Tuesday, April 29, 2008

The Cold Hard Truth About 'Speed' And 'Ice', Australian Medical Association

The Australian Medical Association claimed methamphetamine users were being put in the too-hard basket - with the peak medical body calling for an overhaul of how the health system deals with this very difficult drug problem.

AMA National President, Dr Rosanna Capolingua, released the AMA Position Statement on Methamphetamine at a press conference at the Royal Perth Hospital, saying methamphetamine users who were often aggressive or in a psychotic state were ending up in emergency wards or in police custody.

Dr Capolingua said emergency department staffs were increasingly being placed in harm's way when it came to methamphetamine users.

"Methamphetamine use is an urgent and pressing health problem that is creating a serious safety issue for health care staff," she said.

The AMA is calling for all emergency departments to have a specialist drugs liaison officer to engage and support methamphetamine and other drug users.

Dr Capolingua said using methamphetamines may produce an initial sense of wellbeing and euphoria but dependence on this harmful drug can lead to methamphetamine-induced psychosis. Three in 10 users will experience psychotic episodes with paranoia and hallucinations.

"Methamphetamine should never be referred to as a recreational, soft or party drug. It's a harmful drug at the community and individual level. More than three-quarters of dependent users suffer serious mental health problems such as agitation, aggression, depression and anxiety," Dr Capolingua said.

A recent Western Australian study found that amphetamine-related presentations accounted for 1.2 per cent of emergency department cases.

Dr Capolingua said many agitated or psychotic users brought into emergency wards were often drunk as well - increasing the risk of aggression towards staff and creating clinical management challenges.

"Symptoms usually last two or three hours but users often need to be hospitalised for their own protection and the safety of others. A third require sedation and intensive treatment which obviously takes up considerable hospital resources," she said.

Further research is also needed into methamphetamine-related problems in emergency departments, best practice in treatment, and what services are required to avoid hospital admission or police custody if a patient is not psychotic. The AMA believes low-intensity, supervised hostel-type accommodation may be suitable.

The AMA is also calling for:

- A renewed, comprehensive and sustained public education program on the social and health consequences of methamphetamine use;

- A sustained investment in GP training on how to engage drug users for lifestyle change; and

- More generic programs, such as Life Skills, which are aimed at young people.

The AMA Position Statement can be found here.


Around three per cent of Australians over the age of 14 use the harmful drug at least once a year.

There are approximately 73,000 dependent methamphetamine users in Australia compared to the 45,000 regular heroin users.

Methamphetamine is a stimulant drug available in various forms:

- Powder or 'speed' is usually of relatively low purity and can be snorted, injected or taken orally;

- Methamphetamine base, a damp oily substance, is of higher purity and typically injected; and

- Crystalline methamphetamine, colloquially known as 'crystal' or 'ice' is methamphetamine in its purest form. Ice is usually smoked or injected.

Pseudoephedrine, available from pharmacies as a symptomatic treatment for the common cold, is the usual base for the illicit manufacture of methamphetamines.

Australian Medical Association

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