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Heroin crackdowns up risk of hep C infection

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EXPERTS have called for restrictions in drug supply to be coupled with harm-minimisation strategies after a study of the Australian heroin drought revealed injecting drug users were likely to switch to other drugs that increased the risk of hepatitis C


The three-year study of 368 IV drug users in NSW examined the effects of the sudden Australian heroin drought in 2001, partly caused by local and international policing efforts. In the drought

s first year, the proportion of study participants injecting mainly heroin fell from 74% to 29%, while in the same period participants injecting mainly cocaine increased from 1% to 20%.

Compared with heroin injectors, cocaine injectors were more likely to report risk-taking behaviour

such as sharing needles and syringes

and were twice as likely to acquire hepatitis C infections, the study found.

Our study provides empirical evidence of a relationship between reduced availability of heroin and an increase in drug-related harms among injecting drug users who switched to injecting cocaine,

the authors wrote.

Associate Professor Lisa Maher, study co-author and head of the viral hepatitis epidemiology and prevention program at the National Centre in HIV Epidemiology and Clinical Research, said policing drug supply alone would not contain the spread of blood-b

orne viruses.

Most injecting drug users are multi-drug users. It is fairly na


ve to think if their drug of choice is not available they won

t switch to another,

she said.

If you are going to have a police crackdown in an area there also needs to be access to sterilised needles and syringes and supervised injecting sites to minimise the risk of more blood-borne infections.

Because cocaine had a shorter half-life than heroin it required a greater frequency of injections, increasing the chances of hepatitis C infection, Professor Maher said.

Drug and Alcohol Dependence

2007; 89:244-50.


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