14.1 Key findings for social users
14.2 Social user recommendations
14.3 Key findings for functional users
14.4 Functional user recommendations
14.5 Key findings for dependent users
14.6 Dependent user recommendations
14.7 Indigenous user recommendations

14.1 Key findings for social users

Target audiences

Young people aged 16-24 years, university students, rave partiers, gay, lesbian and bisexual users, rural and regional, and some general users aged 25 years or more, were the primary target audiences using methamphetamines in the social behavioural context. Among workers in the specific industries that were targeted, hospitality workers were more likely to use socially, as well as in a functional context, than construction workers and labourers were.

Characteristics of social users

The primary motivation for using methamphetamines among these social users is the drugs' disinhibitory effects. Users claimed to experience enhanced confidence, increased ability or motivation to converse with others, enhanced energy, alertness and greater physical sensation. Social users are characterised by a number of behavioural characteristics. Firstly, they only use at parties, clubs, social events and other gatherings that involve others, as they see the experience as being one to share. Using alone is frowned upon. Secondly, social users place parameters around their usage that they perceive clearly differentiates their responsible use of drugs from those who develop a dependence. These are what they believe ensures their drug use continues to be low risk. The most common of these parameters are:
  • only using when others are using
  • only using the same amount as friends and
  • not allowing use to affect other areas of their lives such as employment.
As a result, social users claim to only use methamphetamines at the weekend or at special events.

Types of methamphetamines used

Speed and base are the most common methamphetamines used across all social users. These drugs are clearly differentiated from ice, and are used in the same context as each other. Speed and base are the methamphetamines most commonly used at clubs, raves, parties and other social events because they provide a lower, less intense high over a longer period of time. They are also easier to carry and administer than ice, as they are commonly snorted (powdered speed only) or ingested (either alone or mixed in a drink). It is important to note that social users often do not clearly differentiate between speed and base. While it is understood that base is higher in purity and stronger than powered speed, the difference is not considered as substantial, and most social users will use both depending on availability. In the majority of cases when they are asked, users do not differentiate which they are using and will use the terminology of 'speed' to describe all forms of methamphetamines with the exclusion of the white, crystallised form which they identify as ice.

Ice, on the other hand, is considered to be a vastly different drug in terms of purity and strength by social users. Given this, and also due to the fact that it requires equipment for use, it is most commonly used in private premises (not out at clubs and raves). This is usually at a house party, an after party, or for a small minority of social users, before going out to clubs, raves and so on.
Top of page

Patterns of use

Social users of methamphetamines are able to be further segmented into four distinct sub groups based on their attitudes and behaviour towards use of ice. The first of these, 'Ice Blockers', do not use ice despite using other methamphetamines on a regular basis when going out to clubs, pubs and dance venues. This sub group tends to fear ice due to either perceived side effects or the potential for easy addiction. Younger people within all the target audiences in the social user group - youth, students, rave partiers, gay, lesbian and bisexual users, rural and regional - more commonly fell into this category than their older counterparts. That said, a number of the general users over the age of 25 years, were also Ice Blockers.

Other social users will use ice opportunistically when it is offered to them by others at locations such as house parties after a night out (Ice Dabblers). Ice is not their drug of choice, they would prefer other drugs including other forms of methamphetamine and they do not actively seek it out. In fact, they will often have a low regard for ice comparative to other drugs. However, this group tends to be characterised by being receptive to taking almost any drug in a social situation, so will use ice when it is offered by their peers.

'Ice Celebrators' were the third social sub group able to be identified. This sub group consists of those social users who consciously limit their ice usage to special, infrequent occasions, such as all weekend raves, New Year parties, birthdays and special celebrations, although they may or may not use other drugs on a regular basis. If they do use other drugs, it is highly likely that they will use other methamphetamines on a more frequent basis. These users are characterised by planning their ice use ahead of time and will purchase the drug themselves rather than rely on it being offered to them. Older people within the target audiences in the social user group - youth, students, rave partiers, and gay, lesbian and bisexual users - more commonly fell into this category than their younger counterparts.

The final social sub group were social users who claim ice as their drug of choice ('Ice Preferrers'). This sub group may use other drugs occasionally, but ice is the primary drug they seek for use in a social context. Unlike other social users, Ice Preferrers do not regularly use the drug in the context of going out to clubs and so on. The context in which they use is almost always in a house party situation, where circulating the ice pipe results in intense conversation and shared experiences with an 'inner circle' of friends. Often they are older and claim to have 'outgrown' the rave / club scene where speed and base are more commonly used.

Poly drug use is common among social users of methamphetamines (although less so among Ice Preferrers). While speed and base will almost always feature, users will pick among a repertoire of other drugs to enhance the experience of the night. The drugs that are most commonly used in conjunction with speed and base are ecstasy, cocaine (more prevalent in Sydney), marijuana and alcohol. Other drugs used to a lesser extent include dexamphetamine (dexies), GHB (liquid ecstasy), ketamine and a minority also used LSD.

