Priority Area 3: The use of amphetamine-type stimulants

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Priority Area 1: Community awareness and understanding of amphetamine-type stimulant use and related problems
Priority Area 2: The supply of amphetamine-type stimulants
Priority Area 3: The use of amphetamine-type stimulants
Priority Area 4: Problems associated with amphetamine-type stimulant use
Priority Area 5: Organisational and system capacity to prevent and respond to amphetamine-type stimulant problems

Objective

Prevent the use of illicit amphetamine-type stimulants.

Rationale

No single factor is responsible for ATS use. A range of protective and risk factors reduce or increase the probability that an individual will develop any drug related problem, including ATS-related problems (e.g., Loxley et al., 2004; Spooner, 2005). Protective factors include connectedness to school, adults and community; developing educational and social competence; positive family influences; access to employment and high socio-economic status. Risk factors include local availability of ATS, poor family functioning, social and economic deprivation and unemployment. Many of these protective and risk factors also influence the development of a range of other problems such as poor mental health, conduct disorders, and criminal involvement. The diversity of protective and risk factors demands that any response to ATS use and related problems will be multifaceted.

Most prevention strategies are not specific to ATS. Effective prevention strategies generally relate to preventing a range of illicit drug problems and addressing the varied determinants of drug use and other poor health outcomes. This extends beyond the National Amphetamine-Type Stimulant Strategy. However, it will be important to ensure that activities under the Strategy are consistent with broad approaches to address the range of determinants of drug use, such as inequality and the needs of disadvantaged and vulnerable communities, families and individuals, and protective factors such as connectedness to community and culture.

People aged 20-29 years have the highest prevalence of ATS use (see 2004 National Drug Strategy Household Survey; Australian Institute of Health and Welfare, 2005) and in the consultations it was argued that prevention strategies should aim to target people who potentially are about to enter or are in such age groups. Many participants in the consultations proposed that school-based interventions, including ensuring that children are engaged in the school system with an opportunity to develop academic and social competence, and providing evidence-based drug education, were important. It was noted that effective school-based education programs are 23 most often generic to all drugs, rather than being specific to ATS and the Principles for School Drug Education (Meyer & Cahill, 2004) and National Framework for Protocols for Managing the Possession, Use and/or Distribution of Illicit and Other Sanctioned Drugs in Schools (Department of Education, Science and Training, 2000) had relevance for preventing and responding to ATS use in school-aged children. However, it has been noted that some specific interventions that focus on a particular drug can have value. For example, an evaluation of the NSW Department of Education and Training’s Marijuana Matters: A cannabis intervention program, has shown this program to be effective. It was also argued that interventions should target young people in post-secondary and tertiary education settings and those who were making the transition from education settings to employment settings.

It was noted that a significant amount of the reported illicit ATS use among school aged children involved diverted medication prescribed for Attention Deficit Hyperactivity Disorder (ADHD). It is appropriate to examine how ADHD and medication diversion influence more general ATS use and problems (e.g., see Chilcoat & Bresleu, 1999; Molina & Pelham, 2003) and to trial and implement appropriate interventions.

Furthermore, it was revealed that there are some clinical reports of adults using ATS to manage the symptoms of ADHD. This is an area that would benefit from further research. Important issues that require consideration include the extent of this problem, identification and diagnosis of this group of users and the development of effective interventions.

It was observed that law enforcement activities, identified in Priority Area 2, have a role beyond disrupting the supply of ATS. Law enforcement activities communicate a message that illicit ATS use and supply are not condoned by the community. Law enforcement agencies also participate in prevention initiatives and inform the community about ATS use and associated risks and providing advice to parents/carers and consumers.

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Recommended actions

i) Develop an evidence base regarding specific strategies to prevent ATS use

Identify and address the factors that specifically increase/decrease the risk of ATS use. These might include:
Local availability of ATS (e.g., local production; local availability due to being on a distribution route and/or proximity to industry with high rates of use);

Effective diagnosis and treatment of ADHD;
Lack of procedures to prevent misuse and diversion of ADHD medication (e.g., dexamphetamine; Ritalin);
Diversion of pharmaceutical stimulants;
Use of ATS to facilitate continued/heavy alcohol consumption at late-night venues;
Use of ATS in specific contexts (e.g., use of ecstasy as part of some recreational activities or contexts);
Workplace factors, such as fatigue, shift work and cultural acceptability of use;
Factors that influence particular modes of drug administration (e.g., oral ingestion, smoking or injecting);
Factors that influence decisions to use particular drugs such as ecstasy;
Low perception of risks associated with ATS, or some forms of ATS administration, such as oral ingestion or smoking; and
The availability of effective school-based drug education programs aimed at preventing or delaying the use of alcohol and tobacco (noting that the early use of alcohol and tobacco are risk factors for subsequent illicit drug use).

Develop an evidence base about the relative acceptability, for some groups and in some settings, of smoking drugs such as crystal methamphetamine and use this information to develop targeted strategies.

Develop an evidence-base regarding the influence of production, price, purity and availability on ATS use and related problems. Use this evidence-base to inform the development of ATS specific law enforcement and demand reduction strategies.

ii) Address broad determinants of poor health and social outcomes and illicit drug use

Support and expand Australian and State/Territory initiatives to provide effective early intervention programs, crime prevention initiatives and responsible parenting programs that improve academic and social functioning, and physical and mental health outcomes. Examine the impact of such programs on illicit drug use, particularly ATS use. These initiatives might include, for example:

Neighbourhood building/community regeneration strategies and projects;
School engagement;
Crime prevention through environmental design projects;
Early intervention and mentoring programs for at-risk youth; and
Parenting skills and support programs.

Develop and implement national and local initiatives to engage and retain young people in the education system (e.g., 13-18 year olds) and, for older at-risk young people, to connect them with training and employment and/or post secondary/tertiary education opportunities.

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Develop and trial family centred approaches to build resilience and effective prevention of ATS use problems in Indigenous communities.

Ensure that decision- and policy-makers are informed about how broad public policies impact on health, social functioning and drug use.

iii) Enhance the capacity of the education sector to implement prevention responses to illicit drug problems in general and ATS problems in particular

Support schools to deliver evidence-based drug prevention programs (i.e., based on the Principles for School Drug Education). Ensure that such programs have up-to-date and accurate information about patterns of ATS use and related problems. Identify and respond to barriers to widespread adoption of evidence-based drug education in schools.

Support schools’ and post secondary and tertiary education organisations’ responses to at-risk children and young people, including the implementation of school drug policies, such as the National Framework for Protocols for Managing the Possession, Use and/or Distribution of Illicit and Other Sanctioned Drugs in Schools.

Develop and implement strategies to ensure safe and effective use of ADHD medication and avoid diversion of such medication.

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