Crystal Methamphetamine

Transcription

1 Crystal Methamphetamine Understanding and responding to Crystal Methamphetamine use

2 Substance Use 101 Slow down the activity of the brain and CNS Speed up the brain and CNS resulting in increased alertness and physical activity Interfere with the brain and CNS and distort the user s perception of reality Depressants Stimulants Hallucinogens

3 Forms speed, goey, whiz paste, point, pure, wax ice, shabu, crystal, crystal meth, tina, glass, shard

4 History

5 Meth today? Worldwide - increased production of methamphetamine Australia - one of the highest rates of methamphetamine use worldwide (2014 World Drug Report) One point = 0.1g = 100mg = $50-80

6 Recent Methamphetamine use in Australia Australians over 14 who had used alcohol and other drugs in the past 12 months Alcohol Cannabis Ecstacy Cocaine Meth/amphetamines Heroin 2.5% 3.0% 3.5% 2.1% 2.1% 1.6% 2.1% 2.1% 2.3% 0.1% 0.2% 0.2% 10.2% 10.3% 9.1% 86.2% 87.9% 89.9% Source: NDSHS 2013

7 Form of methamphetamine Among those using in the last 12 months, 14 years % Powder Base Crystal Source: Australian Institute of Health and Welfare (AIWH) 2013 National Drug Strategy Household Survey

8 Frequency of use Irregular Users < Once a month Not dependent Mild mental health issues Mild sleep problems Acute harms 55% 25% 20% Regular Users Once a week + Possible dependence Smoking or injecting Severe mental health problems Severe sleep and nutrition issues Acute and long term harms Occasional Users Once a month + Moderate mental health issue Moderate sleep and nutrition problems Acute harms Adapted from NSDHS, 2013

9 Poly-Drug Use Methamphetamine users General population Source: NSDHS, 2014

10 Crime All Drug Offences (Rate per ) Lismore NSW Deal/Traffic Amphetamine (Rate per ) Lismore NSW Use/Possess Amphetamine (Rate per ) Lismore NSW Manufacture Drug (Rate per ) Lismore NSW

11 Who is using it? I m 20 and studying at Uni to be a doctor. I smoke ice maybe twice a month at the most. My parents would be horrified they are naïve and very strict and have high hopes for their private school educated eldest daughter I really enjoy the drug. I get sick from alcohol and paranoid from weed. And as long as I have time to sleep afterwards, it s all good. I have been keeping up with my studies. If it interferes with my life goals I will stop using it. I like to use ice. It makes me feel happy, alert, alive. It s my favourite drug and I take it as much as I can. It annoys me that it is so expensive and that I have to work so hard to get the money to afford it. I am homeless and I work washing windscreens and doing other earns. It s hard work I have had a few so called episodes, always on binges when I haven t slept eaten. The most recent time I got upset at someone who insulted me, saying I was a lowlife Junky. Maybe I wouldn t have reacted quite how I did if I hadn t been on ice, but I like to think I would have stuck up for myself anyway.

12 Who is using it? Particular industries Existing users of amphetamines year olds most likely to use Aboriginal communities Unemployed, single males Men who have sex with men

13 How does the profile of people who use crystal methamphetamine compare with your perceptions or experiences?

14 How does Crystal Methamphetamine work?

15 Neurotransmitters Crystal Methamphetamine affects 3 chemicals in your brain 1. Serotonin 2. Noradrenaline 3. Dopamine!

16 Dopamine = Feel good

17 How and why is Crystal Methamphetamine used?

18 Route of Administration

19 Why? Meth Inside out Why Meth?

20 Possible long term effects Physical Seizure Heart failure or respiratory failure Brain haemorrhage, stroke Kidney failure Cardiac and coronary artery disease Extreme weight loss and malnutrition Psychological and Cognitive Psychosis Depression Anxiety Impaired planning and decision making ability Impulse control Low energy levels Memory problems Anhedonia Emotional regulation Threat sensitivity Attention Motor skills Social and Environmental Violence and aggression Unsafe injecting practices Sexual risk taking Drug driving Criminal activity Social isolation Relationship problems Financial difficulties Lost opportunities

21 Dependence and Withdrawal It s easier to get off than to stay off

22 Psychosis Illusions Suspiciousness Fear Paranoia Hallucinations Delusions Hallucinations Delusions Thought disorder Disorganised or bizarre behaviour

