Both young men were referred to a residential withdrawal service, William through a local AOD worker, and Xavier had previously been there to withdraw from cannabis. The service provides residential withdrawal for young people aged up to 22, for between 10-14 days. It provides a holistic environment for young people, where they have access to therapeutic counselling, specialist AOD workers, and social and recreational programs (including art spaces, weights room, massage etc). They describe the treatment process as hard. William, who has been off methamphetamine for months notes:
“I think people with a meth addiction, different strategies need to be put in place about how they go
about kicking it ... If you’re seeing a counsellor about it, things have to be done differently...
explaining ways to quit, not just you’ve got to stop... For me, I’d do what I did, focus on the two
things that before you used you loved most in the world... and use that as leverage to get out of that
hole”
He noted that after withdrawal, there was a lot of work to do:
“I think any meth addict who goes to see a counsellor needs to be warned, if you want to quit, they
will, but it’s the hard yards. Don’t ever expect that it will be a smooth ride to stop using because it’s
not.”
“You get a lot of issues arise, because you’re not using, but you need to find other ways of dealing
with them rather than going back to using. Because, ultimately, you’re going to feel just as shit as
you were.”
59 Jordan was planning over a number of years to stop using altogether, having mainly restricted to weekends.
“I have a plan in mind, I’ve given myself ‘X’ amount of years to wean myself off it, if I get to a certain point and it hasn’t happened, you try this you try that, but if all things didn’t go to plan in a time frame, I will have to do whatever I need to get off it.”
Both young men were optimistic about being able to stay off methamphetamine. They were linked into ongoing mental health and personal supports, and Xavier was a few months away from securing stable housing for the first time in four years.
Summary
The accounts of the former and current crystal methamphetamine users are consistent with other key informants’ accounts concerning the reduced availability of speed and increase availability of ice. This is also consistent with police purity data also discussed earlier. In addition, they describe the period from using it several times a week, for example, to daily use as happening quite quickly. Poly drug use is obviously a feature, as is injection. The account from Xavier, who is from rural Victoria, points to – at least in his impression – as the increased availability of crystal methamphetamine being about two years ago. Trauma is a common underlying factor in their drug use, which in their cases, involved destructive consequences including alienation from family and many friends.
60
8.
Drug testing populations: Waste Water Analysis
8.1.
Introduction
It is evident thus far that there is a general view that with regards methamphetamine use in Victoria over the past two years is concerned, the issue is being felt more in regional, and perhaps rural areas, than it is in Melbourne.
This section of the report introduces an approach to estimating drug use prevalence that has not been used in Victoria before. It enables comparison of methamphetamine levels between Melbourne, Geelong, Wodonga on the Murray River and the small Wimmera town of Warracknabeal.
8.2.
The approach
Working with the School of Pharmacy and Medical Sciences, University of South Australia, we undertook an innovative method of assessing prevalence of drug use called Waste Water Analysis (WWA). WWA, also referred to as “sewage epidemiology” [101, 102], involves analysis of sewage water for indicators of illicit drug consumption in a population. It is a promising monitoring tool to estimate illicit drug consumption at the community level [10].
WWA can be used to detect changes in drug use over time, with analysis confirming ‘spikes’ over weekends and/or around special events (such as festivals or sporting events) [103]. WWA has demonstrated potential to usefully supplement information gathered by current drug monitoring systems [11]. While used in Europe for a number of years, WWA is relatively new to Australia [10, 104, 105]. It is now being routinely used by the Department of Health in South Australia. At least one Australian jurisdiction is using WWA to test drug use levels amongst an overall prison population. Researchers test wastewater for urinary biomarkers of illicit drugs and together with data on treatment plant flow rates and population levels, estimates are made about illicit substance use among the general population, or used to compare communities. The analysis can also be used to monitor effectiveness or otherwise of drug misuse prevention programs. As a research methodology, it eliminates potential bias in user self-report. However, while showing changes in levels and differentiations between levels, it does not show deeper information such as user cohorts. Nonetheless, WWA is viable source of information concerning levels of methamphetamine use. Nine Victorian water treatment plants were approached to participate in the analysis, of which five agreed. Those that participated were:
Grampians, Wimmera, Mallee Water - Warracknabeal Plant
North East Water - Wodonga Plant
Black Rock treatment plant - covering much of the Geelong population.
Melbourne Water Eastern Treatment Plant (ETP)
Melbourne Water Western Treatment Plant (WTP)
Waste water sampling was conducted on Sunday and Wednesday. The Sunday sampling detects substances consumed on a weekend, while Wednesday is an early-in-the-week sampling period. This is relevant as it can be used as a guide concerning ‘weekend’ versus more regular drug use. Table 8 allows comparison between plants and of the scale of methamphetamine use in the plant
61 catchment area. This is achieved by displaying drug use with the units of dose (so one can compare drugs which have different potency or dosage size) per day, per 1000 people (to allow comparisons between catchments of different size). These units of doses/day/1000 people reflect the total amount of methamphetamine use within that area.
Therefore this allows insights into the number of users within that area, and the rate that the community – as a whole - uses the drug.