What type of help is available?

CBT involves understanding how particular patterns of thinking can affect our feelings, our behaviours, and the situations we encounter in the world. CBT assists a person to firstly identify those patterns of thinking that are working against them, and to develop strategies to make these thoughts work for them instead. This will have a flow-on effect to the person’s feeling and behaviour.

CBT and Motivational Interviewing (MI) have been used in combination with each other and may help people reduce their ice use. Adaptations that have been effective or utilise these techniques to reduce methamphetamine use are Breaking the Ice, ASSIST and Ice: Training for Frontline Workers. 

MI was originally developed to help people experiencing drug and alcohol issues consider how these choices affect their life. It centres on the individual having a conversation with a health professional about their use in a non-judgemental and collaborative way, with the person themselves setting the direction and tone of this conversation. MI can be used even with people who aren’t even contemplating making any changes to their drug use and can assist them in re-assessing the role of drugs in their lives. CBT and MI have been used in combination with each other and may help people reduce their ice use. Adaptations that have been effective or utilise these techniques to reduce methamphetamine use are Breaking the Ice, ASSIST and Ice: Training for Frontline Workers. 

Although not widely used in Australia, contingency management (CM) is another effective approach to treatment for ice dependence. CM involves rewarding people in treatment for alcohol or other drug dependence with incentives (e.g. vouchers, activities) whenever they hit their treatment goals, such as attending a set number of treatment sessions or staying abstinent throughout the program. The idea is to make life without ice more attractive than continuing to use the drug.

Seeing a psychologist is a good way to learn the techniques involved in CBT and MI. Psychologists create a safe space for people to come and talk about things they might not feel comfortable talking about with their family and friends. They can assist people who are trying to understand their thoughts and feelings, and help them to learn skills and techniques to manage these thoughts and feelings. For people who are ready, a psychologist can help with setting goals to encourage changes in their life. 

People presenting to their General Practitioner with mental health concerns may be eligible for 10 Medicare rebatable sessions each calendar year under a Better Access to Mental Health Care Plan. Alternately, the Federal Government has recently introduced an ATAPS (Access to Allied Psychological Services) program by which eligible individuals (as determined by a General Practitioner) can have 12 psychology sessions per calendar year with no out-of-pocket expense.

Psychologists see people experiencing a range of mental health issues and can therefore assist with drug use concerns and any other difficulties you may be experiencing. This option is particularly suitable for people who do not need assistance with basic needs such as housing and food, as they have the means and motivation to attend regularly scheduled counselling appointments. Given that a limited number of subsidised sessions are available, this service is most appropriate for individuals who may only require a limited number of sessions or who don’t need to attend therapy very frequently (for example, once a month).

Drug Counselling appointments can also be booked with a trained counsellor at a drug and alcohol service. Some services may also be able to help with concurrent mental health issues such as anxiety disorders and depression. Again, this option is suitable for those not needing assistance with basic needs but are able to attend regularly scheduled counselling appointments.

Outreach Support can be provided by a trained health professional who visits a person’s home to help them complete daily activities and supports them in tasks such as securing safe housing and attending health check-ups. They may also be trained in providing counselling support for both drug and mental health issues. This option is particularly suitable for people who are severely dependent on ice and unable to attend regular counselling appointments at a clinic due to housing or financial issues.

Online Treatment Programs can involve ‘chatting’ to a trained counsellor over the internet in real-time or by email, or a pre-programmed online “course” that is offered with or without support from a trained professional. For example, Counselling Online provides free drug and alcohol counselling over the internet 24 hours a day, 7 days a week to anyone in Australia. This site also offers a range of practical information, an SMS support program, an online peer support forum, and details about how to find a telephone or face-to-face treatment program in your state.

Online automated programs that have demonstrated benefits for people with drug use problems include the SHADE program (depression and alcohol/other drug use) and OnTrack (alcohol use and depression). Other online automated programs include MoodGym (depression), MindSpot (anxiety and depression), and ThisWayUp (depression and anxiety), which may assist people with additional concerns associated with their ice use. A number of online portals now exist, which can help people work out which is the best online program for them. These include Head to Health, and the DigitalDog. Online services can help provide treatment at times when people most need them and are available 24-hours a day. They can offer support whilst people are waiting to access face-to-face treatment services, or in situations where specialist services are unavailable.

There is also an evidence-based online early intervention for ice use, based on CBT and MI, called Breaking the Ice. The Breaking the Ice program is designed to help individuals become more aware of how their use of ice affects their health and other areas of their life. To access this online program, please visit: https://breakingtheice.org.au/

Residential Rehabilitation, such as ‘rehab’, ‘detox’ or 'withdrawal' clinics are places where people can stay for a few days or up to a few months at a time. The rehabilitation clinics provide accommodation, food and access to health professionals such as nurses and counsellors. These clinics often run daily activities such as education classes, exercise classes, movie sessions and gardening. Nurses and doctors are able to provide support for individuals experiencing withdrawal symptoms, and psychologists, counsellors or support workers assist with emotional difficulties during this time. Residential rehabilitation allows the individual to devote a significant amount of time to their mental health and is an environment where people may be able to set goals and plan for their future. This option is suitable for people who are severely dependent on ice, have limited family support and do not have commitments such as school or work, or who would not otherwise have access to a safe, drug-free environment to withdraw from ice.

