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| Journal of the New Zealand Medical Association,
22-November-2002, Vol 115 No 1166
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The emergence of amphetamine use in New Zealand: findings
from the 1998 and 2001 National Drug Surveys
Chris Wilkins, Krishna Bhatta and Sally Casswell
A number of countries in the Asia Pacific region, including
Australia, Thailand, the Philippines, Hong Kong and Japan experienced increased
use and manufacture of powerful amphetamines, such as methamphetamine, in the
late 1990s. Similar patterns of amphetamine use were reported in Western Europe
in the early part of the decade.1–5
Methamphetamine is an addictive psychostimulant resembling cocaine but with a
longer duration period (4–12 hours).6,7
Chronic high-dose use has effects including hostility, violence, hallucinations,
and paranoid psychosis resembling schizophrenia, and can cause damage to
cardiac, vascular and neurological
systems.6–11
It appears that New Zealand may be belatedly joining this
worldwide trend in amphetamine use. The number of clandestine laboratories
detected in New Zealand producing amphetamines increased from fewer than two per
year before 1998, to nine in 2000, to 41 by 2001* (personal correspondence,
NDIB, 2002). The number of people arrested for the possession of
amphetamine-type substances (ATS) increased from 161 in 1998, to 387 in
2001† (personal correspondence, NDIB,
2002). It has been claimed that in some regions the use of amphetamines now
exceeds the traditionally most widely-used illicit drug in New Zealand –
marijuana.12 The apparent rapid spread of
amphetamine use in New Zealand has been highlighted by a series of feature
articles in popular magazines,12–15
newspaper articles, and a television documentary (20/20).
Police and health statistics on amphetamine use can provide
only a partial picture of the extent of the growth in the use and supply of
these drugs. The police appreciation of the situation is limited to the
population of users they have arrested or of whom they have some investigative
knowledge. The dramatic increase in arrests and seizures of amphetamines is
likely, in part, to reflect greater police awareness of these drugs, and the
allocation of additional enforcement resources to the investigation of these
types of offences. For example, in 2000, the police established the first ever
unit wholly dedicated to the detection of clandestine drug laboratories (the
Clandestine Drug Laboratory Team). Alternatively, in terms of health statistics,
drug users generally only come to the attention of medical professionals when
their use has become seriously problematic, and in the case of amphetamines this
can be preceded by months or even years of regular use and
problems.16,8,9
This paper reports the population prevalence of amphetamine
use in New Zealand from data collected in the most recent National Drug Survey
conducted in 2001, and compares the findings with the previous survey carried
out in 1998. A number of new questions concerning the use and supply of
amphetamines were inserted into the 2001 survey, including questions on
self-reported harms from use and current conditions of supply, and these are
reported. The importance of amphetamine use is placed in the wider context of
drug use in New Zealand, through comparison with the prevalence of two other
popular illicit drugs, marijuana and LSD, from the same surveys. The conclusion
discusses the implications of the survey findings for the characteristics of
drug use in New Zealand, and speculates about likely trends in the near
future.
MethodsThe National Drug Survey
interviews a sample of approximately 5500 people aged 15–45 years about
their alcohol, tobacco, marijuana, and other drug use, using a Computer Assisted
Telephone Interview (CATI) system. Telephone numbers are selected using a
stratified random digit dialling method so that each household nationwide has an
equal chance of being called. Within each household, one person is randomly
selected for an interview. Interviewers receive intensive training at the
beginning of the survey, and a supervisor is present at each shift to monitor
the quality and consistency of interviewing, and to handle any special problems.
Each telephone number is called up to at least ten times in an effort to reach
households that are not responding. The 1998 and 2001 surveys achieved response
rates of 79% and 80% respectively.
During the interview, respondents are asked whether they have ever used substances from a list of twenty ‘other drugs’ for recreational purposes; this list includes two types of amphetamines: ‘stimulants’ and ‘ice’. The interviewer reads out the street names and technical names for each type of drug to ensure a high level of recognition by the respondent. For stimulants they read, ‘uppers, speed, amphetamine, methamphetamine’, and for ice they read ‘crystal methamphetamine’. In 2001, those who had used stimulants in the last 12 months were asked a range of additional questions about their experience of use and supply. These included questions about whether use had harmed eight areas of their lives in the previous 12 months, and how price and availability compared to a year earlier. The findings of the two surveys were analysed for differences between the two samples as a whole, and for differences between the subgroups of the two samples. All comparisons were tested at a 1% level for statistical significance, adjusting for design effects. Only changes that are significant are reported. All analysis was conducted using SAS software. ResultsPrevalence
of use The last-year use of stimulants increased from 2.9% in 1998, to
5.0% in 2001. Increases were found for 15–17 year olds (from 1.6% in 1998,
to 5.3% in 2001) and 20–24 year olds (from 5.8% to 10.5%). Use by men aged
15–17 increased from 1.5% in 1998, to 5.7% in 2001 (Figure 1).
