To those who work in the health system, ‘ICE’ is but one problem among many and pales into the background of the prevailing problems of addiction and misuse of alcohol and drugs.
The ABC strongly promoted its series “The ICE wars”. The first episode showed the heavy investment in law enforcement and we learnt about the impact of clandestine ‘meth’ laboratories on the environment. We saw the Blacktown mental health team caring for a patient with schizophrenia tipped into psychosis by ICE and then calmly responding to a crisis call visiting him in his unfurnished accommodation. Next day, I attended a youth drug and alcohol service where the response was anger to the way the episode celebrated police actions.
The second episode featured a young man being apprehended by police in a country town. He had just been released from prison. I know that town, I know the people who cared for him, I know the impoverished life he had lived and the life-chances he had missed. The police came across as upbeat warriors bent on catching criminals. In this, I saw the state as the oppressor of its outcasts, victims of social and economic policies. Addiction is a proxy index of poverty.
In parallel, The Conversation ran two relevant articles. On 13th February in “Alcohol leads to more violence than other drugs, but you’d never know from the headlines” Stephen Wright and Martin Williams pointed to how alcohol is strongly linked to violent crimes, sexual assaults and murders but the illicit drugs capture the headlines.
The stuff of day-to-day media coverage are the seizures by customs, busts of clandestine laboratories, drug hauls in socially deprived areas and the loading of scruffy individuals into “paddy wagons”. Thus, public discourse becomes dominated by fear and the ‘ICE scourge’ dominates public policy. But to those who work in the health system, ‘ICE’ is but one problem among many and pales into the background of the prevailing problems of addiction and misuse of alcohol and drugs.
When there is violence and murder, it is the drug dealers and traffickers competing for territory. The ‘ICE’ problem is one of poor, underprivileged, people caught up in a cycle of addiction which started early in life but now demands more and more stimulus to maintain any sense of normalcy and to fight off the daemons of withdrawal and psychopathy.
There was a similar message from Nicola Lee in the Conversation on 14th February, “Ice wars message is overblown and unhelpful”, it aimed to disabuse readers about the ICE epidemic: the real facts tell the opposite – we are not “at war” with ‘ICE’.
Methamphetamine use, like most of the illicit drugs, is declining in Australia but, within that decline, there is a group seeking stronger forms of methamphetamine. This is the problem of addiction which needs treatment. Dr Lee points out around 1% in the community use ICE in a year with only a fraction of these being regular users. Among regular ICE users, 75% never become aggressive. Methamphetamine does increase anxiety, agitation and the risk of psychotic behaviour but it also provides comfort for some.
In Pearls and Irritations on 15th March 2015, in a piece “On thin “ICE”, I compared methamphetamine and alcohol harms:
- for every person who uses methamphetamine in a year there are 85 drinking alcohol;
- for every person addicted to methamphetamine there are 20 addicted to alcohol;
- for every ambulance call-out for methamphetamine problems there are 25 for alcohol;
- for every methamphetamine presentation to an Emergency Department there are 30 for alcohol;
- for every amphetamine-related death there are 65 alcohol deaths.
(The estimates of methamphetamine use have since been revised downward by researchers at the Burnet Institute in Melbourne.)
What we don’t see about alcohol is its massive social, health and economic impact ($36 billion in 2008). It harms many others as well as the drinker; it can damage whole communities. Of course, some of our friends, colleagues, may be alcohol dependent but this is outweighed by the depth of impoverishment alcohol wreaks on already compromised lives, lives which haven’t had the life chances that readers of this piece will have had. Research has shown that in one in three child protection cases in Australia the perpetrator had been drinking – one may conjecture on the role of alcohol in cases before the Royal Commission into Institutional Responses to Child Sexual Abuse.
Anne Deveson, who died recently, believed the public media is an integral part of public health – informing, educating and influencing behaviours for the well-being of society. On the other hand, the public media can do great harm as it promotes fear, sensationalism, celebrity, “quick fixes” and “silver bullets” for social problems.
In the 1990’s Australia took steps to reframe the media’s approach to mental illness and suicide and much has been achieved. We need to do the same for the problems of alcohol and drug use.
Unfortunately, the frenzy around ‘ICE’ has influenced the ABC. Let’s hope future episodes and programs are more balanced.
Ian Webster is Emeritus Professor of Public Health and Community Medicine at UNSW.