National Amphetamine-Type Stimulant Strategy Background Paper: Monograph Series No. 69
4.2 Preventing drug use
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In their review of the literature, Loxley and colleagues (2004) reviewed several key strategies targeting prevention of the uptake of drug use. These pertained to particular developmental stages such as pregnancy (e.g., health assessments, home visiting); infancy and early childhood (e.g., parent education, school preparation programs); primary school (e.g., school-based drug education; school organisation and behaviour management); and adolescence (peer intervention and education; youth recreation programs, mentorship, community-based drug education). Other strategies are more broad-based and may target potential drug use as one component within a broader set of goals (e.g., crime prevention, mental health promotion); be workplace interventions (e.g., pre-employment screening; drug testing; workplace health promotion); community-based interventions (e.g., health promotion, social marketing); or target at-risk sub-populations (e.g., those with co-existing mental health problems, programs for some Indigenous communities). Following is an overview of those prevention campaigns most commonly adopted and their application to ATS. Harm reduction strategies are presented in the same format in a subsequent section, followed by discussion of the particular challenges of targeting ATS use.
Specific issues raised during the consultations are outlined in the relevant section. Some general comments related to the content of prevention and harm reduction campaigns. It was suggested that campaigns need to refer to ATS in their entirety. That is, the focus 58 should cover the full range of different ATS and not just focus on one particular drug (e.g., methamphetamine). It was considered important to emphasise that ecstasy is an ATS and its apparent separation from the harms associated with more potent forms, such as methamphetamine, should be addressed. However, other participants raised some concerns about the apparent segmenting of particular drugs and proposed that there was a need to have programs that targeted drug use in general, not just ATS.
A large proportion of participants in the forums raised concerns about the apparent glamorisation and/or portrayal of ATS as relatively ‘soft’ or benign drugs. It was argued that there needed to be a concerted response to the perception among some people that ATS were fun and socially acceptable drugs with no major risks or harms. A number of participants observed that many ATS users underestimated the range and severity of risks associated with use. This issue was also addressed in some of the written submissions. For example, Drug Free Australia (DFA) raised concern at the apparent acceptability of ATS in some groups and observed that:
- In terms of amphetamine type stimulants Australia, which has the highest illicit drug use in the developed world, would do well to emulate the policies of the country [Sweden] with lowest use.
Mass Media Campaigns
Mass media campaigns are universal prevention strategies designed to raise awareness and provide information. However, the aims of mass media campaigns are diverse. For example, they may variously aim to ensure that the community is informed about related activities (e.g., random breath testing), is informed about particular risks of drug use or where to get help, or may have a broader aim of preventing or reducing drug use. While such campaigns have the potential to effectively prevent licit drug use, one common criticism has been that they are rarely subjected to adequate evaluation (Palmgreen & Donohew, 2003) and in particular, evidence is limited regarding their impact with illicit drugs (e.g., see Loxley et al., 2004). They are most likely to have impact when they are part of a multifaceted approach (e.g., raising awareness of the impact of drugs on driving, raising awareness of law enforcement approaches to deter and detect drug impaired driving and road-side drug testing).Top of Page
In order to be effective, mass media campaigns require substantial exposure (in other words, short term initiatives are likely to be ineffective) and have a basis in advanced marketing strategies that effectively target, and communicate with, the desired audience. That is, for example, by focusing on issues that are subjectively relevant for the target audience. The evidence indicates that the effectiveness of a mass media campaign is contingent upon targeting a well-defined audience, understanding the dominant attitudes and beliefs of this audience, in this context designing credible messages, and frequent presentation of these messages to the audience (Bertram et al., 2003). Thus, the aim of the prevention message needs to be matched with the beliefs, attitudes and characteristics of the targeted segment of the community such that it is communicated in a relevant manner. Therefore, it is critical to pre-test prevention messages regarding their impact and appropriateness to the target audience (National Institute on Drug Abuse, 2002).
