NDARC Technical Report No. 175 (2004)
Summary of 2003 Victorian drug trends
Turning Point Alcohol and Drug Centre conducted the Melbourne arm of the 2003 IDRS study between June and October 2003. The project consisted of:
- A structured survey of 152 current injecting drug users recruited from a number of sites across the Melbourne metropolitan area.
- Semi-structured interviews with 57 key informants from a variety of professional settings, selected according to their knowledge about illicit drug use, and level of contact with illicit drug users during the six months preceding the survey.
- Analysis of secondary illicit drug use indicators.
Data collected via these three methods were analysed in order to identify illicit drug related trends in Melbourne for the 2002/03 year. Where appropriate, these data were also compared to findings from the 1997 to 2002 applications of the IDRS in Melbourne. The 2003 IDRS detected a number of trends of relevance during the preceding six to twelve months. Table A provides a summary of identified trends in price, availability, purity and prevalence of use for the four main illicit drug types explored in this study – heroin, methamphetamines, cocaine and cannabis. These are discussed in turn, along with summary details on other drug trends and drug related health and law enforcement trends.
Heroin trends in Melbourne
Trends in heroin use over the past 12 months have been relatively stable. The consistency in reports of heroin price, purity and availability in the 2002 and 2003 IDRS studies is indicative of greater stability in the heroin market since the shortage observed in 2001.
In 2003, heroin was reportedly easy to very easy to access (86%) and availability had been stable. The most frequently reported prices of heroin remained stable at $50 per ‘cap’ and $400 per gram in 2003, with a ‘cap’ being the most popular purchase amount. Frequency of heroin use increased slightly (76 days in 2003, 60 days in 2002), however it has not returned to the levels seen prior to 2001 (176 days in 2000), during the peak of the street heroin market in Melbourne.
As in 2002, a higher proportion of the IDU sample reported that they had mostly used heroin rock (82%) in the previous six months, and intravenous injection still constituted the most common route of administration (90%). Compared to past years, reported street-based heroin dealing decreased (15% in 2003, 31% in 2002), with respondents in 2003 reporting sourcing their heroin from mobile dealers or dealers’ homes.
In general, the heroin market appears to have returned in Melbourne in 2003, however it is clearly not at the levels it was at prior to 2001.
Methamphetamine trends in Melbourne
In the 2002 and 2003 IDRS studies, a distinction was made between the different forms of methamphetamine (speed, base and ice) to improve the precision of data collection on the use, purity and availability of each of these forms.
Findings from the 2003 study suggest that the use of methamphetamines is widespread amongst the IDU surveyed. In 2003, 79% of IDU reported using some form of methamphetamine (either speed, base or ice) in the preceding six months, a proportion comparable to that of the 2002 IDRS (73%). Separating out the forms of methamphetamine, 70% reported using speed, 18% reported using base, and 50% reported using ice in the preceding six months. The prevalence of speed and base use remained stable in 2003, while the prevalence of ice use almost doubled since 2002 (26% in 2002). The trend in ice use by IDU respondents will be carefully monitored in 2004.
The median number of days on which speed had been used in the preceding six months was 12, while for base it was 10, and ice 6 days. Frequency of speed use decreased since 2001 (25 days) and 2002 (24 days), while frequency of base and ice remained stable.
The most common quantity of all forms of methamphetamine purchased (speed, base and ice) was a ‘point’, and the majority of respondents paid $50 for this amount. The most frequently reported price per gram of speed and base was $200, while for ice respondents reported paying $250. Prices reported in 2003 were similar to those reported last year, and the majority of 2003 IDU respondents also reported that prices had been stable (speed 79%, base 67%, ice 57%).
Eighty-one percent of IDU commenting on speed thought that it was easy or very easy to obtain at present, and 63% thought availability had remained stable in the preceding six months. Sixty-seven percent of the IDU commenting on ice reported that it was easy to very easy to obtain, with 29% reporting that it was difficult at present. Sixty percent of respondents who could comment on ice reported that availability had remained stable, while another 17% reported that it had become more difficult in the last six months. Only nine people were able to comment confidently on the availability of base, with five respondents reporting that it was easy to very easy to obtain, and the other four people that it was difficult.
