ATS Literature Review, Consultations & Trial - Odyssey House

Amphetamine‐Type Stimulants: Development of a Treatment Protocol
Most young people who initiate substance use will not develop significant problems.
Experimentation and a variable pattern of onset and termination are therefore common (Newcomb
& Bentler, 1989). However, the aetiologies of substance use initiation, occasional use, regular use
and dependency may be different (Hawkins, Lishner, Catalano, & Howard, 1985). Hence it is
possible that some young people may be more likely to experiment, to experiment earlier, and to
find such experimentation rewarding. Young people who maintain and escalate their use are
believed to be more vulnerable to the presence of more problematic backgrounds and lack adequate
and accessible internal and external resources (Howard, et.al., 2007).
1.5. Problems associated with ATS use
The number of recorded hospital separations 2 for people with drug‐induced psychosis as the primary
problem among those aged 10–49 years increased from 55.5 per million population in 1993–1994, to
253.1 per million population in 2003–2004. In 1999‐2000, the total number of hospital bed‐days for
amphetamine‐induced psychosis was 5,679, increasing to 8,068 in 2003‐04. In 2004/05 there were
15,000 recorded drug treatment episodes for amphetamine or methamphetamine (AIHW, 2006).
Amphetamines accounted for the largest proportion of all drug‐induced psychosis separations from
1999–2000 to 2003–2004, ranging from 41% in 1999–2000 to 55% in 2003–2004, while cannabis
accounted for 39%–45% of separations over this period (Degenhardt, Roxburgh, & McKetin, 2007).
The number of both cannabis‐ and amphetamine‐induced psychosis separations per million
population was highest among the 20–29‐year age group, while age‐specific rates among the 10–19‐
year age group were lower for amphetamine‐induced psychosis than for cannabis‐induced psychosis
(41.6–61.9 and 80.5–111.1 separations per million population, respectively). Data collected over this
period also showed that age‐specific rates for cannabis‐induced psychosis remained relatively stable
across all age groups, compared with steady increases for amphetamine‐induced psychosis
(Degenhardt, et.al., 2007). While some of these presentations will remit, others will clarify into a
diagnosis of schizophrenia (Howard, et.al., 2007).
Increasing doses of ATS may exacerbate the risk and severity of problems, both in terms of physical
and mental health. There is growing evidence about a range of problems, including:
• Cardio‐vascular problems, including hyper‐ and hypotension, increased heart rate and
irregular heart‐beat;
• Risk of cardio‐vascular and cerebro‐vascular crises, such as stroke, in vulnerable individuals;
• Mental health problems, including confusion, paranoia, anxiety, depression and psychosis;
• The likelihood of developing a dependency, especially associated with injecting ATS and
smoking crystalline forms of methamphetamine;
• Risk of blood‐borne viruses (e.g., Hepatitis C and HIV);
• Low levels of concentration;
• Cognitive impairment;
• Poor eating habits, often resulting in poor general health;
• Sleep disorders, tiredness and fatigue;
• Agitation, aggression and violence;
• Increased impulsivity and risk taking;
• Social and family disruption; and
• Accident and injury resulting from the above conditions (NATSS, 2008).
2 Hospital separations refer to the reason for a patient’s stay in hospital based on their medical records after
treatment has been completed, rather than the reason for admission.
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