Psychosocial stress and methamphetamine use: A mixed-methods study of intersectional stigma and Aboriginal and Torres Strait Islander methamphetamine use

Leda Sivak; Rachel Reilly; Jane Lockton; Carla Treloar; Yvette Roe; Rebecca McKetin; Julia Butt; Nadine Ezard; Hilina Winkenweder; James Ward

doi:10.1016/j.drugpo.2023.104189

Psychosocial stress and methamphetamine use: A mixed-methods study of intersectional stigma and Aboriginal and Torres Strait Islander methamphetamine use

Int J Drug Policy. 2023 Nov:121:104189. doi: 10.1016/j.drugpo.2023.104189. Epub 2023 Sep 13.

Authors

Leda Sivak¹, Rachel Reilly², Jane Lockton³, Carla Treloar⁴, Yvette Roe⁵, Rebecca McKetin⁶, Julia Butt⁷, Nadine Ezard⁶, Hilina Winkenweder³, James Ward⁸

Affiliations

¹ Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Australia. Electronic address: leda.sivak@sahmri.com.
² Wardliparingga Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Australia; School of Psychology, University of Adelaide, Australia.
³ School of Psychology, University of Adelaide, Australia.
⁴ Centre for Social Research in Health and the Social Policy Research Centre, University of New South Wales, Australia.
⁵ Molly Wardaguga Research Centre, Charles Darwin University, Australia.
⁶ National Drug and Alcohol Research Centre, University of New South Wales, Australia.
⁷ School of Arts and Humanities, Edith Cowan University, Australia.
⁸ Poche Centre for Indigenous Health, University of Queensland, Australia.

PMID: 37708599
DOI: 10.1016/j.drugpo.2023.104189

Abstract

Background: Regular methamphetamine use can cause a range of physical, psychological and social harms. Stigma is one factor that impacts engagement and successful completion of treatment. In Australia, Aboriginal and Torres Strait Islander people who regularly use methamphetamine experience multiple stigmas, which further compounds access to treatment and quality of life. This paper explores the cumulative and compounding effects of participating in a stigmatised activity such as illicit drug use in relation to the stigma experienced by Aboriginal and Torres Strait Islander people as a population marginalised through colonisation.

Methods: Ten sites nationally participated in a cross-sectional survey measuring a range of factors including psychosocial stress in methamphetamine users. The survey sample size was 734, with 59% identifying as Aboriginal and Torres Strait Islander (n = 433). In addition, a total of 147 mainly Aboriginal and Torres Strait Islander people who use methamphetamine, community and family members, and service providers took part in a total of 19 focus groups and 7 interviews.

Results: Aboriginal and Torres Strait Islander participants experienced multiple psychosocial stressors at significantly higher rates than non-Indigenous participants. These stressors include diminished access to health care (33%), experiences of racism (34%), grief and sorrow (39%), worry for family (46%), and child welfare experiences (46%). The qualitative findings highlight the cumulative impact of historical, political and social stressors on an already stigmatised population.

Conclusions: The findings of this unique analysis demonstrate the disruptive impact of methamphetamine use on the lives of those who use methamphetamines and their family members. They also illustrate challenges, such as stigma, that may confront those seeking assistance for drug-related issues. Aboriginal and Torres Strait Islander community involvement is necessary to provide support and education for the individual, the family, and the community as a whole. Stigma reduction is therefore a worthy target for intervention.

Keywords: Aboriginal and Torres Strait Islander; Intersectionality; Methamphetamine; Mixed-methods; Stigma.

Publication types

Multicenter Study

MeSH terms

Amphetamine-Related Disorders / psychology
Amphetamine-Related Disorders / therapy
Australia / epidemiology
Australian Aboriginal and Torres Strait Islander Peoples*
Child
Cross-Sectional Studies
Humans
Methamphetamine / adverse effects
Patient Acceptance of Health Care
Quality of Life*
Social Stigma
Stress, Psychological*

Substances

Methamphetamine