It is important to recognise that, as with other strategies, mass media campaigns have the potential for unintended consequences, for example by creating interest in a drug where none previously existed, paradoxically glamorising a drug, or introducing naïve members of the community to information about how to use a particular drug. Some campaigns risk stigmatizing and/or marginalising users, reducing the likelihood that they will seek or be able to access treatment. This underlines the critical importance of trialing and evaluating campaigns to ensure that they avoid conveying messages that have the unintended effect of increasing the acceptability or appeal of a drug, or stigmatizing users in a way that hinders the successful implementation of a range of prevention, harm reduction and treatment interventions.
During the consultations, a number of participants suggested that there was a need for mass media campaigns that highlight the risks associated with methamphetamine use, while other participants cautioned that simple ‘scare campaigns’ are rarely effective and, like all interventions, should be evidence-based and subject to proper evaluation. For example, two separate participants commented that:
- Those like the Grim Reaper create fear and alienation; they do not change behaviour.
- For those who feel socially disconnected, scare tactics may have the reverse effect.
A campaign that specifically targeted ATS was ‘Putting the Brakes on Speed’. This community awareness program commenced in 2006 and involved the distribution of a large number of colourful and informative posters and related materials. The aim was to increase awareness in the community and specifically targeted the chemical industry, hotel/motel associations, real estate industry, scientific suppliers, and pharmacies of the existence and indicators of clandestine laboratories. The project encouraged members of the public to report all suspicious behaviour or purchases to the State Drug Investigation Unit Chemical Diversion Desk.
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School-based prevention activities
Many school-based prevention activities are examples of primary prevention that are designed to prevent the initiation of drug use, and to a lesser extent, prevent problems that may arise from drug use. In considering how to plan activities to address a specific drug type, it is noted that school-based drug prevention approaches usually address the broad range of drug use – that is, they aim to prevent the uptake of drugs rather than any specific drug (Spoth et al., 2006). The evidence also indicates that effective school-based prevention programs do not just rely on passive information exchange or a singular focus on skills related to drug use (for example, drug refusal skills), but also include a focus on more generic personal self-management and social skills (Botvin & Griffin, 2003; Midford & Munro, 2006).In Australia, the Principles for school drug education (Department of Education, Science and Training) were developed to encourage the development of evidence-based school drug education. The principles are as follows (see Meyer & Cahill, 2004):
- Base drug education on sound theory and current research and use evaluation to inform decisions;
- Embed drug education within a comprehensive whole school approach to promoting health and wellbeing;
- Establish drug education outcomes that are appropriate to the school context and contribute to the overall goal of minimising drug-related harm;
- Promote a safe, supportive and inclusive school environment as part of seeking to prevent or reduce drug-related harm;
- Promote collaborative relationships between students, staff, families and the broader community in the planning and implementation of school drug education;
- Provide culturally appropriate, targeted and responsive drug education that addresses local needs, values and priorities;
- Acknowledge that a range of risk and protective factors impact on health and education outcomes, and influence choices about drug use;
- Use consistent police and practice to inform and manage responses to drug-related incidents and risks;
- Locate programs within a curriculum framework, thus providing timely, developmentally appropriate and ongoing drug education;
- Ensure that teachers are resourced and supported in their central role in delivering drug education programs;
- Use student-centred, interactive strategies to develop students’ knowledge, skills, attitudes and values; and
- Provide accurate information and meaningful learning activities that dispel myths about drug use and focus on real life contexts and challenges.
