National Amphetamine-Type Stimulant Strategy Background Paper

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48 Shoptaw and Reback (2007) reviewed the available literature on the epidemiology of methamphetamine use in men who have sex with men (MSM), methamphetamine use and risk behaviours for sexually transmitted infections and potential interventions to prevent and respond to these risks. It was found that methamphetamine use was highly prevalent in MSM and there were strong associations observed between methamphetamine use and HIV-related sexual transmission behaviours. Behavioural treatments, from brief interventions to intensive out-patient treatments, produced sustained reductions in methamphetamine use and concomitant sexual risk behaviours among methamphetamine-dependent MSM. While more research has been conducted into methamphetamine use among homosexual populations, few studies have directly compared methamphetamine users according to sexual orientation. A study conducted in Sydney compared homosexual/bisexual male and female regular ecstasy users with their heterosexual counterparts to determine whether patterns of drug use or risk differed across these groups (Degenhardt, 2005). It was found that self-reported risk behaviours such as unprotected sex and needle sharing (among injectors) did not differ according to sexuality. However, homosexual/bisexual men and women were significantly more likely than heterosexual men and women to report a greater number of sexual partners and higher rates of injecting drug use. Increased risk-taking behaviours related to ATS use were raised as an issue during consultations. Particular mention was made of sexual health and concerns raised over the transmission of sexually transmitted infections (STIs). Aggression and violence Most research linking ATS drugs with aggressive and violent behaviour has focused on its association with methamphetamine. The impact of methamphetamine use on neurochemical brain systems is thought to underlie the relationship with aggression. A recent study by Sekine and colleagues (2006) found that chronic methamphetamine users had higher levels of aggression that non-drug using controls and decreased levels of serotonin in areas of the brain involved in the regulation of aggression. However, serotonin depletion is more often documented in relation to ecstasy use than methamphetamine and little evidence has been found for a relationship between ecstasy use and aggression. Methamphetamine is more often implicated in regulation of dopamine and in this regard, may relate to aggressive behaviour via the ‘fight-or flight’ response of the sympathetic nervous system (Haller, Makara & Kruk, 1998). Several studies have found high levels of aggressive behaviour among regular meth/ amphetamine users (Hall et al., 1996; Sommers & Baskin, 2006; Wright & Klee, 2001; Zweben et al., 2004). The 2006 IDRS (O’Brien et al., 2007) asked participants about drugrelated aggression. Verbal aggression following the use of alcohol/other drugs was reported by 33% of the sample and physical aggression by 13%. For both of these behaviours, various formulations of methamphetamine were by far the most common drugs reported as being consumed prior to aggression. For those who had been verbally aggressive, 46% reported taking a form of methamphetamine and for those who had been physically aggressive, 49% reported taking a form of methamphetamine.
49 Police detainees charged with violent offences were not more likely to test positive to methamphetamine than those charged with other forms of offending (Smith, forthcoming). However, heavy or dependent ATS users were more likely to have a history of violent offending. The number of times ATS dependent users were charged with a violent offence in the past 12 months was higher than those detainees not dependent on ATS. Furthermore, it was found that violent detainees dependent on ATS had greater contact with the criminal justice system through arrest or imprisonment than other violent detainees. More specifically, of all violent offenders, aggravated robbery offenders were most likely to report ATS dependence, were more likely to indicate that all of their offending was drug related, and were most likely to have spent time in prison in the past 12 months. A significant difficulty in disentangling the links between meth/amphetamine and violent crime is polydrug use. In attempting to disentangle polydrug use and violent crime, analysis of the drug using histories of incarcerated male offenders found that those who were regular users of both heroin and amphetamine had the highest likelihood of involvement in violent crime, followed by those who were regular amphetamine users, and then regular heron users (Makkai & Payne, 2003, see Table 3.2). Those who were not regular users of either drug had much lower probabilities of involvement in violent crime and lower frequency of offending. Table 3.2: Violent offending histories for regular amphetamine and heroin users, adult male prisoners (%) Regular amphetamine user only Regular heroin user only Regular amphetamine and heroin users Non-regular user of any drug Violent offence history Ever committed any violent offence 81 76 81 65 Ever regularly committed a violent offence 26 29 36 17 Ever regularly committed two or more violent offences 9 8 12 2 Frequency of violent offending (column per cent) More than one day per week 5 9 8 2 One day per week 5 4 5 2 About monthly 4 9 14 4 Less than once a month 34 29 20 35 None in the past six months 22 20 22 24 Never in my life 29 29 31 35 (Total) (100) (100) (100) (100) Source: Australian Institute of Criminology, DUCO Male Survey, 2001
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National Amphetamine-Type Stimulant
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ii Acknowledgments This research wo
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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 14 and 15: 4 Table 1.1: Amphetamine-type stimu
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 60 and 61: 50 It has also been speculated that
Page 62 and 63: 52 Parental ATS use In addition to
Page 64 and 65: 54 The Minnesota Department of Heal
Page 66 and 67: 56 Chapter 4: Prevention and Harm R
Page 68 and 69: 58 should cover the full range of d
Page 70 and 71: 60 specific drug (Spoth et al., 200
Page 72 and 73: 62 be applied regularly and systema
Page 74 and 75: 64 Strategies targeting vulnerable
Page 76 and 77: 66 Examples of particular periods t
Page 78 and 79: 68 At-risk workplaces There is incr
Page 80 and 81: 70 The consultation forum with Abor
Page 82 and 83: 72 young people was noted in the su
Page 84 and 85: 74 and/or others); mental health ef
Page 86 and 87: 76 of the fact that frequently peop
Page 88 and 89: 78 Sexual risk behaviour is a furth
Page 90 and 91: 80 • Cleaning up; • Transport o
Page 92 and 93: 82 Assessing the risks of illicitly
Page 94 and 95: 84 4.4 Challenges of applying preve
Page 96 and 97: 86 but a number of studies are now
Page 98 and 99: 88 The pack included a video, train
Page 100 and 101: 90 Chapter 5: Treatment and Service
Page 102 and 103: 92 to the occurrence of amphetamine
Page 104 and 105: 94 In relation to the need for spec
Page 106 and 107: 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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National Amphetamine-Type Stimulant Strategy Background Paper

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