Acknowledgments
Contributors
Introduction
Why amphetamine-type stimulants?
by Steve Allsop and Nicole Lee
PART 1 INTRODUCTION TO AMPHETAMINE-TYPE STIMULANTS: INFLUENCES ON THEIR ACTION AND EFFECTS
Introduction
Chapter 1 Amphetamine-type stimulant use on a global level and implications for responding
by Rebecca McKetin, Amanda Baker, Frances Kay-Lambkin, and Nicole Lee
Introduction
Amphetamine and methamphetamine
Use patterns and natural history
Global trends in use
Summary
Ecstasy
The ecstasy situation
The emerging market for legal ATS
Conclusions and implications
Chapter 2 Pharmacology of amphetamine-type stimulants and implications for harms and responses
by Irina Majumder and Jason M. White
Overview
Pharmacokinetics and metabolism
The pharmacological action of amphetamine-type stimulants in the brain
Psychological and physiological effects of amphetamine-type substances
Dependence potential of amphetamine-type stimulants
MDMA (Ecstasy)
‘Entactogenic’ properties
MDMA-induced hyperthermia
The post-acute (rebound) and long-term effects of MDMA
Amphetamine and methamphetamine
Medical and related use of amphetamine and methamphetamine
Adverse effects of amphetamine and methamphetamine
Paramethoxyamphetamine (PMA) and paramethoxymethamphetamine (PMMA)
Conclusion
Chapter 3 Neurocognitive effects of amphetamine-type stimulants and implications for intervention
by Dean S. Carson, Daniel F. Hermens, Adam J. Guastella, David P. Bosanquet, and Iain S. McGregor
Introduction
Amphetamines
Pharmacology and history
Patterns of use and administration
Neurocognitive effects of acute use
Neurocognitive effects associated with chronic use
Psychiatric complications associated with chronic use
Empathogens
Pharmacology and patterns of use
Neurocognitive effects of acute use
Prosocial effects of MDMA
Neurocognitive effects of chronic MDMA use
Psychiatric complications associated with chronic use
Interventions
Psychological interventions
Pharmacotherapeutic interventions
Conclusion
Chapter 4 The social contexts and cultural meanings of amphetamine-type stimulant use and their implications for policy and practice
by Robyn Dwyer, Amy Pennay, Rachael Green, Christine Siokou, Monica Barratt, Nicola Thompson, and David Moore
Introduction
A brief history of ATS use
Australian research on ATS use [with 5 case studies]
Responding to the social contexts and cultural meanings of ATS use
Conclusion
Chapter 5 Amphetamine-type stimulant use and risk-taking behaviours
by Libby Topp
Introduction
ATS use and sexual risk-taking
ATS use and sexual risk behaviour
ATS use and HIV and other STIs
ATS use and injecting risk behaviours
ATS use and driving
Prevalence and correlates of drug driving
Risk perceptions among ATS-affected drivers
MDMA-related driving impairment
Meth/amphetamine-related driving impairment
Driver culpability
High-speed police pursuits
ATS use and aggression and violence
Summary
Chapter 6 Ups and downs: Physical and mental health consequences of amphetamine-type stimulant use
by Linda Jenner
Introduction
Physical consequences
Cardiovascular and cerebrovascular problems
Route of administration
Neurotoxicity
Dependence
Bloodborne viruses and sexual health
Polydrug use
Other physical consequences
Mental health consequences of ATS use
Mood disturbances and anxiety
Psychosis
Conclusion
Chapter 7 Effects of amphetamine-type stimulant use and problems for the individual, family, and community
by Paula Ross
Introduction
Psychological and emotional effects on community
Psychological and emotional effects on individual and family
Psychosis: implications for the individual
Psychosis: implications for the family
Cognitive damage: implications for the individual
Cognitive damage: implications for the family
Effects of ATS use on development: implications for the individual
Effects of ATS use on development: implications the family
The impact of ATS use on family members’ emotional states
How families cause, increase or maintain drug use in their members
Special family groups
Parents of drug users
Children of drug users
Siblings of drug users
Conclusion
Chapter 8 The role of health economics in understanding and responding to amphetamine-type stimulants
by Chris Doran
Introduction
What is health economics?
