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Drug Trends 2017: Looking back to think forward Funded by the Australian Government Department of Health
Prepared by Amanda Roxburgh, Toni Karlsson, Rachel Sutherland
On behalf of the Drug Trends Team
2
Characterising the Samples
IDRS Participants
N=888
EDRS Participants
N=786
People who inject drugs
(six times or more past six months)
People who use stimulants
(six times or more past six months)
High levels of dependence
• Opioid dependence (69%)
• Methamphetamine dependence (48%)
• Opioid AND meth dependence (16%)
More sporadic patterns of use across a range
of drugs
Predominantly male 67%
Average age 43 years
Predominantly male 64%
Average age 21 years
3
IDRS: Drug Use Drug of choice (%) 53 54 53
50 52
46 46
20 21 23 24 25
29 32
2 3 8 10 10 8 9
9 7 11
14 15
21
24
0
10
20
30
40
50
602
01
1
201
2
201
3
201
4
201
5
201
6
201
7
% S
am
ple
Heroin Any methamph Morphine
Drug injected most last month (%)
43 42 40 41 41
39 37
11 10
15
22
28
36 35
16 16 17
16
13 12 12
26 25 25
30
34
40 40
0
10
20
30
40
50
60
201
1
201
2
201
3
201
4
201
5
201
6
201
7
% S
am
ple
Heroin Crystal Morphine Any methamph
4
EDRS: Drug Use Drug of choice (%)
42
37
27
32 32 35
30
36 36
17 16
20 19
23 25
29 21
28
11 12
11
15 18
12 15 15
11
0
10
20
30
40
50
602
00
9
201
0
201
1
201
2
201
3
201
4
201
5
201
6
201
7
% S
am
ple
Ecstasy Cannabis Alcohol
Drug used most last month (%)
16
42
33
0
10
20
30
40
50
60
201
1
201
2
201
3
201
4
201
5
201
6
201
7
% S
am
ple
Ecstasy Cannabis Alcohol
Opioids
Heroin and Pharmaceutical Opioids
6
Opioids in context - international
Source: INCB 2011-13 data Berterame et
al, Lancet (2016)
13,440
22,941
31,453
Source: CDC WONDER
7
16
20
0
10
20
30
40
50
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016Rate
s p
er
mill
ion p
opula
tion
Rates of heroin deaths per million population
Heroin deaths in context - Australia
Source: Roxburgh et al, 2017; ABS, 2017
8
IDRS Findings Heroin injecting – use and frequency
79
66 66 65 69
65
56 58
60 64 63
61 59 60 60
58 56 57
37
20
26 29
25 24
17
23 18
24 27
24 28
22 25
30 30 30
0
10
20
30
40
50
60
70
80
90
100
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% P
WID
Heroin injected Heroin Daily
Heroin daily use stable nationally
Some increases e.g. NSW, QLD
Some decreases e.g. SA, WA
NB: Heroin Daily among those who have used heroin
Heroin use stable nationally
Some increases – e.g. ACT, VIC, SA
Decreases – e.g. NSW, WA
9
IDRS Findings Pharmaceutical opioid injecting - use
40
50 45 46
41
49
50 47
42
43 39 39
35 35
28 27 27
16
22 26 26
29 28 31 33 31 27
19 16
13
6 8 9 8 7 0
10
20
30
40
50
60
70
80
90
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% P
WID
Morphine Injected Oxycodone Injected Fentanyl Injected
Morphine – stable nationally
Predominant in NT and TAS
Oxycodone – declining nationally and in
most jurisdictions (Increased NSW)
Fentanyl – stable and low nationally
(Increased NSW)
10
IDRS Findings Daily pharmaceutical opioid injecting
26
6
8
0
10
20
30
40
50
60
70
80
90
100
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% o
f th
ose u
sin
g e
ach o
pio
id
Morphine Daily Oxycodone Daily Fentanyl Daily
Morphine - stable nationally NT daily use
Oxycodone – stable and low nationally
Fentanyl – stable and low nationally
Largely infrequent use of oxycodone and fentanyl
Methamphetamine
12
Methamphetamines in context
26.7 21.7
50.4 57.3
51.2 50.6
28.5 20.2
0
10
20
30
40
50
60
70
80
90
100
% o
f m
eth
users
Crsytal Main Form Speed Main Form
2007 2010 2013 2016
2016 1.4% past
12 mths
Source: NDSHS AIHW
13
76 74 75
79
74 69 67
60
66 68
66 69
72 75
71
84 83 84 82
71 59
54
56 60 61
50 47 38 38
31
0
20
40
60
80
100
2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% S
am
ple
IDRS Meth use EDRS Meth use
Drug Trends Findings Methamphetamine use – Past 6 months
14
49 51 53 50
46 49
41 45
49 50 51 53
59 61
30 29
24 27
16 14 12
22 18 15
19 18 19
12
6 8 8 7 7 4 5 5 7 7 8 9
13
14
0
20
40
60
80
100
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% o
f th
ose u
sin
g m
eth
am
pheta
min
e IDRS Meth Weekly or More EDRS Meth Weekly or More IDRS Meth Daily Use
Drug Trends Findings Methamphetamine use – Frequency
15
Drug Trends Findings – Methamphetamine Forms used
87 82 88
78 80 78
84 84 82 79
76 77
66 66
72 71
69
