Recent Trends in Illegal Drug Use in New Zealand, 2005-2007

RECENT TRENDS IN ILLEGAL DRUG USE IN NEW ZEALAND, 2005-2007

Findings from the 2005, 2006 and 2007 Illicit Drug Monitoring System (IDMS)

C.Wilkins M. Girling P. Sweetsur

Centre for Social and Health Outcomes Research and Evaluation Massey University, P O Box 6137, Wellesley St

February 2008

Table of Contents

Acknowledgements...... 8 Executive Summary ...... 9 Summary ...... 11 Introduction...... 11 Method ...... 11 Demographic characteristics of the frequent drug users...... 12 Drug use patterns of the frequent methamphetamine users ...... 13 Drug use patterns of the frequent ecstasy users ...... 14 Drug use patterns of the frequent injecting drug users ...... 14 New drug types ...... 15 New types of drug users...... 15 Increase in drug use by some users...... 15 Different means of administering drugs...... 16 Current availability of different drug types...... 16 Current purity of different drug types...... 19 Change in the availability of different drug types...... 20 Perceptions of the change in the number of people using different drugs...... 23 Current prices for drugs ...... 26 Change in prices for drugs in past six months ...... 27 Drug related harm ...... 30 Accessing health services...... 31 1. Introduction...... 33 1.1 Aims of IDMS...... 33 1.2 Methodology ...... 34 1.3 Survey of frequent drug users ...... 34 1.4 Survey of key experts (KE)...... 36 1.5 Secondary data sources ...... 36 1.6 Analysis...... 36 2. Demographics of sample...... 38 2.1 Introduction...... 38 2.2 Gender...... 38 2.3 Age...... 39 2.4 Ethnicity...... 39 2.5 Employment status...... 41 2.6 Accommodation...... 43 2.7 Education ...... 43 2.8 Sexual orientation ...... 44 2.9 Marital status...... 45 2.10 Income...... 45 2.11 Location ...... 47 2.12 Drug treatment ...... 48 2.13 Previously interviewed for the IDMS ...... 48 2.14 Summary of the demographics of the frequent drug users ...... 49 3. Drug use patterns ...... 51

Centre for Social and Health Outcomes Research and Evaluation 3 Te Runanga, Wananga, Hauora me te Paekaka 3.1 Introduction...... 51 3.2 Extent of poly drug use ...... 51 3.3 Drug use patterns of the frequent methamphetamine users ...... 51 3.4 Drug use patterns of the frequent ecstasy (MDMA) users...... 53 3.5 Drug use patterns of the frequent injecting drug users ...... 55 3.6 Drug of choice...... 57 3.7 Concurrent use of drugs ...... 60 3.8 Drug types used to recover from drug use ...... 61 3.9 Binging on drugs...... 63 3.10 New drug types ...... 64 3.11 New types of drug users...... 64 3.12 Increase in drug use by some users...... 64 3.13 Different means of administering drugs...... 65 3.14 Different ways of selling drugs...... 65 3.15 Summary of drug use patterns ...... 65 4. Methamphetamine...... 67 4.1 Introduction...... 67 4.2 Knowledge of methamphetamine trends...... 67 4.3 Availability of methamphetamine...... 67 4.4 Price of methamphetamine...... 71 4.5 Purity of methamphetamine...... 74 4.6 Perceptions of the number of people using methamphetamine ...... 78 4.7 Seizures of methamphetamine ...... 80 4.8 Clandestine methamphetamine laboratories dismantled...... 80 4.9 Pseudoephedrine and ephedrine seizures...... 81 4.10 Amphetamine use in the general population...... 82 4.11 Summary of methamphetamine trends ...... 83 5. Crystal methamphetamine ...... 84 5.1 Introduction...... 84 5.2 Knowledge of crystal methamphetamine trends...... 84 5.3 Availability of crystal methamphetamine...... 85 5.4 Price of crystal methamphetamine...... 87 5.5 Purity of crystal methamphetamine ...... 90 5.6 Perceptions of the number of people using crystal methamphetamine...... 93 5.7 Seizures of crystal methamphetamine ...... 94 5.8 Crystal methamphetamine use in the general population ...... 94 5.9 Summary of crystal methamphetamine trends...... 95 6. Ecstasy (MDMA)...... 96 6.1 Introduction...... 96 6.2 Knowledge of ecstasy (MDMA) trends...... 96 6.3 Availability of ecstasy (MDMA) ...... 96 6.4 Price of ecstasy (MDMA)...... 99 6.5 Purity of ecstasy (MDMA) ...... 100 6.6 Perceptions of the number of people using ecstasy (MDMA)...... 102 6.7 Seizures of ecstasy (MDMA)...... 103 6.8 Ecstasy (MDMA) use in the general population...... 104 6.9 Summary of ecstasy (MDMA) trends...... 104 7. Cannabis...... 106

Centre for Social and Health Outcomes Research and Evaluation 4 Te Runanga, Wananga, Hauora me te Paekaka 7.1 Introduction...... 106 7.2 Knowledge of cannabis trends ...... 106 7.3 Availability of cannabis ...... 106 7.4 Price of cannabis ...... 108 7.5 Purity of cannabis...... 110 7.6 Perceptions of the number of people using cannabis...... 112 7.7 Seizures of cannabis plants ...... 113 7.8 Cannabis use in the general population...... 114 7.9 Summary of cannabis trends...... 115 8. LSD ...... 116 8.1 Introduction...... 116 8.2 Knowledge of LSD trends...... 116 8.3 Availability of LSD...... 116 8.4 Price of LSD ...... 119 8.5 Purity of LSD...... 120 8.6 Perceptions of the number of people using LSD ...... 122 8.7 Seizures of LSD ...... 123 8.8 LSD use in the general population...... 124 8.9 Summary of LSD trends ...... 125 9. Opiates ...... 126 9.1 Introduction...... 126 9.2 Knowledge of opiate trends ...... 126 9.3 Availability of opiates...... 127 9.4 Price of opiates...... 129 9.5 Purity of opiates ...... 130 9.6 Perceptions of the number of people using opiates...... 133 9.7 Seizures of Heroin...... 134 9.8 Opiate use in the general population...... 134 9.9 Summary of opiate trends ...... 135 10. Cocaine...... 136 10.1 Introduction...... 136 10.2 Knowledge of cocaine trends...... 136 10.3 Availability of cocaine...... 136 10.4 Price of cocaine...... 138 10.5 Purity of cocaine ...... 139 10.6 Perceptions of the number of people using cocaine...... 140 10.7 Seizures of cocaine...... 141 10.8 Cocaine use in the general population ...... 141 10.9 Summary of cocaine trends...... 142 11. Ketamine ...... 143 11.1 Introduction...... 143 11.2 Knowledge of ketamine trends ...... 143 11.3 Availability of ketamine...... 143 11.4 Price of ketamine ...... 145 11.5 Purity of ketamine...... 146 11.6 Perceptions of the number of people using ketamine ...... 147 11.7 Ketamine use in the general population...... 148 11.8 Summary of ketamine trends ...... 148

Centre for Social and Health Outcomes Research and Evaluation 5 Te Runanga, Wananga, Hauora me te Paekaka 12. GHB ...... 149 12.1 Introduction...... 149 12.2 Knowledge of GHB trends...... 149 12.3 Availability of GHB...... 149 12.4 Price of GHB...... 151 12.5 Purity of GHB ...... 152 12.6 Perceptions of the number of people using GHB ...... 153 12.7 Seizures of GHB ...... 154 12.8 GHB use in the general population...... 154 12.9 Summary of GHB trends...... 155 13. Drug related harm ...... 156 13.1 Introduction...... 156 13.2 Drug related physical problems ...... 156 13.2 Drug related psychological problems ...... 158 13.3 Life impacts...... 159 13.4 Perceptions of the health risk of different drugs...... 163 13.5 Accessing health services...... 164 13.6 Help seeking for drug problems...... 166 13.7 Alcohol and driving ...... 168 13.8 Drug use and driving...... 170 13.9 Summary of drug related harm ...... 171 14. Drug dependency ...... 173 14.1 Introduction...... 173 14.2 Extent drug use out of control...... 173 14.3 Anxious about missing a dose...... 174 14.4 Worry about your drug use ...... 174 14.5 Wish you could stop...... 175 14.6 How difficult find it to stop ...... 175 14.7 Short Dependency Scale (SDS) scores ...... 176 14.8 Summary of drug dependency ...... 177 15. Injecting behaviour ...... 178 15.1 Introduction...... 178 15.2 Location where needles were obtained ...... 178 15.3 Places where drugs were injected ...... 179 15.4 Times used a needle after someone else ...... 179 15.5 Injecting equipment used after someone else ...... 180 15.6 Frequency used a new sterile needle...... 181 15.7 Summary of injecting behaviour...... 182 16. Sexual health...... 184 16.1 Introduction...... 184 16.2 Number of sexual partners ...... 184 16.3 Safe sexual practices with regular partners...... 184 16.4 Safe sexual practices with casual partners ...... 185 16.5 Summary of sexual health...... 187 17. Blood borne virus vaccination and testing...... 188 17.1 Introduction...... 188

Centre for Social and Health Outcomes Research and Evaluation 6 Te Runanga, Wananga, Hauora me te Paekaka 17.2 Vaccination for Hepatitis B...... 188 17.3 Tested for Hepatitis B ...... 189 17.4 Tested for Hepatitis C ...... 190 17.5 HIV...... 192 17.6 Summary of blood borne virus vaccination and testing...... 194 18. Secondary data sources on drug use ...... 195 18.1 Introduction...... 195 18.2 Alcohol and Drug Help-line...... 195 18.3 Odyssey house drug treatment services ...... 197 18.4 Community Alcohol and Drug Services (CADS)...... 199 18.5 Summary of secondary data sources on drug use ...... 200 References...... 201

Centre for Social and Health Outcomes Research and Evaluation 7 Te Runanga, Wananga, Hauora me te Paekaka

Acknowledgements

The Illicit Drug Monitoring System (IDMS) is conducted as part of the National Drug Policy. We gratefully acknowledge the support of a number of government agencies including the New Zealand Police, Ministry of Health, New Zealand Customs Service, Ministry of Justice, Department of Corrections, Ministry of Pacific Island Affairs and Te Puni Kōkiri. We would like to thank Associate Professor Louisa Degenhardt and other researchers at the National Drug and Alcohol Research Centre (NDARC) in Australia for their assistance and materials provided during the development of the IDMS. We acknowledge the New Zealand Needle Exchange who assisted us with the recruitment of frequent drug users for the project. We would like to thank a number of drug treatment organisations who allowed us to recruit frequent drug users from among their clients including Odyssey House, the Salvation Army Bridge Programme, Community Alcohol and Drug Services (CADS) and Higher Ground. We would like to thank all the key experts (KE) who offered their insights for the project and who received no compensation for their time. We would also like to thank the following agencies and organisations who provided secondary data sources on drug use and drug related harm in New Zealand for this report:

• Alcohol Drug Association New Zealand (ADANZ) • Community Alcohol and Drug Services (CADS) • New Zealand Ministry of Health • National Drug Intelligence Bureau (NDIB) • New Zealand Police • New Zealand Customs Service • Odyssey House

The 1998 and 2001 National Drug Surveys were funded by contestable research grants from the Health Research Council (HRC) and partially by direct funding from the Ministry of Health. The 2003 Health Behaviour Survey-Drug Use (2003 HBS-Drug Use) was directly funded by the New Zealand Ministry of Health. The 2006 national survey of legal party pill use was funded from the National Drug Policy Discretionary Fund which is a contestable research pool jointly managed by the New Zealand Inter-Agency Committee of Drugs (IACD) and the New Zealand Ministerial Committee on Drug Policy (MCDP).

We acknowledge the ongoing support of the New Zealand Drug Foundation.

Last, but by no means least, we would like to thank all the interviewers who worked with us on the project and the frequent drug users who agreed to be interviewed for the study.

Correspondence

Dr Chris Wilkins, Centre for Social and Health Outcomes Research and Evaluation (SHORE), Massey University, PO Box 6137, Wellesley Street, Auckland, New Zealand, tel. 00 64 9 366 6136, email: [email protected]

Centre for Social and Health Outcomes Research and Evaluation 8 Te Runanga, Wananga, Hauora me te Paekaka Executive Summary

Introduction The Illicit Drug Monitoring System (IDMS) is conducted annually to provide ongoing and timely information on changes in drug use and drug related harm in New Zealand. The IDMS was first established in 2005. The 2007 IDMS interviewed 324 frequent drug users (similar to the 318 interviewed in 2006) in Auckland, Wellington and Christchurch using purposive sampling and snowballing.

Methamphetamine (‘P’) Availability remained ‘easy/very easy’ in 2005, 2006 and 2007. Price and purity has not changed. Seizures of precursors and detection of clandestine laboratories have remained high in recent years.

Crystal methamphetamine (Ice) Availability was reported to have become ‘more difficult’ in both 2006 and 2007 compared to 2005. Disruptions in availability are likely to reflect the impact of some very large seizures made at the border in 2006 and 2007.

Ecstasy (MDMA) Availability was ‘easy’ in 2006 and 2007. Price may be declining. More people were considered to be using in 2006 than in 2007. National household survey results indicate increasing use. The situation is somewhat confused by the high availability of BZP party pills which are sometimes sold as ecstasy by drug dealers. Chemical analysis of alleged ‘ecstasy’ tablets has discovered a range of substances including BZP.

LSD Availability reported to be ‘difficult/easy’ in 2006 and 2007. Price and purity stable. Some increase in use among those in the dance party community. Use among other drug users stable or declining.

Cocaine Availability was described as ‘more difficult’ in both 2006 and 2007. Less people were reported to be using in both 2007 and 2006. Purity was low in 2006 and 2007. Price was reported to be increasing in 2007.

Cannabis Availability described as ‘very easy/easy’ in 2006 and 2007. Some users considered strength and price to be increasing. This has been attributed to more high potency hydroponic cannabis cultivation.

Opiates Availability was reported to be ‘easy/very easy’ in 2007 and 2006. Price and purity has increased. Lower proportions of users reported recent use of heroin in 2007 compared to 2006. Seizures of heroin at the border

Centre for Social and Health Outcomes Research and Evaluation 9 Te Runanga, Wananga, Hauora me te Paekaka have remained low level. The main source of opiates are opiates illicitly diverted from the medical and drug treatment systems, including morphine, morphine sulphate tablets (MST) and methadone.

GHB (Fantasy) Availability was ‘easy’ in 2006 and 2007. Price was increasing. Number of users was the ‘same/more’.

Ketamine Availability was ‘difficult’ in 2006 and 2007. Purity was high. Number of users was declining.

Nitrous oxide (Nos) Lower proportions of all three groups of frequent drug users reported recent use in 2007 compared to 2006. This appears to be due to the pressure put on retailers to stop selling nitrous oxide and related prosecutions conducted by the Ministry of Health.

BZP party pills Reports of increased use and injection of BZP party pills by frequent injecting drug users.

Ritalin More of the frequent injecting drug users named Ritalin as their ‘drug of choice’ in 2007 compared to 2006. The frequent methamphetamine users used Ritalin on a greater number of days in 2007 compared to 2006.

Drug related harm The frequent methamphetamine users were more likely to report ‘financial problems’ and ‘legal/police’ problems in relation to their drug use in 2007 compared to 2006 and 2005. The frequent injecting drug users were more likely to report ‘legal/police’ problems related to their drug use in 2007 compared to 2006.

Accessing health services The frequent methamphetamine users were more likely to have accessed an ambulance and an Accident and Emergency Department in relation to their drug use in 2007 compared to 2006. The frequent methamphetamine users were also more likely to have accessed a drug and alcohol worker, counsellor and General Practitioner in relation to their drug use in 2007 compared to 2005. Greater utilisation of medical and emergency services suggests heavier use of methamphetamine and other drugs by some methamphetamine users. A higher proportion of the frequent methamphetamine users had also used opiates in 2007 compared to 2006, and this may have contributed to a greater risk of drug overdose and subsequent demand for emergency medical services.

Centre for Social and Health Outcomes Research and Evaluation 10 Te Runanga, Wananga, Hauora me te Paekaka Summary

Introduction

The aim of the IDMS is to provide timely information on illegal drug use and drug related harm to inform appropriate responses to drug problems in New Zealand. This is the third year that the IDMS has been conducted, and the second year it has been conducted with the expanded methodology. The 2006 and 2007 IDMS each interviewed three groups of frequent drug users (i.e. frequent methamphetamine users, frequent injecting drug users and frequent injecting drug users). The first IDMS, conducted in 2005, did not include interviews with frequent injecting drug users.

The IDMS consists of three sources of information: (1) face-to-face interviews with frequent drug users from the community; (2) interviews with key experts (KE) who have regular contact with drug users through their work; and (3) the collation of secondary data sources on drug related statistics. Frequent drug users are considered a sentinel group who can provide accurate information on trends in drug use and drug related harm (see Hando et al., 1997; Breen et al., 2002, Wilkins et al., 2004). A unique feature of the IDMS is that it simultaneously interviews three groups of frequent drug users. The validity of the IDMS comes from the knowledge and experience of the frequent drug users and KE interviewed, rather than from the representative nature of the sampling methodology. The sample of frequent drug users interviewed is not intended to be statistically representative of drug use in the general population.

Method

A total of 324 frequent drug users were interviewed for the 2007 IDMS, including 110 frequent methamphetamine users, 105 frequent ecstasy (MDMA) users and 109 frequent injecting drug users. The frequent drug users were recruited from the three main centres (i.e. Auckland, Wellington and Christchurch) using purposive sampling and ‘snowballing’ (Biernacki and Waldorf, 1981, Watters and Biernacki, 1989). Three separate promotional campaigns were carried to recruit the three groups of frequent drugs users of interest, using posters, flyers and business cards. To be eligible to be interviewed for the study, a respondent had to be 16 years or older, to have used one of three drugs of central interest at least monthly in the past six months, and to have resided in the site location for the past 12 months.

The methodological design of the IDMS (i.e. the simultaneous interview of three groups of frequent drug users) allows aspects of drug use to be examined from a number of perspectives. The findings can be presented and compared by the specific drug user group (i.e. frequent methamphetamine users, frequent ecstasy users and frequent injecting drug users) or as a combined group of all the frequent drug users. As

Centre for Social and Health Outcomes Research and Evaluation 11 Te Runanga, Wananga, Hauora me te Paekaka further annual waves of the IDMS are completed, findings from the specific drug user groups and the combined group of frequent drug users can also be compared through time. In this year’s report we compare the findings from the frequent methamphetamine users, frequent ecstasy users and frequent injecting drug users for 2007 and 2006. We also compare the findings from the frequent methamphetamine users for 2005, 2006 and 2007.

Demographic characteristics of the frequent drug users

In 2007, 69% of the frequent drug users were male. There was no statistically significant difference in the gender of the frequent drug users in 2007 compared to 2006. There was also no statistically significant difference in the gender of the frequent methamphetamine users in 2007 compared to 2006 and 2005.

In 2007, the median age of the sample was 28 years (mean 30 years old, range 16-58 years old). The frequent ecstasy (MDMA) users were younger than either the frequent methamphetamine users (23 years old vs. 31 years old, p<0.0001) or the frequent injecting drug users (23 years old vs. 36 years old, p<0.0001). The frequent injecting drug users were older in 2007 compared to 2006 (36 years old vs. 32 years old, p=0.0046). There was no statistically significant difference in the mean age of the frequent methamphetamine users in 2007 compared to 2006 and 2005.

In 2007, 80% of the frequent drug users were European and 15% were Maori. The frequent methamphetamine users were less likely to be European than the frequent ecstasy users (67% vs. 90%, p=0.0003) or the frequent injecting drug users (67% vs. 83%, p=0.0148). There was no statistically significant difference in the ethnic characteristics of the frequent drug users in 2007 compared to 2006. There was no statistically significant change in the proportion of the frequent methamphetamine users who were non-European in 2007 compared to 2006 and 2005.

In 2007, 46% of the frequent drug users were ‘unemployed, sick or invalid’, 27% were employed (part time or full time) and 20% were high school or tertiary students. The frequent methamphetamine users (64% vs. 17%, p<0.0001) and frequent injecting drug users (75% vs. 17%, p<0.0001) were more likely to be ‘unemployed/sick or invalid’ than the frequent ecstasy (MDMA) users. The frequent ecstasy users were more likely to be students and to be unemployed in 2007 compared to 2006. The frequent methamphetamine users were more likely to be employed and students in 2005 compared to 2006 and 2007.

In 2007, 27% of the frequent drug users had no educational qualifications. The frequent methamphetamine users (33% vs. 7%, p<0.0001) and frequent injecting drug users (41% vs. 7%, p<0.0001) were more likely to have no educational qualifications than the frequent ecstasy (MDMA) users. There was no statistically significant difference in the educational achievement of the sample in 2007 compared to 2006. There was no

Centre for Social and Health Outcomes Research and Evaluation 12 Te Runanga, Wananga, Hauora me te Paekaka difference in the proportion of the frequent methamphetamine users who had no educational qualifications in 2007 compared to 2006 and 2005.

In 2007, the frequent drug users had a median gross annual income of $22,500. The frequent methamphetamine users had a higher mean annual income than either the frequent injecting drug users ($43,438 vs. 26,589, p=0.0355) or the frequent ecstasy users ($43,438 vs. 23,939, p=0.0111). The frequent drug users had lower mean gross annual incomes in 2007 compared to 2006 ($31,246 vs. $40,942, p<0.0001). Low incomes were found among all the frequent drug users in 2007 compared to 2006, but were particularly lower among the frequent ecstasy users ($32,500 vs. $23,939, p<0.0001). The frequent ecstasy users were more likely to be students and unemployed in 2007 compared to 2006 and this is likely to have negatively impacted on their income levels. There was no difference in the mean income of the frequent methamphetamine users in 2007 compared to 2006 and 2005.

Drug use patterns of the frequent methamphetamine users

In 2007, the drug types most commonly used by the frequent methamphetamine users in the previous six months were methamphetamine (97%), cannabis (87%), tobacco (84%), alcohol (79%), crystal methamphetamine (66%), ecstasy (MDMA) (52%), BZP party pills (43%) and LSD (34%). A lower proportion of the frequent methamphetamine users had used BZP party pills in 2006 compared to 2005 (31% vs. 58%, p=0.0009). A higher proportion of frequent methamphetamine users had used ‘other opiates’ in 2007 compared to 2006 (32% vs. 18%) and this was close to being statistically significant (p=0.0582). A higher proportion of the frequent methamphetamine users had used methadone in 2007 compared to 2005 (26% vs. 12%, p=0.048). A lower proportion of the frequent methamphetamine users had used nitrous oxide in 2006 compared to 2005 (15% vs. 47%, p<0.0001) and in 2007 compared to 2005 (24% vs. 47%, p=0.0018).

The frequent methamphetamine users had, on average, used methamphetamine on a greater number of days in 2007 compared to 2005 (68 days vs. 46 days, p=0.006) and in 2006 compared to 2005 (59 days vs. 46 days, p=0.0364). The frequent methamphetamine users had, on average, smoked tobacco on more days in 2007 than in 2006 (175 days vs. 162 days, p=0.0344) and compared to 2005 (175 days vs. 160 days, p<0.0001). The frequent methamphetamine users had, on average, used crystal methamphetamine on more days in 2007 than in 2005 (46 days vs. 30 days, p=0.044) and on more days in 2006 compared to 2005 (56 days vs. 30 days, p=0.0333). The frequent methamphetamine users had, on average, used Ritalin (methylphenidate) on a greater number of days in 2007 compared to 2006 (31 days vs. 12 days, p=0.0369).

In 2007, the drug types most commonly injected by the frequent methamphetamine users in the past six months were heroin (100%), other opiates (77%), Ritalin (62%), methadone (59%), methamphetamine

Centre for Social and Health Outcomes Research and Evaluation 13 Te Runanga, Wananga, Hauora me te Paekaka (35%) and crystal methamphetamine (34%). There was no statistically significant change among the frequent methamphetamine users with respect to the level of injection of drug types in 2007 compared to 2006.

Drug use patterns of the frequent ecstasy users

The drug type which the frequent ecstasy users had, on average, used on a greater number of days in the past six months in 2007 compared to 2006 was alcohol (66 vs. 50 days, p=0.0029). The drug types which the frequent ecstasy users had, on average, used on a fewer number of days in the past six months in 2007 compared 2006 were magic mushrooms (psilocybin) (3 vs. 6 days, p=0.0169) and crystal methamphetamine (4 days vs. 31 days, p=0.011).

In 2007, the drug types most commonly injected by the frequent ecstasy users in the past six months were methadone (33%), other opiates (25%), anti-depressants (20%), and MDA (18%) (Table 3.2). There was no statistically significant change among the frequent ecstasy users with respect to the level of injection of drug types in 2007 compared to 2006.

Drug use patterns of the frequent injecting drug users

In 2007, the drug types most commonly used by the frequent injecting drug users in the past six months were tobacco (90%), cannabis (85%), alcohol (72%), methadone (72%), other opiates (71%), benzodiazepines (54%), methamphetamine (45%) and Ritalin (42%). The drug types which a lower proportion of the frequent injecting drug users had used in 2007 compared to 2006 were heroin (12% vs. 24%, p=0.0394) and MDA (1% vs. 8%, p=0.0253). A lower proportion of the frequent injecting drug users had used nitrous oxide in 2007 compared to 2006, and this was close to being statistically significant (22% vs. 11%, p=0.053).

The drug types which the frequent injecting drug users had, on average, used on a greater number of days in the past six months in 2007 compared to 2006 were BZP party pills (23 vs. 6 days, p=0.0275) and methadone (133 days vs. 92 days, p=0.0033). The drug types which the frequent injecting drug users had, on average, used on a fewer number of days in the past six months in 2007 compared 2006 were crystal methamphetamine (16 vs. 42 days, p=0.0419) and methamphetamine (12 days vs. 43 days, p=0.0064).

Centre for Social and Health Outcomes Research and Evaluation 14 Te Runanga, Wananga, Hauora me te Paekaka In 2007, the drug types most commonly injected by the frequent injecting drug users in the past six months were other opiates (99%), Ritalin (93%), heroin (92%), crystal methamphetamine (80%), ketamine (67%), methamphetamine (65%) and methadone (64%). The frequent injecting drug users were statistically significantly more likely to have injected BZP party pills in 2007 compared to 2006 (74% vs. 32%, p=0.0019).

There were changes in the drug types which the frequent injecting drug users named as their ‘drug of choice’ in 2007 compared to 2006. A lower proportion of the frequent injecting drug users named heroin (4% vs. 12%, p=0.0295) and amphetamine sulphate (5% vs. 13%, p=0.0393) as their drug of choice in 2007 compared to 2006. A higher proportion of frequent injecting drug users named methadone (19% vs. 8%, p=0.0246) and Ritalin (11% vs. 0%, p<0.0001) as their drug of choice in 2007 compared to 2006.

New drug types

The frequent drug users were asked if they had heard about any new drug types in the past six months. Six frequent drug users reported new types of ‘BZP free’ party pills. Five frequent drug users reported an increase in the number of people injecting BZP party pills. Five frequent drug users reported a new type of slow release Ritalin available in new quantities. Three frequent drug users reported an increase in ecstasy use and new types of ecstasy.

New types of drug users

The frequent drug users were asked if they had seen any new types of drug users in the previous six months. Thirty-five frequent drug users said they had noticed more ‘younger’ drug users in the past six months. Twenty-three frequent drug users said there was now a wider range of people using drugs including older people, middle class people and professionals. Six frequent drug users reported increased intravenous drug use. Three frequent drug users reported that more people were injecting BZP party pills.

Increase in drug use by some users

The frequent drug users were asked if there had been any increase in drug use by some drug users in the previous six months. Twenty-one frequent drug users said they were seeing more people using methamphetamine over the past six months. Related to this theme, a further 11 frequent drug users reported existing methamphetamine users using more methamphetamine. Sixteen frequent drug users said they were seeing more ‘younger’ drug users. Eight frequent drug users reported they had seen an increase in ecstasy use over the past six months. Related to this theme, a further six frequent drug users said that ecstasy users were using ecstasy more often and were also using more of other drugs. Five frequent drug users said they had observed greater use of Ritalin over the previous six months.

Centre for Social and Health Outcomes Research and Evaluation 15 Te Runanga, Wananga, Hauora me te Paekaka Different means of administering drugs

The frequent drug users were asked if they had seen people administering drugs in new ways in the past six months. Eleven frequent drug users reported more injection of drugs. One frequent drug user specifically reported an increase in the injection of ecstasy. Another frequent drug user mentioned an increase in the injection of BZP and two frequent drug users had observed an increase in the injection of methamphetamine. Eleven frequent drug users reported more powder ecstasy and more snorting of ecstasy.

Current availability of different drug types

In 2007, the average score for the current availability of methamphetamine for all the frequent drug users was 1.8 which indicates that overall the current availability of methamphetamine was ‘easy/very easy’ (Table 1a). The average score for the current availability of crystal methamphetamine for all the frequent drug users was 2.1 which indicates that overall the current level of availability of crystal methamphetamine was ‘easy’. The average score for the current availability of ecstasy (MDMA) for all the frequent drug users was 2.0 which indicates that overall the current level of availability of ecstasy (MDMA) was ‘easy’. The average score for the current availability of LSD for all the frequent drug users was 2.4 which indicates that overall the current level of availability of LSD was ‘easy/difficult’. The average score for the current availability of cannabis for all the frequent drug users was 1.4 which indicates that overall the current level of availability of cannabis was ‘very easy/ easy’ (Table 1b). The average score for the current availability of opiates for all the frequent drug users was 1.9 which indicates that overall the current availability of opiates was ‘easy/very easy’. The average score for the current availability of cocaine for all the frequent drug users was 3.0 which indicates that overall the current level of availability of cocaine was ‘difficult’. There was no statistically significant change in the current availability of these drug types in 2007 compared to 2006. The frequent methamphetamine users considered the availability of methamphetamine to be ‘easy/very easy’ in 2005, 2006 and 2007. The frequent methamphetamine users considered the availability of crystal methamphetamine to be ‘easy’ in 2005, 2006 and 2007.

Centre for Social and Health Outcomes Research and Evaluation 16 Te Runanga, Wananga, Hauora me te Paekaka Table 1a: Current availability of different drug types, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007

CURRENT Meth- Meth- Crystal Crystal Ecstasy Ecstasy LSD LSD AVAILABILITY amphetamine amphetamine Meth Meth (MDMA) (MDMA) amphetamine amphetamine Number with n=176 n=176 n=107 n=71 n=200 n=157 n=124 n=102 knowledge Very easy [1] 38% 38% 24% 25% 20% 25% 8% 17%

Easy [2] 44% 47% 48% 41% 54% 55% 47% 33%

Difficult [3] 16% 13% 23% 31% 27% 19% 38% 42%

Very difficult 1% 2% 5% 3% 0% 2% 7% 8% (%) [4] Average availability score (1=very 1.8 1.8 2.1 2.1 2.1 2.0 2.4 2.4 easy – 4=very difficult) Overall current Easy/ Easy/ Easy Easy Easy Easy Easy/ Difficult/ status very easy very easy difficult easy

Centre for Social and Health Outcomes Research and Evaluation 17 Te Runanga, Wananga, Hauora me te Paekaka

Table 1b: Current availability of different drug types, 2006-2007

2006 2007 2006 2007 2006 2007

CURRENT Cannabis Cannabis Opiates Opiates Cocaine Cocaine AVAILABILITY Number with n=276 n=263 n=114 n=132 n=29 n=29 knowledge Very easy [1] 41% 35% 60% 64% 10% 3%

Easy [2] 36% 30% 45% 43% 17% 17%

Difficult [3] 4% 5% 10% 18% 48% 52%

Very difficult 0% 1% 4% 4% 24% 28% (%) [4] Average availability score (1=very 1.4 1.4 1.8 1.9 2.9 3.0 easy – 4=very difficult) Overall current Very easy/ Very easy/ Easy/ Easy/ Difficult Difficult status easy easy very easy very easy

Centre for Social and Health Outcomes Research and Evaluation 18 Te Runanga, Wananga, Hauora me te Paekaka

Current purity of different drug types

In 2007, the average score for the current purity of methamphetamine for all the frequent drug users was 2.3 which indicates that overall the purity of methamphetamine was ‘medium/high’. The average score for the current purity of crystal methamphetamine for all the frequent drug users was 2.5 which indicates that overall the purity of crystal methamphetamine was ‘high/medium’. The average score for the current purity of ecstasy (MDMA) for all the frequent drug users was 2.2 which indicates that overall the purity of ecstasy (MDMA) was ‘medium/high’. The average score for the current strength of LSD for all the frequent drug users was 2.2 which indicates that overall the strength of LSD was ‘medium/high’. The average score for the current strength of cannabis for all the frequent drug users was 2.5 which indicates that overall the strength of cannabis was ‘high/medium’. The frequent methamphetamine users were more likely than the frequent ecstasy users to describe the current strength of cannabis as high (2.6 vs. 2.3, p=0.0046). The average score for the current purity of opiates for all the frequent drug users was 2.6 which indicates that overall the purity of opiates was ‘high’. The average score for the current purity of cocaine for all the frequent drug users was 2.0 which indicates that overall the purity of cocaine was ‘medium’. The purity of opiates was considered to be higher in 2007 than in 2006 (2.6 vs. 2.3, p=0.0006). Otherwise, there was no statistically significant change in the current purity of these drug types in 2007 compared to 2006. The frequent methamphetamine users described the purity of methamphetamine as ‘medium/high’ in 2005, 2006 and 2007. The frequent methamphetamine users described the purity of crystal methamphetamine as ‘high/medium’ in 2005, 2006 and 2007.