These findings are suggestive of a still emerging market place, not yet characterised by dependent patterns of use. Further research and clarification is needed and a clearer picture of methamphetamine use would be gained through contact with other sentinel groups.
Cocaine trends in Melbourne
In 2003 the proportion of IDU reporting cocaine use in the preceding six months was 13%, with 10% reporting recent injection. Frequency of cocaine use was very low with a median of two days use in the preceding six months. These findings are low overall compared to other illicit drugs being reported on in the IDRS study, and lower than that reported in 2002.
The difficulty in acquiring cocaine may be one explanation for the decreasing prevalence and frequency of use, while another explanation may be that with the supply and price of heroin and methamphetamine reportedly more stable in 2003, cocaine may still be relatively too expensive for the majority of respondents.
In 2003 only four IDU respondents could confidently comment on trends in cocaine price, purity and availability. Those who could comment reported that it was difficult to obtain, it cost $250- $300 per gram, and respondents rated the purity as being medium to high.
While information collected from IDU and key informants suggests that there is some stability in the price and availability of cocaine in Melbourne, it is difficult to identify clear trends due to the consistently small number of IDU and key informants who are able to comment. The expansion of drug trend monitoring research to other sentinel groups (e.g. non-injecting groups, professionals) will provide a clearer picture of cocaine trends in Melbourne.
Cannabis trends in Melbourne
Cannabis use in Melbourne has remained relatively stable. Eighty-eight percent of IDU had used cannabis in the preceding six months (88% in 2002) and the median number of days used in the last six months was 170 (almost daily use). As in previous years, the overwhelming majority of IDU commenting on cannabis thought it easy to very easy to obtain (90%), with 82% reporting that availability had remained stable in the preceding six months.
The modal price of a gram of cannabis has remained stable since 1999 ($20 hydro, $20 bush), while the price per once has been stable for the past four years ($250 hydro, $200 bush). A gram was the most popular purchase amount. Cannabis appears to be the most widely used illicit drug within Victoria, and is a common addition to the list of drugs used concurrently by injecting drug users.
Other drug trends in Melbourne
The 2003 Melbourne IDRS study has again provided evidence of significant prescription drug use by injecting drug users (e.g. benzodiazepines, buprenorphine, morphine, and anti-depressants).
The majority of IDU (80%) reported having used benzodiazepines in the six months prior to interview and most of these people (78%) mainly obtained their benzodiazepines licitly. Reports from both key informants and IDU indicate that there has been a further reduction in the prevalence of benzodiazepine injection in 2003. Fifteen percent of IDU reported injecting benzodiazepines during the past six months in 2003, compared to 21% last year, and 40% in 2001. This is probably due to the combined effects of the changes in legislation regarding the availability of temazepam gel caps, as well as a concerted education campaign aimed at prescribing doctors by the Victorian state government (Breen et al., 2003).
IDU and key informants reported widespread use and injection of morphine in 2003. The majority of IDU reported obtaining morphine illicitly, and both IDU and key informants reported that each tablet sells for around $50. Also of concern is the ongoing prevalence of buprenorphine diversion and injection among injecting drug users in Melbourne. In 2003, over half (51%) of the respondents reported having injected buprenorphine in their lifetime, and 39% reported having injected the drug in the past six months. Buprenorphine is not designed to be injected and can result in substantial negative health consequences such as vein damage and infections. The high prevalence of buprenorphine and morphine injection is a cause for concern and will continue to be monitored.
Prevalence of anti-depressant use appears to be stable, with 28% of users saying they use these drugs. Frequency of use during last six months increased however, to 160 days in 2003, compared to 90 days in 2002. One quarter of respondents also reported ecstasy use within the last six months in 2003. The primary route of administration of ecstasy during that time was swallowing (19%), followed by injection (12%), perhaps providing further evidence of intersections between drug markets and social networks previously considered separate.
Drug-related health and law enforcement trends
Self-reported recent experience of overdose and receipt of Narcan® continued to decrease in 2003. However, other significant harms associated with injecting drug use (such as injection related health problems, hepatitis C virus transmission and other unsafe injecting behaviour) continue to be of major concern. Ten percent of IDU reported that they had borrowed another person’s used needle/syringe, 24% had passed on their own used needle/syringe and 43% had used other already used injection equipment in the last month.