80
71 74
69 73
70 66
59
60
43
36
26 28
0
20
40
60
80
100
2003 2005 2007 2009 2011 2013 2015 2017%
of
those u
sin
g m
eth
am
pheta
min
e
EDRS - Speed IDRS Speed
Speed
62
54
46
60 46
41
28
30
43 48
46
43
50 50
43
70 67
57
72
63
71
56
65 69
80
84
88
93 98
96
0
20
40
60
80
100
2003 2005 2007 2009 2011 2013 2015 2017
% o
f th
ose u
sin
g m
eth
am
pheta
min
e
EDRS - Crystal IDRS Crystal
Crystal
Diversification of MDMA and other stimulant
markets
17
EDRS Findings: Ecstasy forms used
100 100 100 98 97
95 96 92
85 82
78
60
71
21
30
39
57
67
0
10
20
30
40
50
60
70
80
90
100
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% r
ep
ort
ed
ED
RS
us
e
pills capsules powder MDMA crystals
5
30
50
15 Low
Medium
High
Fluctuates
Perceived purity
Crystal MDMA
17
37 18
28 Low
Medium
High
Fluctuates
Perceived purity
18
EDRS Findings: Ecstasy patterns of use – last six months
26 30
23 28 28 26 27
24 26 30
0
20
40
60
80
100
2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
% o
f th
ose r
ep
ort
ing
rece
nt
use
weekly ecstasy use *
* Includes pills, powder, capsules and MDMA crystals
20
EDRS Findings: Other drug use 2017
97
89
50 48 44
37 33 31
22 18
13 9 7
2
0
10
20
30
40
50
60
70
80
90
100
% R
PU
re
po
rtin
g
* * * *
IDRS – 45% of cannabis users report daily cannabis use
EDRS – 24% of cannabis users report daily cannabis use
22
EDRS Findings Proportions reporting use of capsules of
unknown content
12 10 8 7 14
20
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015 2016 2017
% R
PU
rep
ort
ing
23
EDRS Findings Proportions reporting adverse effects from
stimulants past 12 months
18 18 18 19 19 26
0
10
20
30
40
50
60
70
80
90
100
2012 2013 2014 2015 2016 2017
% R
PU
rep
ort
ing
24
1. Opioids
Carefully monitor heroin and other opioid markets
Synthetic opioids present a future challenge - diversification
Importance of naloxone availability
2. Methamphetamine
Increasing levels of frequent use among IDRS participants
Declining use among EDRS participants
Engage with consumers without stigma to encourage to tx
3. Diversification of MDMA and stimulant markets
Acute harms – toxicity/adverse events – increasingly being reported
Particularly concerning in context of high purity crystal MDMA available
and use of capsules of unknown contents
Importance of communication and accurate information
Summary
25
Targeting gangs and organised crime
9th December 2016
Police Commissioner Mike Bush
Ngā mihi. Congratulations to all staff involved in the lengthy investigation
into the Head Hunters gang in Christchurch. Led by the Canterbury
Organised Crime Unit, this resulted in a number of search warrants being
conducted this week and the arrest of several people on charges including
supplying methamphetamine.
Several more Head Hunters members and associates were arrested in the
lead-up to this week’s operation.
As with other recent operations of this nature, Police staff have offered to
put methamphetamine users identified during the investigation in
contact with agencies that can help with any dependency issues. This
is a good preventative measure to reduce the harm caused by this highly-
addictive and damaging drug.
Thinking Forward –Diversification in response
26
Thinking Forward –Diversification in response
Eugene Ryder – Wellington Black Power – “against p”
27
Thinking Forward -Engagement
28
Thank you - 2017 Drug Trends Team National Drug and Alcohol Research Centre, University of New South Wales
(National, NSW, ACT, SA and the NT)
Dr Courtney Breen, A/Professor Lucinda Burns, Ms Kerryn Butler, Ms Antonia Karlsson, Ms Courtney
O’Donnell, Ms Amanda Roxburgh, Ms Jennifer Stafford, Ms Rachel Sutherland, Ms Julia Uporova, Mr Joe van
Buskirk, and Professor Alison Ritter
Burnet Institute for Medical Research and Public Health (VIC)
Ms Amy Kirwan, Mr Arthur Truong, Dr Campbell Aitken and Professor Paul Dietze
School of Medicine, University of Tasmania (TAS)
Ms Bethany Lusk, Dr Amy Peacock, Dr Allison Matthews and A/Professor Raimondo Bruno
National Drug Research Institute (WA)
Mr James Fetherston, Ms Marina Nelson and Professor Simon Lenton
School of Public Health, The University of Queensland (QLD)
Dr Caroline Salom and Professor Rosa Alati
Northern Territory Department of Health (NT)
Mr Chris Moon, Ms Tania Davidson and Mr Warrant Que Noy
