Australasian Amphetamines Conference 2006 (Sydney)

Workers hooked on party drug
Emily Dunn
September 28, 2006

BUS, truck and taxi drivers are among the biggest users in the workforce of amphetamines, including "ice", a party drug known to cause psychotic episodes.

More than a third of amphetamine users report turning up to work under their influence in the past three months. Use of the drug is prevalent in the hospitality, transport, agriculture and construction industries.

The findings come from the National Centre for Education and Training on Addiction at Adelaide's Flinders University. They will be presented today at the Australasian Amphetamine Conference, the first national conference to examine amphetamine use in Australia.

Using responses from the 2004 National Drug Strategy Household Survey - which surveyed almost 30,000 people on drug use patterns - researchers found workers aged between 18 and 29 were the most likely to use amphetamines.

NSW Police announced this week random drug testing of drivers for speed, cannabis and ecstasy after research from the NSW Health Commission found one in five truck drivers reported using illegal drugs while working.

Professor Anne Roche, from Flinders University, said more than 12 per cent of male workers aged 18 to 29, and 9 per cent of females, reported using amphetamines in the past 12 months. "Of the people who use illicit drugs there are many more people who are in paid employment than who are not," she said. "Research also indicates amphetamine use is on the rise."

Amphetamines are a class of illicit drugs, including speed, that produce feelings of euphoria and alertness. The pure form of the drug, the addictive crystal methamphetamine, commonly known as ice, has concerned health professionals and law enforcers in recent years.

Used enough and in sufficient doses, in some instances the high can transform into paranoia, delusions and hallucinations, exhibited in erratic and sometimes violent behaviour.

This is a particular concern for the workplace, Professor Roche said. "Most people using amphetamines use them recreationally on the weekend, but because it is addictive people can get into difficulty and it can spill over into more regular use.

"The most concerning thing is how [the drug] impairs people's judgement at work, whether you are an accountant or taxi driver."

While hospitality topped the list, industries that required workers to drive or operate heavy machinery followed close behind.

The study showed more than 6 per cent of tradespeople use the drug, compared with 3 per cent of managers and professionals.

"Many of the industries affected involve shift work where people need to stay alert and awake for long periods of time," Professor Roche said. "But it is not all blue collar workers."

She said even recreational use of the drug could impair people's ability to do their jobs properly. Amphetamine users were twice as likely to report a sick day.

"The come down [from methamphetamine] is quite severe … This could affect safety and productivity at work."

NSW government train and bus drivers are tested for drugs, but there is no regular testing for private bus drivers and taxi drivers.

The Rail, Tram and Bus Industry Union said few public transport workers had tested positive for drugs or alcohol.

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A party in your head, but the clean-up is a real mess
September 28, 2006

The illegal drug "ice" can have severe, long-term effects on users' brains, writes Emily Dunn

THE initial rush, or "flash", has been described as better than sex, a feeling of invincible euphoria. But the high that methamphetamine hydrochloride - "ice" - provides the Saturday-night user has repercussions on Monday, with a comedown that ranges from sleeplessness and anxiety to lethargy and depression.

Beaver Hudson, an emergency psychiatry nurse consultant in the emergency department at St Vincent's Hospital in Darlinghurst, is well versed in the effects of ice, having seen more than 500 cases of methamphetamine intoxication in the past two years.

"We get all types of people turning up," Hudson says.

At the Australasian Amphetamine Conference in Sydney tomorrow - the first national conference on amphetamine use - Hudson will describe cases that range from agitated patients to a patient who attemptedsurgery on his genitals.

"He developed an abscess from injecting ice into his penis," Hudson says. "We almost had to amputate it.

"Users can move rapidly from oral ingestion to intravenous injecting, to get the same hit."

In some cases the high can bring on a psychotic episode, including hearing voices and hallucinations, lasting from a few hours to days.

Hudson says the drug can have bizzare and sometimes violent effects on behaviour as a result of decreased inhibition - from patients complaining of shooting pains throughout their body, to patients arriving at the emergency department naked and threatening suicide.

At St Vincent's there are two rooms for behavioural emergencies - with reinforced walls and beds with no sharp edges - where patients suffering paranoia or psychosis are put until the effects of the drug wear off.

