Exploration of patterns of drug use, methamphetamine dependence and associated harms, and barriers to treatment among people who inject drugs in north and south Tasmania

The current study examined patterns of drug use, associated harms, and access to drug treatment among individuals who inject drugs in northern and southern Tasmania. One hundred individuals in the south and 41 in the north were interviewed using the Illicit Drug Reporting System paradigm. Given recent community concern regarding methamphetamine, harms were examined as a function of likely dependence on methamphetamine by classifying respondents into groups based on Stimulant Severity of Dependence scores: no methamphetamine use; methamphetamine use, not likely dependent; and methamphetamine use, likely dependent. Differences were found in patterns of use and harms across the state, suggesting that generalisation of research conducted in the capital city is not appropriate. Even among a sample engaging in high levels of poly-drug use, certain harms were found to be associated specifically with methamphetamine use and dependence. Access to appropriate treatment for methamphetamine use was low among those displaying dependence, with the majority of the sample engaging only in treatment for opioid use disorders. Individuals often perceived that they did not need treatment, despite negative perceptions of methamphetamine use, and viewed treatment options as not efficacious. Lack of perceived need was also noted as a reason for not accessing metal health services despite self-perceived mental health problems. This suggests the importance of education and integrated service delivery to ensure that when clients present to mental health or alcohol and drug services both substance use and mental health needs are met, especially as co-morbid difficulties are common