Centre for Social and Health Outcomes Research and Evaluation 19 Te Runanga, Wananga, Hauora me te Paekaka

Change in the availability of different drug types

In 2007, the average score for the change in availability of methamphetamine for all the frequent drug users was 1.9 which indicates that overall the availability of methamphetamine was ‘stable’ over the past six months (Table 2a). The average score for the change in availability of crystal methamphetamine for all the frequent drug users was 2.1 which indicates that overall the availability of crystal methamphetamine was ‘stable/more difficult’ over the past six months. The average score for the change in the availability of ecstasy (MDMA) for all the frequent drug users was 1.9 which indicates that overall the availability of ecstasy (MDMA) was ‘stable’ over the previous six months. The average score for the change in availability of LSD for all the frequent drug users was 2.0 which indicates that overall the availability of LSD was ‘stable/fluctuating’ over the last six months. The frequent methamphetamine users were more likely than the frequent ecstasy users to say the availability of LSD had become ‘more difficult’ over the past six months (2.2 vs. 1.9, p=0.0327). The average score for the change in the availability of cannabis for all the frequent drug users was 2.0 which indicates that overall the availability of cannabis was ‘stable’ over the past six months (Table 2b). The average score for the change in availability of opiates for all the frequent drug users was 2.0 which indicates that overall the availability of opiates was ‘stable’ over the past six months. The average score for the change in the availability of cocaine for all the frequent drug users was 2.2 which indicates that overall the availability of cocaine was ‘stable/more difficult’ over the past six months. There was no statistically significant change in the availability of these drug types in 2007 compared to 2006. The frequent methamphetamine users were more likely to report the availability of crystal methamphetamine as becoming ‘more difficult’ in 2007 than in 2005.

Centre for Social and Health Outcomes Research and Evaluation 20 Te Runanga, Wananga, Hauora me te Paekaka

Table 2a: Change in availability of different drug types in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007

CHANGE IN Meth- Meth- Crystal Crystal Ecstasy Ecstasy LSD LSD AVAILABILITY amphetamine amphetamine Meth Meth (MDMA) (MDMA) amphetamine amphetamine Number with n=175 n=174 n=106 n=69 n=194 n=154 n=119 n=96 knowledge Easier [1] 20% 28% 10% 16% 19% 28% 16% 20%

Stable [2] 53% 51% 50% 52% 45% 47% 34% 40%

Fluctuates [2] 9% 6% 10% 6% 23% 6% 31% 20%

More 19% 16% 29% 26% 13% 18% 18% 21% difficult [3] Average change in availability 2.0 1.9 2.2 2.1 1.9 1.9 2.0 2.0 score (1=easier – 3=more difficult) Overall current Stable/ Stable/ Stable Stable Stable/ Stable/ Stable Stable status fluctuating fluctuating more difficult more difficult

Centre for Social and Health Outcomes Research and Evaluation 21 Te Runanga, Wananga, Hauora me te Paekaka

Table 2b: Change in availability of different drug types in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007

CHANGE IN Cannabis Cannabis Opiates Opiates Cocaine Cocaine AVAILABILITY Number with n=274 n=261 n=114 n=128 n=29 n=28 knowledge Easier [1] 7% 11% 10% 15% 7% 0%

Stable [2] 69% 71% 73% 61% 57% 64%

Fluctuates [2] 15% 8% 8% 8% 13% 14%

More 9% 9% 10% 16% 23% 21% difficult [3] Average change in availability 2.0 2.0 2.0 2.0 2.2 2.2 score (1=easier – 3=more difficult) Overall current Stable/ Stable/ Stable Stable Stable Stable status more difficult more difficult

Centre for Social and Health Outcomes Research and Evaluation 22 Te Runanga, Wananga, Hauora me te Paekaka Perceptions of the change in the number of people using different drugs

In 2007, the average score for all the frequent drug users in regard to the change in the number of methamphetamine users was 2.3 indicating that overall the ‘same/more’ people were using methamphetamine (Table 3a). The average score for all the frequent drug users in regard to the change in the number of crystal methamphetamine users was 2.1 indicating that overall the ‘same/more’ people were using crystal methamphetamine. The average score for all the frequent drug users in regard to the change in the number of ecstasy (MDMA) users was 2.5 indicating that overall the ‘more/same’ people were using ecstasy (MDMA). The frequent ecstasy users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people they know were using ecstasy in 2007 (2.5 vs. 2.3, p=0.0459). The average score for all the frequent drug users in regard to the change in the number of LSD users was 2.0 indicating that overall ‘about the same’ number of people were using LSD. The frequent ecstasy users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people they know were using LSD compared to six months ago in 2007 (2.3 vs. 1.8, p=0.0036). The average score for all the frequent drug users in regard to the change in the number of cannabis users was 2.1 indicating that overall the ‘same/more’ people were using cannabis (Table 3b). The average score for all the frequent drug users in regard to the change in the number of opiate users was 2.1 indicating that overall the ‘same/more’ people were using opiates. The frequent injecting drug users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people they know were using opiates over the past six months (2.2 vs. 1.8, p=0.0256). The average score for all the frequent drug users in regard to the change in the number of cocaine users was 1.9 indicating that overall the ‘same/less’ people were using cocaine. The average score of the number of people using ecstasy was statistically significantly higher in 2007 compared to 2006 (2.5 vs. 2.3, p=0.0111) indicating that more people were using ecstasy in 2007 compared to 2006. Otherwise there was no statistically significant change in perceptions of the number of people using these drug types in 2007 compared to 2006. The frequent methamphetamine users described the number of people using methamphetamine as ‘more/the same’ in 2005, 2006 and 2007. The frequent methamphetamine users described the number of people using crystal methamphetamine as ‘same/more’ in 2005, 2006 and 2007.

Centre for Social and Health Outcomes Research and Evaluation 23 Te Runanga, Wananga, Hauora me te Paekaka

Table 3a: Users’ perceptions of the change in the number of people using different drugs in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007

CHANGE IN Meth- Meth- Crystal Crystal Ecstasy Ecstasy LSD LSD NUMBER amphetamine amphetamine Meth Meth (MDMA) (MDMA) PEOPLE amphetamine amphetamine USING Number with n=175 n=178 n=108 n=71 n=196 n=159 n=125 n=101 knowledge Less [1] 23% 17% 25% 29% 11% 6% 27% 24%

Same [2] 34% 31% 37% 35% 51% 42% 51% 50%

More [3] 43% 48% 38% 36% 39% 52% 22% 22%

Average change in number of 2.2 2.3 2.1 2.1 2.3 2.5 1.9 2.0 people using score (1=less – 3=more) Overall current Same/ Same/ Same/ Same/ Same/ More/ Same Same status more more more more more same

Centre for Social and Health Outcomes Research and Evaluation 24 Te Runanga, Wananga, Hauora me te Paekaka

Table 3b: Users’ perceptions of the change in the number of people using different drugs in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007

CHANGE IN Cannabis Cannabis Opiates Opiates Cocaine Cocaine NUMBER PEOPLE USING Number with n=279 n=262 n=114 n=127 n=27 n=26 knowledge Less [1] 10% 12% 19% 28% 30% 28%

Same [2] 73% 66% 46% 38% 48% 56%

More [3] 17% 22% 34% 35% 22% 16%

Average change in number of 2.1 2.1 2.1 2.1 1.9 1.9 people using score (1=less – 3=more) Overall current Same/ Same/ Same/ Same/ Same/ Same/ status more more more more less less

Centre for Social and Health Outcomes Research and Evaluation 25 Te Runanga, Wananga, Hauora me te Paekaka Current prices for drugs

Table 4a and 4b present the mean and median prices paid for common retail quantities of different illegal drugs for 2007 and 2006. In 2007, the frequent methamphetamine users paid a lower mean price for a gram of methamphetamine than the frequent injecting drug users ($583 vs. $861, p=0.0004). There was no statistically significant difference in the mean price paid for a point (p=0.4443) or gram (p=0.1763) of methamphetamine in 2007 compared to 2006. There was no statistically significant change in the mean price of a point of crystal methamphetamine in 2007 compared to 2006 (p=0.1914). The mean price paid for a pill of ecstasy by the frequent drug users was lower in 2007 than in 2006 ($55 vs. $59, p=0.0243). There was no statistically significant difference in the mean price paid for a tab of LSD in 2007 compared to 2006 (p=0.486). The mean price paid for an ounce of cannabis was higher in 2007 than in 2006 ($313 vs. $300, p=0.0168). The mean price paid for a milligram of opiates was slightly higher in 2007 compared to 2006 ($1.01 vs. $0.95, p=0.0433). There was no statistically significant change in the mean price paid for a gram of cocaine in 2007 compared to 2006 (p=0.4132).

Table 4a: Mean and median price paid for different drug types by frequent drug users, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007

CURRENT Meth Meth Crystal Crystal Ecstasy Ecstasy LSD LSD PRICE amphet amphet Meth Meth (MDMA) (MDMA) amine amine amphet amphet amine amine Number with n=144 n=130 n=76 n=45 n=190 n=122 n=117 n=75 knowledge Mean price $96 $97 $100 point $106 point $59 pill $55 pill $35 tab $36 tab ($) point point Median $100 $100 $100 point $100 point $60 pill $60 pill $35 tab $40 tab price ($) point point Mean price $606 $663 - $685 - - - - ($) gram gram gram Median $600 $600 - $700 - - - - price ($) gram gram gram

Table 4b: Mean and median price paid for different drug types by frequent drug users, 2006-2007

2006 2007 2006 2007 2006 2007

CURRENT Cannabis Cannabis Opiates Opiates Cocaine Cocaine PRICE Number with n=229 n=207 n=87 n=96 n=25 n=20 knowledge Mean price $20 foil $20 foil $0.95 per $1.01 per $353 $431 ($) milligram milligram gram gram Median $20 foil $20 foil $1.00 per $1.00 per $300 $350 price ($) milligram milligram gram gram Mean price $300 $313 - - - - ($) ounce ounce Median $300 $300 - - - - price ($) ounce ounce

Centre for Social and Health Outcomes Research and Evaluation 26 Te Runanga, Wananga, Hauora me te Paekaka Change in prices for drugs in past six months

In 2007, the average score for the change in the price of methamphetamine for all the frequent drug users was 2.0 which indicates that overall the price was ‘stable’ over the previous six months (Table 5a). The average score for the change in the price of crystal methamphetamine for all the frequent drug users was 2.1 which indicates that overall the price was ‘stable’ over the previous six months. The average score for the change in the price of ecstasy (MDMA) for all the frequent drug users was 1.9 which indicates that the price was ‘stable/decreasing’ over the previous six months. The average score for the change in the price of LSD for all the frequent drug users was 2.1 which indicates that overall the price of LSD was ‘stable’ over the past six months. The average score for the change in the price of cannabis for all the frequent drug users was 2.0 which indicates that overall the price of cannabis was ‘stable’ over the previous six months (Table 5b). The average score for the change in the price of opiates for all the frequent drug users was 2.1 which indicates that overall the price of opiates was ‘stable’ over the previous six months. The average score for the change in the price of cocaine for all the frequent drug users was 2.1 which indicates that overall the price of cocaine was ‘stable/increasing’ over the past six months. The average score for the change in the price of opiates was statistically significantly higher in 2007 compared to 2006 (2.1 vs. 1.9, p=0.0137) indicating that the price of opiates has increased over the past two years. Otherwise there was no statistically significant change in the price of these drug types in 2007 compared to 2006. The frequent methamphetamine users reported no change in the price of methamphetamine or crystal methamphetamine in 2007 compared to 2006 and 2005.

Centre for Social and Health Outcomes Research and Evaluation 27 Te Runanga, Wananga, Hauora me te Paekaka

Table 5a: Change in price paid for different drug types in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007

CHANGE IN Meth- Meth- Crystal Crystal Ecstasy Ecstasy LSD LSD PRICE amphetamine amphetamine Meth Meth (MDMA) (MDMA) amphetamine amphetamine Number with n=155 n=167 n=98 n=69 n=187 n=158 n=117 n=96 knowledge Decreasing [1] 23% 16% 11% 9% 22% 14% 10% 5%

Stable [2] 48% 60% 61% 59% 58% 64% 70% 70%

Fluctuating [2] 12% 10% 10% 12% 12% 15% 9% 11%

Increasing [3] 17% 14% 17% 20% 7% 8% 10% 14%

Average change in price score 1.9 2.0 2.1 2.1 1.8 1.9 2.0 2.1 (1=decreasing – 3=increasing) Overall current Stable/ Stable/ Stable Stable Stable Stable status Stable Stable decreasing decreasing

Centre for Social and Health Outcomes Research and Evaluation 28 Te Runanga, Wananga, Hauora me te Paekaka

Table 5b: Change in price paid for different drug types in the past six months, 2006-2007

2006 2007 2006 2007 2006 2007

CHANGE IN Cannabis Cannabis Opiates Opiates Cocaine Cocaine PRICE Number with n=269 n=253 n=106 n=121 n=24 n=22 knowledge Decreasing [1] 4% 4% 19% 6% 19% 5%

Stable [2] 74% 82% 65% 75% 63% 68%

Fluctuating [2] 10% 5% 5% 4% 21% 9%

Increasing [3] 11% 9% 11% 15% 8% 18%

Average change in price score 2.1 2.0 1.9 2.1 2.0 2.1 (1=decreasing – 3=increasing) Overall current Stable/ Stable/ Stable/ Stable Stable Stable status increasing decreasing increasing

Centre for Social and Health Outcomes Research and Evaluation 29 Te Runanga, Wananga, Hauora me te Paekaka Drug related harm

The frequent drug users were asked if their drug use had had any harmful impact on different areas of their lives in the past six months. The frequent methamphetamine users were statistically significantly more likely to report ‘financial problems’ in 2007 compared to 2006 (75% vs. 54%, p=0.0039) and compared to 2005 (75% vs. 57%, p=0.0222) (Table 6). The frequent methamphetamine users were also more likely to report ‘legal/police’ problems in 2007 compared to 2006 (54% vs. 33%, p=0.0058) and compared to 2005 (54% vs. 22%, p<0.0001). The frequent injecting drug users (45% vs. 28%, p=0.019) were more likely to report ‘legal/police problems’ in 2007 than in 2006.

Table 6: Drug related harms by frequent methamphetamine users, 2005-2007

2005 2006 2007

Different areas of Methamphetamine Methamphetamine Methamphetamine life users users users (n=77) (n=114) (n=110)

Financial problems 57% 54% 75%

Relationship/social 63% 72% 71% problems Work/study 43% 54% 55% problems Legal/police 22% 33% 54% problems

In 2007, the frequent drug users were asked if they had experienced any of a list of specific harmful incidents in relation to their drug use in the past six months. In 2007, the drug related incidents most commonly reported by the frequent methamphetamine users were ‘argued with others’ (77%), ‘lost temper’ (73%) and ‘had reduced work/study performance’ (67%) (Table 7). The drug related incidents most commonly reported by the frequent ecstasy users were ‘couldn’t remember what happened the night before’ (75%), ‘did something under the influence of drugs and later regretted it’ (63%) and ‘had reduced work/study performance’ (59%). The drug related incidents most commonly reported by the frequent injecting drug users were ‘no money for luxuries’ (71%), ‘got into debt/owing money’ (69%) and ‘argued with others’ (68%).

Centre for Social and Health Outcomes Research and Evaluation 30 Te Runanga, Wananga, Hauora me te Paekaka Table 7: Drug related incidents by frequent drug user group, 2007

Accessing health services

The frequent drug users were asked if they had accessed any of a list of health services in relation to their drug use in the previous six months. The frequent methamphetamine users were statistically significantly more likely to have accessed an ambulance (15% vs. 3%, p=0.0014) and accident and emergency (17% vs. 6%, p=0.0351) in relation to their drug use in 2007 compared to 2006 (Table 8). The frequent

Centre for Social and Health Outcomes Research and Evaluation 31 Te Runanga, Wananga, Hauora me te Paekaka methamphetamine users were also statistically significantly more likely to have accessed a drug and alcohol worker (37% vs. 18%, p=0.015), counsellor (42% vs. 18%, p=0.0021) and General Practitioner (38% vs. 18%, p=0.0096) in relation to their drug use in 2007 compared to 2005.

Table 8: Health services accessed in relation to drug use in the past six months by frequent methamphetamine users, 2005-2007 2005 2006 2007 Health service Methamphetamine Methamphetamine Methamphetamine users users users (n=73) (n=114) (n=110) Counsellor 18% 33% 42% General Practitioner 18% 27% 38% Drug and Alcohol 18% 38% 37% worker Accident and 14% 6% 17% Emergency Ambulance 10% 3% 15% Psychologist 7% 10% 15% Social worker 10% 7% 14% Psychiatrist 11% 10% 10% Hospital (admitted) 8% 4% 12% First Aid 3% 2% 6%

Centre for Social and Health Outcomes Research and Evaluation 32 Te Runanga, Wananga, Hauora me te Paekaka 1. Introduction

The IDMS is intended to serve as a strategic drug monitoring system to inform policy and strategic response to illegal drug use and drug related harm in New Zealand. It is designed to be sensitive to new trends in illegal drug use and drug related harm, and to provide ongoing monitoring of existing drug use and drug related harm. The IDMS provides detailed data on the harms and problems experienced by frequent drug users, and the extent to which they access health, medical and emergency services in relation to their drug use. The IDMS also collates a range of leading statistical indicators of changes in illegal drug use and drug related harm, such as national household drug survey data, drug seizure data, calls to the alcohol and drug help-line and admissions to drug treatment programmes.

The information provided by the IDMS is intended to be used by a wide range of people and organisations concerned with drug related harm and drug policy. The value of the IDMS will grow with the completion of each successive annual wave as trends in illegal drug use and drug related harm are able to be viewed over a number of years.

The data collected in the IDMS is not intended to be representative of drug use in the general population in New Zealand; rather the information is intended to be indicative of emerging trends in drug use and drug related harm in New Zealand. The IDMS is not intended to be a definitive study of drug use in New Zealand, but rather to identify trends and characteristics of drug use which merit further research attention and investigation. In this way it is hoped that the IDMS will stimulate best practice and further research as much as it informs drug policy and drug strategy.

The IDMS is a collaborative project drawing on the knowledge and goodwill of people from a range of sectors including central government agencies, drug treatment organisations, drug health services, drug user groups and drug researchers. The success of the IDMS is a testimony to the commitment and cooperation of these people and organisations.

1.1 Aims of IDMS

The principal aims of the IDMS are to:

y Track trends in illegal drug use; y Detect the emergence of new illegal drug types; y Document the availability, price, and purity of illegal drugs of greatest concern; y Document the harms and problems users experience from the use of illegal drugs; y Document social disruption related to illegal drug use. Centre for Social and Health Outcomes Research and Evaluation 33 Te Runanga, Wananga, Hauora me te Paekaka

1.2 Methodology

The IDMS employs research methodologies which have been successfully used in a number of countries to monitor trends in illegal drug use and drug related harm (see Wilkins and Rose, 2003, Griffiths et al., 2000, WHO, 2003, Mounteney and Leirvag, 2004). The drug monitoring programmes which have been conducted in Australia for a number of years, the Illicit Drug Reporting System (IDRS) and Ecstasy and related drugs reporting system (EDRS), provided a natural starting point for the development of a drug monitoring system in New Zealand (see recent examples, Dunn et al., 2007; O’Brien et al., 2007). The methodologies used overseas have been adapted and extended in the IDMS to address the unique features of illegal drug use in New Zealand.

The research methods used in the IDMS were developed and piloted during early research into the socio- economic impact of methamphetamine in New Zealand (see Wilkins et al., 2004). The IDMS proper was conducted for the first time in 2005, and it is intended that it will be conducted annually on an ongoing basis.

A unique design feature of the IDMS is that it simultaneously recruits and interviews three groups of frequent drug users from the community:

(i) Frequent methamphetamine users - at least monthly users of methamphetamine or crystal methamphetamine;

(ii) Frequent ecstasy users - at least monthly users of ecstasy;

(iii) Frequent Intravenous Drug Users (IDU) – at least monthly injectors of any drug. The drug types injected by the IDU sample can include legal pharmaceuticals which may have been illegally diverted from the medical system, such as morphine, methadone and Ritalin.

The information provided by the interviews with the frequent drug users is contextualised with information provided by key experts (KE), who have regular contact with illegal drug users through their employment, and with secondary data sources on illegal drug use such as national household drug survey data, drug seizure statistics, admissions to drug treatment programmes, and calls to drug support and information lines.

1.3 Survey of frequent drug users

Frequent drug users are considered to be a sentinel group for detecting trends in illegal drug use as they often use a number of drug types (rather than just one substance exclusively) and have knowledge of other drug

Centre for Social and Health Outcomes Research and Evaluation 34 Te Runanga, Wananga, Hauora me te Paekaka types through interaction with drug using peers and drug dealers (see Hando et al., 1997, Breen et al., 2002, Wilkins et al., 2004). A total of 324 frequent drug users were interviewed for the 2007 IDMS, including 110 frequent methamphetamine users, 105 frequent ecstasy (MDMA) users and 109 frequent IDU. The frequent drug users interviewed for the study participated in an in-depth, hour-long interview. The questionnaire consisted of ten sections with a total of over 200 possible questions. The interviews with the frequent drug users thus generated an extensive data base of information of recent trends in drug use and related behaviour.

Recruitment and interviewing of the frequent drug users was carried out in the three main centres (i.e. Auckland, Wellington and Christchurch) from July to October 2007. In order to be eligible to be interviewed for the study a respondent had to be 16 years or older, have used one of the main drugs of interest approximately monthly or more often in the past six months, and have resided in the site location for the past 12 months. Participants were recruited through purposive sampling and ‘snowballing’ (Biernacki and Waldorf, 1981, Watters and Biernacki, 1989). Purposive sampling involves the use of targeted recruitment strategies and is used to reach hard-to-reach populations, such as illegal drug users, when general population sampling is not feasible. ‘Snowballing’ is a peer recruitment strategy where interviewers ask those who have recently interviewed to recommend the study to their friends and social acquaintances who may be eligible to participate. In order to ensure that a broadly representative sample of frequent drug users is interviewed for the study, a range of ‘start points’ for recruitment are chosen, based on the demographic profile of users and an understanding of the venues and locations where they are likely to congregate in a given site (see Wilkins et al., 2004, Wilkins et al., 2005d, Wilkins et al., 2005e).

The recruitment of the three samples of frequent drug users was achieved through three separate promotional campaigns. Three separate sets of posters, flyers and business cards were used to recruit each group of frequent drug user. The interviewers left promotional material at a wide range of locations including needle exchanges, pharmacies, music shops, university campuses, clubs and pubs and supermarkets. Those contacting interviewers about participating in the study indicated the type of drug advertisement to which they were responding and were screened for eligibility for that drug type in the study. Participants were administered a structured face-to-face interview at a public venue of their choosing.

Participants were informed that all the information provided was strictly confidential and anonymous, and that the results would only be presented in aggregate. The project was designed so that no individual participant could be identified at a later date. The protocols and procedures used to collect and store the data for the project were approved by the Massey University Human Subjects Ethics Committee. All participants were offered a $20 food or music voucher to compensate them for their time.

Centre for Social and Health Outcomes Research and Evaluation 35 Te Runanga, Wananga, Hauora me te Paekaka 1.4 Survey of key experts (KE)

Key experts (KE) are people who have had regular contact with frequent drug users through their work over the past six months. A total of 19 KE were interviewed for the 2007 IDMS including those working in alcohol and drug treatment agencies, youth services, prisons, needle exchanges, Women’s Refuge, hospital emergency departments, the Prostitutes Collective, New Zealand Drug Foundation, law enforcement, social agencies and local pharmacies.

1.5 Secondary data sources

A range of secondary data sources were used in the 2007 IDMS to place the reports of the frequent drug users and KEs in wider context. Secondary data sources included in this report are:

• 2003 Health Behaviours Survey: Drug Use (HBS-Drug Use) • 2006 national household survey data on drug use, • Drug seizure data • Call statistics from the Drug and Alcohol Help-line • Drug treatment admission statistics

1.6 Analysis

Statistical testing was carried out to identify differences between the frequent methamphetamine users, frequent ecstasy (MDMA) users and frequent injecting drug users for a range of drug measures collected in the study. Testing for differences in proportions (e.g. yes/no questions) was done using Fisher’s exact test. A p-value of greater than 0.05 was defined as indicating no evidence of any differences between the three groups. If a p-value of less than 0.05 was obtained, three Fisher’s exact tests were used to test for differences between each pair-wise combination of modules. The three p-values were adjusted for using Holm’s step- down procedure to maintain an overall alpha level of 0.05. One-way ANOVAs with Tukey-Kramer post-hoc adjustments were used to test for differences between means. Differences between medians were tested using non-parametric one-way ANOVAs. If a p-value of less than 0.05 was obtained, three -parametric one-way ANOVAs were used to test for differences between each pair-wise combination of modules. The three p- values were adjusted for using Holm’s step-down procedure to maintain an overall alpha level of 0.05. Scale- type questions such as difficulty of obtaining a drug or perceived health risk of using a drug were allocated scores (e.g. very difficult=4, difficult=3, easy=2 and very easy=1). Differences between the mean scores were tested using one-way ANOVAs with Tukey-Kramer post-hoc adjustments. One-way ANOVAs assume the samples tested form a normal distribution. With scale-type questions such an assumption can never be met as the scores are based on discrete data however frequency tables show the distribution of data as being

Centre for Social and Health Outcomes Research and Evaluation 36 Te Runanga, Wananga, Hauora me te Paekaka mound shaped, providing an approximation of a normal probability distribution. Comparisons between 2006 and 2007 were made using t-tests, non-parametric one-way ANOVAs and Fisher’s exact tests for means, medians and proportions respectively. Comparisons between 2005, 2006 and 2007 for the frequent methamphetamine users were made using t-tests, non-parametric one-way ANOVAs and Fisher’s exact tests for means, medians and proportions respectively. All analysis was run using SAS software.

National household survey data on drug use in the New Zealand population was able to be compared for the age range 15-45 years old for the years 1998, 2001, 2003 and 2006 (Wilkins and Sweetsur, 2008, Wilkins et al., 2002d). All four years of surveying used the same Computer Assisted Interview (CATI) methodology. A previous comparison of national household drug survey data for the age range 15-45 years old using the same CATI methodology has been completed for 1998, 2001 and 2003 (Wilkins et al., 2006). We also present additional population level comparison data for drug types not featured in the publications above, including opiates, ketamine and GHB. Only small numbers of respondents reported using these drug types in the national household surveys and so the findings should be interpreted with caution. To maximise the sample size we do have available for these drug types we provide comparisons for those aged 13-45 years old in these cases.

Centre for Social and Health Outcomes Research and Evaluation 37 Te Runanga, Wananga, Hauora me te Paekaka 2. Demographics of sample

2.1 Introduction

This chapter presents the demographic characteristics of the frequent drug users interviewed for the 2007 IDMS. The demographic characteristics of the sample are presented by type of drug recruited for, and as a combined sample of all the frequent drug users interviewed. The demographic profile of the 2007 sample is compared with the previous 2006 sample.

2.2 Gender

In 2007, 69% of the frequent drug users were male and this is consistent with the demographic profile of drug users interviewed for previous national household drug surveys (see Wilkins et al., 2005d) (Figure 2.1). There were no statistically significant difference in the gender of the three groups of frequent drug user in 2007 (p=0.3323). There was no statistically significant difference in the gender of the frequent drug users in 2007 compared to 2006 (p=0.2427). There was also no statistically significant change in the gender of the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.5748)

Figure 2.1: Frequent drug users by gender, 2007

100%

90% 26% 31% 31% 80% 36%

70%

60% Female 50% Male 40% 74% 69% 64% 69% 30%

20%

10%

0% Meth Ecstasy IDU All

Centre for Social and Health Outcomes Research and Evaluation 38 Te Runanga, Wananga, Hauora me te Paekaka 2.3 Age

In 2007, the age of the frequent drug users ranged from 16-58 years old (Table 2.1). The median age of the whole sample was 28 years (mean 30 years). The frequent ecstasy users had a lower mean age than either the frequent methamphetamine users (23 years vs. 31 years, p<0.0001) or the frequent injecting drug users (23 years vs. 36 years, p<0.0001). The frequent methamphetamine users had a lower mean age than the frequent injecting drug users (31 years vs. 36 years, p<0.0001).

Table 2.1: Frequent drugs users by age, 2007

Age (years) Methamphetamine Ecstasy users Intravenous drug Combined users (n=110) users (IDU) modules (n=324) (MDMA) (n=105) (n=109)

Median age (years) 29 21 37 28 Mean age (years) 31 23 36 30 Range age (years) 16-57 16-50 16-58 16-58

The mean age of the frequent drug users was higher in 2007 than in 2006 (30 years old vs. 28 years old, p=0.0131) and this was largely due to changes among the frequent injecting drug user sample. The mean age of the frequent injecting drug users was higher in 2007 than in 2006 (i.e. 36 years old vs. 32 years old, p=0.0046). There was no statistically significant difference in the mean age of the other two groups of frequent drug users in 2007 compared to 2006. There was also no statistically significant difference in the mean age of the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.5243).

2.4 Ethnicity

In 2007, 80% of the frequent drug users were European, 15% were Maori, 2% were Pacific Islanders and 2% Asian (Table 2.2). More of the frequent ecstasy users than the frequent methamphetamine users were European (90% vs. 67%, p=0.0003) (Figure 2.2). More of the frequent injecting drug users than the frequent methamphetamine users were European (83% vs. 67%, p=0.0148). There was no statistically significant difference in the proportion of the frequent drug users who identified as European in 2007 compared to 2006 (p=0.6162).

Centre for Social and Health Outcomes Research and Evaluation 39 Te Runanga, Wananga, Hauora me te Paekaka Table 2.2: Frequent drugs users by ethnicity, 2007

Ethnicity Methamphetamine Ecstasy users Intravenous Combined users (n=110) (MDMA) (n=105) drug users (IDU) modules (n=324) (n=109) European 67% 90% 83% 80% Maori 25% 5% 15% 15% Pacific Island 4% 1% 0% 2% Asian 1% 4% 0% 2% Other 3% 1% 2% 2%

Figure 2.2: Frequent drugs users by main ethnic group, 2007

6% 2% 6% 100% 6%

90%

80%

70%

60% 67% Other 83% 80% 50% 90% European

40% Maori

30%

20% 25% 10% 15% 15% 5% 0% Meth Ecstasy IDU All

There was no statistically significant difference in the proportion of the frequent methamphetamine users who identified as European in 2007 compared to 2006 and 2005 (p=0.8133) (Table 2.3).

Table 2.3: Frequent methamphetamine users by ethnicity, 2005-2007

2005 2006 2007 Ethnicity Methamphetamine Methamphetamine Methamphetamine users (n=78) users (n=114) users (n=110) European 68% 71% 67% Maori 26% 23% 25% Pacific Island 4% 3% 4% Asian 3% 1% 1% Other 0% 3% 3%

Centre for Social and Health Outcomes Research and Evaluation 40 Te Runanga, Wananga, Hauora me te Paekaka 2.5 Employment status

In 2007, 35% of the frequent drug users were ‘sick or invalid’, 19% were tertiary students and 18% were working full-time (Table 2.4). A further 9% of the frequent drug users were employed on a part-time basis and 11% were unemployed.

Table 2.4: Frequent drug users by employment status, 2007 Employment status Methamphetamine Ecstasy users Intravenous Combined users (n= 110) drug users modules (MDMA) (IDU) (n=109) (n=324) (n=105)

Sick or invalid 40% 8% 56% 35% Tertiary student 6% 53% 0% 19% Working (full-time) 16% 26% 13% 18% Unemployed 15% 9% 11% 11% Working (part- time/casual) 14% 2% 11% 9% Parenting/care-giving or doing unpaid work at home 7% 1% 7% 5% School student 0% 2% 1% 1% Retired 1% 0% 1% 1% Doing illegal work 1% 0% 0% <1%

The frequent ecstasy users were less likely to be ‘unemployed/sick or invalid’ than either the frequent methamphetamine users (17% vs. 64%, p<0.0001) or the frequent injecting drug users (17% vs. 75%, p<0.0001) (Figure 2.3). The frequent injecting drug users were more likely to be ‘unemployed/sick or invalid’ than the frequent methamphetamine users (75% vs. 64%, p=0.0411). The frequent ecstasy users were more likely to be students than either the frequent methamphetamine users (55% vs. 6%, p<0.0001) or the frequent injecting drug users (55% vs. 1%, p<0.0001).