To date, there is a stronger evidence base for the effectiveness of school-based campaigns in targeting licit drugs, such as alcohol and tobacco, compared to illicit drugs, including ATS (Loxley et al., 2004). A major criticism of such approaches is their limited capacity to address the complex variety of factors associated with the uptake and continuation of drug use (Stubbs et al., 2004). An additional concern is that those young people most in need of such information and assistance are those who may not currently be attending school (e.g., engaged in truancy, been suspended or expelled). Consequently, the ‘Reconnecting Youth Program’ targets youth at risk of dropping out of school and those with multiple problems (Eggert et al., 1994). This program incorporates personal growth classes, social activities and school bonding to teach resiliency skills that moderate the effect of risk factors for drug abuse and has shown evidence of improving school performance as well as enhancing several psychological and emotional attributes of participants. Strategies targeting at-risk youth outside of educational institutions include peer education and those outlined below in the sub-section on ‘young people’.
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The issue of the effectiveness of school-based drug education campaigns generated contention and debate at some consultation forums. While some participants held that these strategies were important and effective, others argued that school-based programs can be problematic. In particular, concern was raised about the uptake of evidence based school drug education, as decisions to implement such programs were locally determined (e.g., by school principals) leaving a significant proportion of schools without effective and evidence based programs. Two comments illustrate some of the issues:
- People are not always keen to take on the responsibility for the policy context of these campaigns or to deliver them at the school level.
- Although the curriculum includes a Health component dealing with drugs, its delivery is dependent on schools and the inclination and capacity of staff.
- Best practice for school drug education is to focus on social skills such as resilience, decision making rather than respond to specific drug phases.
Peer education
Peer-based prevention approaches have been variously used to prevent the uptake of drugs and to reduce problems for those already using drugs. Such strategies have the advantage of being able to access groups who might not otherwise attend general health or drug specialist services. Access may instead be facilitated through outreach or centrebased programs delivered by peer educators and professionals (Substance Abuse and Mental Health Services Administration, 2003). As noted above, peer education may be particularly helpful in targeting young people, during and after their formal education, and during transition periods (e.g., transition to post-secondary education or transition to work) when they may be at increased risk of being exposed to drugs and or make a transition to problematic drug use. Information and advice delivered in this manner may be more likely to have impact. It has been observed that much of the knowledge about drug use, both accurate and inaccurate, is sourced from peers:- … information from a personal source rather than a booklet, or other printed material or some other ‘official’ source is more likely to be understood and assimilated. For these reasons, most knowledge about using drugs is almost exclusively derived from other drug users. (Moore, 1992, p.87)
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Beyond primary prevention, the Australian Injecting and Illicit Drug Users League (AIVL) developed a framework for peer education for drug-user organisations (AIVL, 2006). How ‘peer education’ is defined will have obvious implications for how it is implemented. In relation to this point, AIVL (2006) states:
- Peer education exists independently and predates the existence of funded, externally supported structures or projects…Damon Grogan describes peer education as a “naturally occurring, organic process that occurs within such groups independently of governments or organised structures, but which may be resources and utilised to more effectively achieve positive outcomes (p.4).
Guided by this perspective, AIVL (2006) propose the following principles for formal peer education by drug-user organisations: equality, self-determination and ownership, pragmatic learning, developing community, harm reduction, privacy and confidentiality. In their written submission, AIVL stated:
- A strong argument for the use of peer education lies in…the importance of identity and identification within marginalised populations, and the credibility that is generally accorded to both the messenger and the message…Peer education provides a way to access hidden populations which is crucial for ATS given the diversity of communities using these drugs. Making use of new media technologies, such as the internet and mobile communication, and involving ex-/consumers in the planning, delivery and evaluation of prevention programs were also recommended. One individual submission suggested that campaigns needed to acknowledge the positive experiences expressed by ATS users if they were to be perceived as accurate and balanced in their approach. However, it was also recommended that caution be exercised not to glorify or enhance acceptability of drug use.
Similar projects are conducted in other states and territories. ‘Keep It Simple’ (KIS) is peer education project conducted in the Sydney dance scene. It involves peer educators attending nightclubs, festivals and events and actively engaging attendees with drug information and related issues, including mental and sexual health information, and referrals to available services. External evaluation of the project suggested that attendees viewed the peer educators as approachable and credible in delivering harm reduction messages. ‘Ravesafe Initiative’, ‘Ravesafe Peer Helper Program’ and ‘Amphetamine Peer Outreach Education Project’ are all peer-based strategies operating in Queensland that provide information about drugs and harm reduction practices to young people.
