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On Ice - Methamphetamine Use and Treatment In WA

Wednesday, 15 October 2014

WA's high rate of amphetamine use is in the spotlight, with police, emergency services, treatment services and the community raising concerns in The West Australian.

Amphetamine Use in WA

WA has the highest proportion of amphetamine users in Australia. The 2010 National Drug Strategy Household Survey report (July 2011) summary of methamphetamine use in the past 12 months for non-medical purposes by people aged 14 years or older in each state and territory showed:



NSW
Vic
Qld
WA
SA
Tas
ACT
NT
Aust
1.6%
2.3%
1.9%
3.4%
2.5%
1.1%
1.2%
2.1%
2.1%


Why Do People Use Amphetamines?

 People use alcohol and other drugs because it makes them feel good or better. Methamphetamine is no different in this sense. Methamphetamine can be used functionally in low doses, as a performance enhancing drug, but in higher doses is also extremely rewarding as a recreational drug.

The stimulating effects of methamphetamine, depending on the dose and a person's tolerance, can last between 12 and 21 hours. Users report improved concentration and focus, increased stamina and endurance, and experiences of well-being, confidence and heightened energy.

What Are The Risks?

The same factors that make the drug so attractive to some also make it easy to become dependent upon. People may end up relying on methamphetamine to cope with pressures from work or study, to enhance social activities or sex, or to self-medicate emotional or psychological pain. Considering its accessibility it can become a patterned response that provides a relatively easy "solution" to many different problems.

Wide variability in potency is a contributing factor to developing a dependence, as it encourages regular users to take all of a deal at once, rather than risk "wasting their rush" by trying a small amount first.  This may result in people taking escalating doses, making the risk of acute physical or mental health problems resulting from toxicity more likely.

Compared to dexamphetamine pills or powder, which are typically swallowed or "snorted", crystalline methamphetamine tends to be taken by more efficient and immediate means, such as smoking (vaporisation) or injecting. Clean injecting equipment must be used and never shared to prevent blood-borne viruses such as Hepatitis C and HIV/AIDS.

Other health risks include mood changes, problems with thinking and memory, and damage to major organs.

Family and relationships may be adversely impacted by behavioural effects of the drug, increased criminal behaviour may become a problem for some users, and alcohol and methamphetamine use together may result in increased levels of violence and aggression.

 What Are The Challenges for Treatment Services?

Methamphetamine users do not experience withdrawal in the same way that heroin users do. Most dependent users can abstain for 5 to 7 days with little discomfort, sleeping and eating more than usual during this time. It is in the following weeks that methamphetamine withdrawal symptoms (including low energy and enthusiasm, depressed libido, poor concentration and memory, and irritability and irregular moods) emerge. These may last for several months. There is no specific detoxification medication.

This can be a challenge for in-patient and residential detoxification and rehabilitation services, which are designed typically for alcohol, benzodiazepine, or opioid detoxification. Other challenges for treatment services and consumers include:
  • Methamphetamine users who are wishing to become abstinent can experience an extended period (up to 12 months) of "crashing and craving".
  • The effectiveness of pharmacotherapies in reducing amphetamine type substance (ATS) use and preventing relapse is uncertain.
  • Amphetamine type substance users are often reluctant to enter and remain in treatment. Methamphetamine users tend to seek treatment only when the consequences of their use are severe.
  • Methamphetamine users often present with multiple complex needs.
  • High rates of treatment attrition and subsequent relapse is an issue, particularly among people with more severe dependence and longer duration of use.

What's Needed?

Alcohol and other drug services believe that more attention needs to be given to the treatment of people who experience problems related to amphetamine use and their families, friends and communities. These include:
  • Increased resources to support people who have problems related to amphetamine use to engage with services and to stay engaged for as long as necessary.
  • Harm reduction services designed to effectively engage with current users who are reluctant to enter formal treatment-to-abstinence.
  • Interventions that extend to behavioural management programs that support cognitive re-development and sustained motivation to achieve improvement.
  • A focus on psychosocial interventions - pharmacotherapy has limited impact for people who have problems related to amphetamine use.
  • Interventions that address the range of issues related to methamphetamine use, including improving physical and mental wellbeing, relationships and quality-of-life.
  • Exchange of information and experiences between services and with health and community services outside of the alcohol and other drug sector.

 Finding Information

Drug Aware provides information about amphetamines at www.amphets.com.au

Find Support

Support and information is available to people who experience problems related to amphetamine use, whether it be your own use, or that of a friend or family member. To learn more about the services available, please visit www.greenbook.org.au or call the Alcohol and Drug Information Service, which offers free, confidential counselling, referral and support 24/7, on (08) 9442 5000 or, for WA country callers, 1800 198 024.

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