Awareness campaigns need to target the real victims of ice

This week the federal government launched a television advertising campaign to warn young people and their families about the harms of using crystal methamphetamine, also known as “ice.” The first ad in the A$9 million campaign, depicting ice-fuelled violence in the home and a hospital emergency department, will run for four weeks on television and six weeks online.

The government also set aside A$20 million in Tuesday’s budget for ice awareness campaigns over the next two years. This comes as the Commonwealth government prepares its interim National Ice Taskforce report, which aims to develop a collaborative federal-state response to the drug.

But international evidence suggests such “awareness” campaigns are not the most appropriate way to address harmful methamphetamine use. In fact, fear-based approaches can increase stigma which possibly drives people away from, rather than towards, treatment.

No methamphetamine epidemic

Australian media outlets and politicians claim we’re facing a nationwide “ice epidemic”. But ice is just one – albeit typically very pure – form of methamphetamine and the most up-to-date research estimates that the proportion of Australians who have used any type of methamphetamine (ice, “speed” powder) in the previous year has remained relatively stable for at least the last decade.

Nevertheless, the government and media’s continued use of hyperbolic language – in addition to a tendency to ignore and sometimes dismiss public health experts' advice on ice – has the potential to incite unnecessary fear and misinform the public about this supposed “menace”.

The government’s TV ad campaign started this week.

Victorian premier Daniel Andrews, for instance, recently claimed 80,000 Victorians had used the “evil” drug ice in the previous year. ABC Fact Check subsequently investigated the accuracy of this figure and, based on the most recent National Drug Strategy Household Survey (NDSHS) and expert advice, concluded that the statement was not supported by data.

Use and harm

According to the NDSHS, in 2013 around 2% of the Australian population used any methamphetamine (speed powder, ice or “base”) in the previous 12 months. Only about 16% of these “recent” methamphetamine users reported using the drug once a week or more.

Regardless, using methamphetamine – particularly frequent and heavy use – is associated with serious psychological, physical, social and financial harms.

The risk of experiencing such effects is likely to have increased due to the dramatic rise in purity of methamphetamine in recent years. The average purity of speed powder and crystal methamphetamine seizures in Victoria increased from 12% to 37% and 21% to 64% respectively in the four years up to 2013.

It’s therefore crucial we that don’t undermine the experiences of individuals, families and communities impacted by the harmful use of the drug.

Rather, we need to accurately define the issue, including the nature and extent of methamphetamine use and related harms in rural and regional areas, to allow the development and implementation of cost-effective, evidence-based and timely responses.

Awareness campaigns

Numerous studies have indicated “what works” with regard to public awareness, education and prevention strategies which aim to reduce harms related to licit substances, such as tobacco use and drink driving. But there is little evidence that similar initiatives targeting illegal drugs are effective.

The limited available research suggests that the well-known, graphic Montana Meth Project and Faces of Meth advertising campaigns in the United States are costly, ineffective and possibly even counterproductive.

Faces of Meth campaign.

The findings of one study suggest that the Montana Meth Project might actually increase acceptability and decrease perceptions of risk relating to using methamphetamine.

Another noted that:

“When accounting for a pre-existing downward trend in meth use… [the campaign’s] effects on meth use are statistically indistinguishable from zero.”

Concerns about the efficacy of such initiatives are reflected in the HIV literature, which suggests that fear-based approaches can lead to stigma and poor health outcomes, such as from reduced treatment-seeking.

Reducing the harms from meth use

Many of the evidence-based suggestions put forward by leading experts are not – at least currently – politically palatable and are therefore unlikely to be implemented anytime soon.

Extensive international research, for example, shows safe-injecting facilities such as the one in Sydney’s Kings Cross can have enormous public health benefits. These include preventing blood-borne virus transmission, freeing-up health-care resources and improving drug treatment pathways. However, we are yet to see a comparable service implemented in any of Australia’s other drug use “hot spots.”

It is also unlikely that Australia will soon follow the lead of nations and jurisdictions that have decriminalised, legalised or “controlled” previously illicit substances. These include Portugal and the United States, with Ecuador’s government currently debating the issue.

The average purity of speed powder and crystal methamphetamine seizures in Victoria increased in recent years.Sylvie Bouchard/Shutterstock

As many have said before, drug policies in Australia need to ubiquitously incorporate the proven approach of harm-minimisation.

Although our National Drug Strategic Framework is underpinned by this principle, failure to adopt evidence-based techniques that reduce drug-related harms, such as more safe-injecting facilities and prison-based needle exchanges, indicates a discrepancy between policy and practice.

Because people will choose to engage in drug use (both licit and illicit) regardless of the policies and programs in place, we need to encourage them to do so as safely as possible. We also must continue to inform the public about options for managing drug-related consequences and appropriate and available means for professional support, such as telephone and internet counselling DirectLine and Counselling Online.

Addressing barriers to drug treatment and ensuring that such services are adequately resourced is vital to meeting the needs of methamphetamine and other drug users at the “pointy end” of the spectrum.

But providing targeted and relevant harm reduction education and ensuring that support is available to individuals who aren’t yet ready – or who don’t see a need – to use drug treatment is just as important for preventing the transition to more harmful use patterns.

Brendan Quinn has worked on research projects funded by the National Health and Medical Research Council to study methamphetamine use and related issues.

Paul Dietze has received funding from the National Health and Medical Research Council, the Australian Research Council, the Commonwealth Department of Health and Ageing and the National Drug Law Enforcement Research Fund to study methamphetamine use and harms.