New program on “Ice” to crystallise on October 23
September 5, 2007A new Rural Health Education Foundation program airing on Tuesday October 23 equips health professionals to deal with effects of “Ice” (crystal methamphetamine) use in rural and remote Australia.
“Ice” - Out in the Cold, funded by the Australian Government Department of Health and Ageing, looks at issues surrounding the illicit drug crystal methamphetamine, also known as “Ice” or “Crystal meth”, in the context of rural and remote health care.
The program presents the range of effects that crystal meth or “Ice” can use, and strategies for treatment, management and prevention. The program also includes yet to be released research findings, particularly with regards to patterns of anger, aggression, psychiatric illness, and crime among “Ice” users.
Featuring a panel of experts
The all new program, which airs on the Foundation’s satellite network at 8pm (EST) on Tuesday 23 October , with a repeat at 12.30pm on Friday 26 October , brings together an expert panel.
The program features Dr Adam R Winstock, Senior Staff Specialist/Project Leader SWAT of Sydney South West Area Health Service’s Drug Health Services; Dr Rodger Brough, a rural GP currently working as Drug and Alcohol Physician for South West Healthcare in Warrnambool VIC; Ms Melissa Claire, a clinical psychologist who is completeng PhD research on anger, aggression, violence, crime and psychiatric illness in metamphetamine users at the Centre for Mental Health Studies, University of Newcastle NSW; and Mr Craig Crawford, a paramedic for Rural Ambulance Victoria in Colac.
Potentially dangerous effects
As a long-acting stimulant, “Ice” causes significant strain on the cardiac, respiratory and nervous systems. Effects include suppressed appetite, interference with sleeping behaviour, tremors and convulsions, palpitations, hyperthermia, coma, and death.
In addition to potentially hazardous physical effects, “Ice” also has potent psychological effects, from mood swings and unpredictability to acute psychosis, psychiatric illness (psychosis, anxiety, depression), cognitive impairments (memory, attention, reasoning), and even chronic psychotic disorder. According to program presenter Ms Melissa Claire “it can quickly lead to the emergence of anger, aggression, psychiatric symptomatology and crime.”
“Ice” -induced paranoia, aggression, and increased physical strength can result in a volatile mix in terms of crime and violence. As as a rural ambulance paramedic, program presenter Mr Craig Crawford reports that the sheer physical strength and aggression found in patients under the influence of “Ice” is beyond that found in normal people and those under the influence of other substances. Safety thus becomes a particular concern.
Highly addictive
“Ice” use can quickly lead to dependence, according to Ms Claire. “The drug’s attraction appears to be based on the immediate intense ‘rush’ (or high) that ‘Ice’ gives to the user, as well as increased energy, alertness, confidence, euphoria,” she says. “However, the intensity of the high is equally matched by an intense ‘crash’ period and the emergence of adverse effects (eg aggression, anxiety, suicidality).” The user is thus driven to continue using in order to avoid the unpleasant after-effects.
Treatment & management
According to program presenter Dr Adam Winstock, there are a number of aspects health professionals need to be equipped with, from emergency management of intoxication and withdrawal, distinguishing substance-induced psychosis from underlying illness, to when and what to prescribe, in lieu of patient needs and possible drug interactions.
“Understanding why people use methamphetamine is a key to treatment,” according to Ms Claire. In terms of long-term care for addiction and relapse prevention, stepped-care and motivational interviewing can be useful, but most importantly a non-judgemental approach is crucial.
As in the case of other substance misuse, program presenter Dr Rodger Brough emphasisis the importance for health practitioners to be able to establish a good relationship with these potentially difficult patients to provide them due respect and attention. Some rural general practitioner find themselves taking on patients who are substance abusers because other general practitioners refused to see them.
Issues surrounding substance use in rural areas
Access and stigma are significant issues for users, particularly in rural areas. During 11 years of general practice, Dr Rodger Brough handled a number patients whom he only knew were using after he saw them as a drug and alcohol physician.
“And when they (”Ice” users) present for care, their needs are often acute and require many resources,” according to Melissa Claire. “This can place a high load on rural communities, especially rural health professionals and hospitals, particularly those with limited specialist services and facilities.”
“There needs to be a whole rural substance abuse strategy,” says Dr Brough.
More information
For full details of the program, visit the “Ice” - Out in the Cold program page.