Dovetail’s Cameron Francis offered his keynote presentation early on day one of the Just Ice? Symposium. In doing so, he ensured facts replaced myths and challenged preconceived biases and assumptions. Dovetail provides clinical advice and professional support to workers, services and communities across Queensland who engage with young people affected by alcohol and drug use. As such, Cameron offered a wealth of expertise on this topic.
Cameron encouraged all present at this event to use the term methamphetamine in preference to just ice. In focusing on ice alone, the likely unintended consequence is that other types of methamphetamine will be seen as less problematic. This isn’t the case, all methamphetamine use is potentially harmful.
Cameron described effective drug screening as ‘difficult’, both in terms of potential inaccuracy as well as the need to treat such a process with caution. He presented a case for viewing drug testing, if used, as only a part of the assessment (and re-assessment) process, whether that be in respect of assessing or re-assessing parental capacity or any other matter. He argued that the results of testing should be considered alongside and within the context of other information that is collected, rather than being singularly used in a ‘catchall manner’ as the sole determinant of an assessment outcome.
Cameron spoke to the difficulty of research in this arena, in part due to the fact that Australians have high rates of drug use. This makes questions about whether the prevalence of methamphetamine use has reached ‘epidemic proportions’ hard to answer because our baseline of drug use is high. He spoke to the helpfulness of a Japanese study whereby the majority of those interviewed used methamphetamine only, not a plethora of substances – either illicit substances or those that are ‘legally’ obtained or prescribed, as is often the case in the Australian context.
He spoke to the history of amphetamine use in Australia including World War 2 soldiers using the substance to stay alert. Then from the 1960s onwards, via prescriptions drugs prescribed largely to children to ease nasal congestion as well as women aiming to lose weight. Cameron’s reference to its inclusion in an illustrated airline menu from this period starkly drew attention to significant shifts that have occurred over time in the ways in which amphetamine use has been understood and viewed within our society. He stated that throughout the 1960s, promotions to discourage and divert people from using the substance gained momentum eventually culminating in restrictions being imposed.
By the late 1960s and early 1970s, the illicit manufacture of meth/amphetamines commenced across the world. This shift to illicit manufacture brought with it a shift in the population using meth/amphetamines. It led to less middle aged women using, less oral use and an increase in younger males using as well as more injecting drug use. In the 1970s amphetamine started being produced in backyard laboratories.
By the early 1990s, restrictions were placed on chemicals used to produce amphetamine. By the mid to late 1990s the development of the ‘box lab’ which produced methamphetamine instead of amphetamine was noted. Box labs were sold throughout Australia and methamphetamine took over from amphetamine. This change from amphetamine to methamphetamine increased the harmful effects to users of the substance due to its increased ‘purity’. Methamphetamine has greater effects on the central nervous system and is longer acting. Some forms are suited to more harmful routes of administration such as IV or smoking. It is also more likely to lead to psychosis.
In 1997 methamphetamine was first perceived as a possible threat in Australia. In this year the Australian Federal Police seized 4.5kg of a Chinese ‘new-age’ drug: crystal methamphetamine. Police reported that it was: “too early to describe it as a threat to Australia, but it is a potential threat.”
In early 2000, a heroin drought commenced that coincided with the first waves of significant amounts of crystal methamphetamine, most likely imported from South East Asia. Significant concern built in the Australian community with Alcohol and Other Drug workers reporting ice use increasing, while police seizures were also rapidly increasing. ABC’s 4-Corners screened The Ice Age in 2006.
By this time, ice seemed to decline in availability again with the theory that importation would lead to waves coming through the community. It seemed there was no consistent supply, especially in Queensland. Then, from 2010 to 2013 the major form of methamphetamine altered from powder to crystal, hence the purity of the substance increased. So too did the potential for harm and potency. Psychosis, dependence and aggression were part of this.
Over the last four years Dovetail started receiving anecdotal reports throughout Queensland of:
- Young people using ice again
- Reports of easer access
- Reports of ice appearing in regional centres
- Reports of some young users
- Reports of large scale ice labs appearing in Australia
Cameron reminded those working closely with users of methamphetamine to ensure that water and food was on hand given that often their symptoms are actually about dehydration and a lack of nutrition. He also spoke to misperceptions about overdose with regard to methamphetamine – some believe there is no capacity to overdose, whilst it is known that overheating, stroke and heart attack can be the outcomes of this usage.
He further added that smoking methamphetamine is often seen as not constituting a ‘big deal’ but noted that this is a major way to introduce the drug in a socially inclusive way. Reportedly, people see it as ‘like a joint’ or ‘just a puff’, but describe the ‘come down’ as ‘crappy’ often resulting in a ‘low mood’. Smoking and injecting methods of ingesting the substance are often associated with a ‘rapid decline’ that facilitates people’s desire to ‘re-administer’ more frequently and often.
In respect of the communication that takes place with those who use methamphetamine, Cameron noted the importance of not focusing on harm caused to the brain. This was described as ‘not helpful’. Cameron noted that, while the potential for harm to the brain is real, most research indicates that the brain can heal. A continued focus on telling users about the harm being caused to their brain leads them towards forming a fatalistic ‘sense of doom’ that their brain and subsequently, their functioning, cannot be repaired when, in fact, this is not the case. The fact that the brain can recover and repair should be emphasised throughout the delivery of interventions and treatment.
Cameron also highlighted the need to support the families of those who use this and/or other substances. He also stated families should not be left to feel overwhelmed or solely responsible for managing the ‘roller coaster’ they and other loved ones can often go through, nor should they be left alone to manage detoxification and rehabilitation. Cameron described it as a ‘failure of our systems’ if families are experiencing insufficient or inadequate support.
Cameron also noted that historically our system for assisting both those who use substances and supporting their families and loved ones has developed over time based on medical and other interventions that were designed to address alcohol and heroin use. He observed that there are ‘differences’ in relation to methamphetamine use and the approaches used to best assist users of this particular substance, their families and loved ones have not yet been fully taken into account at a systems level. The current challenge is for community sector services and medical practitioners to ‘sit alongside’ each other and engage in ‘up-front’ discussions for the purpose of re-designing aspects of the system to provide improved responses specifically tailored to the needs of methamphetamine users, their families and loved ones. A contemporary response to methamphetamine use, according to Cameron, requires a collaborative process whereby all key stakeholders work together across the service system to support the user, their family and community.
To read more about Cameron’s presentation, view his Just Ice? Symposium PowerPoint Presentation.
Watch ABC’s 4-Corners’ program on The Ice Age.