Differences in motivation and behaviour of target groups

While the underlying motivations and the behavioural context of use are consistent across target groups, some audiences exhibited certain motivational and behavioural characteristics that have impact on recommendations. These included:
  1. Differences in availability of the three forms of methamphetamines is exacerbated in rural and regional communities. Inconsistent drug supplies mean that methamphetamine users were more likely to use whatever permutation is available. This may result in many younger users being exposed to stronger forms of methamphetamine than they anticipate, as what they are told is simply 'speed' may be a much stronger form.

  2. Boredom is a key factor contributing to the habitual use of methamphetamines among young people living in rural and regional communities. The smaller social networks in these communities resulted in the perception that there is limited choice of social interaction with people outside those who use drugs, and going to venues where drugs are found.

  3. The enhancement of sex is a key motivator for many gay men using methamphetamines, particularly ice. Some may reserve the use of ice for this activity and only use other methamphetamines for social activities. In certain places and situations drugs, particularly methamphetamines, and sex are considered to go hand in hand. These included sex at on site venues, local parks, and after-club house parties. This often leads to unsafe sexual practices.

  4. Ravers, gay men and rural and regional users were more likely to experience the impact of law enforcement when using methamphetamines. This occurred for ravers when police targeted rave parties, for rural and regional when a police 'crackdown' occurred in the town, and for gay men when police increased their presence at sex on site venues and parks where sex occurs. In these circumstances, law enforcement often prompted a change in strategy of using rather than discontinuing use. This can lead to dangerous practices when greater quantities of drugs are used in a shorter period of time in order to dispose of them quickly.
Top of page

Attitudes to risk and harm prevention

Social users believe themselves to use drugs responsibly. In fact, they are defined as a group by the self-imposed parameters they place on their methamphetamine use. As such, they do not see themselves at risk of harms from their drug usage. They can identify a range of societal, mental and physical risks, but tend to perceive these as only applicable to long term, dependent users. That said, there are a number of physical risks that they identify as possible from short term usage, and are therefore relevant to themselves. These include:
  • teeth grinding and through this, teeth decay
  • loss of weight, which was a concern more for males than females
  • loss of vitamins and nutrients that was detrimental to the body
  • harm from the other ingredients used to 'cut' the methamphetamine and
  • the potential for accident or violence for oneself or from others.
Social users claim to mitigate these risks by chewing gum, ensuring that they eat as soon as possible when coming down, using vitamin tablets, trying to buy from the same source to ensure a consistency in quality of the drug, and always using with friends in case of accident or violence. Rather than identify these as harm minimisation strategies, social users see these actions as part of using drugs responsibly.

Treatment approaches

The majority of social users, particularly younger users, perceive that they will discontinue using methamphetamines in the future as their lives and lifestyles change. They believe that their use will cease when they stop going to raves, clubs, and so on, when they get a 'proper' job, and/or when they settle down with marriage and children. Until then, use of drugs is considered almost as a rite of passage – something that is done when young. Older social users maintain that if they wanted to stop using, they could, and their frequency of use tends to vary and change with what is going on in their lives. Across all, it was considered that if they wanted to stop using, it would simply be a matter of not going to the social places where they tend to use methamphetamines – a self-help approach. As such, social users do not see the relevance of treatment services for themselves.

This lack of relevance is enhanced by a low awareness of treatment and support services outside emergency services (ambulance and police) that can be called on for unforeseen accident or violence, and detox and rehab services that they perceive are only for people who have a long term dependency on methamphetamines. Neither of these options are perceived as likely to have the information on cutting back or stopping use that is relevant to their needs, should they be looking for it. In effect, there is a gap in the services available to social users who may want information on how to cut back on use, minimise harms from using and of where to go for support outside a detox and rehab centre25.

14.2 Social user recommendations

The following recommendations are applicable across all of the target audiences that fit within the social users category - young people aged 16-24 years, university students, rave partiers, gay, lesbian and bisexual users, rural and regional, and some general users aged 25 years or more. As the majority of their methamphetamine use occurs while out with friends at a club, pub, dance venues, raves and so on, a similar broad strategy for the development of interventions can be followed for all.

Patterns of use

  1. Many social users, particularly those that are younger, strongly perceive that speed and base have much lower levels of purity and potency than ice, and therefore do not see similar risks associated with the use of these less pure forms of methamphetamines. This makes some social users susceptible to using forms of methamphetamine that are much stronger than what they originally perceive, as they tend to feel that if the methamphetamine is not white and crystallised, it's not ice, and therefore they feel safer in using. While it would be useful to develop interventions that highlight that there are permutations of base that are almost as strong as ice, this would likely have the reverse effect of lessening the fear that many have of ice now. The current emphasis of the preventative campaign of ice being a much stronger, more frightening methamphetamine, appears to be effective among many younger users and should be maintained.

