1.2 Who uses ATS, what influences use and how are ATS used?

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ATS consumption may be described according to social factors and contexts of use.Some groups and contexts of use that may be associated with particular risks include:

Young people (i.e., up to 18 years of age) - early engagement in drug use is associated with a range of problems due to increased vulnerabilities of using at a developmentally young age and there may be an increased risk of subsequent problems including dependence, other drug use, mental health problems and criminal involvement. Young people may also have less ready access to many services resulting in poor management of existing risks and problems;
People with mental health problems - ATS use can exacerbate existing vulnerabilities and problems and compromise effective mental health interventions (for example, some medications may be contra-indicated for patients with a history of ATS dependence). It is pertinent to note that regular ATS use can result in mental health problems even where no previous vulnerability existed;
Gay, lesbian, bisexual and transgender people have higher rates of drug use, including ATS use, compared to the broad community, and yet are often under-represented in treatment populations – there appear to be particular barriers to treatment for people from these communities;
People who work in some industries, such as the hospitality, construction and transport industries, are at higher risk of ATS use and problems;
People who misuse prescribed amphetamines (e.g., dexamphetamine, Ritalin), which may be prescribed for health problems and are sometimes used inappropriately or diverted for others’ misuse;
Some key groups have suggested that ATS use by Indigenous Australians is more common in metropolitan regions and in larger rural towns and communities close to major industries such as mining; and
There has been some suggestion that ATS use may also occur as a result of self-medication of undiagnosed attention deficit hyperactivity disorder (ADHD).

This diversity indicates that interventions will need to target the different risk groups and contexts of use. For example, a strategy that is appropriate in a school setting is likely to be distinct from a strategy that targets the workplace, which will differ from strategies that will be effective in Indigenous communities.

There is a range of common risk and protective factors that predict the experience of conduct disorders, mental health problems, poor educational performance and drug use. Risk factors include limited educational, occupational or social opportunities; poor connection to school,parents/adults and the broader community; poor mental health; poor family functioning; and exposure to trauma. Local availability of drugs can also influence drug use. Protective factors include connection to school, adults and community (e.g. see Loxley et al., 2004; Spooner,2005). Thus, while there is a need for specific strategies to address the risk of ATS use and problems, effective responses will also include broader strategies targeting issues such as social inequities, school engagement, and the needs of vulnerable families.

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The ways in which people take ATS, that is, routes of administration, are influenced by the type of ATS used. All forms of methamphetamine can be smoked and smoking crystalline methamphetamine has more recently become a widespread route of administration. This involves heating the crystals in the bulb of a pipe so they vaporise and can be inhaled. Amphetamine powder is usually snorted while base methamphetamine is commonly swallowed. Both base and crystalline methamphetamine can be injected. Injecting and smoking are the methods of administration most commonly associated with dependence (McKetin, Kelly & McLaren, 2006).

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