Usage in Australia

 

Methamphetamine (N-methylamphetamine) is a potent stimulant commonly used as a recreational drug.  Australia has the highest rate of amphetamine use among the OECD developed nations, with around 2.5% of all Australians over 14 years of age reporting having used methamphetamine over the last year (this compares with 4% who have used ecstasy and 9% who reported using cannabis).

 

Despite a partial slowdown in uptake, Crystal meth (ice) use is still growing, notably among injecting drug users, but methamphetamine use among the non-injecting population is growing as well.

 

 

Meth Users

 

There is no class-related pattern to methamphetamine use in Australia – users come from all walks of life. It is rare for people under 19 to use the drug, but use rate jumps markedly among the twenty year-olds and the highest usage rates occur between 20 and 29 years of age with usage rates reported as high as 6% in 2010-2011.

 

Usage has generally grown, although usage rate among twenty year-olds has actually fallen from a 2007 peak of 7.3%, with the difference being made up by a rise in older and younger users.

 

Unlike many other drugs, methamphetamine use is higher among people with paid employment.

 

Usage tends to be higher among certain industries, notably hospitality (rates of 6.1%), sex workers (variable rates reported), construction (5.5%), the media (5.0%), in mining (4.4%) and in the financial sector (4.0%). Methamphetamine use is also higher among FIFO workers (especially at mines or offshore industrial sites), long-distance drivers and single men as well as among gay men.

 

Although methamphetamine use among men is higher than among women, the gender difference is less than for many other drugs.

 

 

Types of Meth

 

Methamphetamine comes in a variety of forms, most commonly as speed (either powder or pills), as crystal meth or ice (crystal methamphetamine) or as ‘base’ (a sticky paste form).

 

In its pure form it is a white odourless crystalline powder that dissolves readily in water, but in the form of ‘ya-ba’ may be brightly coloured, often candy or fruit flavoured to increase its appeal.

 

Most users prefer the cheaper, lower potency form of speed powder or pills, which can be snorted, swallowed or injected – but a small, significant and growing number of people inject or smoke crystal methamphetamine.

 

Crystal meth is the most potent form of methamphetamine, being up to 15x more potent than pure amphetamine on a per weight basis. Crystal meth (Ice) can be used on its own, but is often laced with other drugs – most commonly ecstasy (XTC) or cannabis.

 

 

The Effects

 

The great majority of methamphetamine users use the drug infrequently and in relatively low doses. The problem is that methamphetamine is addictive and crystal meth extremely so.

 

On average around 10 to 15% of methamphetamine users develop serious drug dependence requiring intervention, but the frequency is substantially higher when dealing with crystal meth.

 

Methamphetamine has a similar chemical structure to the brain’s neurotransmitter dopamine. Dopamine functions as the ‘feel good’ chemical of the brain and regulates the brain’s reward system, motor control and cognitive processes.

 

Taking methamphetamine forces the brain to release large amounts of dopamine, over 1000 times the normal level, inducing distorted feelings of intense pleasure and euphoria that can initially last an entire day.

 

This effect is unique and is substantially higher than the dopamine surge induced by sex or other common pleasures. The ‘rush’ or high usually begins within 5 to 30 minutes after use and may last (at least in the early stages of meth use) up to 16 hours.

 

Intense pleasure is not the only effect. Methamphetamine also disturbs the judgement centres of the brain, disordering activity in the prefrontal cortex that regulates emotional impulses ensuring behaviour is socially appropriate.

 

It triggers the release of noradrenaline in the brain – leading to a heightened aggression and jumpiness or hypervigilance which results from inappropriate activation of the ‘fight or flight’ reflex. The judgement of regular users is often impaired, often being aggressive and occasionally paranoid, and usually marked by a grandiosity and blindness to risk taking.

 

The highs are only temporary. The ecstatic high results from a sudden emptying of the local dopamine stores, so the pleasure ends, only to be followed by a crash, marked by exhaustion, irritability, severe fear and panic and a strong desire to take methamphetamine again.

 

This phase of Methamphetamine withdrawal is marked by a slow progression to deep depression (usually described as worse than what you get with cocaine), lethargy cravings and disrupted sleep (usually insomnia, although over-sleeping with vivid nightmarish dreams may occur). Many users drink heavily at this time or take benzo sleeping pills or cannabis to deal with the insomnia.

 

 

The Costs

 

Even among infrequent users, methamphetamine is a dangerous drug. Severe vascular damage has been reported among injecting users and there is a significant risk of developing ‘muscle meltdown’ (rhabdomyolysis) at higher doses.

 

Chronic users often grind their teeth uncontrollably causing marked damage to the teeth and at any dose methamphetamine can lower the seizure threshold leading to fits.

 

There is a high risk of uncontrolled aggression and at high doses methamphetamine may induce a severe psychosis with extreme paranoia and often bouts of self-mutilation as users attempt to dig out the bugs they imagine are crawling under their skin.

 

These psychotic episodes can be extremely difficult to treat, and currently around 5 to 15% of chronic users fail to recover from psychotic episodes.

 

The picture is even worse than this – regular methamphetamine use, even at relatively low doses, will slowly destroy the dopamine-producing neurons in the brain, so the brain is unable to produce enough dopamine to function normally.

 

This means that, over time, a user would require higher and higher doses of methamphetamine to experience the easy high that occurred with their early use.

 

When users stop taking methamphetamine after a long period of use, they tend to be depressed and lack motivation. Strong cravings are common, especially for sugary foods because they are incapable of feeling pleasure from much else.

 

Unlike common amphetamine, methamphetamine is a neurotoxin (as noted to dopamine-secreting neurons) so users are at increased risk of developing Parkinson’s disease.

 

 

Handling Meth Users

 

Dealing with someone acutely affected by methamphetamine is difficult – trying to restrain them or get them to calm down often exacerbates their aggression and anxiety especially if they are suffering from a bout of drug-induced paranoia.

 

The best immediate treatment is always to try calmly to move affected persons to some quiet, calm spot away from harm and distracting stimuli. Long-term users often appear flat and unmotivated, but these people are often subject to strong cravings that make them very likely to relapse.

 

Treatment programs are slow and often involved but benefit greatly from the support of family and friends. The changes in methamphetamine do usually lessen in time, but it can take up to a full year before a regular user feels normal again.

 

 

Drug Testing

 

Methamphetamine can be detected in both saliva and urine. In saliva (i.e., oral fluid) samples methamphetamine use can be detected up to 12 to 16 hours after use. In urine specimens, methamphetamine use can be detected more than 2 days after infrequent use or nearly up to 4 days after chronic use.

 

Drug tests operate basically a two-level system. The initial tests, to identify the possible presence of a class of drugs are immunoassay screening tests. These tests are very sensitive but they are not absolutely specific – which means they can give false positive tests.

 

There are some drugs that may give a false positive for amphetamines on screening tests.

 

These include:

 

• Prescription amphetamine prodrugs, including : Selegiline

• Over-the counter nasal decongestants, including : Vicks (incl Vapoinhaler)

 

It is important that a person about to undergo drug testing give the collectors a full list of all medicines and supplements they may be taking so that misunderstandings may be avoided.

 

If a positive test result is obtained, the sample would then be subject to a confirmatory GC/MS or LC/MS test, which is absolutely specific.