Synthetic addicts in the Napier suburb of Maraenui are giving up trying to quit the drug, saying getting help is simply too hard.
Many people are affected by synthetic cannabis in the city's poorest suburb, with children as young as 11 known to use the drug.
The Hawke's Bay District Health Board (HBDHB) said help was available for those who needed it, but Maraenui residents said that help was often out of reach.
Sitting outside the Maraenui shops, Jack, 55, was painfully thin. His skin is almost grey. He is retired and smokes $200 worth of synthetics a day - about 10 bags.
"I've been to rehab but at the end of the day I still come back to this community and it's here in the community."
It was too hard to travel to Hastings or Napier's city centre to access addiction services, he said.
"And there's no help here."
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Jack's best friend - another 55-year-old man - died two weeks ago after smoking the drug. It was the third synthetics-related death in the area being investigated by the coroner in the past year.
Despite his mate's death, Jack said he would continue to use synthetics.
"It hasn't put me off...because it's what I like."
There was a free walk-in addiction clinic in Maraenui run by a group of volunteers, but it closed at the end of last year.
HBDHB community mental health manager Justin Lee said there were addiction services in Napier and Hastings for anyone who needed it, but fewer synthetic users sought help.
"While we hear anecdotally that synthetics are out there in our suburbs, we're not seeing a great deal come into our secondary services. If anything, in recent months we have seen a decrease."
Tracey Benson lived in Maraenui all her life and worked at a drug rehabilitation centre run by What Ever It Takes, in neighbouring Onekawa.
She did not believe synthetic use was falling.
"It's quite difficult in our area because there is no support locally, and a lot of these people don't have vehicles, they don't have phones or access to the internet. A lot of them don't know where to start.
"In the heat of the moment when they want to get well, it would seem just too hard to be able to get there and catch the bus."
Given the scale of drug use in Maraenui there needed to be a daily and after-hours addiction service in the suburb, she said.
Community advocate Denis O'Reilly - a life member of Black Power - said a pilot run by Community Action Youth And Drugs to help synthetic users in Napier last year was hugely successful in helping many quit.
It picked people up each day, including some from Maraenui, and got them involved in community activities and volunteer work. But Mr O'Reilly said his organisation could not get funding to continue.
The DHB said developing its addiction service was a key priority, but any plans were on hold until the government's inquiry into mental health and addiction reported back at the end of October.