By Tim Lam
Crystal methamphetamine, more commonly known as ‘ice’, has featured prominently in news headlines in recent times. Stories of violent attacks on innocent bystanders and ice-induced psychosis are reported be occurring with alarming frequency. Crosslight attempts to sort fact from fiction.
Ice: an epidemic?
Epidemic. Scourge. Crisis. These are some of the words used by media and politicians to describe Australia’s ice problem.
The reduced cost and increased purity of methamphetamine in Australia has seen higher levels of harm amongst people who use the drug. Regional and rural communities in particular have been affected by an increase in ice usage.
Some who work in rehabilitation have expressed concerns about the proliferation of alarming media stories. An overemphasis on the harmful effects of ice, without consideration of the possible pathways to rehabilitation, can create the perception that there is little chance of recovery for users.
Ice is undoubtedly a severe health and social issue, but out of the darkness emerge stories of courage, hope and resilience. These stories are a reminder that ice addiction is not a death sentence and that effective treatment options are available.
While ice is a significant health, social and economic issue, experts debate over whether it is in fact an ‘epidemic’.
UnitingCare ReGen CEO Laurence Alvis cautions against overstating the severity of ice in Australia.
“The harm is real and needs to be addressed, but it is still only affecting a small percentage of the population, less than 3 per cent by most reliable measures. This does not constitute an ‘epidemic’,” he said.
“Alcohol, by far, is still responsible for the greatest harm within our communities.”
Methamphetamine use in Australia has remained stable over the past decade. What has changed is the way the drug is taken. The most recent National Drugs Strategy Household Survey indicated that the use of methamphetamine in its purer, and more potent, crystal form (ice) has more than doubled between the period 2010-2013.
The physical symptoms of methamphetamine withdrawal last longer compared to most other drug types. A typical residential withdrawal lasts seven to 10 days. Methamphetamine withdrawal takes about a month.
One of the great community fears is the risk of violence by ice users.
“There is much that family members can do to manage loved ones’ behaviour and reduce risk of violence,” Mr Alvis said.
“We’ve done it in our own services. We have the highest ever rates of people undertaking methamphetamine treatment and our lowest ever rates of violent incidents.”
Rather than adopting an alarmist approach, Mr Alvis suggests increasing funding for evidence-based treatment options. Law enforcement is only part of the solution. It must be complemented with approaches that support people who are methamphetamine dependent.
Misrepresentations of facts and simplistic slogans can further stigmatise an already vulnerable group of people and make the community more afraid to engage with them. Mr Alvis said effective drug policy frameworks are already in place in Australia. The National Drug Strategy’s Harm Minimisation model incorporates three key strategies: supply reduction (policing and border control), demand reduction (treatment services and public health campaigns) and harm reduction (needle and syringe programs, supervised injecting centres). ReGen’s work focuses specifically on the areas of demand reduction and harm reduction.
“Each strategy addresses a different set of needs and complements activities in the other two. In isolation, none will solve the problem,” Mr Alvis explained.
ReGen began noticing an increase in people seeking help with methamphetamine dependence in 2012. The number of people seeking methamphetamine treatment at the agency increased from 6 per cent of total ReGen clients in 2010 to 30 per cent in 2015.
“We recognised that we needed to make some changes to the way we delivered our services so that we could respond to the particular needs of this highly-stigmatised group,” Mr Alvis said.
UnitingCare ReGen began embarking on a new approach to support people who are methamphetamine dependent. It introduced greater flexibility to the ReGen service model and focused on providing people with sustained support over a longer period.
“Our goal was make it easier for people to engage with treatment and stay engaged,” Mr Alvis said.
“So far, it’s working well with our combination of residential and non-residential services, including withdrawal, counselling and rehabilitation programs, producing sustained benefits for participants and their families.”
The Victorian Government has recognised the effectiveness of ReGen’s Torque program. Earlier this year, the state government announced a $24.6 million package to expand treatment services in Victoria. UnitingCare ReGen was chosen to run a new program based at Connections UnitingCare’s NarreWarren site. This will enable ReGen to provide rehabilitation services for people living in Melbourne’s outer south east region.
“Our message to the community is that methamphetamine use is not a death sentence,” Mr Alvis said.
“There are clear risks but, with the right support, people are rebuilding their lives.”
Budget cuts threaten rehabilitation services
Family support is invaluable in helping people recover from methamphetamine dependence, but it can also have a severe emotional and financial toll on family members.
