There Is No Ice Epidemic: A Statistical Analysis

"Epidemic" can be a loaded word, especially when applied to something as complicated as patterns of drug use. But to what extent does it accurately portray the growth and scope of crystal methamphetamine usage in Australia?

At least one news article has used the Illicit Drug Reporting System (IDRS) to bolster claims that ice is on the rise. Even if the reporter gets the details right, and mentions that the IDRS data tracks only injecting drug users, the IDRS might not be appropriate for an article about an ice epidemic. Especially if that article doesn't fully explain the purpose of the IDRS, and lacks references to other statistics.

The handouts that are used to compile data from these systems, issued by the National Drug and Alcohol Research Centre (NDARC), explicitly state why this is so: "It is important to note that the information from the people who inject drugs survey (PWID) is not representative of illicit drug use in the general population and nor is the information representative of all illicit drug users."

The people interviewed as part of the IDRS are not representative of the population. They have a mean age of 41, they are 69 percent male, 83 percent are unemployed, 55 percent have prison experience, and 47 percent are currently in drug treatment. They are mostly recruited through needle exchange programs and word of mouth.

The IDRS is intended to serve as a strategic warning system that identifies emerging trends in a 'sentinel' group. VICE spoke with the national co-ordinator of the IDRS and the Ecstasy and Related Drug Reporting System (EDRS), Natasha Sindicich, about how her organisation's findings had been used. She was somewhat troubled, emphasising, "[w]e speak to these sentinel groups because they act as surveillance systems. They document use and harms over time."

Sindicich offered an example of the IDRS in action: a couple years ago, the system detected an influx in brown heroin, mostly from Afghanistan. Unlike refined white heroin,  brown heroin is a base with leftover 'gunk' from processing. It requires acid before it can be dissolved in water and injected. By detecting the increase of brown heroin the IDRS allowed health professionals to provide pure citric acid to users so they wouldn't resort to more harmful alternatives, like lemon juice.

Not to say the systems can't have broader applications. As Ms Sindicich explained, the IDRS and EDRS are better at tracking the cost of drugs in the groups they survey than undercover policeman, who tend to overpay.

Some have posited the ice epidemic is localised into rural areas. If this is true the IDRS and EDRS are particularly inappropriate tracking tools. The systems monitor urban-based 'surveillance' groups of drug users. The main point is, they can be useful but shouldn't be the single source of data when trying to determine the use of any particular drug in the general population.

The National Drug Strategy Household Surveys (NDSHS), conducted every three years, attempts to provide that information. The last report is from 2013, and it surveyed 23,855 people from across Australia. The focus was on private residences, so the homeless and the institutionalised were not part of the sample. In its summary of people older than 14 who reported recent illicit drug use (within the last 12 months), 2.1 percent reported taking amphetamine or methamphetamine - the same level of use as was recorded in 2010. In 2007, that figure was 2.3percent, and in 2004 it was 3.2 percent. So according to the NDSHS the percentage of people using meth or amphetamine in Australia has seen a slow downward trend.

However, while the percentage of people using some form of amphetamine or methamphetamine remained stable, within that group, 71 percent reported using crystal meth. This is a significant increase from 2010 when it was only 50.8 percent. This was paralleled by a decrease in the reported usage of either powder or base. Furthermore, the frequency of use has increased: the percentage of meth/amphetamine users who report using once a week or more is now 15.5 percent, up from 9.3percent in 2010. Unfortunately, the statistics relating specifically to the frequency of ice use is tarnished by a high relative standard of error in this category for the 2010 survey. However, it's probably safe to say the increase is significant.

So according to the NDSHS the percentage of Australians using some form of meth or amphetamine is not increasing - there is no "epidemic" - but amongst that percentage people are getting high more frequently. They're also more likely to be using crystal meth, which is generally more potent than other forms of methamphetamine.

Statistics that track crimes have been used to support a different take: the narrative of an epidemic. They include the compilations of crime statistics issued by state police forces and the Illicit Drug Data Report (IDDR), which is issued by the Australian Crime Commission.

