ecstsy nd relted drug trends july bulletin Authors: Ms. Jonne Cssr, Ms. Ntsh Sindicich nd Dr. Lucy Burns, Ntionl Drug nd Alcohol Reserch Centre, University of New South Wles. Suggested Cittion: Cssr, J., Sindicich, N. & Burns, L. (). Methmphetmine use nd ssocited risks mongst regulr ecstsy users in the Austrlin Cpitl Territory nd ntionlly. EDRS Drug Trends Bulletin, July. Sydney: Ntionl Drug nd Alcohol Reserch Centre, University of New South Wles. Funded by the Austrlin Government Deprtment of Helth & Ageing Key findings Methmphetmine use decresed mongst the ntionl smple of regulr ecstsy users (REU) over the pst three yers. With respect to the ACT, lthough, methmphetmine use is still reltively low there hs been recent increse in medin dys of use. Onethird of the ntionl smple of REU reported bingeing on ny drug. Bingeing ws defined s the use of drug on continuous bsis for more thn hours without sleep. Of those who hd recently binged, over one third reported using powder methmphetmine (speed) nd over qurter reported using crystl methmphetmine (ice/crystl) during their most recent binge. Using methmphetmine in conjunction with ecstsy use ws reltively low mongst both the ntionl nd ACT REU smples. Eighty percent of recent methmphetmine users in the ACT REU smple scored eight or higher in the AUDIT indicting hzrdous nd hrmful lcohol use. Ntionlly lrger proportion of REU who hd recently used methmphetmine reported very high levels of psychologicl distress compred to those who hd not recently used these substnces. The rte of mphetmine relted hospitl dmissions remined stble in the ACT. There ws n increse in methmphetmine relted rrests in the ACT. Methmphetmine Use nd Associted Risks mongst Regulr Ecstsy Users in the Austrlin Cpitl Territory nd ntionlly Introduction The Austrlin Federl Government recently relesed Ntionl Drugs Cmpign trgeting young users of ice/crystl methmphetmine. The cmpign consists of television nd print dvertisements which im to reduce the motivtion for young Austrlins to use methmphetmines. This cmpign sprked incresed interest in investigting methmphetmine use mongst regulr drug using popultions. In recent yers the use of methmphetmines hs been decresing mongst the generl popultion (Austrlin Institute of Helth nd Welfre, ). A decrese hs lso been seen mongst ntionl sentinel popultion of regulr injecting drug users (IDU) (Stfford et l., ) nd regulr ecstsy users (REU) (Sindicich et l., ). Use ptterns hve differed in the ACT. In, recent use nd medin number of dys of methmphetmine use mongst REU in the ACT incresed whilst decrese ws observed mongst the IDU popultion. This bulletin exmines ptterns of methmphetmine use mong REU in the ACT nd ssocited risks. Risks nd hrms ssocited with methmphetmine use There re considerble risks nd hrms ssocited with methmphetmine use. In previous study investigting regulr methmphetmine users (McKetin, McLren & Kelly, ) reserchers found tht the overll generl helth of methmphetmine users ws below the generl popultion verge. Mentl helth ws prticulrly poor with twothirds of prticipnts reporting mentl helth problem. Some of the long term risks nd hrms re: Sleep disturbnces ISSN Depression nd nxiety Bruxism (teeth grinding) Pnic ttcks Weight loss Seizures Prnoi Socil nd finncil problems
Use of methmphetmines mongst the Austrlin popultion Lifetime methmphetmine use mongst the Austrlin generl popultion decresed between nd 7 (see Figure ) (Austrlin Institute of Helth nd Welfre, ). In 7,.% of prticipnts in the Ntionl Drug Strtegy Household Survey (NDSHS) reported tht they hd ever used methmphetmine in comprison to. in. The use of methmphetmines in the previous twelve months decresed from.% in to.% in 7 (pproximtely, people from the ACT; see Figure ). % Figure : Proportion of ntionl REU who reported recent (lst six months) use of methmphetmine, 7 Speed Bse Ice/crystl Any form 7 7 Source: EDRS REU interviews Figure : proportion of ACT REU who reported recent use of methmphetmines,..7...7...... % % Generl popultion Figure : Prevlence of meth/mphetmine use in Austrli, 7 Ever used 7 Used lst months Source: NDSHS 7 (Austrlin Institute of Helth nd Welfre,, Commonwelth Deprtment of Community Services nd Helth, ) Regulr ecstsy users in the ACT The proportion of prticipnts from the ntionl EDRS smple who hd recently (in the previous six months) used ny form of methmphetmine hs lso shown decline (7% in 7 to % in ; see Figure ). Amongst the ACT smple the proportion of prticipnts who hd recently used speed decresed in (see Figure ) whilst, the proportion of prticipnts who recently used bse methmphetmine (bse) (% in 7; % in ) nd ice/crystl (% in 7; % in ) incresed. 7 Speed Bse Ice/crystl 7 Source: EDRS ACT REU interviews Demogrphics Recent methmphetmine users in the ACT were more likely to be mle (%) (similr to the ntionl smple of REU where mles comprised % of recent methmphetmine users). The mjority of prticipnts who hd recently used methmphetmines in the ACT were between 7 nd yers old (%, % in the ntionl smple). In both the ACT nd ntionl REU smples 7% of recent methmphetmine users hd completed grde. Of those who hd recently used methmphetmines % hd used weekly or more. The primry route of dministrtion mongst REU for speed nd bse ws swllowing (%; 7%) followed by snorting (%; 7%), wheres the primry route of ice/crystl dministrtion ws injecting (%; %).
