Amphetamines: client demographics and treatment
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In 2021–22, amphetamines were reported as a drug of concern (either principal or additional) in 3 in 10 treatment episodes (30% or 62,711 episodes) (Table Drg.5).
AODTS NMDS data for amphetamines correspond to the Australian Standard Classification of Drugs of Concern (ASCDC) for the general ‘amphetamines’ classification, in which methamphetamine is a sub-classification (ABS 2011).
The ASCDC is set up with 3 levels of classification which includes the broad group (e.g., Stimulants and hallucinogens), narrow group and base-level categories (which are the most detailed). Data available in the AODTS NMDS report the narrow group ‘amphetamines’ classification. Base-level categories within this narrow group include:
- Amphetamine analogues
- Amphetamines, not elsewhere classified (n.e.c)
- Amphetamines not further defined (n.f.d).
Changes to coding for methamphetamines has been difficult due to jurisdictional differences in client management systems, and the use of only broad or narrow group coding by some agencies. This has improved over time due to advancements in workforce training, agency coding practices and new system updates.
Data on different forms of amphetamines—methamphetamine specifically—have not been separately reported over time due to the nature of the classification structure used in this collection. Information on methamphetamines as a principal drug of concern was reported for the first time in the 2019–20 Alcohol and Other Drug Treatment Services in Australia annual report.
Amphetamines were the second most common principal drug of concern, recorded in almost 1 in 4 treatment episodes (24% or 49,694 episodes) (Table Drg.4).
Amphetamines have remained the second most common principal drug of concern:
- since 2015–16, when it surpassed cannabis for the first time (Table Drg.5)
- with treatment episodes more than doubling since 2012–13 (22,300 to 49,700 episodes), although this has declined since 2019–20
- in relation to all other drugs of concern, treatment episodes steadily rose between 2012–13 (14%) and 2019–20 (28%) but declined in 2021–22 to 24% (Table Drg.1).
In 2021–22, 2 in 5 amphetamine-related treatment episodes had at least 1 additional drug of concern recorded (37% or 18,200 episodes) (Table Drg.2). The most common additional drugs of concern were cannabis (34% or 10,300 episodes), alcohol (21% or 6,400 episodes) and nicotine (19% or 5,700 episodes) (Table Drg.3). These drugs may not have been the subject of any treatment in the episode.
For information on amphetamine use and harms, please see:
- Tobacco, alcohol and other drugs in Australia: Meth/amphetamine and other stimulants
- National Drug Strategy Household Survey 2019 (Chapter 4: Illicit use of drugs)
In 2021–22, 27,490 clients received treatment for amphetamines as the principal drug of concern. Of these clients:
- 3 in 5 were male (61% of clients) (Table SC.9).
- almost 3 in 5 were aged either 20–29 (25% of clients) or 30–39 years (33%) (Table SC.10). This was consistent for both males and females (Figure AMPHET 1).
- 1 in 5 were Indigenous Australians (20% or 5,400 clients) (Table SC.11). This represents a rate of 905 Indigenous clients per 100,000 population (crude rate) (Table SCR.26).
Figure AMPHET 1: Clients with amphetamines as the principal drug of concern, by sex and age group, 2021–22
The butterfly bar chart shows that in 2021-22, clients receiving treatment for amphetamines as the principal drug of concern were most likely to be aged 30–39 (39.4% of male clients; 40.2% of female clients).
In 2021–22, 49,694 treatment episodes were provided to clients for amphetamines as the principal drug of concern (Table Drg.4).
Among amphetamine-related treatment episodes in 2021–22:
- The most common source of referral were self/family (37% or 18,200 episodes), followed by health services (26%) (Figure AMPHET 2; Table Drg.37).
- The most common main treatment type were counselling (38% of episodes), followed by assessment only (23%) (Figure AMPHET 2; Table Drg.36). This is consistent with previous years, although the proportion of counselling episodes has fluctuated in the 10 years to 2021–22.
- Over 3 in 5 treatment episodes took place in a non-residential treatment facility (63% of episodes) (Table Drg.38).
- The median duration of treatment episodes was just over 5 weeks (36 days) (Table Drg.39). Episode duration varied by main treatment type, with the longest median duration being around 11 weeks (78 days) for counselling (Table Drg.41). Nearly 3 in 10 (27%) treatment episodes lasted 1 to 3 months; a further 26% lasted 2–29 days (Table OV.12).
- Around 1 in 2 episodes ended with a planned completion (52% of episodes), while 25% ended unexpectedly (Figure AMPHET 2; Table Drg.38).
Figure AMPHET 2: Treatment episodes with amphetamines as the principal drug of concern, by main treatment type, reason for cessation or source of referral, 2012–13 to 2021–22
The line graph shows that counselling was the most common main treatment type among treatment episodes for amphetamines across the 10 years to 2021–22, rising from 9,934 episodes in 2012–13, peaking at 24,701 episodes in 2019-20 and falling to 18,653 episodes in 2021–22. Assessment only remained the second most common main treatment types across the period, accounting for 11,400 episodes in 2021–22. Filters allow the user to view data as the number or per cent of episodes for main treatment type, reason for cessation or source of referral.
