AFTER five years working with addicts on the streets of Melbourne, Sian Kennedy knows a drug-induced psychosis when she sees one.
So when one of her female clients turned up on the steps of her office last week, "completely non-responsive and making strange, jerking movements as if she was trying to crawl out of her skin", Kennedy didn't hesitate. Within minutes the woman, unaware of who she was or what she was doing, was ferried by ambulance to the closest hospital psychiatric ward.
Seven days later she is still there and still out of it. It could be another week or more before she is fit for release, perhaps to do it all over again.
That is the nature of crystal methamphetamine, a pure, highly addictive and dangerous drug that began carving an Australian market among established and new drug users when the heroin drought bit in the late 1990s.
Dubbed redneck cocaine in the US, its most lethal quality is that it's cheap. Known as crystal meth or ice for its pure crystalline form, it can be bought for as little as $50 a gram.
The Australian Federal Police says Chinese, Hong Kong and Malaysian syndicates, previously involved in heroin importation, switched to the synthetic drug because it can be manufactured almost anywhere cheaply and, unlike cocaine and heroin, does not depend on crop cycles.
The syndicates have been targeting the wealthy Australian market with devastating success. A recent National Drug and Alcohol Research Centre study found the methamphetamine problem is now as widespread as dependent heroin use was during its peak in the late '90s. As many as 73,000 people in Australia are addicted to methamphetamine, about 1.5 times the number of heroin addicts.
But, unlike heroin, there are no established treatment programs or legal replacement drugs for addicts.
It is a mark of crystal meth's alarming side effects that it has made a big name for itself among the nation's hospital emergency departments, psychiatric services and police.
Last month a 36-year-old Sydney financier, charged with numerous counts of animal cruelty and bestiality, added to the drug's notoriety when he blamed his behaviour on serious mental health problems induced by ice. Brendan McMahon left a trail of dead and dying rabbits - skinned, tortured and brutalised - in the streets and lanes behind his office before he was apprehended.
Kennedy says the drug, "almost guaranteed to make people really, really crazy", has firmly taken hold in Melbourne. In her previous job as a youth drug counsellor at a residential clinic, it accounted for up to one-third of all admissions. "I don't know whether it's because it has a higher purity than speed or [because of] the way people use it," she says. "People who inject ice are pretty out there: they're the ones that walk down the street and scream at random strangers."
The AFP and state police forces believe there is a link between rising crystal meth use and violent crime. "If you look at all the gangland killings in Melbourne in the [past few] years, all the major players in that are associated with the methamphetamine industry," Detective Senior Sergeant Jim O'Brien of Victoria's clandestine laboratory unit says.
In Victoria, crime families are believed to control distribution but in other states the market is allegedly sewn up by ethnic clans and outlawed bikie gangs.
Crystal meth can be consumed in a number of ways - it can be snorted, injected, inserted as a suppository or heated in a glass pipe and the vapours inhaled - and its relative purity gives new users a powerful high.
It instantly sends a flood of dopamine and serotonin, two feel-good chemicals the body releases naturally, to the brain, creating feelings of euphoria and increased alertness. But the comedown can be equally spectacular, leading to depression and, in a growing number of cases, serious drug psychosis.
A recent NDARC study found a 58 per cent rise in the number of recorded hospital admissions for stimulant-related psychosis since 1999. Between 2003 and 2004, 3190 methamphetamine users in Australia were hospitalised for mental and behavioural disorders.
NDARC spokesman Paul Dillon says the drug is crossing established social boundaries. "It's not just people who go to nightclubs or inject drugs," he says. "Students use it, people use it for working, to lose weight, to stay awake. A drug like ecstasy is used in a very specific context, but not amphetamines."
Crystal meth abuse has skyrocketed in countries such as the US, The Philippines and New Zealand, where its use has been connected to an increase in violence and violent crime.
