Volume 199 - Issue 6
Trends in amphetamine-related harms in Victoria
Authors: Cherie Heilbronn, Caroline X Gao, Belinda Lloyd, Karen Smith, David Best and Dan I Lubman
Med J Aust 2013; 199 (6): 395. || doi: 10.5694/mja13.10149
Published online: 16 September 2013
Published online: 16 September 2013
By comparing administrative data for the 2010-11 and 2011-12 financial years, a 318% increase in “ice”-related ambulance attendances was found to underpin a substantial rise in amphetamine-related attendances.
To the Editor: In the 21 November 2011 issue of the Journal, Sara and colleagues identified 97 000 Australians as heavy stimulant users,1 and McKetin and Lubman detailed the public health importance of heavy stimulant consumption, emphasising impacts of “ice”(crystal methamphetamine).2 In addition, there has been growing concern over rising ice use in Australia and related harms, including psychosis, stroke and cardiac abnormalities.2 In Victoria, there is evidence of significant increases in ice use among people who inject drugs (from 36% in 2010 to 53% in 2011)3 and regular “ecstasy” (methylenedioxy-methamphetamine; MDMA) users (from 18% in 2010 to 38% in 2011).4 To examine this issue, we conducted an exploratory study using multiple indicators of amphetamine-related harm from July 2010 to June 2012.
Metropolitan Melbourne ambulance attendance data, coded by researchers who are trained to identify alcohol and other drug (AOD) involvement in ambulance presentations,5 are unique in terms of capacity to distinguish use of ice from use of other amphetamines at a population level. Comparing the 2010–11 and 2011–12 financial years, a 318% increase in ice-related attendances (3.4 to 14.2 attendances per 100 000 population) underpinned a substantial rise in all amphetamine-related attendances (11.1 to 21.1 attendances per 100 000 population). The greatest increase occurred among people aged 15–29 years (8.4 to 39.0 attendances per 100 000 population) — an Australian subpopulation with higher rates of heavy stimulant use1 and increased risk of harms.2
Other indicators also suggest an increasing incidence of harms. Comparing 2010–11 and 2011–12, amphetamine-related episodes of care provided by Victorian AOD services increased by 77% (66.2 to 117.2 episodes per 100 000 population), while amphetamine-related calls to DirectLine, Victoria’s telephone AOD helpline, increased by 194% (1090 to 3210 calls). Compared with our 2011–12 data, all indicators of amphetamine-related harms were lower during the previous peak in ice-related harms (July 2006 to June 2007): 5.1 ice-related ambulance attendances per 100 000 population; 87.3 amphetamine-related episodes of care per 100 000 population; and 2739 amphetamine-related calls to DirectLine.
The data presented here were collated for administrative purposes and limitations exist, with increased media interest in drug use possibly contributing to higher reporting of harms.5 However, consistent upward trends across multiple datasets suggest that increasing harms are real and not an artefact of data collection practices. As such, these findings support growing public health concerns regarding increases in amphetamine-related harms.
Competing interests
Dan Lubman has received speaker fees from AstraZeneca and Janssen, and travel support from Lundbeck.
Acknowledgements
We thank Ambulance Victoria and its paramedics for entering data and Turning Point Alcohol and Drug Centre staff for coding cases for the Ambo Project. This project is funded by the Victorian Department of Health.
References
- Sara GE, Burgess PM, Harris MG, et al. Stimulant use and stimulant use disorders in Australia: findings from the National Survey of Mental Health and Wellbeing. Med J Aust 2011; 195: 607-609. 0_CHDCGECE
- McKetin R, Lubman DI. Heavy stimulant use remains a significant health concern for Australia [editorial]. Med J Aust 2011; 195: 565-566. 0_i1142887
- Kirwan A, Dietze P, Lloyd B. Victorian drug trends 2011: findings from the Illicit Drug Reporting System (IDRS). Australian Drug Trends Series No. 76. Sydney: National Drug and Alcohol Research Centre, University of New South Wales, 2012. 0_i1142889
- Nguyen P, Dietze P, Lloyd B. Victorian trends in ecstasy and related drug markets 2011: findings from the Ecstasy and Related Drugs Reporting System (EDRS). Australian Drug Trends Series No. 85. Sydney: National Drug and Alcohol Research Centre, University of New South Wales, 2012. 0_i1142893
- Lloyd B, McElwee PR. Trends over time in characteristics of pharmaceutical drug-related ambulance attendances in Melbourne. Drug Alcohol Rev 2011; 30: 271-280. 0_i1142896
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