“A new Ice Age?”

An information session about An information session about MethamphetamineMethamphetamine

A presentation by Darren Hayden – WorkCover NSWA presentation by Darren Hayden – WorkCover NSW

Focus - “The hazards associated with the - “The hazards associated with the effects of substances of abuse on clients effects of substances of abuse on clients of emergency service workers, (including of emergency service workers, (including

crisis care workers), and employees of the crisis care workers), and employees of the Accident and Emergency departments of Accident and Emergency departments of

healthcare facilities.”healthcare facilities.”

Consider this comment – Consider this comment –

New South Wales Police Commissioner Ken Moroney was quoted by The Australian as saying, "I don't know in all the time I've been a policeman, which is 41 years, of a greater scourge on the community. The physical and mental manifestations of this drug are absolutely horrific. It has the potential to destroy generations".

What is “Ice”?

Crystal Methamphetamine Hydrochloride is an Crystal Methamphetamine Hydrochloride is an extremely addictive synthetic central nervous extremely addictive synthetic central nervous system stimulant that affects certain parts of the system stimulant that affects certain parts of the brain.brain.

“Ice” is a street name for crystal methamphetamine hydrochloride.

Ice is more potent than other forms of amphetamines. It is more pure that the powder form of methamphetamines (“speed”).

Ice often appears as large, transparent and “sheet-like” crystals that may have a hint of pink, blue, green, or even brown coloration, all depending on the method used to "cook“ (manufacture) it.

How is it made ?How is it made ?

Anhydrous nitrateAnhydrous nitrate EphedrineEphedrine Red PhosphorousRed Phosphorous LithiumLithium AntifreezeAntifreeze Lantern fuelLantern fuel

How is “Ice” taken

Ice is known to be smoked, swallowed, snorted, injected or inserted anally (“shafting”). Some people smoke ice using a glass pipe, while others heat it on aluminium foil and inhale the vapours (“chasing”).

Glass Ice pipe and drugs.

Methods of useMethods of use

“Ice” use in Australia In 2004, 3.2 per cent of Australians aged 14

years and older had used amphetamines for non-medical purposes in the previous year. Over 38 per cent of this group reported the type of amphetamine they used was ice.Australian Institute of Health and Welfare (AIHW) 2005, 2004 National Drug Strategy Household Survey: Detailed findings,Canberra: AIHW

Ice use among injecting drug users increased from 15 per cent in 2000 to 52 per cent in 2004. National Drug and Alcohol Research Centre (NDARC) 2005 Australian Drug Trends 2004: Findings from the Illicit Drug Reporting System, Sydney: NDARC

In 2004, 63 per cent of a sample of people who used ecstasy had tried ice at least once and 45 per cent had used ice in the past 6 months.NCDARC 2005 Australian Trends in Ecstasy and Related Drug Markets 2004: Findings from the Party Drug Initiative, Sydney: NDARC

Closer to home……

In NSW there are currently approx 37000 regular users with 28000 dependent on it

Stages of ICE useStages of ICE use

Rush ( 20 – 40 minutes)Rush ( 20 – 40 minutes)High ( 3 days )High ( 3 days )BingeBingeCrashCrash

What are the effects of “Ice”

"dopamine" is released when we experience happiness"dopamine" is released when we experience happiness

abnormal amount of dopamine is released in the brain, abnormal amount of dopamine is released in the brain, causing intense euphoriacausing intense euphoria

brain gets use to the chemical reaction, creating the brain gets use to the chemical reaction, creating the need for the user to ingest meth more often and with a need for the user to ingest meth more often and with a higher dose higher dose

United Nations recently named meth-amphetamine United Nations recently named meth-amphetamine as the world's most addictive illicit drug.as the world's most addictive illicit drug.

Dilated pupil - stimulant Dilated pupil - stimulant intoxicationintoxication

after taking ice, a person may experience:

feelings of euphoria, excitement and well being

increased alertness, confidence, libido, more energy, feelings of increased strength, talkativeness, restlessness, repeating simple acts, itching, picking and scratching

tremors of the hands and fingers

speeding up of bodily functions, such as increased breathing rate, body temperature, blood pressure, a rapid and irregular heartbeat and excessive sweating

difficulty sleeping, reduced appetite, dilated pupils, dry mouth, stomach cramps, nausea, dizziness, blurred vision and severe headaches

abrupt shifts in thought and speech,

nervousness, panic attacks, anxiety, paranoia irritability, aggression, hostility and

“amphetamine psychosis”, including hallucinations, paranoid delusions and bizarre behaviour.

The variable purity of each batch of ice increases the risk of negative effects and overdose.

ICE : not a great injection drugICE : not a great injection drug

The human face of “Ice” addiction

A common side effect of ice use is the sensation of bugs A common side effect of ice use is the sensation of bugs or insects crawling under the skin of the user. or insects crawling under the skin of the user. (“formication”). Many users will pick and scratch at these (“formication”). Many users will pick and scratch at these bugs causing “bug sores” typical to an ice user/addict.bugs causing “bug sores” typical to an ice user/addict.

Meth needle marksMeth needle marks

Coming down…

a person may experience symptoms such as tension, depression, radical mood swings, uncontrollable violence and exhaustion.

Long Term Use Long-term use of ice can result in:

high blood pressure and increased risk of heart related complications such as heart attack and heart failure

malnutrition and rapid weight loss due to reduced appetite

chronic sleeping problems

reduced immunity and increased susceptibility to infections due to the person not sleeping or eating properly

depression, anxiety, tension and paranoia

brain damage (there is some evidence that amphetamines may damage brain cells resulting in reduced memory function and other impairments in thinking)

dental problems (from grinding teeth) smoking ice can damage the lungs snorting ice can damage the lining of the nose injecting ice can lead to scarring, abscesses and vein

damage. Sharing injecting equipment increases the risk of contracting blood-borne viruses, such as hepatitis B and C, and HIV.