Figure 1. Last-year use of stimulants by age group,
1998 and 2001
 The last-year use of ice increased from 0.1% in 1998, to
0.9% in 2001. Increases were found for 20–24 year olds (from no use in
1998, to 2.2% in 2001), and men aged 20–24 years (from no use to
2.9%).
Between 1998 and 2001, stimulant use increased from 2.9% to
5.0%, while use of marijuana (19.9% and 20.3%) and LSD (3.8% and 3.2%) remained
static (Figure 2).
Conditions of supply in
2001 Those who had used stimulants in the last 12 months in 2001 were
asked how the availability of the drug compared that of a year ago. Forty one
per cent of users thought it was ‘easier’ to get stimulants, 35%
said it was ‘about the same’, 12% thought it was
‘harder’, and 12% ‘did not know’.
Last-year stimulant users were also asked how the price of
the drug compared to that of a year ago. Forty six per cent of users thought the
price was about the same, 20% thought it was lower, 23% didn’t know, and
12% said the price was higher.
Self-reported harms from
amphetamine use in 2001 Those who had used stimulants in the previous 12
months were asked whether their use had harmed eight areas of their life in that
year. One fifth of stimulant users reported harmful effects on ‘energy and
vitality’, while about one in ten reported harms related to
‘financial position’, ‘health’ and ‘work
opportunities’ (Table 1). Very few users reported harmful effects on
‘children’s health or wellbeing’.
 Figure 2. Last-year use of stimulants, marijuana and
LSD, 1998 and 2001
Table 1. Identified areas of life that were harmfully
affected by the use of stimulants in the last year, 2001
DiscussionComparison of the findings of the
National Drug Survey in 2001 and 1998 suggests changes in the nature of drug use
in New Zealand. Although marijuana remains by far New Zealand’s most
widely-used illicit drug, its last-year prevalence did not change between 1998
and 2001. In contrast, the use of amphetamines increased rapidly during this
time, particularly among young people and men. Stimulants moved from being the
third most popular illicit drug type in 1998 to the second most popular by 2001.
In a regional drug survey conducted in 1990,17
stimulants were the fourth most popular illicit drug type, behind marijuana, LSD
and hallucinogenic mushrooms.
Although well designed CATI surveys have been found to
achieve similar results to other survey
methodologies,18 the difficulties of surveying
illicit drug users, and in particular heavy drug
users,19 mean the findings reported here are
likely to underestimate the true number of amphetamine users to some extent.
However, the consistency of the survey methodology between the survey waves
suggests the trends in amphetamine use identified are likely to be fairly
accurate.
A number of users reported harmful effects from amphetamine
use on a range of areas of their lives. The high proportion of users reporting
problems related to ‘energy and vitality’ (20%) is consistent with
the effects of amphetamine, which permit users to sustain long periods of
physical activity while under the influence of the drug, but are followed by a
physical and mental ‘crash’ characterised by exhaustion and
depression.7 The relatively high number of
users reporting problems related to ‘work and work opportunities’
(10%) may reflect the fact that amphetamines are often used to increase
performance and endurance at work and this can eventually cause
problems.1
The questions about harms asked in the survey can provide
only a preliminary assessment of the health risks of amphetamines. Respondents
were asked to provide simple yes/no responses to dichotomous questions about
harm related to their stimulant use in general areas of their life. They were
not able to express the type, or seriousness, of harm experienced. Australian
studies of amphetamine users that have employed more diagnostic questioning
about harms have found users experiencing a range of physical and psychological
problems.9,20,21 For example, Hando et
al20 found users commonly reporting physical
symptoms such as poor appetite (63% of respondents), fatigue (58%), racing heart
(56%), and trouble sleeping (55%), and psychological symptoms such as depression
(64%), anxiety (63%), paranoia (47%) and hallucinations (28%). The Australian
studies all drew on purposive samples rather than representative population
samples and recruited frequent users (eg, once a month) rather than merely
last-year users. A high proportion of participants in these studies were also
intravenous drug users who reported high levels of poly-drug use and this may
have contributed to the harms reported.
