Publication Highlights

Objective: In general, people living in rural Australia tend to have poorer health outcomes including higher rates of AOD use, mental illness and chronic illness. While anecdotal reports suggest that there has been an increase in methamphetamine use in rural Australia, until now, rural patterns and prevalence have not been investigated. This Australian-first study investigated whether lifetime and recent methamphetamine use (including crystal methamphetamine) differed among city, regional and rural residents and whether particular populations were more at-risk.

Method: We conducted secondary analyses of the National Drug Strategy Household Survey (NDSHS) and the Alcohol and Other Treatment Services National Minimum Dataset (AOTDS-NMDS) over three time points: 2007, 2010 and 2013. In looking at the NDSHS data we examined lifetime methamphetamine use (ever used for non-medical purposes); recent methamphetamine use (used for non-medical purposes in past 12 months); and recent crystal methamphetamine use. The AOTD-NMDS was used to determine treatment demand by geographic location and we examined methamphetamine as the principal drug of concern (including amphetamine, methamphetamine, amphetamine analogues, and amphetamines not further defined). The five remoteness categories from the Australian Standard Geographical Classification (ASGC) were collapsed into three: ‘city’ (major cities); ‘regional’ (inner regional); and ‘rural’ (all other areas).

Results: The prevalence of lifetime and recent methamphetamine use and the prevalence of recent crystal methamphetamine use were all significantly (p<.05) higher in rural areas. The use of crystal methamphetamine use increased significantly (p<.05) between 2007 and 2013. There was significantly (p<.05) higher crystal methamphetamine use in rural areas among males, people aged 18-24 years and people who were employed. There was significantly (p<.05) lower crystal methamphetamine use among unemployed people in rural areas. The main form of amphetamine used varied over time and location. In 2013, crystal methamphetamine was the main form used in all locations. It replaced powder as the dominant form ever used by Australians overall or in cities and rural areas. Powder remained the dominant form ever used among people living in regional areas. Methamphetamine-related treatment episodes significantly (p<.01) increased in all areas. This increase, was however, smaller in rural-based services.

Conclusions: While we found a disproportionately larger increase in methamphetamine (including crystal methamphetamine) use the challenge remains to find what produced this differential pattern of use. Numerous service access barriers exist for people living in rural locations and tailored strategies and interventions are needed to address these issues.