The causes, effects and implications of the heroin shortage in the NSW, SA and Victoria

This project aims to:

• examine the context and parameters of the heroin shortage
• determine the effect of the shortage on the price, purity and availability of heroin, distribution and using practises.
• assess the effect of the heroin shortage on heroin and other drug use, public health, crime and the work of law enforcement, health and emergency services
• examine the characteristics of those who left the heroin market as a result of the shortage

  Design and Method

  
  

Existing research was reviewed and available indicator data analysed. Injecting drug users (IDU) were interviewed regarding their patterns of drug use prior to, during and subsequent to the heroin shortage. Additional cohorts of IDU who did not inject heroin for at least one month or who entered methadone maintenance treatment (MMT) during the peak period of the shortage, were also interviewed. Data was collected on treatment seeking behaviour, overdose, presentation to emergency services and criminal behaviour. A range of key informants from law enforcement, drug treatment and detoxification agencies, NSP, and ambulance services were interviewed. To examine the causes of the heroin shortage, plausible theories were collated and assessed according to the available evidence. Following this process, the most plausible model(s) was developed based on the identified factors.

Output

Degenhardt, L., Day, C. & Hall, W. (editors) (2004). The causes, course and consequences of the heroin shortage in Australia. NDLERF Monograph Series No. 3. National Drug Law Enforcement Research Fund: Adelaide.

Dietze, P., Miller, P., Clemens, S., Matthews, S., Gilmour, S., & Collins, L. (2004). The course and consequences of the heroin shortage in Victoria. NDLERF Monograph Series No. 6. National Drug Law Enforcement Research Fund: Adelaide.

Harrison, A., Christie, P., Longo, M., Pointer, S., & Ali, R. (2004). The course and consequences of the heroin shortage in South Australia.NDLERF Monograph Series No. 5. National Drug Law Enforcement Research Fund: Adelaide.

The results have also been presented at a number of national and international conferences, as well as a special presentation to the Ministerial Council on Drug Strategy (MCDS) in November 2004. A press release was also issued at that time.

Other papers that have arisen from this study include:

Day, C., Collins, L., Degenhardt, L., Thetford, C. & Maher, L. (2004) Reliability of heroin users' reports of drug use behaviour using a 24 month timeline-follow-back technique to assess the impact of the Australian heroin shortage, Addiction Research & Theory 12, 433-443.

Day, C., Degenhardt, L., Gilmour, S. & Hall, W. (2004) Effects of a reduction in heroin supply on injecting drug use: analysis of data from needle & syringe programmes, British Medical Journal 329, 428-429.

Day, C., Degenhardt, L., Gilmour, S. & Hall, W. (2005) Changes in blood-borne virus notifications and injecting related harms following reduced heroin supply in New South Wales, Australia, BMC Public Health 5.

Day, C., Degenhardt, L.. & Hall, W. (2006). Documenting the heroin shortage in New South Wales. Drug and Alcohol Review 25, 297 – 305.

Day, C., Degenhardt, L.. & Hall, W. (2006). Changes in the initiation of heroin use after a reduction in heroin supply. Drug and Alcohol Review 25, 307-313.

Degenhardt, L., Conroy, E., Day, C., Gilmour, S. & Hall, W. (2005) The impact of the Australian heroin shortage on demand for and compliance with treatment for drug dependence, Drug and Alcohol Dependence 79, 129-135.

Degenhardt, L., Conroy, E., Gilmour, S. & Collins, L. (2005) The effect of a reduction in heroin supply in Australia upon drug distribution and acquisitive crime, British Journal of Criminology 45, 2-24.

Degenhardt, L., Conroy, E., Gilmour, S. & Hall, W. (2005). The effect of a reduction in heroin supply upon population trends in fatal and non-fatal drug overdoses, Medical Journal of Australia 182, 20-23.

Degenhardt, L., Day, C., Conroy, E., Gilmour, S. & Hall, W. (2005). Age differentials in the impacts of reduced heroin supply: Effects of a "heroin shortage" in NSW, Australia, Drug and Alcohol Dependence 79, 397-404.

Degenhardt, L., Day, C., Dietze, P. et al. (2005). Effects of a sustained heroin shortage in three Australian States, Addiction 7, 908-920.

Degenhardt, L., Day, C., Gilmour, S. & Hall, W. (2005). Changes in community level drug use associated with a reduction in heroin supply, International Journal of Drug Policy 16, 300-307.