Strategies targeting vulnerable groups and/or high risk behaviours
It has been observed that some individuals are at higher risk for drug problems. For example, people who live in dysfunctional families, where one or both parents use illicit drugs or are hazardous drinkers, who are disconnected from family and social networks and/or who experience mental health problems are more likely use and be affected by a range of drug problems (e.g., see Loxley et al., 2004). Strategies that aim to reduce social and other inequities and strategies that address factors that increase the risk of drug use (e.g., effective management of mental health problems; effective parent education and support initiatives) have been found to reduce use and problems related to illicit drug use (e.g., Loxley et al., 2004).Given the diversity of ATS users, the goal of targeting particular groups is particularly relevant to ATS use. Identified groups need to be targeted both in preventing ATS use, and in reducing harms associated with ATS use following initiation of use. In this section, issues related to some of the potential target groups for preventing ATS use are outlined. This includes young people, at-risk occupational groups, Aboriginal and Torres Strait Islander people, and Culturally and Linguistically Diverse populations. In addition, families of users and the general community also represent targets for information provision and assistance. Other target groups, such as gay, lesbian, bisexual and transgender populations, injecting drug users, and ecstasy users have to date been targeted in relation to reducing harms associated with ATS use, and are therefore outlined in a subsequent section. However, given that these groups have been identified as users of ATS, targeting campaigns to prevent uptake of ATS among these groups is an area in need of development.
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Young people
In addition to the potential harms and risks associated with ATS use that apply to the general population, some specific issues pertain to use by young people. Of note are the potential effects of ATS use on brain maturation and development, which could result in various neurological and psychiatric consequences (Rawson et al., 2007). While no published brain imaging studies have reported on methamphetamine use by young persons, animal studies suggest that methamphetamine exposure results in different alterations in central nervous system serotonin and dopamine alterations in adolescent animals than in adults (Dewey et al., 2006).An example of a broad-based prevention campaign targeting youth is The Drug Offensive Amphetamines Campaign, ‘speed catches up with you’. This campaign used both television and radio commercials, and targeted non-users and occasional users between the ages of 15 and 25 years. It aimed to deter potential users from trying amphetamine as well as alerting occasional users to the potential harms and risks of becoming more regular users. An evaluation found that while the campaign was effective in raising awareness among the target groups, it had minimal impact on drug use behaviour (Hando & Hall, 1997).
A more recent example is the Drugaware Amphetamine Education Program currently being conducted by Drug Aware (a program run by the Western Australian State Government Drug and Alcohol Office) in partnership with the WA Network for Alcohol and other Drug Agencies (WANADA). The target group for the campaign is 12 to 29-year-olds who are at risk of ATS use, use ATS infrequently, and use ATS regularly. Youth communication mediums have been used including street press, community youth radio stations, convenience advertising, community-based education initiatives and other services (such as treatment services and needle and syringe programs) to provide information and assistance relating to ATS. As this is a relatively new initiative, its impact has not yet been evaluated. Operating in conjunction with Drug Aware in WA is the Night Venues and Entertainment Events Program (NVEEP), which includes a dug user education program, staff risk management training, and policy development, implementation and enforcement to reduce risk factors within night venues.
While some strategies targeting young people are school-based (outlined previously), others may target a particular drug (such as ecstasy) or context of use (such as nightclubs). However, it has been noted that both prevention and harm reduction strategies need to better target high-risk youth outside of these settings, such as homeless youth, those in juvenile justice environments and so on. Streetwize Communications developed a psychostimulantspecific comic, entitled ‘On the Edge’, targeted at these groups through distribution at venues such as youth centres and refuges. One key aspect to developing the resource was conducting focus groups to determine the information needs of young psychostimulant users to ensure the publication was relevant and appropriate. The information provided relates to issues of side-effects of use, harm reduction strategies, and treatment options, with preliminary evaluation showing recall of content four months after reading the material and sharing the resources with friends (www.streetwize.com.au/publications).
