NDARC Monograph No. 42 (1999)
Key points
- It is estimated that heroin has been used by 1-2% of the Australian population. In 1997, approximately 0.2-0.7% of the Australian adult population were dependent upon heroin.
- The persons who are most likely to use heroin generally come from a disadvantaged background, have had problems at school and home, and are often impulsive. Affiliations with substance using peers also increase the likelihood of substance use, although the reason for this association is unclear.
- The adverse health consequences of heroin use include: heroin dependence; contraction of infectious diseases through risky injecting practices; and premature mortality from overdose, violence and other causes.
- Interventions are needed to reduce the disproportionately large contribution that heroin overdoses make to the number of drug-related deaths in Australia. These include increasing treatment places for dependent heroin users, peer education about the risks of heroin overdose and improving responses to overdose. The distribution of naloxone to heroin users and the supervised injecting rooms may be worthy of trial.
- Public order is affected by the large number of property and drug-related offenses that are committed by a substantial proportion of persons who are heroin dependent. While both crime and heroin use have common causes, the frequency of criminal acts increases with the frequency of heroin use. This has important implications for law enforcement policies, namely, that reducing heroin use among heroin dependent persons may produce significant reductions in criminal activity.
- The range of treatment options for persons dependent upon heroin include: detoxification and abstinence based therapies, and drug substitution treatments, the mo st effective and widely used of which is methadone maintenance treatment. There is considerable evidence that drug substitution treatment results in significant reductions in the negative health consequences of dependent heroin use and the adverse effects that it has on public order.
- There is evidence from a range of sources that heroin use is increasing among young Australians. Considerable increases in treatment services, education of heroin users in methods that will reduce the negative health impact of dependent heroin use, and continuation of existing services such as needle and syringe programs, are necessary to reduce heroin overdose deaths, infectious disease, and the adverse impact of dependent heroin use on public health and public order.