Did the under‐reporting of meth/amphetamine use increase in a general population survey in Australia as negative media coverage increased?

Abstract

Aim To test (1) if there was a change in self‐reported lifetime prevalence of meth/amphetamine use by birth cohort and (2) if the extent of under‐reporting of meth/amphetamine use was associated with the proportion of the population who nominated meth/amphetamine as a drug problem. Design Observational study using seven waves of repeated cross‐sectional nationally representative household surveys between 2001 and 2019. Setting Australia. Participants Participants were from three birth cohorts: 1951–60 (age 68–77 at the 2019 survey; n = 29 458; 55% female), 1961–1970 (age 58–67; n = 29 859; 57% female) and 1971–1980 (age 48–57; n = 28 758; 59% female). Data were weighted to align the sample to the Australian population. Measurements Past year meth/amphetamine use; under‐reporting of lifetime meth/amphetamine use in each birth cohort, year and survey stratum (operationalised as the difference between self‐reported lifetime prevalence in 2001 and that of each subsequent year); proportion of the population who nominated meth/amphetamine as a drug problem in each birth cohort, year and survey stratum. Under‐reporting was regressed on the proportion of people holding negative attitude towards meth/amphetamine. Survey year and birth cohort were adjusted for. Findings Between 2001 and 2019, the lifetime prevalence of meth/amphetamine decreased from 6.1% (95% CI = 5.3–6.9) to 1.7% (95% CI = 1.2–2.2) in the 1951–1960 birth cohort (p < 0.001), from 13.0% (95% CI = 12.0–14.1) to 4.4% (95% CI = 3.7–5.2) in the 1961–1970 birth cohort (p < 0.001) and from 21.4% (95% CI = 19.9–22.9) to 11.2% (95% CI = 10.0–12.4) in the 1971–1980 birth cohort (p < 0.001). The proportion who nominated meth/amphetamine as a ‘drug problem’ increased significantly in all three cohorts (all p < 0.001) and the degree of under‐reporting of meth/amphetamine use was significantly associated with proportion of people who nominated meth/amphetamine as the ‘drug problem’ (b = 0.09, SE = 0.01, p < 0.001). Conclusion In Australia, the actual prevalence of lifetime meth/amphetamine use may be two‐ to fourfold higher than that estimated in the most recent national household surveys (2019). The level of under‐reporting is strongly associated with increasing negative attitudes towards methylamphetamine and d‐amphetamine use over the same period.

Media reporting on alcohol and other drugs in Australia and the Mindframe guidelines: Baseline data

“…The disproportionate media attention may instead reflect increases in harms associated with methamphetamine use perhaps due to increase in the use of crystal (as opposed to less potent forms) methamphetamine, or a perception of increased harms given people who use crystal methamphetamine are more likely to present to hospital [20]. However, it should also be noted that it is difficult to accurately measure the prevalence of illicit drugs such as methamphetamine using population‐based surveys, and it has been suggested that the prevalence of methamphetamine use may be underreported in surveys due to stigma, discrimination and negative attitudes commonly associated with the drug [21].…”

Methamphetamine exposure and depression—A systematic review and meta‐analysis

“…For example, in systematic reviews of harms among people who inject drugs, 602 studies have reported on HIV and 417 studies have reported on hepatitis B and C viruses [21], compared to only 23 studies on mental health indicators [22]. Further, the dearth of literature on methamphetamine and depression could be because studies often lack the sample size to investigate the topic, because methamphetamine use is highly stigmatised, which may lead to under‐reporting of methamphetamine use in the marginalised sub‐population of individuals who use the drug [23]. Efforts to de‐stigmatise methamphetamine use may facilitate more accurate self‐reporting that would provide better prevalence estimates on its use in the population, as well as opportunities for treatment and support to reduce methamphetamine‐related harms for individuals in need.…”

Non-medical use of pharmaceutical opioids with and without other illicit substance use: Trends from two repeated nationally representative Australian surveys

“…The survey did not measure if respondents were using other illicit substances concurrently or simultaneously. Our results are based on self-report household surveys in which substance use may be under-reported ( Chan et al., 2022 ). The method of survey administration could impact the prevalence of reported substance use.…”