Executive Summary

In 1998 the Commonwealth Department of Health and Aged Care commissioned the National Drug and Alcohol Research Centre to conduct a national trial of the Illicit Drug Reporting System (IDRS). The aim of the IDRS is to provide a method of monitoring trends in the use of opiates, cannabis, cocaine and amphetamines. This approach to the monitoring of illicit drugs provides information about emerging trends in illicit drug use and related harms and provides the basis for identifying areas of concern that may require further investigation.

Turning Point, Alcohol and Drug Centre Inc conducted the Melbourne arm of this trial between July and September of 1998. The 1998 IDRS conducted in Melbourne consisted of:

1. A quantitative survey of a total of 293 individuals who were current injecting drug users recruited from a number of sites across the Melbourne metropolitan area.
2. Qualitative interviews with 31 key informants recruited from a variety of professional settings. Participants were selected on the basis of their perceived level of knowledge about illicit drug use, as well as having had contact with illicit drug users over the past 6 months.
3. Analysis of a range of secondary illicit drug indicators.

The data collected in these 3 phases of the study were analysed in order to identify trends in illicit drug use and related harms. For comparison these data were compared to the results obtained in the Melbourne IDRS study that was conducted in 1997.

Summary of drug trends in Victoria
The 1998 IDRS detected a number of drug trends during the past 6-12 months from analyses of the IDU survey, the key informant survey, and other indicators.

Heroin
The major trends evident for the Melbourne heroin market were a decrease in price and increase in the purity of the drug since 1997. Increased frequency of use of heroin was reported by individuals who were injecting drugs, and reports were received of an increase in recreational use and in ‘burning’ of the drug. There was evidence of the continuing development of street-based markets in many locations within Melbourne. A substantial increase in the number of heroin-related fatalities occurred in Victoria from 1997 to 1998, and there was evidence of a high rate of ambulance attendance at non-fatal heroin overdoses in Melbourne during this period.

Amphetamines
Most indicators relating to amphetamines were stable including price, purity and availability. The available evidence suggests that the prevalence of amphetamine use in Melbourne is either stable or has decreased somewhat.

Cocaine
Relatively few key informants or injecting drug users were able to comment on cocaine trends. The responses of those who were able to provide such information indicated price, purity and availability was relatively stable, apart from some evidence of a reduction in price since 1997. Cocaine continues to be used relatively infrequently by individuals who are injecting drugs.

Cannabis
Most aspects of the cannabis market and patterns of use appear to be relatively stable with only a slight reduction in price and no change in availability evident between 1997 and 1998. There is evidence of a continuing trend towards the use of hydroponic production techniques in cannabis cultivation. There appear to be no major changes in the form of the drug used or the prevalence of use of the drug over this period. Cannabis remains the most widely used illicit drug within Victoria.

Other drugs
There is evidence of a continuing high rate of prescription drug use among individuals who are injecting drugs including opiates, benzodiazepines and anti-depressants. There is some evidence in the reduction of use of the benzodiazepine, flunitrazepam among individuals who inject drugs.

Drug-related issues
A number of disturbing trends are apparent in relation to health problems associated with illicit drug use. These include:

• a substantial increase in heroin-related fatalities from 1997 to 1998,
• high rates of non-fatal overdose among individuals injecting heroin, and
• poor health status and continuing high rates of infection with the hepatitis C virus among injecting drug users.

There continues to be an increase in the number of clients who are participating in the methadone program in Victoria. Police arrests have increased for offences relating to heroin and decreased for those in relation to cannabis, a trend which would appear to reflect changes in police policy and enforcement practices.

Research Implications
The findings of the 1998 IDRS suggest the following areas for further investigation:

1. Research into the observed changes in patterns of heroin use, particularly among younger people and focusing on initiation into the injecting of heroin.
2. An examination of the relationship between changes in the characteristics of the heroin market (such as price and purity) upon patterns of heroin use and related consequences. This should include research which would inform the development of approaches to reducing the harms associated with street-based heroin markets in Melbourne.
3. There is an urgent need for research into the development of more effective methods for preventing heroin-related overdose and the transmission of the hepatitis C virus among individuals who inject drugs.
4. Research examining the potency of cannabis currently being consumed in Victoria and related health implications.
5. Prevalence estimation studies that aim to provide estimates of the number of Victorians who are using heroin, amphetamines, cocaine and other illicit drugs that are difficult to measure using general population surveys.

Resources

• TR.073.pdf