Mrket chrcteristics Mrket chrcteristics refer to the price, purity nd vilbility of substnces. The methmphetmine mrket in the ACT differentites somewht cross the three forms of methmphetmine (speed, crystl/ice nd bse) however, some users report tht they use speed nd bse interchngebly without differentition (e.g. use the term meth to refer to both speed nd bse). On closer inspection of dt from those who differentite, there ppers to be subtle differences between the three forms, in terms of price, purity nd loctions whereby the substnces re used. With respect to price point (pproximtely. or onetenth of grm) ws the most populr puchse quntity tht methmphetmines were bought in with the next most populr purchse quntity being grms. The price of speed is $ point nd $ for grm; bse costs $ point nd $^ grm; ice/crystl is more expensive t $ point nd $^ grm. Purity my ccount lrgely for the price difference, with speed nd bse considered to be 'medium' purity nd ice/crystl reported s 'high' purity. Plces of usul use (intoxiction) differed between the substnces, with the mjority of REU reporting speed use in nightclubs nd privte homes; bse most commonly used t hotels nd live music festivls nd ice/crystl in privte homes. ^ smll numbers (<) Behviours ssocited with methmphetmine use Bingeing Prticipnts were sked whether they hd binged on ecstsy nd relted drugs in the six months prior to the EDRS interview. Bingeing ws defined s using the drug on continuous bsis for more thn hours without sleep(ovendon & Loxley, ). Onethird (%) of the ntionl smple hd binged on one or more drugs in the preceding six months. The medin length of the longest binge ws lmost three dys ( hours). Bingeing on psychostimulnts is dngerous s it my increse dysphori nd toxicity which cn led to behviourl nd crdiovsculr effects (Ovendon & Loxley, ). Amongst those who hd binged for over hours in the ntionl smple, ecstsy (%) ws the drug most commonly reported s being used in binge session. However, speed (7%) nd ice/crystl (%) were lso frequently reported s being used to binge. As displyed in Tble hlf of ll REU in the ACT reported bingeing with similr findings to those of the ntionl smple. Tble : Recent (lst six months) bingeing mong REU, Ntionl REU N=7 ACT REU n= Ecstsy Speed 7 Bse Binged* on ny stimulnt (%) Drug binged on (%) Ice/crystl Source: EDRS REU interviews * Binged defined s the use of ny stimulnt for more thn hours continuously without sleep Of those who reported bingeing in the lst six months Stimulnt Overdose Stimulnt overdose is defined s symptoms from toxicity which my indicte person hs suffered n overdose including nuse nd vomiting, chest pin, tremors, incresed body temperture, incresed hert rte, seizure, extreme prnoi, extreme nxiety, pnic, extreme gittion, hllucintions nd excited delirium. Amongst REU in the ACT, hd overdosed on stimulnts in their lifetime. Twentysix prticipnts hd recently overdosed nd of those, five prticipnts ttributed their overdose to the use of methmphetmines (four ttributed it to ice/crystl nd one to speed). Five prticipnts reported tht speed ws contributing drug in the stimulnt overdose nd one reported ice/crystl s contributing drug. Methmphetmine use with ecstsy Prticipnts were sked if they hd used ecstsy with other drugs. Ptterns of use by REU in the ACT did not differ mrkedly from the ntionl smple. Amongst the ACT REU, % of prticipnts hd used speed with ecstsy (7% of the ntionl smple) whilst % hd used bse or ice/crystl with ecstsy (% of the ntionl smple). Five per cent of both the ntionl nd ACT smples hd used bse with ecstsy. Alcohol Use Disorders Identifiction Test (AUDIT) In, the EDRS mde use of the Alcohol Use Disorders Identifiction Test (AUDIT) (Sunders, Aslnd, Bbor, de l Fuente & Grnt, ). The AUDIT ws designed by the World Helth Orgniztion (WHO) s brief screening scle to identify individuls with lcohol problems, including those in erly stges. It is item scle, designed to ssess three conceptul domins: lcohol intke, dependence, nd dverse consequences (Reinert & Allen, ). Totl scores of eight or more re recommended s indictors of hzrdous nd hrmful lcohol use, s well s possible lcohol dependence (Brbor, HigginsBiddle, Sunders & Monteiro, ).