Degenhardt, L., Day, C., Gilmour, S., & Hall, W. (2006). The ‘lessons’ of the Australian ‘heroin shortage’. Substance Abuse, Treatment, Prevention and Policy 1:11.

Degenhardt, L., Day, C., Hall, W., Conroy, E. & Gilmour, S. (2005). Was an increase in cocaine use in New South Wales, Australia, accompanied by an increase in violent crime?, BMC Public Health, 5.

Degenhardt, L., Hall, W., Day, C. et al. (2005). Mapping the consequences of an unanticipated drug supply change of uncertain origins: Response to the commentaries, Addiction 100, 930-932.

Degenhardt, L., Reuter, P., Collins, L. & Hall, W. (2005). Evaluating explanations of the Australian "heroin shortage", Addiction 100, 459-469.

Degenhardt, L., Gascoigne, M. & Howard, J. (2002). Examining the changes in drug use patterns of young people in drug treatment during a period of reduced heroin availability, Youth Studies Australia 21, 11-16.

Gibson, A., Day, C. & Degenhardt, L. (2005) .The impact of illicit drug market changes on health agency operations in Sydney, Australia, Journal of Substance Abuse Treatment 28, 35-40.

Gibson, A., Degenhardt, L., Day, C. & McKetin, R. (2005). Recent trends in heroin supply to markets in Australia, the United States and Western Europe, International Journal of Drug Policy 16, 293-299.

Gilmour, S., Degenhardt, L., Hall, W. & Day, C. (2006). Using intervention time series analyses to assess the effects of imperfectly identifiable natural events: a general method and example, BMC Medical Research Methodology, 6.

Degenhardt, L., Day, C., Gilmour, S. & Hall, W. (2006). The "lessons" of the Australian "heroin shortage", Substance Abuse Treatment Prevention and Policy 1.

Degenhardt, L., Day, C., Conroy, E. & Gilmour, S. (2006). Examining links between injecting cocaine use and street based sex work in NSW, Australia, Journal of Sex Research 43, 107-114.

Dietze, P. & Fitzgerald, J. (2002). Interpreting changes in heroin supply in Melbourne: Droughts, gluts or cycles?, Drug and Alcohol Review 21, 295-303.

Day, C., Topp, L., Rouen, D. et al. (2003). Decreased heroin availability in Sydney in early 2001, Addiction 98, 93-95.

Degenhardt, L., Topp, L. & Day, C. (2003).Issues surrounding the detection of a reduction in drug supply: The case of the heroin shortage in Australia, 2001, Bulletin on Narcotics LIV, 131-140.

Topp, L., Day, C. & Degenhardt, L. (2003). Changes in patterns of drug injection concurrent with a sustained reduction in the availability of heroin in Australia, Drug and Alcohol Dependence 70, 275-286.

Topp, L., Degenhardt, L., Day, C. & Collins, L. (2003). Contemplating drug monitoring systems in the light of Australia's heroin shortage, Drug and Alcohol Review 22,, 3-6.

Shanahan, M., Degenhardt, L. & Hall, W. (2004). Estimating the economic consequences of reduced heroin supply in Australia 2000-2003. NDARC Technical Report No. 195. Sydney, National Drug and Alcohol Research Centre.

Degenhardt, L., Rendle, V., Hall, W., Gilmour, S. & Law, M. (2004). Estimating the size of a heroin using population after a marked reduction in heroin supply. NDARC Technical Report No. 197. Sydney, National Drug and Alcohol Research Centre.

Degenhardt, L., Rendle, V., Hall, W., Gilmour, S. & Law, M. (2004). Estimating the number of heroin users in NSW and Australia, 1997-2002. NDARC Technical Report No. 198. Sydney, National Drug and Alcohol Research Centre.

Gibson, A., Degenhardt, L., Topp, L. et al. (2003). Global and Australian heroin markets. NDARC Technical Report No. 167. Sydney, National Drug and Alcohol Research Centre.

Day, C., Gibson, A., Collins, L., Degenhardt, L. & Dietze, P. (2004). Research methodologies used to obtain retrospective self-reports of the impact of changes in heroin supply on regular users in and out of treatment. NDARC Technical Report No. 176. Sydney, National Drug and Alcohol Research Centre.

Funding

National Drug Law Enforcement Research Fund