Centre for Social and Health Outcomes Research and Evaluation 41 Te Runanga, Wananga, Hauora me te Paekaka Figure 2.3: Frequent drugs users by main employment status, 2007

100%

90% 17%

80% 52% Unemployed/sickness/ 64% 70% 28% retired/parenting 75% 60% Employed (full/part 50% time) 40% 27%

30% 55% Student (tertiary/high school) 20% 30% 24% 10% 20% 1% 0% 6% Meth Ecstasy IDU All

Overall, there was no statistically significant difference in the employment status of the frequent drug users in 2007 compared to 2006 (p=0.1377). The frequent ecstasy users were statistically significantly more likely to be students and unemployed in 2007 than in 2006 (p<0.0001) (Table 2.5).

Table 2.5: Employment status of the frequent ecstasy users, 2006-2007 2006 2007 Employment status Ecstasy users Ecstasy users (n=111) (n=105)

Students 42% 55% Employed 51% 28% Unemployed 6% 17%

The frequent methamphetamine users were more likely to employed and students in 2005 compared to 2006 (p<0.0001) and 2007 (p<0.0001) (Table 2.6)

Table 2.6: Employment status of the frequent methamphetamine users, 2005-2007 2005 2006 2007 Employment status Methamphetamine Methamphetamine Methamphetamine users (n=77) users (n=114) users (n=110)

Students 18% 13% 6% Employed 51% 22% 30% Unemployed 31% 65% 64%

Centre for Social and Health Outcomes Research and Evaluation 42 Te Runanga, Wananga, Hauora me te Paekaka 2.6 Accommodation

In 2007, 62% of the frequent drug users were currently living in a rented private house with a further 9% currently living in their parents’ or family’s private house (Table 2.7). Ten percent of the frequent drug users were currently living at a boarding house or hostel. Four percent of the frequent drug users were currently homeless or living in a shelter or refuge.

Table 2.7: Frequent drugs users by type of current accommodation type, 2007 Accommodation type Methamphetamine Ecstasy users Intravenous Combined users (n= 110) drug users modules (MDMA) (IDU) (n=109) (n=324) (n=105)

Rented house 48% 77% 62% 62% Boarding house/hostel 9% 5% 17% 10% Parents/family house 8% 12% 7% 9% Drug treatment residence 21% 0% 1% 7% Own house 11% 1% 6% 6% No fixed address/homeless 2% 2% 6% 3% Shelter/refuge 0% 2% 0% 1% Other 1% 1% 1% 1%

2.7 Education

In 2007, 27% of the frequent drug users had no educational qualifications, 31% had a high school qualification, 21% a trade qualification and 20% a tertiary qualification as their highest educational qualification (Figure 2.4). The frequent ecstasy users were less likely to have no educational qualifications than either the frequent methamphetamine users (7% vs. 33%, p<0.0001) or the frequent injecting drug users (7% vs. 41%, p<0.0001). There was no statistically significant difference in the proportion of the frequent drug users who had no educational qualifications 2007 compared to 2006 (p=0.5909). There was also no statistically significant difference in the proportion of the frequent methamphetamine users who had no educational qualifications in 2007 compared to 2006 and 2005.

Centre for Social and Health Outcomes Research and Evaluation 43 Te Runanga, Wananga, Hauora me te Paekaka Figure 2.4: Frequent drugs users by highest educational achievement, 2007

100% 10% 20% 90% 24% 28% 80% 24% 70% 21% Tertiary Qualifications 22% 18% 60% Trade/Technical 25% Certificate/Other 50% 21% High School 31% Qualifications 40% No Qualifications 30% 48%

20% 41% 33% 27% 10% 7% 0% Meth Ecstasy IDU All

2.8 Sexual orientation

The frequent drug users were read four categories of sexual orientation and were asked which best described their own sexual identity. Due to the small numbers of participants indicating non-heterosexual orientations, we do not present a comparison of specific sexual orientation by frequent drug user group. In 2007, 87% of the frequent drug users were heterosexual (n=283), 8% were bisexual (n=25), 4% were gay males (n=12) and 1% lesbian females (n=2) (Figure 2.5).

Figure 2.5: Frequent drugs users by sexual orientation, 2007

1% 8%

Heterosexual Gay male Lesbian Bisexual

87%

Centre for Social and Health Outcomes Research and Evaluation 44 Te Runanga, Wananga, Hauora me te Paekaka In 2007, statistically significantly more of the frequent injecting drug users were non-heterosexual than the frequent methamphetamine users (17% vs. 6%, p=0.0375) (Table 2.8).

Table 2.8: Frequent drug users by broad sexual orientation, 2007 Broad sexual Methamphetamine Ecstasy users Intravenous Combined orientation users (n= 110) drug users (IDU) modules (n=324) (MDMA) (n=105) (n=109)

Heterosexual 94% 86% 83% 87% Non-heterosexual 6% 14% 17% 13%

2.9 Marital status

In 2007, 50% of the frequent drug users were single, 40% were in regular relationships (i.e. regular partner or defacto/married), and 10% were separated, divorced or widowed (Table 2.9). The frequent ecstasy users were statistically significantly more likely to be ‘single’ than either the frequent methamphetamine users (67% vs. 41%, p=0.0006) or frequent injecting drug users (67% vs. 44%, p=0.0078).

Table 2.9: Frequent drugs users by marital status, 2007 Marital status Methamphetamine Ecstasy users Intravenous Combined users (n= 108) drug users (IDU) modules (MDMA) (n=108) (n=321) (n=105)

Single 41% 67% 44% 50% With a regular partner 29% 27% 25% 27% Married/ defacto 15% 3% 21% 13% Separated 6% 3% 7% 6% Divorced 9% 0% 1% 3% Widowed 0% 1% 1% 1%

2.10 Income

In 2007, the frequent methamphetamine users had a statistically significantly higher mean gross annual income (i.e. both from legal and illegal sources) than the frequent injecting drug users ($43,438 vs. $26,589, p=0.0355) (Table 2.10). The frequent methamphetamine users also had a higher mean income than the frequent ecstasy users ($43,438 vs. $23,939, p=0.0111).

Centre for Social and Health Outcomes Research and Evaluation 45 Te Runanga, Wananga, Hauora me te Paekaka Table 2.10: Frequent drugs users by gross annual income, 2007 Gross Annual Methamphetamine Ecstasy users Intravenous drug Combined income (legal + users (n=96) users (IDU) (n=96) modules (n=291) illegal) (MDMA) (n=99)

Median income $27,500 $17,500 $17,500 $22,500 Mean income $43,438 $23,939 $26,589 $31,246 Range income $0-$500,000 $0-$85,000 $2,500-$85,000 $0-$500,000

In 2007, the frequent ecstasy users were statistically significantly more likely to earn less than $20,000 gross annual income than the frequent methamphetamine users (56% vs. 35%, p=0.0186) (Table 2.11).

Table 2.11: Frequent drug users by gross annual income group, 2007

Income Methamphetamine Ecstasy users Intravenous drug Combined users (n=96) users (IDU) (n=96) modules (n=291) (MDMA) (n=99)

0$-$20,000 35% 56% 51% 47% $20,001-$50,000 46% 38% 41% 42% $50,001-$100,000 15% 6% 8% 10% $100,000+ 4% 0% 0% 1%

The frequent drug users had statistically significantly lower mean gross annual incomes ($31,246 vs. $40,942, p<0.0001) and median gross annual incomes ($22,500 vs. $27,500, p=0.023) in 2007 compared to 2006. Lower incomes were found among all the frequent drug user groups (Table 2.12). The mean income of the frequent ecstasy users ($23,939 vs. $32,500, p<0.0001) and the frequent injecting drug users ($26,589 vs. $33,430, p<0.0001) was statistically significantly lower in 2007 compared to 2006. The median income of the frequent methamphetamine users was statistically significantly lower in 2007 than in 2006 ($27,500 vs. $35,000, p=0.0432).

Table 2.12: Frequent drugs users by gross annual income, 2006-2007 2006 2007 Gross Annual Combined Combined income (legal + modules modules illegal) (n=292) (n=291)

Median income 27,500 $22,500 Mean income 40,942 $31,246 Range income $0-600,000 $0-$500,000

The frequent ecstasy users were statistically significantly more likely to earn less than $20,000 gross annual income in 2007 compared to 2006 (56% vs. 30%, p<0.0001) (Table 2.13).

Centre for Social and Health Outcomes Research and Evaluation 46 Te Runanga, Wananga, Hauora me te Paekaka

Table 2.13: Frequent ecstasy users by gross annual income group, 2006-2007

2006 2007 Income Ecstasy users Ecstasy users (n=103) (n=99)

$0-$20,000 30% 56% $20,000+ 70% 44%

There was no statistically significant difference in the mean gross annual income of the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.4519) (Table 2.14).

Table 2.14: Frequent methamphetamine users by gross annual income, 2005-2007 2005 2006 2007 Gross Annual Meth- Meth- Meth- income (legal + amphetamine amphetamine amphetamine illegal) users (n=71) users (n=103) users (n=96)

Median income 27,500 35,000 $27,500 Mean income 43,873 55,655 $43,438 Range income $2,500-500,000 $0-500,000 $0-$500,000

2.11 Location

The IDMS sample of frequent drug users is not intended to be representative of drug use in the general population or of drug use in the centres where recruitment takes place. However, when we employed the same promotion and recruitment methods in each of the three sites we obtained three quite different samples of frequent drug users which may indicate some local variation in drug use. Epidemiological research is required to establish whether the local differences found reflect real differences in drug use between localities or were merely some function of the way the drug using populations responded to the study in each location. In 2007, higher proportions of frequent injecting drug users were recruited in Christchurch while higher proportions of frequent methamphetamine users were recruited in Auckland (Figure 2.6). The higher proportions of frequent methamphetamine users recruited in Auckland are consistent with previous findings from the national household drug survey which found higher proportions of amphetamine use in Auckland and the upper half of the North Island (Wilkins et al., 2005d).

Centre for Social and Health Outcomes Research and Evaluation 47 Te Runanga, Wananga, Hauora me te Paekaka

Figure 2.6: Frequent drugs users by location, 2007

100% 5% 90% 17% 25% 80% 12% 37% 52% 70%

60% 28% Christchurch 50% Wellington Auckland 40% 71% 36% 30% 58% 47% 20%

10% 12% 0% Meth Ecstasy IDU All

2.12 Drug treatment

In 2007, 28% of the frequent drug users reported they were in some form of drug treatment. The frequent ecstasy users were less likely to currently be in drug treatment than either the frequent methamphetamine users (4% vs. 37%, p<0.0001) or the frequent injecting drug users (4% vs. 41%, p<0.0001).

In 2007, 21% of the frequent drug users indicated that they were currently in a methadone maintenance programme and a further 9% said they had been in a methadone programme in the past. More of those among the frequent injecting drug users than frequent methamphetamine users reported they had ever been in a methadone maintenance programme (65% vs. 22%, p<0.0001). Only one frequent ecstasy user reported having ever been in a methadone maintenance programme.

2.13 Previously interviewed for the IDMS

In 2007, 4% of the frequent drug users (n=12) indicated they had participated in a previous wave of the IDMS. This included 2% of the frequent methamphetamine users, 1% of the frequent ecstasy (MDMA) and 8% of the frequent injecting drug users.

Centre for Social and Health Outcomes Research and Evaluation 48 Te Runanga, Wananga, Hauora me te Paekaka 2.14 Summary of the demographics of the frequent drug users

• Two thirds of the frequent drug users were male in 2007 and 2006

• In 2007, the median age of the frequent drug users was 28 years old

• The frequent ecstasy users were younger than both the frequent methamphetamine users and the frequent injecting drug users in 2007 and 2006

• The mean age of the frequent injecting drug users was higher in 2007 than in 2006

• There was no difference in the mean age of frequent methamphetamine users in 2007 compared to 2006 and 2005

• In 2007, 80% of the frequent drug users were European and 15% Maori.

• The frequent ecstasy users and frequent injecting drug users were more likely to be European than the frequent methamphetamine users in 2007 and 2006

• There was no change in the proportion of the frequent methamphetamine users who were non- European in 2007 compared to 2006 and 2005

• In 2007, 46% of the frequent drug users were unemployed, sick or invalid. Only 27% of the frequent drug users were employed (i.e. part-time or full-time) with 20% students (i.e. high school or tertiary). The frequent methamphetamine users and frequent injecting drug users were more likely than the frequent ecstasy users to be unemployed/sick or invalid

• The frequent ecstasy users were more likely to be students and unemployed in 2007 compared to 2006

• The frequent methamphetamine users were more likely to be employed and students in 2005 than in 2006 and 2007

• In 2007, 27% of the frequent drug users had no educational qualifications. The frequent methamphetamine users and frequent injecting drug users were more likely to have no educational qualifications than the frequent ecstasy users

• There was no difference in the proportion of frequent drug users who had no educational qualifications in 2007 compared to 2006

• There was also no difference in the proportion of frequent methamphetamine users who had no educational qualifications in 2007 compared to 2006 and 2005

• In 2007, the frequent drug users had a median annual gross income of $22,500. The frequent ecstasy users were more likely to earn less than $20,000 gross annual income than the frequent methamphetamine users

Centre for Social and Health Outcomes Research and Evaluation 49 Te Runanga, Wananga, Hauora me te Paekaka • The frequent drug users had lower mean gross annual incomes ($31,246 vs. $40,942, p<0.0001) and lower median gross annual incomes (22,500 vs. $27,500, p=0.023) in 2007 compared to 2006

• In 2007, the largest fall in annual incomes was found among the frequent ecstasy users and this is likely to reflect the fact that more of the frequent drug users were students and unemployed in 2007 than in 2006

• There was no difference in the mean income of the frequent methamphetamine users in 2007 compared to 2006 and 2005

Centre for Social and Health Outcomes Research and Evaluation 50 Te Runanga, Wananga, Hauora me te Paekaka 3. Drug use patterns

3.1 Introduction

The frequent drug users were asked a series of questions about their use of a range of different drug types including alcohol, tobacco, amphetamines, hallucinogens, opiates, and pharmaceuticals. The frequent drug users were asked whether they had used a particular drug type in their lifetimes and whether they had used the drug in the past six months. If a frequent drug user indicated they had used a drug type in the past six months they were asked on how many days they had used the drug in the past six months and how they had administered the drug in the previous six months.

3.2 Extent of poly drug use

In 2007, the frequent drug users had tried an average of 14 drug types in their lifetimes (median 14, range 3- 24). The frequent injecting drug users had used a greater average number of drug types in their lifetimes than the frequent ecstasy users (15 vs. 11 drug types, p<0.0001). The frequent methamphetamine users had also used a greater average number of drug types in their lifetimes than the frequent ecstasy users (15 vs. 11 drug types, p<0.0001).

In 2007, the frequent drug users had used an average of seven drug types in the past six months (median 7, range 1-21). The frequent methamphetamine users had used a greater number of drug types in the previous six months than the frequent ecstasy users (8 vs. 7 drug types, p=0.0045) and the frequent injecting drug users (8 vs. 7 drug types, p=0.05).

3.3 Drug use patterns of the frequent methamphetamine users

In 2007, the drug types most commonly used by the frequent methamphetamine users in the previous six months were methamphetamine (97%), cannabis (87%), tobacco (84%), alcohol (79%), crystal methamphetamine (66%), ecstasy (MDMA) (52%), BZP party pills (43%) and LSD (34%) (Table 3.1). A lower proportion of the frequent methamphetamine users had used BZP party pills in 2006 compared to 2005 (31% vs. 58%, p=0.0009). A higher proportion of frequent methamphetamine users had used ‘other opiates’ in 2007 compared to 2006 (32% vs. 18%) and this was close to being statistically significant (p=0.0582). A higher proportion of the frequent methamphetamine users had used methadone in 2007 compared to 2005 (26% vs. 12%, p=0.048). A higher proportion of the frequent methamphetamine users had used magic mushrooms (psilocybin) in 2007 compared to 2006 (26 vs. 11%, p=0.0058). Changes to the format of the magic mushrooms question may have inflated the number of people indicating they had used this drug in 2007 compared to 2006. In 2007, a stand alone category was created in the questionnaire for magic

Centre for Social and Health Outcomes Research and Evaluation 51 Te Runanga, Wananga, Hauora me te Paekaka mushrooms as fairly large numbers of people had mentioned this drug type in the ‘other’ category of the question in 2006. As a result ‘magic mushrooms’ was actively read out to the participants in 2007. Previously, in 2006, magic mushrooms was only recorded if the participant indicated they had used this drug type in answer to a general question at the end of the section concerning whether they had used any other drug types in the past six months which had not been previously mentioned by the interviewer (i.e. ‘any other drugs?’). A lower proportion of the frequent methamphetamine users had used nitrous oxide in 2006 compared to 2005 (15% vs. 47%, p<0.0001) and in 2007 compared to 2005 (24% vs. 47%, p=0.0018).

Table 3.1: Poly drug use of the frequent methamphetamine users, 2005-2007

2005 2006 2007 2005 2006 2007 2005 2006 2007

Drug type Last six Last six Last six Mean Mean Mean Injected Injected Injected months months months days days days past six past six past six (n=78) (n=114) (n=110) used used used months months months Methamphetamine 100% 100% 97% 46 days 59 days 68 days 31% 28% 35%

Cannabis 79% 86% 87% 105 days 118 days 123 days - - -

Tobacco 71% 81% 84% 160 days 162 days 175 days - - -

Alcohol 74% 86% 79% 58 days 66 days 67 days - - -

Crystal 64% 66% 66% 30 days 56 days 46 days 27% 28% 34% methamphetamine Ecstasy (MDMA) 45% 49% 52% 12 days 7 days 9 days 6% 16% 7%

BZP party pills 58% 31% 43% 15 days 12 days 11 days 2% 3% 9%

LSD 31% 34% 34% 3 days 7 days 15 days 8% 0% 0%

Benzodiazepines 23% 25% 33% 29 days 45 days 42 days 11% 11% 3%

Other opiates 22% 18% 32% 63 days 41 days 51 days 82% 60% 77% (morphine, MST, homebake, M- Eslon, Kapanol) Methadone 12% 15% 26% 78 days 93 days 86 days 89% 71% 59%

Magic mushrooms n/a 11% 26% - 4 days 11 days - - - (psilocybin) Ritalin n/a 21% 24% - 12 days 31 days - 58% 62% (methylphenidate) Nitrous oxide 47% 15% 24% 12 days 10 days 3days - - -

Amphetamine 28% 25% 20% 12 days 19 days 31 days 18% 24% 23%

GHB 21% 13% 16% 22 days 5 days 37 days 0% 0% 0%

Ketamine 8% 6% 14% 6 days 4 days 5 days 0% 0% 7%

Anti-depressants 13% 5% 14% 60 days 19 days 77 days 10% 0% 13%

Amyl nitrate 18% 11% 12% 4 days 6 days 18 days - - -

Cocaine 15% 11% 7% 4 days 5 days 28 days 17% 17% 25%

MDA 9% 5% 7% 3 days 1 days 7 days 0% 0% 0%

Heroin 5% 8% 6% 63 days 35 days 73 days 75% 89% 100%

Centre for Social and Health Outcomes Research and Evaluation 52 Te Runanga, Wananga, Hauora me te Paekaka Solvents n/a 1% 3% - 24 days 3 days - - -

When a frequent methamphetamine user indicated they had used a drug type in the past six months they were then asked on how many days they had used the drug during the previous six months. In 2007, the drug types used by the frequent methamphetamine users on the greatest number of days, on average, during the past six months were tobacco (175 days), cannabis (123 days), methadone (86 days), anti-depressants (77 days) and heroin (73 days) (Table 3.1). The frequent methamphetamine users had, on average, used methamphetamine on a greater number of days in 2007 compared to 2005 (68 days vs. 46 days, p=0.006) and in 2006 compared to 2005 (59 days vs. 46 days, p=0.0364). The frequent methamphetamine users had, on average, smoked tobacco on more days in 2007 than in 2006 (175 days vs. 162 days, p=0.0344) and compared to 2005 (175 days vs. 160 days, p<0.0001). The frequent methamphetamine users had, on average, used crystal methamphetamine on more days in 2007 than in 2005 (46 days vs. 30 days, p=0.044) and on more days in 2006 compared to 2005 (56 days vs. 30 days, p=0.0333). The frequent methamphetamine users had used LSD on more days in 2007 than in 2005 (15 days vs. 3 days) and this was close to being statistically significant (p=0.0528). The frequent methamphetamine users had, on average, used Ritalin (methylphenidate) on a greater number of days in 2007 compared to 2006 (31 days vs. 12 days, p=0.0369).

When a frequent methamphetamine user had used a drug type in the past six months they were also asked about all the different ways they had administered the drug during the past six months. In 2007, the drug types most commonly injected by the frequent methamphetamine users in the past six months were heroin (100%), other opiates (77%), Ritalin (62%), methadone (59%), methamphetamine (35%) and crystal methamphetamine (34%) (Table 3.1). There was no statistically significant change among the frequent methamphetamine users with respect to the level of injection of drug types in 2007 compared to 2006 and 2005.

3.4 Drug use patterns of the frequent ecstasy (MDMA) users

In 2007, the drug types most commonly used by the frequent ecstasy users in the past six months were ecstasy (100%), alcohol (96%), cannabis (89%), tobacco (67%), BZP party pills (45%) and LSD (40%) (Table 3.2). The drug type which a greater proportion of the frequent ecstasy users had used in 2007 compared to 2006 was magic mushrooms (31% vs. 17%, p=0.0169). As discussed in the previous section, the magic mushrooms question was reformatted in 2007 and this may have resulted in a higher level of recorded use in 2007 compared to 2006. The drug types which a lower proportion of the frequent ecstasy users had used in 2007 compared to 2006 were BZP party pills (45% vs. 65%, p=0.004) and nitrous oxide (32% vs. 49%, p=0.0185).

Centre for Social and Health Outcomes Research and Evaluation 53 Te Runanga, Wananga, Hauora me te Paekaka Table 3.2: Poly drug use of the frequent ecstasy (MDMA) users, 2006-2007

2006 2007 2006 2007 2006 2007 Drug type Last six Last six Mean Mean Injected Injected months months days used days used past six past six (n=111) (n=105) months months Ecstasy (MDMA) 100% 100% 9 days 10 days 0% 4%

Alcohol 98% 96% 50 days 66 days - -

Cannabis 92% 89% 58 days 61 days - -

Tobacco 61% 67% 107 days 104 days - -

BZP party pills 65% 45% 8 days 11 days 0% 0%

LSD 49% 40% 4 days 5 days 0% 0%

Nitrous oxide 49% 32% 10 days 8 days - -

Magic mushrooms 17% 31% 6 days 3 days - - (psilocybin) Amphetamine 32% 30% 5 days 5 days 3% 3%

Methamphetamine 23% 23% 13 days 6 days 8% 8%

Amyl nitrate 18% 15% 5 days 2 days - -

Ritalin 13% 14% 13 days 7 days 14% 7% (methylphenidate) Crystal 5% 11% 31 days 4 days 17% 0% methamphetamine Benzodiazepines 13% 10% 13 days 41 days 0% 0%

Ketamine 11% 10% 8 days 4 days 0% 0%

GHB 11% 10% 12 days 4 days 0% 0%

MDA 16% 10% 4 days 1 day 0% 18%

Other opiates 10% 8% 6 days 3 days 18% 25% (morphine, MST, homebake, M- Eslon, Kapanol) Cocaine 9% 6% 2 days 7 days 0% 0%

Anti-depressants 3% 5% 5 days 4 days 0% 20%

Methadone 2% 3% 6 days 61 days 33% 33%

Solvents 0% 1% 0 days 1 day - -

Heroin 0% 0% 0 days 0 days 0% 0%

Centre for Social and Health Outcomes Research and Evaluation 54 Te Runanga, Wananga, Hauora me te Paekaka When a frequent ecstasy user indicated they had used a drug type in the past six months they were then asked on how many days they had used the drug during the previous six months. In 2007, the drug types used by the frequent ecstasy users on the greatest number of days, on average, during the past six months were methadone (105 days), tobacco (104 days), alcohol (66 days), cannabis (61 days) and benzodiazepines (41 days) (Table 3.2). The drug type which the frequent ecstasy users had, on average, used on a greater number of days in 2007 compared to 2006 was alcohol (66 vs. 50 days, p=0.0029). The drug types which the frequent ecstasy users had, on average, used on a fewer number of days in 2007 compared 2006 were magic mushrooms (3 vs. 6 days, p=0.0169) and crystal methamphetamine (4 days vs. 31 days, p=0.011).

When a frequent ecstasy user had used a drug type in the past six months they were also asked about all the different ways they had administered the drug during the past six months. In 2007, the drug types most commonly injected by the frequent ecstasy users in the past six months were methadone (33%), other opiates (25%), anti-depressants (20%), and MDA (18%) (Table 3.2). There was no statistically significant change among the frequent ecstasy users with respect to the level of injection of drug types in 2007 compared to 2006.

3.5 Drug use patterns of the frequent injecting drug users

In 2007, the drug types most commonly used by the frequent injecting drug users in the previous six months were tobacco (90%), cannabis (85%), alcohol (72%), methadone (72%), other opiates (71%), benzodiazepines (54%), methamphetamine (45%) and Ritalin (42%) (Table 3.3). The drug types which a lower proportion of the frequent injecting drug users had used in 2007 compared to 2006 were ‘heroin’ (12% vs. 24%, p=0.0394) and MDA (1% vs. 8%, p=0.0253). A lower proportion of the frequent injecting drug users had used nitrous oxide in 2007 compared to 2006, and this was close to being statistically significant (22% vs. 11%, p=0.053).

Centre for Social and Health Outcomes Research and Evaluation 55 Te Runanga, Wananga, Hauora me te Paekaka Table 3.3: Poly drug use of the frequent injecting drug users, 2006-2007

2006 2007 2006 2007 2006 2007

Drug type Last six Last six Mean Mean Injected Injected months months days used days used past six past six (n=93) (n=109) months months Tobacco 86% 90% 181 days 174 days - -

Cannabis 80% 85% 123 days 107 days - -

Alcohol 68% 72% 48 days 36 days - -

Methadone 74% 72% 92 days 133 days 56% 64%

Other opiates 77% 71% 85 days 84 days 96% 99% (morphine, MST, homebake, M- Eslon, Kapanol) Benzodiazepines 57% 54% 43 days 46 days 10% 12%

Methamphetamine 40% 45% 43 days 12 days 70% 65%

Ritalin 43% 42% 41 days 39 days 90% 93% (methylphenidate) BZP party pills 30% 31% 6 days 23 days 32% 74%

Ecstasy (MDMA) 29% 22% 6 days 8 days 44% 33%

Crystal 24% 18% 42 days 16 days 68% 80% methamphetamine Amphetamine 18% 17% 19 days 24 days 71% 61%

LSD 20% 15% 3 days 3 days 0% 6%

Amyl nitrate 16% 13% 15 days 2 days - -

Heroin 24% 12% 71 days 67 days 100% 92%

Nitrous oxide 22% 11% 7 days 7days - -

Magic mushrooms 5% 10% 3 days 3 days - - (psilocybin) Anti-depressants 9% 8% 8 days 12 days 0% 0%

Ketamine 4% 6% 2 days 2 days 100% 67%

Solvents 2% 2% 1 day 1 day - -

GHB 3% 2% 2 days 2 days 0% 0%

MDA 8% 1% 6 days 1 days 75% -

Cocaine 9% 1% 9 days 1 days 17% -

When a frequent injecting drug user indicated they had used a drug type in the past six months they were then asked on how many days they had used the drug during the previous six months. In 2007, the drug types used by the frequent injecting drug users on the greatest number of days, on average, during the previous six months were tobacco (174 days), methadone (133 days), cannabis (107 days), other opiates (84 days), heroin (67 days), benzodiazepines (46 days) and Ritalin (39 days) (Table 3.3). The drug types which the frequent Centre for Social and Health Outcomes Research and Evaluation 56 Te Runanga, Wananga, Hauora me te Paekaka injecting drug users had, on average, used on a greater number of days in 2007 compared to 2006 were BZP party pills (23 vs. 6 days, p=0.0275) and methadone (133 days vs. 92 days, p=0.0033). The drug types which the frequent injecting drug users had, on average, used on a fewer number of days in 2007 compared 2006 were crystal methamphetamine (16 vs. 42 days, p=0.0419) and methamphetamine (12 days vs. 43 days, p=0.0064).

When a frequent injecting drug user had used a drug type in the previous six months they were also asked about all the different ways they had administered the drug during the past six months. In 2007, the drug types most commonly injected by the frequent injecting drug users in the past six months were other opiates (99%), Ritalin (93%), heroin (92%), crystal methamphetamine (80%), ketamine (67%), methamphetamine (65%) and methadone (64%) (Table 3.3). The frequent injecting drug users were statistically significantly more likely to have injected BZP party pills in 2007 compared to 2006 (74% vs. 32%, p=0.0019).

3.6 Drug of choice

The frequent drug users were asked what their main drug of choice was (i.e. their favourite or preferred drug). In 2007, the drug type most commonly mentioned by the frequent methamphetamine users as their drug of choice was methamphetamine (31%), followed by cannabis (26%) and alcohol (11%) (Table 3.4). The frequent methamphetamine users were more likely to name alcohol as their drug of choice in 2007 compared to 2006 and 2005, and this difference was close to being statistically significant (p=0.0666). The frequent methamphetamine users were statistically significantly less likely to name ecstasy as their drug of choice in 2007 compared to 2005 (4% vs. 18%, p=0.0069). They were also statistically significantly less likely to name ecstasy as their drug of choice in 2006 compared to 2005 (5% vs. 18%, p=0.0194). Otherwise there was no statistically significant change in the frequent methamphetamine user’s drug of choice between 2007 and 2006 and 2005.

Centre for Social and Health Outcomes Research and Evaluation 57 Te Runanga, Wananga, Hauora me te Paekaka Table 3.4: Drug of choice by frequent methamphetamine users, 2005-2007 2006 2006 2007 Drug of choice Meth- Meth- Meth- amphetamine amphetamine amphetamine users (n=67) users (n=112) users (n=109)

Meth- 25% 34% 31% amphetamine Cannabis 28% 27% 26% Alcohol 3% 4% 11% Heroin 6% 7% 8%

Amphetamine 0% 1% 5% sulphate

Other opiates 6% 1% 5%

Ecstasy (MDMA) 18% 5% 4% Crystal meth 0% 6% 4% amphetamine LSD 3% 6% 3% Tobacco 0% 1% 1% Methadone 1% 0% 1% Cocaine 6% 5% 1% GHB 0% 0% 1% Benzodiazepines 0% 0% 1% BZP party pills 0% 0% 0% Nitrous oxide 0% 0% 0% Ketamine 1% 0% 0% Steroids 0% 0% 0% Ritalin 0% 0% 0% (methylphenidate)

The drug type most commonly mentioned by the frequent ecstasy users as their drug of choice in 2007 was ecstasy (51%), followed by cannabis (17%) and alcohol (11%) (Table 3.5). There was no statistically significant change in the frequent ecstasy user’s drug of choice between 2007 and 2006. The drug type most commonly mentioned by the frequent injecting drug users as their drug of choice in 2007 was ‘other opiates’ (48%), followed by methadone (19%) and Ritalin (11%). The drug types which a lower proportion of frequent injecting drug users named as their ‘drug of choice’ in 2007 compared to 2006 were heroin (4% vs. 12%, p=0.0295) and amphetamine sulphate (5% vs. 13%, p=0.0393). The drug types which a higher proportion of frequent injecting drug users named as their ‘drug of choice’ in 2007 compared to 2006 were methadone (19% vs. 8%, p=0.0246) and Ritalin (11% vs. 0%, p<0.0001).