Amongst REU who hd recently used methmphetmines in the ACT the men on the AUDIT ws slightly higher (.) thn the totl ACT REU smple (.). Eighty percent of recent methmphetmine users scored eight or more on the AUDIT compred to 7% of the REU smple. Tble : Kessler scores mongst recent nd non recent methmphetmine use K ctegory Recent speed Recent bse Recent ice/ Nonrecent use (n=) use (n=) crystl use methmphetmine (n=) use (n=7) Helth nd psychologicl distress reported by recent methmphetmine users % reporting no or low distress (score ) Mentl helth % reporting moderte distress (score ) % reporting high distress (score ) % reporting very high distress (score () 7 In the ACT % of REU reported recently hving mentl helth problem. Amongst those who hd recently used methmphetmines the proportion reporting mentl helth problems ws slightly lower t %. Psychologicl Distress The EDRS included the Kessler Psychologicl Distress Scle (K), questionnire designed to yield globl mesure of psychologicl distress bsed on questions bout the level of nxiety nd depressive symptoms experienced in the most recent fourweek period (Kessler, ). The minimum score ws nd the mximum ws. The scle ws divided into four ctegories to describe distress. Those scoring between nd were considered to hve low levels of psychologicl distress; scores of to were clssed s reporting moderte levels of psychologicl distress; to s high levels of psychologicl distress; nd to s very high levels of psychologicl distress. Tble shows the scores of the REU in Austrli nd the ACT in compred to the generl popultion. The results show tht higher proportion of REU reported high to very high psychologicl distress. Tble : Kessler scores in the 7 NSDHS Detiled Results nd REU smple, K Ctegory Austrlin Popultion > yers REU n=7 ACT REU N= % reporting low distress (score ) % reporting moderte distress (score ) % reporting high distress (score ) 7 % reporting very high distress (score ) Source: AIHW, b, NSDHS Detiled Results; EDRS REU interviews, Tble shows scores on the K of ntionl REU who hd recently (six months preceding interview) used methmphetmine. Results show tht higher proportions of recent speed, bse nd ice/crystl users reported very high psychologicl distress in comprison to those who hd not recently used ny form of methmphetmine. Source: EDRS REU interviews Methmphetmine dependence Methmphetmine dependence impcts on physicl nd mentl helth (McKetin, McLren & Kelly, ). In the Severity of Dependence Scle (SDS) ws dministered to prticipnts who hd recently used methmphetmines. An SDS score of four or greter is indictive of problemtic mphetmine use (Topp & Mttick, 7). In, % of REU in the ntionl smple nd the ACT smple scored four or more on the SDS, indicting problemtic nd dependent use of methmphetmine. Hospitl dmissions for mphetmines Hospitl dt do not differentite between types of mphetmine nd lso include ecstsy relted dmissions. Figure shows the rte of inptient hospitl dmissions relting to principle dignosis of mphetmine per million persons by jurisdiction in /7. NSW recorded the highest number of mphetminerelted hospitl dmissions in /7 t dmissions per million persons, representing n increse from 7 dmissions per million persons in /. Most other jurisdictions remined reltively stble over tht time spn.