In the US, where the drug is popular among the gay community, it has also been linked to a sharp increase in the incidence of HIV. Almost one in three gay men who tested positive for HIV in Los Angeles last year reported using crystal meth, according to a US study reported in Newsweek last month.
Dillon disputes this correlation, saying although the drug is a disinhibitor and often linked to hypersexual behaviour and unsafe sex, "there's a whole pile of other factors coming into play". Police say there's no evidence that Australia's gay community has been similarly affected.
"Some sections of the gay community took to ice very quickly in 1998-99," says NSW Drug Squad commander Detective Superintendent David Laidlaw. "But they have now become aware of its highly addictive nature and impact due to the increased risk-taking behaviour associated with the drug, including the likelihood of contracting blood-borne viruses such as HIV and hepatitis C."
All the same, Dillon and police across the country attest to the severity of the crystal meth problem now gripping Australia. "It's the issue in Australia at the moment in terms of drugs and has been for the last couple of years, but it doesn't get a lot of attention because not many people die from it," Dillon says. "The big issue with amphetamines in Australia is the whole problem of psychosis."
Sydney's St Vincent's Hospital director of emergency Gordian Fulde estimates that between 2000 and 2004, there was a five-fold increase, in his hospital, in cases involving violence associated with the use of crystal meth. He says the medical community knew some years ago, from overseas reports, that the drug and associated physical and mental problems were on their way. But he had no concept of what he was dealing with until he came face to face with a user in the throes of a full-blown psychotic episode.
In the worst cases, the scenario is frighteningly familiar.
"The police car is rocking in the ambulance bay," Fulde says. "We need six people to get anywhere near [the patient] to physically restrain them, to sedate them. The extreme examples are like nothing else in the world. There's just this unchecked violence and animalistic behaviour. They get paranoid and there's no boundaries, nothing in the patient's head stopping the action. They can beat their own head to a pulp on the side of the wall."
In 25 years as emergency department director he says "nothing has scared me as much as these people".
Royal Perth Hospital psychiatrist Nigel Armstrong says his hospital has been forced to put extra psychiatric teams into its emergency department because it had become a "de facto psychiatric clinic". "Clinically, we see a lot of people in ED with drug-induced pathology and the ones that give us the most grief are those with amphetamine-induced psychoses because we have to find [secure] beds for them," he says.
Many users recover once they give up the drug, but a significant proportion of users don't.
National Drug Research Institute director Steve Allsop says "anyone who uses enough crystal methamphetamine on enough occasions - even if they're psychologically robust - can end up with mental health problems".
Problems range from low-level anxiety and depression as users are coming off the drug, to psychosis that requires hospitalisation, a problem that is often dose-related.
Sustained and regular use of ice has also been known to lead to strokes and heart attacks even among young victims.
The chemicals used to make the drug are so toxic that those who regularly inhale it risk having their teeth crumble.
Allsop says as the potency of crystal meth has increased in recent years, so has the corresponding harm. AFP border and international network national manager Mike Phelan says this is because of improved and expanded production.
The AFP is forging closer ties with its Southeast Asian counterparts to track the sale of precursor chemicals and stop production before ice reaches Australia's borders.
AFP and the Australian Customs Service, with Fijian and New Zealand police, raided a lab in Suva last year capable of producing 500kg of ice a week, almost all of it bound for the Australian market.
"I think we're making a lot of headway, particularly over the last couple of years we've made some very large seizures and lab takedowns, which is extremely important," Phelan says.
Import volumes are stabilising, but he fears they won't necessarily stay that way.
"I predicted a few years ago that we would see a big rise in the use of methamphetamines," Phelan says, "and I would say we're still looking at that original prediction."
Newshawk: Empower Activists http://www.napnt.org/donate.html
Pubdate: Mon, 05 Sep 2005
Source: Australian, The (Australia)
Author: Amanda Hodge
Copyright: 2005 The Australian
Contact: http://www.theaustralian.news.com.au/files/aus_letters.htm
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