The role of economic evaluation in ATS treatment
Which type of economic evaluation technique is most appropriate?
What are the key steps in undertaking an economic evaluation?
The Drummond checklist for good evaluation
The ACE-Prevention protocol
Economic costs of ATS use
Summary
PART 2 PERSONAL PRSPECTIVES
Introduction
Chapter 9 A line before work: my functional life using methamphetamine
by ‘Alice’
Beginnings and general use
Work and university use
Overall impact: the good and the bad
Chapter 10 Making use of speed skilfully to interrogate and embrace life
by ‘Ned Winger’
Chapter 11 MDMA: A tale of controlled hedonism
by ‘Chris’
Chapter 12 Living with amphetamine problems – a family’s story
by ‘Susan McFarlaine’
Chapter 13 The impact of amphetamine-type stimulants on operational policing: a personal choice for which everyone pays
by Corey Allen
Chapter 14 The impact of amphetamine-type stimulants on ambulance services
by Alan Eade
Introduction
Environmental issues
Myths
Information
Polydrug use
Complex presentations
Issues around manufacturing
Summary
Chapter 15 The impact of amphetamine-type stimulant use on emergency department services
by Jason Armstrong and Kane Guthrie
Chapter 16 The impact of amphetamine-type stimulant use on mental health services
by Brendan Pawsey and Christopher Hynan
Introduction
Mental health service staff attitudes to AOD and ATS in particular
Management of clients’/patients’ presentations: acute intoxication and withdrawal
Impact on staff
Impact of other clients/patients
Supervision issues for MH staff around dual diagnosis
PART 3 EVIDENCE TO INFORM RESPONSES TO ATS-RELATED HARM
Introduction
Chapter 17 The impact of amphetamine-type stimulant use on law enforcement: patterns and responses
by Toni Makkai and Jennifer Beattie
Introduction
International production and supply
Australian legal framework
Domestic production
Arrests
Local markets
ATS and crime
Responses
Summary
Chapter 18 Prevention and public health approaches to amphetamine-type stimulant use and related harm
by Steve Allsop
Introduction
Prevention
Mass media campaigns
Community mobilisation approaches
School-based prevention activities
Peer-based interventions
Workplace interventions
Preventing and reducing problems for current users
Understanding the importance of subjective perceptions about and functions of drugs
Reducing the risks associated with illegally manufactured drugs
Reducing the effects of ATS use on others
Interventions tailored to different contexts and settings of use
Sexual risk-taking and injecting behaviours
Peer education
Challenges in public health responses to ATS
The need for multifaceted responses
Conclusion
Chapter 19 Clinical responses to amphetamine-type stimulant problems
By Nicole Lee and Linda Jenner
Introduction
Settings and types of interventions
Primary-care settings
Outpatient interventions
Residential rehabilitation
Withdrawal for ATS users
Treatment for co-occurring mental health and ATS use problems
Summary
Chapter 20 Pharmacotherapy of amphetamine-type stimulants
by Matthew Brensilver, Victoria Johnson, Annette Groteer, Keith G Heinzerling, and Stephen Shoptaw
Introduction
Medication targets for methamphetamine pharmacotherapies: rationale
Clinical trials of pharmacotherapies for methamphetamine dependence
Antagonist strategies
Agonist strategies
Bupropion
Serotonergic medications
GABAergic mechanisms
Explaining variability in treatment outcomes
Moderating variables and pharmacogenetics
Conclusions and future directions
PART 4 CHALLENGES IN MANAGEMENT: PRACTICAL APPROACHES TO CARE
Introduction
Chapter 21 Effective responses in general health and other mainstream services
by Robert Ali, Sonali Meena, and Linda Gowing
Introduction
Case study: David
What are the immediate issues to consider?