Number of rrests,,,,,,7 Number of dmissions 7,7,,,,,7,, 7,,7,.,,,.,,7 /7 7..,,.,..,,., Figure : Amphetminetype stimulnts: consumer nd provider rrests, //7, Figure : Number of principl mphetminerelted hospitl dmissions per million persons mong people ged yers, by jurisdiction, //7 Ntionl NSW ACT VIC TAS* SA WA NT QLD Jurisdictions Consumer Source: AIHW, ACT, TAS, NT, QLD, SA, NSW, VIC nd WA Helth Deprtments, Roxburgh nd Burns (in press) * from, numbers in TAS included dmissions from n dditionl drug withdrwl unit Criminl ctivities ssocited with methmphetmines In recent study, % of regulr methmphetmine users in n Austrlin smple hd committed crime in the previous month (McKetin, McLren & Kelly, ) nd twelve percent hd committed violent crime in the previous months. Methmphetmine users who hd committed violent crime hd previous history of ntisocil behviour e.g. history of Childhood Conduct Disorder. Almost onethird of users who hd committed violent crime were under the influence of methmphetmine when they committed the crime (McKetin, McLren & Kelly, ). The Austrlin Crime Commission colltes ntionl crime figures nd clssifies consumers s offenders who re chrged with usertype offences (e.g., possession nd use of illicit drugs), nd providers s offenders who re chrged with supplytype offences (e.g., trfficking, selling, mnufcture or cultivtion). Figure shows the number of ntionl consumer nd provider methmphetmine rrests over time. An increse in numbers of offences hs been observed since /. Provider Totl Source: (Austrlin Crime Commission,, Austrlin Crime Commission,, Austrlin Crime Commission,, Austrlin Crime Commission,, Austrlin Crime Commission, 7, Austrlin Crime Commission,, Austrlin Bureu of Criminl Intelligence,, Austrlin Bureu of Criminl Intelligence,, Austrlin Bureu of Criminl Intelligence, ) Note: Totl my exceed the sum of the components totl includes those offenders for whom consumer/provider sttus ws not stted. Dt for 7/ were not vilble t the time of publiction With respect to REU, just over onethird (%) of the ACT REU smple reported hving engged in some form of criminl ctivity in the month prior to interview (Tble ). The proportion of REU who reported tht they hd sold drugs in the preceding six months remined stble from 7 (%, % in 7). The proportion reporting they hd committed property crime lso remined stble (%) nd slightly higher percent reported committing violent crime (% in, % in 7). Tble : Criminl ctivity reported by ACT REU, 7 (N=) (N=) (N=) (N=) (N=7) (N=) Criminl ctivity in the lst month (%) Any crime Drug deling Property crime Frud Violent crime Arrested in the pst months Source: EDRS REU interviews,
Tble presents the number of consumer nd provider rrests for mphetminetype stimulnts mde in the ACT between 7 nd 7. The number of totl rrests hs been incresing since /, from totl of rrests to totl of rrests in /7.In /, the number of consumer rrests incresed for both mles ( in /, 77 in /7) nd femles ( in /, in /7). In /7, the number of provider relted rrests decresed for mles in /, in /7). more on the AUDIT indicting tht recent methmphetmine users hd hzrdous nd hrmful lcohol use, s well s possible lcohol dependence. Tble : Number of mphetminetype stimulnts consumer nd provider rrests, ACT, 77 In the ACT pproximtely people per million were dmitted to hospitl for methmphetmine relted illness. This hs remined stble since /. Yer Consumer Provider Totl rrests More recent methmphetmine users scored in the very high psychologicl distress ctegory on the K compred to nonrecent users. More non recent methmphetmine users reported low psychologicl distress. Twelve percent scored in the rnge for methmphetmine dependence on the SDS in the ACT in. The totl number of rrests for methmphetmine relted crime hs incresed both ntionlly nd in the ACT. Thirtyfour percent of REU in the ACT reported committing crime in the previous month. Mle Femle Mle Femle 7/ / / / 7 / / / References / 7 7 / AUSTRALIAN BUREAU OF CRIMINAL INTELLIGENCE () Austrlin Illicit Drug Report. Cnberr, Austrlin Bureu of Criminl Intelligence. /7 77 Source: ABCI (7); ACC (7) Note: Figures for ACT / were not vilble Note: Arrest dt from 7/ to / exclude AFP dt Note: Dt not vilble for the 7/ finncil yer Summry nd Implictions The use of methmphetmine hs been decresing mongst the Austrlin popultion. In the ACT however, REU hve been using methmphetmine more frequently. Most recent