Impact of the heroin shortage: Additional research

Research Summary no. 19

Louisa Degenhardt, Carolyn Day

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

Methodology

The researchers used data collected as part of a larger study of a heroin shortage which occurred in Australia in 2001. The research involved secondary analysis of existing databases and, where possible, time series analysis. The researchers also conducted semi-structured interviews with a variety of representatives from law enforcement and health agencies, as well as heroin users who were in and out of treatment. Specifically, the researchers examined: the impact (if any) of the heroin shortage on initiation into heroin use; whether the associated increase in cocaine use led to an increase in violent crime and/or an increase in sex work; and the impact of law enforcement operations on harm reduction in the context of the heroin shortage.

Key findings:

  • Between 1996 and 2004 there was a marked decrease in the proportion of heroin users aged 24 years or less, who were interviewed as part of the Illicit Drug Reporting System (IDRS). A marked drop in numbers from this age group occurred in 2001, the year when the heroin shortage emerged. This suggests that fewer young heroin users were in the market at that time.
  • Of those injecting drug users who reported first injecting between 1993 and 2000, similar proportions reported that heroin and amphetamine were the first drugs they injected. After 2000, methamphetamine was the most commonly reported as the drug that was first injected. Consequently, the reduction in heroin availability probably resulted in a reduction in the number of new heroin injectors in Australia.
  • It has been suggested that between 2,745 and 10,560 young persons who would otherwise have commenced heroin use in 2001 did not do so because of the reduction of heroin supply. Had they begun heroin use at this time it is anticipated that approximately one in four would have progressed to regular or dependent heroin use. Therefore it could be claimed that there has been a reduction of between 700 and 2,500 dependent heroin users and a substantial reduction in future heroin-related morbidity and mortality in Australia.
  • There was a significant increase in cocaine use and cocaine possession offences in NSW in the months immediately following the reduction in heroin supply. There was also a significant increase in incidents of robbery involving weapons (other than firearms), but no increases in offences involving firearms, in homicides or in reported assaults. This led to the conclusion that the increased use of cocaine among injecting drug users resulted in increases in violent crime. Other Australian jurisdictions that also experienced the heroin shortage did not experience either an increase in cocaine use or an increase in violent crimes.
  • In addition to an increase in cocaine use in NSW following the heroin shortage, there was an increase in prostitution offences. Key informants reported that: there were increased numbers of illicit drug users engaging in street-based sex work; the sex workers were more visible; there was a general decline in their health; and that there was an exacerbation of risky behaviours which were thought to be linked to increased cocaine use.
  • Both fatal and non-fatal heroin overdoses decreased significantly when the heroin supply was reduced; but the reductions were greater among younger age groups than they were among older age groups. No clear increases were seen in the numbers of non-fatal overdoses that were associated with the use of other drugs.

Implications for police

The reduction in the supply of heroin that occurred in early 2001 probably led to a switch towards cocaine use (in NSW) and methamphetamine use in most other Australian jurisdictions. Nevertheless, there is little doubt that the shortage was associated with a dramatic decrease in fatal and non-fatal overdoses.

The heroin shortage also enhanced broader policing capabilities by freeing up resources that would otherwise have been used to control drug markets and related criminal activity.

The fact that NSW did not experience an increase in firearm-related crimes following increases in cocaine use (as has been the case in the United States) is most likely as a result of Australia’s stringent gun laws.

The heroin shortage has provided an important insight into what can result if a reduction in the supply of drugs is achieved. This research provides valuable information concerning the ways in which reductions in drug supply affects different groups in the community in different ways. In this case, younger heroin users were particularly affected by the heroin shortage and it led to a disproportionate reduction in harms (in particular deaths) in this group.

The reduction in heroin supply did, however, lead to some adverse outcomes such as increases in cocaine use, street prostitution and offences in which weapons (other than firearms) were involved. In instituting, changing, or increasing supply reduction measures, it is important for police to try to anticipate the likely adverse outcomes and to have measures in place to address them. This may, for example, involve working with colleagues in other sectors to ensure that they are in a position to prepare for any unintended outcomes.