PopulationPopulation based secondary school surveys have indicated that in Australia there is a growing trend towards the use of psychostimulants among students, despite overall low levels of use. For example, data from the 1999 Secondary School Survey indicated that 11% of students reported having ever used amphetamine-type stimulants (ATS), compared to 9% in 1996 (White, 2001). The data also indicated that 3% of 12 year olds and 12% of 17 year olds had ever used an ATS, while around 6% of all students had used amphetamines in the past year, with prevalence increasing with age — 2% of 12 year olds and 10% of 17 year olds. Only 1–2% of students reported recent use of an ATS. Gender differences were minimal.
These rates of ATS use for 14 to 19 year olds were mirrored in the 2001 National Drug Strategy Household Survey (Australian Institute of Health and Welfare, 2002b) where 8.4% of young people reported lifetime use of ATS, 6.2% reported recent use and 1.2% of young people in this age group reported use in the last week. Approximately 10% of ATS users aged 14–19 years reported daily or weekly use. Gender differences were minimal although females reported slightly higher rates of lifetime and recent ATS use than males. However, there were higher rates of ATS use amongst males than females in the 20 to 29 year old age group, with 25% of males and 19% of females reporting lifetime use and 14.1% of males and 8.2% of females reporting recent use. The drug most likely to have been injected by both age groups was an amphetamine.
Youth populations reported low rates of lifetime cocaine use (3–4%). Prevalence rates of MDMA use tended to increase with age, with 4% of secondary students and 7% of 14 to 19 year olds reporting lifetime use (Australian Institute of Health and Welfare, 2002b; White, 2001). Significant gender effects occurred, with males reporting greater rates of cocaine and MDMA use than females (Australian Institute of Health and Welfare, 2002b; White, 2001). For 20 to 29 year olds, 22.5% of males and 16.9% of females reported lifetime MDMA use, with 12.5% of males and 8.3% of females reporting recent use (Australian Institute of Health and Welfare, 2002b). Recent use of ATS and MDMA tended to increase with age, but this pattern did not emerge for cocaine, the use of which was fairly even across the ages (Australian Institute of Health and Welfare, 2002b; White, 2001).Top of page
Comparisons with international dataWhile different data collection methodologies make global comparisons of youth populations difficult, some broad trends can be observed. Stable, but elevated, levels of cocaine use have been noted among youth in the Americas (4–5%), which are somewhat higher than rates in Australia and Europe (2–3% and 1–2% respectively) (Maxwell, 2003; United Nations Office on Drugs and Crime, 2003).
The highest reports of ATS use by young people come from East and Southeast Asia and Australia with prevalence rates ranging from 8–10% (United Nations Office on Drugs and Crime, 2003). Europe, the Americas and Africa largely report lower levels of ATS use by young people (approximately 2–5%), with some pockets of higher-level use, which often correspond to areas of methamphetamine production or transhipment routes.
For MDMA use, surveys in Australia, the USA and Canada report similar prevalence rates (about 7%). In contrast, the average lifetime prevalence of MDMA use in 32 European countries among 15 to 16 year olds was only 2.5% (Maxwell, 2003; United Nations Office on Drugs and Crime, 2003).
Juvenile detention and treatment samplesA 1999 survey of 300 clients in New South Wales (NSW) Juvenile Justice Centres found significantly higher lifetime rates of amphetamine (56%) and cocaine (34%) use than in the general population (Copeland, Howard, Keogh & Seidler, 2003). These rates also represented an increase from the levels of use reported in a 1994 survey (Copeland et al., 2003).
The number of young people admitted to residential AOD treatment services with problematic psychostimulant use (particularly ATS use) has also increased (Degenhardt & Topp, 2003; Howard & Arcuri, 2003a). Howard and Arcuri (2003a) profiled 178 young people assessed for a state-wide adolescent residential treatment agency across five sites finding that more than a quarter of clients nominated psychostimulants as their major drug of concern.Top of page
Route of administrationIn the Howard and Arcuri study (2003a) the most popular route of administration for first psychostimulant use was intranasal ingestion (26%), whilst injection was the preferred route of administration for recent use (55%). 83% of clients who nominated ATS as their primary drug of concern preferred injection as their route of administration. A similar pattern was observed for cocaine use, where inhalation (61%) was the most popular initial route of administration, whilst injection (51%) was the most popular recent route of administration. Likewise, rates of injection of designer drugs increased substantially from first to most recent route of administration (9.1% to 12.2%), a finding similar to that of Topp and colleagues (Topp, Breen et al., 2002; Topp et al., 1999).
Reasons for and patterns of psychostimulant use by young peopleLike most drug use, the reasons given by young people for initiating psychostimulant use are not necessarily the reasons they maintain use. Understandably, congruent with the developmental stages of adolescence, the reasons for initiation of psychostimulant use include 'curiosity/experimentation' and the 'influence of peers' (Dennis & Ballard, 2002; Howard & Arcuri, 2003a).
In contrast, reasons for continued psychostimulant use are largely associated with 'the effect' or 'dependence' and because psychostimulants are 'fun' (Howard & Arcuri, 2003a). Other reasons proposed for continuation of use include the management of trauma or symptoms of depression (Buckstein, Dunne, Ayres, Arnold et al., 1997; Herman, 1992).
Psychostimulants are often included in the colloquially termed 'party drugs' category (Topp, Breen et al., 2002) and their use has been linked to raves (dance parties), good times and celebrations (Dennis & Ballard, 2002;Weir, 2000). In contrast to heroin use, daily use of psychostimulants for extended periods is considered to be relatively rare (Topp, Kaye et al., 2002) and the withdrawal from this class of drugs is relatively benign. Thus, psychostimulant users are less likely to seek and access treatment than heroin users (Hall et al., 1993; Shearer et al., 2002).
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Psychostimulant use amongst young people is characterised by three distinct patterns of use:
- Experimental use — this type of use can be seen as a part of normal adolescent risk-taking. Experimentation or occasional psychostimulant use is most common in the younger Australian population. Data show that the majority of young people do not experience extensive problems or continue psychostimulant use and 'recent' psychostimulant users only reported using the drug every few months (Australian Institute of Health and Welfare, 2002b).
- Rave or club scene use — these young people are often regarded as 'functional users', in that their use is restricted to weekend or event-specific use. A UK survey of 16–29 year olds found that 91% of members of the dance club scene had used psychostimulants, particularly MDMA (Weir, 2000).
- Problematic use — this pattern of psychostimulant use is characterised by chaotic and dependent use, is usually associated with injecting drug use and often results in negative outcomes (e.g. homelessness and criminal behaviour).