NT Drug Trends 2012: Findings from the Illicit Drug Reporting System (IDRS)

 EXECUTIVE SUMMARY

This report presents the 2012 Illicit Drug Reporting System (IDRS) results for the Northern Territory (NT). This is the eleventh year this study has been conducted in the NT.
 
The IDRS is coordinated by the National Drug and Alcohol Research Centre (NDARC) at the University of New South Wales. It is funded by the Australian Government Department of Health and Ageing.
 
The IDRS analyses data from a survey of people who inject drugs (PWID, referred to in this report as participants or respondents), a survey of key experts (KE) and secondary illicit drug-related indicator data in order to monitor the price, purity and availability of a range of illicit drugs. The IDRS also identifies emerging drug trends through comparison of results obtained in previous years.
 
Demographic characteristics of the survey respondents
As in previous years, the 2012 sample of PWID was predominantly male (71%). The mean age was 42 years and 94% of the respondents were unemployed or on a pension at the time of interview. Three percent reported full-time employment, down from 8% in 2011. The percentage of respondents who identified as Aboriginal and/or Torres Strait Islander was stable at 28%. Ninety-four percent reported heterosexual status while 6% identified as bisexual and 1% as gay or lesbian. Year 10 was again the mean for years of education although 38% reported some form of post-secondary education. Reported participation in treatment increased to 10% of the sample (4% in 2011) and 59% reported prior prison history.
 
The demographic profile of the IDRS sample is similar to that surveyed in previous years.
 
Patterns of drug use
Recent drug use refers to use in the six months preceding the IDRS interview. Morphine was the illicit drug recently used by the largest proportion of the participant survey sample (77%), followed by cannabis (71%). Morphine was the drug most recently injected (66%) followed by speed powder (44%).
 
Morphine was again the drug injected most often in the last month (71% of the sample), with 66% of the sample also reporting morphine as the most recent drug injected. In 2011, 68% of the sample reported morphine as the drug most often injected in the last month and 68% reported morphine as the last drug injected.
 
Methamphetamine powder (“speed powder” or “speed”) was again the form most frequently used by PWID in the previous six months (46%), followed by crystal methamphetamine (“crystal”, “ice” or “shabu”) at 26%, methamphetamine base (“base”) at 6% and methamphetamine liquid at 5%.
 
Eleven percent of the sample reported recent heroin use, a small increase on the 9% found in 2012. Seventy percent reported heroin use at some time in their lives. Twenty-nine percent of the sample (34% in 2011) reported recent use of any form of methadone (including prescribed and non-prescribed methadone liquid and Physeptone). Twelve percent of the sample reported recent use of either prescribed or non-prescribed Subutex (buprenorphine) while 12% reported recent use of Suboxone (buprenorphine-naloxone). Nineteen percent of the sample reported recent injection of oxycodone (27% in 2011) and 56% reported recent use of over-the-counter (OTC) codeine, similar to the 52% who reported recent OTC codeine use in 2011.
 
Recent use and injection of all forms of benzodiazepines declined. Thirty-five percent of respondents reported recent use of some form of benzodiazepine (61% in 2011); recent use of illicit Alprazolam declined from 26% in 2011 to 18% this year and recent injection from 20% to 7%.
 
Recent use of cocaine remained low at 4%, as did recent use of hallucinogens (4%), inhalants (0%) and steroids (3%). Recent alcohol use was reported by 54% of the sample (63% in 2011) and daily use of tobacco was reported by 90% of the sample (97% in 2011).
 
Key experts comments mostly agree with the demographic and drug use patterns described above, although they emphasised an increased impact on treatment services and in law enforcement from the use of crystal methamphetamine. Some KE also stated that injection-related harms from the use of benzodiazepines, Xanax in particular, were increasing.
 
Heroin
Eleven percent of the sample reported recent heroin use (9% in 2011), on a median of 5 days. Any form of heroin, including homebake, was recently used by 12% of the sample (11% in 2011) on a median of 4 days. In 2011, white or off-white heroin powder was the form most frequently used.
 
