Crystal methamphetamine smoking among regular ecstasy users in Australia: increases in use and associations with harm.
BACKGROUND
This study examined (a) changes in crystal methamphetamine use among regular ecstasy users (REU) in Australia and (b) associations of crystal use and smoking with demographics, drug use and harm.


METHODS
Cross-sectional surveys (2000-06) of REU in three Australian capital cities, and in 2006, 750 REU in all Australian capital cities. The interview included: demographics, drug use, risk behaviour, recent criminal activity and methamphetamine dependence using Severity of Dependence Scale.


RESULTS
There was little change in overall methamphetamine use, but a marked increase in crystal methamphetamine smoking. Among recent methamphetamine users in 2006 (n = 606), crystal methamphetamine users (n = 364) reported more frequent methamphetamine use and higher levels of dependence. Compared with those who had used only other forms of methamphetamine, recent crystal methamphetamine users were more likely to 'binge' on drugs for > or = 48 hours, engage in crime and experience financial and legal problems related to drug use. Non-smoking crystal methamphetamine users (n = 78) more often reported recent injecting and heroin use. Recent smokers were more likely to have: greater polydrug use, recently overdosed on a 'party drug', and accessed medical services for their drug use. Many of these associations were accounted for by their injecting and heavier methamphetamine use, rather than smoking per se.


CONCLUSIONS
Crystal methamphetamine smoking among REU has increased markedly and is associated with significant harm. This appears related to smokers' heavier levels of methamphetamine use. Effective harm reduction strategies should be tailored to these specific risks.
Kinner
Stuart A
SA
Queensland Alcohol and Drug Research and Education Centre, School of Population Health, University of Queensland, Australia. s.kinner@uq.edu.au
Degenhardt
Louisa
L
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D001315:Australia; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects; D003415:Crime; D003430:Cross-Sectional Studies; D005260:Female; D006213:Hallucinogens / Q000009:adverse effects; D040261:Harm Reduction; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage / Q000009:adverse effects*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D011569:Psychiatric Status Rating Scales; D012309:Risk-Taking; D012720:Severity of Illness Index; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D000697:Central Nervous System Stimulants; D006213:Hallucinogens; D013287:Illicit Drugs; D008694:Methamphetamine; D018817:N-Methyl-3,4-methylenedioxyamphetamine