    That said, interventions that are targeted towards social users should take into account that it is speed and base that are most commonly being used at public venues, so any intervention that targets ice specifically would be considered largely irrelevant. Interventions will need to strike a careful balance between prompting social users to think about their use of speed and base without lessening the risks associated with the other methamphetamines when compared to ice, or in decreasing the impact of the current campaigns that aim to prevent the use of ice.
Top of page

Developing interventions

  1. Development of interventions should recognise the current perceptions of social users in regards to the relevance of support and information services for themselves, as well as addressing the perception social users hold of who these services are currently aimed at (that is, they are only for dependent users). This would require a two-sided approach to development of interventions:
    • interventions should aim at increasing motivations for giving up, cutting back on use and, if required, seeking support and treatment and
    • eliminate the perception that the only services available with information and support are detox and rehab services.

  2. The approach with social users should be one of minimising harms in order to prevent a continuance into more dependent behaviour. Strategies that aim to prevent use would be seen as irrelevant, and likely to not be deemed credible, as users perceive themselves relatively educated on the risks of taking methamphetamines.

Approach 1: Motivating to cut back or cease use

  1. Critical to increasing motivations to give up and cut back among social users will be in recognising that they hold the attitude that they use drugs responsibly. They do not see their use as harmful, as they have a set of control parameters on their use, which they believe differentiate them from dependents. Any intervention that tries to establish that any type of drug use at all is dangerous will be seen as irrelevant, and therefore dismissed. Instead, social users can be challenged to whether they are sticking to the boundaries they place on drug use – effectively asking them to self-assess whether their use is still within the boundaries they determine as responsible.

  2. Other means of motivating social users will be on reinforcing the risks they see as relevant, particularly the potential for accident or violence while doing extreme things – 'doing things they wouldn't normally do' and in the potential for loss of relationships. These are risks that are considered credible by social users.

  3. Organisations such as ACON should be consulted on strategies that are being used to combat the risk of unsafe sexual practices when using methamphetamines. These organisations would have a greater awareness of the issue and of how this risk may be highlighted to gay men in an effective manner.

  4. Recognition should be given to the fact that users will attempt to cut back or quit themselves, and that many will be able to achieve this without the need to access treatment and support services. Consideration could be given to providing information through relevant channels that will assist users in being successful during their attempts at giving up or cutting back themselves.

Approach 2: Raising awareness of appropriate information, support and treatment services

  1. Social users do not know of any information, support or treatment service aimed at them. Currently, they are only aware of detox and rehab services being available to people using methamphetamines, and these are considered as only useful to 'junkies'. Even if they wanted information or support social users would not contact these services as they are not considered appropriate for themselves. Strategies should aim to eliminate the perception that services are only for dependents, and raise awareness that there are services available for people who just need some information on how to go about cutting back.

  2. Critical to this will be in the availability of such services. Strategies to eliminate the perception that information and support services are only for dependents will not be effective unless alternatives to detox and rehab are established. Further, these services should be designed with users of psychostimulants, in particular methamphetamines, in mind.
Top of page

Communication channels

  1. Development of targeted interventions will need to take into account what information can be made available in a more public forum and what should be limited to targeted channels. For example, it may not be suitable to have harm minimisation messages on standard information channels that reach the broader public. However, targeted channels would provide a means of delivering these messages.

  2. Standard information channels, such as the mainstream media, could be used to raise awareness about relevant information and support services and eliminate the perception that assistance services are only for dependents.

  3. Targeted media sources, such as convenience advertising at the locations where methamphetamines are used, and other channels that are specific to each target audience such as student council magazines or newsletters at universities, could be used to deliver messages aimed at motivating social users to contemplate giving up or cutting back on use. For example, a checklist of the boundaries social users place on their usage could be posed as questions on a poster or a hand out at raves. This would provide a tool for self-assessment and encourage users to think about their own use, without being immediately dismissed as just another 'anti-drugs' campaign.

  4. Locations where this type of information could be seen by social users are clubs, dance venues, raves, pubs and so on. Other targeted media sources would include age and gender specific magazines. Information such as this is available from media companies for the mainstream audience.

  5. Strategies that are aimed at the gay and lesbian target group should take into consideration the information and publications that are already produced by organisations such as ACON. Their experience in developing messages and disseminating information for this audience will be important to incorporate in moving forward with this audience.

  6. Similar channels could be used to deliver harm minimisation messages, rather than more mainstream channels.

  7. The Internet could offer a highly effective tool to prompt self-assessment and to deliver harm minimisation messages to social users. Links from websites that are frequently used, such as 'the Pill Report', and others that provide information on what is in drugs, should be considered.

Other strategies

  1. Consideration should be given to the development of more active interventions for certain social user groups. Diversionary programs may be useful in regional and rural communities where boredom and a lack of other social options are key drivers for take up and continued use of methamphetamines. Such strategies will require further development and will also require local community buy in and assistance.

  2. Recognition that law enforcement can lead to dangerous drug taking practices in some instances should be taken into consideration when executing such activities.