Peer-based strategies also have a potential role in harm reduction, as well as being used to prevent ATS uptake. For example, such strategies can be used to prevent drug-related harms such as sexual risk behaviours, transitions to injecting drug use, transmission of blood-borne viruses and preventing and responding effectively to drug overdose. Peer education and support have been shown to be effective, both overseas and in Australia, as risk reduction strategies to prevent infection with HIV in injecting drug user communities (e.g., Dowsett et al., 1999). Further, it has been asserted that peer education can be effective in increasing knowledge about hepatitis C, preventing further transmission of hepatitis C and encouraging behaviour change (e.g., Sansom 2001).
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During consultations, there was widespread recognition of the need to target campaigns to certain audiences. With regards to young people, campaigns needed to be variously targeted, such as:
- segmented into programs for specific age groups, for example, primary school, 14 to 18 years old and 18 to 21 years old;
- those who are frequently absent from school;
- those who leave school after Year 10 and are in the transition from school to post secondary/tertiary education and/or work;
- ‘at risk’ children, as identified from the evidence base regarding social determinants of use; and
- young offenders in detention centres.
- a need to identify the risk factors of the problematic group of 17-21 year olds as they apply to depression, anxiety, early childhood experience; and to understand the nature of the drugs they are ingesting, and behaviours that lead to addiction.
- The vast majority use on recreational/occasional basis and so won’t use treatment services – not necessary or relevant to them. Therefore need to focus on harm reduction via peer education and use of Internet and other new technologies.
- … tak[ing] care of yourself and your mates.
- The Committee recommends that public education and demand reduction campaigns for illicit drugs be factual, informative and appropriately targeted. The Committee also recommends that such campaigns seek input from young people, and take account of user experiences of amphetamines and other synthetic drugs (AOSD) (p.ix).
Peer education approaches were also emphasised in some submissions. For example, the Northern Territory AIDS & Hepatitis Council Inc provided an outline of the Youth Amphetamine Information Project (YAIP) that was established as a six month pilot project. The aim of the project was to develop up-to-date and accurate information on amphetamines and to implement a peer-based education training program targeting young people at risk of amphetamine use. In conducting the project, it was noted that: young people lacked knowledge about amphetamine and related harms; young people stated that they preferred to receive drug education from people who they consider to have drug use experience (namely, peer education); it was important to engage young people via accessible communication tools such as text messages, interactive web-based tools and email; and, it was important to be strategic in selecting venues for conducting workshops, to maximise participation.
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The Red Cross Save a Mate Project (SAM) incorporates peer education with other prevention and harm reductions strategies. SAM is a drug education and first aid program, which aims to reduce incidents of harm and death associated with the use of alcohol and other drugs. The program is aimed specifically at at-risk youth, school children, nightclub staff, inmates in correctional facilities and those in drug rehabilitation programs. Volunteers aged 18 to 30 are selected and trained in harm minimisation and first aid strategies to deliver the three components of the program: alcohol and other drug specific First Aid training; pubs, clubs and venue initiative (includes training venue staff in responding to emergencies); and peer education teams (includes attendance at events to promote safer partying and harm reduction strategies to young people). SAM operates in New South Wales, Queensland, South Australia, ACT and Northern Territory, and will shortly commence in other states.