"About 90 per cent of methamphetamine presentations are handled in the behavioural emergency rooms," Hudson says.

Varieties of methamphetamine range from "speed" or "base", which has purity of about 10 to 20 per cent, to crystal methamphetamine, known as "ice" or "crystal", which is about 80 per cent pure.

While speed is usually swallowed or snorted, ice is more commonly injected or smoked through a glass pipe, giving the user a much stronger high along with bigger "comedowns" and a greater risk of addiction.

Professor Iain McGregor, from the psychopharmacology laboratory at the University of Sydney, says while snorting takes about two minutes to take effect on the brain, smoking or injecting takes a matter of seconds.

Faster absorption of the vapours produced when the drug is smoked, combined with greater purity, produces the "rush."

"Not only is the drug stronger, it also produces an immediate rush which is one of the reasons it is addictive," says McGregor, who will present findings from methamphetamine studies on animals at the conference tomorrow.

When methamphetamine enters the brain it works to boost levels of the neurotransmitters dopamine, noradrenaline and serotonin.

These neurotransmitters are natural chemicals that make us feel excited, alert and motivated.

While other party drugs such as ecstasy work primarily to boost serotonin, methamphetamine works primarily on dopamine, flooding the brain with this chemical and preventing the natural flow of the chemical back into the neuron.

" High levels of dopamine make the world seem very interesting and exciting," McGregor says.

"However, if levels are too high then people lose their ability to make sense of the world, resulting in psychosis and bizarre behaviour. Dopamine is also intimately involved in sexual motivation, and dopamine boosters such as methamphetamine produce sexual overdrive."

As the drug wears off, dopamine production becomes exhausted and the brain experiences a depletion or "comedown".

"The world seems a lot less interesting, and dull," McGregor says.

As the brain becomes accustomed to dopamine, users crave bigger doses of methamphetamine to achieve the same high. "Long-term users develop a motivational toxicity where they can't do anything without the drug."

McGregor says long-term use of methamphetamine can also cause long-term damage to dopamine neurons as well as more general adverse effects on the brain. Research from the University of California Los Angeles showed long-term methamphetamine users had a reduced volume of brain tissue in the prefrontal cortex, responsible for higher cognitive ability, and in the hippocampus, involved in learning and memory.

Stimulation of the adrenaline receptors also affects the the central nervous system, causing increased physical activity, wakefulness and heart rate and decreased appetite - symptoms Beaver Hudson sees in his patients any given weekend in Sydney.

Hudson points out, however, that symptoms are often difficult to attribute to methamphetamine use alone.

"Nine times out of 10 there are always other drugs involved, they take something to mitigate the agitation they feel," Hudson says. "The effects can accumulate."

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Drug attack guidelines
Matthew Franklin and Simon Kearney
September 28, 2006

AMBULANCE officers will be advised to sedate violent victims of methamphetamine overdoses under guidelines to be released today.

The protocols suggest ambulance workers inject violent overdose victims with the sedative Midazolam to help them overcome the effects of psychostimulant toxicity, which include seizures, agitation, panic, delirium and paranoid hallucinations.

Parliamentary Secretary for Health Christopher Pyne will announce the guidelines today when he opens the first Australasian Amphetamines Conference in Sydney. Mr Pyne yesterday described the use of methamphetamines such as ice and speed as the nation's worst emerging drug menace.

Figures from St Vincent's Hospital in Sydney's inner-city Darlinghurst show ice is sending people aged from 16 to 60 to emergency wards in psychotic or agitated states.

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Ice isolation ward to fight drug epidemic
September 28, 2006 09:51am
Article from: Herald-Sun

A DEDICATED ice isolation ward to treat the growing number of amphetamine addicts will be set up at St Vincent's hospital in Sydney's east.

St Vincent's is to create a 20-bed detoxification unit at Gorman House - as well as a six-bed psychiatric emergency care unit.

Health Minister John Hatzistergos will announce the unit at a speech to the Australian Amphetamine Conference in Sydney today.

He will outline a $600,000 plan to establish centres in Sydney as well as Newcastle.

They will operate like the current cannabis clinics and be the first of their kind to specifically treat people suffering health problems linked to the use of methamphetamines like ice and speed.