This stress is exacerbated by the lack of accessible treatment services in the community. Federal government cuts to health services means thousands of people needing vital drug and alcohol support are being turned away. ReGen has a long waiting list that can vary from 20 to 50 people.
Trevor King, UnitingCare ReGen’s Director of Programs, said families are bearing a particular burden when it comes to dealing with ice.
“We know that families can be a tremendous source of support for recovery, but we also know that they can experience significant stigma, grief, financial stress and social isolation,” he said.
“The damage to health, relationships, employment and other indicators of wellbeing can be severe.”
The federal government launched a $20 million ‘Ice Destroys Lives’ media campaign this year and spent an additional $1 million on a controversial ‘dob-in-a-dealer’ hotline.
“Cutting treatment services, while spending millions on ineffective, fear-based TV campaigns and ‘dob-in-a-dealer’ phone lines is not helpful,” Mr King said.
One of the government initiatives to tackle ice is the National Ice Taskforce launched by then Prime Minister Tony Abbott in April this year. Common feedback from the community consultations was the need for more rehabilitation services. Both residential and non-residential rehabilitation services throughout the country are struggling to meet demand.
Taskforce members Ken Lay and Dr Sally McCarthy met with ReGen staff, consumer consultants and participants earlier this year to hear about the success of their Torque program.
“We have been very encouraged by the work of the Taskforce, both in their consultations with service providers and discussions with people who use our services,” Mr King said.
“Taskforce head Ken Lay has consistently recognised that we can’t arrest our way out of this problem. He sees the need for a broad based response that includes evidence-based and adequately resourced treatment services and a focus on building resilience amongst children to prevent future AOD (alcohol and other drug) use.”
Mr King is confident the Taskforce will make informed recommendations to the federal government. However, he expressed concerns at the government’s approach to ice, which has seen the drug framed as a law enforcement issue, rather than a health issue.
“Tony Abbott called for national leadership on this issue but offered little more than service cuts and ‘tough on drugs’ rhetoric,” he said.
“From the outset, the federal government focused almost entirely on law enforcement, while cutting funding to treatment and harm reduction services and removing public health peak bodies.”
The final National Ice Taskforce report, including a clear strategy and recommendations, will be presented to the Council of Australian Governments before the end of the year.
Facts about ice
- An estimated 2-3 per cent of the Australian population use methamphetamine. Approximately half of them use ice (1-1.5 per cent of the population).
- The prevalence of methamphetamine use in Australia has remained stable since 2001.
- The use of methamphetamine in powder form has decreased from 51 per cent of all methamphetamine use in 2010 to 29 per cent in 2013. However, the use of the drug in crystal form (ice) has more than doubled from 22 per cent of all methamphetamine use to 50 per cent during that same period.
- Ice is not a major drug of choice for young people aged 12-17. An estimated 2.9 per cent have tried methamphetamine compared to 28 per cent for alcohol and 14.8 per cent for cannabis.
- The price of crystal methamphetamine has decreased dramatically to about a third of the cost in 2009, making it more accessible and affordable.
- Ice-related emergencies rose by 27 per cent in regional Victoria from 2012-13 to 2013-14. There was a 10 per cent increase for metropolitan Melbourne in the same period.
- Alcohol remains overwhelmingly the cause of ambulance call outs with an average of 45 ambulance call-outs a day, compared to 4 per day for ice.
- For every dollar spent on drug treatment, the community saves $7, compared with $2 for stronger policing.
SARAH’S STORY
Sarah is a mother of two boys, aged eight and nine. She was also an ice addict and had been using the drug for 11 years. For Sarah, ice was a means to cope with the trauma of an abusive relationship.
“I know there are other people out there who want to have a good time and party and really get off on the drug, but I never did. I did it as an escape from my situation,” Sarah said.
Sarah’s partner at the time was also an ice user. Because of its purity, ice is the more potent form of methamphetamine and its side effects are more intense. A symptom of using ice is that it heightens paranoia, irritability and aggression. Stories of ice destroying families and crippling relationships are sadly all too common.
“Having a partner on ice brings out a lot of anger and rage in domestic violence,” Sarah said.
“Whatever’s in you – if you’ve got torment or fury or anger – the drug will bring it out 10 times. It’ll bring it all up to the forefront and it’ll come out.”
Road to recovery
Last November, Sarah decided she wanted to end her addiction and visited the detox unit at UnitingCare ReGen’s Curran Place facility.
“I had enough of my lifestyle and the drugs,” Sarah explained.
“I wanted to be a better mother for my children and to give them a chance of having a good life.”