However, as already indicated, aside from some basic monitoring and evaluation strategies with a number of programs, the evidence base about ATS specific primary prevention strategies is limited. For example, to date, only one study has reported on prevention strategies specifically targeting methamphetamine use among adolescents. Spoth and colleagues (2006) concluded that effective prevention strategies should focus on brief universal interventions that incorporate: reducing early initiation into drug use (alcohol, tobacco, cannabis); skills-building opportunities; alternative activities; and family and/or peer support. At a recent meeting of the United Nations Office on Drugs and Crime, the following strategies for preventing the use of methamphetamine by young people were suggested: school-based activities (e.g., life skills training, teacher training, use of positive reinforcement techniques); careful targeting of high-risk families for pre-school interventions; using peer-based techniques to deliver information and skills; and empowering communities to reduce drug-related harm (United Nations Office on Drugs and Crime, 2006).
These various reports suggest that at-risk young people should be a particular target of prevention and harm reduction strategies. This in turn indicates that organisations that are involved in providing services to at-risk young people should be a component of any prevention or harm reduction strategy, and any program should include strategies to enhance their capacity (resources and skills) to recognise and intervene in escalating ATS use, including identification of those at high-risk of developing problematic patterns of use. Such activities and interventions need to be accessible and relevant to young people, and accurately describe the potential risks and harms involved with ATS use.
At-risk workplaces
There is increasing evidence about the use of ATS in association with work, with associated risks of working under the influence of drugs and impact on absenteeism. The impact of ATS use in the workplace can result in:- Overwhelming tiredness at the onset of the working week;
- Otherwise unaccountable irritability, agitation or mood swings;
- Difficulty concentrating and reduced performance;
- Mental health problems, such as paranoia, delusions, feeling despondent or depressed;
- Lack of concern about otherwise serious matters; and
- Health problems, such as palpitations, infected injection sites or lesions (National Centre for Education and Training on Addiction, 2006).
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Recently, a project was conducted by the NSW Injury Risk Management Research Centre in collaboration with the University of NSW into stimulant use by long distance truck drivers (Williamson et al., 2006). The first study aimed to identify factors that may predict drug use by reanalysing data from previous national surveys with long distance truck drivers, while the second study aimed to update and expand this information by conducting an in-depth survey of drivers. The strongest predictors of stimulant use by long distance truck drivers, according to self-reported reasons for use, were fatigue and productivity-based payment systems. The second study found that one in five truck drivers used stimulants at least sometimes and more than half had used these drugs at some point in their career. The most common stimulants used were illicit forms of amphetamine-type stimulants.
As a result of concern about ATS use in this population, some state-based strategies have been introduced. In NSW, the Roads and Traffic Authority has developed educational materials, including information booklets and posters, for drivers and operators highlighting the dangers of using drugs and the need for more appropriate fatigue management strategies. Roadside drug testing is now being developed and implemented in a number of jurisdictions as a means to deter and detect drug impaired driving. While not restricted to the transport industry (indeed most governments have indicated an intention to target various high-risk groups and locations) this strategy will have direct relevance for the industry. In NSW, for example, a Drug Driving Working Party was convened to manage research and field trials in preparation for commencement of legislation to implement drug testing of drivers. This included the introduction of random roadside drug testing for the presence of certain illicit drugs, and compulsory drug testing of any driver involved in a fatal traffic accident. Similarly, random drug testing was introduced in Victoria in 2004, and while various trials and evaluations are still underway, roadside drug testing has been implemented or is currently being considered in most other states and territories (Lenne, 2007).
At a number of consultations, concern was expressed regarding the use of ATS in relation to work and it was suggested that the workplace should be a site for prevention and harm reduction strategies. Some participants suggested that there was a need to identify and disseminate models of managing ATS use in the workplace, some identifying current programs such as recently developed programs in the Department of Defense and guidelines for responding to drug problems developed by organisations such as Work Cover. For example, one participant observed that:
- Some industries, such as the construction industry, do undertake screening and offer drug education programs and use employment contracts which make provision for drug treatment or dismissal although there is a concern that some ATS users know how to beat the screening process.
