National Amphetamine-Type Stimulant Strategy Background Paper

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4 Table 1.1: <strong>Amphetamine</strong>-type stimulants commonly used in Australia Drug type Common names Forms Route of administration <strong>Amphetamine</strong>, dexamphetamines Speed, whiz, uppers, goey, dexies, pep pills White, yellow, pink or brown powder or tablets Oral, intranasal, injection, anal Methamphetamine Meth, speed, whiz, fast, uppers, goey, louee, Lou Reed, rabbit tail, pep pills; in paste form can be referred to as base, pure, point or wax; in liquid form can be referred to as leopard’s blood, ox blood, red speed or liquid red White, yellow or brown powder, paste, tablets or a red liquid Oral, intranasal, injection, anal Crystalline methamphetamine hydrochloride (D-methamphetamine)— purified methamphetamine Ice, meth, d-meth, glass, crystal, batu, shabu (from the Philippines) Crystal—resembles crushed ice Smoking, intranasal, injection 3,4-methylenedioxymethamphetamine (MDMA) XTC, X, Ecstasy, Adam, M & M, eccy, E, Go, Scooby Snacks, hug, bea Tablet, gel tab, powder Oral, intranasal, smoking, injecting a. Dexamphetamine (also known as dextroamphetamine sulphate) is sold in tablet form in Australia for ADHD and narcolepsy, in accordance with state and territory laws. It is also used illicitly. b. In tablet form, the drug can be inserted into the anus or the vagina to avoid the irritation to the user’s stomach which commonly occurs when taken orally (also known as ‘shafting’ or ‘shelving’). c. Terminology noted in Queensland. Source: Australian Forensic Drug Laboratory, South Australia Forensic Science Centre. MDMA is chemically related to the amphetamine module, but has different pharmacological properties in that it not only stimulates the central nervous system, but also has hallucinogenic and/or entactogenic effects (United Nations Drug Control Programme, 1996). Consequently, MDMA may be classified as a stimulant or a hallucinogen or an entactogen. MDMA is included in official statistics as an ATS, particularly seizure and arrest data, and these sources often do not distinguish between amphetamine and MDMA. On this basis, MDMA is included as an ATS for the purposes of this background paper. The general misunderstanding and confusion about the various terms that are used to describe ATS was raised in the submission received from Turning Point Drug and Alcohol and Drug Centre in Melbourne: There needs to be a definitive statement that covers terminology and description of the mechanisms of action of ATS. The terminology should take into account use of terms that are primarily clinical and those that are primarily used in the justice system. We do not believe that each sector needs to use exactly the same terms as the terms serve different purposes in the different sectors (e.g., the term ATS is generally used among
5 justice and frontline workers and the term amphetamines is more commonly used among health workers) but each sector needs to understand the terms used in other sectors and why they might be different to those used in their own sector. An organization or consortium could be charged with Australia wide consultation among the sectors with an interest in this area to develop a consensus on terminology that would be used both at the state and federal level when talking about ATS. In addition to illicit ATS, there are several licit stimulants such as dextroamphetamine and methylphenidate, and phentermine based diet pills, such as duromine. Licit ATS are used primarily in medications to treat attention deficit hyperactivity disorder (ADHD) such as dexamphetamine and Ritalin; anorectics in the treatment of obesity, such as clobenzorex and dexfenfluramine; narcolepsy treatment such as modafinil; and in nasal inhalers, such as levomethamphetamine and propylhexedrine (United Nations Drug Control Programme, 1996). Given the potential misuse of these drugs in illicit markets and debate about their therapeutic value, these drugs are subject to ongoing review by medical, health and law enforcement authorities. At present, few studies have investigated prevalence and patterns of use associated with diversion of these drugs to illicit use, highlighting this as an area for future research. 1.3 History of amphetamine-type stimulants The use of amphetamine has been documented for centuries in China, where the ma huang plant (Ephedra vulgaris) has been used to treat people with asthma (Tyler, 1986). The ma huang plant contains ephedrine which is a central nervous system stimulant first produced by chemical synthesis in 1887 in Germany (Tyler, 1986). Following this discovery, amphetamine came into medical and recreational use in the 1920s primarily through the treatment of colds and asthma. In 1932 the Benzedrine Inhaler was introduced as an over the counter product and became a licit substitute for cocaine which had been declared illegal by the US federal government in 1914 (Tyler, 1986). By 1940, thirty-nine disorders had been identified for which Benzedrine – one of the three main kinds of amphetamine – was the recommended treatment, including night blindness, sea sickness and impotence (Tyler, 1986). Methamphetamine, more potent and easier to make than amphetamine, was discovered in Japan in 1919 (Bell, 2006). The crystalline powder was soluble in water, making it easy to inject. During World War II and the Vietnam War methamphetamine was widely used by the armed forces to increase alertness, confidence, feelings of increased strength and to suppress appetite. In the United States in the 1950s, legally manufactured tablets of both dextroamphetamine (Dexedrine) and methamphetamine (Methedrine) became readily available and were used by college students, truck drivers, and athletes. These drugs were often used as a substitute for cocaine, which had become illegal, and one of the primary reasons for use was to remain alert for extended periods of time. By the 1960s the market in methamphetamine had changed from being predominantly licit to illicit. The black market consisted first of the diversion of supplies from pharmaceutical companies, chemists and doctors. This was followed by the synthesis, manufacture and distribution of methamphetamine by motor cycle and other criminal gangs and syndicates,
Page 1: National Amphetamine-Type Stimulant
Page 4 and 5: ii Acknowledgments This research wo
Page 6 and 7: iv Table of contents Acknowledgemen
Page 8 and 9: vi List of tables Table 1.1: Amphet
Page 10 and 11: viii
Page 12 and 13: 2 The NDS framework and the Law Enf
Page 16 and 17: 6 particularly on the Pacific Coast
Page 18 and 19: 8 Figure 1.1: MDMA (ecstasy) tablet
