The course and consequences of the heroin shortage in South Australia

Research Summary no. 5

Adam Harrison, Paul Christie, Dr Marie Longo, Sophie Pointer, Dr Robert Ali

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

Methodology

The researchers undertook semi-structured interviews with 41 key informants from the health and law enforcement sectors and 43 individuals receiving drug treatment for heroin dependence. In addition, data was obtained from a range of health and law enforcement agencies in South Australia.

Key findings:

  • The heroin shortage in South Australia began suddenly in early 2001 without any indicators to signal its approach. Within the first few months of 2001 the availability of heroin was severely restricted and that which could be sourced was of low purity.
  • Following the onset of the shortage there was a reduction in the number of fatal and non-fatal heroin overdoses and less heroin was being used.
  • There was an increase in methamphetamine use. There was also an increase in the intravenous use of benzodiazepines1 and other opioids2 which was associated with vein problems in users.
  • Key informants reported that there was an increase in mental health difficulties, psychosis3 and violence associated with increased methamphetamine use, however this was not reflected in hospital data concerning drug-induced psychosis.
  • There was no increase recorded for treatment-seeking for opioids, however there was an increase in demand for methamphetamine-related treatment.
  • After the heroin shortage occurred, there was less delineation between depressant illicit drug users and psycho-stimulant4 illicit drug users. There was also an increase in the use of multiple substances by illicit drug users.
  • The extent of injecting drug use remained stable during the heroin shortage with a potential increase in the extent of injecting drug use being identified in 2002/03. There has also been a marked increase in the injection of drugs that are non-injectable, which has resulted in vein problems for these users.
  • While there was only a modest increase in emergency department data which indicated an increase in the number of psychosis incidents, key informant data indicated a rise in drug-related psychosis, mental health issues, problems with psycho-social functioning, violence, sleep deprivation, appetite suppression, nutritional problems and drug-related injuries. The key informants attributed these changes to increased methamphetamine use.
  • After the onset of the heroin shortage there was a spike in robberies without a weapon, however there were no other changes in the rates of crime incidents which were attributable to the heroin shortage.
  • Key informants made a number of observations that were not borne out in crime data. Specifically, key informants indicated that there had been an increase in rates of acquisitive and violent crime, increased methamphetamine production, increased fraud related to heroin dealing, a rise in prostitution, and a rise in methamphetamine-related driving offences.
  • There appeared to be an increase in stress and panic among heroin users which led to an increase in opportunistic crime, such as robbery without a weapon. The primary impact of the heroin shortage on law enforcement agencies in South Australia, as identified by key informants, was a shift in the focus of Operation Mantle (a major SA Police drug initiative) from heroin to methamphetamine. There was also an increase in the detection of clandestine laboratories, predominantly controlled by Outlaw Motor Cycle Groups. In addition, there was a need to provide more information to SA Police on how to handle people acting under the influence of methamphetamine.

Implications for police

The heroin shortage that occurred in Australia in early 2001 provided the law enforcement sector with a unique insight into the workings and impacts of the heroin markets in Australia. It also provided a good opportunity to better understand the ways in which the results of drug supply reduction activities can impact on illicit drug users, on policing and health organisations, and on the broader community.

Enhancing the knowledge base in this area allows police to better target supply reduction initiatives so as to impact upon the most harmful facets of the heroin market. This understanding will provide opportunities to work with other agencies to ensure that an appropriate balance of measures from different organisations are put into place to address changing patterns of drug-related problems.

  1. Benzodiazepines are a group of sedative drugs commonly prescribed for conditions such as insomnia and anxiety. Included in this group are drugs such as Valium(tm) (diazepam), Serapax(tm) (oxazepam), and Normison(tm) (temazepam).
  2. Opioids are the group of drugs that includes heroin, morphine, methadone, oxycodone.
  3. Psychosis is a mental state characterized by a loss of contact with reality and an inability to think rationally. A psychotic person often behaves inappropriately and is incapable of normal social functioning.
  4. Psycho-stimulant drugs are those which elevate mood and arousal and include cocaine and methamphetamine and ecstasy.