Look west for Australian evidence of the relationship between amphetamine-type stimulant prescribing and...

To investigate Western Australian (WA) data on the relationship between the prescription of Amphetamine-Type Stimulants (ATS), and the non-medical use of prescription ATS and other forms of meth/amphetamine, for both adults (18+) and minors (<18).

Two WA specific data sources were identified. The Stimulant Regulatory Scheme provided comprehensive ATS prescribing data from 2004 until 2017, and Australian Secondary School Alcohol and Drug (ASSAD) surveys provided details of non-medical prescription ATS use by WA adolescents (12-17). Other data sources included National Drug Strategy Household Surveys (NDSHS), the Pharmaceutical Benefits Scheme (PBS), and the National Wastewater Drug Monitoring Program (NWDMP).

Over 95% of WA ATS prescribing has been for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). WA adults have consistently received prescription ATS at a much higher rate than other Australian adults. The most recent published data reported that in 2017 WA adults were 2.6 times as likely as other Australian adults to be supplied an ATS for ADHD. Drug treatment, NDSHS and NWDMP data indicate that WA adult rates of non-medical meth/amphetamine use have also regularly exceeded the Australian rate. Furthermore, the little data that exist on the non-medical use of prescription ATS by Australian adults suggests that it may also be disproportionately common in WA. From 1993 until 2002 the proportion of WA minors prescribed ATS grew rapidly and was the highest in Australia. Following regulatory reforms prescribing rates declined. By 2010 they were approximately half the 2002 rate. Over a similar timeframe there was a 72% fall in WA adolescent self-reported, past-week, non-medical amphetamine use. Since 2011 WA minor ATS prescribing rates have rebounded significantly. Unfortunately, useful data on adolescent meth/amphetamine use since 2011 is not available. Nonetheless, two ASSAD snapshots, in 2005 and 2017, suggest that more WA adolescents use prescription ATS non-medically than medically.

The data for WA adults suggest a correlation, but does not establish a causal connection, between ATS prescribing and the non-medical use of ATS and other forms of meth/amphetamine. Although it is clear that there is significant illicit prescription ATS use by WA adolescents, little is known about the contribution that the prescription of ATS makes to subsequent meth/amphetamine and other drug use. There is a critical need for research that investigates long-term, population-wide patterns and individual experiences of both those prescribed ATS and the broader population, to inform policy, prevention and treatment responses.