Patterns of illicit drug use in NSW, Australia following a reduction in heroin supply

Objective: To examine whether a reduction in the availability of heroin in New South Wales (NSW) in 2001 was associated with community level changes in heroin and other drug use. Method: Data from the NSW Alcohol and Drug Information Service (ADIS) on the number of persons calling about different drug types were used to examine NSW trends in calls of concern about heroin and other drugs. ADIS is a 24-h telephone information and counselling service in NSW; data from ADIS has previously been shown to be related to trends in drug use. Data from an inner Sydney needle and syringe program on drugs injected by clients were also used to examine time trends among a sentinel group of injecting drug users (IDU). Time series analysis was used to model the series. Results: There was a significant reduction in calls regarding heroin associated with the reduction in heroin supply. Increases in calls about cocaine and methamphetamine were also associated with the heroin shortage. The reduction in calls about heroin appeared to be sustained, whereas the increases in calls about cocaine and methamphetamine were not. Conclusions: Decreases in heroin supply were associated with sustained decreases in the use of heroin at a community level. Substitution of other drugs probably occurred among some users, such substitution did not appear to be sustained, as the number of calls returned to pre-shortage levels. Implications: Drug supply reduction may lead to increases in use of other drug types. The health implications of such changes need to be borne in mind by law enforcement and health services. (c) 2005 Elsevier B.V. All rights reserved.