Clinical and demographic characteristics of people who smoke versus inject crystalline methamphetamine in Australia: Findings from a pharmacotherapy trial.

Rebecca McKETIN, Brendan Quinn, Peter Higgs, Michael Berk, Olivia M Dean, Alyna Turner, Peter J Kelly, Dan I Lubman, Gregory Carter, Amanda L Baker, Victoria Manning, Tamsin Thomas, Ramez Bathish, Dayle Raftery, Lucy Saunders, Anna Wrobel, Alcyone Meehan, Barbara Sinclair, David Reid, Shalini Arunogiri, Harry Hill, Frank Cordaro, Paul M Dietze

Journal: Drug and alcohol review 2022;40(7):1249-1255

PMID: 33022140

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Abstract

INTRODUCTION AND AIMS

There has been a rapid increase in smoking crystalline methamphetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use methamphetamine.

DESIGN AND METHODS

Participants (N = 151) were dependent on methamphetamine, aged 18-60 years, enrolled in a pharmacotherapy trial for methamphetamine dependence, and reported either injecting (n = 54) or smoking (n = 97) methamphetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking methamphetamine and to compare the clinical characteristics of participants who smoked versus injected.

RESULTS

Compared to participants who injected methamphetamine, those who smoked methamphetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked methamphetamine used methamphetamine on more days in the past 4 weeks than participants who injected methamphetamine (26 vs. 19 days, P = 0.001); they did not differ significantly in their severity of methamphetamine dependence, withdrawal, craving or psychiatric symptoms (P > 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = -1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = -1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = -1.1 (0.5), P = 0.022].

DISCUSSION AND CONCLUSIONS

Smoking crystalline methamphetamine is associated with a younger less marginalised demographic profile than injecting methamphetamine, but a similarly severe clinical profile.

Address: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.; School of Psychology and Public Health, La Trobe University, Melbourne, Australia.; Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.; Department of Psychiatry, University of Melbourne, Melbourne, Australia.; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.; Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia.; Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.; Florey Institute for Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia.; Deakin University, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia.; Illawarra Health and Medical Research Institute and School of Psychology, University of Wollongong, Wollongong, Australia.; Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Australia.; Turning Point, Eastern Health, Richmond, Australia.; Centre for Brain and Mental Health Priority Research Centre, School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.; Drug and Alcohol Services, Illawarra Shoalhaven Local Health District, Wollongong, Australia.; Mental Health and Drug and Alcohol Services, Barwon Health, Geelong, Australia.; Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia.; National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.

DOI: 10.1111/dar.13183

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MeSH Terms: Adolescent, Adult, Amphetamine-Related Disorders, Australia, Central Nervous System Stimulants, Demography, Humans, Methamphetamine, Middle Aged, Smoking, Young Adult