Heroin

Understanding and describing Australian illicit drug markets

This study has provided a detailed description of the drug purchase and drug use patterns of a cohort of people who inject drugs, and an understanding of changes that occurred between 2009 and 2014. During this period, heroin, methamphetamine, benzodiazepines and other opioids were typically purchased between 10am and 2pm with very little search time, were used almost immediately following their acquisition, and sharing a purchase or pooling money with a partner or friend was common, as were larger (>$100) purchases. Reported drug purchases and drug use both occurred more frequently in private homes than public settings, and this became increasingly so over time. Although the primary drug of the cohort remained heroin, two trends in drug use were observed: a transition from heroin to cannabis use, consistent with some of the cohort ‘maturing out’; and among existing methamphetamine users, a transition from powder to crystal methamphetamine use and increased methamphetamine consumption, corresponding with increased availability of the crystal form and a dramatic decrease in purity-adjusted price.

Impact of the heroin shortage: Additional research

Plain English summary and implications for police prepared by Roger Nicholas.

Psycho-stimulant use, health and criminal activity among injecting heroin users

Plain English summary and implications for police prepared by Roger Nicholas.

The course and consequences of the heroin shortage in Victoria

Plain English summary and implications for police prepared by Roger Nicholas.

The course and consequences of the heroin shortage in South Australia

Plain English summary and implications for police prepared by Roger Nicholas.

The course and consequences of the heroin shortage in NSW

Plain English summary and implications for police prepared by Roger Nicholas.

The causes, course and consequences of the heroin shortage in Australia

Plain English summary and implications for police prepared by Roger Nicholas.

Impact of the heroin shortage: Additional research

In early 2001, Australia experienced a sudden and dramatic decrease in heroin availability, concomitant with increases in price and decreases in purity. This phenomenon, known as the 'heroin shortage', was assessed in a comprehensive body of research examining the causes, course and consequence of the shortage). As a result of those findings a number of additional questions were raised, and some findings required further and more detailed analysis, which are addressed in the current report. The aims of the research presented in this report were to: i) assess what impact, if any, the heroin shortage had on initiation to heroin use; ii) examine whether the associated increase in cocaine use led to a) an increase in violent crime and b) an increase in sex work; iii) provide a more detailed and analytical analysis of fatal and non-fatal drug overdose; and iv) provide a closer examination of the impact of law enforcement operations on harm reduction in the context of the heroin shortage.

Psycho-stimulant use, health and criminal activity among injecting heroin users

This research sought to inform three questions of relevance to illicit drug policy: what effect does the perceived price, purity and availability of heroin have on (a) heroin use and (b) heroin expenditure; what effect does the perceived risk of scoring, perceived hassle associated with scoring and amount of contact with police have on (a) heroin use and (b) heroin expenditure; and what differences are there in terms of adverse health and behavioural outcomes between IDUs who use heroin only and IDUs who use a combination of heroin and psycho-stimulant drugs, such as cocaine and methamphetamine? To address these questions a sample of 296 Sydney IDUs were surveyed. For this sample of IDUs, most of the law enforcement-related variables exerted no significant effect on heroin use and expenditure. Neither the cost of heroin, nor its purity, nor the perceived risk and hassle associated with purchasing heroin were related to either drug expenditure or use. There was a significant relationship between the amount of contact with police and heroin expenditure but it was in the opposite direction to that which would be expected if police contact directly reduces heroin expenditure. IDUs who had more contact with police spent more on heroin each week than IDUs who had relatively infrequent contact with police. The only law enforcement-related variable that appeared to be related to heroin use and expenditure in the manner expected was time to score. IDUs who took longer to score spent significantly less on the drug, and used significantly less of it.

The course and consequences of the heroin shortage in Victoria

This report presents the findings of the Victorian component of a national investigation into the heroin shortage which began in early 2001. The aim of the research was to investigate the heroin shortage in Melbourne in some detail with a view to examining the longer term consequences of the heroin shortage in Victoria. Based on analysis of existing data sources as well as a series of key informant interviews, the project documents the heroin shortage in Victoria, including changes in the price, purity and availability of other drugs, and examines resulting changes in drug use among injecting drug users; changes in the health effects of drug use; changes in drug treatment; changes in drug related criminal activity associated with the heroin shortage; changes in health and law enforcement agency operations; and key informant impressions of the heroin shortage. The analysis finds that the heroin shortage was characterised by reports of decreased availability and purity, and increased price, of heroin in Melbourne; however recent data on heroin seizure purity show an increase in purity since the most acute phase of the shortage. The heroin shortage was also associated with a decrease in the reported use of heroin and overall injection frequency reported by samples of injecting drug users in Melbourne; a dramatic decline in the number of heroin related deaths in Victoria; a dramatic decline in the number of non fatal heroin overdoses in Melbourne that was most acute in the Central Business District; a dramatic decline in the number of opioid hospitalisations in Victoria; a decline in the number of courses of treatment for opioids provided by the specialist drug treatment service system; a short term increase in the number of robbery incidents recorded by Victoria Police; and a decline in heroin related incidents recorded in areas of Melbourne containing street based drug markets. The shortage also enabled health and law enforcement agencies to focus on other issues or drugs that were not able to be addressed during the earlier heroin epidemic. The overall extent of injecting drug use apparently changed little in Victoria as a result of the heroin shortage, with injecting drug users shifting their drug use to amphetamines, benzodiazepines, prescribed opioids and cannabis. The findings also suggest the emergence of a market for prescribed pharmaceuticals among injecting drug users that has been sustained in the longer term. Health agencies noted a decline in the general physical health of injecting drug users and in their mental health, primarily associated with the use of stimulant drugs, and an increase in injection related problems and risky injecting practices. Unlike other jurisdictions, there did not appear to be an increase the use of cocaine.

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