OPINION: Real links between meth and madness

WITH the advent of new technologies, help for ice users is only a click away.

This is good news given the strong link between the drug and psychosis. Earlier this month, my colleagues and I published an article in JAMA Psychiatry (a journal of the American Medical Association) confirming this link and recommending improved treatment for people who use methamphetamine, the drug known on the street as ‘‘ice’’.

We found ice users were five times more likely to experience psychotic symptoms when they were on the drug than when they were not. There was also a strong dose-related effect. We tracked 278 methamphetamine users over several years, and excluded people with pre-existing psychotic conditions, like schizophrenia, so we are confident that the symptoms of psychosis were not due to a pre-existing mental health condition.

Ice addiction is a tenacious thing, and for people who have succumbed to this habit, they are plagued by cravings for the drug, severe mood swings, not to mention the psychosis. I like to joke that ‘‘I don’t understand why people find psychosis so confusing’’, but it is no laughing matter.

When paranoia slips into a delusion state, and people start to believe what isn’t real, it can be terrifying.

People describe being followed, spied on – they will take down the number plate of every car behind them, spend hours searching their house for bugging devices, and some people stay bailed up in their homes for days, convinced that people are waiting for them outside. 

When the ambulance or police intervene, they think ASIO has arrived.

We found 48per cent of ice users experienced psychotic symptoms when they were using ice daily.

This increased to 69per cent if they were smoking pot and drinking heavily as well. 

Fortunately few were being chased by ASIO (in most cases it was only our research team trying to find them), and most escaped unscathed.

The good news is that nine in 10 people recovered from the psychosis when they stopped using ice.

Even cutting back substantially reduced the level of paranoia. This is why treatment is so important.

But for many people, the idea of ‘‘going to treatment’’ conjures up images of snake oil, men in white coats and psychobabble.

Or of being bludgeoned with a reality checklist of faults by some straight-laced dude with a clip board. 

Cast this image alongside the prospect of losing a dear friend, as we all find in our favourite poison, and it is unsurprising that the majority of ice users don’t seek professional help.

Luckily, most establishments that post the sign ‘‘drug rehabilitation’’ on their door are less enigmatic.

Most are a share house of people in the same boat, coupled with a raft of structured activities and group counselling sessions led by professionals.

This provides respite for many drug users, who want a safe and structured environment where they can recover.

But these types of residential treatment programs aren’t for everyone: if you are working or have kids, taking weeks out of your schedule to stay in a residential service just may not be practical.

The philosophies vary as well – many have a religious underpinning and most are abstinence based.

 This doesn’t appeal to everyone, and if it doesn’t appeal to you, there are plenty of other options.

The Stimulant Treatment Program is one such option. Located in the Wesley Mission building in Newcastle West, professional counsellors provide confidential one-on-one sessions to help people with their drug use and lifestyle issues. 

This is a more pragmatic approach for a lot of people, and it is under-pinned by psychological treatments that have a strong evidence base.

Clients attending the Stimulant Treatment Program say that they like the non-judgmental attitude of the counsellors, who are knowledgeable – they specialise in helping ice users.

Counsellors help clients work out their goals and how to achieve them. You have to do homework though –  as one client said, it is hard work, but you get out of it what you put in.

If the idea of walking into a ‘‘clinic’’ is too confronting, help is now available online. ‘‘Breaking the Ice’’ is an web-based intervention that is being trialled as a treatment for stimulant use. 

It provides a secure site where you can log in and do your treatment anonymously. The activities are similar to what you would do with a face-to-face counsellor, but you can do it at your own pace and in your own time.

Breaking the Ice available at https://breakingtheice.anu.edu.au

The JAMA Psychiatry article methamphetamine use and psychosis is available at: http://archpsyc.jamanetwork.com/journal.aspx.

Dr Rebecca McKetin is a Fellow at the Centre for Research on Ageing, Health and Wellbeing in the Australian National University.

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