org/10.1002/14651858.CD002209.pub2


McNair, R., Monaghan, M., & Montgomery, P. (2023). Heroin assisted treatment for key health outcomes in people with chronic heroin addictions: A context-focused systematic review. Drug and Alcohol Dependence, 247, 109869. https://doi.org/10.1016/j.drugalcdep.2023.109869


National Drugs in Wastewater Testing Programme—Quarter 1, 2025. (n.d.). New Zealand Police. Retrieved August 7, 2025, from https://www.police.govt.nz/about-us/publication/national-drugs-wastewater-testing-programme-quarter-1-2025


Nyx, E., & Kalicum, J. (2024). A case study of the DULF compassion club and fulfillment centre—A logical step forward in harm reduction. International Journal of Drug Policy, 131, 104537. https://doi.org/10.1016/j.drugpo.2024.104537


Prohibition Profits Transformed the Mob. (n.d.). Prohibition: An Interactive History. Retrieved August 7, 2025, from https://prohibition.themobmuseum.org/the-history/the-rise-of-organized-crime/the-mob-during-prohibition/


Rolles, S., Murkin, G., Powell, M., Kushlick, D., & Slater, J. (2012). Alternative World Drug Report: Counting the Costs of the War on Drugs. https://www.opensocietyfoundations.org/publications/alternative-world-drug-report-counting-costs-war-drugs


Smart, R., & Reuter, P. (2022). Does heroin-assisted treatment reduce crime? A review of randomized-controlled trials. Addiction, 117(3), 518–531. https://doi.org/10.1111/add.15601


Sordo, L., Barrio, G., Bravo, M. J., Indave, B. I., Degenhardt, L., Wiessing, L., Ferri, M., & Pastor-Barriuso, R. (2017). Mortality risk during and after opioid substitution treatment: Systematic review and meta-analysis of cohort studies. BMJ, 357, j1550. https://doi.org/10.1136/bmj.j1550


Strang, J., Groshkova, T., Uchtenhagen, A., Brink, W. van den, Haasen, C., Schechter, M. T., Lintzeris, N., Bell, J., Pirona, A., Oviedo-Joekes, E., Simon, R., & Metrebian, N. (2015). Heroin on trial: Systematic review and meta-analysis of randomised trials of diamorphine-prescribing as treatment for refractory heroin addiction. The British Journal of Psychiatry, 207(1), 5–14. https://doi.org/10.1192/bjp.bp.114.149195


Tardelli, V. S., Bisaga, A., Arcadepani, F. B., Gerra, G., Levin, F. R., & Fidalgo, T. M. (2020). Prescription psychostimulants for the treatment of stimulant use disorder: A systematic review and meta-analysis. Psychopharmacology, 237(8), 2233–2255. https://doi.org/10.1007/s00213-020-05563-3


The New Zealand Illicit Drug Harm Index 2023: Research Report | Ministry of Health NZ. (2024, July 2). https://www.health.govt.nz/publications/the-new-zealand-illicit-drug-harm-index-2023-research-report


Weatherburn, D., & Lind, B. (1997). The impact of law enforcement activity on a heroin market. Addiction, 92(5), 557–569. https://doi.org/10.1111/j.1360-0443.1997.tb02913.x


Werb, D., Rowell, G., Guyatt, G., Kerr, T., Montaner, J., & Wood, E. (2011). Effect of drug law enforcement on drug market violence: A systematic review. International Journal of Drug Policy, 22(2), 87–94. https://doi.org/10.1016/j.drugpo.2011.02.002


Whelan, J. (2025, May 26). Providing safe smoking kits could reduce harm from meth use – but NZ law won’t allow it. The Conversation. http://theconversation.com/providing-safe-smoking-kits-could-reduce-harm-from-meth-use-but-nz-law-wont-allow-it-254695


Wilkins, C., van der Sanden, R., Rychert, M., S. Romeo, J., & Graydon-Guy, T. (2024). NZ Drug Trends Survey 2024 Bulletin. Massey University.


Wood, E., Tyndall, M. W., Spittal, P. M., Li, K., Anis, A. H., Hogg, R. S., Montaner, J. S. G., O’Shaughnessy, M. V., & Schechter, M. T. (2003). Impact of supply-side policies for control of illicit drugs in the face of the AIDS and overdose epidemics: Investigation of a massive heroin seizure. CMAJ, 168(2), 165–169.


In addition to the above references, the following publications may be of interest to those who wish to explore this subject further:

 
 
 

Comments

bottom of page