14.3 Key findings for functional users

Target audiences

Functional users of methamphetamines can be found among any of the target audiences found within the social users group – young people aged 16-24 years, ravers, students, gay and lesbian users, and rural and regional users. However, functional use was more common among the older users within these groups and among the respondents that fell into the general users over the age of 25 years target group. It should be noted, that functional use by these target audiences groups was often due to excesses of social use rather than primarily motivated for functional purposes. That is, their primary motivations for using methamphetamines were still that of social users.

The target audiences of workers in particular industries such as construction, labouring, hospitality, long haul truck drivers and sex workers, fall directly into the functional user category. However, use of methamphetamines in an employment context is not limited to these only and was found among respondents from a number of industries, including both unskilled and semi-skilled roles. As well as the targeted industries (trades and construction, labouring, driving, hospitality and sex workers) functional use was found in more professional roles such as IT, management, finance, and in the area of health. University students can also be included in this behavioural context when using to study or to complete assignments to meet a deadline.
Top of page

Characteristics of functional users

Functional use of methamphetamines is associated with achieving a specific task, most commonly in the context of employment. The key motivation is the enabling effect of the drugs, with methamphetamines used to enhance confidence, alertness, concentration, motivation, energy and stamina, depending on the nature of the task. Increases in one or all of these characteristics effectively enable the user to achieve the task more quickly or more thoroughly.

Functional users are characterised by the way they justify their drug use to themselves. Many see their use of methamphetamines as a 'means to an end' and usually do not acknowledge the illicit nature of methamphetamine use. Further, many functional users are reluctant to see themselves as drug takers, particularly the more regular users. Instead, many see themselves as workers simply trying to get the job done or people with a goal to achieve.

Types of methamphetamines used

Speed and base are the common choice of methamphetamine used in this behavioural context due to the longer lasting, lower intensity effects of these two drugs compared to ice. Speed and base are considered more suitable for tasks of longer duration such as a day labouring, long periods of time spent driving or concentrating on details. Ice may be used in a functional context by those who require a more intense effect over a shorter period of time. For example, some sex workers prefer the intense short term high of ice. As with all target audiences, preferences for a particular form of methamphetamine are usually balanced against availability.

Typical routes of administration for methamphetamines in this context varied widely. They could be from labourers who may snort powdered speed, to trade and construction workers who regularly dissolve base in water to ingest, to drivers that are regular injectors. Note, these are examples only. Different routes of administration were used across all industries.

Patterns of Use

Users in a functional context can be segmented into three sub groups, two of which illustrate contexts where the line between social use and functional use becomes blurred. The first of these 'Manic Mondays', are social users who have experienced a lapse in discipline. Methamphetamine use is very much a social activity to undertake with friends, but these users also take drugs to get through the first day of the working week following social use. This usually occurs when the social occasion lasts longer than expected and users allow themselves to break one of their own rules of not using at work, or during times of the year when a lot of festivals or raves are happening. The next functional sub group, 'Slippers', are functional users who regularly use methamphetamines to get through the working day or a specific task. They typically evolve from Manic Mondays, as their attitudes and behaviours become increasingly comfortable with more regular, mid-week use.

Some university students fall directly into the category of Slippers. They regularly use methamphetamines to enhance their energy and concentration for study and assignments. These students will actively seek out methamphetamines specifically for this reason, rather than simply to recover from using them the night before.

Both of these functional sub groups can include any of the social using groups that are discussed above. They tend to identify similar risks and harms and have similar awareness and knowledge levels on treatment services.

The final functional sub group, 'Workers' differ greatly from others within this behavioural context. This group tends to encapsulate workers from the specific industries that are identified in the research brief, however is not limited to these only. Workers use methamphetamines almost exclusively for functional reasons, usually for improving performance on the job, rather than as part of social interactions. For example, methamphetamines are used in construction and labouring to keep up energy, stamina and motivation and to get the job done as quickly as possible. For truck and other drivers, methamphetamines help maintain alertness and concentration during long hours on the road and enable them to maintain tight deadlines. .Hospitability workers use the drugs for all of these reasons over the long shifts they do.

The key distinction between Workers and other functional user groups is that they are more self-permitting of their own usage behaviour. Whereas Manic Mondays and Slippers identify that their functional use is a result of their social use, and will fear being caught using at work as it may results in job loss, Workers often perceive their drug use as a 'necessity' for keeping their job. Workers in industries where employment is short term contractual or where there is a high degree of competition for roles, such as labouring and construction, often feel trapped into continued use. Anecdotal evidence indicated that drug use was accepted, even encouraged, by a small minority of employers.

Behaviours among Workers can border on dependency with use being frequent and sometimes continuous over comparatively longer periods (from four to seven days in succession depending on the role). Some may continue use of the drug to time spent outside of work in order to avoid a comedown.
Top of page

Attitudes to risk and harm prevention

Like social users, functional users are aware of many of the risks associated with drug use but tend to see most risks as only relevant to those who use frequently over a long period of time. And again, similar to social users they will more readily identify with the impact of some physical risks that they can see might affect them in the short term rather than other societal or mental risks.