A median price of $110 per cap was reported for heroin, an increase on the $80 found last year. Most respondents described heroin as difficult (25%) or very difficult (33%) to obtain.
 
Methamphetamine
Forty-eight percent of the sample reported recent use of any form of methamphetamine, which includes speed powder, ice, base and liquid, a decline on the 55% found in 2011. Speed powder was again the form most frequently used (46%) and injected 44%. Use (26%) and injection (25%) of crystal methamphetamine was stable (28% and 24% respectively in 2011).
 
A median price of $150 per point for speed powder was reported, an increase on the $100 f0und last year. Crystal methamphetamine was found to have a median price of $150 a point, as was the case in 2011. Prices for speed powder and crystal were largely seen as stable (43% and 50% of those able to comment), although substantial proportions reported that they had been increasing (38% and 32% respectively).
 
Eighty-nine percent of those able to comment considered that speed powder was currently either easy or very easy to obtain, an increase from the 80% who rated current powder availability as easy or very easy in 2011. Sixty-seven percent of those able to respond rated crystal methamphetamine as easy or very easy to obtain.
 
Cocaine
Reported recent use of cocaine increased to 4% of the survey sample, remaining low as in previous years. As in 2011, no participants were able to comment upon cocaine price, purity or availability
 
Cannabis
Cannabis was again the second most frequently used drug. Seventy-one percent of the sample reported recent use, as was the case in 2011. Hydroponic cannabis was again the form most commonly and most often used and a pattern of daily use remained most common. Cannabis was smoked by participants on a median of 90 days, a result similar to that obtained in recent years.
 
The median price of hydroponic cannabis was stable at $30 a gram or a bag and the median price of bush cannabis had increased to $30 a gram from the $15 found in 2011.
 
Hydro was considered easy or very easy to obtain by 88% of those able to respond, a decline on the 95% found in 2011 but still a large majority. Hydro availability was considered stable by 81% of respondents. Bush cannabis was also rated as easy (48%) or very easy (35%) to obtain and recent availability was rated as stable.
 
Methadone
Ten percent of the sample reported recent use of illicit methadone liquid in the preceding six months, the same proportion as in 2011, while only 4% reported recent use of licit methadone liquid (3% in 2011). Nineteen percent of the sample reported recent use of illicit Physeptone (27% in 2011). Only 2% reported recent use of licit Physeptone, as compared to 5% in 2011.
 
The median price of a millilitre of methadone syrup was stable at one dollar, as it has been since 2006. The median price of 10mg Physeptone tablets was also stable at $20. Prices were reported to be either stable (55%) or increasing (25%).
 
Sixty-two percent of respondents rated current availability of illicit methadone as difficult, an increase on the 57% found in 2011 and lower than the 75% in 2010. The findings suggest that over time illicit methadone has become harder to obtain.
 
Morphine
Recent use of any form of morphine (both licit and illicit) decreased to 77% of the sample (81% in 2011). Illicit morphine continued to be the form most often used. Median days of use remained stable (daily) as did median days of injection (daily).
 
As in previous years, MS Contin 100mg was the morphine form most frequently purchased by the IDRS sample. Sixty-eight participants reported purchasing MS Contin 100mg at a median price of $80, the same median price found since 2008. 
 
Kapanol 100mg was again the form next most frequently purchased (41 purchasers) and in 2012 the median price was $80, stable since 2008.
 
As has been the case since 2009, the majority of respondents (52%) rated illicit morphine as currently easy to obtain. The proportion of those who considered illicit morphine as difficult to obtain increased from 20% in 2011 to 25%.
 
Oxycodone
Twenty-two percent of respondents reported use of some form of oxycodone in the six months preceding the interview, a decline on the 32% found in 2011, attributable to a decline in the reported use of illicit oxycodone from 26% to 19%.
 
As in previous years, a small proportion of the NT IDRS sample reported purchasing illicit oxycodone. No participants reported purchasing 20mg oxycodone, six reported paying a median of $38 for 40mg oxycodone and twelve reported paying a median of $60 for 80mg oxycodone. Three-quarters (73%) of those who responded considered price to have remained stable over the preceding six months.
 