Centre for Social and Health Outcomes Research and Evaluation 58 Te Runanga, Wananga, Hauora me te Paekaka Table 3.5: Drug of choice by frequent ecstasy users and frequent injecting drug users, 2006-2007 2006 2007 2006 2007 Drug of choice Ecstasy Ecstasy Intravenous Intravenous users users drug users drug users (MDMA) (MDMA) (IDU) (IDU) (n=103) (n=103) (n=109) (n=109)

Meth- 8% 1% 1% 6% amphetamine Cannabis 16% 17% 0% 0% Alcohol 17% 11% 0% 0% Heroin 1% 0% 12% 4%

Amphetamine 2% 1% 13% 5% sulphate

Other opiates 1% 0% 55% 48%

Ecstasy (MDMA) 49% 51% 0% 2% Crystal meth 0% 1% 3% 1% amphetamine LSD 7% 7% 0% 0% Tobacco 0% 1% 0% 0% Methadone 0% 0% 8% 19% Cocaine 4% 4% 0% 0% GHB 0% 0% 0% 0% Benzodiazepines 1% 1% 0% 1% BZP party pills 1% 0% 0% 4% Nitrous oxide 0% 1% 0% 0% Ketamine 1% 1% 0% 0% Steroids 0% 0% 0% 1% Ritalin 0% 1% 0% 11% (methylphenidate)

Centre for Social and Health Outcomes Research and Evaluation 59 Te Runanga, Wananga, Hauora me te Paekaka 3.7 Concurrent use of drugs

In 2007, 91% of the frequent methamphetamine users usually used other drug types when they used methamphetamine. The drug types most commonly used in combination with methamphetamine were cannabis (66%), tobacco (58%), alcohol (55%) and other opiates (19%) (Table 3.6). Eighty-nine percent of the frequent ecstasy (MDMA) users usually used other drug types with their ecstasy (MDMA). The drug types most commonly used in combination with ecstasy (MDMA) were alcohol (85%), cannabis (41%) and tobacco (40%). Forty-seven percent of the frequent ecstasy users typically drank five or more standard drinks in a single session. Seventy-five percent of the injecting drug users usually used other drug types with the drug they injected. The drug types most commonly used at the same time as the drug they injected were tobacco (55%), cannabis (54%), benzodiazepines (30%) and alcohol (23%). There were some changes in the drug types which the frequent methamphetamine used in combination with methamphetamine in 2007 compared to 2006. The frequent methamphetamine users were statistically significantly more likely to use ‘other opiates’ in combination with methamphetamine in 2007 compared to 2006 (19% vs. 4%, p=0.0021) (Table 3.6). The frequent methamphetamine users were less likely to use ‘other opiates’ in combination with methamphetamine in 2006 compared to 2005 (4% vs. 14%, p=0.0444). The frequent methamphetamine users were statistically significantly less likely to have used nitrous oxide in combination with methamphetamine in 2007 compared to 2005 (0% vs. 13%, p=0.0009).

Centre for Social and Health Outcomes Research and Evaluation 60 Te Runanga, Wananga, Hauora me te Paekaka

Table 3.6: Other drug types used concurrently with methamphetamine, 2005-2007

2006 2006 2007

Drug types used Methamphetamine Methamphetamine Methamphetamine concurrently users (n=71) users (n=102) users (n=100) Cannabis 67% 74% 66% Tobacco 68% 83% 58% Alcohol 46% 61% 55% Other opiates 14% 4% 19% Benzodiazepines 7% 9% 12% Crystal 17% 5% 12% methamphetamine Ecstasy (MDMA) 18% 9% 11% Amphetamine 14% 4% 6% sulphate GHB 13% 1% 6% LSD 8% 4% 5% BZP party pills 8% 7% 3% Cocaine 6% 1% 3% Heroin 1% 4% 2% MDA 10% 0% 2% Ketamine 6% 0% 2% Amyl/Butyl nitrate 4% 0% 2% Nitrous oxide 13% 4% 0%

3.8 Drug types used to recover from drug use

In 2007, 83% of the frequent methamphetamine users usually used other drug types to help them recover from their methamphetamine use. The drug types most commonly used to recover from methamphetamine were cannabis (69%), tobacco (45%), benzodiazepines (19%), alcohol (16%) and other opiates (12%) (Table 3.7). Sixty-two percent of the frequent ecstasy (MDMA) users usually used other drug types to help them recover from their ecstasy (MDMA) use. The drug types most commonly used to recover from ecstasy (MDMA) were cannabis (82%), tobacco (20%), alcohol (14%) and benzodiazepines (14%). Forty-five percent of the injecting drug users usually used other drug types to help them recover from the drug they inject. The drug types most commonly used to help recover from the drug they inject were cannabis (53%), benzodiazepines (16%), tobacco (16%), alcohol (16%) and other opiates (14%).

Centre for Social and Health Outcomes Research and Evaluation 61 Te Runanga, Wananga, Hauora me te Paekaka Table 3.7: Other drug types used to recover from methamphetamine, ecstasy (MDMA) and injecting drug use, 2007

Drug types used to Methamphetamine Ecstasy users Intravenous drug recover users (n= 91) (MDMA) (n=65) users (IDU) (n=49)

Cannabis 69% 82% 53% Tobacco 45% 20% 16% Benzodiazepines 19% 14% 16% Alcohol 16% 14% 16% Other opiates 12% 0% 14% Crystal 4% 2% 2% methamphetamine

Ecstasy (MDMA) 2% 0% 0% LSD 2% 2% 0% GHB 2% 0% 0% BZP party pills 1% 0% 0% Amphetamine 0% 0% 4% sulphate

Nitrous oxide 0% 2% 0% Cocaine 0% 3% 0% Methamphetamine 0% 2% 2% MDA 0% 0% 0% Ketamine 0% 2% 0% Amyl/Butyl nitrate 0% 0% 0%

Centre for Social and Health Outcomes Research and Evaluation 62 Te Runanga, Wananga, Hauora me te Paekaka 3.9 Binging on drugs

The frequent drug users were asked what drug types they had binged on in the previous six months. Binging on a drug was defined as using a drug for 48 hours or more continuously without sleep. In 2007, 60% of the frequent drug users had binged on a drug in the previous six months. This included 81% of the frequent methamphetamine users, 45% of the frequent ecstasy (MDMA) users, and 52% of the frequent injecting drug users. The drug types which the frequent methamphetamine users most commonly binged on were methamphetamine (88%), alcohol (43%), cannabis (38%), and crystal methamphetamine (38%) (Table 3.8). The drug types which the frequent ecstasy (MDMA) users most commonly binged on were alcohol (87%), ecstasy (81%), cannabis (55%), legal piperazine party pills (21%), amphetamine sulphate (15%) and LSD (13%). The drug types which the frequent injecting drug users most commonly binged on were methamphetamine (56%), alcohol (50%), cannabis (41%), ecstasy (31%) and crystal methamphetamine (23%).

Table 3.8: Drug types binged on in the previous six months, 2007

Drug types binged Methamphetamine Ecstasy users Intravenous drug Combined on (used 48 hours users (n= 89) (MDMA) (n=47) users (IDU) modules +) (n=57) (n=193) Methamphetamine 88% 19% 39% 56% Alcohol 43% 87% 32% 50% Cannabis 38% 55% 33% 41% Crystal 38% 2% 16% 23% methamphetamine

Ecstasy (MDMA) 19% 81% 7% 31% LSD 18% 13% 2% 12% BZP party pills 11% 21% 18% 16%

Other opiates 10% 0% 30% 13% Amphetamine 9% 15% 4% 9% sulphate

GHB 8% 6% 0% 5% Methadone 7% 0% 11% 6% Ketamine 4% 0% 0% 2% Anti-depressants 4% 0% 0% 2% Amyl/Butyl nitrate 3% 0% 0% 2% Heroin 3% 0% 4% 3% Cocaine 3% 6% 0% 3% Benzodiazepines 2% 2% 16% 6% MDA 2% 0% 0% 1% Nitrous oxide 1% 6% 0% 2%

Centre for Social and Health Outcomes Research and Evaluation 63 Te Runanga, Wananga, Hauora me te Paekaka 3.10 New drug types

The frequent drug users were asked if they had heard about any new drug types in the past six months. In 2007, a total of 58 frequent drug users provided reports of new drug types. We will present those changes which were confirmed by from more than one frequent drug user. Six frequent drug users reported new types of ‘BZP free’ party pills. Five frequent drug users reported an increase in the number of people injecting BZP party pills. Five frequent drug users reported different forms of ice and that methamphetamine was being used by a wider cross section of the population. Five frequent drug users reported a new type of slow release Ritalin in new quantities. Three frequent drug users reported an increase in ecstasy use and new types of ecstasy. Two frequent drug users said ketamine was now more popular.

3.11 New types of drug users

The frequent drug users were asked if they had seen any new types of drug users in the previous six months. In 2007, a total of 77 frequent drug users provided reports of new types of drug user. We will present those changes which were confirmed by from more than one frequent drug user. Thirty-five frequent drug users said they had noticed more ‘younger’ drug users in the past six months. Two of the frequent drug users noting this trend toward younger users also said they had observed more ‘girls’ using drugs. Twenty-three frequent drug users said there was now a wider range of people using drugs including older people, middle class people and professionals. Six frequent drug users reported increased intravenous drug use. Three frequent drug users reported that more people were injecting BZP party pills.

3.12 Increase in drug use by some users

The frequent drug users were asked if there had been any increase in drug use by some drug users in the previous six months. In 2007, a total of 77 frequent drug users provided reports of increases. We will present those increases which were confirmed by more than one frequent drug user. There were further reports of some of the themes raised in the previous open questions in this section. Sixteen frequent drug users said they were seeing more ‘younger’ drug users. Five frequent drug users said they had observed greater use of Ritalin over the previous six months. Twenty-one frequent drugs said they were seeing more people using methamphetamine over the past six months. Related to this theme, a further 11 frequent drug users reported existing methamphetamine users using more methamphetamine. Eight frequent drug users reported they had seen an increase in ecstasy use over the past six months. Related to this theme, a further six frequent drug users said that ecstasy users were using ecstasy more often and were also using more of other drugs.

Centre for Social and Health Outcomes Research and Evaluation 64 Te Runanga, Wananga, Hauora me te Paekaka 3.13 Different means of administering drugs

The frequent drug users were asked if there had seen people administering drugs in new ways in the past six months. In 2007, a total of 65 frequent drug users provided reports of new ways of taking drugs. We will present the reports which were confirmed by from more than one frequent drug user. Eleven frequent drug users reported more injection of drugs. One frequent drug user specifically reported an increase in the injection of ecstasy. Another frequent drug user specifically mentioned an increase in the injection of BZP and two an increase in the injection of methamphetamine. Eleven frequent drug users said there was now more shafting of drugs (i.e. insertion in the anus), and five of these frequent drug users mentioned this behaviour in relation to ecstasy. Eleven frequent drug users reported more powder ecstasy and the snorting of ecstasy.

3.14 Different ways of selling drugs

The frequent drug users were asked if they noticed any new ways that drugs were being sold in the past six months. In 2007, a total of 26 frequent drug users provided reports of changes in the ways in which drugs were being sold. Four frequent drug users reported more open selling of drugs from the streets.

3.15 Summary of drug use patterns

• In 2007, the drug types most commonly used by the frequent methamphetamine users were methamphetamine, cannabis, tobacco, alcohol, crystal methamphetamine and ecstasy

• A higher proportion of the frequent methamphetamine users had used methadone in 2007 compared to 2005

• A lower proportion of the frequent methamphetamine users had used nitrous oxide in 2007 compared to 2005

• A lower proportion of the frequent methamphetamine users had used BZP party pills in 2006 compared to 2005

• The frequent methamphetamine increased the number of days they used methamphetamine and tobacco in 2007 compared to 2006 and 2005

• The frequent methamphetamine users used crystal methamphetamine on more days in 2007 and 2006 compared to 2005

• In 2007, the drug types most commonly used by the frequent ecstasy users were ecstasy (MDMA), alcohol, cannabis, tobacco and BZP party pills

Centre for Social and Health Outcomes Research and Evaluation 65 Te Runanga, Wananga, Hauora me te Paekaka • A lower proportion of the frequent ecstasy users had used BZP party pills and nitrous oxide in 2007 compared to 2006

• The frequent ecstasy users increased the number of days they used alcohol in 2007 compared to 2006

• The frequent ecstasy users decreased the number of days they used magic mushrooms and crystal methamphetamine in 2007 compared to 2006

• In 2007, the drug types most commonly used by the frequent injecting drug users were tobacco, cannabis, alcohol, methadone, other opiates, benzodiazepines, methamphetamine and Ritalin

• A lower proportion of the frequent injecting drug users had used heroin, MDA and nitrous oxide in 2007 compared to 2006

• The frequent injecting drug users increased the number of days they used BZP party pills and methadone in 2007 compared to 2006

• The frequent injecting drug users decreased the number of days they used crystal methamphetamine and methamphetamine in 2007 compared to 2006

• A greater proportion of the frequent injecting drug users had injected BZP party pills in 2007 compared to 2006

• A higher proportion of the frequent injecting drug users named methadone and Ritalin as their drug of choice in 2007 compared to 2006

• A lower proportion of the frequent injecting drug users named heroin and amphetamine sulphate as their drug of choice in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 66 Te Runanga, Wananga, Hauora me te Paekaka 4. Methamphetamine

4.1 Introduction

Methamphetamine (‘P’, or ‘pure’) is a powerful psychostimulant with pharmacological characteristics and effects which closely resemble those of cocaine (Gawin and Ellinwood, 1988, Hall and Hando, 1994, Kuhn et al., 1998, Shearer et al., 2002). Chronic and high dose use of methamphetamine causes hostility, paranoia, hallucinations, and obsessive behaviour (Hall and Hando, 1994, Kuhn et al., 1998, Shearer et al., 2002). Heavy methamphetamine users often go on extended binges where they use the drug continuously over several days or even weeks without sleep. As a binge lengthens the user experiences states of panic and terror, which can lead to paranoid psychoses resembling schizophrenia in people with no pre-existing psychological conditions (Gawin and Ellinwood, 1988). Binges end in a ‘crash’ characterised by depression, fatigue, insomnia, headaches, and a strong psychological craving to use the drug again (Gawin and Ellinwood, 1988). Physiological harm from methamphetamine use includes damage to cardiac and vascular systems, and damage to dopamine terminals in the brain, with possible implications for mood and movement disorder in later life (Kuhn et al., 1998, Shearer et al., 2002).

4.2 Knowledge of methamphetamine trends

In 2007, 56% of the frequent drug users interviewed (n=179) indicated they felt confident enough to comment on the price, purity and availability of methamphetamine in the previous six months. This included 93% of the frequent methamphetamine users (n=100), 25% of the frequent ecstasy users (n=26) and 49% of the frequent injecting drug users (n=53).

4.3 Availability of methamphetamine

4.3.1 Current availability

In 2007, 47% of the frequent drug users described the current availability of methamphetamine as ‘easy’, with a further 38% describing the availability of the drug as ‘very easy’ (Table 4.1). The average score for the current availability of methamphetamine for all the frequent drug users was 1.8 which indicates that overall the current availability of methamphetamine was ‘easy/very easy’ in 2007. There was no statistically significant difference in the average score of availability between the three groups of frequent drug users, with all three groups indicating the current availability of methamphetamine was ‘easy/very easy’ in 2007 (p=0.597).

Centre for Social and Health Outcomes Research and Evaluation 67 Te Runanga, Wananga, Hauora me te Paekaka Table 4.1: Current availability of methamphetamine by frequent drug user group, 2007 Current availability Methamphetamine Ecstasy users Intravenous drug Combined of users (MDMA) users (IDU) modules methamphetamine (n=102) (n=23) (n=51) (n=176) (%) Very easy [1] 36% 35% 43% 38% Easy [2] 50% 43% 43% 47% Difficult [3] 13% 17% 12% 13% Very difficult [4] 1% 4% 2% 2% Average availability score (1=very easy – 1.8 1.9 1.7 1.8 4=very difficult) Overall current Easy/ Easy/ Easy/ Easy/ status very easy very easy very easy very easy

There was no statistically significant change in the average score of the current availability of methamphetamine in 2007 compared to 2006 (p=0.7732) indicating the availability of methamphetamine has remained ‘easy/very easy’ over the past two years (Table 4.2).

Table 4.2: Current availability of methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Current availability Combined Combined of modules modules methamphetamine (n=176) (n=176) (%) Very easy [1] 38% 38% Easy [2] 44% 47% Difficult [3] 16% 13% Very difficult [4] 1% 2% Average availability score (1=very easy 1.8 1.8 – 4=very difficult) Overall current Easy/ Easy/ status very easy very easy

Centre for Social and Health Outcomes Research and Evaluation 68 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant change in the average score of the current availability of methamphetamine by the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.1614) indicating the availability of methamphetamine has remained ‘easy/very easy’ over the past three years (Table 4.3).

Table 4.3: Current availability of methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Current availability Methamphetamine Methamphetamine Methamphetamine of users users users methamphetamine (n=71) (n=106) (n=102) (%) Very easy [1] 52% 43% 36% Easy [2] 38% 42% 50% Difficult [3] 10% 13% 13% Very difficult [4] 0% 2% 1% Average availability score (1=very easy 1.6 1.7 1.8 – 4=very difficult) Overall current Easy/ Easy/ Easy/ status very easy very easy very easy

4.3.2 Change in availability

In 2007, 51% of the frequent drug users reported that the availability of methamphetamine was ‘stable’ in the past six months with 28% saying the availability of methamphetamine had become ‘easier’ over the past six months (Table 4.4). The average score for the change in availability of methamphetamine for all the frequent drug users was 1.9, which indicates that overall the availability of methamphetamine was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in availability between the three groups of frequent drug users, with all three groups indicating that availability of methamphetamine had been ‘stable’ over the previous six months in 2007 (p=0.3786).

Centre for Social and Health Outcomes Research and Evaluation 69 Te Runanga, Wananga, Hauora me te Paekaka Table 4.4: Change in availability of methamphetamine by frequent drug user group, 2007 Change in Methamphetamine Ecstasy users Intravenous drug Combined availability of users (MDMA) users (IDU) modules methamphetamine (n=102) (n=21) (n=51) (n=174) (%) Easier [1] 27% 29% 27% 28% Stable [2] 48% 43% 59% 51% Fluctuates [2] 7% 0% 8% 6% More difficult [3] 18% 29% 6% 16% Average change in availability score 1.9 2.0 1.8 1.9 (1=easier – 3=more difficult) Overall recent Stable Stable Stable Stable change

There was no statistically significant difference in the average score for the change in the availability of methamphetamine in 2007 compared to 2006 (p=0.1096) indicating that the availability of methamphetamine has remained stable over the past two years (Table 4.5).

Table 4.5: Change in availability of methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Change in Combined Combined availability of modules modules methamphetamine (n=175) (n=174) (%) Easier [1] 20% 28% Stable [2] 53% 51% Fluctuates [2] 9% 6% More difficult [3] 19% 16% Average change in availability score 2.0 1.9 (1=easier – 3=more difficult) Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 70 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score for the change in the availability of methamphetamine by the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.1204) indicating that the availability of methamphetamine has remained stable over the past three years (Table 4.6).

Table 4.6: Change in availability of methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Change in Methamphetamine Methamphetamine Methamphetamine availability of users users users methamphetamine (n=67) (n=105) (n=102) (%) Easier [1] 28% 15% 27% Stable [2] 49% 57% 48% Fluctuates [2] 9% 9% 7% More difficult [3] 13% 19% 18% Average change in availability score 1.9 2.0 1.9 (1=easier – 3=more difficult) Overall recent Stable Stable Stable change

4.4 Price of methamphetamine

4.4.1 Current price

In 2007, the frequent drug users reported the current median price of a point (0.1 grams) of methamphetamine to be $100 (Table 4.7). The current median price of a gram of methamphetamine was reported to be $600. There was no statistically significant difference between the three groups of frequent drug users with respect to the mean price paid for a point of methamphetamine in 2007 (p=0.8027). The mean price paid for a gram of methamphetamine was lower among the frequent methamphetamine users than the frequent injecting drug users in 2007 ($583 vs. $861, p=0.0004). The KE spoken to reported the current price of a point of methamphetamine to be $100.

Table 4.7: Current median (mean) price for methamphetamine (NZD) by frequent drug user group, 2007 Current price of Methamphetamine Ecstasy users Intravenous drug Combined methamphetamine users (MDMA) users (IDU) modules

Number with n=71 n=21 n=38 n=130 knowledge Median (mean) price $100 ($98) $100 ($95) $100 ($97) $100 ($97) ‘point’ (0.1 grams) Number with n=43 n=7 n=18 n=68 knowledge Median (mean) price $600 ($584) $600 ($643) $800 ($861) $600 ($663) gram

Centre for Social and Health Outcomes Research and Evaluation 71 Te Runanga, Wananga, Hauora me te Paekaka

There was no statistically significant difference in the mean price paid for a point (p=0.4443) or gram (p=0.1763) of methamphetamine in 2007 compared to 2006 (Table 4.8).

Table 4.8: Current median (mean) price for methamphetamine (NZD) by combined frequent drug users, 2006-2007 2006 2007 Current price of Combined Combined methamphetamine modules modules Number with n=144 n=130 knowledge Median (mean) price $100 ($96) $100 ($97) ‘point’ (0.1 grams) Number with n=75 n=68 knowledge Median (mean) price $600 ($606) $600 ($663) gram

There was no statistically significant difference in the mean price paid by the frequent methamphetamine users for a point (p=0.2637) or gram (p=0.0872) of methamphetamine in 2007 compared to 2006 and 2005 (Table 4.9).

Table 4.9: Current median (mean) price for methamphetamine (NZD) by frequent methamphetamine users, 2005-2007 2005 2006 2007 Current price of Methamphetamine Methamphetamine Methamphetamine methamphetamine users users users

Number with n=48 n=78 n=71 knowledge Median (mean) price $100 ($101) $100 ($93) $100 ($98) ‘point’ (0.1 grams) Number with n=34 n=53 n=43 knowledge Median (mean) price $725 ($688) $600 ($579) $600 ($584) gram

4.4.2 Change in price

In 2007, 60% of the frequent drug users reported that the price of methamphetamine had been ‘stable’ in the previous six months (Table 4.10). The average score for the change in the price of methamphetamine for all the frequent drug users was 2.0 which indicates that overall the price of methamphetamine was ‘stable’ over the previous six months in 2007. There was no statistically significant difference in the average score for the

Centre for Social and Health Outcomes Research and Evaluation 72 Te Runanga, Wananga, Hauora me te Paekaka change in price of methamphetamine between the three groups of frequent drug users, with all three groups indicating that the price of methamphetamine had been ‘stable’ over the previous six months in 2007 (p=0.7457). The KE described the price of methamphetamine as ‘stable’ over the past six months.

Table 4.10: Change in the price of methamphetamine in the past six months by frequent drug user group, 2007 Change in price of Methamphetamine Ecstasy users Intravenous drug Combined methamphetamine users (MDMA) users (IDU) modules (%) (n=96) (n=17) (n=54) (n=167) Decreasing [1] 19% 12% 13% 16% Stable [2] 52% 76% 69% 60% Fluctuating [2] 9% 6% 11% 10% Increasing [3] 20% 6% 7% 14% Average change in price score 2.0 1.9 1.9 2.0 (1=decreasing – 3=increasing) Overall recent Stable Stable Stable Stable change

There was no statistically significant difference in the average score for the change in the price of methamphetamine in 2007 compared to 2006 (p=0.6113) indicating that the price of methamphetamine has remained ‘stable’ over the past two years (Table 4.11).

Table 4.11: Change in the price of methamphetamine in the past six months by combined frequent drug users, 2006-2007 2006 2007 Change in price of Combined Combined methamphetamine modules modules (%) (n=155) (n=167) Decreasing [1] 23% 16% Stable [2] 48% 60% Fluctuating [2] 12% 10% Increasing [3] 17% 14% Average change in price score 1.9 2.0 (1=decreasing – 3=increasing) Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 73 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score by the frequent methamphetamine users for the change in the price of methamphetamine in 2007 compared to 2006 and 2005 (p=0.3729) indicating that the price of methamphetamine has remained ‘stable’ over the past three years (Table 4.12).

Table 4.12: Change in the price of methamphetamine in the past six months by frequent methamphetamine users, 2005-2007 2005 2006 2007

Change in price of Methamphetamine Methamphetamine Methamphetamine methamphetamine users users users (%) (n=64) (n=96) (n=96)

Decreasing [1] 25% 23% 19% Stable [2] 53% 46% 52% Fluctuating [2] 9% 16% 9% Increasing [3] 13% 16% 20% Average change in price score 2.0 1.9 2.0 (1=decreasing – 3=increasing) Overall recent Stable Stable Stable change

4.5 Purity of methamphetamine

4.5.1 Current purity

In 2007, 36% of the frequent drug users described the current purity of methamphetamine as ‘high’, with a further 36% describing the current purity of the drug as ‘fluctuating’ (Table 4.13). The average score for the current purity of methamphetamine for all the frequent drug users was 2.3, which indicates that overall the level of purity of methamphetamine was ‘medium/high’ in 2007. There was no statistically significant difference in the average score for purity between the three groups of frequent drug users with all three groups indicating the current purity of methamphetamine was ‘medium/high’ in 2007(p=0.3868).

Centre for Social and Health Outcomes Research and Evaluation 74 Te Runanga, Wananga, Hauora me te Paekaka Table 4.13: Current purity of methamphetamine by frequent drug user group, 2007 Current purity Methamphetamine Ecstasy users Intravenous drug Combined methamphetamine users (MDMA) users (IDU) modules (%) (n=102) (n=18) (n=46) (n=166) Low [1] 9% 11% 7% 8% Medium [2] 16% 28% 26% 20% Fluctuates [2] 34% 22% 43% 36% High [3] 41% 39% 24% 36% Average purity score 2.3 2.3 2.2 2.3 (1=low – 3=high) Medium/ Medium/ Medium/ Medium/ Overall current status high high high high

There was no statistically significant difference in the average score for the current purity of methamphetamine in 2007 compared to 2006 (p=1) indicating the current purity of methamphetamine has remained ‘medium/high’ over the past two years (Table 4.14).

Table 4.14: Current purity of methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Current purity Combined Combined methamphetamine modules modules (%) (n=166) (n=166) Low [1] 6% 8% Medium [2] 23% 20% Fluctuates [2] 37% 36% High [3] 34% 36% Average purity score 2.3 2.3 (1=low – 3=high) Medium/ Medium/ Overall current status high high

Centre for Social and Health Outcomes Research and Evaluation 75 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score for the current purity of methamphetamine by the frequent methamphetamine users in 2007 compared to 2006 and 2005 (p=0.8848) indicating the current purity of methamphetamine has remained ‘medium/high’ over the past three years (Table 4.15).

Table 4.15: Current purity of methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Current purity Methamphetamine Methamphetamine Methamphetamine methamphetamine users users users (%) (n=68) (n=101) (n=102)

Low [1] 3% 6% 9% Medium [2] 25% 20% 16% Fluctuates [2] 37% 40% 34% High [3] 35% 35% 41% Average purity score 2.3 2.3 2.3 (1=low – 3=high) Medium/ Medium/ Medium/ Overall current status high high high

4.5.2 Change in purity

In 2007, 33% of the frequent drug users reported that the purity of methamphetamine had been ‘stable’ in the previous six months, with a further 30% saying that purity had ‘fluctuated’ over this time (Table 4.16). The average score for the change in the purity of methamphetamine for all the frequent drug users was 1.9 which indicates that overall the purity of methamphetamine was ‘stable/fluctuating’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in purity of methamphetamine between the three groups of frequent drug users, with all three groups indicating that the purity of methamphetamine had been ‘stable/fluctuating’ over the previous six months in 2007 (p=0.7638). KE said the purity of methamphetamine had been ‘stable/fluctuating’ over the past six months.

Table 4.16: Change in purity of methamphetamine by frequent drug user group, 2007 Change in purity of Methamphetamine Ecstasy users Intravenous drug Combined methamphetamine users (MDMA) users (IDU) modules (%) (n=100) (n=15) (n=45) (n=160) Decreasing [1] 24% 27% 13% 21% Stable [2] 37% 40% 22% 33% Fluctuating [2] 23% 13% 51% 30% Increasing [3] 16% 20% 13% 16% Average change in purity score 1.9 1.9 2.0 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ Stable/ change fluctuates fluctuates fluctuates fluctuates

Centre for Social and Health Outcomes Research and Evaluation 76 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score for the change in the purity of methamphetamine in 2007 compared to 2006 (p=0.2523) indicating the purity of methamphetamine has remained ‘stable/fluctuating’ over the past two years (Table 4.17).

Table 4.17: Change in purity of methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Change in purity of Combined Combined methamphetamine modules modules (%) (n=156) (n=160) Decreasing [1] 15% 21% Stable [2] 41% 33% Fluctuating [2] 28% 30% Increasing [3] 17% 16% Average change in purity score 2.0 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change fluctuates fluctuates

There was no statistically significant difference in the average score by the frequent methamphetamine users for the change in the purity of methamphetamine in 2007 compared to 2006 and 2005 (p=0.5943) indicating the purity of methamphetamine has remained ‘stable/fluctuating’ over the past three years (Table 4.18).

Table 4.18: Change in purity of methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Change in purity of Methamphetamine Methamphetamine Methamphetamine methamphetamine users users users (%) (n=68) (n=96) (n=100)

Decreasing [1] 21% 16% 24% Stable [2] 35% 41% 37% Fluctuating [2] 31% 28% 23% Increasing [3] 13% 16% 16% Average change in purity score 1.9 2.0 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ change fluctuates fluctuates fluctuates

Centre for Social and Health Outcomes Research and Evaluation 77 Te Runanga, Wananga, Hauora me te Paekaka 4.6 Perceptions of the number of people using methamphetamine

In 2007, 48% of the frequent drug users thought ‘more’ people they know were using methamphetamine and 31% said ‘about the same’ number of people were using methamphetamine (Table 4.19). The average score for all the frequent drug users for the question was 2.3 indicating that overall ‘more/the same’ number of people were using methamphetamine compared to six months ago in 2007. There was no statistically significant difference between the frequent drug users concerning perceptions of the number of people using methamphetamine with all three groups saying the number of people using methamphetamine was ‘more/ the same’ in the past six months in 2007 (p=0.7354). The KE believed the number of people using methamphetamine had been ‘stable/increasing’ over the past six months.

Table 4.19: Perceptions of the number of people using methamphetamine by frequent drug user group, 2007 Number of people Methamphetamine Ecstasy users Intravenous drug Combined using users (MDMA) users (IDU) modules methamphetamine (n=101) (n=27) (n=50) (n=178) (%) Less [1] 19% 22% 12% 17% Same [2] 30% 26% 38% 31% More [3] 51% 41% 46% 48% Average number of people using score 2.3 2.2 2.4 2.3 (1=less – 3=more)

Overall recent More/ More/ More/ More/ change same same same same

There was no statistically significant difference in the average score for the change in the number of people using methamphetamine in 2007 compared to 2006 (p=0.1781) indicating that ‘more/the same’ number of people have been using methamphetamine over the past two years (Table 4.20).

Table 4.20: Perceptions of the number of people using methamphetamine by combined frequent drug users, 2006-2007 2006 2007

Number of people Combined Combined using modules modules methamphetamine (n=175) (n=178) (%) Less [1] 23% 17% Same [2] 34% 31% More [3] 43% 48% Average number of people using score 2.2 2.3 (1=less – 3=more)

Overall recent More/ More/ change same same

Centre for Social and Health Outcomes Research and Evaluation 78 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score by the frequent methamphetamine users for the change in the number of people using methamphetamine in 2007 compared to 2006 and 2005 (p=0.8923) indicating that ‘more/the same’ number of people have been using methamphetamine over the past three years (Table 4.21).

Table 4.21: Perceptions of the number of people using methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007 Number of people Methamphetamine Methamphetamine Methamphetamine using users users users methamphetamine (n=71) (n=102) (n=101) (%) Less [1] 17% 19% 19% Same [2] 38% 33% 30% More [3] 44% 48% 51% Average number of people using score 2.3 2.3 2.3 (1=less – 3=more)

Overall recent More/ More/ More/ change same same same

Centre for Social and Health Outcomes Research and Evaluation 79 Te Runanga, Wananga, Hauora me te Paekaka 4.7 Seizures of methamphetamine

Annual seizures of methamphetamine made by the New Zealand Police and New Zealand Customs Service have fluctuated since 1999 (Figure 4.1). Particularly large seizures of methamphetamine were recorded in the 2002 and 2006 calendar years.

Figure 4.1: Grams of methamphetamine seized in New Zealand, 1999-2006

8,906 9,000

8,000

7,000 6,392

6,000

5,000

4,000

Weight (grams) 2,631 3,000 1,923 2,200 1,701 2,000 1,562 1,370

1,000

0 1999 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

4.8 Clandestine methamphetamine laboratories dismantled

The number of clandestine methamphetamine laboratories dismantled each year by the New Zealand Police increased dramatically from the year 2000 until 2003 (Figure 4.2). Since 2003 the number of methamphetamine laboratories dismantled each year appears to have plateaued at around 200 per year (i.e. the average number of methamphetamine laboratories detected for the years 2003-2006 is 200 laboratories). However, there has been a consistent increase in the number of laboratories detected in the past three years (i.e. the number of methamphetamine laboratories detected in 2006 is 16% higher than the number detected in 2004).

Centre for Social and Health Outcomes Research and Evaluation 80 Te Runanga, Wananga, Hauora me te Paekaka Figure 4.2: Number of methamphetamine laboratories dismantled in New Zealand, 2000-2006

250

211 200 202 204 182 170

150

100 Number (labsdetected)

50 41

9 0 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

4.9 Pseudoephedrine and ephedrine seizures

Pseudoephedrine and ephedrine are precursor chemicals used to synthesise methamphetamine in New Zealand. Seizures of pills and capsules of these precursor chemicals by the New Zealand Customs Service have increased dramatically since 2001 (Figure 4.3). In 2002, ephedrine products were classified as Class C controlled drugs under the Misuse of Drugs Act 1975, and there was a subsequent greater focus on these substances by enforcement agencies. The number of pseudoephedrine pills seized in 2006 was 983% higher than in 2002 (i.e. 2,763,494 in 2006 vs. 254,987 in 2002).