Unlike social users, functional users see the possibility of loss of employment as the biggest risk to their drug taking, however, this is viewed differently according to which sub group they are in. The sub groups of Manic Mondays and Slippers (social users who have gone too far) fear calling in sick, so use methamphetamines again to enable themselves to get through a workday. However, they fear the potential of getting caught using at work and subsequent loss of employment. These groups - Manic Mondays and Slippers - advocate many of the same parameters of responsible use as social users and are often aware that they have broken the boundaries they set themselves, particularly those around employment. They may hold some fear of increasing dependency, given the frequency with which they are using although they still maintain guidelines surrounding their use in order to minimise long term risk.

In contrast, for many of those who fall into the Workers, loss of employment is more to do with not taking drugs than taking them. For this group, their use of drugs is due to the need to continue in employment. Workers are usually aware of the frequency with which they use and have a set of boundaries that they claim differentiate them from dependents. These include using smaller, measured amounts (not bingeing), having regular days off using, maintaining control over and managing other areas of their life such as finances and homelife, and most importantly maintaining employment. It is this last point that is the critical boundary that Workers most strongly believe differentiates them from dependents. In their perception, people who have become dependent on methamphetamines are not able to maintain a family, relationships and employment. The fact that they can is the key factor in Workers believing themselves as not being dependent or an 'addict', despite the frequency with which they use methamphetamines.

Treatment approaches

Functional users have the same lack of awareness in regards to treatment and support services outside of emergency services and detox and rehab as social users. Similarly, they tend to carry the same perception of detox and rehab services as social users, that is, they are for "junkies". One of the key factors that these users claim differentiates them from "junkies" (or dependents) is their maintenance of employment. The Catch-22 is that this is the very aspect of their lives that motivates Workers (within the functional user group) to use, and is also the key barrier to seeking support or treatment. All functional users, but Workers in particular, fear that taking time off work to receive treatment and support would directly jeopardise income. This fear is exacerbated in the small number of cases where methamphetamine use is expected in the work place (by the individual, the industry, other employees and even the employer).

As these workers do not perceive themselves as having any options for treatment and support than rehab and detox, they do not identify any services as relevant to their specific needs. While they may fear that their frequency of use indicates increasing susceptibility to dependency, they do not see themselves as a dependent, and they do not see the services on offer as suitable for them.

14.4 Functional user recommendations

The following recommendations have been designed predominantly for the Workers sub group of the functional user category. These can be applied directly in the industries specified as of interest in the research brief –construction, labouring, hospitability and long haul truck drivers as well as other industries that the research indicated has relatively high usage of methamphetamines. Some recommendations have also been made for students that use in a functional context. The recommendations that have been provided for social users can be used to target those functional users that fall into the Manic Mondays and Slippers categories.

Key to discouraging use within the specified industries would be to eliminate the reasons that Workers need to maintain high levels of concentration and alertness over time. For example, long haul truck drivers will be less likely to take methamphetamines if they did not have to stay awake and drive for long periods to meet tight deadlines. Similarly, hospitability workers would be less likely to use methamphetamines in a functional context if the did not have to work such long shifts with few opportunities for social activities. Unfortunately, recommendations in regards to regulations and nature of each occupation are unpractical and this avenue has not been pursued in the development of recommendations.
Top of page

Patterns of use

  1. The underlying motivation for use of methamphetamines by Workers in particular industries is on maintaining employment. As such, they justify their usage as it provides a means to an end and they identify the loss of employment as a strong barrier to stopping use. Exacerbating this barrier, is the perception that it is their maintenance of employment that sets them apart from dependent users.

    The overarching strategy for the development of interventions aimed towards Workers should take into account the fear that they hold of stopping use of methamphetamines being equal to a cessation of employment.

Developing interventions

  1. Critical to development of interventions for Workers will be providing information, support and treatment options that allow users to maintain employment. This will directly address the perception they hold that the only options for support services are detox and rehab centres, and that they will have to take time off work to attend.

  2. A two-sided approach to the development of interventions could be pursued with Workers from specific industries. As with social users, interventions should aim to:
    • increase motivations for giving up, cutting back on use and if required seeking support and treatment and
    • eliminate the perception that the only services available with information, support and treatment are detox and rehab services.

Approach 1: Motivating to cut back or cease use

  1. Workers will only be open to being motivated to cut back and/or cease use of methamphetamines if they can be, firstly, reassured that they can stop using methamphetamines and maintain employment. Interventions should make allowances for this or the cessation of use will not be considered.

  2. After this, Workers should be motivated to cease use by being challenged about the frequency of use. Most fear dependency and will respond if measures are provided on how to cut back on use without jeopardising their employment.

