Hearings held at the East Maitland Court House for the special commission of inquiry into the drug ice have focused on the impact the stimulant is having on children, adolescents and their families in the Hunter and New England region, with school principals and family service managers taking to the stand.

Only one witness, a principal of a Hunter school, had a closed hearing, while five other witnesses spoke about the nature, prevalence and impact of crystal methamphetamine and other illicit amphetamine-type stimulants ("ATS") in the Hunter and New England region.

The assistant senior counsel Sally Dowling SC flagged the commission would be hearing evidence in coming days about the effects on children of pre-natal exposure to methamphetamine - a topic the commission has not yet covered.

In her introduction Ms Dowling said that number of people over the age of 16 hospitalised for methamphetamine-related issues in the Hunter and Central Coast was above the state average and had "increased dramatically" since the 2012 to 2013 period.

"Maitland, Moree Plains and Cessnock each experience more than double the state average of convictions for possession or use of amphetamines," she said.

Anne-Marie Connelly, the manager client services of Cessnock Community Services - part of the NSW Department of Family and Community Services - was first to speak and said that "younger and younger" people were using the drug in the region, including children as young as 12.

Over the past decade working in the Cessnock area she said the inter-generational risk of using methamphetamine and ATS had become increasing apparent.

"The exposure to parents using has desensitised young people to the negative consequences ... It appears there's a higher likelihood of a young person using ice because of that inter-generational effect."

The biggest issues associated with parents using the drug were that children could experience neglect, inadequate nutrition, and exposure to a lifestyle that could bring "high risk people" into contact with them, occasioning a higher risk of physical and sexual harm.

Ms Connelly said that of the 143 children who entered care in the Hunter district between July 1, 2018, and May 31, 2019, 59 children had parents who were impacted by the drug 'ice'. She later clarified that these were not official figures from FACS.

Children using the drug became vulnerable to other risks, she said.

"The worst case scenarios there have been young men and women who have been seriously psychically and sexually assaulted over a period of time. Over the past twelve months there has been at least three or four cases where there have been elements of what I just spoke about."

Ms Connelly said there was one case in the region of a 14-year-old girl using the app Tinder to find people who would supply her with the drug.

"In exchange she was having to perform sexual favors."

The fact that the cost of a point of ice had almost halved in the region over five years, she said, was only making it "more accessible" to children and families.

"It appears to have increased appearance in schools in the area," she said.

David Lowe the manager of Juvenile Justice in the Hunter New England region for the Department of Justice NSW said that 28 per cent of the service's current clients were using ice. The service provides caseworkers for young people in the community on supervision orders and those on remand and control orders.

"Predominantly, it's within the older cohort ,16,17,18, who use ice."

Mr Lowe said that addiction posed a variety of problems for young people, including increasing the likelihood they will re-offend, disengagement from services, including education and Juvenile Justice, and homelessness.

Detoxification facilities for young people in the region were "almost non-existent", he said, and young people with higher levels of ice use were often excluded from mental health and rehabilitation services because of the intensity of withdrawal symptoms.

"It can really be a barrier to support," he said. "Some are trying to detox at home or in custody. Sometimes custody is the only option to detox then transition to those detox services."

Juvenile Justice funds two residential detoxification facilities in Dubbo and Coffs Harbour. While Mr Lowe said that he had "some successes" with the programs, the geographical distance was a "huge challenge" for his clients.

Both Ms Connelly and Mr Lowe said that intervention in drug use was most effective when there was a "wrap around of services" that could assist clients.

"And an understanding of the relationships and connections the families already have within the communities," Ms Connelly said.

Debborah Beckwith and Tony Gadd of the NSW Department of Education, and Susan Walton of Maitland Community Corrections also spoke at the hearing.