People are seeking help for crystal meth use, but what will they find?

The study, produced by the National Drug and Alcohol Research Centre (NDARC), found the rate of treatment episodes for methamphetamine increased from 77 per 100,000 population to 262 over the 16-year period.
 
But the data analysis from the Alcohol and Other Drug Treatment National Minimum Data Set also revealed many people received ‘minimal treatment options’, including case management and assessments, not intensive rehabilitation services.
 
Lead author Associate Professor Rebecca McKetin told newsGP the treatment records reflected increased uptake of the drug in Australia, which coincided with higher levels of imported smokable high-purity crystalline methamphetamine (crystal meth).
 
‘When there is more problematic use you tend to see more people seeking treatment,’ she said.
 
‘It’s only since we’ve seen crystal meth became a big thing that we’ve seen smoking. That’s a really high-risk practice for becoming addicted. Now we’re seeing that new generation coming into treatment.
 
‘[Treatment-seeking] is very indicative of the underlying population of people who do need help.’
 
Associate Professor McKetin says the sharp rise in episodes of care for use disorders mirrors similar increases in methamphetamine-related hospital admissions for accidents, overdoses and misadventures, and increases in police arrest and drug seizure data.
 
‘There are a whole bunch of indicators trending upwards,’ she said.
 
The analysis also found treatment episodes increased for younger people who smoked crystal meth, with the rate of injecting drug users recording no significant increase. The smoking group was, on average, five years younger at an average of 30 years old.
 
But while treatment episodes have increased, the lack of higher level interventions could lead to significant health issues down the track.
 
‘What we are seeing is really severe levels of dependence, we are seeing a lot of mental health problems. They still need help,’ Associate Professor McKetin said.
 
‘It’s actually quite concerning that they’re not getting that intensive treatment. If you don’t break that cycle now they’re still going to be there in 5–10 years and some of them will have moved on to injecting, and all the health issues that go with it.’
 
Dr Hester Wilson, Chair of the RACGP Specific Interests Addiction Medicine network, works in inner-Sydney and says methamphetamines are available, cheap and potent.
 
‘My understanding is the rates of use are still very low, but what we and my colleagues in general practice are seeing is more of this [treatment seeking] in communities, perhaps more in rural and regional communities,’ she said.
 
‘You will have people who are having more side effects and more complications because it is so concentrated and potent. More people are getting into trouble with it [and] because it’s so potent they start to get into dependency before they know it.’
 
Dr Wilson says GPs need to have an awareness of the drug and ways to assist, given its potential health impacts.
 
She points to the training available through the RACGP to help doctors screen patients, give them advice and refer to more specialist supports.
 
Case management can be an effective option for many people, she says, as it can be a comprehensive offering to connect other health and social services.
 
Dr Wilson would also like to see more funding to drug and alcohol services, noting increased treatment-seeking will strain the small sector’s capacity.
 
‘We have limited drug and alcohol services and with more people seeking help, we need to put more money into services,’ she said.
 
Melbourne-based GP Dr Paul Grinzi, who also has a special interest in alcohol and other drug treatment, says an increasing rise in smoked and injected methamphetamine use had been apparent in recent years.
 
‘GPs are often seeing family members worried about their relative’s use of methamphetamines,’ he said.
 
‘Whilst we may occasionally encounter a patient who is acutely intoxicated, we will more commonly be encountering patients with comorbid anxiety, non-accidental injuries or associated symptoms such as insomnia.’
 
He also recommends the Alcohol and Other Drugs GP Education Program to boost resources available to doctors to assist families and patients.
 
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