Crystal Methamphetamine Understanding and responding to Crystal - - PowerPoint PPT Presentation

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Crystal Methamphetamine

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Understanding and responding to Crystal Methamphetamine use

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Substance Use 101

• Slow down the

activity of the brain and CNS

Depressants

• Speed up the brain

and CNS resulting in increased alertness and physical activity

Stimulants

• Interfere with the

brain and CNS and distort the user’s perception of reality

Hallucinogens

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

speed, goey, whiz paste, point, pure, wax ice, shabu, crystal, crystal meth, tina, glass, shard

Forms

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

History

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Meth today?

– Worldwide - increased production of methamphetamine – Australia - one of the highest rates of methamphetamine use worldwide (2014 World Drug Report)

One “point”= 0.1g = 100mg = $50-80

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Recent Methamphetamine use in Australia

Source: NDSHS 2013

0.2% 2.3% 1.6% 3.5% 9.1% 89.9% 0.2% 2.1% 2.1% 3.0% 10.3% 87.9% 0.1% 2.1% 2.1% 2.5% 10.2% 86.2%

Heroin Meth/amphetamines Cocaine Ecstacy Cannabis Alcohol

Australians over 14 who had used alcohol and other drugs in the past 12 months

2013 2010 2007

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Form of methamphetamine

Among those using in the last 12 months, ≥ 14 years 10 20 30 40 50 60 2007 2010 2013 Powder Base Crystal %

Source: Australian Institute of Health and Welfare (AIWH) 2013 National Drug Strategy Household Survey

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Frequency of use

55% 25% 20%

Irregular Users < Once a month

• Not dependent
• Mild mental health

issues

• Mild sleep problems
• Acute harms

Occasional Users Once a month +

• Moderate mental

health issue

• Moderate sleep and

nutrition problems

• Acute harms

Regular Users Once a week +

• Possible dependence
• Smoking or injecting
• Severe mental health

problems

• Severe sleep and nutrition

issues

• Acute and long term harms

Adapted from NSDHS, 2013

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

10 20 30 40 50 60 70 80 90 Methamphetamine users General population

Source: NSDHS, 2014

Poly-Drug Use

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Crime

Use/Possess Amphetamine

(Rate per 100 000)

All Drug Offences

(Rate per 100 000)

742.5 665.7 2537.9 1501.6 2015 2014 Lismore NSW 112.9 81.8 141.6 62.9 2015 2014 Lismore NSW 9 13.5 23.4 30.8 2014 2015 Lismore NSW

Deal/Traffic Amphetamine

(Rate per 100 000)

1.3 1.2 2014 2015 Lismore NSW

Manufacture Drug

(Rate per 100 000)

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Who is using it?

“I’m 20 and studying at Uni to be a

• doctor. I smoke ice maybe twice a

month at the most. My parents would be horrified – they are naïve and very strict and have high hopes for their private school educated eldest daughter … I really enjoy the

• drug. I get sick from alcohol and

paranoid from weed. And as long as I have time to sleep afterwards, it’s all good. I have been keeping up with my studies. If it interferes with my life goals I will stop using it”. “I like to use ice. It makes me feel happy, alert, alive. It’s my favourite drug and I take it as much as I can. It annoys me that it is so expensive and that I have to work so hard to get the money to afford

• it. I am homeless and I work washing

windscreens and doing other earns. It’s hard work … I have had a few so called “episodes”, always on binges when I haven’t slept eaten. The most recent time I got upset at someone who insulted me, saying I was a “lowlife Junky”. Maybe I wouldn’t have reacted quite how I did if I hadn’t been on ice, but I like to think I would have stuck up for myself anyway.”

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Who is using it?

20-35 year olds most likely to use Existing users of amphetamines Unemployed, single males Men who have sex with men Particular industries Aboriginal communities

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

How does the profile of people who use crystal methamphetamine compare with your perceptions or experiences?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

How does Crystal Methamphetamine work?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Crystal Methamphetamine affects 3 chemicals in your brain

• 1. Serotonin
• 2. Noradrenaline
• 3. Dopamine!

Neurotransmitters

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Dopamine = Feel good

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

How and why is Crystal Methamphetamine used?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Route of Administration

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Why?

Meth Inside out – Why Meth?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Possible long term effects

Physical Psychological and Cognitive Social and Environmental

• Seizure
• Heart failure or

respiratory failure

• Brain haemorrhage,

stroke

• Kidney failure
• Cardiac and coronary

artery disease

• Extreme weight loss and

malnutrition

• Psychosis
• Depression
• Anxiety
• Impaired planning and

decision making ability

• Impulse control
• Low energy levels
• Memory problems
• Anhedonia
• Emotional regulation
• Threat sensitivity
• Attention
• Motor skills
• Violence and aggression

Unsafe injecting practices

• Sexual risk taking
• Drug driving
• Criminal activity
• Social isolation
• Relationship problems
• Financial difficulties
• Lost opportunities

