Hospitalisations due to methamphetamine use in the Hunter New England district have skyrocketed by 800 per cent in a decade.
Health data shows the district recorded 1146 of these hospitalisations in 2022/23, rising from 125 in 2012/13.
The district had the second highest rate per capita in NSW of these hospitalisations, followed by Mid North Coast.
A federal inquiry into the health effects of alcohol and other drugs in Australia held hearings this week, and the NSW Drug Summit begins on Friday.
Garth Popple, who attended the last drug summit in 1999, is executive director of We Help Ourselves Hunter Valley.
It's the only non-government organisation to run a government-funded alcohol and drug dependence residential program in the Hunter.
Based at Cessnock, it's been running for about 22 years.
"Of the people we treat, 75 to 80 per cent identified methamphetamines as a problem," Mr Popple said.
"Ten to 15 years ago, we had that amount of people for opioids or a mix of cannabis/alcohol/opioids. The pendulum has shifted big time."
Mr Popple said there was a "really bad amphetamines problem in Newcastle and the Hunter".
"But we're lean on the ground for services," he said.
Of those seeking treatment in NSW for alcohol, amphetamines, opioids and cannabis, only 49 per cent were able to get it, UNSW research showed last month.
While amphetamines are a big concern in Hunter New England given the ongoing ice epidemic, alcohol remains the biggest problem drug.
Data shows the district recorded 6671 alcohol-related hospitalisations in 2022/23, while other drugs recorded 4724 hospitalisations.
The Hunter had the fourth worst per capita rate of all drug-related hospitalisations among the 15 health districts, behind Central Coast, Mid North Coast and Northern NSW.
The Central Coast had the worst rate of alcohol-related hospitalisations, followed by Far West, Northern Sydney, Mid North Coast and Hunter New England.
Hunter New England Health lists its drug and alcohol services online, which includes a 12-bed inpatient withdrawal unit based at Belmont Hospital.
The district also runs drug and alcohol counselling services, cannabis and stimulant treatment clinics and an opioid program.
Mr Popple said these kinds of services were "great for the people who have the capacity to turn up".
"The people we see have lost that capacity a long time ago. That's why they've ended up in the court system, prison and homeless.
"We get those cases and start putting structure back into their lives."
They get treated with a psychosocial therapeutic program for 90 days, with an average retention of about 60 days.
"As there's no real drug replacement program for amphetamines, it leaves NGOs [non-government organisations] to do the heavy lifting for acute care clients."
Mr Popple's organisation has 30 beds, including seven beds for drug court and MERIT [Magistrates Early Referral Into Treatment] cases.
It treats about 175 Hunter people a year. It also presently has 99 people being treated at its Newcastle site on a day program for amphetamines addiction.
"We're at 100 per cent occupancy most of the time," he said.
"We're trying to get funds to maintain current levels of treatment. That's my first goal."
He said the organisation was "always struggling with costs".
"We receive $150 per bed per day in government funding, but the recommended standard is $250 per bed per day."
He said it should not be forgotten that the service saved society the much larger cost of having more drug users on the street.
"It costs more than triple what we get to leave these people untreated in the community," he said.
"Our grants are tied to treatment, not petrol, food, infrastructure and wages - which are all rising.
"Our hot water system has gone belly up. The quote to replace it was $75,000. We're applying for club and building society grants. The money ain't going to come from the government."
In a submission to the federal inquiry, The Royal Australian and New Zealand College of Psychiatrists said it was "critical to recognise" alcohol and other drug issues as mental health issues.
The Special Commission of Inquiry into the drug ice handed down its findings in February 2020 after 14 months of hearings.
In response, the NSW government in 2022 committed $500 million over four years for health and justice reforms.
"We got $60,000 from the ice inquiry for a 12-seater bus in the Hunter," Mr Popple said, adding they hadn't received the van yet due to supply chain issues.
A $4 million drug and alcohol support service in the Hunter, funded from the ice inquiry money and run by Social Futures, opened in May.
The service is based in Singleton, but will also serve people in surrounding areas such as Cessnock, Kurri Kurri, Muswellbrook and Maitland.
The ice inquiry recommended the complete decriminalisation of drug possession in the state, as well as the introduction of pill testing at music festivals and the abolition of drug dogs.
In response, the Minns government in February began a "two-strike" policy, which meant people caught with small amounts of drugs such as ice, cocaine and MDMA could receive $400 on-the-spot fines.
However, police have discretion on whether to fine people or lay charges.