In 2021–22, 4 in 5 (80%) amphetamine-related treatment episodes were for methamphetamine as the principal drug of concern (Table Drg.5). Treatment episodes increased from 18% to 80% since 2012–13 (from 4,050 to 39,912 episodes) (Figure AMPHET 3).
The rise in reported episodes for methamphetamine may be due to a combination of factors, including improvements in agency coding practices for methamphetamine, treatment system updates and increases in funded treatment services.
Figure AMPHET 3: Treatment episodes with amphetamines as the principal drug of concern, by amphetamine type, 2012–13 to 2021–22
The line graph shows that methamphetamine has remained the most common amphetamine type among treatment episodes for amphetamines since 2015–16, when it overtook ‘Amphetamines not further defined’. Methamphetamine accounted for 39,912 treatment episodes in 2021–22. A filter allows the user to view data as the number or per cent of episodes.
How does a client’s method of use relate to the form of amphetamine used?
A client’s usual method of administering their principal drug of concern may indicate the form of drug used, particularly for amphetamines. For example:
- Clients who report smoking or inhaling amphetamines are most likely to be using amphetamines in crystal form.
- Clients who report ingesting or snorting are most likely to be using a powder form.
- Clients who report injecting amphetamines may be using any form of amphetamines, as each form (base, crystal and powder) can be injected. However, recent data from the Illicit Drug Reporting System (an annual survey of people who inject drugs) indicate that crystal and powder are the most common forms used among people who inject methamphetamine (Sutherland et al. 2022).
Among all amphetamine-related treatment episodes in 2021–22, smoking/inhaling was the most common method of use (50% of episodes), followed by injecting (33%) (Figure AMPHET 4; Table Drg.6). This was similar for methamphetamine (52% and 36% for smoking/inhaling and injecting, respectively) (Table Drg.6).
Between 2012–13 and 2021–22:
- The number of episodes where clients reported smoking/inhaling amphetamines increased from 8,400 episodes in 2012–13 to 25,000 episodes in 2021–22 (Figure AMPHET 4; Table Drg.6). This declined from 29,200 episodes in 2020–21, reflecting an overall decline in treatment episodes for amphetamines in the past two years.
- The number of episodes where clients injected amphetamines more than doubled between 2012–13 to 2019–20 (from 10,000 to 22,375 episodes), falling to 16,300 in 2021–22 (Figure AMPHET 4; Table Drg.6).
Figure AMPHET 4: Treatment episodes with amphetamines as the principal drug of concern, by method of use, 2012–13 to 2021–22
The line graph shows that ‘Smokes or inhales’ has remained the most common method of use among treatment episodes for amphetamines since 2014–15, when it overtook ‘Injects’ for the first time. ‘Smokes or inhales’ was the method of use in 25,024 episodes for amphetamines in 2021–22, while ‘Injects’ was the second most common method of use in 16,314 episodes.
The rise in treatment episodes between 2013–14 and 2019–20 where clients report injecting amphetamines may be related to several factors, including increases in treatment episodes overall, and particularly for people who might have been injecting amphetamines and heroin interchangeably (AIHW 2015).
Additionally, increases in treatment episodes for smoking methamphetamine from 2010 onwards is associated with increased importation of high purity crystalline methamphetamine into Australia (Degenhardt et al. 2017). National Drug and Alcohol Research Centre (NDARC) analysis of AODTS NMDS data indicates this greater availability of crystalline methamphetamines is reflected in the increased number of episodes identifying smoking as a method of use (McKetin et al. 2021).
Treatment episodes for methamphetamines where smoking was the method of use was primarily provided to among younger clients (median age 30 years), who were more likely to receive main treatment types of assessment only or support and case management (McKetin et al. 2021).
ABS 2011. Australian Standard Classification of Drugs of Concern, 2011. ABS cat. no. 1248.0. Canberra: ABS.
AIHW 2015. Trends in methylamphetamine availability, use and treatment, 2003–04 to 2013–14. Drug treatment series no. 26. Cat. no. HSE 165. Canberra: AIHW
Degenhardt L, Sara G, McKetin R, Roxburgh A, Dobbins T, Farrell M et al. 2017. Crystalline methamphetamine use and methamphetamine-related harms in Australia. Drug and Alcohol Review 36:160–70.
McKetin R, Chrzanowska A, Man N, Peacock A, Sutherland R & Degenhardt L. 2021. Trends in treatment episodes for methamphetamine smoking and injecting in Australia, 2003–2019. Drug and Alcohol Review.
Sutherland R, Uporova J, King C, Jones F, Karlsson A, Gibbs D, et al. 2022. Australian Drug Trends 2022: Key Findings from the National Illicit Drug Reporting System (IDRS) Interviews, Sydney: National Drug and Alcohol Research Centre, University of New South Wales, accessed 3 April 2023.