  3. Recognition should be given to the fact that users will attempt to cut back or quit themselves, and that many will be able to achieve this without the need to access treatment and support services once they are motivated to do so. Underlying both the recommendations above should be the provision of information on possible approaches that will assist Workers in their attempts to quit on their own and still maintain employment. For example, encouraging a long haul truck driver, who is accustomed to using methamphetamines on long trips, to cease use, will be more effective if alternative methods or hints on how to accomplish the trip are provided. Similarly, providing measures to hospitality workers on how to complete long shifts at work, and also enjoy options for social activity in the their time off that do not involve methamphetamines would be useful.
Top of page

Approach 2: Raising awareness of appropriate information, support and treatment services

  1. Workers are only aware of information, support or treatment services that they perceive are for dependents, that is detox and rehab. As they believe they are not dependents (as proved by them maintaining employment in their perception), they will not consider these services. Measures to raise awareness about information and support services that are aimed specifically at people who feel they must use to maintain employment should be implemented.

  2. Before the above recommendation is considered, there is a need to identify if such services are available and/or possible.

Communication channels

  1. Standard information channels such as the mainstream media could be used to raise awareness about information and support services that are not detox and rehab, and that focus specifically on methamphetamines. This will assist in eliminating the widely held public perception that drug assistance services are only for dependents.

  2. Any interventions that aim to raise awareness of methamphetamines as an issue, and/ or motivate Workers to contemplate stopping use, should be developed and delivered in cooperation of the relevant industry bodies – truck driving associations, hospitality organisations, regulators for construction and labouring industries. These industry bodies will be best placed to understand appropriate specific communication channels for Workers within these industries.

Other strategies

  1. More active interventions within industries should be considered. Workers in some industries may benefit from encouraging active interventions by employers to provide industry specific support information. With the support of industry bodies it may be possible for industry wide drug testing to be used to discourage use. This was seen as particularly relevant for drivers (truck and taxi), but may be able to be applied across the construction and labouring industries.

  2. Any of these active interventions should consider the views of the relevant industry body, and will be more effective if developed and implemented with their cooperation.

Recommendations for university students that use in a functional context

  1. The majority of university students that use methamphetamines in a functional context are also often social users. Therefore, they will be exposed to the same interventions as social users. Consideration should be given as to whether it is appropriate to deliver additional messages regarding the functional use of methamphetamines among students through targeted channels. As an important element of targeting these students will be openly recognising the behaviour that they feel is secret, and asking them relevant questions in regards to their use, any communications may also expose other students to the concept of using in a functional manner. In turn, this could motivate or encourage use.

  2. If university students that use in a functional context are targeted with specific messages, they may be motivated to consider stopping use or cutting back through a fear of dependency. Students have the perception that they will stop using once they get through the busy times at university, achieve their degree and get out into the 'real world'. Thus some will be motivated to reconsider their use by being challenged:
    • on their frequency and need to use to complete assignments
    • on whether they are sure they will stop using when they graduate and begin their careers and
    • on whether they have become reliant on methamphetamines to enhance their mental performance.

  3. Communication channels for students who use in a functional context include the Internet (via relevant website) and on-campus information and websites. Like students who use in a social context, tools for self-assessment could be delivered via these means.

  4. Other information that could be considered helpful by students who use in a functional manner will be:
    • tools and strategies on how to get through exam periods without using methamphetamines
    • information on ways to stop using by themselves (if they are finding it difficult to do so) and
    • the availability of support and treatment services that they can seek help from if they feel it is required. As some criticism was levelled at services that are available on campus, this information should include those available off campus also.
Top of page

14.5 Key findings for dependent users

Target audiences

Dependent users could be found across the majority of the target audiences identified in the research brief, however, they were most commonly older users within the these groups. Further, many respondents that fell into the Dependent behavioural context were drawn from the older general groups aged 25 years or more. These came from a broad cross section of society. Where some respondents in the dependent behavioural context are from low socio-economic or unemployed backgrounds, others work in skilled and semi-skilled employment, for example, clerical positions, nursing, IT, and finance.

Characteristics of dependent users

For the purpose of this research, dependent use was categorised using the following definition: 'uncontrollable, compulsive drug seeking and use, even in the face of negative health and social consequences'26. This definition was used as it encompasses both psychological as well as physical dependence. Both health and social problems are included as indicators of addiction, rather than symptoms related to physical withdrawal being the only determining factor.

Users in the dependent behavioural context demonstrated an uncontrollable, compulsive craving for either the drug, or the act of taking the drug (particularly injecting). This was claimed to be what prompted their next act of using. The primary motivators for continued use by this group included the temporary escape that methamphetamine use allows from mental and lifestyle problems, the sense of 'normality' that they perceive use as providing, and for many injectors, the psychological fulfilment gained from using the needle. Frequency of use among dependent users may range from three to four days per week to several times per day.

Types of methamphetamines used

The more pure forms of methamphetamines such as base or ice are generally preferred by this group. Typically they were injectors (usually had a preference for base) or smokers (usually had a preference for ice). Some claimed to change their preferred method of administration depending on the methamphetamine available, for example, some regular injectors claimed to have a preference for smoking ice over injecting it if it was the methamphetamine available.