23 Ice psychosis hits people in different ways. While I have used a lot A LOT of ice, I have never become psychotic. However, I have supported friends through all sorts of experiences. Some people are just a little paranoid, thinking people are talking about them or following them. Others lose touch with what is real and imagine plots or hear voices. Fear is a really big part of it. Some people become very afraid absolutely terrified. I have managed friends through all the stages. It s important to keep calm and stay with them. Scared people are unpredictable and can become violent, in which I think is self-preservation. It s important to make sure you don t become part of the threat. I get them somewhere they are comfortable, often their own home. I try and get them to eat something or have a rest. It s obviously best for them not to use any more ice, but a benzo can help. With some people you can divert them, get them to talk about other things, even have sex, until they calm down and sleep. For some TV or the Net will divert them, for others it will rev them up. With others, they are so scared they are immobilised. Move slowly. Be careful in what you say. Don t play into their fantasy, but don t disagree. Lots of non-committal mmm s. You will not be able to talk them out of it, you just need to look after them and make sure they don t do anything stupid. You need to be a friend. Jake on supporting friends through psychosis Users News, Issue 81, 2015

24 Responding to Psychosis Avoid confrontation very important with people suffering from methamphetamine psychosis: keep a safe distance from the person speak in a quiet voice avoid physical contact minimise direct eye contact do not disagree or argue with them be reassuring and supportive If you are in a public place and someone suffering from methamphetamine psychosis presents a danger to themselves or to other people, call 000 for emergency medical assistance.

25 Cognitive Effects Poor verbal memory Slowed mental processing speed Reduced executive mental skills Disinhibition (poor self-control) Reduced ability to avoid distraction Thinking about immediate desires rather than future negative consequences Difficulty switching between different activities

26 What might be some of the practical implications of these thinking impairments? How could you deal with some of these effects?

27 Stigma and Discrimination Illicit drug dependence is the most stigmatised health condition in the world (WHO, 2010) What might be some of the implications of stigmatising substance use? What can be done to reduce stigma towards people who might be using substances?

28 Recovery from Using Crystal Methamphetamine

29 Treatment People do recover from Crystal Meth dependence No pharmacotherapies are available though amphetamine substitution being trialled Standard treatment approaches are: Counselling (motivational interviewing and CBT) Support groups Sleep, Exercise, Food and Time

30 Recovery Recovery

31 State-wide services Service Program Contacts Alcohol and Drug Information Service Stimulant Treatment Line Family Drug Support Counselling Online Drug & Alcohol Specialist Advisory Service 24/7 education, information, referral, crisis counselling and support. Anyone can call. 24/7 advice, support, referral and counselling for people concerned about stimulants or for information on the Stimulant Treatment Program. 24/7 telephone support and counselling for families in need due to drug or alcohol issues. 24/7 free online counselling service for people using alcohol or other drugs, their family members and friends. For health professionals only. Advice on clinical diagnosis and management of patients with alcohol and other drug related problems. Available 24/ or yourroom.com.au or fds.org.au counsellingonline.org.au

32 Local services Service Program Contact Riverlands Drug and Alcohol Centre 16-bed detoxification unit, pharmacotherapy clinic, outpatient counselling services, education, CM clinical liaison service MERIT Drug court diversion program Namatjira Haven The Buttery Narcotics Anonymous Needle and Syringe Program Residential Drug and Alcohol rehabilitation program for Aboriginal men. Residential rehabilitation program. Community outreach programs. A self-help group for people using or in recovery from crystal methamphetamine. Access to a range of safe injecting equipment and disposal bins. Harm reduction information available na.org.au Hunter St, Lismore safesharps.org.au

33 Take Home Messages 2.1% of the Australian population has used methamphetamine in past 12 months - 1% have used crystal methamphetamine (CM) in past 12 months CMhas a high potential for dependence Longer term CM use has significant effects on brain chemistry: - Paranoia - Dependence and Withdrawal - Cognitive deficits Recovery from longer term CM use is possible

34 Thank you Kim Gussy Senior Project Officer Substance Misuse Program Sam Booker Senior Project Officer Substance Misuse Program In partnership with Bulgarr Ngaru Aboriginal Medical Corporation