Pubdate: Fri, 30 Nov 2001 Source: Australian, The (Australia) Copyright: 2001 News Limited Contact: http://www.theaustralian.com.au/ Details: http://www.mapinc.org/media/35 Author: Jamie Walker HIV RISK RISES WITH HEROIN DROUGHT AUSTRALIA faces a new wave of HIV because her oin addicts are switching to alternative drugs and adopting more dangerous injecting habits. Leading drug researcher Alex Wodak warned yesterday that this scenario could be the legacy of the "drought" that had left heroin in unprecedented short supply. While the shortage had reduced overdose deaths, the shift to injectable cocaine and amphetamines had the potential to cause a break-out in the relatively stable rate of HIV, as well as other blood-borne viral infections. Heroin had a longer-lasting "hit", meaning dependent users were likely to inject cocaine and amphetamine more frequently, Dr Wodak said. They were at increased risk of using dirty needles or sharing them, both high-risk activities for HIV. "Cocaine users who go through binges may inject up to 20 times a day, as compared to five or six for a particularly busy heroin user," he said. "If someone is injecting that often, keeping up with them so they are using sterile needles is formidably difficult." Dr Wodak is director of Sydney's St Vincent's Drug and Alcohol Services unit, servicing the illicit drug hot spots of Kings Cross and Darlinghust. Ten per cent of all Australian heroin overdose deaths occur within a 2km radius of Kings Cross. The national death toll was 959 in 1999, the latest year for which full figures are available. Dr Wodak said preliminary data suggested that overdose deaths had fallen by two-thirds in Melbourne and 50 per cent in Sydney since the start of the heroin shortage last Christmas. But the overseas experience was cautionary, Dr Wodak said. Vancouver had undergone a similar shift in its illicit drug market in 1994, with users switching from heroin to injectable cocaine. Within two years, more than 25 per cent of the Canadian city's dependent drug users were HIV positive, and the epidemic was "still raging". "There are many examples around the world where the multiplier effect of HIV occuring in injecting drug users is enormous for the general population," Dr Wodak said. He said the HIV rate in Sydney was currently "very stable", with the infection of fewer than 2 per cent of drug users who did not have the additional risk factor of engaging in homosexual male sex. A study by the National Drug and Alcohol Research Council this week highlighted the increased use of methamphetamine - an especially potent form of amphetamine also known as ice or shabu - by heroin addicts unable to secure their drug of choice. Hospital staff, ambulance crews and police are increasingly being confronted by violent and erratic behaviour triggered by heavy amphetamines and cocaine. "At least with heroin we have a drug we understand well, and . . . a treatment system that works for a majority of people for a majority of the time," Dr Wodak said. - --- MAP posted-by: Richard Lake