” It is generally agreed responses to alcohol and other drug use in Aboriginal and Torres Strait Islander communities should be community owned and driven.

The Mallee District Aboriginal Services (MDAS) in Victoria, for example, has conducted research to advocate for service improvement. MDAS developed a short film where Aboriginal people discuss how they have reduced their own ice use and ice use in their families.

This work highlights the vital role of families in helping people to give up using ice and avoid relapse. The Family Wellbeing Program has been shown to empower Aboriginal individuals and families to take greater control of their lives “

From The Conversation report

NACCHO has report extensively on the ICE use SEE ALL ARTICLES

While rates of methamphetamine use in Australia have remained fairly stable at 2.1% over the past ten years, there has been a shift among people who use the lower-grade powdered form of methamphetamine (speed) to using the higher-grade crystal form (ice) in recent times.

Ice is much stronger than speed and has the potential to cause greater problems.

Purity and availability have increased, while the price of both speed and ice has decreased. The number of people using weekly or more has grown, which is an indication of dependence.

As a result, Australia has seen significant increases in ambulance call-outs, hospital visits, people seeking treatment and police arrests related to methamphetamine use.

There has been particular concern about increases in methamphetamine use among Aboriginal and Torres Strait Islander people. So what do we know about ice in these communities? And what are the effective responses?

Rates of use

Across Australia, around 2.3% of Aboriginal and Torres Strait Islander people 15 years and over report using methamphetamines in the past year. This is similar to the general population rate of 2.1%.

Methamphetamine use in remote Aboriginal communities appears to be very limited. Only 0.8% of the remote area population uses methamphetamine. Like the general population, the greater percentage of users are in the cities.

However, there are concerns this may be changing. Remote areas, which are largely populated by Aboriginal communities, showed an increase in recent use of methamphetamine between 2010 and 2013.

Seeking help

The data is limited, but the rate of Aboriginal people seeking treatment for methamphetamine-related problems seems to be following the same upward trend as other people who use. Service providers report the use of ice in particular has increased among young Aboriginal people.

Although there is no widely available medicine to treat methamphetamine dependence, psychological treatment is effective. One study found people who use methamphetamine have the best treatment outcomes of all alcohol and other drug users.

Cognitive behaviour therapy (CBT), motivational interviewing (MI) and acceptance and commitment therapy (ACT) are both effective, as is residential rehabilitation. As little as two sessions of CBT and MI increases abstinence, even among heavily dependent users.

The evidence is limited for mutual support groups, such as 12-Step (Alcoholics and Narcotics Anonymous) and SMART Recovery (Self-Management and Recovery Training). But this type of post-treatment support may increase the chances of maintaining abstinence. Peer worker or telephone contact are other options, but there is little methamphetamine-specific research.

The overall relapse rate after treatment, however, is high and there are few ongoing supports after treatment.

Although Aboriginal and Torres Strait Islander people access these interventions through both mainstream and Aboriginal-specific services, little is known about their outcomes.

Prison diversion programs

There are a number of mechanisms through which people who use drugs can access treatment via the justice system.

Drug courts, for instance, divert illicit drug users from the prison system into treatment. These operate in most states and have been found to be effective.

Aboriginal people are heavily over-represented in the justice system, but participation rates in drug court programs varies. Where drug courts have taken a collaborative approach to design and implementation, working closely with Aboriginal and other organisations, participation rates are higher.

Improving access to treatment and support

It is generally agreed responses to alcohol and other drug use in Aboriginal and Torres Strait Islander communities should be community owned and driven.

The Mallee District Aboriginal Services (MDAS) in Victoria, for example, has conducted research to advocate for service improvement. MDAS developed a short film where Aboriginal people discuss how they have reduced their own ice use and ice use in their families.

This work highlights the vital role of families in helping people to give up using ice and avoid relapse. The Family Wellbeing Program has been shown to empower Aboriginal individuals and families to take greater control of their lives. This may involve re-engaging in education and employment, addressing challenges such as family conflict and advocating for community services and support.

MDAS is partnering with La Trobe University to evaluate whether the program is a useful add-on to alcohol and drug treatment in supporting individuals and families who are affected by ice use.

The Victorian government has made some progress in improving treatment and support. It has piloted an 18-month program to link mainstream specialist services with Aboriginal services. The aim is to build the capacity of both sectors to respond specifically to Aboriginal people and their families who are affected by the use of methamphetamine. The pilot is under evaluation.

But there is plenty of room for improvement. Both the Aboriginal and generalist drug and alcohol workforce have identified a need to be better skilled in responding to the needs of Aboriginal people who use methamphetamine.

Culturally appropriate harm-reduction strategies are critical for people who continue to use methamphetamine. Indigenous people in the United States, for example, have successfully used culturally targeted education and social marketing, plus individual and family treatment, to reduce methamphetamine-related incidents and arrests.

Finally, we need better data and project evaulations to create an accurate picture of methamphetamine use among Aboriginal Australians and develop more effective responses.

NACCHO APP Alerts : New app makes it easier to find Aboriginal  treatment services

Illicit drug use is associated with many risks of harm to the user and to their family and friends. People who use illicit drugs place themself at risk of health problems, exposure to violence, family breakdown, crime and housing difficulties

Winner: photo of the year (above ) Gary Ramage’s ‘Ice Nation’ portrays the scene as a man named Bill is in the throes of an ice-induced medical emergency. It took nine hospital staff including security guards to restrain the man before he could be treated by a medical crew. The judges said Gary’s work had great social impact and they praised him for telling the story of one of Australia’s most significant social problems ‘without stigmatising the victim, and with empathy for everyone in the room’.

