The causes, course and consequences of the heroin shortage in Australia

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Author: Louisa Degenhardt, Carolyn Day, Wayne Hall

Resource Type: Monographs

NDARC Monograph No. 53 (2004)

INTRODUCTION

In early 2001, Australia experienced an abrupt and substantial reduction in the availability of heroin that was widely reported by health and law enforcement key informants across Australia (Rouen, Dolan et al. 2001). The reduction was notable because in the several years preceding its onset heroin had been readily available in most Australian capital cities with a high purity and low price, something that had not occurred in Australia previously. This was particularly evident in steeply increasing overdose deaths, rising nonfatal overdoses and drug-related crime in public heroin markets in Sydney and Melbourne (Topp, Day et al. 2003).

There have been other marked interruptions to illicit drug supply in the 20th century. There seems to have been a shortage of illicit morphine and heroin in the US during World War II (Courtwright 1982; Courtwright, Joseph et al. 1990; Jonnes 1996; Massing 2000), and a heroin shortage in the US in the early 1970s (Jonnes 1996; Massing 2000). However, these events were not well documented apart from narrative historical accounts (e.g. Courtwright, 1982; Jonnes, 1996). The Australian heroin shortage of 2001 was remarkable for the relative wealth of data and information that were available in drug monitoring systems that had been developed in the preceding half decade. These data meant that Australian researchers had an unprecedented opportunity to examine the impact of a marked reduction in the availability of heroin on heroin use and heroin related harm.

The present study was commissioned by the National Drug Law Enforcement Research Fund (NDLERF) to provide a detailed description of the course of the heroin shortage, a comprehensive analysis of its effects and an examination of the factors contributing to its occurrence. The work was undertaken by researchers from the National Drug and Alcohol Research Centre (NDARC) in collaboration with researchers from Turning Point in Victoria and the Drug and Alcohol Services Council (DASC) in South Australia (SA).

The objectives of the research were to:

  • Describe the structure and dynamics of the heroin market in Australia and document any changes that may have resulted from the reduced supply of heroin;
  • Document the progression of the heroin shortage;
  • Identify and evaluate theories regarding the cause of the heroin shortage;
  • Document the impact of the heroin shortage on the extent and methods of heroin and otherdrug use, public health, treatment utilisation, the commission of crime, health service provision and law enforcement operations; and
  • Consider the implications of the heroin shortage for drug policy in Australia and other countries.

 

While some objectives were examined at a national and international level, other objectives were achieved by a focused examination of drug markets in three jurisdictions: New South Wales (NSW), Victoria and South Australia (SA). NSW and Victoria contained by far the largest heroin markets in Australia during the period under study, whereas the SA heroin market was much more limited in scope and probably dependent upon the Sydney and Melbourne markets for its supply. This report contains the results of the nationally focused work and brings together the investigations of the three jurisdictional drug markets. Statistical analysis of the trends described herein can be found in the three accompanying jurisdictional reports - NSW, Victoria and SA (Degenhardt and Day 2004; Dietze, Miller et al. 2004; Harrison, Christie et al. 2004) - which contain detailed information of the heroin shortage and its impact on these drug markets.

In this study, we have looked across different sources of data in all areas of investigation. This has been done to verify whether different data sources conveyed the same patterns of changes (or lack thereof) and to critically evaluate the implications of the similarities or differences across these data sources. In order to examine the shortage retrospectively, a number of data sources and methodological approaches were utilised. These included interviews with regular heroin users, key informants with good knowledge of different aspects of illicit drug markets around the time of the heroin shortage, and indicator data such as arrests and overdose deaths. Each methodological approach and data source has a number of inherent biases, and to overcome these, we have triangulated across data sources where possible.

Chapter 1 of this report provides a brief discussion of the areas in which each of these data sources can provide valuable information, and a discussion of the limitations of the information.

Chapter 2 examines global trends in heroin production and trafficking prior to the heroin shortage. It provides a background on the global situation with respect to heroin markets. An historical review of the Australian heroin market is then briefly provided in Chapter 3, as a backdrop against which to consider the heroin shortage. Chapter 4 documents the heroin shortage. It is preceded by a discussion of data sources appropriate for studying these consequences.

Chapter 5 outlines the approach taken towards the investigation of the possible causes of the shortage, enumerating and evaluating various factors that have been hypothesised to be responsible for the reduction in heroin supply. As will be clear in this chapter, complex markets such as heroin markets are affected by multiple factors, and more than one factor is likely to have contributed to the sharp reduction in heroin supply in Australia in 2001.

Chapter 6 provides a brief summary of the changes documented across the three States in the study. The summary depicts the changes (or lack thereof) detected, and similarities and differences across the States in these changes where they were found. For details on the changes documented, the reader is encouraged to read the three reports describing in detail the NSW, Victorian and SA markets separately.

The following chapters consider some of the implications of the reduction in heroin supply, its causes and its consequences. Chapters 7 and 8 consider the implications for health and law enforcement (as broad concepts). Chapter 9 considers the implications of the Australian heroin shortage for Australian and global drug policy.

This report should be read in concert with the accompanying jurisdictional reports which provide more extensive discussion and statistical analysis of the progress and impact of the heroin shortage in the three drug markets selected for in-depth study.

This series of reports is the result of 18 months’ cooperation with 172 key informants and 141 heroin users. It is notable for the cooperation and landmark collaboration between health and law enforcement agencies attempting to uncover as many sources of information to document an event that, although not unique, is probably the best documented reduction in drug supply in history. We trust that it provides readers with useful information on the dynamics of drug supply, use, and harms and helps to understand something of the confluence of events that produced this particular occurrence of reduced heroin supply.