Centre for Social and Health Outcomes Research and Evaluation 81 Te Runanga, Wananga, Hauora me te Paekaka Figure 4.3: Number of tablets/capsules of ephedrine precursors seized in New Zealand, 2000-2006

3,000,000 2,763,494

2,500,000 2,046,312 1,857,692 2,000,000

1,500,000 830,320 1,000,000 Number (pills/capsules)

500,000 254,987 10,308 32,653

0 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

4.10 Amphetamine use in the general population

The New Zealand national household drug survey asks about amphetamine use in general and this category includes amphetamine sulphate and methamphetamine. There was no statistically significant change in the proportion of the New Zealand population aged 15-45 years old who had ever tried amphetamines between 2006 and 2003 (9.0% vs. 9.3%, p=0.7290) (Wilkins and Sweetsur, 2008). A higher proportion of the population had tried amphetamine in 2006 compared to 1998 (9.3% vs. 7.6%, p=0.0315) (Wilkins and Sweetsur, 2008). There was also no statistically significant change in the proportion of the population who had used amphetamine in the previous 12 months in 2006 compared to 2003 (3.4% vs. 4.0%; p=0.3377) (Wilkins and Sweetsur, 2008). A lower proportion of the population had used amphetamines in the past year in 2006 compared to 2001 (3.4% vs. 5.0%, p=0.0085) (Wilkins and Sweetsur, 2008).

Centre for Social and Health Outcomes Research and Evaluation 82 Te Runanga, Wananga, Hauora me te Paekaka 4.11 Summary of methamphetamine trends

• In 2007, the current availability of methamphetamine was reported to be ‘easy/very easy’

• The availability of methamphetamine has not changed in 2007 compared to 2006

• The frequent methamphetamine users reported that the availability of methamphetamine had not changed in 2007 compared to 2006 and 2005

• In 2007, a point (0.1 grams) of methamphetamine cost a median price of $100 and a gram of methamphetamine cost a median price of $600. The frequent methamphetamine users paid lower prices for a gram of methamphetamine than the other frequent drug users

• The overall price of methamphetamine has not changed over the past three years

• In 2007, the current purity of methamphetamine was considered to be ‘medium/high’

• The frequent methamphetamine users reported the purity of methamphetamine to be ‘medium/high’ in 2005, 2006 and 2007

• The purity of methamphetamine has remained ‘stable/fluctuating’ over the past two years

• The number of people using methamphetamine was described as ‘more/the same’ in both 2006 and 2007

• The frequent methamphetamine users described the number of people using methamphetamine as ‘more/the same’ in 2005, 2006 and 2007

• The number of clandestine methamphetamine laboratories detected in 2006 was 16% higher than the number detected in 2004

• The number of pills of methamphetamine precursors seized was 983% higher in 2006 compared to 2002

• National household survey data indicates that the population prevalence of use of amphetamine did not change in 2006 compared to 2003

Centre for Social and Health Outcomes Research and Evaluation 83 Te Runanga, Wananga, Hauora me te Paekaka 5. Crystal methamphetamine

5.1 Introduction

Crystal methamphetamine (‘ice’, ‘crystal’ or ‘shabu’) is the crystallised form of methamphetamine (Matsumoto et al., 2002, McKetin and McLaren, 2004). It is currently thought to be largely manufactured in Asia and smuggled into New Zealand across the border. Imported crystal methamphetamine is sometimes perceived by users to be more professionally made and more potent than the locally manufactured methamphetamine, known in New Zealand as ‘P’ or pure (Wilkins et al., 2004). However, recent ESR analysis suggests that there is typically little difference in purity between locally made methamphetamine and imported crystal methamphetamine in New Zealand. Among drug users there is sometimes no clear distinction between methamphetamine and crystal methamphetamine, with some users describing all methamphetamine as crystal methamphetamine including the locally made ‘P’. With respect to pharmacological effects there may be little difference between the two substances, yet based on the understanding that local users sometimes distinguish between a local methamphetamine and imported crystal methamphetamine there is some justification for monitoring the two separately.

In 2006, we found that approximately 40% of the frequent drug users answering the crystal methamphetamine section did not appear to make a ready distinction between crystal methamphetamine and methamphetamine (i.e. they provided identical answers to the two sections). Consequently in 2007, in order to ensure the participant did make a clear distinction between crystal methamphetamine and methamphetamine the interviewer provided the participant with a short description of crystal methamphetamine (i.e. ‘ice comes in large crystals and is usually imported’) and was directed to skip the crystal methamphetamine section if the participant did not make a ready distinction between methamphetamine and crystal methamphetamine. As a result, less people answered the crystal methamphetamine section in 2007 than in 2006, but we contend that the 2007 respondents are likely to have greater levels of knowledge of crystal methamphetamine.

In this chapter we draw on the knowledge of the frequent methamphetamine users to compare trends in crystal methamphetamine in 2007 back to 2006 and 2005. However, low numbers in 2005 reduce our ability to find statistically significant differences over these years.

5.2 Knowledge of crystal methamphetamine trends

In 2007, 23% of the frequent drug users interviewed (n=74) indicated they felt confident enough to comment on the price, purity and availability of crystal methamphetamine in the previous six months. This included 51% of the frequent methamphetamine users (n=53), 3% of the frequent ecstasy users (n=2) and 17% of the

Centre for Social and Health Outcomes Research and Evaluation 84 Te Runanga, Wananga, Hauora me te Paekaka frequent injecting drug users (n=18). As there were only small numbers of frequent drug users in some individual modules with knowledge of crystal methamphetamine we present the findings for the combined group of all the frequent drug users.

5.3 Availability of crystal methamphetamine

5.3.1 Current availability

In 2007, 41% of the frequent drug users described the current availability of crystal methamphetamine as ‘easy’, while 31% described the current availability of crystal methamphetamine as ‘difficult’ (Table 5.1). The average score for the current availability of crystal methamphetamine was 2.1, which indicates that overall the current level of availability of crystal methamphetamine was ‘easy’ in 2007. There was no statistically significant difference in the average score for the current availability of crystal methamphetamine in 2007 compared to 2006 (p=0.8195), indicating that the availability of crystal methamphetamine has remained ‘easy’ over the past two years.

Table 5.1: Current availability of crystal methamphetamine by combined frequent drug users, 2006-2007

2006 2007 Current availability Combined Combined of crystal modules modules methamphetamine (n=107) (n=71) (%) Very easy [1] 24% 25% Easy [2] 48% 41% Difficult [3] 23% 31% Very difficult [4] 5% 3% Average availability score (1=very easy 2.1 2.1 – 4=very difficult) Overall current Easy Easy status

There was some evidence that the current availability of crystal methamphetamine had declined over the past three years. The frequent methamphetamine users were more likely to say the current availability of crystal methamphetamine was difficult in 2007 compared to 2005 (2.1 vs. 1.8), although this difference was not statistically significant (p=0.1501) (Table 5.2).

Centre for Social and Health Outcomes Research and Evaluation 85 Te Runanga, Wananga, Hauora me te Paekaka Table 5.2: Current availability of crystal methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Current availability Methamphetamine Methamphetamine Methamphetamine of crystal users users users methamphetamine (n=39) (n=64) (n=52) (%) Very easy [1] 38% 25% 29% Easy [2] 46% 52% 37% Difficult [3] 15% 19% 33% Very difficult [4] 0% 5% 2% Average availability score (1=very easy 1.8 2.0 2.1 – 4=very difficult) Overall current Easy Easy Easy status

5.3.2 Change in availability

In 2007, 52% of the frequent drug users reported that the availability of crystal methamphetamine had been ‘stable’ in the previous six months, with a further 26% saying the availability of crystal methamphetamine had become ‘more difficult’ in the past six months (Table 5.3). The average score for the change in availability of crystal methamphetamine was 2.1, which indicates that overall the availability of crystal methamphetamine was ‘stable/more difficult’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in the availability of crystal methamphetamine in 2007 compared to 2006 (p=0.3644), which indicates that the availability of crystal methamphetamine has remained ‘stable/more difficult’ over the past two years. The recent decline in the availability of crystal methamphetamine, as reported by the frequent drug users, may reflect the impact of the significant seizures of imported crystal methamphetamine made in 2006 and more recently in 2007.

Table 5.3: Change in availability of crystal methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Change in Combined Combined availability modules modules of crystal (n=106) (n=69) methamphetamine (%) Easier [1] 10% 16% Stable [2] 50% 52% Fluctuates [2] 10% 6% More difficult [3] 29% 26% Average change in availability score 2.2 2.1 (1=easier – 3=more difficult)

Overall recent Stable/ Stable/ change more difficult more difficult

Centre for Social and Health Outcomes Research and Evaluation 86 Te Runanga, Wananga, Hauora me te Paekaka The frequent methamphetamine users were statistically significantly more likely to say the availability of crystal methamphetamine was more difficult in 2007 compared to 2005 (2.2 vs. 1.8, p=0.0178) (Table 5.4). The frequent methamphetamine users were also more likely to say the availability of crystal methamphetamine was more difficult in 2006 compared to 2005 (2.1 vs. 1.8), and this was close to being statistically significant (p=0.0555).

Table 5.4: Change in availability of crystal methamphetamine by frequent methamphetamine users, 2005- 2007 2005 2006 2007 Change in Methamphetamine Methamphetamine Methamphetamine availability users users users of crystal (n=40) (n=64) (n=50) methamphetamine (%) Easier [1] 28% 13% 12% Stable [2] 52% 50% 52% Fluctuates [2] 10% 14% 6% More difficult [3] 10% 23% 30% Average change in availability score 1.8 2.1 2.2 (1=easier – 3=more difficult)

Overall recent Stable/ Stable/ Stable/ change easier more difficult more difficult

5.4 Price of crystal methamphetamine

5.4.1 Current price

In 2007, the frequent drug users reported the current median price of a point (0.1 grams) of crystal methamphetamine to be $100, and the current median price of a gram of crystal methamphetamine to be $700 (Table 5.5). There was no statistically significant change in the mean price of a point of crystal methamphetamine in 2007 compared to 2006 (p=0.1914). Participants were not asked about the price of a gram of crystal methamphetamine in 2006.

Centre for Social and Health Outcomes Research and Evaluation 87 Te Runanga, Wananga, Hauora me te Paekaka Table 5.5: Current median (mean) price for crystal methamphetamine (NZD) by combined frequent drug users, 2006-2007 2006 2007 Current price of Combined Combined crystal modules modules methamphetamine

Number with n=76 n=45 knowledge Median (mean) price $100 ($100) $100 ($106) ‘point’ (0.1 grams) Number with - n=36 knowledge Median (mean) price - $700 ($685) gram

There was no statistically significant change in the mean price paid by the frequent methamphetamine users for a point of crystal methamphetamine in 2007 compared to 2006 and 2005 (p=0.0786).

Table 5.6: Current median (mean) price for crystal methamphetamine (NZD) by frequent methamphetamine users, 2005-2007 2005 2006 2007 Current price of Methamphetamine Methamphetamine Methamphetamine crystal users users users methamphetamine

Number with n=32 n=38 n=34 knowledge Median (mean) price $100 ($113) $100 ($95) $100 ($107) ‘point’ (0.1 grams)

Centre for Social and Health Outcomes Research and Evaluation 88 Te Runanga, Wananga, Hauora me te Paekaka 5.4.2 Change in price

In 2007, 59% of the frequent drug users reported that the price of crystal methamphetamine had been ‘stable’ in the previous six months and 20% reported that the price of crystal methamphetamine had ‘increased’ in the past six months (Table 5.7). The average score for the change in the price of crystal methamphetamine was 2.1, which indicates that overall the price was ‘stable’ over the past six months in 2007. There was no statistically significant change in the average score for the change in the price of crystal methamphetamine in 2007 compared to 2006 (p=0.5137), indicating the price of crystal methamphetamine has remained ‘stable’ over the past two years.

Table 5.7: Change in the price of crystal methamphetamine in the past six months by combined frequent drug users, 2006-2007 2006 2007 Change in price of Combined Combined crystal modules modules methamphetamine (n=98) (n=69) (%) Decreasing [1] 11% 9% Stable [2] 61% 59% Fluctuating [2] 10% 12% Increasing [3] 17% 20% Average change in price score 2.1 2.1 (1=decreasing – 3=increasing) Overall recent Stable Stable change

There was some evidence that the price of crystal methamphetamine has been increasing over the past three years. The frequent methamphetamine users were more likely to say the price of crystal methamphetamine was increasing in 2007 compared to 2005 (2.2 vs. 2.0), although this difference was not found to be statistically significant (p=0.426) (Table 5.8).

Centre for Social and Health Outcomes Research and Evaluation 89 Te Runanga, Wananga, Hauora me te Paekaka Table 5.8: Change in the price of crystal methamphetamine in the past six months by frequent methamphetamine users, 2005-2007 2005 2006 2007 Change in price of Methamphetamine Methamphetamine Methamphetamine crystal users users users methamphetamine (n=37) (n=61) (n=49) (%) Decreasing [1] 16% 11% 8% Stable [2] 62% 56% 55% Fluctuating [2] 3% 13% 10% Increasing [3] 19% 20% 27% Average change in price score 2.0 2.1 2.2 (1=decreasing – 3=increasing) Overall recent Stable Stable Stable change

5.5 Purity of crystal methamphetamine

5.5.1 Current purity

In 2007, 52% of the frequent drug users described the current purity of crystal methamphetamine as ‘high’, with a further 26% describing the current purity as ‘fluctuating’ (Table 5.9). The average score for the current purity of crystal methamphetamine was 2.5, which indicates the purity of crystal methamphetamine was ‘high/medium’ in 2007. There was no statistically significant difference in the average score for the current purity of crystal methamphetamine in 2007 compared to 2006 (p=0.3375), indicating that the purity of crystal methamphetamine has remained ‘high/medium’ over the past two years.

Table 5.9: Current purity of crystal methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Current purity Combined Combined crystal modules modules methamphetamine (n=103) (n=73) (%) Low [1] 9% 4% Medium [2] 25% 18% Fluctuates [2] 18% 26% High [3] 48% 52% Average purity score (1=low – 3=high) 2.4 2.5

Overall current High/ High/ status medium medium

Centre for Social and Health Outcomes Research and Evaluation 90 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score by the frequent methamphetamine users for the current purity of crystal methamphetamine in 2007 compared to 2006 and 2005 (p=0.3375), indicating that the purity of crystal methamphetamine has remained ‘high/medium’ over the past three years (Table 5.10).

Table 5.10: Current purity of crystal methamphetamine by frequent methamphetamine users, 2005-2007 2005 2006 2007

Current purity Methamphetamine Methamphetamine Methamphetamine crystal users users users methamphetamine (n=40) (n=63) (n=53) (%) Low [1] 10% 10% 4% Medium [2] 13% 19% 19% Fluctuates [2] 20% 16% 21% High [3] 58% 56% 57% Average purity score (1=low – 3=high) 2.5 2.5 2.5

Overall current High/ High/ High/ status medium medium medium

5.5.2 Change in purity

In 2007, 51% of the frequent drug users reported that the purity of crystal methamphetamine had been ‘stable’ in the previous six months, with a further 22% saying that purity had ‘fluctuated’ over this time (Table 5.11). The average score for the change in the purity of crystal methamphetamine for all the frequent drug users was 2.1, which indicates that overall the purity of crystal methamphetamine was ‘stable/fluctuating’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in purity of crystal methamphetamine in 2007 compared to 2006 (p=0.4755), indicating the purity of crystal methamphetamine has remained ‘stable/fluctuating’ over the past two years.

Table 5.11: Change in purity of crystal methamphetamine by combined frequent drug users, 2006-2007 2006 2007 Change in purity of Combined Combined crystal modules modules methamphetamine (n=102) (n=68) (%) Decreasing [1] 13% 9% Stable [2] 54% 51% Fluctuating [2] 18% 22% Increasing [3] 16% 18% Average change in purity score 2.0 2.1 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change fluctuates fluctuates Centre for Social and Health Outcomes Research and Evaluation 91 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the average score by the frequent methamphetamine users for the change in purity of crystal methamphetamine in 2007 compared to 2006 and 2005 (p=0.3178), indicating the purity of crystal methamphetamine has remained ‘stable/fluctuating’ over the past three years (Table 5.12).

Table 5.12: Change in purity of crystal methamphetamine by the frequent methamphetamine users, 2005- 2007 2005 2006 2007

Change in purity of Methamphetamine Methamphetamine Methamphetamine crystal users users users methamphetamine (n=38) (n=62) (n=50) (%) Decreasing [1] 5% 16% 8% Stable [2] 55% 48% 56% Fluctuating [2] 16% 18% 18% Increasing [3] 24% 18% 18% Average change in purity score 2.2 2.0 2.1 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ change increasing fluctuates increasing

Centre for Social and Health Outcomes Research and Evaluation 92 Te Runanga, Wananga, Hauora me te Paekaka 5.6 Perceptions of the number of people using crystal methamphetamine

In 2007, 36% of the frequent drug users thought ‘more’ people they know were using crystal methamphetamine, while 35% said ‘about the same’ number were using crystal methamphetamine (Table 5.13). The average score for all the frequent drug users for the question was 2.1 indicating that overall ‘the same/more’ people were using crystal methamphetamine compared to six months ago in 2007. There was no statistically significant difference in the average score for the change in the number of people using crystal methamphetamine in 2007 compared to 2006 (p=0.6417), indicating that the number of people using crystal methamphetamine has remained the ‘same/more’ over the past two years.

Table 5.13: Perceptions of the number of people using crystal methamphetamine, 2006-2007 2006 2007 Number of people Combined Combined using crystal modules modules methamphetamine (n=108) (n=71) (%) Less [1] 25% 29% Same [2] 37% 35% More [3] 38% 36% Average number of people using score 2.1 2.1 (1=less – 3=more) Overall recent Same/ Same/ change more more

There was some evidence that the increase in the number of people using crystal methamphetamine has been declining over the past three years. The frequent methamphetamine users were more likely to say that less people they know were using crystal methamphetamine in 2007 compared to 2005 (2.1 vs. 2.3), although this difference was not found to be statistically significant (p=0.4154) (Table 5.14).

Table 5.14: Perceptions of the number of people using crystal methamphetamine by frequent methamphetamine users, 2006-2007 2005 2006 2007

Number of people Methamphetamine Methamphetamine Methamphetamine using crystal users users users methamphetamine (n=26) (n=65) (n=52) (%) Less [1] 12% 23% 31% Same [2] 42% 32% 29% More [3] 46% 45% 40% Average number of people using score 2.3 2.2 2.1 (1=less – 3=more) Overall recent Same/ Same/ Same/ change more more more

Centre for Social and Health Outcomes Research and Evaluation 93 Te Runanga, Wananga, Hauora me te Paekaka

5.7 Seizures of crystal methamphetamine

Increased annual seizures of crystal methamphetamine have been recorded since 2004 (Figure 5.1). Seizures of crystal methamphetamine increased dramatically in 2006 and this was largely accounted for by a single very large interception at the border of 95 kilograms of crystal methamphetamine and 150 kilograms of pseudoephedrine. This is the largest seizure of crystal methamphetamine made in New Zealand to date.

Figure 5.1: Grams of crystal methamphetamine seized in New Zealand, 2002-2006

96,795 100000

90000

80000

70000

60000

50000

40000 26,268 Weight (grams) 30000 16,019 20000

10000 908 862

0 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

5.8 Crystal methamphetamine use in the general population

The New Zealand national household drug survey asks specifically about ice (crystal methamphetamine). There was no statistically significant change in the proportion of the New Zealand population aged 15-45 years old who had ever tried crystal methamphetamine between 2003 and 2006 (1.8% both years, p=0.8993) (Wilkins and Sweetsur, 2008). A higher proportion of the population had tried crystal methamphetamine in 2006 compared to 1998 (1.8% vs. 0.2%, p<0.0001) (Wilkins and Sweetsur, 2008). There was also no statistically significant change in the proportion of the population who had used crystal methamphetamine in the previous 12 months in 2006 compared to 2003 (0.8% vs. 0.9%; p=0.7067) (Wilkins and Sweetsur, 2008).

Centre for Social and Health Outcomes Research and Evaluation 94 Te Runanga, Wananga, Hauora me te Paekaka 5.9 Summary of crystal methamphetamine trends

• In 2007, the current availability of crystal methamphetamine was reported to be ‘easy’

• The availability of crystal methamphetamine was reported to be ‘stable/more difficult’ in both 2006 and 2007. Large seizures of crystal methamphetamine at the border in 2006 and 2007 appear to have impacted on the availability of this drug in New Zealand

• The frequent methamphetamine users were more likely to say the availability of crystal methamphetamine was ‘more difficult’ in 2007 compared to 2005. Again this is consistent with the impact of large seizures of crystal methamphetamine in 2006 and 2007

• In 2007, a point (0.1 grams) of crystal methamphetamine cost a median price of $100 and a gram cost a median price of $700

• The price of crystal methamphetamine has not changed over the past three years

• In 2007, the current purity of crystal methamphetamine was described as ‘high/medium’

• The purity of crystal methamphetamine was described as ‘high/medium’ in 2007 and 2006

• The frequent methamphetamine users described the purity of crystal methamphetamine as ‘high/medium’ in 2005, 2006 and 2007

• The number of people using crystal methamphetamine was described as the ‘same/more’ in both 2006 and 2007

• Annual seizures of crystal methamphetamine have increased dramatically since 2004. A single very large seizures was made in 2006

Centre for Social and Health Outcomes Research and Evaluation 95 Te Runanga, Wananga, Hauora me te Paekaka 6. Ecstasy (MDMA)

6.1 Introduction

Ecstasy (3,4-methylenedioxymethamphetamine, MDMA or ‘E' or ‘X’) has both amphetamine and hallucinogenic effects (Kuhn et al., 1998, Gowing et al., 2001, Gowing et al., 2002, Topp et al., 1998). Ecstasy (MDMA) increases heart rate, blood pressure, and body temperature, and produces a sense of energy and alertness (like standard amphetamines), but also a state of empathy for others (due to increased release of serotonin) (Kuhn et al., 1998). High doses of ecstasy (MDMA) cause teeth clenching, paranoia, anxiety and confusion (Kuhn et al., 1998). Ecstasy (MDMA) can cause hyperthermia (extreme heat stroke) resulting in death when combined with sustained physical exercise and elevated temperatures, conditions commonly found in dance clubs (these environments compound the natural pharmacological effect of ecstasy on the body’s thermoregulatory mechanism) (Gowing et al., 2001, Gowing et al., 2002). Ecstasy (MDMA) can also cause water intoxication and death when excessive amounts of water are consumed as the drug inhibits the body’s ability to excrete fluid (Topp et al., 1998, Gowing et al., 2002). Although cases of serious adverse effects from ecstasy (MDMA) use appear low relative to the extent of use, it is the unpredictability of adverse events (dose is not predictive of adverse effects) and risk of mortality that makes the risks significant (Gowing et al., 2002). Long term effects from ecstasy (MDMA) include insomnia, energy loss, depression, irritability, muscle aches, and blurred vision (Topp et al., 1998). Ecstasy (MDMA) has also been controversially linked to damage to serotonin terminals in the brain, with possible implications for short term memory, cognitive function and mood regulation (Gowing et al., 2002).

6.2 Knowledge of ecstasy (MDMA) trends

In 2007, 50% of the frequent drug users interviewed (n=161) indicated they felt confident enough to comment on the price, purity and availability of ecstasy (MDMA) in the previous six months. This included 39% of the frequent methamphetamine users (n=43), 97% of the frequent ecstasy users (n=102) and 15% of the frequent injecting drug users (n=16).

6.3 Availability of ecstasy (MDMA)

6.3.1 Current availability of ecstasy (MDMA)

In 2007, 55% of the frequent drug users described the current availability of ecstasy (MDMA) as ‘easy’ with 25% describing the availability of the drug as ‘very easy’ (Table 6.1). The average score for the current availability of ecstasy (MDMA) for all the frequent drug users was 2.0, which indicates that overall the current level of availability of ecstasy (MDMA) was ‘easy’ in 2007. There was no statistically significant

Centre for Social and Health Outcomes Research and Evaluation 96 Te Runanga, Wananga, Hauora me te Paekaka difference in the average score for the current availability of ecstasy (MDMA) between the three groups of frequent drug users in 2007 (p=0.7978).

Table 6.1: Current availability of ecstasy (MDMA) by frequent drug user group, 2007 Current Methamphetamin Ecstasy users Combined availability of e users (MDMA) modules ecstasy (MDMA) (n=41) (n=100) (n=157) (includes (%) frequent injecting drug users) Very easy [1] 29% 23% 25% Easy [2] 44% 60% 55% Difficult [3] 22% 17% 19% Very difficult [4] 5% 0% 2% Average availability score (1=very easy 2.0 1.9 2.0 – 4=very difficult) Overall current Easy Easy Easy status

There was no statistically significant difference in the average score for the current availability of ecstasy in 2007 compared to 2006 (p=0.1889), indicating that the availability of ecstasy has remained ‘easy’ over the past two years (Table 6.2).

Table 6.2: Current availability of ecstasy (MDMA) by combined frequent drug users, 2006-2007 2006 2007 Current Combined Combined availability of modules modules ecstasy (MDMA) (n=200) (n=157) (%) Very easy [1] 20% 25% Easy [2] 54% 55% Difficult [3] 27% 19% Very difficult [4] 0% 2% Average availability score 2.1 2.0 (1=very easy – 4=very difficult) Overall current Easy Easy status

6.3.2 Change in availability of ecstasy (MDMA)

In 2007, 47% of the frequent drug users reported that the availability of ecstasy (MDMA) had been ‘stable’ in the previous six months and 28% indicated that the availability of ecstasy (MDMA) had become ‘easier’ in the previous six months (Table 6.3). The average score for the change in the availability of ecstasy (MDMA) for all the frequent drug users was 1.9, which indicates that overall the availability of ecstasy Centre for Social and Health Outcomes Research and Evaluation 97 Te Runanga, Wananga, Hauora me te Paekaka (MDMA) was ‘stable’ over the last six months in 2007. There was no statistically significant difference in the average score for the change in availability of ecstasy (MDMA) between the three groups of frequent drug users, with all three groups indicating that the availability of ecstasy (MDMA) had been ‘stable’ over the previous six months in 2007 (p=0.1057). Several KE reported the availability of ecstasy had become easier in the past six months.

Table 6.3: Change in availability of ecstasy (MDMA) by frequent drug user group, 2007 Change in Methamphetamine Ecstasy users Combined modules availability users (MDMA) (n=154)(includes of ecstasy (n=59) (n=106) frequent injecting (MDMA) (%) drug users) Easier [1] 27% 32% 28% Stable [2] 39% 46% 47% Fluctuates [2] 2% 8% 6% More difficult [3] 32% 13% 18% Average change in availability 2.0 1.8 1.9 score (1=easier – 3=more difficult) Overall recent Stable Stable Stable change

There was no statistically significant difference in the average score for the change in the availability of ecstasy in 2007 compared to 2006 (p=0.6001), indicating that the availability of ecstasy was ‘stable’ in 2007 and 2006 (Table 6.4).

Table 6.4: Change in availability of ecstasy (MDMA) by combined frequent drug users, 2006-2007 2006 2007 Change in Combined Combined availability modules modules of ecstasy (n=194) (n=154) (MDMA) (%) Easier [1] 19% 28% Stable [2] 45% 47% Fluctuates [2] 23% 6% More difficult [3] 13% 18% Average change in availability 1.9 1.9 score (1=easier – 3=more difficult) Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 98 Te Runanga, Wananga, Hauora me te Paekaka 6.4 Price of ecstasy (MDMA)

6.4.1 Current price of ecstasy (MDMA)

In 2007, the median price paid for a pill of ecstasy (MDMA) was reported to be $60 (Table 6.5). There was no statistically significant difference between the three groups of frequent drug user with respect to the mean price paid for a pill of ecstasy in 2007 (p=0.0724).

Table 6.5: Current median (mean) price for ecstasy (MDMA) (NZD) by frequent drug user group, 2007 Current price of Methamphetamine Ecstasy users Intravenous drug Combined ecstasy (MDMA) users (MDMA) users (IDU) modules (n=36) (n=73) (n=13) (n=122) Median (mean) price $50 ($52) $60 ($56) $60 ($60) $60 ($55) ‘pill’

The mean price paid for a pill of ecstasy by the frequent drug users was lower in 2007 than in 2006 ($55 vs. $59, p=0.0243) (Table 6.6).

Table 6.6: Current median (mean) price for ecstasy (MDMA) (NZD) by combined frequent drug users, 2006- 2007 2006 2007 Current price of Combined Combined ecstasy (MDMA) modules modules (n=190) (n=122) Median (mean) $60 ($59) $60 ($55) price ‘pill’

6.4.2 Change in price of ecstasy (MDMA)

In 2007, 64% of the frequent drug users reported that the price of ecstasy (MDMA) had been ‘stable’ in the previous six months with 15% saying the price had ‘fluctuated’ (Table 6.7). The average score for the change in the price of ecstasy (MDMA) for all the frequent drug users was 1.9, which indicates that overall the price of ecstasy was ‘stable’ over the previous six months in 2007. There was no statistically significant difference in the average score for the change in price of ecstasy (MDMA) between the three groups of frequent drug users, with all three groups indicating that the price of ecstasy (MDMA) had been ‘stable’ over the past six months in 2007 (p=0.2375).

Centre for Social and Health Outcomes Research and Evaluation 99 Te Runanga, Wananga, Hauora me te Paekaka Table 6.7: Change in the price of ecstasy (MDMA) in the past six months by frequent drug user group, 2007 Change in price Methamphetamine Ecstasy users Combined of ecstasy users (MDMA) modules (MDMA) (%) (n=43) (n=100) (n=158) (includes frequent injecting drug users) Decreasing [1] 26% 10% 14% Stable [2] 49% 69% 64% Fluctuating [2] 16% 13% 15% Increasing [3] 9% 8% 8% Average change in price score 1.8 2.0 1.9 (1=decreasing – 3=increasing) Overall recent Stable Stable Stable change

There was no statistically significant difference in the average score for the change in the price of ecstasy in 2007 compared to 2006 (p=0.0867) indicating that the price of ecstasy has remained ‘stable/decreasing’ over the past two years (Table 6.8).

Table 6.8: Change in the price of ecstasy (MDMA) in the past six months by combined frequent drug users, 2006-2007 2006 2007 Change in price Combined Combined of ecstasy modules modules (MDMA) (%) (n=187) (n=158) Decreasing [1] 22% 14% Stable [2] 58% 64% Fluctuating [2] 12% 15% Increasing [3] 7% 8% Average change in price score 1.8 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change decreasing decreasing

6.5 Purity of ecstasy (MDMA)

6.5.1 Current purity of ecstasy (MDMA)

In 2007, 33% of the frequent drug users described the current purity of ecstasy (MDMA) as ‘fluctuating’ and 30% described it as ‘high’ (Table 6.9). The average score for the current purity of ecstasy (MDMA) for all the frequent drug users was 2.2 which indicates that overall the purity of ecstasy (MDMA) was ‘medium/high’ in 2007. There was no statistically significant difference in the average score for the purity of

Centre for Social and Health Outcomes Research and Evaluation 100 Te Runanga, Wananga, Hauora me te Paekaka ecstasy (MDMA) between the three groups of frequent drug users with all three groups indicating the current purity of ecstasy (MDMA) was ‘medium/high’ in 2007 (p=0.5128).

Table 6.9: Current purity of ecstasy (MDMA) by frequent drug user group, 2007 Current purity of Methamphetamine Ecstasy users Combined modules ecstasy (MDMA) users (MDMA) (n=156) (includes (%) (n=42) (n=98) frequent injecting drug users) Low [1] 7% 7% 8% Medium [2] 43% 23% 29% Fluctuates [2] 29% 38% 33% High [3] 21% 32% 30% Average purity score (1=low – 2.1 2.2 2.2 3=high) Overall current Medium/ Medium/ Medium/ status high high high

There was no statistically significant difference in the average score for the current purity of ecstasy in 2007 compared to 2006 (p=0.8089) indicating that the purity of ecstasy has remained ‘medium/high’ over the past two years (Table 6.10).

Table 6.10: Current purity of ecstasy (MDMA) by combined frequent drug user group, 2006-2007 2006 2007 Current purity of Combined Combined ecstasy (MDMA) modules modules (%) (n=191) (n=156) Low [1] 8% 8% Medium [2] 31% 29% Fluctuates [2] 32% 33% High [3] 29% 30% Average purity score (1=low – 2.2 2.2 3=high) Overall current Medium/ Medium/ status high high

6.5.2 Change in purity of ecstasy (MDMA)

In 2007, 39% of the frequent drug users reported that the purity of ecstasy (MDMA) had been ‘stable’ in the previous six months, with a further 36% saying that purity had ‘fluctuated’ over this time (Table 6.11). The average score for the change in the purity of ecstasy (MDMA) for all the frequent drug users was 1.9, which indicates that overall the purity of ecstasy (MDMA) was ‘stable/fluctuating’ over the last six months in 2007. There was no statistically significant difference in the average score for the change in purity of ecstasy (MDMA) between the three groups of frequent drug users, with all three groups indicating that the purity of ecstasy (MDMA) had been ‘stable/fluctuating’ over the previous six months in 2007 (p=0.9195).

