Explain stimulant crash and why there is no methadone for ice — CASC communication station

Open. Name time; ask patient and sister top concerns (craving, "going mad," fear of addiction medications). [1]

Explain ice intoxication and MAP. "High-dose methamphetamine can drive the brain's dopamine systems so hard that people develop paranoia and hearing voices for a period — often while still knowing where they are. Heavier use periods make this more likely. We treat the danger now and watch how symptoms change when the drug is out of the system before deciding if this is a long-term primary illness." [3]

Explain the crash. "After a binge people often crash — sleeping a lot, then around the second day feeling low, empty, irritable and craving. That low mood window is when suicide risk can rise, so we take safety seriously even if he seems calmer than during the high." [2]

No methadone-for-ice. "For heroin there are licensed medicines like methadone or buprenorphine that replace and stabilise. For methamphetamine, guidelines say the main treatment is structured psychosocial care — things like programmes that reward drug-free tests (contingency management), counselling skills, and dual-diagnosis support. Some research medicines exist in specialist settings, but there is no approved standard anti-craving tablet we must start today like methadone." [1][4]

Sister's depot demand. Acknowledge fear; explain time-limited medicine for psychosis if needed, early review, dual formulation — not automatic lifelong depot after one ice-related episode. [3]

Plan. Safety plan (means, contacts, when to return), sleep/food/support, AOD and mental-health follow-up within days, harm reduction, written info, teach-back. [1][2]

Close. Summarise; check understanding; crisis numbers. [1]