Oxycodone was rated as easy or very easy to obtain by 63% of the sample and difficult to obtain by 38%.
 
Subutex (buprenorphine)
Recent use of illicit Subutex increased from 8% in 2011 to 12% this year. A frequency of weekly or less remained the most common pattern of use. Two participants reported a median price for 8mg of Subutex of $23, the same median price as reported in 2011.
 
Suboxone
Eight percent of the sample had recently used illicit Suboxone (15% in 2010) on a median of 6 days. Six percent of the sample had recently injected illicit Suboxone, on a median of 2 days. Five participants reported purchasing illicit 8mg Suboxone for a median of $30. Reports of Suboxone availability were mixed.
 
Over-the-counter codeine
Nineteen percent of the sample reported recent use of over-the-counter (OTC) codeine in the previous six months, a notably lower proportion than that found in previous years (52% in 2011). Recent injection remained low at 1%. Nurofen Plus was again the most commonly used OTC brand of codeine.
 
Benzodiazepines
There was a marked decrease in the recent use of benzodiazepines (35% in 2012 compared to 61% in 2011 and 67% in 2010), representing the lowest rate of usage seen to date. Recent injection of benzodiazepines also declined to the lowest proportion seen (11%) since 2003.
Recent use of illicit Alprazolam use also declined, to 18%, half the 36% found in 2011.
 
Ecstasy, LSD, Seroquel, inhalants, tobacco and alcohol
Recent use of ecstasy (7%), Seroquel (6%) and inhalants (0%) remained low, as in previous years.
 
Recent use of alcohol declined from 63% in 2011 to 54% this year. Respondents reporting the more frequent categories of use, daily and almost daily, declined, with an increase in weekly or less use. Recent use of tobacco remained high (90%) and frequent (daily).
 
Most health key experts identified crystal methamphetamine as the most problematic illicit drug at the time of interview. There was a consistent report that the number of clients seeking treatment for this drug had increased and a common perception that this was due to an increase in the availability and use of crystal methamphetamine.
 
Health
Seventeen percent of the sample had overdosed on heroin at least once in their lives but only one participant reported a heroin overdose within the past year. Twenty-nine percent of the sample had overdosed on a drug other than heroin, and of those 11% had overdosed within the past year. Nineteen percent reported a recent overdose, a marked increase on the proportions found in recent years.
 
Ten percent of the sample reported current treatment (12% in 2010) and 12% reported having attended treatment within six months of interview.
 
Rates of hospital admissions related to opioids, amphetamine and cannabis all declined.
 
Sharing of injecting equipment rates were higher than that found in 2011, accounted for mainly by increased sharing of spoons and tourniquets. Three percent of respondents used a needle after someone else and 17% had reused their own needle at least once.
 
Location of last injection was mainly in a private home with needles sourced almost exclusively from a Needle and Syringe Program.
 
A dirty hit (46%), scarring/bruising (42%) and difficulty injecting (34%) were again identified as the main injection-related problems in the month prior to interview.
 
Twenty-six percent of the sample reported experiencing a mental health problem in the six months prior to interview, with depression and anxiety again the most frequent mental health problems reported.
 
Thirty-five percent of participants had high or very high levels of distress as measured by the Kessler Psychological Distress Scale (K10).
 
More than half the participants had driven a car within the preceding six months and, of these, 72% had driven under the influence of drugs, mainly morphine and cannabis.
 
Law enforcement and criminal behaviour
One-fifth of the sample had been arrested in the preceding 12 months.
 
Sixteen percent of the sample reported engaging in some form of criminal activity in the previous month, most commonly dealing and property crime.
 
The number of ATS seizures decreased from 167 in 2009/10 to 71 in 2010/11 while the amount seized increased.
 
In 2009/10 there were two heroin consumer arrests and no cocaine arrests. Cannabis consumer and provider arrests totalled 460.
 
Half (51%) of the sample had spent $50 or more on drugs on the day prior to the interview.
 
Law enforcement key experts identified crystal methamphetamine as the most problematic illicit drug at the time of interview, relating its increased availability and use to an increase in crimes involving violence.