Dive Deeper to Measure the Toll of “Ice” on Mental Health
The use of methamphetamine (“ice”) is a major public health problem in Australia – the most recent large-scale survey, in 2019, estimates that more than 1.3 million people over the age of 14 have used it under the influence of alcohol. form or another during their lifetime.
It is also important to note that methamphetamine consumption is generally higher in rural areas of Australia than in metropolitan cities.
Then if we look at mental health and the link between the two, we find that 13% of Australians have an anxiety disorder and 10% have symptoms of depression. These disorders usually coexist and the risks of suffering from one or the other of these disorders are very similar.
The third most common mental health disorder in Australia is substance use and generally coexists with anxiety and depression.
But much of the research regarding methamphetamine use and mental health effects has focused on the risk of developing psychosis, and experimental studies have shown that “ice” can induce psychosis.
The evidence regarding depression and anxiety and methamphetamine use is much less conclusive, although previous data, including that of the Australian Institute of Health and Welfare (AIHW) report cited above, suggests that the rates depression and anxiety are more common among methamphetamine users than in the rest of the world. population in Australia.
Additionally, a systematic review, led by Rebecca McKetin of the Center for Mental Health Research at the Australian National University, found evidence of an association between methamphetamine use and depression, but no evidence of a link with them. anxiety disorders.
The most commonly reported form of methamphetamine in Australia is the crystalline form – ice – which is typically ingested while smoking. The social costs of methamphetamine use in Australia are largely linked to crime, including law enforcement and the justice system. The estimated costs of premature mortality and workplace impacts are also high.
Methamphetamine use is attributed to a significant global disease burden and is associated with high levels of health service use. Health problems resulting from methamphetamine use include cardiovascular disease, kidney problems, oral health, high risk of stroke, and significant psychological damage.
Almost 1.5% of AIHW respondents said they had used methamphetamine in the past 12 months.
With all of this in mind, we wanted to study, in more depth, the prevalence rates of moderate to severe anxiety and depression in a large cohort of participants using methamphetamine, and to examine whether the anxiety experience moderate to severe and moderate to severe depression were associated with demographic, socioeconomic, substance use, or other specific health and social factors.
A collaborative study of 850 people
The current study is part of the Monash VMAX study, a project between the Burnet Institute and Monash Rural Health. It involves over 850 community people in metro and rural Victoria who use methamphetamine. Recruitment of participants was done through networking and snowball sampling (where one participant helps recruit another).
All were over 18 years old and had used methamphetamine at least once a month for the past six months, and used primarily non-injection methods of administration.
We found that 60% of the VMAX cohort had a moderate to severe score for anxiety or depression.
The proportion of participants with moderate to severe depression or anxiety was higher than Australians in the general population who suffered from anxiety or depression. By far the majority of the sample was dependent, male, non-Aboriginal, lived in a metropolitan or large rural town, and was unemployed.
It is important that interventions and services meet clients’ needs related to depression or anxiety, as well as their methamphetamine use.
When we analyzed demographic, socioeconomic, substance use patterns, and other health and social factors related to anxiety and depression among methamphetamine users, we found that poor or very self-rated health. poor, methamphetamine addiction and unemployment were associated with higher risks of suffering from moderate to severe anxiety or depression.
Living in a large rural town, identifying as Aboriginal and Torres Strait Islander, and smoking methamphetamine were associated with a lower likelihood of experiencing moderate to severe depression.
Being female was associated with a higher likelihood of experiencing moderate to severe anxiety.
These results highlight that health services are likely to experience high levels of depression and anxiety in people who use methamphetamine compared to the general population.
Health services play an important role in the management or referral for treatment of mental illness. Diagnoses of anxiety or depression can pave the way for an integrated model of care to treat common co-morbidities.
Integrated models of care provide a “no-wrong” approach that allows people who use methamphetamine to seek professional support for their mental health.
Therefore, it is important that interventions and services address clients’ needs related to depression or anxiety, as well as their methamphetamine use.
Little focus on non-injectors
There is another important consideration when examining depression and anxiety in methamphetamine users. Very few studies have examined these associations in people recruited from non-treatment or non-detention settings, or in those who primarily use non-injection methods of administration, such as smoking, snorting, “shelving” (insert medication in the anus), and orally.
Overall, previous research has recruited participants from health facilities such as rehabilitation centers or secure injection rooms. Recruitment via these parameters may be less of a problem; However, it has also been suggested that people who take treatment for their methamphetamine use are likely to have different characteristics than those who do not seek treatment.
Read more: Reassessing the social context of illicit drug use and addiction
In addition, people on treatment for methamphetamine tend to have a longer history of illicit substance use in general and are more likely to administer by injection. This is problematic, as mentioned earlier, because the majority of people who use methamphetamine are more likely to use non-injection methods of administration,
Little attention to anxiety
Another important contribution that the present study makes to the literature are the results relating to anxiety. While comorbid anxiety is commonly associated with other types of substance use disorders, the association between methamphetamine use and anxiety has received little attention.
Importantly, our study also highlights the association between anxiety and depression in methamphetamine smokers. This has been a previously neglected area of research in Australia.
The results of our study are consistent with the high prevalence of anxiety and depression in people who inject methamphetamine. While the odds of suffering from moderate to severe depression were lower for smokers in the present study, the prevalence of anxiety and depression in this cohort is high compared to the general population.
It is important that further research on methamphetamine smokers examine the concomitant relationship between anxiety and depression, as well as anxiety, independently.
This article first appeared on Monash Lens. Read the original article