The course and consequences of the heroin shortage in Victoria

Monograph no. 6

Paul Dietze, Peter Miller, Susan Clemens, Sharon Matthews, Stuart Gilmour, Linette Collins

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.