NDARC Technical Report No. 234 (2005)
EXECUTIVE SUMMARY
There are numerous harms associated with injecting drug use to both individuals and community, including blood-borne viral infections and overdose. Although there is a plethora of research examining these phenomena among injecting drug users, the research has been focused on metropolitan dwelling injecting drug users (IDU), with very few studies including rural IDU. Therefore the current study aimed to examine: patterns of drug use, injecting harms and blood-borne virus infection (BBVI) risk; needle and syringe procurement; drug service utilisation; and BBVI testing among rural and outer metropolitan IDU. Given the range of psychosocial factors that may compound harms in rural areas, suicide attempts, hepatitis C-related discrimination and quality of life were also examined.
A cross-sectional survey, using an interviewer administered structured questionnaire, was conducted in 11 different areas across NSW. Participants were recruited through needle and syringe programs (NSP), snowballing techniques and advertisement.
Two hundred and sixty IDU were interviewed: 164 rural and 96 metropolitan. Age, gender, education and employment were similar for rural and metropolitan participants. Both samples reported use of a range of drugs, but rural participants were less likely than metropolitan participants to report daily heroin use (2% vs. 10%), but more likely to report having injected morphine (50% vs. 21%) in the last six months. Similar proportions reported using a needle/syringe after another person. Rural participants were less likely to report use of NSPs (36% vs. 80%), and reported a significantly longer period of time between BBVI testing. Fewer than half the sample reported having experienced a barrier to treatment, but there was no difference between the two groups.
More than a third of the sample had previously attempted suicide, but this was not associated with region. Those who had attempted suicide tended to be younger than those who had not. Recent (preceding 12 months) hepatitis C-related discrimination was reported by 24% of the sample, with no difference between regions. Discriminatory incidents most commonly occurred in healthcare settings. Participants had a mean global quality of life 59.4 (SD 22.3). Rural participants had a lower global quality of life score than metropolitan participants (56.1 vs. 64.5).
Samples of rural IDU are similar to metropolitan samples, although they report some differences in patterns of drug use. Quality of life, however, was lower for rural IDU. Service provision, including access to new injecting equipment, BBVI testing and drug treatment was found to cause considerable problems for rural IDU. These issues warrant further consideration.
Citation: Day, C., Conroy, E., Lowe, J., Kimber, J., Page, K. and Dolan, K. (2005) Drug use and harms among rural and metropolitan injecting drug users: Findings from the rural injectors project, Sydney: National Drug and Alcohol Research Centre.