Local ‘ice’ strategy begins to crystallise

PHN senior project officer, Substance Misuse Program, Samantha Booker addressing a group of local GPs

In a concerted effort to increase awareness of the realities and misconceptions surrounding crystal methamphetamine, a.k.a. ‘ice’, the North Coast Primary Health Network has begun a series of roadshows to promote better understanding of the drug’s challenges amongst both the medical and general communities.

The program includes on-request briefings to GP practices and interested community groups, as well as an open symposium in Ballina on 3 August, where a range of frontline workers and experts will share experiences and advice.

The PHN’s campaign is being held in conjunction with the Bulgarr Ngaru Medical Aboriginal Corporation, further confirmation that the damaging and addictive drug continues to make significant inroads into sections of the local Indigenous community.

The push follows a nationwide focus on the drug, some of it ill-informed, as well as the PHN’s local effort that has included a taskforce forum last year, and the recent announcement of a $5.7M Commonwealth funding package to target the health aspect of ice on the North Coast.

According to PHN senior project officer, Substance Misuse Program, Samantha Booker, who is coordinating the practice briefings, around 2 per cent of Australians over 14 years have used the drug in the past 12 months, a figure that, despite frequent talk of an ice ‘epidemic’, has barely changed in a decade.

However, there are mounting concerns that society could be on the cusp of a usage boom, largely due to changes in the manner in which crystal meth is being consumed. These changes, according to treatment expert and author Ted Noffs, of the famous Wayside Chapel family, result from the increasing purity of the drug.

“What Emergency medicine specialist Dr David Caldicott thinks we should be worried about is that methamphetamine is becoming purer, and that consumers are shifting from injecting to smoking it,” Noffs writes in the recently published Breaking the Ice - How We Will Get Through Australia’s Methamphetamine Crisis.

In the view of Noffs and other notables in the field, a key part of a successful strategy will be the introduction of medically supervised drug consumption rooms, akin to those set up for users of heroin.

Noffs, who will appear at next month’s Byron Writers Festival, reports that while some may see the switch from injecting to smoking as potentially reducing blood-borne infections, it could mean increased consumption by younger people and especially girls.

Dr Caldicott dismisses the notion of an ice ‘epidemic’ and the portrayal of all users as being prone to extreme violence, a fear highlighted in the federal government’s widely-run 2015 TV commercial.

He told Noffs, “The demographic changes in methamphetamine consumption are, to me, and in the long term from a public health perspective, far more concerning than the circulating moral panic suggesting that we’ve supposedly got axe-wielding cannibal people wandering the streets of Canberra or Sydney.”

That said, between 25%-40% of regular users on the North Coast have experienced psychotic symptoms in the past month, according to Samantha Booker, who says that while less than one-in-four users develops a dependency, the time to become addicted is much faster than either heroin or alcohol.

It should be noted that a significant number of ice users engage in poly-drug use, notably cannabis and high levels of tobacco and alcohol consumption.

Ms Booker says the proportional use of ice crystal has grown much faster than the two less-potent meth forms (powder and base), adding that while the effects on the brain are rapid and pleasurable, despite a range of physiological risks, the coming down period can be so unpleasant that regular users are often inclined to have more hits to maintain the high.

Significantly, cognitive function amongst those who have been clean for as long as nine months has been found to be less than for current users.

Recovery from ice dependency is certainly possible, Ms Booker says, although the journey is seldom easy, especially for those exposed to peer pressure from drug users, or in circumstances where positive lifestyle options are limited.

At present, there is no pharmacotherapy treatment option, so ice dependency is best addressed through medical advice, counseling, support groups and lifestyle adjustment, with family understanding, rather than despair or condemnation, being a crucial factor.

As Dr Caldicott told Matt Noffs, “If you’re a parent, try to learn what it means to consume that drug, and why your child is using it - it’s not usually to piss you off… try to have a rational dialogue about what it is and the potential harms associated with it.”

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