Professor Nicole Lee shares the latest on methamphetamine at the NZ Drug Foundation's On the Road to Health Symposium, held in May 2021.
Professor Nicole Lee is a leader in alcohol and other drug approaches, with 30 years experience in policy and practice implementation. She is known internationally for her work in methamphetamine treatment and policy.
Drugs like methamphetamine are much more dangerous because they are unregulated.
While methamphetamine is currently illegal, it wasn't too long ago in in Australia and New Zealand's history that amphetamines were sold legally. Benzedrine inhalers, for example, could be obtained and used on planes for a pick-me-up mid-flight. Public sentiment towards amphetamines has changed dramatically in that time. Nicole contrasted the Benzedrine advertisements with recent campaigns from the Australian Government to encourage people not to use methamphetamine. These sensationalised campaigns reflect the large concern that the community now hold about these drugs.
When amphetamine and methamphetamine were regulated pharmaceutical drugs there were relatively few problems. There were certainly people who were dependant, there were certainly people who had some issues with it, but not to the same extent that we are seeing now.
Nicole reflects that as laws became stricter so did the problems experienced from methamphetamine.
Methamphetamine has a low population prevalence (the number of people who use it) at 1.3 percent in Australia and 1.1 percent in New Zealand. And, in fact, the proportion of people in Australia who use methamphetamine has decreased since 2001 - from about 3.5 percent in the early 2000s. This decrease can be seen in both the three yearly household survey and wastewater data collection.
And, most people in Australia who use methamphetamine don't use it often. Nicole shared that about 70 percent used less than once a month, about 15 percent use it between one and three times a month, and about 15 percent use it more than once a week.
Despite there being a decrease in use, methamphetamine is still the drug that Australian's were most likely to associated with a 'drug problem' and half of the people who responded to the National Drug Survey nominated methamphetamine as the drug of most concern to the community.
Why has concern about methamphetamine increased when the use of it has decreased?
That question can partially be answered by an increase in harm indicators such as treatment and hospital presentations, ambulance call outs, and deaths related to methamphetamine use.
The data indicates that fewer people are using methamphetamine, but more of those who are using it are shifting to more harmful methods and forms of methamphetamine.
The good news is that treatment is effective. But, relapse rates are high and it is common for people to use methamphetamine again three years after completing treatment.
Nicole recommended strengthening support after people complete treatment and focusing particularly on reducing relapse and reducing harms. Peer support is critical.
Reflecting that most people who use methamphetamine only use it occasionally - and are unlikely to come to or need treatment, Nicole also recommended approaches that help people to reduce the impact on their wellbeing from methamphetamine use. These included their mental health, nutrition, sleep, and sexual health.
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This experience was shared by a young, queer Māori man as part of Rewired - a support group for men who have sex with men and use methamphetamine, run by the NZ Aids Foundation and NZ Drug Foundation.