AIHW Report Trends in methylamphetamine availability, use and treatment  2003–04 to 2013–14 Released October 2015

DOWNOAD THE AIHW REPORT HERE

SUMMARY

Illicit drug use is associated with many risks of harm to the user and to their family and friends. The Harms associated with methylamphetamine, especially its crystal (ice) form are particularly concerning, and can result in significantly harmful long-term psychological and physical effects. Changes in the use of methylamphetamine have been one area of increasing concern among health professionals and the Australian community.

Terminology for methylamphetamine – commonly referred to as methamphetamine or “meth” – varies across data sources.

Not all data sources collect data on methylamphetamine specifically; some use the broader classes of drugs, amphetamines, amphetamine-type stimulants, or “meth/amphetamines”, in which methylamphetamine belongs. Box 2 provides a description of each of the terms used throughout this report.

Production and supply of amphetamine-type stimulants has been increasing.

In recent years, arrest, seizure and detection data indicate that production and supply of amphetamine-type stimulants (ATS) is rapidly increasing, both in Australia and internationally. Over the four years since 2009-10 detections (the identification of illicit drugs at the Australian border) increased by 86% between 2011-12 and 2012-13, and a further 18% in 2013-14, and the total weight of these detections in 2013-14 was 27 times as high as it was in 2009-10. The total number of arrests for ATS increased – accounting for 15% of all arrests in 2009-10 and 23% in 2013-14.

Methylamphetamine is consistently reported as very accessible.

As well as consistent prices, methylamphetamine purity has remained consistently high since 2008, particularly for crystal, and all forms of methylamphetamine have been consistently reported as “easy” or “very easy” to obtain since 2007.

The form of methylamphetamine used has changed from powder to crystal in recent years.

While the proportion of the population who used meth/amphetamines in the last 12 months declined between 2004 and 2013 (from 3.2% to 2.1%) more recently there has been substantial change in the form of methylamphetamine used- from powder to crystal (ice). More of those who recently used methylamphetamine in 2013 reported crystal as the main form used (50% of recent users) compared with powder (29% or recent users).

Between 2010 and 2013, there has been an increase in new users of “meth/amphetamine”, especially crystal.

In 2013, a larger proportion of recent users had first used “meth/amphetamines” – 34% compared with 27% in both 2007 and 2010. This cohort of new users is opting mainly for crystal rather than the powder form of “meth/amphetamines”.

Since 2004, there has been a shift in the pattern of recent “meth/amphetamine” use by socioeconomic status, remoteness area and Indigenous status.

In 2013, recent users of “meth/amphetamine” were more commonly aged 20-29 and most likely to be male. In 2004, people living in the two most advantaged socioeconomic status (SES) quintiles were the more likely to be recent users of meth/amphetamine. However, by 2010 they were the least likely to be users. Since 2007, people living in Remote and very remote areas and Aboriginal and Torres Strait Islander people (hereafter referred to as “Indigenous Australians”) were more likely to be recent “methamphetamine” users.

Since 2009-10 the number of episodes for clients injecting and smoking amphetamines has increased.

Over the 5 years to 2013-14, the number of episodes for clients both injecting and smoking (clients who reported “smoking or “inhaling”) amphetamines increased, while use via other methods, remained relatively stable. Clients who smoke amphetamines are most likely to have never injected drugs, indicating that these clients are a different type of user. While characteristically, injectors and smokers appear to be relatively similar, there are some noticeable differences – more young people smoke that inject and slightly more females and Indigenous Australians inject than smoke.

Background

In 2013, around 2.9 million people in Australia reported they had used illicit drugs in the previous 12 months (AIHW 2014). Both nationally and internationally, the proportion of people using illicit drugs has remained relatively stable over the last 10 years—15% of adults in Australia in 2013, and globally around 5% of the adult population in 2010 (AIHW 2014, UNODC 2012). However, usage patterns continue to change. Changes in the use of methylamphetamine have been one area of increasing concern among health professionals and the Australian community.

The harms associated with methylamphetamine, especially its crystal (ice) form, are particularly concerning. Crystal is highly addictive and causes disruption to an individual’s brain function. Crystal use can also result in harmful long-term psychological and physical effects, such as paranoia, substance dependence, memory loss, liver damage and cardiovascular diseases (Darke et al. 2007).

In Australia, the National Drug Strategy (NDS) has provided the overarching framework for addressing licit and illicit drug use since 1985. The broad aims of the NDS are to prevent and reduce the uptake and misuse of drugs, the production and supply of illicit drugs and the negative social, economic and health consequences of drug use. The NDS addresses the production and use of methylamphetamine in a number of ways (see Box 1 for further details).

Due to the significant negative consequences of methylamphetamine use (crystal specifically) on individuals and their families, the Australian Government has launched a National Ice Taskforce to develop the National Ice Action Strategy to address the use of ice and its impacts.

The taskforce delivered an interim report to the Council of Australian Governments (COAG) on 23 July 2015 and the strategy will be delivered to COAG by the end of 2015 <http://www.dpmc.gov.au/taskforces/national-ice-taskforce>. Alcohol and other drug treatment services (AODTS) play an important role in efforts to reduce the recent trends in methylamphetamine use (AIHW 2011).

This report presents data on the use, availability and market activity of methylamphetamine over the period 2003–04 to 2013–14 and compares these with trends in drug treatment. The analyses presented in this report provide insights for policy makers and practitioners to tailor intervention strategies and services to reduce the harms associated with methylamphetamine. They also indicate possible areas for further, more targeted research. See Box 2 for an explanation of terminology used in this report.