Publications.Thesis Index.hando

PhD Thesis - Hando, J

Patterns of illicit psychostimulant use in Australia and correlates of harm
Hando J (1997)

Abstract:
Official statistics and research studies suggest that amphetamine use increased among young Australian adults during the middle 1980s. Since then, amphetamines have remained the second most widely used drug after cannabis, yet little is known about this use. Some studies have found injection to be popular route of amphetamine administration, a concern given the risks of HIV transmission via needle sharing practices, and the occurrence of serious health symptoms from the chronic, heavy use of amphetmines. In comparison, fewer people have used other psychostimulants such as MDMA or cocaine in Australia, and little problematic use has been noted with these drugs.

A number of studies were conducted for the present thesis to explore the nature of amphetamine use in more detail, and the intervention needs of amphetamine users. This would allow informed decisions to be made about the individual and public health effects of amphetamine use in Australia. Two surveys recruited cross-sectional samples of amphetamine users from the community using multiple methods. They found that amphetamine users represent a heterogenous group of young adults who often use the drug on a recreational basis at social gatherings. About half usually injected amphetamines, a third of whom continued to share needles. Regular users, particularly injectors, were more likely to experience substantial levels of psychological morbidity, health problems, dependence and social dysfunction which could precipitate help-seeking behaviour. A need for amphetamine-specific treatment was evident, popular choices of which included pharmacotherapies, natural therapies and counselling. However, both existing treatments and potential amphetamine-specific treatments require proper evaluation, an area in which little work has been done so far. Other responses, such as the provision of useful, accurate information is also required. Given the documented importance of informal controls among psychostimulant users, strategies, which utilise peer support and self-help approaches need to be further explored. Formal controls such as law enforcement also need to be reconsidered to determine their effectiveness and any unintended harmful consequences.

A survey of young offenders in detention was also conducted to examine amphetamine use among a high risk group of youth. As expected, amphetamine use was common among this sample, the majority of whom injected amphetamines. Substantial minorities of this sample reported amphetamine-related problems and a need for help, suggesting that the use of this drug is a concern among young detainees.

The final study examined the best ways to study hidden populations of amphetamine and other illicit drug users on a regular basis, given the historically episodic nature of drug use, particularly amphetamines. Such information is required so that changes in illicit drug use can be detected early and appropriate responses implemented before serious problems arise. Four methods were examined: a survey of injectors, a key informant study of professionals working in the drug field and illicit drug users, an analysis of existing secondary indicators and an ethnographic study of a high risk group of illicit drug users, the first three of which were recommended for inclusion in a monitoring system. This system would enable the collection of both quantitative and qualitative data on a range of illicit drugs in a relatively brief, quick and cost-effective manner. It is recommended that this information be supplemented with specialist studies of hidden and clinical populations of illicit drug users that utilise a combination of methodologies to measure drug use behaviours.

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