Investigators

Danielle Horyniak


Supervisors

Professor Louisa Degenhardt, Professor Paul Dietze, Doctor Peter Higgs


Background

People who inject drugs (PWID) are exposed to blood-borne virus (BBV) infections, injecting-related injuries and risk of drug overdose, and experience greater levels of both physical and mental impairment compared with the general population. Additionally, injecting drug use is associated with a range of social and economic harms.

Young people who inject drugs may be at even greater risk of adverse outcomes compared with their older counterparts. They have generally only been injecting drugs for a short period of time, and studies have shown that younger PWID may have different drug use patterns and risk behaviours compared with more experienced injectors. Additionally, younger PWID may have limited knowledge of safe injection and harm reduction practices, and may not be reached by mainstream health and harm reduction services.

Most research among PWID in Australia has been cross-sectional, with studies generally focussed on an older sample of PWID who initiated injecting drug use in the late 1990s, a period that was characterised by the ready availability of heroin - markedly different to the drug market characteristics of today. It is unclear whether patterns of drug use and related risk behaviour among this older cohort is reflective of newer, younger injectors.


Aims

The broad objective of this PhD research is to gather detailed information about young PWID in Melbourne, and to explore risk and protective factors for adverse health outcomes among this group.

Specific areas which will be investigated include:

·  The role of age in influencing patterns of drug use, and health and crime-related behaviours

·  The role of drug market factors, including changing availability of specific drug types, in influencing the ways in which people use illicit drugs; and

·  Patterns of injecting drug use in the current drug market settings, including emerging PWID populations and the emergence of the injection of pharmaceutical opioids (e.g. morphine, oxycodone).


Methods

A combination of quantitative and qualitative research methods will be used, and data from a range of sources will be explored. The role of age in influencing drug use patterns and related behaviours is being explored using data from the Illicit Drug Reporting System, a national repeat cross-sectional study. Data for other study aims will be sourced from the Melbourne Injecting Drug User Cohort Study (MIX), a longitudinal cohort of young heroin and amphetamine injectors. A qualitative study will also be conducted with emerging PWID populations.


Progress

·  The age analysis has been completed. Results suggest that young people use drugs in different ways to older PWID, and that increasing age is significantly associated with reductions in criminal activity, high-risk injecting behaviours and heroin overdose.

·  Drug market analysis in progress – results indicate that PWID tend to initiate injecting with whatever drugs are available in the market at the time, and that while people maintain a ‘preference’ for this drug in the long-term, this does not have a significant impact on their current patterns of use.

·  From MIX, we identified the potential emergence of injecting drug use among migrants from East Africa. A qualitative study is currently underway to explore this further.


Presentations

1.  Horyniak D, Degenardt L, Higgs P, Burns L, Dietze P. The role of drug market factors in shaping injecting initiation and current drug use, Population Health Congress, 9-12 September 2012, Adelaide, Australia

2.  Horyniak D, Degenhardt L, Kerr T, Stoové M, Higgs P and Dietze P. The role of drug market factors in shaping injecting initiation and current patterns of drug use: findings from the Melbourne Injecting drug user Cohort Study, Annual Meeting of the College of Problems on Drug Dependence, 9-14 June 2012, Palm Springs, USA

3.  Horyniak D, Degenhardt L, Higgs P, Burns L, Dietze P. Injecting drug use in Australia: Cohort trends in injecting initiation, heroin use and heroin overdose, Population Health Congress, 9-12 September 2012, Adelaide, Australia [poster]


Publications

1.  Horyniak D, Higgs P, Degenhardt L, Cogger S, Power R, Dietze P. A case series of people of East African ethnicity who inject drugs in Melbourne, Australia [letter] Australian & New Zealand Journal of Public Health (Accepted 27th July 2012)


Timeline

2011 – 2014

Contact

For more information relating to this project, please contact Danielle Horyniak: