Management of Methamphetamine Psychosis: Stage 2: Acute Care Interventions for the Treatment of Methamphetamine Psychosis & Assertive Community Care for the Post-discharge Treatment of Methamphetamine Psychosis

This report presents the findings of the Acute Care and the Assertive Community Care Trials which are part of the Methamphetamine Research Program currently being undertaken by Drug and Alcohol Services South Australia (DASSA). The impetus for an investigation into methamphetamine-induced psychosis in South Australia arose from discussions held during a meeting of World Health Organisation (WHO) international experts in Bangkok in November 1999. A consensus was reached at this meeting that a priority area for study should be the nature and clinical management of methamphetamine-induced psychotic disorders.

The Acute Care project was Part l of a study investigating treatment options for methamphetamine-induced psychosis in South Australia. This project built upon the work that was undertaken in Stage I (conducted in 2000 to 2002). Stage 1 was a multi-site World Health Organization Study conducted in Australia, Japan, Thailand and the Philippines. The Australian arm of this study clarified the nature of the methamphetamine-induced psychosis problem in South Australia, explored the characteristics of individuals presenting with the condition to acute care facilities (including their concomitant drug and alcohol and other psychiatric diagnoses), and provided the first indications of the true scope of the problem in South Australia. This study also indicated that there would be sufficient numbers of patients with methamphetamine psychosis eligible for recruitment into future research projects including the current research.

The Assertive Community Care project was Phase II of a study investigating treatment options for methamphetamine-induced psychosis in South Australia. This study used assertive follow-up techniques (to enhance patient retention in treatment) combined with a coordinated care approach wherein a case manager facilitated the patients’ access to treatment services, as the individual patients’ needs required. Interviews were conducted at baseline (while hospitalised), and 3 months and 6 months post-discharge (where possible) to compare client outcomes with those participants allocated to the control treatment arm, consisting of routine hospital post-discharge care.