National Amphetamine-Type Stimulant Strategy Background Paper

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86 but a number of studies are now underway. For example, researchers at the National Drug Research Institute (NDRI) are exploring how web-based communications provide accurate and inaccurate information about illicit drug use, while researchers at the University of Tasmania are currently examining the effectiveness of internet-based delivery of harm reduction information. A number of other findings from the Victorian Inquiry (Drugs and Crime Prevention Committee, 2004) can inform us how we might maximise the effectiveness of ATS-specific prevention strategies. It was emphasised that there was a need to consider the reasons potential and actual consumers, such as young people, cite for using ATS, on both personal and social levels. Thus, for example, a recent international report on global trends in psychostimulant use identified that there is a common perception that amphetamine and ecstasy are more benign and socially acceptable than drugs such as heroin (United Nations Office for Drug Control and Crime Prevention, 2001). ATS may be attractive to some people, particularly young people, if they perceive that such drugs are associated with sociability, having less health risks, are relatively low cost, and have mood-enhancing effects (United Nations Drug Control Programme, 1996). As in other reports, the Victorian Inquiry (Drugs and Crime Prevention Committee, 2004) also concluded that multifaceted approaches were likely to be the most effective. For example, it was recommended that any campaign addressing ATS should include: • Peer-based strategies, including delivering information and education to prevent uptake of use and presence at events to provide harm reduction information and assistance; • Youth media such as popular radio stations, should be used to communicate information and advice to young people who were regarded as one high risk group. Other electronic media were identified as pertinent in any approach that aims to engage young people; • The Internet to communicate information and advice, not only to young people, but also parents, club owners, licensees, people working in the entertainment industry, and school staff; • Information specifically targeting the needs of parents/carers/families; • Information specifically targeting professionals who respond to ATS; and • Interventions tailored to meet the needs of specific populations such as Aboriginal and Torres Strait Islander people, or high-risk groups such as people in the gay community. In summary, it is again indicated that the various, and overlapping, target groups and the diverse patterns and contexts of ATS use and related problems, and the apparent limited impact of any single approach, demands the need for multifaceted approaches applying several strategies tailored to specific needs and circumstances.
87 4.5 Building the capacity of the workforce to engage in prevention and harm reduction As many people at risk of, or currently using, ATS, do not come into contact with treatment agencies, or have a tenuous link with such services, workforce development strategies need to target a range of health professionals. Those likely to be affected include GPs, psychiatrists, mental health workers, accident and emergency staff, ambulance officers, youth workers, community health workers, staff from needle and syringe programs and consumer organisations. Thus, people in the workforce who come into contact with ATS users need to be appropriately informed and skilled to respond effectively to problems arising from the use of these drugs. This issue is addressed more comprehensively in Chapter 5 (‘Treatment’), but briefly introduced here. Given the identification of GPs and community health services as services commonly accessed by ATS consumers, it was suggested by a number of participants at consultations that GPs could take a critical role in communicating harm reduction messages and information. It was suggested that many patients might attend their GP for problems that are potentially ATS related (e.g., sleep disorders; depressed mood). As noted by one participant, these clinical encounters provide an opportunity to screen for ATS use and provide information about harm reduction and, where indicated, referral for further treatment: Primary health care providers such as GPs, represent an entry point and should be mobilised into a harm reduction role and given better referral pathways. It was suggested that screening programs for ATS use could be established at a range of points of contact where high-risk individuals congregate or present for advice, such as sexual health clinics, community health centres and so on. For example, one participant who self-identified as a youth worker, argued it was important to: Engage consumers in an appropriate environment and context to provide immediate support and referrals whilst offering safer sex products and practical harm reduction information. Health workers need to be aware of the warning signs of escalating use and increase the capacity for self-assessment among users (NSW Health, 2006). In addition, information is needed regarding drug pharmacology and interactions, and the immediate and long-term effects of ATS use. Given the unpredictable nature of some ATS presentations, training in effective interventions, dual-diagnosis, primary mental health assessment skills, deescalation skills and risk-management skills are likely to enhance worker confidence and capacity to manage acutely intoxicated users (NSW Health, 2006). In order to ensure staff and client safety, such education and training needs to be supported by the development of policies and procedures for working with ATS users, including the management of potentially violent clients. A major project to develop training materials for health professionals working with ATS users was initially undertaken in Victoria under funding from the National Drug Strategy. This led to the development of a comprehensive training kit, ‘From Go to Whoa: Amphetamines and Analogues, The Trainers Package for Health Professionals (Pead et al., 1996).
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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
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vi List of tables Table 1.1: Amphet
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viii
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2 The NDS framework and the Law Enf
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4 Table 1.1: Amphetamine-type stimu
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6 particularly on the Pacific Coast
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8 Figure 1.1: MDMA (ecstasy) tablet
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10 a 10-year period. While some of
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12 Figure 1.4: Forms of methampheta
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14 Figure 1.5: Median purity of met
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16 As noted, the route of administr
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18 Chapter 2: Setting the Context T
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20 Figure 2.2: Prevalence of ecstas
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22 19 years (Dunn et al., 2007). Th
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24 The use of MDMA among police det
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26 this survey is conducted with th
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28 models might be useful. On the o
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30 the questionnaire in February 20
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32 2.5 Summary According to the lat
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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
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 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
Page 108 and 109: 98 addressed not only the drug user
Page 110 and 111: 100 Research conducted in the subse
Page 112 and 113: 102 users, data that may be general
Page 114 and 115: 104 that limit brain exposure to me
Page 116 and 117: 106 only significant difference was
Page 118 and 119: 108 through the use of antipsychoti
Page 120 and 121: 110 to develop the capacity of the
Page 122 and 123: 112 It was also suggested that link
Page 124 and 125: 114 as new evidence emerges. New ps
Page 126 and 127: 116 border in 2000 (McKetin et al.,
Page 128 and 129: 118 Table 6.1: Number of clandestin
Page 130 and 131: 120 Table 6.2: Examples of domestic
Page 132 and 133: 122 Tasmania In 2004, strengthened
Page 134 and 135: 124 Recommendations from the consul
Page 136 and 137: 126 Although there are a number of
Page 138 and 139: 128 illegal drugs. When incarcerate
Page 140 and 141: 130 heroin) (Payne et al., 2007). I
Page 142 and 143: 132 Some examples of diversion prog
Page 144 and 145: 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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