There is currently no approved medication for treatment (including substitution therapy) of methamphetamine dependence in Australia. Researchers in Australia and other countries are conducting clinical trials to test whether certain medications have the potential to help with treatment of methamphetamine dependence. So far, no medication has been consistently shown to be effective and safe enough to be routinely prescribed by health practitioners.

There is growing evidence supporting the use of multicomponent treatment programs for ice dependence. Multicomponent treatment programs combine multiple treatment approaches in a single program. The idea behind combining multiple approaches is that treatment will be more effective if it targets many of the processes driving ice dependence all at once.

The Matrix Model is a multicomponent treatment program that combines CBT, MI, CM, and other methods to treat ice dependence. This model has been trialled successfully in North America and is currently being trialled for the first time in Australia in several states and territories. If the program delivers promising results it may be offered in other states and territories. For more information, please visit the website.

Withdrawal is the first stage to overcome when recovering from ice dependence. Withdrawal refers to the unpleasant bodily reactions people experience when they stop consuming a substance that their body has adjusted to having in its system. Withdrawal from methamphetamines such as ice generally takes longer than withdrawal from other drugs, making it more difficult for people who are dependent on methamphetamines to make it through treatment and recovery.

For example, withdrawal symptoms for heroin or alcohol typically start within 24 hours of stopping drug use, peak over the next couple of days and subside within a week. For methamphetamines, people typically experience a 2 to 3 day “comedown” or “crash” phase before withdrawal symptoms kick in. During the crash phase people typically feel exhausted and need to sleep to regain energy. After the crash, people then experience intense withdrawal symptoms such as strong cravings, sleeping difficulties, headaches and pain and stiffness in the body for up to 10 days. It’s around this point in time, 1 – 2 weeks into withdrawal, when people are at the greatest risk of starting to use methamphetamines again and when they need the most support. While withdrawal symptoms become less intense at this point, they can last for a further two weeks or more. Methamphetamine cravings persist throughout the entire withdrawal period and can carry on for up to three months.

The severity of ice withdrawal will depend on how long and how much people have been using, and the level of dependence a person has developed on ice (click here for a screener for dependence). The longer an individual has been using a drug like ice and the greater the quantity they have been using, the more intense the withdrawal symptoms will be. The mental and physical health of the person using ice will also affect the severity of withdrawal, which is why we recommend seeking assistance to help build up mental and physical health in preparation for the withdrawal period. Although everyone’s withdrawal from ice will be different, there are some common symptoms of withdrawal from ice that can be found here.

Working through withdrawal is a major achievement. Making it through this period does not, however guarantee that someone will stop using ice or treat the cause of dependence. Further treatment is needed to help people refrain from using ice and build a satisfying and meaningful life without it.

There are a number of treatment and support options available for someone experiencing problems (including dependence) with ice or other drugs outlined in the “Treatments that work for ice use” section above. If you are unsure of which option is best for you or a loved one, your local doctor should be able to conduct an initial assessment and refer you to a service that fits your needs.

Often issues other than a person’s ice use will be addressed in treatment. These might include other substance use, mental and physical health issues, or problems relating to social networks, housing, employment and financial security. These issues are often addressed as they have the potential to interrupt treatment and/or increase the likelihood of someone starting to use ice again once they have left the treatment environment.

Recovery from ice dependence is challenging and can take 12 to 18 months or longer due to the significant readjustments that are required in the person’s thinking and lifestyle. There can be times when people go in and out of treatment and continue using ice on and off. This is common and a normal part of the process. Health professionals will be there to support you and your loved ones along the way. They are there to provide support and guidance and will listen to any concerns you may have. Post treatment support (also known as aftercare) options are also available to provide further assistance to someone who has completed treatment but would like additional support to keep them on track over the longer term. Examples of post treatment supports include telephone or online counselling and ongoing involvement with a peer support group.

Families and friends can play a critical role in the recovery of people who might be experiencing problems with ice or other drugs. Research has shown that people who are dependent on methamphetamines such as ice are more likely to recover if they report having social support.

Being around someone who is using or dependent on ice can be stressful though, especially if they are someone you love. As a friend or family member you may feel anxious at times because of the changes you see in your loved one when they are using ice. You may at times feel desperate or helpless if your loved one continues to use ice. It’s important that you look out for yourself as well as your loved one by seeking support when you need it, whether this be from a friend or health professional, and looking after yourself with a healthy diet, adequate sleep and regular exercise. If you require further support, Family Drug Support and the Family and Friends Support program are two free, nationally available support options specifically for families and friends. Other support information is also provided below.