Amphetamines: client demographics and treatment

In 2020–21, amphetamines were reported as a drug of concern (either principal or additional) in 3 in 10 treatment episodes (31% or 69,600 episodes) (Table Drg.4).

AODTS NMDS data for amphetamines correspond to the Australian Standard Classification of Drugs of Concern (ASCDC) for the general ‘amphetamines’ classification, in which methamphetamine is a sub-classification (ABS 2011).

The ASCDC is set up with 3 levels of classification which includes the broad group (e.g. Stimulants and hallucinogens), narrow group and base-level categories (which are the most detailed). Data available in the AODTS NMDS report the narrow group ‘amphetamines’ classification. Base-level categories within this narrow group include:

  • Amphetamine
  • Dexamphetamine
  • Methamphetamine
  • Amphetamine analogues
  • Amphetamines, not elsewhere classified (nec)
  • Amphetamines, not further defined (nfd).

Changes to coding for methamphetamines has been difficult due to jurisdictional differences in client management systems, and the use of only broad or narrow group coding by some agencies. This has improved over time due to advancements in workforce training, agency coding practices and new system updates.

Data on different forms of amphetamines—methamphetamine specifically—have not been separately reported over time due to the nature of the classification structure used in this collection. Information on methamphetamines as a principal drug of concern was reported for the first time in the 2019–20 AODTS NMDS report.

Amphetamines was the second most common principal drug of concern, recorded in almost 1 in 4 treatment episodes (24% or 54,300 episodes) (Table Drg.4). Amphetamines has remained the second most common PDOC since 2015–16, when it surpassed cannabis for the first time (Table Drg.5). Treatment episodes for amphetamines have increased by 220% since 2011–12 (16,900 to 54,300 episodes), although this has declined since 2019–20. Proportionally, treatment episodes for amphetamine-related treatment steadily rose (in relation to all drugs) between 2011–12 (11%) and 2019–20 (28%) but declined in 2020–21 (Figure AMPHET2; Table Drg.1).

In 2020–21, 2 in 5 amphetamine-related treatment episodes had at least 1 additional drug of concern recorded (39% or 21,200 episodes) (Table Drg.2). The most common additional drugs of concern were cannabis (34% or 12,000 episodes), alcohol (21% or 7,400 episodes) and nicotine (18% or 6,500 episodes) (Figure DRUGS1; Table Drg.3). These drugs may not have been the subject of any treatment in the episode.

For information on amphetamine use and harms, please see:

Client demographics

In 2020–21, 30,200 clients received treatment for amphetamines as the principal drug of concern. Of these clients:

  • Just under 2 in 3 were male (64% of clients) (Table SC.9).
  • Almost 7 in 10 were aged 20–29 (30% of clients) or 30–39 years (39%) (Table SC.10). This was consistent for both males and females (Figure AMPHET1).
  • Around 1 in 5 were Indigenous Australians (19% or 5,700 clients) (Table SC.11). This represents a crude rate of 981 Indigenous clients per 100,000 population (crude rate) (Table SCR.26).

Figure AMPHET1: Clients with amphetamines as the principal drug of concern, by sex and age group, 2020–21 (per cent)

The butterfly bar chart shows that male clients receiving treatment for amphetamines as the principal drug of concern were most likely to be aged 20–29 (28.1% of clients) or 30–39 (38.7%) in 2020–21. This was similar for female clients (33.5% aged 20–29 and 39.9% aged 30–39).

Treatment

In 2020–21, 54,300 treatment episodes were provided to clients for amphetamines as the principal drug of concern (Table Drg.4). The median duration of these treatment episodes was just over 5 weeks (36 days) (Table Drg.39). Episode duration varied by main treatment type, with the longest median duration being around 10 weeks (72 days) for counselling (Table Drg.41). Nearly 3 in 10 (28%) treatment episodes lasted 1 to 3 months; a further 26% lasted 2–29 days (Table OV.12).

Among amphetamine-related treatment episodes in 2020–21:

  • The most common source of referral was self/family (36% or 19,500 episodes), followed by health services (29%) (Figure AMPHET2; Table Drg.37).
    • Across the 10 years to 2020–21, self/family remained the most common source of referral.
    • Referrals from health services have been increasing over this period, and as the second most common referral source, are 29% of episodes (Figure AMPHET2; Table Drg.37).
  • The most common main treatment type was counselling (41% of episodes), followed by assessment only (20%) (Figure AMPHET2; Table Drg.36). This is consistent with previous years, although the proportion of counselling episodes has fluctuated in the 10 years to 2020–21.
  • Almost 2 in 3 treatment episodes took place in a non-residential treatment facility (64% of episodes) (Table Drg.38).
  • Around 1 in 2 episodes ended with a planned completion (52% of episodes), while 26% ended unexpectedly (Figure AMPHET2; Table Drg.38).