Centre for Social and Health Outcomes Research and Evaluation 101 Te Runanga, Wananga, Hauora me te Paekaka

Table 6.11: Change in purity of ecstasy (MDMA) by frequent drug user group, 2007 Change in purity Methamphetamine Ecstasy users Combined modules of ecstasy users (MDMA) (n=151) (includes (MDMA) (n=40) (n=95) frequent injecting (%) drug users) Decreasing [1] 15% 15% 15% Stable [2] 38% 38% 39% Fluctuating [2] 35% 39% 36% Increasing [3] 13% 8% 10%

Average change in purity score 2.0 1.9 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ change Fluctuates Fluctuates fluctuates

There was no statistically significant difference in the average score for the change in purity of ecstasy in 2007 compared to 2006 (p=0.7855) indicating that the purity of ecstasy has remained ‘stable/fluctuating’ over the past two years (Table 6.12).

Table 6.12: Change in purity of ecstasy (MDMA) by combined frequent drug users, 2006-2007 2006 2007 Change in purity Combined Combined of ecstasy modules modules (MDMA) (n=183) (n=151) (%) Decreasing [1] 14% 15% Stable [2] 36% 39% Fluctuating [2] 40% 36% Increasing [3] 10% 10%

Average change in purity score 2.0 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change fluctuates fluctuates

6.6 Perceptions of the number of people using ecstasy (MDMA)

In 2007, 52% of the frequent drug users thought ‘more’ of people they know were using ecstasy (MDMA) and 42% said the ‘same’ number of people they know were using ecstasy (MDMA) in the previous six months (Table 6.13). The average score for all the frequent drug users for the question was 2.5 indicating that overall the ‘more/same’ people were using ecstasy (MDMA) compared to six months ago in 2007. The frequent ecstasy users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people were using ecstasy in 2007 (2.5 vs. 2.3, p=0.0459). Several KE reported that they had observed increased use of ecstasy in the past six months.

Centre for Social and Health Outcomes Research and Evaluation 102 Te Runanga, Wananga, Hauora me te Paekaka

Table 6.13: Perceptions of the number of people using ecstasy (MDMA) by frequent drug user group, 2007 Number of Methamphetamine Ecstasy users Combined modules people using users (MDMA) (n=159) (includes ecstasy (MDMA) (n=42) (n=102) frequent injecting (%) drug users) Less [1] 14% 3% 6% Same [2] 43% 39% 42% More [3] 43% 58% 52%

Average number of people using 2.3 2.5 2.5 score (1=less – 3=more) Overall recent Same/ More/ More/ change More same same

The average score for the number of people using ecstasy was statistically significantly higher in 2007 compared to 2006 (2.5 vs. 2.3, p=0.0111) indicating that more people were using ecstasy in 2007 compared to 2006 (Table 6.14).

Table 6.14: Perceptions of the number of people using ecstasy (MDMA) by combined frequent drug users, 2006-2007 2006 2007 Number of Combined Combined people using modules modules ecstasy (MDMA) (n=196) (n=159) (%) Less [1] 11% 6% Same [2] 51% 42% More [3] 39% 52%

Average number of people using 2.3 2.5 score (1=less – 3=more) Overall recent Same/ More/ change more same

6.7 Seizures of ecstasy (MDMA)

Annual seizures of ecstasy (MDMA) pills made by the New Zealand Police and New Zealand Customs Service increased dramatically in 2001 and remained high until 2003 (Figure 6.1). Seizures of ecstasy (MDMA) have declined steady since 2003 to fairly low levels. KE in drug enforcement attribute the recent decline in seizures of ecstasy (MDMA) to more elaborate smuggling methods being used by international drug trafficking groups rather than a decline in the use of the drug.

Centre for Social and Health Outcomes Research and Evaluation 103 Te Runanga, Wananga, Hauora me te Paekaka Figure 6.1: Pills of ecstasy (MDMA) seized in New Zealand, 2000-2006

300,000 266,175 256,973

250,000

200,000

150,000

Number (pills) (pills) Number 83,448 100,000 45,387 25,401 50,000 9,352 4,995

0 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

6.8 Ecstasy (MDMA) use in the general population

The proportion of the New Zealand population aged 15-45 years old who had ever tried ecstasy (MDMA) increased in 2006 compared to 2003 (8.0% vs. 5.5%, p=0.0019) (Wilkins and Sweetsur, 2008). There was also an increase in the proportion of the population who had ever tried ecstasy in 2006 compared to 2001 (8.0% vs. 5.4%, p=0.0003) and in 2006 compared to 1998 (8.0% vs. 3.1%, p=0.0019) (Wilkins and Sweetsur, 2008). There was no statistically significant change in the proportion of people who had used ecstasy in the previous year in 2006 compared to 2003, although this was close to being statistically significant (3.9% vs. 2.9%, p=0.0808) (Wilkins and Sweetsur, 2008). There was a statistically significant increase in the last year use of ecstasy in 2006 compared to 1998 (3.9% vs. 1.5%, p<0.0001) (Wilkins and Sweetsur, 2008).

6.9 Summary of ecstasy (MDMA) trends

• In 2007, the current availability of ecstasy (MDMA) was reported to be ‘easy’

• The availability of ecstasy (MDMA) remained the same in 2006 and 2007

• In 2007, a pill of ecstasy (MDMA) cost a median price of $60

Centre for Social and Health Outcomes Research and Evaluation 104 Te Runanga, Wananga, Hauora me te Paekaka

• The mean price of a pill of ecstasy was lower in 2007 than in 2006

• In 2007, the current purity of ecstasy (MDMA) was considered to be ‘medium/high’

• The purity of ecstasy (MDMA) has been ‘stable/fluctuating’ over the past two years

• In 2007, the frequent ecstasy users were more likely to say that ‘more’ people they know were using ecstasy than the other frequent drug user groups

• Overall, the frequent drug users perceived that ‘more’ people were using ecstasy in 2007 than in 2006

• Annual seizures of ecstasy (MDMA) have declined dramatically in recent years and this is thought to reflect the fact that drug smugglers are using more sophisticated smuggling techniques

• National household survey data indicates the population prevalence of use of ecstasy (MDMA) has increased in recent years

Centre for Social and Health Outcomes Research and Evaluation 105 Te Runanga, Wananga, Hauora me te Paekaka 7. Cannabis

7.1 Introduction

Cannabis is New Zealand’s most widely used illegal drug and the third most popular drug after alcohol and tobacco. The supply of cannabis in New Zealand is met almost entirely through domestic cannabis cultivation, either via clandestine outdoor cultivation or indoor hydroponics growing techniques (Yska, 1990, Wilkins et al., 2002b, Wilkins and Casswell, 2003). The black market for cannabis in New Zealand has recently been estimated to have an annual dollar turnover of $131-$190 million dollars (NZD) (Wilkins et al., 2002a, Wilkins et al., 2005c). Cannabis is sold in New Zealand within private social networks and from public drug houses, known as ‘tinny’ houses (Wilkins et al., 2005b). Recent analysis of cannabis purchasing in New Zealand has found that adolescents aged 15-17 years old were more likely to purchase their cannabis from ‘tinny’ houses than older cannabis buyers (Wilkins et al., 2005b). Exploration of the structure of the illegal market for cannabis in New Zealand suggests that many cannabis users receive their cannabis for ‘free’ during group consumption sessions, and that many heavy cannabis users finance their spending on cannabis through selling cannabis (Wilkins and Sweetsur, 2006a). High spending on cannabis has greatest financial impact among low income groups, where approximately 8% of low income cannabis buyers are spending 20% or more of their gross annual personal income on cannabis (Wilkins and Sweetsur, 2007).

7.2 Knowledge of cannabis trends

In 2007, 82% of the frequent drug users interviewed (n=262) indicated they felt confident enough to comment on the price, purity and availability of cannabis in the previous six months. This included 84% of the frequent methamphetamine users (n=92), 87% of the frequent ecstasy users (n=91) and 73% of the frequent injecting drug users (n=79).

7.3 Availability of cannabis

7.3.1 Current availability of cannabis

In 2007, 64% of the frequent drug users described the current availability of cannabis as ‘very easy’, with a further 30% describing the availability of the drug as ‘easy’ (Table 7.1). The average score for the current availability of cannabis for all the frequent drug users was 1.4 which indicates that overall the current level of availability of cannabis was ‘very easy/easy’ in 2007. There was no statistically significant difference in the average score for the current availability of cannabis between the three groups of frequent drug users, with all three groups reporting the current availability of cannabis as ‘very easy/easy’ in 2007 (p=0.6114).

Centre for Social and Health Outcomes Research and Evaluation 106 Te Runanga, Wananga, Hauora me te Paekaka Table 7.1: Current availability of cannabis by frequent drug user group, 2007 Current Methamphetamine Ecstasy users Intravenous drug Combined availability of users (MDMA) users (IDU) modules cannabis (%) (n=99) (n=93) (n=78) (n=263) Very easy [1] 70% 59% 64% 64% Easy [2] 25% 32% 33% 30% Difficult [3] 5% 6% 1% 5% Very difficult [4] 0% 2% 1% 1%

Average availability score (1=very easy 1.4 1.5 1.4 1.4 – 4=very difficult) Overall current Very easy/ Very easy/ Very easy/ Very easy status easy easy easy / easy

There was no statistically significant difference in the average score for the current availability of cannabis in 2007 compared to 2006 (p=0.3027) indicating that the availability of cannabis has remained ‘very easy/easy’ over the past two years (Table 7.2).

Table 7.2: Current availability of cannabis by combined frequent drug users, 2006-2007 2006 2007 Current Combined Combined availability of modules modules cannabis (%) (n=276) (n=263) Very easy [1] 60% 64% Easy [2] 36% 30% Difficult [3] 4% 5% Very difficult [4] 0% 1%

Average availability score 1.5 1.4 (1=very easy – 4=very difficult) Overall current Very easy Very easy status / easy / easy

7.3.2 Change in availability of cannabis

In 2007, 71% of the frequent drug users reported that the availability of cannabis had been ‘stable’ in the previous six months (Table 7.3). The average score for the change in the availability of cannabis for all the frequent drug users was 2.0 which indicates that overall the availability of cannabis was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in availability of cannabis between the three groups of frequent drug users, with all three groups indicating that the availability of cannabis had been ‘stable’ over the previous six months in 2007 (p=0.06).

Centre for Social and Health Outcomes Research and Evaluation 107 Te Runanga, Wananga, Hauora me te Paekaka Table 7.3: Change in availability of cannabis by frequent drug user group, 2007 Change in Methamphetamine Ecstasy users Intravenous drug Combined availability users (MDMA) users (IDU) modules of cannabis (%) (n=91) (n=92) (n=78) (n=261) Easier [1] 9% 18% 5% 11% Stable [2] 73% 63% 79% 71% Fluctuates [2] 7% 11% 8% 8% More difficult [3] 12% 8% 8% 9%

Average change in availability score (1=easier – 3=more 2.1 1.9 2.0 2.0 difficult) Overall recent Stable Stable Stable Stable change

There was no statistically significant difference in the average score for the change in availability of cannabis in 2007 compared to 2006 (p=0.3603) indicating that the availability of cannabis remained ‘stable’ over the past two years (Table 7.4).

Table 7.4: Change in availability of cannabis by combined frequent drug users, 2006-2007 2006 2007 Change in Combined Combined availability modules modules of cannabis (%) (n=274) (n=261) Easier [1] 7% 11% Stable [2] 69% 71% Fluctuates [2] 15% 8% More difficult [3] 9% 9%

Average change in availability score (1=easier – 2.0 2.0 3=more difficult) Overall recent Stable Stable change

7.4 Price of cannabis

7.4.1 Current price of cannabis

In 2007, the median price paid for a ‘tinny/foil’ (1.5 grams) of cannabis was $20 (Table 7.5). The median price paid for an ounce (28 grams) of cannabis was $300. There was no statistically significant difference in the mean price paid for a ‘tinny/ foil’ (p=0.2891) or an ounce (p=0.753) of cannabis between the three groups of frequent drug users.

Centre for Social and Health Outcomes Research and Evaluation 108 Te Runanga, Wananga, Hauora me te Paekaka Table 7.5: Current median (mean) price for cannabis (NZD) by frequent drug user group, 2007 Current price of Methamphetamine Ecstasy users Intravenous drug Combined cannabis users (MDMA) users (IDU) modules

Number with n=69 n=74 n=64 n=207 knowledge Median (mean) price for a ‘tinny/foil’ (1.5 $20 ($20) $20 ($20) $20 ($20) $20 ($20) grams) Number with n=45 n=24 n=62 n=101 knowledge Median (mean) price for an ounce (28 $300 ($312) $300 ($308) $300 ($317) $300 ($313) grams)

There was no statistically significant change in the mean price paid for a ‘tinny/foil’ of cannabis in 2007 compared to 2006 (p=0.4194) (Table 7.6). The mean price paid for an ounce of cannabis was statistically significantly higher in 2007 compared to 2006 ($313 vs. $300, p=0.0168).

Table 7.6: Current median (mean) price for cannabis (NZD) by combined frequent drug users, 2006-2007 2006 2007 Current price of Combined Combined cannabis modules modules

Number with n=229 n=207 knowledge Median (mean) price for a ‘tinny/foil’ $20 ($20.37) $20 ($20.22) (1.5 grams) Number with n=175 n=101 knowledge Median (mean) price for an ounce $300 ($300) $300 ($313) (28 grams)

7.4.2 Change in price of cannabis

In 2007, 82% of the frequent drug users reported that the price of cannabis had been ‘stable’ in the previous six months (Table 7.7). The average score for the change in the price of cannabis for all the frequent drug users was 2.0 which indicates that overall the price of cannabis was ‘stable’ over the previous six months in 2007. There was no statistically significant difference in the average score for the change in price of cannabis between the three groups of frequent drug users with all three groups saying the price of cannabis had been stable over the past six months in 2007 (p=0.5941).

Centre for Social and Health Outcomes Research and Evaluation 109 Te Runanga, Wananga, Hauora me te Paekaka Table 7.7: Change in the price of cannabis in the last six months by frequent drug user group, 2007 Change in price of Methamphetamine Ecstasy users Intravenous drug Combined cannabis (%) users (MDMA) users (IDU) modules (n=92) (n=83) (n=78) (n=253) Decreasing [1] 7% 5% 4% 4% Stable [2] 89% 80% 77% 82% Fluctuating [2] 0% 7% 8% 5% Increasing [3] 7% 8% 12% 9% Average change in price score (1=decreasing – 2.0 2.0 2.1 2.0 3=increasing) Overall recent Stable Stable Stable Stable change

There was no statistically significant change in the average score of the change in the price of cannabis in 2007 compared to 2006 (p=0.5466) indicating that the price of cannabis has remained ‘stable’ over the past two years (Table 7.8).

Table 7.8: Change in the price of cannabis in the last six months by combined frequent drug users, 2006- 2007 Change in price of Combined Combined cannabis (%) modules modules (n=269) (n=253) Decreasing [1] 4% 4% Stable [2] 74% 82% Fluctuating [2] 10% 5% Increasing [3] 11% 9% Average change in price score (1=decreasing – 2.1 2.0 3=increasing) Overall recent Stable Stable change

7.5 Purity of cannabis

7.5.1 Current purity of cannabis

In 2007, 51% of the frequent drug users described the current strength of cannabis as ‘high’ with 34% reporting the purity as ‘fluctuating’ (Table 7.9). The average score for the current strength of cannabis for all the frequent drug users was 2.5 which indicates that overall the current strength of cannabis is ‘high/medium’. The frequent methamphetamine users were more likely than the frequent ecstasy users to report the current purity of cannabis as high (2.6 vs. 2.3, p=0.0046). The frequent injecting drug users were also more likely than the frequent ecstasy users to report the current strength of cannabis to be high and this was close to being statistically significant (2.5 vs. 2.3, p=0.0536). Centre for Social and Health Outcomes Research and Evaluation 110 Te Runanga, Wananga, Hauora me te Paekaka

Table 7.9: Current purity of cannabis by frequent drug user group, 2007 Current purity of Methamphetamine Ecstasy users Intravenous drug Combined cannabis users (MDMA) users (IDU) modules (%) (n=91) (n=88) (n=79) (n=258) Low [1] 0% 5% 0% 2% Medium [2] 11% 15% 15% 14% Fluctuates [2] 27% 42% 32% 34% High [3] 60% 39% 53% 51% Average purity score 2.6 2.3 2.5 2.5 (1=low – 3=high) Overall current High/ Fluctuates/ High/ High/ status medium high medium medium

There was no statistically significant change in the average score for the current strength of cannabis in 2007 compared to 2006 (p=0.2066) indicating that the strength of cannabis has remained ‘high/medium’ over the past two years (Table 7.10). However, the frequent methamphetamine users thought the strength of cannabis was higher in 2007 than in 2006 (2.6 vs. 2.4, p=0.0284). A number of law enforcement KE reported increasing incidence of hydroponic cannabis cultivation and this type of cultivation can produce particularly potent forms of cannabis for sale. This trend in cannabis cultivation may explain the reports of more potent cannabis by the frequent methamphetamine users in 2007 compared to 2006.

Table 7.10: Current purity of cannabis by combined frequent drug users and by frequent methamphetamine users, 2006-2007 2006 2007 2006 2007 Current purity of Combined Combined Methamphetamine Methamphetamine cannabis modules modules users users (%) (n=267) (n=258) (n=96) (n=91) Low [1] 4% 2% 4% 0% Medium [2] 16% 14% 25% 11% Fluctuates [2] 33% 34% 25% 27% High [3] 47% 51% 46% 60% Average purity score (1=low – 2.4 2.5 2.4 2.6 3=high) Overall current High/ High/ High/ High status medium medium medium

7.5.2 Change in purity of cannabis

In 2007, 50% of the frequent drug users reported that the strength of cannabis had been ‘stable’ in the previous six months, with a further 30% saying that the strength of cannabis had ‘fluctuated’ over this time (Table 7.11). The average score for the change in the strength of cannabis for all the frequent drug users was 2.1 which indicates that overall the strength of cannabis was ‘stable/fluctuating’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in strength of Centre for Social and Health Outcomes Research and Evaluation 111 Te Runanga, Wananga, Hauora me te Paekaka cannabis between the three groups of frequent drug users, with all three groups indicating that the strength of cannabis had been ‘stable/fluctuating’ over the previous six months in 2007 (p=0.3969).

Table 7.11: Change in purity of cannabis by frequent drug user group, 2007 Change in purity of Methamphetamine Ecstasy users Intravenous drug Combined cannabis users (MDMA) users (IDU) modules (%) (n=90) (n=85) (n=79) (n=254) Decreasing [1] 3% 6% 1% 4% Stable [2] 59% 39% 52% 50% Fluctuating [2] 18% 41% 30% 30% Increasing [3] 20% 14% 16% 17%

Average change in purity score 2.2 2.1 2.2 2.1 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ Stable/ change Fluctuates Fluctuates fluctuates fluctuates

There was no statistically significant change in the average score for the change in strength of cannabis in 2007 compared to 2006 (p=0.9175) indicating that the strength of cannabis has remained ‘stable/increasing’ over the past two years (Table 7.12).

Table 7.12: Change in purity of cannabis by combined frequent drug users, 2006-2007 2006 2007 Change in purity Combined Combined of cannabis modules modules (%) (n=262) (n=254) Decreasing [1] 5% 4% Stable [2] 46% 50% Fluctuating [2] 31% 30% Increasing [3] 18% 17%

Average change in purity score 2.1 2.1 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change increasing increasing

7.6 Perceptions of the number of people using cannabis

In 2007, 66% of the frequent drugs thought ‘about the same’ number of people they know were using cannabis compared to six months ago and 22% said ‘more’ people were using cannabis (Table 7.13). The average score for all the frequent drug users for the question was 2.1 indicating that overall the ‘same/more’ people were using cannabis compared to six months ago. There was no statistically significant difference in Centre for Social and Health Outcomes Research and Evaluation 112 Te Runanga, Wananga, Hauora me te Paekaka perceptions of the number of people using cannabis between the three groups of frequent drug users, with all three saying the ‘same/more’ people they know were using cannabis compared to six months ago (p=0.8413).

Table 7.13: Perceptions of the number of people using cannabis by frequent drug user group, 2007 Number of people Methamphetamine Ecstasy users Intravenous drug Combined using cannabis (%) users (MDMA) users (IDU) modules (n=91) (n=93) (n=78) (n=262) Less [1] 12% 15% 8% 12% Same [2] 64% 62% 72% 66% More [3] 24% 23% 19% 22%

Average number of people using score 2.1 2.1 2.1 2.1 (1=less – 3=more) Overall recent Same/ Same/ Same/ Same/ change More more more more

There was no statistically significant difference in the average score for the change in the number of people using cannabis in 2007 compared to 2006 (p=0.583), indicating that the number of people using cannabis has remained the ‘same/more’ over the past two years (Table 7.14).

Table 7.14: Perceptions of the number of people using cannabis by combined frequent drug users, 2006-2007 2006 2007 Number of Combined Combined people using modules modules cannabis (%) (n=279) (n=262) Less [1] 10% 12% Same [2] 73% 66% More [3] 17% 22%

Average number of people using score (1=less – 2.1 2.1 3=more) Overall recent Same/ Same/ change more more

7.7 Seizures of cannabis plants

Annual seizures of cannabis plants by the New Zealand Police have been on average higher in the last three years than the preceding three years. Between 2003-2005 an average of 164,600 cannabis plants were seized and destroyed each year by police (Figure 7.1). This compares to an average of 89,920 plants seized each

Centre for Social and Health Outcomes Research and Evaluation 113 Te Runanga, Wananga, Hauora me te Paekaka year from 2000-2002. Figures on the number of cannabis plants seized in 2006 were not available at the time of writing this report.

Figure 7.1 Annual seizures of cannabis plants, 2000-2005

193,740 200,000

180,000 162,263

160,000 137,863

140,000

120,000 105,131 90,857 100,000 73,772 80,000 Number (plants) (plants) Number 60,000

40,000

20,000

0 2000 2001 2002 2003 2004 2005

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

7.8 Cannabis use in the general population

The proportion of the New Zealand population aged 15-45 years old who had ever tried cannabis decreased in 2006 compared to 2003 (44.1% vs. 53.8%, p<0.0001) (Wilkins and Sweetsur, 2008). The proportion of people who had used cannabis in the previous 12 months decreased in 2006 compared to 2001 (17.9% vs. 20.3%, p=0.0448) (Wilkins and Sweetsur, 2008). Note, the last year result only just comes under the 0.05% cut off point for statistical significance and so should be treated with some caution.

Centre for Social and Health Outcomes Research and Evaluation 114 Te Runanga, Wananga, Hauora me te Paekaka 7.9 Summary of cannabis trends

• In 2007, the current availability of cannabis was reported to be ‘very easy/easy’

• The availability of cannabis was the same in 2007 as in 2006

• In 2007, a ‘tinny’ (i.e. 1.5 grams) of cannabis cost a median price of $20, while an ounce of cannabis currently cost a median price of $300

• The mean price of an ounce of cannabis was higher in 2007 than in 2006

• In 2007, the current strength of cannabis was described as ‘high/medium’

• The frequent methamphetamine users and frequent injecting drug users thought the current strength of cannabis was higher than the frequent ecstasy users

• The frequent methamphetamine users considered the strength of cannabis to be higher in 2007 than in 2006

• Overall, the strength of cannabis was considered to be ‘stable/increasing’ in 2007 and 2006

• The number of people using cannabis was described as the ‘same/more’ in both 2006 and 2007

• National household survey data suggests that the population prevalence of use of cannabis may have decreased in recent years

Centre for Social and Health Outcomes Research and Evaluation 115 Te Runanga, Wananga, Hauora me te Paekaka 8. LSD

8.1 Introduction

Lysergic acid diethylamide or LSD (‘trips’ or ‘acid’) is a hallucinogen which gained notoriety in many Western countries during the 1960s. While the use of LSD waned in many other countries in subsequent decades, LSD remained relatively popular among drug users in New Zealand. Comparison of national household drug surveys conducted in 1990 and 1998 found increased use of LSD in the population (Field and Casswell, 1999). Between 1990-1994, New Zealand had the seventh highest number of LSD seizures of 24 countries surveyed (New Zealand Customs Service, 2002). In more recent years, the use of LSD in New Zealand has been eclipsed to some extent by the emergence of ecstasy and methamphetamine (Wilkins et al., 2002c, Wilkins et al., 2002d, Wilkins et al., 2003).

8.2 Knowledge of LSD trends

In 2007, 32% of the frequent drug users interviewed (n=103) indicated they felt confident enough to comment on the price, purity and availability of LSD in the previous six months. This included 37% of the frequent methamphetamine users (n=40), 43% of the frequent ecstasy users (n=40) and 17% of the frequent injecting drug users (n=18). As there were only very small numbers of frequent injecting drug users with knowledge of LSD, we included these users in the combined group of frequent drug users and not as a separate frequent drug user group.

8.3 Availability of LSD

8.3.1 Current availability of LSD

In 2007, 42% of the frequent drug users described the current availability of LSD as ‘difficult’ and 33% said the availability of LSD was ‘easy’ (Table 8.1). The average score for the current availability of LSD for all the frequent drug users was 2.4 which indicates that overall the current level of availability of LSD is ‘difficult/easy’ in 2007. There was no statistically significant difference in the average score for the current availability for LSD between the three groups of frequent drug users, with all three groups reporting the current availability of LSD as ‘difficult/easy’ in 2007 (p=0.2289).

Centre for Social and Health Outcomes Research and Evaluation 116 Te Runanga, Wananga, Hauora me te Paekaka Table 8.1: Current availability of LSD by frequent drug user group, 2007 Current Methamphetamine Ecstasy users Combined modules availability of users (MDMA) (n=102) (includes LSD (%) (n=39) (n=45) frequent injecting drug users) Very easy [1] 15% 20% 17% Easy [2] 23% 38% 33% Difficult [3] 49% 38% 42% Very difficult [4] 13% 4% 8%

Average availability score (1=very easy – 2.6 2.3 2.4 4=very difficult) Overall current Difficult/ Difficult/ Difficult/ status easy easy easy

There was no statistically significant difference in the average score for the current availability of LSD in 2007 compared to 2006 (p=0.7665) indicating that the availability of LSD has remained ‘difficult/easy’ over the past two years (Table 8.2).

Table 8.2: Current availability of LSD by combined frequent drug users, 2006-2007 2006 2007 Current Combined Combined availability of modules modules LSD (%) (n=124) (n=102) Very easy [1] 8% 17% Easy [2] 47% 33% Difficult [3] 38% 42% Very difficult [4] 7% 8%

Average availability score (1=very easy – 2.4 2.4 4=very difficult) Overall current Easy/ Difficult/ status difficult easy

8.3.2 Change in availability of LSD

In 2007, 40% of the frequent drug users reported that the availability of LSD had been ‘stable’ in the previous six months, with a further 21% saying availability had been ‘more difficult’ over the past six months (Table 8.3). The average score for the change in availability of LSD for all the frequent drug users was 2.0 which indicates that overall the availability of LSD was ‘stable/fluctuating’ over the past six months in 2007. The frequent methamphetamine users were more likely than the frequent ecstasy users to say that the availability of LSD had become ‘more difficult’ in the past six months in 2007 (2.2 vs. 1.9, p=0.0327).

Centre for Social and Health Outcomes Research and Evaluation 117 Te Runanga, Wananga, Hauora me te Paekaka Table 8.3: Change in availability of LSD by frequent drug user group, 2007 Change in Methamphetamine Ecstasy users Combined modules availability users (MDMA) (n=96) (includes of LSD (%) (n=39) (n=39) frequent injecting drug users) Easier [1] 15% 18% 20% Stable [2] 38% 44% 40% Fluctuates [2] 8% 33% 20% More difficult [3] 38% 5% 21%

Average change in availability 2.2 1.9 2.0 score (1=easier – 3=more difficult) Overall recent Stable/ Stable/ Stable change more difficult fluctuates

There was no statistically significant difference in the average score for the change in availability of LSD in 2007 compared to 2006 (p=0.8604) indicating that the availability of LSD has remained ‘stable’ over the past two years (Table 8.4).

Table 8.4: Change in availability of LSD by combined frequent drug users, 2006-2007 Change in Combined Combined availability modules modules of LSD (%) (n=119) (n=96) Easier [1] 16% 20% Stable [2] 34% 40% Fluctuates [2] 31% 20% More difficult [3] 18% 21%

Average change in availability 2.0 2.0 score (1=easier – 3=more difficult) Overall recent Stable/ Stable/ change fluctuates fluctuates

Centre for Social and Health Outcomes Research and Evaluation 118 Te Runanga, Wananga, Hauora me te Paekaka 8.4 Price of LSD

8.4.1 Current price of LSD

In 2007, the median price paid for a ‘tab’ of LSD was $40 (Table 8.5). There was no statistically significant difference in the mean price paid for a ‘tab’ of LSD between the three groups of frequent drug users.

Table 8.5: Current median (mean) price for LSD (NZD) by frequent drug user group, 2007 Current price of Methamphetamine Ecstasy users Intravenous drug Combined LSD users (MDMA) users (IDU) modules (n=32) (n=31) (n=12) (n=75) Median (mean) price $33 ($36) $40 ($39) $30 ($31) $40 ($36) for a ‘tab’

There was no statistically significant difference in the mean price paid for a tab of LSD in 2007 compared to 2006 (p=0.486) (Table 8.6).

Table 8.6: Current median (mean) price for LSD (NZD) by combined frequent drug users, 2006-2007

2006 2007 Current price of Combined Combined LSD modules modules (n=117) (n=75) Median (mean) $35 ($35) $40 ($36) price for a ‘tab’

8.4.2 Change in price of LSD

In 2007, 70% of the frequent drug users reported that the price of LSD had been ‘stable’ in the previous six months (Table 8.4). The average score for the change in the price of LSD for all the frequent drug users was 2.1 which indicates that overall the price of LSD was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in price of LSD between the three groups of frequent drug users, with all three describing the price as ‘stable’ in 2007 (p=0.584).

Centre for Social and Health Outcomes Research and Evaluation 119 Te Runanga, Wananga, Hauora me te Paekaka Table 8.7: Change in the price of LSD in the past six months by frequent drug user group, 2007 Change in price Methamphetamine Ecstasy users Combined modules of LSD (%) users (MDMA) (n=96) (includes (n=39) (n=40) frequent injecting drug users) Decreasing [1] 5% 5% 5% Stable [2] 67% 70% 70% Fluctuating [2] 10% 13% 11% Increasing [3] 18% 13% 14%

Average change in price score (1=decreasing – 2.1 2.1 2.1 3=increasing) Overall recent Stable Stable Stable change

There was no statistically significant difference in the average score for the change in the price of LSD in 2007 compared to 2006 (p=0.173), indicating that the price of LSD has remained ‘stable’ over the past two years (Table 8.8).

Table 8.8: Change in the price of LSD in the past six months by combined frequent drug users, 2006-2007 2006 2007 Change in price Combined Combined of LSD (%) modules modules (n=117) (n=96) Decreasing [1] 10% 5% Stable [2] 70% 70% Fluctuating [2] 9% 11% Increasing [3] 10% 14%

Average change in price score (1=decreasing – 2.0 2.1 3=increasing) Overall recent Stable Stable change

8.5 Purity of LSD

8.5.1 Current purity of LSD

In 2007, 35% of the frequent drug users described the current strength of LSD as ‘high’ with 26% reporting its current strength to be ‘fluctuating’ (Table 8.9). The average score for the current strength of LSD for all the frequent drug users was 2.2 which indicates that overall the strength of LSD was ‘medium/high’ in 2007. There was no statistically significant difference between the three groups of frequent drug users with respect to the current strength of LSD with all three groups reporting the strength of LSD as ‘medium/high’ in 2007 (p=0.1897).

Centre for Social and Health Outcomes Research and Evaluation 120 Te Runanga, Wananga, Hauora me te Paekaka Table 8.9: Current purity of LSD by frequent drug user group, 2007 Current purity of Methamphetamine Ecstasy users Combined modules LSD users (MDMA) (n=92) (includes (%) (n=37) (n=38) frequent injecting drug users) Low [1] 22% 8% 16% Medium [2] 27% 18% 23% Fluctuates [2] 22% 32% 26% High [3] 30% 42% 35% Average purity score (1=low – 2.1 2.3 2.2 3=high) Overall current Medium/ Medium/ Medium/ status high high high

There was no statistically significant difference in the average score for the current purity of LSD in 2007 compared to 2006 (p=0.8991) indicating that the strength of LSD has remained ‘medium/high’ over the past two years (Table 8.10).

