Scattered: the inside story of ice in Australia. Malcolm Knox. Sydney: Allen & Unwin, 2008 (xi + 290 pp). ISBN 978 1 74175 358 5.

Malcolm Knox is a Walkley Award-winning journalist and he has a keen grasp of both the pharmacology and psychiatric effects of crystal methamphetamine. Scattered provides a lucid, elegant description of the turbulent recent history of ice in Australia. Knox goes beyond the statistics and includes a series of case vignettes, exploring the human cost of this drug in the Australian context.

Knox explains that the heroin drought in Australia since 2000 has led to an alternative, yet far more damaging, drug supplanting the somnolent effects of the opioids. Ice is relatively cheap, hitting the streets in all our capital cities (and everywhere a truck goes), and provides an instant, profound teeth-grinding hit, far more potent than any other methamphetamine in history.

This book is a roller coaster read in three sections: going up, the high, and coming down. In many ways, the book’s structure follows the effects of this most potent psychostimulant on many unfortunate users. Many patients that I have seen in my addiction practice have suffered severe drug-induced ice psychoses requiring urgent hospitalisation and larger than usual doses of tranquilliser medication. Such patients are alarming to both doctors and nursing staff alike.

Practitioners at the coalface can only hope that ice becomes less popular and that we are spared the prospect of such violent psychosis or a terrified patient hiding under a desk, paranoid about imaginary helicopters spying on his every move.

This book will not be to everybody’s taste because of the graphic descriptions of ice-fuelled violence and sexual depravity, but it should be required reading for all doctors who encounter such patients on the edge of oblivion.