“Meth mouth” tooth damage

Personality/Physical changes of regular ice users/addicts

Loss of weightLoss of weight

Withdrawal from activitiesWithdrawal from activities

Scabs on skin (from excessive scratching)Scabs on skin (from excessive scratching)

Rotting teethRotting teeth

Strong chemical body odorStrong chemical body odor

Unusual obsessive/repetitive behaviorUnusual obsessive/repetitive behavior

Aggressive behaviorAggressive behavior

Uncontrolled, often violent emotional outburstsUncontrolled, often violent emotional outbursts

Paranoia/DelusionsParanoia/Delusions

Full-blown toxic psychosisFull-blown toxic psychosis

WithdrawalSome of the symptoms may include:disorientationhungerextreme fatigue and exhaustiondecreased energy, apathy and the limited

ability to experience pleasureanxiety, irritability and depressioncraving ice.

Lisa Burns, Coordinator of Newtown Neighbourhood Centre states:

Dramatic increase in use of “Ice” among Dramatic increase in use of “Ice” among clients of the centreclients of the centre

Increase in drug relatedIncrease in drug related

crime ie: Break and Entercrime ie: Break and Enter Increase in HomelessnessIncrease in HomelessnessDecline in behaviour (client attitude, Decline in behaviour (client attitude,

edginess and propensity for aggression) edginess and propensity for aggression)

Increase in reported CRV incidents from Increase in reported CRV incidents from 2/Year to 1/Week in last eight months2/Year to 1/Week in last eight months

Increase in Workers Compensation ClaimsIncrease in Workers Compensation Claims

Lack of referral places (where to sendLack of referral places (where to send

clients for treatment)clients for treatment)

Lack of resources (counsellors all booked Lack of resources (counsellors all booked up) up)

Health Care Workers. Mr Beaver Hudson - Mental Health & Psychiatric Unit - St Vincent’s Accident & Emergency Department states:

Increase in last two yearsIncrease in last two years

of “Ice” induced symptomsof “Ice” induced symptoms

Paranoia: belief that staff are going to Paranoia: belief that staff are going to kill them (fighting for life, pleading kill them (fighting for life, pleading with staff)with staff)

TreatmentTreatment Pharmacology oral medication Pharmacology oral medication

-mechanical/physical restraints-mechanical/physical restraints ““Ice Block.” Behavioural Assessment Room Ice Block.” Behavioural Assessment Room

(contain behaviour & noise, & provides privacy & (contain behaviour & noise, & provides privacy & confidentiality for client) confidentiality for client)

Policies/ProceduresPolicies/Procedures Policies to deal with clientsPolicies to deal with clients behaviour (No tolerance, risk assess)behaviour (No tolerance, risk assess) Security staff essential to managing & Security staff essential to managing &

restraining clientsrestraining clients Understanding behaviour/pattern of behaviour. Understanding behaviour/pattern of behaviour.

De-escalation. De-escalation.

Team structures and one point of contact for Team structures and one point of contact for client communication. client communication.

Introduction of training specific to managing Introduction of training specific to managing affected clientsaffected clients

Staff debriefing on incidences. Staff debriefing on incidences. Different people have different reactions to Different people have different reactions to

situation. Support services.situation. Support services.

What’s the story: Statewide

Amphetamine, Ecstasy and Cocaine: A Amphetamine, Ecstasy and Cocaine: A Prevention and Treatment PlanPrevention and Treatment Plan

New clinics at St Vincent’s Hospital and Royal New clinics at St Vincent’s Hospital and Royal Newcastle CentreNewcastle Centre

Adoption of principles from National illicit Drug Adoption of principles from National illicit Drug StrategyStrategy

Development of treatment plans, clinical Development of treatment plans, clinical guidelines and specialist training for Area Health guidelines and specialist training for Area Health Service StaffService Staff

Taskforce to combat use of illicit drugs by long Taskforce to combat use of illicit drugs by long distance driversdistance drivers

What’s been done about it?- Federally/Internationally

National illicit Drug StrategyNational illicit Drug Strategy Family, Parenting, School, Tertiary, Peer, Family, Parenting, School, Tertiary, Peer,

Workplace education schemes and Workplace Workplace education schemes and Workplace developing and Training to be rolled out to the developing and Training to be rolled out to the states. states.

Community mobilisation and social marketing Community mobilisation and social marketing campaignscampaigns

Cooperation with other countries to control Cooperation with other countries to control precursors: pseudoephedrineprecursors: pseudoephedrine

How can we help?

Education/advisory campaignsEducation/advisory campaignsSeminars/training Seminars/training Audits Audits Building of stakeholder relationships Building of stakeholder relationships

(Police, local councils, hospitals)(Police, local councils, hospitals)Liaising with states/territories to develop Liaising with states/territories to develop

strategies and programs.strategies and programs.

End of Presentation – Thank you

Any questions?Any questions?

Resources/Further Information available at - Resources/Further Information available at - National Drug & Alcohol Research Centre (NDARC) at the University of NSWNational Drug & Alcohol Research Centre (NDARC) at the University of NSW – –

http://ndarc.med.unsw.edu.au/http://ndarc.med.unsw.edu.au/

National Illicit Drug StrategyNational Illicit Drug Strategy - - http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/health-pubhlth-http://www.health.gov.au/internet/wcms/Publishing.nsf/Content/health-pubhlth-strateg-drugs-illicit-index.htmstrateg-drugs-illicit-index.htm

Australasian Amphetamine Conference - Australasian Amphetamine Conference - http://www.amphetamines.org.au/index.htmhttp://www.amphetamines.org.au/index.htm