Methamphetamine use in Australia

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Methamphetamine use in Australia

• Epidemic or endemic?

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PART I Is it an epidemic?PART II Changing
patterns of use

• Two parts

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PART IIs Australia Experiencing an epidemic of
methamphetamine use?

• Is methamphetamine use unusually high in
  Australia?
• Has methamphetamine use increased?
• Have indicators of use/ harm increased?

Epidemic the occurrence in a community or
region of a number of cases of a disease that is
unusually large or unexpected for the given place
and time Bres, 1986
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1. Is Methamphetamine use unusually high in
Australia in comparison with other countries?
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Methamphetamine use around the world
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Methamphetamine use compared to Australia
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Methamphetamine use compared to Australia
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Cocaine use
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Cannabis use
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Methamphetamine use is unusually high in
Australia in comparison with other countries

• Yes.

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2. Is there evidence of a significant increase in
methamphetamine use in Australia?
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Trend in methamphetamine use in Australia
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Methamphetamine use cf. other countries
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Methamphetamine use significantly increased
between 1995 and 1998 and has since declined
Use has remained high in comparison with other
countries across this entire period

• Yes.

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3. Have other indicators of use/harms increased?
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Arrests for ATS in Australia
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Methamphetamine treatment episodes in Australia
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Hospital admissions for stimulants in Australia
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Indicators of harms have increased and remain high

• Yes

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Has Australia Experienced an epidemic of
methamphetamine use?

• Yes.
• Australia has unusually high levels of
  methamphetamine use compared to other countries,
  which further increased from 1995 to 2004.
• Use has since decreased, but problems from the
  drug remain high.

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PART IIChanging patterns of use within this
epidemic

• Shift from amphetamine to methamphetamine
• Increase in crystalline methamphetamine use
• Increase in smoking methamphetamine

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1. Amphetamine to methamphetamine

• Amphetamine

Methylamphetamine or methamphetamine
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1. Amphetamine to methamphetamine
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Methamphetamine vs. amphetamine seizures analysed
by police
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2. Speed to crystal meth

• speed
• base (or paste)
• crystal meth or ice

Photographs provided by the Victorian Police
Forensic Services Department and the Australian
Customs Service
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2. Speed to crystal meth
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Crystalline methamphetamine use in NSW
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Seizures base and crystal meth
Data provided by the Victorian Police Forensic
Services Department
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Increased purity of powder, or speed
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3. Shift to smoking methamphetamine

• Ecstasy and related drugs Reporting System
• Regular ecstasy users in 2007
• 86 of crystalline meth users smoked the drug
• Illicit Drug Reporting System
• Injecting drug users in 2007
• 35 of crystalline methamphetamine users smoked
  it (remainder injected)

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Sydney methamphetamine users in 2004
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Increasing treatment admissions for
methamphetamine smoking
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Methamphetamine treatment entrants in Sydney

• Methamphetamine Treatment Evaluation Study
  (MATES)
• 400 methamphetamine treatment entrants from
  Sydney/Brisbane
• Smoking methamphetamine
• 41 smoked methamphetamine in the month before
  treatment
• Over half (55 ) were also injecting the drug

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Sydney methamphetamine treatment entrants
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Sydney methamphetamine treatment entrants
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Onset of use, dependence and treatment for
current methamphetamine treatment entrants
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Onset of methamphetamine use Meth smokers vs.
other treatment entrants
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Onset of methamphetamine dependenceMeth smokers
vs. other treatment entrants
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First treatment episodeMeth smokers vs. other
treatment entrants
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Summary

• Pre 1996
• Low purity amphetamine powder
• Half of our current meth treatment entrants began
  using methamphetamine
• 1996-1998
• Methamphetamine powder
• Coincided with sharp increase in prevalence and
  indicators of use/harm
• 1999 onward
• Crystalline methamphetamine
• Overall increase in purity of methamphetamine
• Smoking methamphetamine among IDU
• Emergence of a new cohort of crystal meth
  smokers who are only now beginning to enter
  treatment

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Conclusion
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• Methamphetamine use is high in Australia compared
  to other countries
• We have seen a rise in use between 1995 2004
  which has since declined
• Problems from use have remained high largely
  among to people who began using in the 1990s
• The emergence of a new cohort of crystalline
  methamphetamine smokers

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Implications

• Responses to methamphetamine need to be sustained
• Development of effective treatments
• Education and harm reduction around smoking
• Prevention of transitions to injecting
• New cohort of crystal meth smokers is different
• Appropriateness/ accessibility of current
  treatment and health services
• HIV prevention (not accessing NSPs)
• Early warning and prevention
• This problem began in the 1990s

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Thank youwww.ndarc.med.unsw.edu.au

• Rebecca McKetin, BSc (Psychol) PhD
• National Drug and Alcohol Research Centre
• University of New South Wales
• r.mcketin_at_unsw.edu.au