National Amphetamine-Type Stimulant Strategy Background Paper: Monograph Series No. 69
2.2 Australian surveys with key consumer groups
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Use of ATS is more prevalent among certain population groups than in the general population, as evidenced by surveys with key consumer groups. Three such groups are injecting drug users, regular users of ecstasy and related drugs, and incarcerated persons. Amongst all three groups, use of methamphetamine is considerably higher than the general population. Use of methamphetamine around the time of the interview is highest for police detainees. However over a longer time frame, a greater percent of injecting drug users (IDU) report use of methamphetamine followed by regular ‘ecstasy users’ (REU) (see Table 2.1).
Injecting drug users
According to the 2004 NDSHS, 1.9% (n=313,500) of those aged 14 years and older were estimated to have ever injected illicit drugs and 0.4% (n=73,800) were estimated to have injected in the past 12 months (Australian Institute of Health and Welfare, 2005a). Of those who had reported using meth/amphetamine in the past 12 months 82% had never injected, 14% had injected powder and 12% had injected crystal. In comparison, 87% of recent heroin users injected the drug. However, just over half of users reported they were more likely to initiate their first use of meth/amphetamine via injection (59%) compared to a quarter of heroin users (25%).Table 2.1: Use of ATS among key sentinel groups in 2006 (%)
(a) Data are for meth power (speed) only
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The 2006 Illicit Drug Reporting System (IDRS) reported on a sample of 914 IDU from every jurisdiction of Australia. Of the total sample, 96% reported lifetime use of a form of methamphetamine and 94% reported injecting a form of methamphetamine in their lifetime (O’Brien et al., 2007). Lifetime use of speed was reported by 90% (86% reported lifetime injection), lifetime use of crystal methamphetamine was reported by 78% (75% reported lifetime injection), and lifetime use of base was reported 62% (60% reported lifetime injection). In the last six months, 79% of the total sample reported use of any form of methamphetamine and 78% reported injecting a form of methamphetamine in the last six months. In the last six months, 57% used (55% injected) crystal methamphetamine, 56% used (55% injected) speed powder, and 38% used (37% injected) base. While prevalence of speed and base were comparable to the previous year, recent use of crystal methamphetamine had increased from 43% in 2005 to 57% in 2006.
Amongst the total national sample, 49% reported that meth/amphetamine were the first drug they had injected (compared to 41% for heroin) and 30% that methamphetamine was the last drug injected (compared to 26% for heroin) (O’Brien et al., 2007). Furthermore, methamphetamine was the drug nominated by the greatest proportion of IDU (33%) as the drug most often injected in the last month (compared to 27% for heroin). However, heroin remained the drug of choice for the largest proportion of the sample (48%), with 23% nominating methamphetamine as their drug of choice.
Regular ecstasy users
The 2006 Ecstasy and Related Drugs Reporting System (EDRS) reported on a sample of 752 REU from every jurisdiction in Australia. Participants were recruited on the basis of using ecstasy at least monthly during the previous six months. The median age of first use of ecstasy was 18 years, and the median age at which regular use commenced was 19 years (Dunn et al., 2007). The median duration of ecstasy use was three years. Approximately half (48%) of the total sample reported using ecstasy fortnightly to monthly and 23% reported using ecstasy more than once a week. A median of 2 tablets was used in a typical session. Participants were asked about ‘binge’ use, defined as use of a drug continuously for more than 48 hours without sleep. Of the total sample, 49% had binged in the last six months and of these, 90% had binged on ecstasy, 54% on speed and 49% on crystal methamphetamine.With regards to use of methamphetamine, of the total REU sample, 84% reported lifetime use of speed, 65% crystal methamphetamine, and 52% base (Dunn et al., 2007). In the last six months (recent use), 64% had used speed, 49% crystal methamphetamine, and 34% base. While rates of base use were comparable to 2005, recent use of speed decreased from 74% in 2005 to 64% in 2006, and recent use of crystal methamphetamine increased from 38% in 2005 to 49% in 2006.