- The use of alcohol and other drugs has a significant impact on Australian workplaces in terms of accidents, lost productivity and absenteeism. While alcohol and other drug use may impact on the way people work, so may work related factors such as stress influence the way people use drugs. Occupational settings including transport, forestry, construction, industrial and hospitality industries have been noted as areas that have an association with the prevalence of ATS use.
Concern was raised during the consultation process that there is only minimal drug and ATS specific research within both Aboriginal and Torres Strait Islander people and communities and Culturally and Linguistically Diverse (CALD) communities. This relates not only to the use of ATS among these populations, but also how to target effective prevention campaigns to current users and those at-risk. Prevalence rates of use are variable and a lack of specific information makes it difficult to determine not only the need, but also the nature of any prevention strategy.
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The consultation forum with Aboriginal alcohol and drug workers in Western Australia conducted by the Drug and Alcohol Office, and submitted to the ATS Strategy project team, resulted in the following recommendations in any approach to prevent and respond to ATS use among Indigenous people:
- Need to strengthen aspects of Aboriginal identity, including families, culture and community capacity;
- A holistic approach focusing on family and group interventions in appropriate settings should be used to address alcohol and other drug (AOD) use;
- Develop specific strategies to support Aboriginal grandparents and others who are carers of children due to parental use;
- Educate ATS users on harm reduction strategies, including prevention of blood borne virus transmission;
- Develop youth specific treatment programs provided in a range of settings;
- Improve coordination between AOD, mental health and acute health sectors in early detection and management of co-morbid mental health and AOD problems;
- Need for workforce training programs to develop drug related and knowledge/skills of Aboriginal culture;
- Improve shared case management between AOD, corrections and child safety agencies to enhance continuity of care and reduce barriers to accessing assistance;
- Expand drug diversion programs for Aboriginal people in coordination with local Aboriginal communities; and
- Incorporate aspects of Aboriginal culture and law into justice programs.
- Identify and promote positive Indigenous role models for children, such as through a mentoring program;
- Enlist the support and guidance of elders in the community;
- Design specific, separate programs for men, women and children that involve activitybased, recreational activities and for some, “going bush”;
- Develop parenting/carers programs that take place within the home;
- Develop and implement programs that address socioeconomic factors related to unemployment and homelessness; and
- Employ visual media when aiming programs at Indigenous people.
Parents and families
Consultations also raised the issue that parents/carers and families have limited knowledge about patterns of use and particular risks associated with use. In addition, many have remained unclear about the various treatment and other options for intervention. As potential sources of support for a drug user, families that are wellinformed can be an effective site for intervention. In addition to being knowledgeable about the effects of drugs and associated drugs, families may also need information on where to get help and how to access support services. It is therefore important that information is made available on a wider level so that those affected indirectly by ATS use have a better understanding of the issues and available resources.Top of Page
Discussions during the consultations highlighted the need for support and help for families. This was stated not only in relation to assisting a family member who is a consumer, but also for family members to access support for themselves as someone affected by another’s ATS use. Thus, families need information about what services are available, treatment options and opportunities for respite. Particular mention was made in regards to Indigenous families and the large number of grandparents caring for children due to parental use. Issues of poverty, threats of violence, and a sense of despair and desperation often permeate these circumstances and there is heightened need for support.
In all consultations it was noted that parents/carers/families needed enhanced access to information (warning signs, drug types etc), knowledge of available services for their children and, in some cases, how to get support themselves. This is a particular issue with some ATS because it was noted that some of the behavioural and mental health problems accompanying ATS use created particular problems for families. It was observed that parents represent a resource and support for their adolescent children and can be used in this capacity to prevent ATS use in the first instance and help children who have already begun to use. The need to strengthen and improve communication between parents and 2 young people was noted in the submission from Drug Free Australia, which referred to evidence supporting the conclusion that:
- … teens who have a positive relationship with their parents are less likely to engage in risky behaviours, and consequently recommended a need to:
Others were concerned about child protection issues, both in relation to exposure to parental ATS use and to clandestine laboratories. Where parents/carers are involved in ATS production, the risks associated with clandestine laboratories were a particular concern. It was agreed by many participants that there was a need to develop a range of child protection measures across the range of situations, including exposure to:
- Parental drug use during pregnancy;
- Parental drug use during the various developmental stages; and
- The risks of clandestine laboratories.
