Harm reduction

Harm reduction focuses on identifying and targeting specific risks that arise from alcohol and other drug use. This may include risks to the individual, as well as their family and friends (DoH 2017).

Minimising risky behaviours

Examples of programs that aim to minimise risky behaviours include:

  • Needle and syringe programs (NSPs) are designed to reduce the sharing of injecting equipment through the provision of sterile needles and syringes to people who inject drugs. NSPs are a cost-effective measure that have successfully prevented the spread of HIV and hepatitis C infection. NSPs also provide counselling services and actively encourage clients into drug treatment programs (Dolan et al. 2005).
  • Supervised drug consumption facilities/rooms and medically supervised injecting centres (MSIC) are places where people can use and inject drugs under the supervision of registered nurses, counsellors and health education professionals. MSIC services aim to prevent injury and death by being present when someone injects in order to provide immediate medical assistance as required. Kings Cross in Sydney has been home to a MSIC since 2001 (Uniting 2017) and a second opened in Richmond, Victoria, in July 2018.
  • Drug testing, also known as pill testing, allows people who are thinking about using drugs to test their pills/drugs at designated sites. The test informs them of the purity of the drug, as well as the substances it contains (AIHW 2020). This helps people to make informed decisions about whether or not a drug is safe to consume.
  • Smoke-free laws exist in Australia to protect people from harmful second-hand tobacco smoke. This includes banning smoking in all enclosed public spaces and certain outdoor public areas, such as children’s play areas, sport grounds and transport hubs.
  • Drink and drug driving laws are enforced across Australia to deter people from operating a vehicle under the influence of alcohol and or drugs and prevent deaths and significant injuries on the road. It is a criminal offence for drivers with a learner or probationary licence to have a blood alcohol concentration above zero and for full licence holders to have a blood alcohol concentration above 0.05 grams of alcohol per 100 millilitres of blood. Any presence of an illicit substance is also a criminal offence for drivers, regardless of the type of licence held.
  • Take-home naloxone programs enable those people at risk of opioid overdose or adverse reaction, and their friends and family members to access naloxone at community pharmacies. Given in a timely manner, naloxone can reverse the effects of opioid overdose.

Opioid overdose represents a significant and ongoing problem for Australia’s public health. Naloxone is a medication that reverses the effects of opioids and is an important means of responding to the harms associated with opioid overdose (including death) (Penington Institute 2018).

The Illicit Drug Reporting System (IDRS) reported that in 2019, 85% of participants had heard of naloxone, and 57% had heard of take-home naloxone (Peacock et al. 2019). Of the participants in the IDRS:

  • 30% had been trained in the use of naloxone, an increase from 23% in 2018, and
  • of those who had completed naloxone training, 47% had used naloxone to resuscitate someone who had overdosed.

Community support for harm reduction measures

In 2019, the NDSHS included two new questions about support for drug testing at designated sites (i.e. pill testing) and supervised drug consumption facilities/rooms. These measures were generally well supported, with more people supporting pill testing than drug consumption rooms. Support for both measures was highest among younger people and people who had used drugs in the past 12 months (AIHW 2020).

Pill testing

Almost 3 in 5 (57%) Australians aged 14 and over supported pill testing and 27% opposed it. Over three-quarters (78%) of people who had recently used drugs supported pill testing, compared with 47% of those who had never used drugs. Over 3 in 5 (61%) people aged 14–39 supported this measure, compared with 53% of people in the age groups from 40 and over. Support for pill testing varied according to demographic factors.

  • Support was highest in Major cities (59%) and decreased with increased remoteness (48% in Remote and very remote areas).
  • Support was highest in the most advantaged socioeconomic area (66%) and lowest in the most disadvantaged area (51%).
  • Support was highest among people with a bachelor degree or higher (66%), and lowest among people who had completed year 11 or less (47%).

Supervised drug consumption rooms

Just under half (47%) of Australians supported supervised drug consumption rooms and 32% opposed it. Nearly two-thirds (65%) of people who had recently used drugs supported this measure, compared with 39% of people who had never used drugs. Half (50%) of people in the age groups between 14 and 39 supported this measure, compared with 44% of people in the age groups from 40 and over. Support also varied by demographic factors.

  • Support was highest among people in Major cities (59%) and decreased with increased remoteness (48% in Remote and very remote areas).
  • Support was highest among people in the most advantaged socioeconomic area (66%) and lowest among people in the most disadvantaged area (51%).
  • Support was highest among people with a bachelor degree or higher (66%) and lowest among people who had completed year 11 or less (47%).

References

AIHW 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW. Viewed 21 July 2020.

DoH (Department of Health 2017). National Drug Strategy 2017–2026. Canberra: Australian Government. Viewed 12 January 2018.

Dolan K, MacDonald M, Silins E & Topp L 2005. Needle and syringe programs: a review of the evidence. Canberra: Australian Government Department of Health and Ageing. Viewed 25 January 2018.

Peacock A, Uporova J, Karlsson A Gibbs D, Swanton R, Kelly G, Price O, Bruno R, Dietze P, Lenton S, Salom C, Degenhardt L & Farrell M 2019. Australian Drug Trends 2019: Key findings from the National Illicit Drug Reporting System Interviews. Sydney, National Drug and Alcohol Research Centre, UNSW Australia.

Penington Institute (2018). Saving Lives: Australian naloxone access model. Melbourne: Penington Institute. Viewed 16 April 2020.

Uniting 2017. Uniting Medically Supervised Injecting Centre: get to know our story. Viewed 25 January 2018.