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Prisoners
The overall imprisonment rate at 30 June 2006 was 163 prisoners per 100,000 adult population (n=25,353) (Australian Institute of Criminology, 2007a). This represents an increase of more than 20 percent since 1996, although the rate of imprisonment appears to be slowing with only a 1% increase since 30 June 2005 (Mouzos et al., 2007). This increase is comprised of a 6% increase in remand prisoners and a 2% decline in sentenced prisoners (Mouzos et al., 2007). The average length of sentence for offenders in custody is less than 12 months in every jurisdiction and this brief period inhibits the capacity of the prison service to effect behaviour change, rehabilitate or re-educate drug offenders and highlights the need for throughcare models to address the needs of prisoners (Borzycki, 2005).A majority of the prison population and those in community corrections are male. Between 1984 and 2005, the overall imprisonment rate for males increased from 170 to 309 per 100,000 adult male population, while the female rate of imprisonment across the same period increased from 7 per 100,000 to 22 per 100,000 (Australian Institute of Criminology, 2007a). Indigenous people are over represented in the prison population and in community corrections. In 2004-05, the national community corrections rate was 337.9 per 100 000 adults compared to the national rate for Indigenous offenders of 2946.3 per 100 000 (Steering Committee for the Review of Government Service Provision, 2006). The majority of all those receiving a sentence is most likely to be for a violent offence followed by a property offence (Australian Institute of Health and Welfare, 2007).
According to the Drug Use Careers of Offenders (DUCO) male prisoner survey, the majority of offenders reported having used illegal drugs and commonly engaged in polydrug use. In the survey, 58% of male offenders reported lifetime use of amphetamine, 42% reported use in the six months prior to arrest, and 31% reported being a regular user (see Table 2.2) (Makkai & Payne, 2003). The conversion rate from having ever used to regular use was 53%. Amongst those who were current users, 44% reporting using several times a day; 13% once a day, 24% one or several times a week and 19% reporting using one to several times a month or less. The prevalence of methamphetamine use varied across different offender types, with regular violent offenders, homicide offenders and non-regular offenders less likely to have been regular methamphetamine users prior to incarceration (see Table 2.2).
Following the DUCO male offender survey, a subsequent survey was conducted with a sample of 470 females incarcerated in six jurisdictions in Australia. This study found that 61% had tried amphetamine, 42% had used in the six months prior to their imprisonment and 37% had been regular users (Johnson, 2004). Thirty-nine percent reporting using several times a day and 17% reported using on a daily basis. Thirty-nine percent of the sample reported being regular users of more than one type of illegal drug in the six months prior to arrest. Of those who were amphetamine users, 63% also used cannabis, 40% used heroin, and 30% used benzodiazepines, with only 19% reporting use of amphetamine only.
An interesting trend noted in the 2002 Drug Use in Australia (DUMA) report was that, among those who provided a urine sample across all sites of the study, female detainees were more likely than male detainees to test positive for amphetamine (39% compared to 28%) (Makkai & McGregor, 2003). Differences between males and females fluctuate each year in the DUMA survey and this may be due to the smaller sample size for female respondents. However, these percentages are considerably higher than those reported by women in the general population.
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Table 2.2: Prevalence of methamphetamine use among incarcerated male offenders
Source: Australian Institute of Criminology, DUCO Male Survey, 2001
The use of MDMA among police detainees is uncommon. Urinalysis testing of police detainees found that the proportion testing positive to MDMA increased from 0.5% in 2000 to 2.5% in 2006 (Mouzos et al., 2007). Caution must be exercised with self-reported use of MDMA as the drug is often sold under this label, but may not always contain MDMA when chemically tested (Dunn et al., 2007). This is confirmed by comparing police detainees’ self-reported use of MDMA with their urinalysis results. A substantial proportion of those who report use in the past 48 hours do not test positive to MDMA (Mouzos et al., 2006).
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The high domestic demand for ATS is reflected in arrest figures for ATS offences Australiawide, which are greater than any other drug category except cannabis (AIC, 2007). Arrests for ATS offences (including MDMA) have risen from around 4% of all drug arrests in 1995-96 to around 14% in 2005-06 —around 75% of all drug arrests relate to cannabis (see Figure 2.3).
Figure 2.3: Arrests for drug-related offences
Source: Australian Institute of Criminology, 2007
By comparison with the general population of drug users, police detainees report much higher rates of injecting. Injecting drug use was more common among heroin and methamphetamine adult users, with 88% of heroin users and 70% of methamphetamine users reporting they had injected that drug in the past 12 months (Mouzos et al., 2007). Of those who had injected in the past 30 days, detainees reported injecting an average of 27 times and this was consistent with findings from the previous year in 2005 (Mouzos et al., 2007).
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