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Dependence and Withdrawal

It’s easier to get off than to stay off

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Psychosis

• Hallucinations
• Delusions
• Thought disorder
• Disorganised or bizarre behaviour

Illusions Suspiciousness Fear Paranoia Hallucinations Delusions

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

“Ice psychosis hits people in different ways. While I have used a lot – A LOT – of ice, I have never become psychotic. However, I have supported friends through all sorts of experiences. Some people are just a little paranoid, thinking people are talking about them or following them. Others lose touch with what is real and imagine plots or hear voices. Fear is a really big part of it. Some people become very afraid – absolutely terrified. I have managed friends through all the stages. It’s important to keep calm and stay with them. Scared people are unpredictable and can become violent, in which I think is self-preservation. It’s important to make sure you don’t become part of the threat. I get them somewhere they are comfortable, often their own home. I try and get them to eat something or have a rest. It’s obviously best for them not to use any more ice, but a benzo can help. With some people you can divert them, get them to talk about other things, even have sex, until they calm down and sleep. For some TV or the Net will divert them, for others it will rev them up. With others, they are so scared they are immobilised. Move slowly. Be careful in what you say. Don’t play into their fantasy, but don’t disagree. Lots of non-committal “mmm”’s. You will not be able to talk them out of it, you just need to look after them and make sure they don’t do anything stupid. You need to be a friend.”

Jake on supporting friends through psychosis Users News, Issue 81, 2015

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Responding to Psychosis

• Avoid confrontation – very important with people

suffering from methamphetamine psychosis:

keep a safe distance from the person speak in a quiet voice avoid physical contact minimise direct eye contact do not disagree or argue with them be reassuring and supportive

• If you are in a public place and someone suffering

from methamphetamine psychosis presents a danger to themselves or to other people, call 000 for emergency medical assistance.

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Cognitive Effects

• Poor verbal memory
• Slowed mental processing speed
• Reduced executive mental skills
• Disinhibition (poor self-control)
• Reduced ability to avoid distraction
• Thinking about immediate desires rather than

future negative consequences

• Difficulty switching between different activities

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

What might be some of the practical implications of these thinking impairments? How could you deal with some of these effects?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Stigma and Discrimination

• Illicit drug dependence is the most stigmatised

health condition in the world (WHO, 2010)

What might be some of the implications of stigmatising substance use? What can be done to reduce stigma towards people who might be using substances?

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Recovery from Using Crystal Methamphetamine

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Treatment

• People do recover from Crystal Meth dependence
• No pharmacotherapies are available though

amphetamine substitution being trialled

• Standard treatment approaches are:

– Counselling (motivational interviewing and CBT) – Support groups – Sleep, Exercise, Food and Time

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Recovery

Recovery

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

State-wide services

Service Program Contacts Alcohol and Drug Information Service 24/7 education, information, referral, crisis counselling and support. Anyone can call. 02 9361 8000 or 1800 422 599 yourroom.com.au Stimulant Treatment Line 24/7 advice, support, referral and counselling for people concerned about stimulants or for information on the Stimulant Treatment Program. 02 9361 8088 or 1800 101 188 Family Drug Support 24/7 telephone support and counselling for families in need due to drug or alcohol issues. 1300 368 186 fds.org.au Counselling Online 24/7 free online counselling service for people using alcohol or other drugs, their family members and friends. counsellingonline.org.au Drug & Alcohol Specialist Advisory Service For health professionals only. Advice on clinical diagnosis and management of patients with alcohol and other drug related problems. Available 24/7. 1800 023 687

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Local services

Service Program Contact Riverlands Drug and Alcohol Centre 16-bed detoxification unit, pharmacotherapy clinic, outpatient counselling services, education, CM clinical liaison service. 6620 7600 MERIT Drug court diversion program 6620 7650 Namatjira Haven Residential Drug and Alcohol rehabilitation program for Aboriginal men. 6628 1098 The Buttery Residential rehabilitation program. Community

• utreach programs.

6687 1111 Narcotics Anonymous A self-help group for people using or in recovery from crystal methamphetamine. 8004 1214 na.org.au Needle and Syringe Program Access to a range of safe injecting equipment and disposal bins. Harm reduction information available. 6622 2222 50 Hunter St, Lismore safesharps.org.au

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Take Home Messages

• 2.1% of the Australian population has used methamphetamine

in past 12 months

• 1% have used crystal methamphetamine (CM) in past 12

months

• CMhas a high potential for dependence
• Longer term CM use has significant effects on brain chemistry:
• Paranoia
• Dependence and Withdrawal
• Cognitive deficits
• Recovery from longer term CM use is possible

Healthy North Coast Ltd (ABN: 18 154 252 132), trading as North Coast Primary Health Network www.ncphn.org.au

Thank you

Kim Gussy Senior Project Officer Substance Misuse Program kgussy@ncphn.org.au 02 6627 3300 Sam Booker Senior Project Officer Substance Misuse Program sbooker@ncphn.org.au 02 6627 3300

In partnership with Bulgarr Ngaru Aboriginal Medical Corporation