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Other frequently used drugs
Use of cannabis by PWID is also common. The 2021 IDRS showed that:
- Over two-thirds (67%) of PWID had used cannabis in the last 6 months, stable from 67% in 2020.
- Just over half (51%) of those who had recently used cannabis reported daily use (Sutherland et al. 2021).
PWID also use pharmaceutical drugs, particularly prescription opioids, at higher rates than the general population (Sutherland et al. 2021). This likely reflects the practice of substituting pharmaceutical drugs for illicit drugs, such as heroin. Data from the 2021 IDRS showed that, in the last 6 months:
- 16% of participants reported non-prescribed use of morphine.
- 9% reported non-prescribed use of oxycodone, down from 11% in 2020.
- 9% reported non-prescribed use of buprenorphine-naloxone film, stable from 9% in 2020.
- 6% reported non-prescribed use of buprenorphine.
- 6% reported non-prescribed use of fentanyl (Sutherland et al. 2021).
Use of cocaine is also common among PWID, with 15% of participants in the 2021 IDRS reporting using cocaine in the last 6 months, stable from 17% in 2020 (Sutherland et al. 2021).
Health and harms
Injecting drug use is a major risk factor for transmitting blood-borne viruses, including HIV, hepatitis B and hepatitis C. Needle and syringe sharing among people who inject drugs is partly responsible for transmitting infection, although unsafe sexual behaviours also play a role (AIHW 2012).
Burden of disease and injury
The Australian Burden of Disease study, 2018, found that unsafe injecting practices were responsible for 0.9% of the total burden of disease and injuries in 2018 (AIHW 2021).
Unsafe injecting practices are linked to Hepatitis B, Hepatitis C, HIV/AIDS, liver cancer and chronic liver disease. Liver cancer and chronic liver disease are the long-term consequences of contracting hepatitis B and hepatitis C infection. Acute hepatitis C and B were responsible for 74% and 33% of burden (respectively) (AIHW 2021). Chronic liver disease and liver cancer were each responsible for 27% of the burden due to unsafe injecting practices (AIHW 2021).
The IDRS report on trends in self-reported past year non-fatal overdose and responses to overdose found that, between 2009 and 2020, the proportion of participants who reported receiving no treatment on the occasion of their overdose fluctuated, but remained above 10% (Thomas et al. 2021).
Injecting risk behaviours
Data from the Australian Needle Syringe Program Survey (ANSPS) provides some evidence of the risk of harms related to injecting drug use in persons who regularly inject drugs in Australia:
- The proportion of respondents reporting recent reuse of needles and syringes (including the reuse of one’s own syringes) decreased over the past 5 years (from 27% in 2016 to 23% in 2020).
- The proportion of respondents reporting receptive sharing of needles and syringes in the last month also decreased over the past 5 years (from 19% in 2016 to 16% in 2020) (Heard et al. 2021).
Data from the 2021 IDRS provide additional evidence of risks for harms, including:
- 1 in 10 (10%) participants reported lending a needle to someone after they had used it, and 6% reported borrowing a needle after someone else had used it (consistent with 5% in 2020).
- Almost 2 in 5 (38%) participants reporting re-using their own needle in the last month.
- Almost 2 in 5 (18%) participants reporting sharing other injecting equipment (for example, spoons) in the last month. This is a decrease from 25% in 2020 and a high of 51% in 2000 (Peacock et al. 2021) (Table S3.63; Figure PWID3).