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Crystal meth harms on the rise in Australia

Ambulance call-outs to ice users have tripled in two years and harm from ice (also known as crystal meth) has risen higher than the previous peak in 2006 – a period known as the “ice age”. These are the…

Use of crystal meth – commonly known as ice – is rising among some groups of existing drug users. Image from shutterstock.com

Ambulance call-outs to ice users have tripled in two years and harm from ice (also known as crystal meth) has risen higher than the previous peak in 2006 – a period known as the “ice age”. These are the findings of a report I co-authored in today’s Medical Journal of Australia.

While overall meth and amphetamine use remains stable in the general population, ice use is rising among some groups of existing drug users. However, it’s unclear whether these users alone are driving the rise in ice-related harms.

You’ve probably heard of ice and crystal meth, but let’s take a step back and look at the group of drugs.

While “speed” is the street name for the powder form of both amphetamine and methamphetamine, “ice” or “crystal” specifically refers to the crystalline form of methamphetamine. Ice is generally smoked or used intravenously, leading to faster absorption and slower metabolism by the body, resulting in a more intense high.

The effects of amphetamine and methamphetamine range from increased energy, alertness and euphoria, to anxiety, paranoia, hallucinations and violence. Large doses can cause extremely high heart rate and body temperature, strokes and heart attacks; while long-term use may lead to dependence or even brain damage.

Piecing together the data

Meth and amphetamine use in the Australian general population is high compared with the United States or the United Kingdom, with 2.5% of Australians 14 years or older reporting use in the preceding year. This is double the rate of other developed countries.

Some studies suggest the proportion of Australians reporting recent use has been declining since 1998 - and the current reported proportion is the lowest in the past 15 years. But these estimates do not specifically ask about ice. And they don’t capture hard-to-reach populations such as dependent or poly-drug users, who take a combination of drugs to achieve the desired high.

Importantly, studies that address this paucity of evidence show rising ice use since 2009, with recent use almost doubling among Australians who regularly use ecstasy: 15% of ecstasy users also took ice in 2009, rising to 29% in 2012. Ice use among people who inject drugs has also increased, from 37% in 2009 to 54% in 2012.

Tracking the harm

With rising use comes rising harms. Our study found that from 2009/10 to 2011/12, meth and amphetamine-related ambulance attendances in metropolitan Melbourne doubled (from 445 to 880 cases), predominantly driven by rising ice-related attendances (from 136 to 592 cases).

The reasons for ambulance call-outs ranged from anxiety, paranoia or hallucinations to physical health problems, such as high heart rates, palpitations, gastrointestinal symptoms or injury resulting from assault, self harm or accidents.

Image from shutterstock.com

The behavioural effects of ice, including confusion, agitation and aggression, adds to the complexity of paramedic assessment and treatment. More than three-quarters of ice and other meth and amphetamine-related attendances require transfer to hospital for further assessment in an emergency department.

We also found that in 2011/12, the rate of people seeking meth and amphetamine-related treatment was two to three times higher than in 2009/10, for both face-to-face treatment, including counselling and withdrawal programs, and telephone counselling.

Changing demographics?

But this many not be the full story. On the one hand, the characteristics of users for whom ambulances are called and those who attend drug treatment services have changed little. This suggests that the types of people using ice and other amphetamines may not be changing. Instead, existing users may be experiencing a greater number of harms.

On the other hand, anecdotal reports from treatment agencies and other sources suggest changing patterns of ice consumption, with greater availability, use and associated harms in regional areas where ice use has traditionally been low.

Emerging anecdotal evidence also indicates that use – and harm - is increasing among people in occupational groups not traditionally associated with stimulant use, such as young tradespeople and professionals. Little is known about how ice affects these emerging user populations; researchers and clinicians are particularly concerned about the interplay between physical, behavioural, mental health and social problems.

We know that ice-related harm is growing. But given we’re dealing with research data and anecdotal evidence, questions remain about the factors that might be driving the rise in harm: whether it’s new populations of users, more harms for existing users, or changing patterns of use.

It’s also unclear how these rising harms will impact on the community, particularly for delivering services to high-risk groups.

To minimise harms, we need to promote a greater understanding of ice use in the community to enable appropriate prevention, intervention and service responses that are evidence-based and target those who are most at risk.

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18 Comments sorted by

  1. Stephen Ralph

    carer at n/a

    Is "hard to reach" populations code for indigenous Australians?

    Have there been studies into WHY an increasing number of youth are turning to drugs - are they disillusioned, bored, thrill-seeking....stupid?

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    1. Bill Budd

      Lecturer, Researcher

      In reply to Stephen Ralph

      I think "all of the above" is the answer Stephen and I wonder if this is a far more serious problem than even Cherie Holbourn indicates above. While ambulance and hospital admission data will give a reliable indication that the problem is increasing, these may be quite limited indicators of the actual magnitude of the problem.

