Ice is the worst drug scourge Australia has faced. It is far more potent, far more dangerous, and far more addictive than any other illegal drug. – Prime Minister Tony Abbott, Liberal Party of Australia email to subscribers, August 13, 2015.
“Ice” is the crystalline form of methamphetamine. The other main forms of methamphetamine are “speed” (a powder) and “base” (a paste). They all have the same chemical structure but differ in potency and purity, with ice typically three to four times stronger than speed but the purity of all forms depends on how it is made.
It is worth testing the prime minister’s comments, made as he announced new funding for the Australian Crime Commission to tackle ice, against the evidence.
Is it the worst drug scourge Australia has faced?
Mr Abbott’s office did not respond to requests for data to support his statement.
Terms like “worst” and “scourge” are subjective and not checkable, so it is not possible to test this part of the statement against a data set.
But we do know that ice is not the most widely used illicit drug and the percentage of the population using has not increased over at least the last decade. However, harms have increased substantially among people already using.
According to the latest population statistics, 2.1% of the population reported using methamphetamine in the 12 months prior to the survey, which was conducted in 2013. This includes people who have used once in a year and those who use every day. This statistic has remained stable for at least the last 10 years, so there does not appear to be a huge increase in new users.
As a comparison, just over 10% of the population report using cannabis in the last year, 4.7% pharmaceuticals (for non-medical purposes), 2.5% ecstasy (MDMA) and 2.1% cocaine.
The same data show that about half of methamphetamine users prefer ice over other forms. The proportion of users who use ice as their main form of methamphetamine has doubled since 2010 - from 22% of users to 50% of users. This suggests that regular users are switching from speed to ice.
In addition, these data show that existing users are using more frequently, with a larger percentage of users reporting using weekly or daily, but a lower quantity. As a result of these changes, we have seen an increase in harms associated with methamphetamine use.
Is it far more dangerous?
It is difficult to compare drugs in terms of severity. Fewer people use ice than alcohol, tobacco, cannabis, ecstasy and pharmaceuticals for non-medical purposes; 2.1% of Australians are methamphetamine users (1% use ice), while 80% are alcohol users and 10% are cannabis users.
Alcohol is still the major drug-related reason for ambulance call-outs and still results in the most deaths and illnesses every year compared to other drugs. However, the prime minister was not comparing ice to legal drugs like alcohol – he said it was more dangerous “than any other illegal drug”.
In Victoria, there are an average of 4.7 methaphetamine-related ambulance attendances a day (3.4 of those for ice) and about 87% of those cases are transported to hospital. This is less than alcohol (34 attendances per day), benzodiazepines (8.3 attendances per day) and heroin (5.1 attendances per day). And it is similar to cannabis, with 4.4 attendances a day and around 86% transported to hospital.
Among illegal drugs, heroin and other opioids are typically involved in the most deaths, even though fewer people use them compared to other substances. Methamphetamine, including “ice”, has the second-highest death rate among illegal drugs.
In Australia, according to the latest accurate data, there were 101 deaths involving methamphetamine with 20% of those attributed solely to methamphetamine (the rest involved a mix of drugs) compared to 617 deaths involving heroin. However, the trend seems to signal increasing deaths with methamphetamine, while heroin deaths are projected to remain stable.
One of the biggest harms from illicit drugs comes from the fact that they are illegal. Methamphetamine is manufactured using different methods and ingredients and vary widely in purity and potency depending how it is made and who makes it.
Is it far more addictive?
The dependence potential of any drug depends on a number of factors, including the drug itself, the person who is using it and how it is used. It is difficult to get a precise measure of how “addictive” a drug is, but using methamphetamine three to four times a week or more is likely to be a sign of dependence.
Among people who have used any form of methamphetamine in the last year, around 15% used at least weekly. This is higher among ice users with about 25% using weekly or more.
How does this compare to other drugs? In 2007, The Lancet published a paper that compared the dependence potential of a range of drugs, including amphetamines. The paper concluded that heroin and cocaine among the illicit drugs, and tobacco, barbiturates, alcohol and benzodiazepines among the legally available drugs, are more likely to produce dependence than amphetamines.
Methamphetamine is a drug that can cause substantial harms. Potency is difficult to compare between drugs, so it is not possible to confirm the accuracy of this statement.
However, it is an overstatement to say that ice is far more addictive and far more dangerous than other illicit drugs.
While we certainly need to address the harms associated with methamphetamine use, we should keep in mind that our most widely used drug – alcohol - still results in more harms to individuals and the community, and other illicit drugs are also associated with more harms.
This is overall a balanced and sensible article. However, I would be more reserved about the statement referring to the paper in The Lancet (2007). That paper, which focused on the harmfulness of drugs, was an exploration of expert opinion. There remains considerable division about the addictiveness of crystal methamphetamine, with many experts viewing it as top of the range for both harm and addictiveness. The basic science of it remains in dispute. – Michael Farrell