ATS Literature Review, Consultations & Trial - Odyssey House

Amphetamine‐Type Stimulants: Development of a Treatment Protocol
associated with ATS use; the management of co‐existing anxiety and depression; and the
management of severely dependent ATS users who are resistant to standard interventions.
3.1. Characteristics of methamphetamine users entering treatment
The Center for Substance Abuse Treatment in the US funded the Methamphetamine Treatment
Project to evaluate and compare treatment approaches for methamphetamine users. As part of this
study, drug use patterns, history of physical and sexual abuse, history of suicidality and
psychopathology were assessed in 1016 methamphetamine clients between 1999 and 2001 across
eight sites (Christian, Huber, Brecht, et.al., 2007). Of the 1016 participants, 55% were female and
45% were male. The mean age was 32.8 (SD=8.0 years) and participants reported using for a mean
of 11 years (SD=7.7 years), with 5 of these years recognised as frequent or problematic use.
The study found that participants struggled with psychological issues, including depression and
anxiety symptoms. Twenty‐six percent had symptoms which were severe enough to have required
admission to a psychiatric facility, 32% had been on prescribed psychiatric medications at some
point in their lives and 19% reported visual or auditory hallucinations. Sixty percent of participants
in this study had suffered from depression at some point in their lives, 34% admitted to thoughts of
suicide and 21% had attempted suicide at some point in their lifetime (Christian, et.al., 2007).
Another significant factor for many ATS users is sexual abuse, and this study found 20% of both men
and women had been sexually abused. A total of 39% of the total sample, and 58% of the women
also reported having been forced to engage in sex. Participants admitting to sexual abuse also
demonstrated significantly more psychological distress and scored more highly on psychotic‐like
thinking, anxiety, depression, suicidal ideation, and suicide attempts than those without a history of
abuse (Christian, et.al., 2007).
Baker, Boggs and Lewin (2001), in their study of 64 regular amphetamine users in Newcastle (NSW,
Australia), found high levels of psychopathology, social dysfunction, criminal behaviour, poor health
and high levels of unemployment. The Opiate Treatment Scale, amphetamine version of the
Severity of Dependence Scale and the Contemplation Ladder (to determine stage of change) were
administered.
Although 40.6% of subjects reported being at the preparation or action phase, the majority of
subjects were at earlier stages, indicating a need for a range of interventions to be available for
users at different stages. It is suggested that clients in the precontemplation and contemplation
stages may be best accessed via needle and syringe programs or primary health care, where brief
interventions may be delivered with harm reduction goals (Baker, et.al., 2001).
Currently, the National Drug and Alcohol Research Centre (NDARC) is conducting the first Australian
longitudinal cohort study of dependent methamphetamine users. The Methamphetamine
Treatment Evaluation Study (MATES) is examining:
• Rates of psychiatric disorders and psychotic symptoms among people seeking treatment for
methamphetamine dependence. This includes Major Depression, Panic Disorder,
Agoraphobia, Social Phobia, and Generalized Anxiety Disorder;
• The characteristics of those entering treatment for methamphetamine dependence.
Information included in the study relates to abstinence rates, criminal involvement, general
health functioning and contact with health services and the criminal justice system;
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