methmphetmine users were mle nd between the ges of 7 nd Reflecting the trget udience for the Austrlin Federl Government s recent methmphetmine cmpign. Hlf of prticipnts in the ACT EDRS reported bingeing on ny drug in the previous six months. Of those who hd binged it ws common to hve binged on methmphetmine. It ws uncommon for prticipnts in the ACT to report methmphetmine s the drug contributing most to stimulnt overdose. Smll proportions of REU reported using methmphetmine with ecstsy in the ACT. Eighty percent of recent methmphetmine users scored eight or Findings from this investigtion show tht methmphetmine use mongst the ACT REU is more frequent thn the ntionl REU smple. The incresing recent use nd frequency of use show tht the focus on methmphetmine by the Ntionl Drugs Cmpign s trgeting n pproprite demogrphic. AUSTRALIAN BUREAU OF CRIMINAL INTELLIGENCE () Austrlin Illicit Drug Report. Cnberr, Austrlin Bureu of Criminl Intelligence. AUSTRALIAN BUREAU OF CRIMINAL INTELLIGENCE () Austrlin Illicit Drug Report. Cnberr, Austrlin Bureu of Criminl Intelligence. AUSTRALIAN CRIME COMMISSION () Austrlin Illicit Drug Report. Cnberr, Austrlin Crime Commission. AUSTRALIAN CRIME COMMISSION () Austrlin Illict Drug Dt Report. Cnberr, Austrlin Crime Commission. AUSTRALIAN CRIME COMMISSION () Austrlin Illicit Drug Dt Report. Cnberr, Austrlin Crime Commission. AUSTRALIAN CRIME COMMISSION () Austrlin Illicit Drug Dt Report. Cnberr, Austrlin Crime Commission. AUSTRALIAN CRIME COMMISSION (7) Austrlin Illicit Drug Dt Report /. Cnberr, Austrlin Crime Commission. AUSTRALIAN CRIME COMMISSION () Austrlin Illicit Drug Dt Report 7. Cnberr, Austrlin Crime Commission. AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE () Ntionl Drug Strtegy Household Survey detiled findings. Cnberr, Austrlin Institute of Helth nd Welfre. AUSTRALIAN INSTITUTE OF HEALTH AND WELFARE () 7 Ntionl Drug Strtegy Household Survey: detiled findings. Drug sttistics series no.. Ct. no. PHE 7. Cnberr, AIHW. BARBOR, T., HIGGINSBIDDLE, J., SAUNDERS, J. & MONTEIRO, M. () The Alcohol Use Disorders Identifiction Test: Gudelines for use in primry cre. Switzerlnd, World Helth Orgniztion. COMMONWEALTH DEPARTMENT OF COMMUNITY SERVICES AND HEALTH () Sttistics on Drug Abuse in Austrli : An informtion document for use in ssocition with the Ntionl Cmpign Aginst Drug Abuse. Cnberr, Austrlin Government Publishing Service. KESSLER, R. C., ANDREWS, G., COLPE, L.J., HIRIPI, E., MROCZEK, D.K.,
NORMAND, SL.T., WALTERS, E.E. & ZASLAVSKY, A.M. () Short screening scles to monitor popultion prevlences nd trends in nonspecific psychologicl distress. Psychologicl Medicine,, 7. MCKETIN, R., MCLAREN, J. & KELLY, E. () The Sydney methmphetmine mrket: ptterns of supply, use, personl hrms nd socil consequences. NDLERF Monogrph No.. Sydney, Ntionl Drug nd Alcohol Reserch Centre, University of NSW. OVENDON, C. & LOXLEY, W. () Bingeing on psychostimulnts in Austrli: Do we know wht it mens (nd does it mtter)? Addiction Reserch,,. REINERT, D. & ALLEN, J. () The Alcohol Use Disorders Identifiction Test (AUDIT): A review of recent reserch. Alcoholism: Clinicl nd Experimentl Reserch,, 77. SAUNDERS, J., AASLAND, O., BARBOR, T. & DE LA FUENTE, J. () Development of the Alcohol Use Disorders Identifiction Test (AUDIT): WHO collbortive project on erly detection of persons with hrmful lcohol consumption: II. Addiction,, 7. SAUNDERS, J. B., AASLAND, O. G., BABOR, T. F., DE LA FUENTE, J. R. & GRANT, M. () Development of the Alcohol Use Disorders Identifiction Test (AUDIT): WHO collbortive project on erly detection of persons with hrmful lcohol consumption. Addiction,, 7. SINDICICH, N., BURNS, L., GEORGE, J., KONG, F., MATTHEWS, A., RAINSFORD, C., ROWE, P., SCOTT, L. & WHITE, N. () Austrlin Trends in Ecstsy nd relted Drug Mrkets : Finds from the Ecstsy nd Relted Drugs Reporting System (EDRS). Austrlin Drug Trends Series. Sydney, Ntionl Drug nd Alcohol Reserch Centre, University of New South Wles. STAFFORD, J., SINDICICH, N., BURNS, L., CASSAR, J., COGGER, S., DE GRAAFF, B., GEORGE, J., MOON, C., PHILLIPS, B., QUINN, B. & WHITE, N. () Austrlin Drug Trends : Findings from the Illicit Drug Reporting System (IDRS). Austrlin Drug Trends Series. Sydney, Ntionl Drug nd Alcohol Reserch Centre, University of New South Wles. TOPP, L. & MATTICK, R. (7) Choosing cutoff on the Severity of Dependence Scle (SDS) for mphetmine users. Addiction,,. 7