Page 20 and 21: 10 a 10-year period. While some of
Page 22 and 23: 12 Figure 1.4: Forms of methampheta
Page 24 and 25: 14 Figure 1.5: Median purity of met
Page 26 and 27: 16 As noted, the route of administr
Page 28 and 29: 18 Chapter 2: Setting the Context T
Page 30 and 31: 20 Figure 2.2: Prevalence of ecstas
Page 32 and 33: 22 19 years (Dunn et al., 2007). Th
Page 34 and 35: 24 The use of MDMA among police det
Page 36 and 37: 26 this survey is conducted with th
Page 38 and 39: 28 models might be useful. On the o
Page 40 and 41: 30 the questionnaire in February 20
Page 42 and 43: 32 2.5 Summary According to the lat
Page 44 and 45: 34 anxiety, agitation, tremor, teet
Page 46 and 47: 36 may be stronger than the link wi
Page 48 and 49: 38 Srisurapanot and colleagues (200
Page 50 and 51: 40 Psychiatric problems appear to o
Page 52 and 53: 42 In 2005, there was a total of 68
Page 54 and 55: 44 The most recent EDRS survey foun
Page 56 and 57: 46 same reasons they use the drugs
Page 58 and 59: 48 Shoptaw and Reback (2007) review
Page 60 and 61: 50 It has also been speculated that
Page 62 and 63: 52 Parental ATS use In addition to
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54 The Minnesota Department of Heal
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56 Chapter 4: Prevention and Harm R
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58 should cover the full range of d
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60 specific drug (Spoth et al., 200
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62 be applied regularly and systema
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64 Strategies targeting vulnerable
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66 Examples of particular periods t
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68 At-risk workplaces There is incr
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70 The consultation forum with Abor
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72 young people was noted in the su
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74 and/or others); mental health ef
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76 of the fact that frequently peop
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78 Sexual risk behaviour is a furth
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80 • Cleaning up; • Transport o
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82 Assessing the risks of illicitly
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84 4.4 Challenges of applying preve
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86 but a number of studies are now
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88 The pack included a video, train
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90 Chapter 5: Treatment and Service
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92 to the occurrence of amphetamine
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94 In relation to the need for spec
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96 These studies replicate earlier
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98 addressed not only the drug user
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100 Research conducted in the subse
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102 users, data that may be general
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104 that limit brain exposure to me
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106 only significant difference was
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108 through the use of antipsychoti
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110 to develop the capacity of the
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112 It was also suggested that link
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114 as new evidence emerges. New ps
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116 border in 2000 (McKetin et al.,
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118 Table 6.1: Number of clandestin
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120 Table 6.2: Examples of domestic
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122 Tasmania In 2004, strengthened
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124 Recommendations from the consul
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126 Although there are a number of
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128 illegal drugs. When incarcerate
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130 heroin) (Payne et al., 2007). I
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132 Some examples of diversion prog
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134 Other research has compared psy
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136 Rehabilitation in Corrections T
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138 Synthetic Drugs measure will im
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140 • Stealing from motor vehicle
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142 criminal offences There continu
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144 • Increase international coll
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146 • Ensuring offence and penalt
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148 Law enforcement agencies are pl
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150 Appendix 1 National consultatio
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152 Appendix 2 Written submissions
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154 Australian Institute of Health
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156 Bowers, J. & Johnson, S. (2003)
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158 Crits-Christoph, P., Siqueland,
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160 Drug & Alcohol Services South A
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162 Halkitis, P.N., Parsons, J.T.,
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164 Hull, P., Rawstorne, P., Zablot
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166 Leek, L., Seneque, D., & Ward,
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168 McKetin, R., McLaren, J., Kelly
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170 NSW Health (2006). Psychostimul
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172 Ressler, K.J., & Nemeroff, C.B.
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174 Small, W., Kerr, T., Charette,
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176 United Nations Office for Drug
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178
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