Upcoming changes for this guidance
This content will be strengthened so it more completely reflects our commitment to practice framed by te Tiriti o Waitangi, based on a mana-enhancing paradigm for practice, and drawing from Te Ao Māori principles of oranga to support mana tamaiti, whakapapa and whanaungatanga. We each need to consider how we can apply these principles to our practice when reading this guidance. The following resources provide support:
Practice for working effectively with Māori
Our practice shift
What is methamphetamine
Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. It is a synthetic stimulant that is produced and sold illegally in the form of pills, capsules, powder and crystals. Methamphetamine is most commonly known in New Zealand as 'P'. Also called ice, crystal, crack, tina, go, and meth.
It can be taken many ways, including swallowed, snorted or injected, but most often is smoked and inhaled using a glass pipe.
Physical effects of meth
Meth affects all users differently. It depends on how it is administered (smoking, inhalation, injection or ingestion), how much is taken, personality characteristics of the user, and their mood at the time of use.
Meth floods the brain with dopamine (a 'feel-good' brain chemical), inhibits sleep and suppresses hunger. Effects can last from 4 to 16 hours. The high is followed by a comedown (crash) that can last for days, involving irritability, depression, physical exhaustion and long periods of sleep. The user often takes more meth to feel better, leading to a repetitive cycle of use, in which larger and more frequent amounts are taken.
Meth use tends to exacerbate pre-existing behavioural traits, so an angry person may become more prone to angry outbursts.
Signs that a person may be using meth
People (including rangatahi) using meth can seem:
- lacking in focus
- overly confident.
People who use meth over 3 or more consecutive days may:
- stop eating or sleeping
- seem agitated, have mood swings, and see, hear or feel things that aren’t there (hallucinations)
- experience a dry mouth, nausea, psychosis and paranoia
- have dilated pupils, seem anxious or confused, make violent threats.
The aroma of meth may resemble nail polish remover, cat urine, rotten eggs or burning plastic due to the chemicals used in its manufacture.
Sustained use over time may lead to weight loss.
Engage and assess the impact of meth use
If a parent or caregiver is using, it doesn't automatically mean that they are unable to care for tamariki or rangatahi but we have to make sense of how their use is impacting on their ability to parent.
Research suggests that rangatahi may try meth, but it doesn't necessarily become a drug of choice. Supports may need to be directed towards managing addictions (such as cannabis or alcohol misuse) rather than meth being a core dependency.
1 Understand the context of meth use and the impact on behaviour
There are 4 key areas to consider when assessing the impact of meth use — what the effect is, how withdrawal is managed, the impact on the user’s mental state and the impact on their behaviour.
We should also consider the user's own history of trauma and how it impacts on their use and current situation.
Effects on tamariki and rangatahi when parents and caregivers use meth
Research identifies the following risks to tamariki from parents and caregivers who use meth:
- Increased risk of neglect — during meth use, parents and caregivers are unable to supervise tamariki or rangatahi so have difficulty meeting their basic needs. When a meth user is 'coming down', they may sleep for long periods and experience lethargy and depression. Tamariki may be left to their own devices or older rangatahi may be expected to care for younger siblings. The physical care of the home may be poor, and tamariki may experience inadequate nutrition and hygiene. Tamariki, particularly tamariki nohinohi (toddlers), who are exposed to adults using meth are at risk of ingesting meth because they can touch contaminated surfaces and put fingers and objects into their mouths. They may not be able to eliminate chemicals from the body as well as adults can because they are growing and their brains are still developing.
- Tamariki and rangatahi may have increased exposure to adult sexual behaviour, as meth users may experience heightened sexuality and reduced inhibitions.
- Tamariki are at risk of physical abuse due to users experiencing irritability and paranoia as they come down after drug use.
- Tamariki are at risk of emotional abuse as they may be socialised into the meth culture and associated violence, and they may be encouraged to lie or steal or accompany their parents or caregivers during illegal activity.
- When tamariki observe their parent's paranoid or violent behaviour, they are at risk of learning to respond to distress in similar ways, perceive intervention from professionals as intrusive, and adopt maladaptive coping skills consistent with the environment they have grown up in.
Effects on unborn babies
Research on unborn babies is limited but does suggests that meth use during pregnancy increases the risk of:
- reduced foetal growth and higher rates of premature births
- placental abruption (separation of the placenta from the wall of the uterus, which is potentially life threatening for mother and baby)
- stress in infants when meth is used in the first trimester
- more lethargy in infants when meth is used in the second trimester
- poorer quality of movement and greater physiological stress when meth is used in the third trimester.
Meth-exposed infants are often irritable as newborns but can be soothed by holding and swaddling. Meth-exposed infants typically have no feeding issues and do gain weight.
2 Engage with parents/caregivers or rangatahi who are using meth
Meth users may have difficulty organising and comprehending information presented to them, including directions and following through with plans. We need to give them specific information and check that they understand.
It is not helpful to hold a hui or seek agreement to any long-term plans until at least 3 days after use when they have come through the 'crash' stage.
We should have an open, honest, non-judgemental conversation but recognise that they may not be able to answer some of our questions if they have not had the support to consider the impact of their meth use. Use the knowledge and recommendations from professionals working in the addiction space to find ways to minimise any harm caused by meth use.
For rangatahi, use the substances and choices scale (SACS) as a guide to screen their use.
- Identify the people and places they consider safe and who can support them.
- Find out what they do to protect their tamariki from exposure to meth.
- Find out how they ensure there is enough food available and who is caring for their tamariki.
- Ask what their plan is for their tamariki when they are 'crashing'.
Harm minimisation requires specialist support so find ways to link users, and in particular rangatahi and their whānau, to services that can support them.
3 Help get support and treatment
Collaborate with professionals working in the addiction area.
Using drug tests will provide a snapshot in time. If the parent or rangatahi has acknowledged use, consider what value a urine or hair test would offer.
Potentially, a drug test can be used to evidence and support changes if the results are negative.
Positive tests require analyses about the impact of use on their behaviour and any risks to themselves or others. In general, substance use only becomes a problem when it causes problems to themselves or whānau or tamariki around them. Spend time understanding the meth user’s desire to seek and accept support. Consider where they might be in the stages of change. Acknowledge this is a journey so safety plans and agreements need to consider how they will manage relapse.
Rangatahi in youth justice may be supported through the Alcohol and Other Drug Treatment Court.
Rangatahi in residence may need added support if managing a crash and/or withdrawal. Medical assessment and advice should guide our care responses.
Meth labs – when tamariki or rangatahi are exposed to a methamphetamine clandestine laboratory
If a staff member suspects the presence of a meth lab, they should not enter the area and they should alert the Police. If a staff member is already in the building, they should leave immediately.
Take all reasonable steps to ensure the safety of any tamariki or rangatahi present.