National Drug Strategy
National Drug Strategy

National Amphetamine-Type Stimulant Strategy Background Paper: Monograph Series No. 69

4.4 Challenges of applying prevention and harm reduction strategies to amphetamine-type stimulants

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There are a number of challenges in any attempt to apply prevention and/or harm reduction approaches to ATS use and related problems. In particular, a large number of ATS users do not perceive themselves as drug users and do not access many of the services or resources that may be accessed by other drug consumers. Furthermore, as indicated above, there are diverse target groups suggesting that there may be a need to develop specifically targeted and appropriate approaches.

At present, there is only limited evidence to guide the implementation of ATS-specific strategies to prevent and reduce problems, and most of this has focused on specific campaigns and peer-interventions. Although a range of interventions have been implemented, most reports are descriptive and thorough evaluation and formal publication are often lacking. Based on a general analysis of prevention, Hando and colleagues (1999) suggested the following key principles be adopted in designing harm reduction strategies:

Gowing and colleagues (2001) reviewed prevention activities specifically in relation to ecstasy. As in other research, they noted that it was critical to base any prevention strategies on an understanding of the subjective functions that the drug might serve. Consistent with research with other drugs, they observed that subjective functions of drug use are likely to be more influential on decisions to use and continue using than knowledge or experience of negative effects. Observing no compelling evidence for preference for any particular approach, they identified the criteria that underpinned successful programs. These included: Top of Page

In a review of drug use among young males in the United Kingdom, Boys and colleagues (1999) similarly noted that it was important to understand the factors that were related to ATS use and had influence on future use. The researchers also noted that positive reasons for using might well be more influential than potential and actual negative consequences of use. It was found that:
Such evidence is not an argument that people should not be made aware of risks and problems arising from drug use. Rather, it emphasises that the subjective nature of perceptions of risk and negative consequences should be taken into account in designing interventions and that focusing on negative consequences alone may be insufficient. This underlines the earlier observation regarding the limited impact of ‘scare tactics’. It also underlines the argument for targeted interventions in their own right and accompanying broader, mass media campaigns: It is also pertinent to comment on the implications of recent communication developments. Many people access information (accurate and inaccurate) about ATS via the Internet. As already noted, concerns have been expressed that drug production and distribution are being facilitated by the Internet. For example, Klee (2001) advised that this was an emerging concern: And: The Inquiry into Amphetamine and ‘Party Drug’ Use in Victoria (DCPC, 2004) reported that various organisations had developed or were developing information and other interventions for use over the Internet, for example targeting young people (Drug Aware, Drug and Alcohol Office, WA; RaveSafe, Victoria; Somazone, Australian Drug Foundation). However, again there is limited research into the potential role of the Internet (and other emerging electronic media) in encouraging ATS use and/or in preventing use and reducing problems, but a number of studies are now underway. For example, researchers at the National Drug Research Institute (NDRI) are exploring how web-based communications provide accurate and inaccurate information about illicit drug use, while researchers at the University of Tasmania are currently examining the effectiveness of internet-based delivery of harm reduction information.

A number of other findings from the Victorian Inquiry (Drugs and Crime Prevention Committee, 2004) can inform us how we might maximise the effectiveness of ATS-specific prevention strategies. It was emphasised that there was a need to consider the reasons potential and actual consumers, such as young people, cite for using ATS, on both personal and social levels. Thus, for example, a recent international report on global trends in psychostimulant use identified that there is a common perception that amphetamine and ecstasy are more benign and socially acceptable than drugs such as heroin (United Nations Office for Drug Control and Crime Prevention, 2001). ATS may be attractive to some people, particularly young people, if they perceive that such drugs are associated with sociability, having less health risks, are relatively low cost, and have mood-enhancing effects (United Nations Drug Control Programme, 1996).

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As in other reports, the Victorian Inquiry (Drugs and Crime Prevention Committee, 2004) also concluded that multifaceted approaches were likely to be the most effective. For example, it was recommended that any campaign addressing ATS should include: In summary, it is again indicated that the various, and overlapping, target groups and the diverse patterns and contexts of ATS use and related problems, and the apparent limited impact of any single approach, demands the need for multifaceted approaches applying several strategies tailored to specific needs and circumstances.

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