Overall, it was seen that the level of self-reported criminal activity amongst IDU was relatively stable. Key informants reported that in general, crime levels had remained stable and that in most (but not all) areas, the level of police activity had continued to decrease significantly from the previous IDRS studies. IDU reports provided a variable picture of police activity during the six months prior to interview with 59% reporting that it had increased, 32% reporting no change, and 3% reported less activity. The majority of IDU participants (76%) reported that police activity had had no effect on the difficulty in acquiring drugs recently.
Conclusions
The 2003 Victorian IDRS study has provided evidence of both changes, and stability, within the illicit drug market places of metropolitan Melbourne. As in previous Melbourne IDRS studies, the demographic characteristics of the 2003 IDU sample were strikingly similar to those reported in past years. Also consistent with previous surveys, the majority of the sample reported that heroin was the drug they injected most often (65%), the last drug they injected (65%) and their drug of choice (69%).
Findings from the 2003 study suggest that the heroin market in Melbourne has now stabilised, after the reported shortage observed in 2001 (Fry & Miller, 2002). In particular, it has been reported in the current study that heroin is easy to access, and the price and purity have remained relatively stable over the past two years. Nevertheless, heroin supply in Melbourne is clearly not at the levels it was at prior to 2001 and the trend in heroin use will continue to be monitored.
Methamphetamine use was widespread amongst the IDU sampled in 2003. Prevalence of use, price and availability remained relatively stable in 2003, however the was a marked increase in reported use and injection of ice (the purest form of methamphetamine). Considering the potential harms associated with the use of this drug type, the trend in ice use will continue to be monitored. In contrast, data from the 2003 IDRS study suggests that the prevalence of other psychostimulant use (i.e. cocaine and ecstasy) has decreased.
The 2003 Melbourne IDRS study has again provided evidence of significant prescription drug use by injecting drug users (e.g. morphine, buprenorphine, benzodiazepines and anti-depressants). There is also substantial evidence of misuse of these drug types. Of particular concern, is the continuing illicit use and injection of morphine and buprenorphine amongst injecting drug users. Further research is planned to investigate these issues in greater detail.
Continuing trends in the level of injection equipment sharing and associated health problems experienced by IDU (such as vein damage, poor general health and hepatitis C) have again been reported. Further research is needed to investigate the reasons for the continued levels of unsafe injecting. The experience in Victoria has shown that the IDRS is an effective drug trend monitoring system and is valuable for informing policy and research.
Implications of 2003 findings
While the aim of the IDRS study is to monitor emerging trends in illicit drug use and related problems. The role of the Melbourne arm of the IDRS study is to identify yearly illicit drug use trends, and provide recommendations regarding key issues that warrant further in-depth investigation and increased policy focus.
The findings of the 2003 Melbourne IDRS study suggest the following priority areas:
- Continued monitoring of illicit drug markets for changes in price, purity and availability trends, and evidence of increasing harms.
- Further research to monitor the characteristics and impact of psychostimulant use in Melbourne, including an increased focus upon sentinel target groups other than injecting drug users and a consideration of the impact upon health and law enforcement sectors.
- Expansion of Victoria’s routine drug trend monitoring, through new methods and new sentinel groups, to improve the understanding of intersecting drug markets and related harms.
- Research to explore the nature of prescription drug use among injecting drug users in Melbourne, the extent of prescription drug diversion, the characteristics of the illicit market, and the health harms associated with prescription drug misuse.
- Further research to gain a better understanding of the determinants of unsafe injecting, particularly for those injecting practices that increase the risk of blood-borne virus transmission (e.g. HIV, HCV and HBV).
Since 1997, the Melbourne arm of the national IDRS study has proven to be a reliable, cost-effective and informative mechanism for the monitoring of illicit drug trends in Victoria. It yields data that are comparable from year-to-year and across jurisdictions, and it is a study that has much to offer health and law enforcement sectors in their efforts to respond more effectively to illicit drug trends.
Citation: Jenkinson, R., Miller, P. and Fry, C. (2004) Victorian Drug Trends 2003: Findings from the Illicit Drug Reporting System (IDRS), Sydney: National Drug and Alcohol Research Centre.