Hospitals and drug clinics are bracing themselves for more patients presenting with psychosis and cardiovascular problems after a significant increase in use of the drug "ice".
The number of injecting drug users who used ice in the last six months has increased from 55 per cent to 61 per cent in the last year, according to the National Drug and Alcohol Research Centre's annual survey released on Monday.
Overall, methamphetamine use remained stable, but there was a shift from snorting it as "speed" to smoking or injecting in its crystal form, as ice.
Chief investigator Lucy Burns, of the University of NSW, said the figures were concerning because ice was more addictive than other forms of methamphetamine and its use was associated with psychosis and violence.
"Heroin remains the drug of choice for people who inject drugs but ice is pretty up there too," Dr Burns said. "There's been a move to the crystal use of methamphetamine and of course that's the stronger form."
Injecting the drug also exposed people to a greater risk of blood-borne viruses.
The proportion of injecting drug users who used ice remained stable at 74 per cent in NSW, but it leapt from 55 per cent to 75 per cent in Victoria and also rose to 72 per cent in the ACT.
Use of the drug ice is growing faster among injecting drug users in Victoria than in any other part of Australia.
Dr Burns said the increase was significant.
"Ice is metabolised by the body more quickly than other forms of methamphetamine, is more addictive and its use is associated with drug-induced psychosis, violence and erratic behaviour," she said. "Injecting ice also puts people at a number of other major risks, including acquiring septicaemia, Hepatitis C and HIV."
NSW injectors were using ice more than once a week, while in Victoria they were using it fortnightly and in the ACT they were taking it twice a week.
Among recreational drug users, the use of ice was statistically stable, with about one in five people reporting that they used the drug regularly nationally, although it was as high as one in three in Victoria.
They were more likely to take methamphetamine in powder form.
The clinical director of the drug and alcohol service at St Vincent's Hospital, Nadine Ezard, said the number of people presenting at Sydney emergency departments for methamphetamine-related problems had more than tripled in the last five years.
"They're using stronger forms and more often, therefore we're expecting to see more problems associated with it because the presentations we see tend to be dose related," Associate Professor Ezard said.
These included psychosis and cardiovascular problems.
Last year, more than 20,000 people around Australia received treatment for drug problems where methamphetamine was the principal drug of concern.
Associate Professor Ezard said the residential withdrawal service at St Vincent's Hospital was receiving proportionally fewer residents with opioid and alcohol problems and proportionally more people who used stimulants as the primary drug of concern.
The implications were broad, with people intoxicated by crystal methamphetamine more likely to engage in risky behaviour such as unprotected sex.
Demand had exploded in the stimulant treatment program at St Vincent's that was set up NSW Health in response to concerns about ice in 2006.
In January last year, there were 120 people on the program.
There are now 200 on the program and 100 on the waiting list and most of them are employed, unlike the methadone clinic where just three per cent are employed.
"It's a different cohort to people on the opioid treatment program," Associate Professor Ezard said.
"We would like to intervene before people lose their jobs."
The National Drug and Alcohol Centre's survey of ecstasy users had happier news, reporting that the use of synthetic cannabis had halved among this group.
They were also less likely to buy psychoactive substances online.
with Dan Harrison