      As Cherie says, poly drug use, where combinations of substances are used, become an extremely dangerous cocktail, both for the user and those who happen to come in contact…

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    2. Jock Mackenzie

      Research Assistant (Treatment and Systems) Turning Point Alcohol and Drug Centre at Monash University

      In reply to Stephen Ralph

      "Hard to reach" would also include the GLBTIQ community ie Gay, Lesbian etc - crystal meth use or tina as it is often know has taken off big time in Victoria since the mid 2000's often in the context of sex parties where safe sex and safe injecting practices go right out the window - one key reason for the rising rates of HIV and HCV in the gay community in the last few years. These harms are totally disconnected from the acute harms uncovered by ambulance call-out data.

      Incredibly there is a…

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    3. Stephen Ralph

      carer at n/a

      In reply to Jock Mackenzie

      Why are the GLBT community hard to reach?

      My guess is that they would be very accessible at the many gay venues around the nation. Action needs to start at these venues to make patrons aware of the dangers of drugs.

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    4. Tracy Soh

      Addiction Medicine Physician at Eastern Health / Turning Point Alcohol & Drug Centre

      In reply to Stephen Ralph

      Any group that feels marginalised can be difficult to reach - this would include indigenous people but also other groups within our community. When you are dealing with drugs which are illegal, even with assurances of confidentiality it is difficult to get people to speak openly due to concerns about legal issues. There is often an element of shame for some people which makes them not wish to discuss things.

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    5. Stephen Ralph

      carer at n/a

      In reply to Tracy Soh

      In respect of the many "young" drug users, I imagine there is an element of the danger and illegality drugs acting as a catalyst to intake.

      Drugs may represent a counter-culture that is attractive in it's rebellious nature. The we're young and invincible sentiment that sees so many people become addicted the wide range of drugs including alcohol & tobacco.

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    6. Jock Mackenzie

      Research Assistant (Treatment and Systems) Turning Point Alcohol and Drug Centre at Monash University

      In reply to Stephen Ralph

      Yes that would be one avenue but most of the activities I described is organised online, the drug use that occurs in venues is tame compared with what happens behind private doors - I reckon the best outreach would be in the same online forums that this activity is occurring.

      But before you get there you need real political will and dare I say courage both inside and outside the community to take this seriously.

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  2. Trevor Kerr

    ISTP

    The ice users who have to be attended by paramedics, is there any evidence on whether concurrent ethanol abuse is part of the problem? (I wish no offence to the alcohol lobby & its' many agents.)

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    1. Sebastian Poeckes

      Retired

      In reply to Trevor Kerr

      In my experience it's not just ethanol that is associated with drug use, but tobacco. In fact I would go so far as to say that I have never met a junkie who wasn't a smoker. Nicotine is the gateway drug.

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  3. John Crest

    logged in via email @live.com.au

    Easy. Don't send an ambulance to someone suffering the ill effects of self taken illicit drugs (ice included).

    Problem solved.

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    1. Grant Mahy

      Unemployed

      In reply to John Crest

      Ah the voice of reason and humanity. I thought TC had intelligent readers!

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    2. In reply to Grant Mahy

      Comment removed by moderator.

  4. Grant Mahy

    Unemployed

    Another win for the madness we know as the drug war. Crystal Meth of course being a direct product of that war when the DEA banned the precursor P2P for methamphetamine. The result being clandestine bakers discovered using ephedrine to make meth.

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  5. Gordon Angus Mackinlay

    Clinical Psychologist

    I always have serious doubts about the use of statistics so beloved by academia.

    Having been in the 'trade' for quite some years what I can only say with certainty is that the use of illicit drugs has increased with the rise in population.

    The quoted Melbourne figures are not of INDIVIDUALS but of MULTIPLE attendances by the ambulance service of requests for the SAME INDIVIDUAL. So its not 592 INDIVIDUALS but say 100 seen six times.

    A recent patient scheduled had 14 attendances by ambulance…

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    1. Grant Mahy

      Unemployed

      In reply to Gordon Angus Mackinlay

      Unfortunately Gordan statistics are the best we have for giving a snapshot of the broader problem. I do tend to agree somewhat though and I expect researchers would also agree that there are problems in gathering adequate and accurate data in the black economy of illicit drugs.

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    2. Michael Sheehan

      Geographer at Analyst

      In reply to Gordon Angus Mackinlay

      "cocaine being common (once more) with bricklayers."
      Now, I know that the CFMEU is a very effective and powerful trade union. But I also know that in Australia, cocaine retails for about $300 a gram. Brickies in 2013 are clearly a lot better off than when I was a teenager!

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  6. Ben H

    logged in via email @gmail.com

    Wait a minute, taking pseudoephedrine out of pharmacies didn't solve this problem?

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