The National Drug and Alcohol Research Centre and National Drug Household Survey suggested amphetamines were the second most commonly used illicit drug after cannabis.

About 9 per cent of Australians have used amphetamines - and 36,900 are regular users.

But very few seek treatment or even recognise they have a problem.

"Methamphetamines are extremely dangerous drugs, ruining young lives," Mr Hatzistergos said.

"Clinicians say they're more addictive and more harmful than they used to be, leading to violent, impulsive and unpredictable reactions in users."

He said methamphetamines led to increased cases of psychosis, violence, health problems and crime.

"We want to provide specialised treatment services for methamphetamine users who aren't accessing standard drug and alcohol clinics because they don't believe they have a drug problem," Mr Hatzistergos said.

"These clinics will boost services already being provided in hospital emergency departments."

Users will need a referral from a GP or other agencies - and can even admit themselves.

But Opposition Leader Peter Debnam blamed the epidemic on Labor.

"Sydney is the drug capital of Australia because for 12 years the Labor Government has given mixed messages to dealers and young people tempted by drugs not only with taxpayer-funded injection rooms but ... also defunded crop eradication programs attacking marijuana," he said.

"They simply haven't put the resources into education or law enforcement and undermined efforts of police to pursue drug dealers."

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But Opposition Leader Peter Debnam blamed the epidemic on Labor.

"Sydney is the drug capital of Australia because for 12 years the Labor Government has given mixed messages to dealers and young people tempted by drugs not only with taxpayer-funded injection rooms but ... also defunded crop eradication programs attacking marijuana," he said.

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Drug clinics set up
September 28, 2006

TWO specialist clinics to treat methamphetamine users will be set up in Sydney and the Hunter region, the NSW Government has announced.

Speaking at the inaugural Australasian Amphetamine Conference in Sydney today, Health Minister John Hatzistergos said the clinics, at St Vincent's Hospital and the Royal Newcastle Centre, would be similar to the four cannabis centres already set up across the state.

The clinics, at a cost of $600,000, would boost emergency departments and improve coordination between drug and alcohol services and mental health services, as well as providing peer support, education programs and referral services.

St Vincent's would have access to 20 detoxification beds and six psychiatric care beds, and the Newcastle clinic access to another 24 detoxification beds, Mr Hatzistergos said.

"We recognise the dangers of amphetamine use and we aim to tackle the problem on all levels of government, on a whole-of-government basis, involving the whole of the community," Mr Hatzistergos told conference delegates.

Figures from the National Drugs and Alcohol Research Centre suggested there were 37,000 regular amphetamine users in NSW aged 15-49, he said.

Of these, 28,000 were dependent on the drug, with only one in ten users surveyed saying they had received treatment in the past 12 months.

Two-thirds of methamphetamine users reported experiencing mental health problems, with one-fifth describing these problems as "severe".

Also speaking at the conference, parliamentary health secretary Christopher Pyne reinforced the Federal Government's commitment to a zero-tolerance stance on illegal drugs, launching two new sets of guidelines for medical practitioners dealing with amphetamine overdose patients.

"We make a very clear statement that we oppose drugs," Mr Pyne said.

"We don't support any program or policy that would suggest that we could manage the drug problem... we believe that attacking it at its heart and emphatically is the only way."

The Federal Government had spent more than $1.2 billion on tackling drug-related problems, including the "enormous" issue of methamphetamine abuse, Mr Pyne said.

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Christopher Pyne said:

We don't support any program or policy that would suggest that we could manage the drug problem...

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Harm minimisation the only way
October 29, 2006 12:00

AT the first Australasian Amphetamine Conference at Darling Harbour yesterday, delegates were asked to accept an over-riding message - that harm minimisation is the best, probably even the only, workable approach to the problem of illegal drug use.

While harm minimisation proponents asserted that harm reduction strategies include measures to disrupt the supply of illegal drugs and strategies to discourage the use of such drugs, the underlying message was constant: the principle focus of policy in the realm of illegal drug use ought to be on making sure users are as at little risk as possible.

Which is a motherhood statement. No-one would suggest that the health risks addicted drug users are exposed to should be disregarded.

But the fundamental problem with the harm reduction approach is that it tends to skate past the real issue - which is that drugs such as illegal amphetamines are a chronic social blight which we should be doing our upmost to oppose.

