Executive Summary

In 1996, the Commonwealth Department of Health and Aged Care commissioned the National Drug and Alcohol Research Centre (NDARC) to trial the Illicit Drug Reporting System (IDRS) and in 2000, the full IDRS was conducted nationally for the first time, with all jurisdictions following standard procedure manuals. In 2001, the Northern Territory (NT) did not receive funding to participate in the national IDRS and the current NT Drug Trends was conducted to provide similar data for the NT. The purpose of NT Drug Trends is to detect trends and indicate what may require more in-depth research and contribute to other policy decisions. It acts as an early warning system and detects significant changes or emerging trends in drug use patterns through:

A quantitative survey of people who inject drugs (PWID) recruited throughout greater Darwin. Inclusion criteria were injecting at least monthly for the past six months and Darwin as the principal place of residence in the preceding 12 months.
Qualitative interviews with key informants recruited from professional settings. Inclusion criteria were at least weekly contact with illicit drug users in the previous six months or contact with at least ten illicit drug users in the previous six months.
Analysis of secondary indicator data on illicit drug use or associated harm

This report examines illicit drug use patterns and trends through the analysis of data collected by these three methods.

Survey of Injecting Drug Users (PWID)
The 135 PWID were surveyed in June 2001 and the sample was predominantly male, of Caucasian origin, mean age of 34.3 years, unemployed and not currently in drug treatment. Ten percent of the sample identified as Indigenous and this proportion is similar to that reported in 2000. Half of the sample had a prison history and one in three had been arrested in the previous year. The mean age of first injection was 20 years and amphetamine was most likely to be the first drug injected. Heroin was the preferred drug of most PWID, but morphine was the drug most likely to be last injected. Polydrug use was prevalent, with nine drugs being the median number ever used. The median number of drugs used in the six months before the survey was six and three on the day before the survey. Most PWID injected daily.

Key Informant Interviews
The 11 key informants were employed in alcohol and drug treatment agencies (Government and non-Government), other health services, the Needle and Syringe Program, the ambulance service or in private practice. Four key informants identified amphetamine as the main illicit drug used, five nominated morphine and two selected cannabis. None identified heroin or cocaine.

Other Indicators
Information from a range of secondary data sources complemented and validated the injecting drug user survey and key informant interviews. These sources included population surveys, needle and syringe program data, opiate-related overdose data, health and law enforcement data and treatment agency client information.

Amphetamine/methamphetamine trends

Most likely to be first drug injected, particularly by youth;
Youth more likely to last inject amphetamine;
A diverse population of users and use patterns, with many recreational users;
Intravenous use was the most common means of administration;
Increasing numbers of youth and Indigenous users;
Polydrug use was common and increasing;
Most users were not in any form of treatment;
Powder was the main form of amphetamine available, but purer forms such as crystal methamphetamine (Ice) were more available;
Four-fold increase from 2000 to 2001 (6% : 24%) in the proportion of PWID using crystal methamphetamine (Ice) in the last 6 months;
Average purity had increased from 5% in 2000 to 11% in 2001;
Cost per gram averaged $80 and stable, points of crystal methamphetamine sold for an average of $50;
Easy to obtain and availability was stable;
An increase in suppliers and local manufactures;
Reports of increased benzodiazepine use; and
Cannabis use was common, often on a daily basis, and alcohol was consumed regularly.

Cannabis trends

Most users were not in any form of treatment;
Polydrug use was common;
The prices were usually $25 for 1 gram and $300 per ounce and stable;
Hydroponic cannabis was most commonly used;
Potency was high and stable;
Cannabis was very easy to obtain and stable;
Amphetamine was also used; and
Most PWID used cannabis often on a daily basis.

Morphine and heroin trends

Heroin was the preferred opiate;
Morphine was most commonly used opiate and the drug most often last injected by PWID;
Indigenous users were seen as an emerging group;
More people were using, especially young people, and using more of the drug;
Most users did not access treatment;
Polydrug use was prevalent and increasing;
Intravenous use was the most common route of administration;
Heroin sold for an average price of $550 per gram and the price had dropped from $600 in 2000, but the price of a cap of heroin had increased from $50 in 2000 to $100 in 2001;
Heroin purity was low and availability fluctuated;
MS Contin® 100mg tablets were most common form of morphine, but other forms were becoming more available;
A 100mg MS Contin® tablet usually cost $50 and the price was stable; MS Contin® 60 mg sold for $30 while the 30 mg form sold for $15;
Diversion of legal morphine prescriptions was common and the black market was busier and more aggressive, especially when morphine was difficult to obtain;
Morphine was easy to obtain;
Benzodiazepine use, particularly temazepam (Normison®), had increased and the proportion injecting it had also increased;
More morphine users also using amphetamine; and
Cannabis and alcohol was also commonly used.

Cocaine trends

Cocaine use uncommon in Darwin;
Snorting was the most common route of administration, followed by injection;
Powder was the most common form available;
Purity was medium to high;
Cocaine sold for an average of $300 per gram and $100 per cap, purity was medium but fluctuated; and
Cocaine remained difficult to obtain and availability fluctuated.

Other drugs

Polydrug use was prevalent and increasing;
Alcohol and cannabis use were high;
Benzodiazepine use increasing, from both licit and illicit sources, particularly temazepam;
Increase in the injection of non-injectable drugs, particularly benzodiazepines and methadone;
Ecstasy use common and availability had increased;
Injection was the main route of administration of ecstasy among the PWID;
Anti-depressant use common;
A decrease in the use of hallucinogens;
Other designer drug use was uncommon; and
The majority of illicit drug users smoked tobacco on a daily basis.

Drug-related issues

Criminal activity prevalent, particularly dealing and property crime;
Increased property crime, particularly among youth;
Increase in violent crimes, especially assaults and robberies;
Reported increase in police presence but no increase in drug seizures;
More suppliers, user-dealers and trading goods for drugs;
Awareness of safe injecting, but still sharing injecting equipment;
Injecting-related health problems were common, particularly bruising, scarring, infections, difficulty injecting and Hepatitis C;
Fewer drug clients at treatment agencies;
An increase in users with mental health and behavioural issues;
Non-fatal drug overdoses common among injecting drug users; and
Fatal opiate overdoses were rare.

Policy/Research Implications
The findings from this study suggest the following key areas for further investigation:

Monitoring of Schedule 8 narcotics (morphine) and Schedule 4 benzodiazepine consumption rates, in-depth analysis of supply pathways, demand characteristics and health impacts.
Development of appropriate and credible harm reduction strategies for non-injectable drugs, particularly benzodiazepines.
Research into the psychological impact of methamphetamine, cannabis and polydrug and the development of mental health and behavioural disorders.
Development of appropriate and credible harm minimisation information for polydrug users.
Development of relevant and culturally appropriate harm minimization resources to overcome literacy and cultural barriers.