The relatively recent popularity of amphetamines in New
Zealand may be concealing the level of harm from these drugs to some extent. A
time lag of ‘several years’ before users of methamphetamine powder
reported serious problems has been noted by key informants in the Australian
Illicit Drug Reporting System (IDRS) (compared with only a few months for
ice).16 Gawin and
Ellinwood8 observe users of psychomotor
stimulants commonly progress to addiction only after two to five years of use.
More comprehensive and detailed diagnostic questioning, with ongoing monitoring,
is required to adequately evaluate the harm of amphetamine use in New
Zealand.
Given that the large-scale domestic production of
amphetamines has only recently been established in New Zealand, it is possible
that amphetamine use will continue to increase. However, there are several
reasons to believe that use may stabilise in the near future.
First, the health risks associated with amphetamine use are
serious, particularly when compared with other popular illicit drugs in New
Zealand, such as marijuana and LSD. As more new users experience problems, or
know someone who has experienced problems, the initial enthusiasm for the drug
may wane.
Second, the price of amphetamines in New Zealand is still
high relative to other popular illicit drugs. At street level, methamphetamine
sells for about $100–180 per gram22 and
more pure amphetamine (Pure) sells for about $1000 per
gram.15 In comparison, a tab of LSD can be
purchased for approximately $30–40, and 1.5 grams of marijuana can be
bought for $20.23 The high prices paid for
amphetamine are exacerbated by difficulties in verifying the quality of
purchases before payment is made.24 With
marijuana, quality can be established through physical inspection before money
is handed over,25,26 whereas the generic
pharmaceutical characteristics of amphetamine (ie, chemical powder) means that
purchasers face a greater risk of receiving low quality or fraudulent
drugs.
Third, there is likely to be a stiffening of the enforcement
response to amphetamine use and manufacture in New Zealand. The police are
seeking to reclassify methamphetamine to the most serious level of offence under
the Misuse of Drugs Act 1975 (ie, Class A), and to expedite the specification of
explicit quantities for presumption of supply, additional powers of search, the
creation of a special offence of amphetamine manufacture, and legislation to
control precursor chemicals used in domestic
manufacture.22 Experience in Australia and the
United States indicates stricter control of precursors can have an impact on
domestic production.27,28
Finally, the prevalence of amphetamine use in New Zealand
already appears high compared to other countries in the Asia Pacific region,
including Australia (3.4%),29 with only
Thailand (5.9%)2 reporting a higher last-year
prevalence level.‡ Many countries in
Western Europe that experienced rapid growth in amphetamine use in the mid
1990s, are now experiencing reductions in use, including the United Kingdom
(from 2.9% in 1996, to 1.9% in 2000), the Netherlands (from 5.1% in 1996, to
2.8% in 1999), and Spain (from 4.1% in 1996, to 2.5% in
1998).2,§ The Asia Pacific region may well
experience a similar downward phase of the ‘new’ drug
cycle.
Author information:
Chris Wilkins, Economist; Krishna Bhatta, Statistician; Sally Casswell,
Professor and Director, Centre for Social and Health Outcomes Research and
Evaluation (SHORE), Massey University, Auckland
Acknowledgements:
The national drug comparison survey was a project of the Alcohol & Public
Health Research Unit (APHRU), and was funded as a programme of the Health
Research Council and the Alcohol Advisory Council. The funding for the survey
was provided by the Health Research Council as an investigator-initiated grant
to Professor Sally Casswell. The project was managed by Dr Chris Wilkins with
Rachael Lane, Mary Blade and Heather Seal. The data management and statistical
analysis were carried out by Dr Krishna Bhatta and Dr Megan Pledger, assisted by
Michael Ford and Alistair Stewart. We acknowledge the time and willingness of
participants to respond to the survey, without which the project could not have
taken place.
Correspondence: Dr
Chris Wilkins, Centre for Social and Health Outcomes Research and Evaluation
(SHORE), Massey University, PO Box 6137, Auckland. Fax: 09 366 5149; email: c.wilkins@massey.ac.nz
References:
Endnotes:
* These
detections of amphetamine laboratories refer to the production of all types of
amphetamine drugs, including ecstasy. However, there has been only one reported
case of ecstasy manufacture in New Zealand to date (in 2001).
† Arrest
data for amphetamine offences include offences involving all types of
amphetamines, including ecstasy. At present the police do not specify what type
of amphetamine was involved in an arrest (personal correspondence, NDIB,
2002).
‡ Precise
comparisons are not possible due to differences in the age range of surveys and
different survey methodologies.
§ Again,
comparisons cannot be precise due to the differences in the age range and
methodologies of the surveys.
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