So our primary focus ought to be on ridding the community of the potentially fatal menace of illegal drugs, rather than on protecting addicts against themselves.

For here is an inescapable reality - the use of illegal drugs is a choice. No-one is obliged to consume methamphetamine, no more than they are compelled to inject heroin or smoke cannabis. So there is an ethical dimension to the issue which should not be de-emphasised.

And let's not suggest inferentially that illegal drug use is acceptable because it is inevitable. For in fact, it is neither.

As a result of determined police campaigns here and abroad, heroin is now in short supply - with the consequence that heroin overdoses have diminished almost to zero. That is unalloyed good news.

Plainly, addiction is not to be trivialised and it is simplistic to suggest addicts should "just quit''.

They need help and support, which should be provided - to those who are willing to be helped.

But we ensure the most important message remains undiluted - choosing to take illegal drugs in the first place is the root of the problem. Doing all in our power to discourage people from such a disastrous choice, and all we can to make illegal drugs unavailable, ought to be our primary focus.

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A cold and lonely place to die
By Clare Masters, Health Reporter
September 28, 2006 12:00

Before and after - the ravages of ice. / The Daily Telegraph

LIKE any popular culture trend, drugs are slave to fashion – and the latest look on the narcotic scene is ice.

Its other name is methamphetamine and, while ice may be relatively new player, it belongs to a family of drugs that are well known.

Cousin to speed, ice is usually 60 to 100 per cent purity and is a long-acting, highly toxic drug that sends users into a vicious cycle of soaring highs and crashing lows.

From gutters to dance floors to hospital wards, ice is an epidemic raging through Sydney society.

The physical toll of the drug is charted by the ravaging effect it can have on the body – the psychotic rage of ice users driven to violence is well-known.

Ice is also tipping a slice of this society into psychotic episodes from which some may never recover, and the use and addiction is racing far, far ahead of medical science's mostly hopeful but generally useless offerings of treatment.

Ice users in hospital beds are poly drug users, usually with tracks in their arms to indicate intravenous use, they probably have a history of drug abuse, in all likelihood they have a pre-existing mental condition that ice has set fire to.

But there is a whole other invisible section of society who use pipes rather than needles to get high and, while ice may cause them mental health issues, those problems will retreat if they can wean themselves off the drug. If.

Doctors classify drug use according to three categories: Dependence, harmful and hazardous.

St Vincent Hospital's Dr Robert Graham defines "dependence" as addiction, "harmful" as the by-product of the drug causing psychological or social harm and "hazardous" use at a level that is not causing harm but does have associated risks.

"The implications for people who use will be dependent on how much they use and the way they use . . . the way we treat someone who is injecting will be different for someone who is smoking it once a week on a recreational basis."

Dr Graham is basing his hypothesis on an overseas study of cocaine users which found that – despite a frenzied party period – if users were able to stop using the drug, they were eventually able to revert back to "normal" life with no scars to show for it.

But that is the kicker when it comes to ice – it is greedy and addictive.

While heroin is often presented as a one-hit-and-you're-gone drug, it can in fact take years for a user to develop a killer habit.

With ice it is a slippery slope towards the addiction trap – experts warn it can take only a couple of sessions before the rot sets in, and that addiction can induce a psychotic state in someone with no history of mental illness.

Drug rehabiliation manage Mark Ferry from the Ted Noffs Foundation said: "The young men like it because it makes them big and brave and tough and invincible – with the girls there can be a link with weight loss.

"It is different in the way other drugs are taken, some people will use it for a party drug for raves, others will be dedicated in their uses and will go through binges which can result in a big crash at the other end."

The US Faces of Meth series – a timeline of the physical toll of ice addiction – is a pictorial essay on how destructive methamphetamine can be, and local versions can be seen on a weekly basis at St Vincent Hospital.

The emergency ward at this inner city hospital is the last stop for many on the Sydney drug scene who have pushed their use from hazardous to dependent. The traffic of ice victims has got so bad that a dedicated amphetamine addict clinic is being set up in a 20-bed detoxification unit.

The centre will work with mental health professionals to provide holistic treatment for ice addicts – with a large focus on counselling and psychological-based strategies.

Australian doctors are only just now trialling treatments for ice abuse.