Once again, these reports do not, and were never intended to, track drug usage in the general population. The IDDR tracks drug use among police detainees via a self-report survey and voluntary urinalysis. Both of these systems detected an upward trend in the use of crystal meth, an increase of about 2-3 percent between 2011-12 and 2012-13. These levels are 10-15 percent higher than the low point registered in 2009-10 but are still below all the figures reported between 2003 and 2007.

The other important usage related statistic the IDDR tracks is the amount of Amphetamine-Type Stimulants (ATS) being encountered on Australia's borders. There has been a drastic increase in the number of seizures (85.6 percent for this reporting period) and their average weight. The weight increased by over 500 percent but is skewed by "3 large detections in sea cargo" which had a combined weight of over 1,250 kilograms.

On the other side of the coin is local manufacture. NSW Police Chief Andrew Scipione has pointed to the number of drug labs the police have shut down as proof of an ice epidemic. From September last year to August this year, 100 labs were shut down around the state. Reports say Queensland might have the most drug labs of any state. And in Western Australia authorities shut down 25 labs in 2008, 142 in 2012, 135 in 2013, and so far this year they've raided 70. WA police credit the decrease to better policing and tighter restrictions on lab chemicals and equipment. The long-term impact made on meth usage by the closure of labs is unknown.

Stopping meth at manufacturing and distribution levels is complicated, as explained by Gail Bell in a Monthly article from 2008. "Methamphetamines are imported when they can't be homemade… When the imports dry up because of increased vigilance by Customs, the pendulum swings back to local law-breaking ingenuity."

Also, the data on manufacture and importation does not necessarily point to an increase in demand or, if it does, fails to attribute this to new (as opposed to existing) ice users.

Drug offence statistics have a similar problem - they don't track reoffenders. According to the most recent report from the NSW Bureau of Crime Statistics and Research, drug offences related to the use or possession of methamphetamines are up by 16.1 percent over the last 24 months. On the other hand dealing and trafficking offences related to amphetamines only saw a slight increase. Nationally the same pattern was observed, with Victoria recording that possession and use jumped 18.5 percent while manufacturing and trafficking increased by just 1.9 percent.

Ambulance data from Victoria has also demonstrated a rise in meth related incidents, both overall and for crystal meth specifically. According to Turning Point's Ambo Project, there was a 198 percent increase in ice-related ambulance attendances from 2011/12 to 2012/13 (from 77 calls to 231). There was also a 6-9 percent increase (for regional and metropolitan Victoria respectively) in the number of those attendances that required a hospital transfer.

The information contained in the crime and ambulance data only shows a rise in meth related offences and seizures. Interpreted flatly, they could be used as evidence for something like an "epidemic".

Cautiously, however, such a correlation could be said to be in line with the data provided by the NDSHS. Presuming that the amount of people using and dealing has remained the same, the fact that ice is replacing less potent forms of meth could still lead to more meth related drug offences, and ambulance attendances. Higher levels of methamphetamine are correlated with an increase in reckless behaviour (including crime).  Users are also more likely to experience an overdose or a psychotic episode that commands police and paramedic attention.

Paul Dietze, of the Burnet Institute in Melbourne, (who inspired this article with his references to national studies that suggested stable crystal meth use nationally) told the Guardian this month: "The perception of an ice epidemic is being driven by the experience of harms people are seeing," he said. "What we are arguing is that this is probably due to the changes in purity, not an increase in users."

Rising purity would correlate with an interesting discrepancy in the IDRS statistics. There, 50 percent of respondents stated that heroin was their drug of choice and 24 percent said it was methamphetamine (14 percent for ice). But when asked which drug they've injected most often in the last month Heroin drops to 41 percent and Methamphetamine increases to 30 percent (Ice 22 percent). This, Sindicich explained, has to do with the relative potency of the drugs: "Heroin hasn't been great since 2000 and so this group is switching to stimulants. You get ice and you don't need anything else for the next 2 to 3 days. Heroin is gone after four to six hours."

Sindicich also concurred with Dietze's assessment. But just because we're not facing an epidemic doesn't mean there aren't serious concerns. On the contrary, higher levels of drug abuse in active users, involving more powerful drugs, can be very troubling. "[We're seeing] an increase in frequency as well as potency," Sindicich emphasised, referring to the IDRS group, "Fortnightly to weekly. It is an issue; we'll keep an eye on it. If they're injecting more than once a day that's a problem."

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