Differences in methamphetamine use among

IDRS & EDRS Participants Prepared by Amanda Roxburgh, Toni Karlsson, and Rachel Sutherland

On behalf of the Drug Trends Team

2

Characterising the Samples

IDRS Participants

N=888

EDRS Participants

N=786

People who inject drugs

(six times or more past six months)

People who use stimulants

(six times or more past six months)

High levels of dependence

• Opioid dependence (69%)

• Methamphetamine dependence (48%)

• Opioid AND meth dependence (15%)

42% using stimulants weekly or more

often – more sporadic patterns of use

Predominantly male 67%

Average age 43 years

Predominantly male 64%

Average age 21 years

4

71

31

61

12

0

20

40

60

80

100

2017

% S

am

ple

IDRS Meth use EDRS Meth use

IDRS weekly or more EDRS weekly or more

Drug Trends Findings Methamphetamine use – Past 6 months

6

Drug Trends Findings Forms used among methamphetamine users

87 82 88

78 80

78

84 84 82

79 76

77

66 66

72 71

69

80

71 74

69 73

70 66

59

60

43

36

26 28

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013 2015 2017

% o

f th

ose u

sin

g m

eth

am

pheta

min

e

EDRS - Speed IDRS Speed

Speed

62

54

46

60 46

41

28

30

43 48

46

43

50 50

43

70 67

57

72

63

71

56

65 69

80

84

88

93 98

96

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013 2015 2017

% o

f th

ose u

sin

g m

eth

am

pheta

min

e

EDRS - Crystal IDRS Crystal

Crystal

7

37

44

51 53 58

64

70 66

75

80

88 92

86

80

85 92

0

20

40

60

80

100

2010 2011 2012 2013 2014 2015 2016 2017

% o

f th

ose u

sin

g c

rysta

l

IDRS % Injected EDRS % Smoked

Drug Trends Findings Crystal use – Route of Administration

8

Methamphetamine dependence among methamphetamine users (SDS)

21

27

20

43 39 41

46 48 48

0

20

40

60

80

100

2012 2013 2014 2015 2016 2017

% o

f th

ose u

sin

g m

eth

am

ph

eta

min

e

EDRS IDRS

9

IDRS Findings: Dependence on opioids and methamphetamine

Opioid

69%

Meth

48% 16%

10

Treatment among those who are methamphetamine dependent

27 22

0

20

40

60

80

100

% o

f th

ose w

ho a

re d

ependent

EDRS IDRS

11

IDRS Findings Treatment among those who are dependent

54

22

0

20

40

60

80

100

Opioid Tx Methamphetamine Tx

% a

mong

those w

ho a

re d

ependen

t

IDRS Participants

12

IDRS Findings Mental health by methamphetamine use

44

25

55

35

23

46

0

20

40

60

80

100

Mental Health Problems Attended Tx High VHigh Distress K10

% s

am

ple

by m

eth

am

pheta

min

e u

se

IDRS Meth IDRS No Meth

13

EDRS Findings Mental health by methamphetamine use

52

31

48 42

26

34

0

20

40

60

80

100

Mental Health Problems Attended Tx High VHigh Distress K10

% s

am

ple

by m

eth

am

pheta

min

e u

se

EDRS Meth EDRS No Meth

*

14

Drug Trends Findings Mental health among those using methamphetamine

44

25

55 52

31

48

0

20

40

60

80

100

Mental Health Problems Attended Tx High VHigh Distress K10

% a

mong

those u

sin

g m

eth

am

pheta

min

e

IDRS EDRS

15

EDRS Findings Drug use by methamphetamine use

35 27

70

36

54

18

45

27

16

65

20 23

13

27

0

20

40

60

80

100

Weekly ormore E use

Caspulesunknowncontent

CrsytalMDMA

DailyCannabis

use

Bingestimulant

use

Audit zone 4 NPS use

% s

am

ple

by m

eth

am

pheta

min

e u

se

EDRS Meth EDRS No Meth

* *

* *

16

EDRS Findings Risk and harms by methamphetamine use

30

16

42

24

7

30

0

20

40

60

80

100

Adverse events Arrested past 12months

Drug dealing

% s

am

ple

by m

eth

am

pheta

min

e u

se

EDRS Meth EDRS No Meth

*

*

17

IDRS Findings Drug use by methamphetamine use

44

28

46 45 41

49

34 42 41 38

0

20

40

60

80

100

Injecting Daily Heroin Daily CannabisDaily

InjectionScarring

DifficultyInjecting

% s

am

ple

by m

eth

am

pheta

min

e u

se

IDRS Meth IDRS No Meth

18

IDRS Findings Risk and harms by methamphetamine use

37

28

19 14

0

20

40

60

80

100

Arrested past 12 months Drug dealing

% s

am

ple

by m

eth

am

pheta

min

e u

se

IDRS Meth IDRS No Meth

* *

19

o Methamphetamine use among people who inject drugs

(IDRS)

Majority using and majority doing so weekly or more often

Crystal form predominant – and mostly injecting

48% dependent and this has increased over past 4 years

Doesn’t appear to be a clear marker for:

– increased risk or harm re: use patterns, injecting harms,

psychological distress

Does appear to be a marker for:

– engagement in criminal activity, contact with law enforcement

Many other mediating factors for risk and harm:

– High levels of opioid dependence, homelessness,

unemployment, injecting drug use

Summary - IDRS

20

o Methamphetamine use among people who use stimulants

regularly (EDRS):

Minority using and minority doing so weekly or more often

Powder form predominant – crystal predominantly smoked

20% dependent

Appears to be a clearer marker for increased risk and harm:

– other drug use: E.G. Frequency of ecstasy and

cannabis use, problem drinking

– risk behaviours: E.G. binge stimulant use, using

capsules of unknown content, drug dealing

– harms: E.G. experiencing adverse events, contact with

law enforcement, psychological distress

Summary -EDRS

21

o Psychological distress high across both groups

Accessibility of mental health care is clearly still an issue across

both groups and needs to be addressed

o Treatment uptake low across both groups

Encourage both groups into treatment

Continued development of treatments available -

pharmacotherapy

For EDRS participants

– Screening for methamphetamine use and problems without

stigmatising

For IDRS participants

– Important to address methamphetamine dependence among

this group BUT

– to treat substance use in isolation misses the point

– Other complex needs to be addressed – housing, financial

etc.

Policy Responses –IDRS and EDRS

22

Thank you 2017 Drug Trends Team

National Drug and Alcohol Research Centre, University of New South Wales

(National, NSW, ACT, SA and the NT)

Dr Courtney Breen, A/Professor Lucinda Burns, Ms Kerryn Butler, Ms Antonia Karlsson, Ms

Courtney O’Donnell, Ms Amanda Roxburgh, Ms Jennifer Stafford, Ms Rachel Sutherland, Ms

Julia Uporova, Mr Joe van Buskirk, and Professor Alison Ritter

Burnet Institute for Medical Research and Public Health (VIC)

Ms Amy Kirwan, Mr Arthur Truong, Dr Campbell Aitken and Professor Paul Dietze

School of Medicine, University of Tasmania (TAS)

Ms Bethany Lusk, Dr Amy Peacock, Dr Allison Matthews and A/Professor Raimondo Bruno

National Drug Research Institute (WA)

Mr James Fetherston, Ms Marina Nelson and Professor Simon Lenton

School of Public Health, The University of Queensland (QLD)

Dr Caroline Salom and Professor Rosa Alati

Northern Territory Department of Health (NT)

Mr Chris Moon, Ms Tania Davidson and Mr Warrant Que Noy