"This area of medical science is in its infancy – where we are now is where methadone was at 40 years ago," Dr Graham said.

Has your family been hit by the ice epidemic? Share your experiences through the feedback form below

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No easy fix: treatment uncertain for addicts of party drug
Emily Dunn
September 29, 2006

THERE is no proven drug treatment for amphetamine addiction and health professionals remain unsure of the best therapies for users dependent on party drugs such as speed and ice.

At the Australasian Amphetamine Conference in Sydney yesterday, Adrian Dunlop, of the Turning Point Alcohol and Drug Centre in Melbourne, said unlike the methadone treatments available to heroin addicts, there was no pharmaceutical treatment for amphetamine addiction.

"Those that have been trialled have had side effects - people have got sick using them," Dr Dunlop said. This week, the NSW Health Minister, John Hatzistergos, said two specialist clinics to treat amphetamine users, at St Vincent's Hospital and the Royal Newcastle Centre, would go ahead.

A spokesman for St Vincent's Hospital in Sydney said the hospital was yet to decide on what treatments would be offered at the new clinic.

Pharmaceutical treatments were being tested, he said, and the hospital would use the new funding to treat both the detoxification and mental health problems faced by amphetamine users.

At the conference yesterday, Rebecca McKetin, of the National Drug and Alcohol Research Centre, said structured counselling had helped reduce the frequency of drug use and had helped alleviate mental health problems suffered by users.

"There isn't the same evidence on pharmaceutical therapy; we need to do better on developing drug treatments," Dr McKetin said. "Amphetamines are a different drug system to heroin - they require a different treatment."

The Herald yesterday reported that transport workers, including bus, train and taxi drivers, were among the biggest users of amphetamines in the workforce.

Professor Steve Allsop, of the National Drug Research Institute, has warned that some workplace drug use was ignored by employers. "In industries where people work long hours and are required to stay up late … employers have ignored drug use because it is convenient," he said.

Train and bus drivers are subject to random drug tests, but there is no industry testing for taxi drivers.

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$2 billion drug hauls as Australian agents tackle a new ice age
Date: October 1 2006
John Kidman

MORE than $1 billion worth of deadly crystal methamphetamine, also known as ice, has been seized on Australia's doorstep in the past three years, federal authorities have revealed.

Dozens of clandestine factories capable of producing as much again of the so-called party drug have been dismantled across Asia and the Pacific over the same period.

The biggest, a converted shampoo factory set up to produce almost $3 million worth of the addictive, harmful stimulant each day, was shut down with the help of Australian Federal Police in northern Malaysia on July 9.

The bust netted more than half a tonne of ice in various stages of manufacture, AFP officers said.

Senior federal agents said a large portion of the drug was headed for nightclubs and dance party venues in Sydney, Brisbane and Melbourne.

The seizure followed two 900-kilogram hauls that involved Australian and local police in Indonesia's Tangerang province in the past year, and the confiscation of more than a tonne of ice destined for Australia from Suva in June 2004.

A federal inquiry into the alarming surge in amphetamine use was told in May that the AFP had become so concerned about imported ice that it devoted nearly all its local resources to the problem in the Philippines, Malaysia, Indonesia and Thailand.

NSW Police Commissioner Ken Moroney last week described ice as more destructive than heroin. "The physical and mental manifestations of this drug are absolutely horrific," Mr Moroney said. "It has the potential to destroy generations."

Health authorities say there are more than 70,000 methamphetamine users in Australia and more than a third of them are addicted to ice.

A National Drug and Alcohol Research Centre study last year found an almost 60 per cent rise in drug-related psychoses since 1999, about the same time as the first major South-East Asian ice shipments arrived.

AFP federal border manager Mike Phelan said the agency was focusing on thwarting imports of precursor chemicals used to make crystal meth.

A tonne of Australian-bound cold remedy ingredient pseudoephedrine was seized in Greece in April with the AFP's help.

"I'm not a chemist, but my best advice says that ephedrine makes one for one . . . so we clearly contributed to stopping at least a tonne of ice being manufactured here," Mr Phelan said.

Domestically, the AFP seized 143 kilograms of methamphetamine - almost all of it ice - in 2004-05, while NSW Police say the local manufacture of ice has begun to take off.