Table 8.10: Current purity of LSD by combined frequent drug users, 2006-2007 2006 2007 Current purity of Combined Combined LSD modules modules (%) (n=121) (n=92) Low [1] 8% 16% Medium [2] 41% 23% Fluctuates [2] 26% 26% High [3] 26% 35% Average purity score (1=low – 2.2 2.2 3=high) Overall current Medium/ Medium/ status high high

8.5.2 Change in purity of LSD

In 2007, 39% of the frequent drug users reported that the strength of LSD had been ‘stable’ in the previous six months while 28% said it had ‘fluctuated’ in the past six months (Table 8.11). The average score for the change in the strength of LSD for all the frequent drug users was 2.0 which indicates that overall the strength of LSD had been ‘stable/fluctuating’ over the past six months in 2007. The frequent methamphetamine users were statistically significantly more likely than the frequent ecstasy users to say the strength of LSD had declined in 2007 (1.8 vs. 2.2, p=0.0089).

Centre for Social and Health Outcomes Research and Evaluation 121 Te Runanga, Wananga, Hauora me te Paekaka Table 8.11: Change in purity of LSD by frequent drug user group, 2007 Change in purity Methamphetamine Ecstasy users Combined modules of cannabis users (MDMA) (n=85) (includes (%) (n=37) (n=31) frequent injecting drug users) Decreasing [1] 27% 3% 18% Stable [2] 38% 48% 39% Fluctuating [2] 30% 26% 28% Increasing [3] 5% 23% 15% Average change in purity score 1.8 2.2 2.0 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ change decreasing increasing fluctuating

There was no statistically significant difference in the average score for the change in the purity of LSD in 2007 compared to 2006 (p=0.5988), indicating that the strength of LSD has remained ‘stable/fluctuating’ over the past two years (Table 8.12).

Table 8.12: Change in purity of LSD by combined frequent drug users, 2006-2007 2006 2007 Change in purity Combined Combined of cannabis modules modules (%) (n=109) (n=85) Decreasing [1] 13% 18% Stable [2] 44% 39% Fluctuating [2] 28% 28% Increasing [3] 15% 15% Average change in purity score 2.0 2.0 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change fluctuating fluctuating

8.6 Perceptions of the number of people using LSD

In 2007, 50% of frequent drugs thought ‘about the same’ number of people they know were using LSD with 24% saying ‘less’ people were using the drug (Table 8.13). The average score for all the frequent drug users for the question was 2.0 indicating that overall ‘about the same’ number of people were using LSD compared to six months ago in 2007. The frequent ecstasy users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people they know were using LSD compared to six months ago in 2007 (2.3 vs. 1.8, p=0.0036). Several KE indicated there may have been some revival of the popularity of LSD, although other KE considered its use to be on the decline.

Centre for Social and Health Outcomes Research and Evaluation 122 Te Runanga, Wananga, Hauora me te Paekaka Table 8.13: Perceptions of the number of people using LSD by frequent drug user group, 2007 Number of Methamphetamine Ecstasy users Combined modules people using users (MDMA) (n=101) (includes LSD (%) (n=39) (n=45) frequent injecting drug users) Less [1] 36% 13% 24% Same [2] 51% 47% 50% More [3] 13% 40% 22% Average number of people using 1.8 2.3 2.0 score (1=less – 3=more) Overall recent Same/ Same/ Same change Less more

There was no statistically significant difference in the average score for the change in the number of people using LSD in 2007 compared to 2006 (p=0.3649) indicating that the number of people using LSD has remained ‘the same’ over the past two years (Table 8.13).

Table 8.13: Perceptions of the number of people using LSD by frequent drug user group, 2007 2006 2007 Number of Combined Combined people using modules modules LSD (%) (n=125) (n=101) Less [1] 27% 24% Same [2] 51% 50% More [3] 22% 22% Average number of people using 1.9 2.0 score (1=less – 3=more) Overall recent Same Same change

8.7 Seizures of LSD

Annual seizures of LSD by New Zealand Police and the New Zealand Customs Service fell dramatically after 2000 and returned only briefly to previous levels in 2003 (Figure 8.1). Since 2004 there have been increasing seizures of LSD, but these are yet to approach the levels achieved in 1999 and 2000. LSD is an odourless, colourless, concentrated liquid and is consequently extremely difficult to detect.

Centre for Social and Health Outcomes Research and Evaluation 123 Te Runanga, Wananga, Hauora me te Paekaka Figure 8.1: Tabs of LSD seized in New Zealand, 1999-2006

19,331 20,000

18,000

16,000 13,687 14,000

12,000

10,000 7,033 8,000 Number (tabs)

6,000 3,471 4,000 1,057 479 1,328 2,000 434

0 1999 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

8.8 LSD use in the general population

The proportion of the New Zealand population aged 15-45 years old who had ever tried LSD remained the same in 2006 compared to 2003 (8.5% versus 8.1%, p=0.6789) (Wilkins and Sweetsur, 2008). The proportion of the population who had used LSD in the previous 12 months also remained the same in 2006 compared to 2003 (1.8% vs. 1.9%, p=0.9388) (Wilkins and Sweetsur, 2008). The proportion of the population who had used LSD was statistically significantly lower in 2006 compared to 2001 (1.8% vs. 3.2%, p=0.0071) and lower in 2006 compared to 1998 (1.8% vs. 3.9%, p=0.0002 (Wilkins and Sweetsur, 2008).

Centre for Social and Health Outcomes Research and Evaluation 124 Te Runanga, Wananga, Hauora me te Paekaka 8.9 Summary of LSD trends

• In 2007, the current availability of LSD was reported to be ‘difficult/easy’

• In 2007, the frequent methamphetamine users were more likely to say the availability of LSD had become ‘more difficult’ in the past six months

• The availability of LSD was considered to have been ‘stable/fluctuating’ over the past two years

• In 2007, the median price paid for a ‘tab’ of LSD was $40

• The price of LSD is reported to have been ‘stable’ over the past two years

• In 2007, the current strength of LSD was described as ‘medium/high’

• In 2007, the frequent methamphetamine users were more likely to say the strength of LSD had declined in the past six months

• The strength of LSD was considered to be ‘stable/fluctuating’ in 2007 and 2006

• In 2007, the frequent ecstasy users were more likely to say that ‘more’ people they know were using LSD in the past six months

• The number of people using LSD was described as the ‘same’ in 2006 and 2007

• The number of tabs of LSD seized each year declined dramatically after 2000 and has remained relatively low since that time. There has been some increase in seizures of LSD since 2004

• National household survey data suggests that the population prevalence of LSD remained the same in 2006 compared to 2003. The population use of LSD had previous decreased in 2003 compared to 2001

Centre for Social and Health Outcomes Research and Evaluation 125 Te Runanga, Wananga, Hauora me te Paekaka 9. Opiates

9.1 Introduction

The international supply of heroin into New Zealand was substantially disrupted in the late 1970s by successful drug enforcement operations (Newbold, 2000, New Zealand Customs Service, 2002). Three domestic sources of opiates subsequently emerged in New Zealand to replace the regular supply of imported heroin: (1) morphine sulphate tablets (MST or misties); (2) ‘homebake heroin’ (made from codeine-based tablets); and (3) opium (extracted from opium poppies) (New Zealand Customs Service, 2002). Interceptions of heroin intended for the New Zealand domestic market remain spasmodic despite the presence of a fairly large market for heroin in nearby Sydney (New Zealand Customs Service, 2002).

9.2 Knowledge of opiate trends

In 2007, 41% of the frequent drug users interviewed (n=132) indicated they felt confident enough to comment on the price, purity and availability of opiates in the previous six months. This included 32% of the frequent methamphetamine users (n=35), 6% of the frequent ecstasy users (n=6) and 83% of the frequent injecting drug users (n=91). As there were only small numbers of frequent ecstasy users with knowledge of opiates, we only included these users in the combined group of frequent drug users and not as a separate frequent drug user group.

9.2.1 Types of opiates

In 2007, the frequent drug users were asked to specify the type of opiate for which they had the best knowledge of its price, purity and availability. Three-quarters of the frequent drug users nominated morphine derivatives (MST, M-Eslon, Kapanol) and a further 13% said ‘homebake heroin’ (Table 9.1). Internationally sourced heroin was nominated by only 4% of the frequent drug users.

Table 9.1: Type of opiate which the frequent drug users had most knowledge of, 2007 Type of opiate Methamphetamine Intravenous drug Combined modules users users (IDU) (n=113) (includes (n=33) (n=74) frequent ecstasy users) Morphine (MST, misties, M- 67% 82% 75% Eslon, Kapanol) Homebake heroin 6% 15% 13% Poppies (opium) 15% 1% 7% Heroin 12% 1% 4%

Centre for Social and Health Outcomes Research and Evaluation 126 Te Runanga, Wananga, Hauora me te Paekaka 9.3 Availability of opiates

9.3.1 Current availability of opiates

In 2007, 43% of the frequent drug users described the current availability of opiates as ‘easy’, with a further 35% of frequent drug users describing availability of opiates as ‘very easy’ (Table 9.2). The average score for the current availability of opiates for all the frequent drug users was 1.9, which indicates that overall the current availability of opiates was ‘easy/very easy’ in 2007. There was no statistically significant difference in the average score for the current availability of opiates between the frequent methamphetamine users and the frequent injecting drug users, with both groups reporting the current availability of opiates as ‘easy/very easy’ in 2007 (p=0.2708).

Table 9.2: Current availability of opiates by frequent drug user group, 2007 Current availability Methamphetamine Intravenous drug Combined modules of opiates (%) users users (IDU) (n=132) (includes (n=35) (n=91) frequent ecstasy users) Very easy [1] 26% 40% 35% Easy [2] 51% 42% 43% Difficult [3] 20% 15% 18% Very difficult [4] 3% 3% 4% Average availability score (1=very easy – 2.0 1.8 1.9 4=very difficult) Overall current Easy/ Easy/ Easy/ status Very easy Very easy Very easy

There was no statistically significant difference in the average score for the current availability of opiates in 2007 compared to 2006 (p=0.1878), indicating that the availability of opiates has remained ‘easy/very easy’ over the past two years (Table 9.3).

Table 9.3: Current availability of opiates by combined frequent drug users, 2006-2007 2006 2007 Current availability Combined Combined of opiates (%) modules modules (n=114) (n=132) Very easy [1] 41% 35% Easy [2] 45% 43% Difficult [3] 10% 18% Very difficult [4] 4% 4% Average availability score (1=very easy – 1.8 1.9 4=very difficult) Overall current Easy/ Easy/ status Very easy Very easy

Centre for Social and Health Outcomes Research and Evaluation 127 Te Runanga, Wananga, Hauora me te Paekaka 9.3.2 Change in availability of opiates

In 2007, 61% of the frequent drug users reported that the availability of opiates had been ‘stable’ in the past six months (Table 9.4). The average score for the change in availability of opiates for all the frequent drug users was 2.0, which indicates that overall the availability of opiates had been ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in the availability of opiates between the frequent methamphetamine users and the frequent injecting drug users, with both groups reporting that the availability of opiates had been ‘stable’ over the previous six months in 2007 (p=0.4184).

Table 9.4: Change in availability of opiates by frequent drug user group, 2007

Change in Methamphetamine Intravenous drug Combined modules availability users users (IDU) (n=128) (includes of opiates (%) (n=34) (n=90) frequent ecstasy users)

Easier [1] 24% 12% 15%

Stable [2] 53% 64% 61%

Fluctuates [2] 6% 8% 8% More difficult [3] 18% 16% 16%

Average change in availability score 1.9 2.0 2.0 (1=easier – 3=more difficult) Overall recent Stable Stable Stable change

There was no statistically significant difference in the average score for the change in availability of opiates in 2007 compared to 2006 (p=0.8089) indicating that the availability of opiates has remained ‘stable’ over the past two years (Table 9.5).

Table 9.5: Change in availability of opiates by combined frequent drug users, 2006-2007

2006 2007

Change in Combined Combined availability modules modules of opiates (%) (n=114) (n=128)

Easier [1] 10% 15% Stable [2] 73% 61%

Fluctuates [2] 8% 8%

More difficult [3] 10% 16%

Average change in availability score 2.0 2.0 (1=easier – 3=more difficult)

Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 128 Te Runanga, Wananga, Hauora me te Paekaka 9.4 Price of opiates

9.4.1 Current price of opiates

In 2007, the frequent drug users reported paying a median price of $1 per milligram for opiates (Table 9.6). There was no statistically significant difference in the mean price paid for opiates between the frequent methamphetamine users and the frequent injecting drug users (p=0.0695).

Table 9.6: Current median (mean) price for opiates (NZD) by frequent drug user group, 2007

Current price of Methamphetamine Intravenous drug Combined modules opiates users users (IDU) (n=96) (includes (n=19) (n=76) frequent ecstasy users)

Median (mean) price $1.00 ($0.96) $1.00 ($1.03) $1.00 ($1.01) per milligram

The mean price paid for a milligram of opiates was slightly higher in 2007 compared to 2006 ($1.01 vs. $0.95, p=0.0433) (Table 9.7).

Table 9.7: Current median (mean) price for opiates (NZD) by combined frequent drug users, 2006-2007

2006 2007

Current price of Combined modules Combined modules opiates (n=87) (n=96)

Median (mean) price $1.00 ($0.95) $1.00 ($1.01) per milligram

9.4.2 Change in price of opiates

In 2007, 75% of the frequent drug users reported that the price of opiates had been ‘stable’ in the previous six months (Table 9.8). The average score for the change in the price of opiates for all the frequent drug users was 2.1 which indicates that overall the price of opiates was ‘stable’ over the previous six months in 2007. There was no statistically significant difference in the average score for the change in price of opiates between the frequent methamphetamine users and the frequent injecting drug users, with both groups reporting the price had been ‘stable’ over the previous six months in 2007 (p=0.2109).

Centre for Social and Health Outcomes Research and Evaluation 129 Te Runanga, Wananga, Hauora me te Paekaka Table 9.8: Change in the price of opiates in the past six months by frequent drug user group, 2007

Change in price of Methamphetamine Intravenous drug Combined modules opiates (%) users users (IDU) (n=121) (includes (n=28) (n=89) frequent ecstasy users)

Decreasing [1] 11% 4% 6%

Stable [2] 79% 73% 75%

Fluctuating [2] 0% 6% 4%

Increasing [3] 11% 17% 15%

Average change in price score 2.0 2.1 2.1 (1=decreasing – 3=increasing)

Overall recent Stable Stable Stable change

The average score for the change in the price of opiates was statistically significantly higher in 2007 compared to 2006 (2.1 vs. 1.9, p=0.0137) indicating that the price of opiates has increased over the past two years (Table 9.9).

Table 9.9: Change in the price of opiates in the past six months by combined frequent drug users, 2006-2007

2006 2007

Change in price of Combined Combined opiates (%) modules modules (n=106) (n=121)

Decreasing [1] 19% 6%

Stable [2] 65% 75%

Fluctuating [2] 5% 4%

Increasing [3] 11% 15%

Average change in price score 1.9 2.1 (1=decreasing – 3=increasing)

Overall recent Stable/ Stable change increasing

9.5 Purity of opiates

9.5.1 Current purity of opiates

In 2007, 59% of the frequent drug users described the current purity of opiates as ‘high’ and a further 21% said the purity of opiates was ‘medium’ (Table 9.10). The average score for the current purity of opiates for

Centre for Social and Health Outcomes Research and Evaluation 130 Te Runanga, Wananga, Hauora me te Paekaka all the frequent drug users was 2.6 which indicates that overall the purity of opiates was ‘high’ in 2007. There was no statistically significant difference in the average score for the purity of opiates between the frequent methamphetamine users and the frequent injecting drug users, with both groups reporting the current purity of opiates as ‘high’ in 2007 (p=0.1304).

Table 9.10: Current purity of opiates by frequent drug user group, 2007

Current purity of Methamphetamine Intravenous drug Combined opiates users users (IDU) modules (%) (n=28) (n=84) (n=125) (includes frequent ecstasy users) Low [1] 3% 0% 2% Medium [2] 9% 27% 21% Fluctuates [2] 14% 17% 18% High [3] 74% 56% 59% Average purity score 2.7 2.6 2.6 (1=low – 3=high) Overall current status High High High

The purity of opiates was statistically significantly higher in 2007 compared to 2006 (2.6 vs. 2.3, p=0.0006) (Table 9.11).

Table 9.11: Current purity of opiates by combined frequent drug users, 2006-2007

2006 2007

Current purity of Combined Combined opiates modules modules (%) (n=98) (n=125)

Low [1] 10% 2%

Medium [2] 32% 21%

Fluctuates [2] 18% 18% High [3] 40% 59%

Average purity score 2.3 2.6 (1=low – 3=high)

Medium/ Overall current status High high ]

9.5.2 Change in purity of opiates

In 2007, 80% of the frequent drug users reported that the purity of opiates had been ‘stable’ in the previous six months with 15% saying the purity of opiates had fluctuated over the past six months (Table 9.12). The average score for the change in the purity of opiates for all the frequent drug users was 2.0, which indicates that overall the purity of opiates had been ‘stable/fluctuating’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in the purity of opiates between the

Centre for Social and Health Outcomes Research and Evaluation 131 Te Runanga, Wananga, Hauora me te Paekaka frequent methamphetamine users and the frequent injecting drug users, with both groups reporting that the purity of opiates had been ‘stable/fluctuating’ over the previous six months in 2007 (p=0.1867).

Table 9.12: Change in purity of opiates by frequent drug user group, 2007

Change in purity of Methamphetamine Intravenous drug Combined modules opiates users users (IDU) (n=125) (includes (%) (n=33) (n=87) frequent ecstasy users) Decreasing [1] 6% 2% 3% Stable [2] 85% 80% 80% Fluctuating [2] 9% 15% 15% Increasing [3] 0% 2% 2% Average change in purity score 1.9 2.0 2.0 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ Stable/ change fluctuating fluctuating fluctuating

There was no statistically significant difference in the average score for the change in the purity of opiates in 2007 compared to 2006 (p=0.8812) indicating that the purity of opiates has remained ‘stable’ over the past two years (Table 9.13).

Table 9.13: Change in purity of opiates by combined frequent drug users, 2006-2007

2006 2007

Change in purity of Combined Combined opiates modules modules (%) (n=108) (n=125)

Decreasing [1] 9% 3%

Stable [2] 69% 80%

Fluctuating [2] 14% 15%

Increasing [3] 8% 2% Average change in purity score 2.0 2.0 (1=decreasing – 3=increasing)

Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 132 Te Runanga, Wananga, Hauora me te Paekaka 9.6 Perceptions of the number of people using opiates

In 2007, 38% of the frequent drugs thought ‘about the same’ number of people they know were using opiates, 35% said ‘more’ people were using opiates and 28% said that ‘less’ people they know were using opiates (Table 9.14). The average score for all the frequent drug users for the question was 2.1 indicating that overall ‘about the same’ number of people were using opiates compared to six months ago in 2007. The frequent injecting drug users were statistically significantly more likely than the frequent methamphetamine users to say that ‘more’ people they know were using opiates over the past six months in 2007 (2.2 vs. 1.8, p=0.0256).

Table 9.14: Perceptions of the number of people using opiates by frequent drug user group, 2007

Number of people Methamphetamine Intravenous drug Combined modules using opiates (%) users users (IDU) (n=127) (includes (n=33) (n=90) frequent ecstasy users)

Less [1] 45% 19% 28%

Same [2] 27% 44% 38% More [3] 27% 36% 35%

Average number of people using score 1.8 2.2 2.1 (1=less – 3=more)

Overall recent Same/ Same/ Same/ change Less more more

There was no statistically significant difference in the average score for the change in the number of people using opiates in 2007 compared to 2006 (p=0.4236), indicating that the number of people using opiates has remained ‘same/more’ over the past two years (Table 9.15).

Table 9.15: Perceptions of the number of people using opiates by combined frequent drug users, 2006-2007

2006 2007

Number of people Combined Combined using opiates (%) modules modules (n=114) (n=127)

Less [1] 19% 28%

Same [2] 46% 38% More [3] 34% 35%

Average number of people using score 2.1 2.1 (1=less – 3=more)

Overall recent Same/ Same/ change more more

Centre for Social and Health Outcomes Research and Evaluation 133 Te Runanga, Wananga, Hauora me te Paekaka 9.7 Seizures of Heroin

There has been considerable variation in the quantity of heroin seized by the New Zealand Police and the New Zealand Customs Service over the previous five years, and this reflects some of the issues discussed in the introduction to this chapter (Figure 9.1). In 2006, 12 millilitres of heroin was seized in syringes during the course of investigations. The previous seizures of heroin were recorded in grams, and consequently the 2006 seizures could not be included in the existing statistical series.

Figure 9.1: Grams of heroin seized in New Zealand, 2000-2005

6,000 5,536

5,000

4,000

3,000

Weight (grams) (grams) Weight 2,000 1,466

1,000 211 84 1 10

0 2000 2001 2002 2003 2004 2005

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

9.8 Opiate use in the general population

The proportion of the New Zealand population aged 13-45 years old who had ever tried opiates remained the same in 2006 compared to 2003 (0.6% vs. 0.5%, p=0.7885). The proportion of respondents aged 13-45 who had used opiates in the previous 12 months also remained the same in 2006 compared to 2003 (0.13% vs. 0.15%, p=0.8188). Low numbers involved in these survey results indicate they should be viewed with caution. In 2003 only 19 respondents surveyed had ever tried opiates and in the 2006 survey only 10 respondents had ever tried opiates. With respect to more recent use, only four respondents had used opiates in the previous 12 months in 2003 and in 2006 it was only three respondents. These results illustrate the difficulties of measuring the less common forms of drug use using a population based sampling approach.

Centre for Social and Health Outcomes Research and Evaluation 134 Te Runanga, Wananga, Hauora me te Paekaka 9.9 Summary of opiate trends

• In 2007, the opiates most commonly used in New Zealand continue to be locally sourced morphine and locally manufactured homebake heroin

• In 2007, the current availability of opiates was reported to be ‘easy/very easy’

• The availability of opiates has not changed over the past two years

• In 2007, a milligram of opiates currently costs a median price of $1.00

• The mean price paid for a milligram of opiates increased slightly from $0.95 in 2006 to $1.01 in 2007

• The price of opiates was considered to have increased in 2007 compared to 2006

• In 2007, the current purity of opiates was reported to be ‘high’

• The purity of opiates was considered to be higher in 2007 than in 2006

• The number of people using opiates was described as the ‘same/more’ in both 2007 and 2006

• Seizures of internationally sourced heroin have remained low level over the past three years

Centre for Social and Health Outcomes Research and Evaluation 135 Te Runanga, Wananga, Hauora me te Paekaka 10. Cocaine

10.1 Introduction

Cocaine is derived from the coca plant which is clandestinely cultivated in only three South American countries: Columbia, Peru and Bolivia (National Drug Intelligence Bureau, 2005). The high price of cocaine and its short duration of action (i.e. around 20 minutes) have traditionally contributed to a weak demand for cocaine in New Zealand. On the supply side, geographical isolation, a small population and tight border controls have played a part in restricting the supply of cocaine to the domestic New Zealand market (New Zealand Customs Service, 2002). However, New Zealand is sometimes used as a transit point to smuggle cocaine into the much larger Australian market (New Zealand Customs Service, 2002).

10.2 Knowledge of cocaine trends

In 2007, 9% of the frequent drug users interviewed (n=30) indicated they felt confident enough to comment on the price, purity and availability of cocaine in the previous six months. This included 14% of the frequent methamphetamine users (n=15), 8% of the frequent ecstasy users (n=8) and 6% of the frequent injecting drug users (n=7). As there were only small numbers of frequent drug users with knowledge of cocaine, we have not compared the results by frequent drug user group.

10.3 Availability of cocaine

10.3.1 Current availability of cocaine

In 2007, 52% of the frequent drug users described the current availability of cocaine as ‘difficult’, with a further 28% of frequent drug users describing the availability of cocaine as ‘very difficult’ (Table 10.1). The average score for the current availability of cocaine for all the frequent drug users was 3.0, which indicates that overall the current level of availability of cocaine is ‘difficult’ in 2007. There was no statistically significant difference in the average score for the current availability of cocaine in 2007 compared to 2006 (p=0.4429) indicating the availability of cocaine has remained ‘difficult’ over the past two years.

Centre for Social and Health Outcomes Research and Evaluation 136 Te Runanga, Wananga, Hauora me te Paekaka Table 10.1: Current availability of cocaine by combined frequent drug users, 2006-2007

2006 2007 Current availability Combined Combined of cocaine (%) modules modules (n=29) (n=29) Very easy [1] 10% 3% Easy [2] 17% 17% Difficult [3] 48% 52% Very difficult [4] 24% 28% Average availability score (1=very easy – 2.9 3.0 4=very difficult) Overall current Difficult Difficult status

10.3.2 Change in availability of cocaine

In 2007, 64% of the frequent drug users reported that the availability of cocaine had been ‘stable’ in the previous six months and 21% said the availability of cocaine had become ‘more difficult’ over this time (Table 10.2). The average score for the change in the availability of cocaine for all the frequent drug users was 2.2, which indicates that overall the availability of cocaine was ‘stable/more difficult’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in availability of cocaine in 2007 compared to 2006 (p=0.707) indicating the availability of cocaine has continued to be ‘stable/more difficult’ over the past two years.

Table 10.2: Change in availability of cocaine by combined frequent drug users, 2006-2007

2006 2007 Change in Combined Combined availability modules modules of cocaine (%) (n=30) (n=28) Easier [1] 7% 0% Stable [2] 57% 64% Fluctuates [2] 13% 14% More difficult [3] 23% 21% Average change in availability score 2.2 2.2 (1=easier – 3=more difficult)

Overall recent Stable/ Stable/ change more difficult more difficult

Centre for Social and Health Outcomes Research and Evaluation 137 Te Runanga, Wananga, Hauora me te Paekaka 10.4 Price of cocaine

10.4.1 Current price of cocaine

In 2007, the median price paid for a ‘gram’ of cocaine was $350 (Table 10.3). There was no statistically significant change in the mean price paid for a gram of cocaine in 2007 compared to 2006 (p=0.4132).

Table 10.3: Current median (mean) price for cocaine (NZD) by combined frequent drug users, 2006-2007 2006 2007 Current price of Combined Combined cocaine modules modules (n=25) (n=20) Median (mean) price $300 ($353) $350 ($431) for a gram

10.4.2 Change in price of cocaine

In 2007, 68% of the frequent drug users reported that the price of cocaine had been ‘stable’ in the past six months (Table 10.4). The average score for the change in the price of cocaine for all the frequent drug users was 2.1, which indicates that overall the price of cocaine was ‘stable/increasing’ over the past six months in 2007. There was no statistically significant difference in the average score of the change in the price of cocaine in 2007 compared to 2006 (p=0.3015) indicating the price of cocaine remained ‘stable’ over the past two years.

Table 10.4: Change in the price of cocaine in the past six months by combined frequent drug users, 2006- 2007 2006 2007 Change in price of Combined Combined cocaine (%) modules modules (n=24) (n=22) Decreasing [1] 19% 5% Stable [2] 63% 68% Fluctuating [2] 21% 9% Increasing [3] 8% 18% Average change in price score (1=decreasing – 3=increasing) 2.0 2.1

Overall recent Stable/ Stable/ change decreasing increasing

Centre for Social and Health Outcomes Research and Evaluation 138 Te Runanga, Wananga, Hauora me te Paekaka 10.5 Purity of cocaine

10.5.1 Current purity of cocaine

In 2007, 31% of the frequent drug users described the current purity of cocaine as ‘low’ and a further 27% described it as ‘medium’ (Table 10.5). The average score for the current purity of cocaine for all the frequent drug users was 2.0, which indicates that overall the strength of cocaine was ‘medium’ in 2007. There was no statistically significant difference in the average score for the purity of cocaine in 2007 compared to 2006 (p=0.1167) indicating the purity of cocaine has remained ‘low/medium’ over the past two years.

Table 10.5: Current purity of cocaine by combined frequent drug users, 2006-2007

2006 2007 Current purity of Combined Combined cocaine modules modules (%) (n=24) (n=26) Low [1] 50% 31% Medium [2] 21% 27% Fluctuates [2] 17% 15% High [3] 13% 27% Average purity score 1.6 2.0 (1=low – 3=high)

Low/ Low/ Overall current status medium medium

10.5.2 Change in purity of cocaine

In 2007, 48% of the frequent drug users reported that the purity of cocaine had been ‘stable’ in the past six months, and a further 32% said the purity of cocaine had ‘fluctuated’ over this time (Table 10.6). The average score for the change in the purity of cocaine for all the frequent drug users was 1.9, which indicates that overall the purity of cocaine was ‘stable/decreasing’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in purity of cocaine in 2007 compared to 2006 (p=0.2386) indicating the purity of cocaine remained ‘stable’ over the past two years.

Centre for Social and Health Outcomes Research and Evaluation 139 Te Runanga, Wananga, Hauora me te Paekaka Table 10.6: Change in purity of cocaine by combined frequent drug users, 2006-2007

2006 2007 Change in purity of Combined Combined cocaine modules modules (%) (n=20) (n=25) Decreasing [1] 35% 16% Stable [2] 35% 48% Fluctuating [2] 25% 32% Increasing [3] 5% 4% Average change in purity score 1.7 1.9 (1=decreasing – 3=increasing) Overall recent Stable/ Stable/ change decreasing fluctuating

10.6 Perceptions of the number of people using cocaine

In 2007, 56% of the frequent drugs thought ‘about the same’ number of people they know were using cocaine and 28% said ‘less’ people they know were using the drug (Table 10.7). The average score for all the frequent drug users for the question was 1.9 indicating that overall about the ‘same/less’ people were using cocaine compared to six months ago in 2007. There was no statistically significant difference in the average score for the change in the number of people using cocaine in 2007 compared to 2006 (p=0.8141) indicating the number of people using cocaine remained the ‘same/less’ over the past two years.

Table 10.7: Perceptions of the number of people using cocaine by combined frequent drug users, 2006-2007

2006 2007 Number of people Combined Combined using cocaine (%) modules modules (n=27) (n=26) Less [1] 30% 28% Same [2] 48% 56% More [3] 22% 16%

Average number of people using score 1.9 1.9 (1=less – 3=more)

Overall recent Same/ Same/ change less less

Centre for Social and Health Outcomes Research and Evaluation 140 Te Runanga, Wananga, Hauora me te Paekaka 10.7 Seizures of cocaine

Annual seizures of cocaine made by the New Zealand Police and New Zealand Customs Service increased sharply in 2003 and have remained at relatively high levels since then (Figure 10.1). A particularly large amount of cocaine was seized in 2006. Much of the cocaine seized in New Zealand is done so at the border (during international transit) and is believed to be destined for the larger Australian market (New Zealand Customs, 2002).

Figure 10.1: Grams of cocaine seized in New Zealand, 1999-2006

35000 32,954

30000

25000

20000 18,020

15000 Weight (grams) (grams) Weight

10000 7,859 7,554

5000 415 895 8 267

0 1999 2000 2001 2002 2003 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

10.8 Cocaine use in the general population

The proportion of the New Zealand population aged 15-45 years old who had ever tried cocaine increased in 2006 compared to 2003 (4.5% vs. 3.1%, p=0.0225) (Wilkins and Sweetsur, 2008). The proportion of the population who had ever tried cocaine was also higher in 2006 compared to 2001 (4.5% vs. 3.3%, p=0.0289) (Wilkins and Sweetsur, 2008). There was also a statistically significant increase in the proportion of people who had used cocaine in the previous year in 2006 compared to 2003 (1.1% vs. 0.5%, p=0.0147) (Wilkins and Sweetsur, 2008). Low numbers involved in these survey results indicate they should be treated with some caution. Sixteen survey respondents reported using cocaine in the previous 12 months in 2003 and 22 respondents reported using cocaine in the previous 12 months in 2006.

