Amanda gave us an extensive overview of the effects of methamphetamines and effective treatments. Amanda acknowledged the short term psychological and physical effects that attract users initially. The feeling of a euphoric state, mood enhancement and higher energy levels amongst other effects were discussed.
However, the adverse effects are wide-ranging; Amanda stressed that poly-drug use is very high in methamphetamine users which complicate how users react. Physical harms were discussed along with the social impairments, and issue of high levels of risky use. There are also mental health effects as methamphetamine can induce psychosis and is associated with mood and anxiety disorders. A quarter of psychostimulant users experience suicidal ideation. The rates of suicidal ideation and attempted suicide go up for long-term and frequent users of methamphetamine.
However there is hope!
Cognitive Behaviour Therapy (CBT), motivational interviewing techniques and general counselling are all advantageous for reducing amphetamine use, depression and distress associated with psychosis. Amanda described a study which showed that even brief interventions (1-2 sessions) were effective and the more sessions attended increased the effectiveness of the treatment.
Therefore, therapists and counsellors play a vital role in how effective the treatment will be by developing a relationship with the patient to help increase fidelity rates for treatment sessions. How health professionals get patients motivated when they have anhedonia, cognitive deficits, and other issues associated with methamphetamine and other drug use also affect treatment effectiveness. By simply actively listening, being sincerely empathic and positive, patients may be more willing to cooperate and engage in treatment.
Other interventions are also effective and are important to utilise when appropriate. Social impairments in particular can be assisted by health and well-being treatments. These treatments that focus on healthy lifestyles concentrate on improving mental health in general, diets, sleep hygiene, smoking cessation etc. Mutual aid groups such as SMART recovery and AA have benefits to help patients learn life and social skills and be integrated back into society. Also using treatments delivered by phone and online help patients keep engaged as they don’t need to turn up to sessions which can be a major issue in alcohol and other drug counselling.
Amanda described treatments that have reduced methamphetamine use and associated mental health issues. However she also recognized that co-occurring substance use and mental disorders prove to be a difficult task to navigate as users who reach out for help are sometimes left being bounced around mental health and drug counselling services. We need to find ways to help clinicians feel confident and not deskilled in both substance use and mental health disorders.
National Drug and Alcohol Research Centre, UNSW
NHMRC CRE in Mental Health & Substance Use