Patterns of use

Based on differences in demographics, polydrug behaviours, attitudes toward ice and mode of administration, three behavioural sub groups of dependent users were able to be identified.

Two of these, 'Meth Devotees' and 'Ice Zealots', were similar in many ways. These two sub groups regularly used methamphetamines, but never heroin ('methamphetamine only' dependents). The majority of respondents in these two sub groups claimed to be employed, and their drug use is often highly confidential.

Despite these similarities, differences existed between the two sub groups. Most Meth Devotees claimed to have used methamphetamines for a long time and often regarded these drugs as a necessary pick me up in the morning (much the same way other people regard their 'morning coffee'). They have a preference for speed or base, are usually injectors, and rarely use in a social context. This group often relate their dependent use to a trauma or other instance in their life where they allowed their personal parameters on usage to slip and they became accustomed to continued use. In contrast, Ice Zealots regularly use in a social context as well as frequently alone. Their preference is for ice over other methamphetamines, and the primary mode of administration is smoking. Dependency appears to be more of a gradual slide from social smoking to more regular, solitary use rather than a specific trauma or instance in their lives (as with Meth Devotees). They are regular poly drug users.

The final dependent sub group, 'Heroin Co-Dependents', represent the extreme of all methamphetamine users. This sub group differ markedly from other dependent groups and are characterised by their current or past use of heroin and heroin replacement therapies. Heroin Co-Dependents often rationalised their motivation for using methamphetamines as inherently linked to the psychological fulfilment of injecting, rather than the effects of the drug itself. This motivation is not found among other groups with injectors. After this, the motivation for use of methamphetamines is often due to the poor availability or quality of heroin. This group prefer base and ice, however, Heroin Co-Dependents are the least discriminatory of all user groups concerning their choice of methamphetamines. Drug use is frequently alone and can be as often as several times a day.
Top of page

Attitudes to risk and harm prevention

Many dependent users found the long term societal risk factors that all respondents identified as possible with long term use as relevant to themselves. Many had experienced loss of employment and the need to find other methods of gaining money such as sex work or theft, loss of family (including some mothers whose children had been removed from them), and the potential for violent behaviour towards others. However, a number of dependents in the Meth Devotees sub group did not consider these as relevant to themselves as they claimed to lead a 'normal' life despite being regular injectors of speed or base.. This was seen to be illustrated by their ability to maintain employment, finances and relationships with others. This group is differentiated from the functional Workers sub group, as they openly admit to using the drug everyday in order to continue living a normal life rather than for work purposes only.

Dependents were less willing to admit that they found the long term physical or mental risks that were identified across groups, as relevant to themselves. . While they might have felt these harms could occur to others, very few claimed to experience these themselves. For example, while they might admit to "freaking out" while on methamphetamines, none claimed to have experienced any form of speed psychosis.

Perhaps the most relevant risk that dependents identified was the possibility of contracting blood borne diseases through sharing of needles. However, all dependents claimed to practice needle hygiene and felt that the access provided to clean and safe equipment at needle exchange programs ensured that they never shared equipment (although most claimed to know others that did).

Treatment approaches

As dependent users accept their reliance on methamphetamines, they tend to have greater awareness and knowledge that treatment and support services are available with many able to identify by name the detox and rehab services local to their geographic area. Many had experienced these services. Injectors tended to be aware of the local needle and syringe programs and 'Heroin Co-dependents' knew of clinics that offered heroin replacement programs. Despite this greater knowledge, dependent users had the same difficulty as social and functional users in identifying alternative treatment and support services besides emergency services and detox and rehab.

The drivers behind dependent users having previously sought out assistance from treatment and support services were problems with the law, or pressure from family or friends. For a small number it had been loss of employment. Those that had experienced treatment and support identified the key barrier to attempting again, had been the failure to succeed the first time. Critically, their expectations of what they would receive at support services were not met. Further many identified a lack of support and difficulties experienced finding housing, employment and so on after detox and rehab as influencing their decision to start using methamphetamines again. Many believe that they would have been more likely to be successful after treatment if their addiction was assisted by a methamphetamine substitute.

14.6 Dependent user recommendations

Patterns of use

  1. Recognition should be given to the stark differences found between dependents who only used methamphetamines and those who also used heroin. Those who use 'methamphetamines only' tend to perceive themselves as more capable to functioning in the 'normal' world than users of heroin. This has implications in how services are developed and targeted.

  2. Similarly, there is a tendency in public information to associate dependent use of methamphetamines primarily with ice. Any interventions and services developed for dependent users should be designed in recognition that this is not the case in reality (although ice will be used if other methamphetamines are not around). Top of page

Developing interventions

  1. Currently, dependent users have the perception that support and treatment services do not cater for the unique needs of a 'methamphetamine only' user, compared to a heroin co-dependent user. This creates much of the negativity towards existing services and the fear of attempting to use them either for the first time, or for a repeated attempt. Interventions for dependent users should be focused on assessing the suitability of the services themselves for methamphetamine users before any attempts to address the perceptions of these services should be considered.

