Forum proceedings/overview of workshop TimeActivities 6.30pm – 7.15pmSetting the scene – expert speakers 7.15pm – 7.30pmWhat can you do? 7.35pm – 8.30pmQ & A Panel discussion:

See the person not the drug

Powder methamphetamine ‘speed’ 10% purity Usually snorted or injected Damp/oily methamphetamine ‘base’ 21% purity - Usually swallowed Crystalline methamphetamine ‘ice’ or ‘crystal meth’ Up to 80% purity Usually smoked or injected AMPHETAMINE TYPE STIMULANTS (ATS) Methamphetamine Amphetamine Ice Base Other pharmaceuticals Dexamphetamine Pills and powders (speed)

History of ATS

What’s going on with “ice” in Australia? Data suggests existing users switching from ‘speed’ to ‘ice’ 70% of users are occasional users 30% of users are regular users – 10-15% of users are weekly/daily users The heaviest users of this drug are year olds Use is also higher in those who: – are already engaged in drug use – unemployed – live in regional and remote areas – LGBTQI communities Various data sources report: – treatment seeking and emergency department admissions increasing – higher purity of the drug available – price of ‘ice’ decreasing Source: NDSHS, 2014, Australian Institute for Health and Welfare

How does methamphetamine work? Dopamine Pleasure Motivation Attention and memory Planning Noradrenaline Arousal Mood Attention Flight or fight Serotonin Mood Sleep Cognition Perception Body temperature

Immediate effects Low dose: Euphoria (high) Confidence Alertness Motivation Talkativeness Decreased appetite Increased: Energy Heart rate Body temperature Sex drive Higher dose: Aggressiveness, hostility and violence Nervousness, anxious, agitation, paranoia, hallucinations, etc. Psychotic symptoms Overdose/stroke/seizure

‘Crash’ Exhaustion, fatigue Sleep disturbance Mood disturbances – typically flat mood Cravings Generalised aches and pains

Decrease motivation Depression and anxiety Poor concentration/memory Psychotic symptoms Agitation and aggression Disturbed sleep Long term effects Weight loss Dependence Chest pains Damage to dopamine receptors

Jay’s story

Know that help is out there Withdrawal and treatment

Types of treatment available include: Withdrawal management/detoxification programs Stimulant Treatment Program (STP) Counselling – out-patient Residential rehabilitation Online and phone counselling (24 hours) Youth specific services (outreach) Aboriginal specific AOD services Mental Health services Self-help/peer support (Crystal Methamphetamine Anonymous or Narcotic Anonymous programs) Family support/therapy

PhaseTime since last useCommon signs/symptoms Withdrawal Typically commences 2-4 days after last use Peaks in severity over 7-10 days Subsides over 2-4 weeks Strong cravings Fluctuating mood and energy levels: irritability, restlessness, anxiety and agitation Fatigue Disturbed sleep including vivid dreams, insomnia General aches, pains, headaches Muscle tension Increased appetite Poor concentration and attention Disturbances of thought and perception can re-emerge Withdrawal

Counselling works The earlier people seek treatment, the better the outcome Brief therapy: 2-4 sessions increases abstinence rates in dependent users Mid-length therapy: showed that 12 sessions of Acceptance and Commitment Therapy and mindfulness reduced drug use Long term therapy: showed residential rehab is effective increasing abstinence

Pharmacological treatment Currently no ‘magic pill’ (drug based treatment) available to treat ‘ice’ dependence Managing the symptoms of withdrawal/detoxification through medication may be helpful Brief psycho-social treatment (i.e. counselling) seems to be the most effective in treating people who are dependent on ’ice’

Working with families Stay connected to the person Provide information and support Explain how their behaviour is impacting you/family life Understand ‘binge and crash’ cycles and home life Psychosis Crisis plans

Responding to an intoxicated person Be aware that an intoxicated person has impaired judgement and will probably see the interaction differently to you Create a calm environment – try to promote a positive, helpful interaction Maintain a calm, non-judgemental respectful approach Allow more personal space than usual Call an ambulance/police if you are worried about medical emergency/violence

We’re all in this together Prevention and what can we do?

It takes a village... “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead

Source: Kimberly midnight swimming program shelters Aboriginal teens

We know why people take drugs We know the harms We know the risk factors People use alcohol and drugs every day

Risk factors Disconnection Abusive relationships Trauma Mental illness Unemployment Availability Friends/peer use

What can I do? Be informed about alcohol and drugs Be a good role model/mentor Discuss alcohol and drug use with your child Join your local Community Drug Action Team Join a ‘Good Sports Club’ Develop safe environments that reduce risk of harmful drug use Be part of the solution

Summary Crystalline methamphetamines use still relatively low – and the majority of users are taking the drug less than monthly Where use is high the impact is great – for both the user and their family and friends The drug is more available, cheaper and purity is high Help and support is available – treatment works Communities can address AOD issues

Debbie’s story

Where to go for more info? THIS NEEDS TO BE UPDATED FOR YOUR LOCAL AREA Alcohol & Drug Information Service (ADIS) NSW: Sydney metropolitan: Regional & rural NSW free call: * Stimulant Treatment Line (NSW only) Sydney metropolitan: Regional and rural NSW free call: * Family Drug Support