Community
The 2004 NDSHS provides some indication of the public perception of ATS. Small proportions of the community identified meth/amphetamine (5.5%) and ecstasy (2.6%) as drugs perceived to be related to a ‘drug problem’ (Australian Institute of Health and Welfare, 2005a). This was matched by equally small proportions that reported that they perceived use of meth/amphetamine (3.1%) and ecstasy (4.2%) as ‘acceptable’. With regards to law enforcement, very few supported any legalisation of personal use of meth/amphetamine, and the small degree of support for such changes had declined from previous surveys (6.8% in 2001 versus 4.7% in 2004). Proportions in favour of increasing penalties for meth/ amphetamine sale and supply remained stable and high (83.7% in 2001 versus 85.7% in 2004). Respondents were also asked what actions should be taken for those found in possession of these drugs for personal use. The greatest proportions of respondents nominated ‘referral to treatment/education program’ for both meth/amphetamine (42.6%) and ecstasy (41.1%). A ‘fine’ was nominated by 19.7% for meth/amphetamine and by 24.6% for ecstasy, and ‘prison sentence’ by 20.8% for meth/amphetamine and 14.8% for ecstasy.The consultations indicated that there was general agreement that there was a need to educate the community about the nature and prevalence of ATS related harm – for example, many participants believed that in the community heroin was considered the major drug of concern, with little consideration of the harms arising from ATS.
For the community, much of the information about ATS use is provided by the popular media, which is sometimes sensationalist and/or inaccurate, and might contribute to barriers to effective prevention, law enforcement and treatment initiatives. It is suggested that, as well as implementing effective information and education campaigns, one needs to address sources of misinformation. For example, a number of commentators have suggested that media guidelines should be developed similar to those for media reporting of suicide and mental illness (Penrose-Wall, Baume & Martin, 1999). Further, the Internet and peers also represent potential sources of misinformation. Thus, any campaigns related to ATS use, whether targeting current consumers, community members or preventing the uptake use, need to ensure the credibility of information sources and adopt strategies to regulate the quality and accuracy of the information provided.
In all community consultations strong concerns were expressed about the media’s portrayal of ATS use and some commented that this had resulted in a kind of ‘hysteria’ that was ill-informed. In particular, there was concern about the over-emphasis on crystal methamphetamine use, and with the use of terms such as ‘party drugs’. In addition, it was felt that significant emphasis had been placed on psychosis and little on the more prevalent mental health problems such as anxiety and depression. Such stories contributed to inaccurate understanding of ATS use and the associated harms and that they could have the unintended consequences of: glamorising or creating interest in ATS: confounding effective prevention and law enforcement strategies; contributing to misdiagnosis (for example, a number of people commented that any agitation was being inappropriately diagnosed as psychosis); and further marginalising consumers, having an impact of the probability of seeking and/or receiving treatment. It was suggested that guidelines or a code of conduct be developed in partnership with the media about reporting about drug use, in particular ATS use. This approach was emphasised in the submission from the Australian Psychological Society (APS), which stated that there was a need to:
- develop more sophisticated and informed responses and advocacy to the media on the issue of ATS and advocate for the development of a Media code of conduct around the reporting of ATS and other drug incidents.
- ...the recent media focus on the extreme effects of crystal methamphetamine has not been helpful in encouraging users into treatment. These media reports may result in users who are less severe believing that they do not require intervention unless they are experiencing extreme problems, and also becoming more reluctant to seek treatment for fear of being classified as a ‘hard drug user’.