  2. Methamphetamine users who do not use heroin feel that their needs in regards to treatment and support services are different than heroin users in the following ways:

    • They perceive their 'addiction' as primarily psychological, rather than physical, and it is claimed that 'detox and rehab' services are not perceived to cater for their immediate and ongoing psychological needs for any length of time. It is perceived that they seem to be better equipped to getting heroin users on heroin replacement programs, then placing users into the community again. As 'methamphetamine only' dependents do not have a replacement therapy they perceive their psychological needs as different and the real core of their addiction rather than physical elements.

    • For many, their greatest fear is that they will not be able to function 'normally' in society without methamphetamines. By services advocating that users 'cut ties and start fresh' (as it is claimed that many do) this fear is exacerbated rather than overcome. While this approach may be necessary for some users, it is considered with trepidation by most. This service approach then becomes a key barrier for methamphetamine users in seeking treatment.

    • Existing services almost always use a residential 'detox and rehab' approach which is a barrier to those who do not want to leave existing employment (as many Meth Devotees claimed to be in) to get assistance. It is perceived that the majority of heroin co-dependents do not have jobs to lose when wanting to seek treatment.

    • There is no methamphetamine substitute as there is a substitute for heroin. While most identify that their addiction is predominantly psychological, they feel that such a substitute would help in dealing with difficulties they encounter in adjusting to not using methamphetamines. The alternative of not having a substitute (going 'cold turkey') is a barrier to contemplating treatment.

    An assessment should be made as to whether existing treatment and support services are equipped and knowledgeable about the different needs of methamphetamine users (such as those mentioned above), as opposed to those who use also use heroin, and as to whether these perceptions and claims are accurate from the service perspective. A more detailed understanding on these issues, and what they would recommend in regards to treatment of 'methamphetamine only' dependents, should be gained from those working in treatment and support services.

  3. Given the current perception that there is a lack of treatment and support services that are both trained and equipped to assist with methamphetamine users, some consideration should be given to providing staff of hospitals and established drug and alcohol services training about the specific needs of those dependent on methamphetamines. Users currently feel that there is a stigma attached to methamphetamine users among the staff of these generalised services, which is a barrier to seeking treatment and support.

  4. Only after such an assessment of the status of services is completed should attempts to change the existing perception that dependents have of services be considered. Channels of communication through which this could be done are through frequently used programs such as needle and exchange centres, other service providers, and user websites.
Top of page

14.7 Indigenous user recommendations

Difficulties in recruitment in Indigenous communities (discussed in the methodology and in the previous section) resulted in a skew in the sample to urban, dependent users. This has an impact on the recommendations that can be made in regards to the target audience.
  1. Although the research was unable to ascertain the prevalence of methamphetamine use within Indigenous communities, stakeholders clearly felt that there was a role for prevention messages to discourage initial use within this target audience, as some saw it as an issue that could increase in significance.

  2. Both users and stakeholders identified that the risk for psychosis from methamphetamine use, as shown in the recent ice advertising on television, was an effective and critical message to use within a campaign aimed at prevention. Given the claimed resonance of this message in this target audience, consideration should be given to further developing this message for Indigenous communities.

  3. It was also suggested by stakeholders that diversionary programs should be considered within an approach aimed at prevention. This assists in acting as a barrier to take up of methamphetamines due to boredom or a sense of disempowerment.

  4. It was also apparent that there is a need for harm minimisation messages to be provided for people already using methamphetamines within Indigenous communities (as has been recommended for other target audiences who use in a social behavioural context).

  5. While users suggested television as an appropriate medium for these messages, this should be balanced with broader policy objectives in regards to drug use. As with other audiences, harm minimisation approaches may be better suited to targeted communication channels, such as age, gender and/or culturally specific print media, or locations where methamphetamines are commonly used such as clubs and pubs.

  6. As suggested above in the dependent users section, some consideration should be given to providing education about methamphetamines for staff in hospital and drug and alcohol services to assist in overcoming the stigma that is perceived to be attached to users.

  7. The community approach that the Block in Redfern has used of 'banning' ice usage should be highlighted to empower other Indigenous communities. This allows each individual community to own the decision to limit the impact of drugs within their community. Such an approach has been used effectively for other substances.

  8. The use of role models - people who have overcome difficulties with methamphetamines - delivering messages on minimising harm from use and in overcoming addiction could be an effective tool to get Indigenous users to contemplate treatment.

  9. If this avenue is pursued it should account for the diversity within Indigenous communities in terms of age, lifestyle, and location (remote, regional and urban).

25 The exception to this perceived lack of services was among the gay and lesbian community, where established organisations such as ACON provide such information.
26 Leshner, Dr A.,Director of the National Institute of Drug Abuse within the US National Institute of Health, the essence of drug addiction page on the NIDA website

Top of page