• This stereotype only represents a small portion of ice users in Australia. (Getty)Source: Getty
Stick thin, sunken eyes, blistered sores, violent rages; how accurate our perceptions of ice addicts? We get the facts from a drug expert.
Sharon Verghis

29 Nov 2017 - 2:39 PM  UPDATED 8 Dec 2017 - 4:46 PM

In the 1930s anti-marijuana propaganda movie Reefer Madness, young, naïve Americans are shown plunging into the abyss of addiction – and even committing weed-fuelled rape and murder – after just one or two hits of a joint.

It seems laughably alarmist now, but a similar heightened cultural hysteria may have already emerged around methamphetamine, or ice, as it’s common to hear ‘if you try ice once, you’re hooked’. 

Drug addiction is certainly not encouraged by anyone. But as we search for the truth surrounding drug addiction, we need to know the facts. So the real question here is: how quickly can you get addicted to ice and how potent a drug is it really?

Only a small proportion of people who are using methamphetamine are dependent.

Addiction is a complex disease, involving an interplay of biological, psychological and social components, according to Associate Professor Nadine Ezard, clinical director of the Alcohol and Drug Service, St Vincent’s Hospital Sydney

A founding fellow of the Australasian Chapter of Addiction Medicine, Ezard has worked with drug and alcohol users for over 20 years both in Australia and overseas. She currently directs Sydney’s specialist stimulant treatment program, which treats the rising number of people with methamphetamine use disorders since 2006. 

Methamphetamine, Ezard says, can be “very potent. It gets into the brain very quickly, whether it's smoked or injected, so it does mean for a certain proportion of people who are using it, they just start using it more frequently… and over time, they become tolerant to more and more of the drug”. 

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“[Its potency] does encourage that repeated self-administration, that kind of reward-chasing behaviour that has the potential for dependence.” 

In terms of physical effects: “ice does stop you from sleeping. And the combination of insomnia and the drug does make people vulnerable to psychosis. It might be in mild form, like paranoia or you might hear things, or sometimes it can be thinking that people are after them.” 

But there are two vital issues to stress, Ezard says. “Only a small proportion of people who are using methamphetamine are dependent.” 

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According to the 2016 National Drug Strategy Household Survey, just over six per cent of Australians over age 14 had ever used methamphetamine including ice. Of those who had used methamphetamines (including ice) in the past 12 months, 20.4 per cent used it weekly or daily, 10.6 per cent used it once a month, 24.7 per cent used it every few months and 44 per cent used it once or twice.

“So what we understand from the survey is that the majority of people who use methamphetamine do so once a month or less, and are probably not having many problems.”

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The second aspect of the ice story is how the Reefer Madness-style hysteria and sensationalism around the drug is hindering people seeking help and creating a distorted picture of users, Ezard claims.

She says despite the stereotypes, the majority of methamphetamine users do not react aggressively or violently while under the influence of the drug.

“The majority of the people who seek treatment in our clinic you wouldn’t recognise as [having a problem]…They are sustaining relationships, and looking after themselves in other ways.

“If you look at studies like [Burnet Institute research officer] Brendan Quinn did in Melbourne where they interviewed a group of people who use meth in the community and asked them if they were having problems with their use, many people, even those who had turned up at hospital with psychosis or other methamphetamine-related problems, or scored [positive] on a screening test for dependency, they didn’t recognise they had problems related to their use.”

Ice acts fast on the brain, making it a potent drug.

Why? Because there may be an inaccurate assumption that to have a ‘ice problem’ which therefore requires treatment, you need to be throwing chairs and picking your skin. Instead, Ezard defines a heavy user with an addiction problem as someone who is using ice every week.

So then, at what point will an ice user typically recognise that they might need help? Ezard says this can depend on the individual. “We know from clinical data that there is up to a 10-year delay from when people first start having problems related to meth, and seeking treatment.” 

Ezard sees a range of clients from a variety of demographics. “But people who seek treatment tend to be intravenous users, they might have severe mental or physical problems related to their use, or they might have other issues related to parenting that makes them want to seek treatment.” 

“The majority of the people who seek treatment in our clinic you wouldn’t recognise as [having a problem]…They are sustaining relationships, and looking after themselves in other ways.

Some come on the back of court orders, others are self-referred. “It’s a whole range. Some people are on parole, and so they’ve got a parole officer. But nearly all the people are self-referred at St Vincent’s.

"The majority of people are voluntarily seek[ing] treatment because they are starting to see [that their] relationships in trouble or they might have just lost a job, or sometimes it is a family member that encourages people into seeking help, sometimes people are spending too much money, or they’re starting to run into other trouble associated with their use, so it might be gambling, or internet porn.” 

The first step, she says, is “we try to understand what people are looking for and what their goals might be. We help them assess how much they are using, if it’s increasing, or if there any other red flags that might prove concerning in terms of risks.” 

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Ezard stresses that the main thing is to help people understand how to decrease the harmful risks associated with methamphetamine use. “The second thing is that we help you understand if you might be having some issues related to that, and if you do want to do something about it, we can then refer you into treatment. But we don’t tell people what to do.”

There is so much pain and shame around the issue, for the users as well as their family and friends, and “so we do need to create support [for all involved]. Stigma is a big preventative barrier for people seeking treatment.”

“We need to treat it as a public health problem like any other. No one asks to be dependent on this drug. It’s not a choice. There’s nothing to be ashamed about. And the more we can do to encourage communities to understand it as a health problem, and not some sort of moral or behavioural problem, the better.”

For more information about ice, access the online toolkit providing information and resources about crystal methamphetamine (including where and when to get help): Cracks in the Ice.

If you or someone you know is in need support, please:

If you, or someone you know is in need of free, evidence-based help to manage their mood, alcohol, or drug use, please visit The Shade Project.

All six episodes of Struggle Street series two are available to view on SBS On Demand

Struggle Street series two is produced by KEO Films with funding support from Screen Australia and Film Victoria.

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