Figure AMPHET2: Treatment episodes with amphetamines as the principal drug of concern, by main treatment type, reason for cessation or source of referral, 2011–12 to 2020–21 (number or per cent)

The line graph shows that counselling was the most common main treatment type among treatment episodes for amphetamines across the 10 years to 2020–21, rising from 7,522 episodes in 2011–12 to for 21,997 in 2020–21. Assessment only remained the second most common main treatment types across the period, accounting for 11,122 episodes in 2020–21. Filters allow the user to view data as the number or per cent of episodes for main treatment type, reason for cessation or source of referral.

Methamphetamine-related treatment episodes

In 2020–21, almost 4 in 5 (79%) amphetamine-related treatment episodes were for methamphetamine as the principal drug of concern (Table Drg.5). Treatment episodes increased from 16% to 79% since 2011–12 (from 2,800 to 42,700 episodes) (Figure AMPHET3).

Figure AMPHET3: Treatment episodes with amphetamines as the principal drug of concern, by amphetamine type, 2011–12 to 2020–21 (number or per cent)

The line graph shows that methamphetamine has remained the most common amphetamine type among treatment episodes for amphetamines since 2015–16, when it overtook ‘Amphetamines not further defined’. Methamphetamine accounted for 42,659 treatment episodes in 2020–21. A filter allows the user to view data as the number or per cent of episodes.

The rise in reported episodes for methamphetamine may be due to a combination of factors including improvements in agency coding practices for methamphetamine, treatment system updates and increases in funded treatment services.

Additionally, National Drug and Alcohol Research Centre (NDARC) analysis of AODTS NMDS data indicates that increased treatment episodes for methamphetamine since 2002–03 is due to smoking as a method of use. Treatment for this method of use occurred among younger clients (median age 30 years) whose main treatment type was either assessment only or support and case management (McKetin et al. 2021).

Increases in AODTS NMDS treatment episodes for smoking methamphetamine from 2010 onwards coincides with increases in importation of smokable, high purity methamphetamine into Australia (Degenhardt et al. 2017).

Method of use

How does a client’s method of use relate to the form of amphetamine used?

A client’s usual method of administering their principal drug of concern may indicate the form of drug used, particularly for amphetamines. For example:

  • Clients who report smoking or inhaling amphetamines are most likely to be using amphetamines in crystal form.
  • Clients who report ingesting or snorting are most likely to be using a powder form.
  • Clients who report injecting amphetamines may be using any form of amphetamines, as each form (base, crystal and powder) can be injected. However, recent data from the Illicit Drug Reporting System (an annual survey of people who inject drugs) indicate that crystal and powder are the most common forms used among people who inject methamphetamine (Sutherland et al. 2021).

Among all amphetamine-related treatment episodes in 2020–21:

  • Smoking/inhaling was the most common method of use (51% of episodes), followed by injecting (35%) (Figure AMPHET4; Table Drg.6). This was similar for methamphetamine (52% and 37% for smoking/inhaling and injecting, respectively) (Table Drg.6).

Between 2011–12 and 2020–21:

  • The number of episodes where clients reported smoking/inhaling amphetamines increased from 5,281 episodes in 2011–12 to 29,162 episodes in 2020–21 (Figure AMPHET4; Table Drg.6). This declined from 32,231 episodes in 2019–20, reflecting the overall decline in treatment episodes for amphetamines in the past year.
  • The number of episodes where clients injected amphetamines increased almost 4-fold, from 8,638 to 22,375 in 2019–20, falling to 18,732 in 2020–21 (Figure AMPHET4; Table Drg.6).

Figure AMPHET4: Treatment episodes with amphetamines as the principal drug of concern, by method of use, 2011–12 to 2020–21 (number)

The line graph shows that ‘Smokes or inhales’ has remained the most common method of use among treatment episodes for amphetamines since 2014–15, when it overtook ‘Injects’ for the first time. ‘Smokes or inhales’ was the method of use in 29,162 episodes for amphetamines in 2020–21, while ‘Injects’ was the second most common method of use in 18,732 episodes.

ABS 2011. Australian Standard Classification of Drugs of Concern, 2011. ABS cat. no. 1248.0. Canberra: ABS.

Degenhardt L, Sara G, McKetin R, Roxburgh A, Dobbins T, Farrell M et al. 2017. Crystalline methamphetamine use and methamphetamine-related harms in Australia. Drug and Alcohol Review 36:160–70.

McKetin R, Chrzanowska A, Man N, Peacock A, Sutherland R & Degenhardt L. 2021. Trends in treatment episodes for methamphetamine smoking and injecting in Australia, 2003–2019. Drug and Alcohol Review.