Sarah recalled spending much of the first three days at the detox facility “crashing out”, as ice deprives a person of sleep.
Withdrawal is just the first step in the recovery process. After completing detox, Curran Place referred Sarah to UnitingCare ReGen’s Torque rehabilitation program. This is a six-week non-residential rehabilitation program run at ReGen’s Coburg site. It assists participants to develop coping skills and maintain their motivation to cease substance use. The period following withdrawal is a vulnerable time as there is a high potential for relapse.
“The first three or so weeks I was in there, I was really overwhelmed and didn’t take much in. I thought ‘what was the point of me being here?’” Sarah said.
Meeting other people was a major part of Sarah’s rehabilitation process. She reflected that being in a safe and secure group environment helped break some of the social anxieties many drug addicts have.
“I had a big social phobia because ice isolates you from people. You think you’re the only one living this life. But in a group, you realise you’re not the only one living this life and that there are people out there,” she said.
“Just sharing stories and hearing other stories helped me out too. You can learn from other people and they can learn from your stories.”
In addition to interacting with other recovering addicts, Torque helps participants reintegrate into society through gym sessions at the Coburg Leisure Centre. Other activities such as drumming, art therapy sessions and mindfulness exercises are also available to improve physical and emotional wellbeing.
A key feature of Torque is cognitive behavioural therapy (CBT) sessions. CBT aims to prevent relapse by challenging problematic thinking patterns and increasing the participants’ range of coping skills.
“A lot of drug addicts, especially me, didn’t have any problem-solving skills and so I turned towards drugs,” Sarah said.
“ReGen staff teach you ways around the problems when they arise and what to do about it.
“They teach you skills that I’ve basically been looking for my whole life – how to cope through hard times and how to disassociate yourself from many things that may trigger drug use.”
Because Torque is a non-residential day program, participants return home every night. For Sarah, this gave her an opportunity to practice the new skills she acquired in a non-supervised environment. This can be a challenging process, but Sarah said Torque provided her a safety net that she could return to each morning.
During rehabilitation, Sarah had one-on-one sessions with a counsellor to identify the reasons for her drug use and establish goals she wanted to achieve. These sessions helped Sarah confront many of the fears and anxieties that contributed to her drug use.
“I didn’t look at the drug itself. I looked at the reasons behind the drug and why I took the drug. So I had to face a lot of fear that was there, a lot of terror that I’d been through and a lot of trauma,” she said.
For Sarah, participating in Torque encouraged her to confront her fears instead of escaping from them.
“It has turned my life around. It really has,” she said.
“There are times when trauma comes up and I’ve got to face the pain and the hurt and the fear to be able to move forward.
“I now have no desire for the drug because I’ve passed the point of the drug. I’m going straight to the source of it – the fear.”
The journey continues
Earlier this year, Sarah gave a talk at the annual ReGen innovation seminar. Sarah’s mother was in attendance as a show of support for her daughter. Post-treatment support from family and friends is critical for long-term recovery from drug dependence.
“I’ve got a good supportive mother who helps me,” Sarah said.
“She helped look after my children and if you could get a group of supportive people around you, it helps as well.”
Ice is a complex, multi-layered problem and there are no quick-fix solutions. Approaches to combating ice need to take into account other social issues, such as domestic violence. Sarah believes many people in an abusive relationship turn to ice to block out the pain. She also suggests having effective rehabilitation services in prison to help cut down ice addiction in the community.
Sarah’s story demonstrates that it is possible to recover from ice addiction and, in the process, develop important life-long skills. She advises ice addicts to take up the detox and rehabilitation services offered by agencies like UnitingCare ReGen to help turn their life around.
“There’s nothing good about the drug,” she said.
“To get off ice you have to want to change, otherwise it’s quite pointless.
“I definitely recommend Curran Place detox and then the Torque program through ReGen because I’ve never met any group like it. It’s been a real success story for myself.
“I don’t think ReGen get enough coverage for what they do. They’re so good they should be global. Really, they are wonderful.”
Sarah recently completed UnitingCare ReGen’s Consumer Participation Training and is now assisting the agency as a consumer consultant. In her new role, Sarah will be helping other drug addicts overcome their addiction.
“I’m able to give back to what the people of ReGen have given me as I can train up and help other drug addicts for them. It’s something that I really look forward to.”
If you or someone you know is looking for drug and alcohol addiction treatment options, visit UnitingCare ReGen’s website at www.regen.org.au or call 1800 700 514.
Image by Garth Jones.
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