How would you conduct an assessment with David
David’s assessment for substance use disorders
How would you respond to identified problems?
Further assessment
Interactions between stimulants and therapeutic agents for depression
Summary
Chapter 22 Opportunistic interventions for methamphetamine use: reducing the risks
by Amy Pennay, Dan I. Lubman, and Tiffany Reichert
Introduction
The typical user
What are the harms associated with methamphetamine use?
Brief interventions
Escalating use
Methamphetamine use and the workplace
Mental health problems among methamphetamine users
Types of intervention
Working with an agitated user
Methamphetamine dependence
Withdrawal treatment
Conclusion
Chapter 23 Taking a reinforcing approach to treatment entry and retention
by Martin Iguchi
Introduction
Outreach and initial engagement
Treatment
Taking a reinforcing approach
Reinforcing behaviours that might compete with drug use
Impact of a reinforcing approach on the counselling environment
Conclusion
Chapter 24 Engaging methamphetamine users in treatment and managing the challenges
by Glenys Dore and Lisa Juckes
Introduction
Obstacles to treatment
The process of change
Assessment of mental state
Managing withdrawal
Managing hostile behaviour during withdrawal
Managing cravings
Managing depression
Futher history
Where to from here?
Chapter 25 Treatment and care for young amphetamine-type stimulant users
by Andrew Bruun, Dominic Ennis, Horace Wansborough, Rachael Green, and Penny Mitchell
Introduction
Engaging young people in treatment
Improving access for young people
Responding to immediate concerns at critical moments
Incremental assessment
Pre-admission assessment
Comprehensive assessment
Motivation and change
Customised intervention to facilitate change
Cognitive behaviour approaches
Family-focused interventions
The community reinforcement approach
Making progress
Conclusion
Chapter 26 Working with same sex-attracted, sex and gender diverse persons
by John Howard, Atari Metcalf, Simon Beck, and Angela Matheson
Introduction
Language
Becoming same-sex attracted
Drug use among same-sex attracted
Methamphetamine
SSA, sex and gender-diverse people, drug use, and mental health
Heterosexism, homophobia, transphobia, discrimination, and bullying
Venues, bodies, and ageing
Barriers and incentives to treatment
What can we do?
What can clinicians do?
Conclusions
Chapter 27 Working with people affected by co-occurring amphetamine-type stimulant and mental health problems
by Lisa Juckes
Introduction
Factors affecting presentation
Working with people with anxiety disorders
Effects of ATS use on the course of anxiety disorders
Intervention with co-occurring ATS use and anxiety disorders
Medication in treatment of anxiety disorders and ATS use
Working with people with mood disorders
Possible impact of ATS use on the course of mood disorders
Intervention with co-occurring mood disorder and ATS use
Medication in treatment of mood disorders and ATS use
Working with people with psychotic illness
Possible impact of amphetamine-type stimulant use on the course of psychotic illness
Medication in treatment of schizophrenia and ATS use Intervention with co-occurring psychotic illness and ATS use
Working with people with Attention-Deficit/Hyperactivity Disorder
Intervention for co-occurring ADHD and ATS use
Intervention for the treatment of co-occurring ADHD and ATS use
Working with people with personality disorders
Impact of ATS use on the presentation of personality disorder
Intervention for co-occurring personality disorders and ATS use
Medication in treatment of co-occurring personality disorders and ATS use
Working with people with co-occurring medical issues
Chapter 28 Stepped-care approaches for amphetamine-type stimulant problems
By Amanda Baker, Frances Kay-Lambkin, Madeleine deVille, Rebecca McKetin, and Nicole Lee
Introduction
Factors to consider in offering stepped care
A case study of stepped care
Case formulation
Treatment
Challenges and outcomes
Conclusion
References
Index
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