NSW Detective Inspector Rod Henness told the first Australasian Amphetamines Conference in Sydney on Friday that several sophisticated laboratories capable of making ice had been found over the past few months.

NSW and federal police raided what they described as the biggest domestic ice lab yet discovered, near Murwillumbah in April, which housed enough chemicals to produce about $30 million of speed.

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Police redesign drug tactics to break the rise of ice
Simon Kearney and Michelle Wiese-Bockmann
October 02, 2006

POLICE have recast their crime-fighting strategies to take on the proliferation of the illicit drug ice among the young.

In a move likely to be mirrored around the country, NSW's state crime command put the new strategy to identify ice users and dealers across the state in place due to the rapid growth of seizures of crystal methamphetamine from people aged 18 to 21.

"We are developing investigative strategies to detect suppliers and manufacturers," NSW drug squad commander David Laidlaw said. The sharp rise in 18- to 21-year-olds was first noticed in March last year. NSW state crime command has begun working with local area commands to identify dealers and users.

NSW police will rewrite training manuals to teach officers how to deal with the often violent psychosis that comes with amphetamine intoxication.

NSW Police intelligence has found that users mistakenly believe ice is a "clean" drug because the crystals mean it is free from contaminants.

Police Commissioner Ken Moroney told The Australian last week that ice was a greater scourge than heroin. The crackdown comes as a longtime user told The Australian ice is virtually the only form of amphetamines available on Sydney's streets.

Stephen Taylor, 50, does not fit the usual image of a drug addict. A user for more than 20 years, he has kept control of his habit.

Mr Taylor said he began using the powdered amphetamine "speed" 22 years ago but now had no choice but to use ice.

"It's all you can get. I'd like to get some 'base' but it's not that readily available," he said.

"Suddenly it went from $250 a gram to $400 a gram and they called it ice. It is stronger, so you don't use as much."

Mr Taylor, who is on the board of the NSW Users and AIDS Association, said he would like to see an end to the "harassment" of users, but he does not believe the drug should be legalised.

An Adelaide rehabilitation clinic has also experienced the flood of ice, with users of the drug making up 95 per cent of their clients, where they were a handful five years ago.

Counsellor Georgina Karapas said people turned up to Shay-Louise House hopelessly and chronically addicted to the drug.

Ambulance services around the country have reported that methamphetamine call-outs had overtaken heroin calls.

Alan Eade from the Metropolitan Ambulance Service in Melbourne told a conference in Sydney that it had been forced to change training - previously set up for heroin overdoses.

"One of the side effects is a violent psychosis," he said.

"That means ambulance workers need to engage closely with police to effectively manage these people.

"Emergency hospital staff, police, alcohol and drug workers and paramedics are all at risk."

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Drug users 'should pay medical bills'
Last Update: Thursday, October 5, 2006. 6:35pm (AEST)

A Federal Government backbencher is calling for people who use amphetamines and other recreational drugs to pay their own medical bills.

The Liberal Member for the Gold Coast seat of Moncrieff says thousands of Australians are admitted to hospital each year as a result of taking such drugs.

Steven Ciobo says they use public hospital beds, ambulances and medical treatment that could be devoted to people with other illnesses and injuries.

"Given the high incidence of psychosis that these drugs are causing, given that taxpayers are footing the bill of thousands of dollars for those that have a psychotic episode when on these drugs, I think they should have to pay when they are discharged from the hospital," he said.

"Or at least work out a way where they make contributions towards the cost."

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Drug council rejects medical bills plan
Last Update: Friday, October 6, 2006. 1:00pm (AEST)

The Gold Coast Drug Council says a federal MP's proposal to charge recreational drug users their own medical costs is flawed.

The federal Member for Moncrieff, Stephen Ciobo, wants people who use amphetamines and other recreational drugs to pay their own medical bills.

He says the system would act as a deterrent to drug use.

Drug council president Sean Cousins has doubts about the plan and says it could discourage people from seeking treatment.

"A hospital is all about treating people, not interviewing you and seeing whether you are going to pay or not pay," he said.

"Are we going to discourage smoking-related illness by asking them to pay? Are we going to ask for alcohol-related illnesses to pay for their treatment?

"Any public debate on the wider issue is a good thing, but we want to encourage people into treatment."

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