National Amphetamine-Type Stimulant Strategy Background Paper

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Chapter 5: Treatment and Service Provision
5.1 Amphetamine-type stimulant treatment presentations
As indicated in Chapter 3, there are a number of adverse consequences arising from
use of amphetamine-type stimulants (ATS). However, as noted in a review by Baker and
colleagues (2004), many amphetamine users do not seek treatment and often have a weak
relationship with treatment services in that retention rates are low. Earlier reviews observed
that this was to some extent because the services were not perceived as being oriented to
ATS users’ needs and offered little in the way of specific treatment for ATS related problems.
Rather, they were largely designed to provide treatment to alcohol and opioid problems
(e.g., Kamieniecki et al., 1998; Vincent et al., 1999).
While the last decade has seen improvements in the knowledge base to guide interventions,
and many services have mobilised to respond to the challenges set by increased ATS use,
the clinical evidence base continues to lag behind that which exists for treating other drug
problems, such as tobacco, alcohol and opioid dependence, and treatment links with people
affected by ATS use remain tenuous. With this in mind, it is also pertinent to point out that
many of the approaches used to engage and treat other drug dependent clients are relevant
to working with ATS dependent individuals (e.g., building a therapeutic alliance; good
assessment; identification of underlying and co-existing conditions; integrated as opposed
to disaggregated care for co-existing problems).
Discussions focused on treatment were dominant throughout the consultation process.
Some general observations included the need:
• To seek the input of drug users to determine what works;
• For specific ATS treatments versus blindly applying what works for other drugs;
• For more research to define a typology of different presentations matched to best
practice in treatment;
• To adopt a holistic approach that addresses the broader socioeconomic issues rather
than just the immediate presentation;
• To build the evidence-base to inform treatment; and
• To provide better support, resources and improved access in relation to treatment
in rural and remote areas.
While acknowledging the observation that there is more limited use of treatment, recent
Australian national data suggest that many ATS users do access treatment. The ‘Alcohol
and Other Drugs Treatment Services in Australia 2004-05: Report on the National Minimum
Data Set’ (Australian Institute of Health and Welfare, 2006a) is the fifth report in the series
of annual publications that provides information about clients using treatment services in
Australia by the principal drug of concern. Data contained in the Alcohol and Other Drug
Treatment Services National Minimum Data Set (AODTS-NMDS) refer to ‘closed treatment