THE NATIONAL DRUG and Alcohol Research Centre based in the University of New South Wales, Sydney, a federally funded organisation, has recently released three research reports.

Report No. 68 `Heroin-Related Deaths in New South Wales 1992-1996' was given page three treatment in the Sydney Morning Herald on 16 April 1999, headlined `Heroin deaths soar to crisis level'. The Sydney broadsheet continued:

NSW heroin overdose deaths have jumped by 134 per cent in Sydney and a massive 230 per cent outside the metropolitan area over just five years.

The study also found that one in three deaths occur within two kilometres of Kings Cross and four kilometres of Cabramatta.

`If you need any more proof that these are the biggest drug markets in NSW and Australia this is it,' said Dr Shane Darke, the senior lecturer with the research centre who headed the study.

`You have 35 per cent of the deaths in these two little places, while 20 per cent were in the bush. It's an extraordinary statistic,' Dr Darke said.

There was a `substantial rise' in heroin-related fatalities in NSW from 152 deaths in 1992 to 226 in 1996. Seven out of 10 deaths were in Sydney.

Illawarra, 43 deaths 5 per cent, now outstripped the Hunter, 35 deaths.

The study reported a large and significant increase in blood morphine concentrations among those who had died. This indicated heroin purity had `increased by over half again,' Dr Darke said. However, multi-drug use was also a big factor, with three in four victims having another drug in their system at the time of death.

The purer the heroin the greater the risk if combined with excess alcohol, because the body has a greater drug load on board.

The study should focus policy planners' attention on high risk areas such as Wollongong and the far North Coast.

Safe injecting rooms should especially be considered for Cabramatta. It is unique because almost two-thirds of those taking fatal overdoses there die in a public place, such as a street, park, railway station or parked car.

Appropriately staffed such rooms would provide immediate assistance in cases of overdose.

`Distributing naloxone, a heroin antidote used by ambulance officers, to users, so friends and family could revive them if they overdosed could be one solution in Kings Cross,' Dr Darke said.

State-wide, six in 10 die in their own homes. In Kings Cross, 47 per cent at home, 25 per cent in a hotel room and the rest in public places.

Yet the study found only 15 per cent died instantly after heroin was administered, and in eight out of 10 deaths no-one intervened.

The `typical' overdose victim in the study was a single, unemployed Australian-born male, about 30 and not in a drug treatment program.

Report No. 69 `Trends in methadone-related deaths in the UK and Australia 1985-1995'.

This report analyses data on trends in opioid deaths in general, and methadone deaths in particular, in the UK between 1985 and 1995. A comparison is made between trends Australia and the UK. The trends showed an increase in opioid deaths in both countries, however, the UK had a lower rate of opioid overdose deaths than Australia but methadone played a contributory role in a larger proportion of opioid deaths in the UK.

This latter trend could be explained by the greater availability of methadone and the lower rate of supervised methadone dosing in the UK.

Report No. 72 `NSW Drug Trends 1998' [Findings from the Illicit Drug Reporting System (IDRS)].

The purpose of the IDRS is to provide a coordinated approach to the monitoring of data associated with the use of opiates, cocaine, amphetamines and cannabis, and act as a strategic early warning system for emerging illicit drug problems.

The reader is referred to the original paper for details on the methodology used in this study.

The research revealed an increase in heroin use and an increase in cocaine injection among heroin users. Both of these trends in use were accompanied by medium to high purity of these drugs, which were easily available, and cheaper than in 1997.

The health consequences in 1998 were that there were more treatment admissions and enquires relating to heroin than for any other drug, and there was also a continuing trend for more opioid-related deaths. Cocaine IV-users suffered more injection-related problems, as well as poor mental and physical health.

The IDRS also found that high potency cannabis continued to be available, and smoking of heroin among cannabis users, and psychological problems among cannabis users continued a trend found in previous years.

There was also a continuing trend for use of pharmaceutical substances among injecting drug users, particularly methadone, benzodiazepines and anti-depressants. Amphetamine use appeared to be relatively low and stable, as did the price, availability and purity.