Centre for Social and Health Outcomes Research and Evaluation 141 Te Runanga, Wananga, Hauora me te Paekaka 10.9 Summary of cocaine trends

• In 2007, the current availability of cocaine was reported to be ‘difficult’

• The availability of cocaine has been ‘stable/more difficult’ over the past two years

• In 2007, a gram of cocaine currently cost a median price of $350

• The price of cocaine was reported to have been ‘stable’ over the previous two years

• In 2007, the purity of cocaine was considered to be ‘low/medium’

• The purity of cocaine has remained ‘stable/fluctuating’ over the past two years

• The number of people using cocaine was described as the ‘same/less’ in 2007 and 2006

• Annual seizures of cocaine increased sharply in 2003 with particularly large seizures achieved in 2006. However, most of these seizures are made at the border and are considered to be destined for the larger Australian market

• National household survey data indicates that the population prevalence of use of cocaine has increased in recent years

Centre for Social and Health Outcomes Research and Evaluation 142 Te Runanga, Wananga, Hauora me te Paekaka

11. Ketamine

11.1 Introduction

Ketamine (‘special K’ or ‘vitamin K’) is a rapidly acting anaesthetic that is used in veterinary surgery and less commonly in human surgery (Copeland and Dillon, 2005, White et al., 2004). Ketamine produces dissociate and hallucinogenic effects, including an ‘out-of-body’ like experience, analgesia and amnesia (Copeland and Dillon, 2005, Community Alcohol and Drug Services (CADS), 2005). Too much ketamine can result in the user having bizarre experiences including ‘near death experiences’ known as ‘falling into a k-hole’. The use of ketamine has been linked with a range of unpleasant psychological effects including anxiety, panic attacks, flashbacks, persistent perceptual changes, depression, suicide, paranoid delusions, fragmentation of personality and aggression (Copeland and Dillon, 2005). Ketamine is also thought to have a strong potential to give rise to dependence after repeated use (Copeland and Dillon, 2005). A selling point of ketamine is said to be the short duration of its halluncingenic effects (ie. 1-2 hours) compared to LSD and ecstasy (National Drug Intelligence Bureau, 2005). Supplies of ketamine for recreational use are generally illegally diverted from veterinary sources (Copeland and Dillon, 2005, National Drug Intelligence Bureau, 2005). Ketamine is supplied in tablet form and is sometimes fraudulently sold as ecstasy (Community Alcohol and Drug Services (CADS), 2005). Ketamine is currently listed as a prescription medicine and is consequently not classified under the Misuse of Drug Act 1975.

11.2 Knowledge of ketamine trends

In 2007, 6% of the frequent drug users interviewed (n=19) indicated they felt confident enough to comment on the price, purity and availability of ketamine in the previous six months. This included 9% of the frequent methamphetamine users (n=10), 5% of the frequent ecstasy users (n=5) and 4% of the frequent injecting drug users (n=4). As there were only very small numbers of frequent drug users with knowledge of ketamine, we have not compared the results by frequent drug user group. The small sample size with knowledge of ketamine indicates that results should be interpreted with caution.

11.3 Availability of ketamine

11.3.1 Current availability of ketamine

In 2007, 39% of the frequent drug users described the current availability of ketamine as ‘easy’, and 33% described the current availability of ketamine as ‘difficult’ (Table 11.1). The average score for the current availability of ketamine for all the frequent drug users was 2.7, which indicates that overall the current level of availability of ketamine was ‘difficult’ in 2007. There was no statistically significant difference in the Centre for Social and Health Outcomes Research and Evaluation 143 Te Runanga, Wananga, Hauora me te Paekaka average score for the current availability of ketamine in 2007 compared to 2006 (p=0.9805) indicating the availability of ketamine has remained ‘difficult’ over the past two years.

Table 11.1: Current availability of ketamine by combined frequent drug users, 2006-2007

2006 2007 Current availability Combined Combined of ketamine (%) modules modules (n=14) (n=18) Very easy [1] 14% 6% Easy [2] 14% 39% Difficult [3] 57% 33% Very difficult [4] 14% 22% Average availability score (1=very easy – 2.7 2.7 4=very difficult) Overall current Difficult Difficult status

11.3.2 Change in availability of ketamine

In 2007, 41% of the frequent drug users reported that the availability of ketamine had been ‘stable’ in the previous six months (Table 11.2). The average score for the change in the availability of ketamine for all the frequent drug users was 2.0, which indicates that overall the availability of ketamine was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in availability of ketamine in 2007 compared to 2006 (p=1) indicating the availability of ketamine has remained ‘stable’ over the past two years.

Table 11.2: Change in availability of ketamine by combined frequent drug users, 2006-2007

2006 2007 Change in Combined Combined availability modules modules of ketamine (%) (n=12) (n=17) Easier [1] 17% 29% Stable [2] 50% 41% Fluctuates [2] 17% 0% More difficult [3] 17% 29%

Average change in availability score (1=easier – 3=more 2.0 2.0 difficult) Overall recent Stable Stable change

Centre for Social and Health Outcomes Research and Evaluation 144 Te Runanga, Wananga, Hauora me te Paekaka 11.4 Price of ketamine

11.4.1 Current price of ketamine

In 2007, the frequent drug users provided the price of ketamine in ‘bumps’ and ‘grams’. The numbers of frequent drug users reporting prices was low for both quantities. The median price paid for a ‘bump’ of ketamine was $60, and the median price paid for a ‘gram’ of ketamine was $115 (Table 11.3). Table 11.3 also presents the prices reported paid for a gram of ketamine in 2006. The small number of participants reporting prices for ketamine in 2007 and 2006 prevents any reliable statistical comparison between the years.

Table 11.3: Current median (mean) price for ketamine (NZD) by combined frequent drug users, 2006-2007

2006 2007 Current price of Combined Combined ketamine modules modules

Number with - n=2 knowledge Median (mean) price - $60 ($60) for a bump

Number with n=8 knowledge (n=6) Median (mean) price $200 ($193) $115 ($135) for a gram

11.4.2 Change in price of ketamine

In 2007, 40% of the frequent drug users reported that the price of ketamine had been ‘stable’ in the previous six months and 40% said it had been ‘increasing’ over the past six months (Table 11.4). The average score for the change in the price of ketamine for all the frequent drug users was 2.2, which indicates that overall the price of ketamine had been ‘stable/increasing’ over the previous six months in 2007. Low numbers prevent any reliable statistical comparison between 2007 and 2006.

Centre for Social and Health Outcomes Research and Evaluation 145 Te Runanga, Wananga, Hauora me te Paekaka Table 11.4: Change in the price of ketamine in the last six months by combined frequent drug users, 2006- 2007 2006 2007 Change in price of Combined Combined ketamine (%) modules modules (n=7) (n=10) Decreasing [1] 14% 20% Stable [2] 29% 40% Fluctuating [2] 29% 0% Increasing [3] 29% 40% Average change in price score (1=decreasing – 3=increasing) 2.1 2.2

Overall recent Stable/ Stable/ change fluctuating increasing

11.5 Purity of ketamine

11.5.1 Current purity of ketamine

In 2007, 93% of the frequent drug users described the current purity of ketamine as ‘high’ (Table 11.5). The average score for the current purity of ketamine for all the frequent drug users was 2.9, which indicates that overall the strength of ketamine was ‘high’ in 2007. There was no statistically significant difference in the average score of the current purity of ketamine in 2007 compared to 2006, although the difference was close to being statistically significant (p=0.0607).

Table 11.5: Current purity of ketamine by combined frequent drug users, 2006-2007

2006 2007 Current purity of Combined Combined ketamine modules modules (%) (n=13) (n=15) Low [1] 8% 0% Medium [2] 15% 0% Fluctuates [2] 15% 7% High [3] 62% 93% Average purity score 2.5 2.9 (1=low – 3=high) High/ High Overall current status medium

Centre for Social and Health Outcomes Research and Evaluation 146 Te Runanga, Wananga, Hauora me te Paekaka 11.5.2 Change in purity of ketamine

In 2007, 77% of the frequent drug users reported that the purity of ketamine had been ‘stable’ in the previous six months (Table 11.6). The average score for the change in the purity of ketamine for all the frequent drug users was 2.2, which indicates that overall the purity of ketamine was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in purity of ketamine in 2007 compared to 2006 (p=0.6976) indicating the purity of ketamine has remained ‘stable’ over the past two years.

Table 11.6: Change in purity of ketamine by combined frequent drug users, 2006-2007

2006 2007 Change in purity of Combined Combined ketamine modules modules (%) (n=12) (n=13) Decreasing [1] 8% 0% Stable [2] 67% 77% Fluctuating [2] 8% 8% Increasing [3] 17% 15% Average change in purity score 2.1 2.2 (1=decreasing – 3=increasing) Overall recent Stable Stable change

11.6 Perceptions of the number of people using ketamine

In 2007, 40% of the frequent drugs thought ‘about the same’ number of people they know were using ketamine, 33% said ‘less’ people they know were using ketamine and 20% said that ‘more’ people they know were using the ketamine (Table 11.7). The average score for all the frequent drug users for the question was 1.9, indicating that overall the ‘same/less’ people were using ketamine compared to six months ago in 2007. There was no statistically significant difference in the average score of the number of people using ketamine in 2007 compared to 2006 (p=0.8151), indicating that the number of people using ketamine has remained the ‘same/less’ over the past two years.

Centre for Social and Health Outcomes Research and Evaluation 147 Te Runanga, Wananga, Hauora me te Paekaka Table 11.7: Perceptions of the number of people using ketamine by combined frequent drug users, 2006- 2007 2006 2007 Number of people Combined Combined using ketamine (%) modules modules (n=15) (n=15) Less [1] 36% 33% Same [2] 36% 40% More [3] 29% 20% Average number of people using score 1.9 1.9 (1=less – 3=more)

Overall recent Same/ Same/ change less less

11.7 Ketamine use in the general population

The proportion of the New Zealand population aged 13-45 years old who had ever tried ketamine did not change in 2006 compared to 2003 (0.8% vs. 0.8%, p=0.9479). There was also no statistically significantly change in the proportion of people who had used ketamine in the past year in 2006 compared to 2003 (0.15% vs. 0.19%, p=0.7474). Low numbers involved in these survey results indicate they should be treated with caution. Only six survey respondents reported using ketamine in the previous 12 months in 2003 and only three respondents reported using ketamine in the previous 12 months in 2006.

11.8 Summary of ketamine trends

• Only a small number of the frequent drug users indicated that they had knowledge of ketamine trends in 2006 and 2007. As a result the findings in this chapter should be treated with some caution

• In 2007, the current availability of ketamine was reported to be ‘difficult’

• The availability of ketamine is thought to have been ‘stable’ over the past two years

• In 2007, a gram of ketamine cost a median price of $115

• In 2007, the current purity of ketamine was considered to be ‘high’

• The purity of ketamine has been ‘stable’ over the past two years

• The number of people using ketamine was described as the ‘same/less’ over the past two years

Centre for Social and Health Outcomes Research and Evaluation 148 Te Runanga, Wananga, Hauora me te Paekaka 12. GHB

12.1 Introduction

Gamma-hydroxybutyric acid (GHB, GBL, Fantasy, liquid ecstasy, or One4B) was originally used as a medical anaesthetic (Kuhn et al., 1998). It was withdrawn from the market in the United States in the late 1980s due to serious adverse side-effects (Kuhn et al., 1998). It is an odourless, colourless liquid with a slightly salty taste (Kuhn et al., 1998). GHB has a very steep dose response curve, which means there is only a very small difference in dose between the ‘the desired recreational effect’ and overdose, coma and death (Expert Advisory Committee on Drugs, 2001). When GHB is mixed with other depressants, such as alcohol, the depressant effects are increased which further increases the risk of a life threatening result (Community Alcohol and Drug Services (CADS), 2005, White et al., 2004). There have been a number of hospitalisations related to GHB use in New Zealand including several deaths (Expert Advisory Committee on Drugs, 2001).

12.2 Knowledge of GHB trends

In 2007, 10% of the frequent drug users interviewed (n=31) indicated they felt confident enough to comment on the price, purity and availability of GHB in the previous six months. This included 17% of the frequent methamphetamine users (n=19), 7% of the frequent ecstasy users (n=7) and 5% of the frequent injecting drug users (n=5). As there were only small numbers of frequent drug users with knowledge of GHB, we have not compared the results by frequent drug user group.

12.3 Availability of GHB

12.3.1 Current availability of GHB

In 2007, 38% of the frequent drug users described the current availability of GHB as ‘very easy’ with a further 31% saying its availability was ‘easy’ (Table 12.1). The average score for the current availability of GHB for all the frequent drug users was 2.0, which indicates that overall the current level of availability of GHB was ‘easy’ in 2007. There was no statistically significant difference in the average score for the current availability of GHB in 2007 compared to 2006 (p=0.6352) indicating the availability of GHB has remained ‘easy’ over the past two years.

Centre for Social and Health Outcomes Research and Evaluation 149 Te Runanga, Wananga, Hauora me te Paekaka Table 12.1: Current availability of GHB by combined frequent drug users, 2006-2007

2006 2007 Current availability Combined Combined of GHB (%) modules modules (n=24) (n=29) Very easy [1] 29% 38% Easy [2] 40% 31% Difficult [3] 29% 28% Very difficult [4] 4% 3% Average availability score (1=very easy – 2.1 2.0 4=very difficult) Overall current Easy Easy status

12.3.2 Change in availability of GHB

In 2007, 43% of the frequent drug users reported that the availability of GHB had been ‘stable’ in the previous six months (Table 12.2). The average score for the change in the availability of GHB for all the frequent drug users was 2.0, which indicates that overall the availability of GHB was ‘stable’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in availability of GHB in 2007 compared to 2006 (p=0.2933) indicating the availability of GHB has remained ‘stable’ over the past two years.

Table 12.2: Change in availability of GHB by combined frequent drug users, 2006-2007

2006 2007 Change in Combined Combined availability modules modules of GHB (%) (n=23) (n=28) Easier [1] 43% 21% Stable [2] 30% 43% Fluctuates [2] 4% 14% More difficult [3] 22% 21% Average change in availability score 1.8 2.0 (1=easier – 3=more difficult) Overall recent Easier/ Stable change stable

Centre for Social and Health Outcomes Research and Evaluation 150 Te Runanga, Wananga, Hauora me te Paekaka 12.4 Price of GHB

12.4.1 Current price of GHB

In 2007, the median price paid for a millilitre of GHB was $5 (Table 12.3). There was no statistically significant difference in the average price paid for a millilitre of GHB in 2007 compared to 2006 (p=0.3284).

Table 12.3: Current median (mean) price for GHB (NZD) by combined frequent drug users, 2006-2007

2006 2007 Current price of Combined Combined GHB modules modules (n=20) (n=17) Median (mean) price $5.50 ($6.10) $5.00 ($5.05) for a millilitre

12.4.2 Change in price of GHB

In 2007, 60% of the frequent drug users reported that the price of GHB had been ‘stable’ in the previous six months and 32% reported the price was ‘increasing’ (Table 12.4). The average score for the change in the price of GHB for all the frequent drug users was 2.3, which indicates that the price of GHB was ‘stable/increasing’ over the previous six months in 2007. There was no statistically significant difference in the average score for the change in price of GHB in 2007 compared to 2006 (p=0.9912) indicating the price of GHB has remained ‘stable/increasing’ over the past two years.

Table 12.4: Change in the price of GHB in the last six months by combined frequent drug users, 2006-2007

2006 2007 Change in price of Combined Combined GHB (%) modules modules (n=22) (n=25) Decreasing [1] 9% 0% Stable [2] 36% 60% Fluctuating [2] 14% 8% Increasing [3] 41% 32% Average change in price score 2.3 2.3 (1=decreasing – 3=increasing) Stable/ Stable/ Overall recent increasing increasing change

Centre for Social and Health Outcomes Research and Evaluation 151 Te Runanga, Wananga, Hauora me te Paekaka 12.5 Purity of GHB

12.5.1 Current purity of GHB

In 2007, 67% of the frequent drug users described the current purity of GHB as ‘high’ (Table 12.5). The average score for the current purity of GHB for all the frequent drug users was 2.6, which indicates that overall the purity of GHB was ‘high’ in 2007. The average score for the current purity of GHB was higher in 2007 than in 2006 (2.6 vs. 2.1, p=0.0043) indicating the current purity of GHB was higher in 2007 than in 2006.

Table 12.5: Current purity of GHB by combined frequent drug users, 2006-2007

2006 2007 Current purity of Combined Combined GHB modules modules (%) (n=20) (n=27) Low [1] 25% 4% Medium [2] 30% 15% Fluctuates [2] 15% 15% High [3] 30% 67% Average purity score 2.1 2.6 (1=low – 3=high) Overall current status Medium/ High high

12.5.2 Change in purity of GHB

In 2007, 50% of the frequent drug users reported that the purity of GHB had been ‘stable’ in the previous six months and 21% said the purity of GHB had ‘fluctuated’ over this time (Table 12.6). The average score for the change in the purity of GHB for all the frequent drug users was 2.0, which indicates that overall the purity of GHB had been ‘stable/fluctuating’ over the past six months in 2007. There was no statistically significant difference in the average score for the change in purity of GHB in 2007 compared to 2006 (p=0.8142) indicating the purity of GHB has remained ‘stable’ over the past two years.

Centre for Social and Health Outcomes Research and Evaluation 152 Te Runanga, Wananga, Hauora me te Paekaka Table 12.6: Change in purity of GHB by combined frequent drug users, 2006-2007

2006 2007 Change in purity of Combined Combined GHB modules modules (%) (n=21) (n=24) Decreasing [1] 19% 17% Stable [2] 52% 50% Fluctuating [2] 10% 21% Increasing [3] 19% 13% Average change in purity score 2.0 2.0 (1=decreasing – 3=increasing) Overall recent Stable Stable change

12.6 Perceptions of the number of people using GHB

In 2007, 47% of the frequent drugs thought ‘more’ people they know were using GHB, and 37% said ‘about the same’ number of people were using GHB (Table 12.7). The average score for all the frequent drug users for the question was 2.3 indicating that overall the ‘same/more’ people were using GHB compared to six months ago in 2007. There was no statistically significant difference in the average score of the number of people using GHB in 2007 compared to 2006 (p=0.8984) indicating the number of people using GHB has remained the ‘same/more’ over the past two years.

Table 12.7: Perceptions of the number of people using GHB by combined frequent drug users, 2006-2007

2006 2007 Number of people Combined Combined using GHB (%) modules modules (n=22) (n=31) Less [1] 18% 17% Same [2] 36% 37% More [3] 45% 47% Average number of people using score 2.3 2.3 (1=less – 3=more) Overall recent Same/ Same/ change more more

Centre for Social and Health Outcomes Research and Evaluation 153 Te Runanga, Wananga, Hauora me te Paekaka 12.7 Seizures of GHB

Drug enforcement agencies advise that GHB was not seized in large quantities before 2004 and consequently seizures were not routinely recorded. A joint New Zealand Police and New Zealand Customs Service operation in 2004 led to a particularly large seizure of 45.7 litres of GHB (Figure 12.1). In 2005, 22.7 litres of GHB was seized and this declined to 2.3 litres in 2006.

Figure 12.1: Millilitres of GHB seized in New Zealand, 2004-2006

45,739 50,000

45,000

40,000

35,000

30,000 22,739

25,000

20,000

Volume (millilitres) (millilitres) Volume 15,000

10,000 2,314

5,000

0 2004 2005 2006

Source : National Drug Intelligence Bureau (NDIB) (2005, 2006)

12.8 GHB use in the general population

The proportion of the New Zealand population aged 13-45 years old who had ever tried GHB did not change in 2006 compared to 2003 (1.6% vs. 1.3%, p=0.34). There was also no statistically significant change in the proportion of people who had used GHB in the previous year in 2006 compared to 2003 (0.3% vs. 0.5%, p=0.1547). Low numbers involved in these survey results indicate they should be treated with some caution. Fourteen survey respondents reported using GHB in the previous 12 months in 2003 and only six respondents reported using GHB in the previous 12 months in 2006.

Centre for Social and Health Outcomes Research and Evaluation 154 Te Runanga, Wananga, Hauora me te Paekaka 12.9 Summary of GHB trends

• Only a small number of the frequent drug users indicated that they had knowledge of GHB trends in 2006 and in 2007. As a consequence, the findings in this chapter should be treated with some caution

• In 2007, the current availability of GHB was reported to be ‘easy’

• The availability of GHB is thought to have been ‘stable’ over the past two years

• In 2007, a millilitre of GHB cost a median price of $5.00

• The price of GHB was reported to have been ‘stable/increasing’ in 2006 and 2007

• In 2007, the current purity of GHB was considered to be ‘high’

• The purity of GHB appears to be higher in 2007 than in 2006

• The number of people using GHB was described as the ‘same/more’ in 2006 and 2007

• Annual seizures of GHB have declined since 2004

Centre for Social and Health Outcomes Research and Evaluation 155 Te Runanga, Wananga, Hauora me te Paekaka 13. Drug related harm

13.1 Introduction

The frequent drug users were asked about a number of different aspects of harm related to their drug use including specific physical and psychological problems they may have suffered and harmful incidents they may have experienced. The frequent drug users were also asked about the health services they may have accessed in relation to their drug use and the extent to which they had driven under the influence of drugs.

13.2 Drug related physical problems

The frequent drug users were asked if they had experienced any of a list of 22 physical problems from their drug use in the past six months. The frequent methamphetamine users were asked about physical problems related to methamphetamine use, the frequent ecstasy (MDMA) users were asked about physical problems related to ecstasy use and the frequent injecting drug users were asked about physical problems related to opiate use.

In 2007, the physical problems most often reported in relation to methamphetamine use were insomnia (91%), poor appetite (82%), hot and cold flushes (76%), profuse sweating (69%), headaches (67%), weight loss (63%), muscular aches (63%) and heart palpitations (57%) (Table 13.1). The physical problems most often reported in relation to ecstasy (MDMA) use were poor appetite (68%), insomnia (68%), hot and cold flushes (47%), tremors and shakes (42%) and heart palpitations (40%). The physical problems most often reported in relation to opiate use were poor appetite (81%), hot and cold flushes (73%), profuse sweating (72%), insomnia (71%), muscular aches (62%), joint pains (62%) and weight loss (61%).

Centre for Social and Health Outcomes Research and Evaluation 156 Te Runanga, Wananga, Hauora me te Paekaka Table 13.1: Drug related physical problems by drug type, 2007

Drug type Methamphetamine Ecstasy (MDMA) Opiates

Physical problem Methamphetamine Ecstasy users Intravenous drug users (MDMA) users (IDU) (n=110) (n=105) (n=109) Insomnia 91% 68% 71% Poor appetite 82% 68% 81% Hot/cold flushes 76% 47% 73% Profuse sweating 69% 42% 72% Headaches 67% 35% 57% Weight loss 63% 30% 61% Muscular aches 63% 22% 62% Heart palpitations 57% 40% 49% Teeth 57% 30% 56% Joint pains 56% 22% 62% Blurred vision 55% 37% 41% Shortness of breath 54% 29% 49% Dizziness 54% 35% 46% Skin problems 51% 13% 31% Tremors/ shakes 50% 42% 50% Numbness/ tingling 48% 37% 45% Stomach pains 45% 14% 58% Chest pains 43% 11% 22% Vomiting 29% 15% 49% Inability to urinate 26% 31% 30% Fainting/ passing out 17% 7% 14% Fits/ seizures 7% 2% 6%

In 2007, the frequent methamphetamine users who reported physical problems from their methamphetamine use reported a mean of 12 physical problems in the past six months (median 12, range 1-21). The frequent ecstasy (MDMA) users who reported physical problems from their ecstasy use reported a mean of 7 physical problems in the past six months (median 7, range 1-17). The frequent injecting drug users who reported physical problems from their injecting drug use reported a mean of 11 physical problems in the past six months (median 12, range 1-22). The frequent ecstasy users reported a statistically significantly lower mean number of physical problems from their drug use than the frequent methamphetamine users (7 vs. 12 problems, p<0.0001) and the frequent injecting drug users (7 vs. 11 problems, p<0.0001).

Centre for Social and Health Outcomes Research and Evaluation 157 Te Runanga, Wananga, Hauora me te Paekaka 13.2 Drug related psychological problems

The frequent drug users were also asked if they had experienced any of a list of 19 psychological problems from their drug use in the previous six months. The frequent methamphetamine users were asked about psychological problems related to methamphetamine, the frequent ecstasy (MDMA) users were asked about psychological problems related to ecstasy (MDMA) use and the frequent injecting drug users were asked about psychological problems related to opiates. In 2007, the psychological problems most often reported in relation to methamphetamine use were irritability (82%), mood swings (81%), poor concentration (80%), short temper (75%), confusion (72%), anxiety (69%), loss of energy (68%) and strange thoughts (67%) (Table 13.2). Twenty-five percent of the frequent methamphetamine users reported experiencing suicidal thoughts in relation to their methamphetamine use. The psychological problems most often reported in relation to ecstasy (MDMA) use were strange thoughts (64%), mood swings (60%), confusion (60%), memory lapses (59%) and poor concentration (57%). Five percent of the frequent ecstasy (MDMA) users reported experiencing suicidal thoughts in relation to their ecstasy (MDMA) use. The psychological problems most often reported in relation to opiate use were poor concentration (74%), loss of energy (72%), mood swings (73%), memory lapses (72%), irritability (71%), anxiety (63%), short temper (61%), loss of sex urge (60%) and depression (60%). Twenty percent of the frequent injecting drug users reported experiencing suicidal thoughts in relation to their opiate use.

Centre for Social and Health Outcomes Research and Evaluation 158 Te Runanga, Wananga, Hauora me te Paekaka Table 13.2: Drug related psychological problems by drug type, 2007

Drug type Methamphetamine Ecstasy (MDMA) Opiates

Psychological Methamphetamine Ecstasy users Intravenous drug problem users (MDMA) users (IDU) (n=110) (n=105) (n=109) Irritability 82% 46% 71% Mood swings 81% 60% 70% Poor concentration 80% 57% 74% Short temper 75% 38% 61% Confusion 72% 60% 54% Memory lapse 70% 59% 65% Anxiety 69% 31% 63% Loss of energy 68% 47% 72% Strange thoughts 67% 64% 41% Paranoia 67% 27% 44% Depression 58% 31% 60% Sound hallucinations 48% 30% 22% Visual hallucinations 45% 28% 18% Flashbacks 45% 21% 22% Panic attacks 44% 11% 35% Loss of sex urge 41% 22% 60% Violent behaviour 37% 4% 13% Suicide thoughts 25% 5% 20% Suicide attempts 8% 2% 7%

In 2007, the frequent methamphetamine users who reported psychological problems from their methamphetamine use reported a mean of 11 psychological problems in the past six months (median 12, range 1-19). The frequent ecstasy (MDMA) users who reported psychological problems from their ecstasy use reported a mean of seven psychological problems in the past six months (median 6, range 1-17). The frequent injecting drug users who reported psychological problems from their injecting drug use reported a mean of nine psychological problems in the past six months (median 9, range 1-18). The frequent ecstasy users reported a statistically significantly lower mean number of psychological problems from their drug use than the frequent methamphetamine users (7 vs. 11 problems, p<0.0001) and the frequent injecting drug users (7 vs. 9 problems, p=0.0004).

13.3 Life impacts

The frequent drug users were asked whether their drug use had impacted on eight general areas of their lives in the previous six months. In 2007, the frequent ecstasy users were statistically significantly less likely to Centre for Social and Health Outcomes Research and Evaluation 159 Te Runanga, Wananga, Hauora me te Paekaka report financial problems related to their drug use than either the frequent methamphetamine users (57% vs. 75%, p=0.012) or the frequent injecting drug users (57% vs. 82%, p=0.0003) (Table 13.3). The frequent ecstasy users were statistically significantly less likely to report harm to their energy and vitality from their drug use than either the frequent methamphetamine users (51% vs. 77%, p<0.0001) or the frequent injecting drug users (51% vs. 80%, p<0.0001). The frequent ecstasy users were also less likely to report harm to their health from their drug use than either the frequent methamphetamine users (43% vs. 77%, p<0.0001) or the frequent injecting drug users (43% vs. 71%, p<0.0001). The frequent ecstasy users were statistically significantly less likely to report harm to their relationships from their drug use than either the frequent methamphetamine users (38% vs. 71%, p<0.0001) or the frequent injecting drug users (38% vs. 72%, p<0.0001). The frequent ecstasy users were less likely to report harm to their life opportunities from their drug use than either the frequent methamphetamine users (18% vs. 63%, p<0.0001) or the frequent injecting drug users (18% vs. 71%, p<0.0001). There was no statistically significant difference between the three groups of frequent drug users with respect to the level of work/study problems (p=0.4064). The frequent ecstasy users were less likely to report harm to their home life from their drug use than either the frequent methamphetamine users (21% vs. 67%, p<0.0001) or the frequent injecting drug users (21% vs. 60%, p<0.0001). The frequent ecstasy users were less likely to report legal/police problems related to their drug use than either the frequent methamphetamine users (12% vs. 54%, p<0.0001) or the frequent injecting drug users (12% vs. 45%, p<0.0001).

Table 13.3: Drug related harms by frequent drug user group, 2007

Different areas of Methamphetamine Ecstasy users Intravenous Combined life users (MDMA) drug users (IDU) modules (n=110) (n=105) (n=109) (n=324) Financial problems 75% 57% 82% 72% Energy and vitality 77% 51% 80% 70% Health 76% 43% 71% 64% Relationship/social 71% 38% 72% 61% problems Life opportunities 63% 18% 71% 51% Work/study 55% 49% 47% 50% problems Home life 67% 21% 60% 50% Legal/police 54% 12% 45% 37% problems

Centre for Social and Health Outcomes Research and Evaluation 160 Te Runanga, Wananga, Hauora me te Paekaka The frequent drug users were statistically significantly more likely to report ‘financial problems’ (72% vs. 49%, p<0.0001) and ‘legal and police problems’ (37% vs. 23%, p<0.0001) related to their drug use in 2007 than in 2006 (Table 13.4).

Table 13.4: Drug related harms by combined frequent drug users, 2006-2007

2006 2007 Different areas of Combined Combined life modules modules (n=317) (n=324) Financial problems 49% 72% Relationship/social 55% 61% problems Work/study 47% 50% problems Legal/police 23% 37% problems

The frequent methamphetamine users were statistically significantly more likely to report ‘financial problems’ related to their drug use in 2007 compared to 2006 (75% vs. 54%, p=0.0039) and compared to 2005 (75% vs. 57%, p=0.0222) (Table 13.5). The frequent methamphetamine users were more likely to report ‘legal/police’ problems in relation to their drug use in 2007 compared to 2006 (54% vs. 33%, p=0.0058) and compared to 2005 (54% vs. 22%, p<0.0001). The frequent injecting drug users (45% vs. 28%, p=0.019) were also more likely to report ‘legal/police problems’ in 2007 than in 2006.

Table 13.5: Drug related harms by frequent methamphetamine users, 2005-2007

2005 2006 2007

Different areas of Methamphetamine Methamphetamine Methamphetamine life users users users (n=77) (n=114) (n=110)

Financial problems 57% 54% 75%

Relationship/social 63% 72% 71% problems Work/study 43% 54% 55% problems Legal/police 22% 33% 54% problems

13.3.2 Specific drug related harmful incidents

The frequent drug users were asked if they had experienced any of a list of specific harmful incidents in relation to their drug use in the past six months. In 2007, the drug related incidents most commonly reported by the frequent methamphetamine users were ‘argued with others’ (77%), ‘lost temper’ (73%) and ‘had Centre for Social and Health Outcomes Research and Evaluation 161 Te Runanga, Wananga, Hauora me te Paekaka reduced work/study performance’ (67%) (Table 13.6). The drug related incidents most commonly reported by the frequent ecstasy users were ‘couldn’t remember what happened the night before’ (75%), ‘did something under the influence of drugs and later regretted it’ (63%) and ‘had reduced work/study performance’ (59%). The drug related incidents most commonly reported by the frequent injecting drug users were ‘no money for luxuries’ (71%), ‘got into debt/owing money’ (69%) and ‘argued with others’ (68%).

Table 13.6: Drug related incidents by frequent drug user group, 2007

Drug related incident Meth- Ecstasy Intravenous Combined amphetamine users drug users modules users (MDMA) (IDU) (n=324) (n=110) (n=105) (n=109) Argued with others 77% 38% 68% 61% Lost your temper 73% 41% 61% 59% Had reduced work/study 67% 59% 42% 56% performance No money for luxuries 66% 41% 71% 59% Damaged a friendship 66% 25% 50% 47% Damaged a friendship 66% 25% 50% 47% Did something under the influence of 65% 63% 48% 59% drugs and later regretted it Got into debt/owing money 63% 36% 69% 56% Took sick leave/did not attend 61% 51% 32% 48% classes Upset a family relationship 60% 14% 48% 41% Ended a personal relationship 58% 10% 37% 35% Couldn’t remember what happened 55% 75% 42% 57% the night before Damaged property (you) 55% 33% 27% 38% No money for food or rent 53% 21% 50% 42% Got arrested 46% 12% 31% 30% Had unprotected sex 45% 39% 39% 41% Passed out 44% 39% 38% 40% Stole property (you) 44% 21% 31% 32% Physically hurt someone else 40% 9% 24% 24% Spent some nights sleeping rough 39% 10% 27% 26% (i.e living on the streets) Got a traffic ticket 37% 7% 28% 24% Had sex and later regretted it 32% 29% 23% 28% Was kicked out of where I was living 31% 7% 27% 22% Sacked/lose business/quit study 31% 3% 15% 16% course Physically hurt yourself 29% 32% 29% 30% Charged with a driving offence (eg. 23% 4% 12% 14% DIC) Overdosed on drugs 20% 10% 17% 16% Had a car crash 17% 5% 13% 12% Were sexually harassed 11% 10% 11% 11% Were sexually assaulted 8% 3% 5% 5% Centre for Social and Health Outcomes Research and Evaluation 162 Te Runanga, Wananga, Hauora me te Paekaka Those frequent drug users who had experienced a drug related incident were asked what drug type they mainly considered to be responsible these problems. In 2007, the drug types which the frequent methamphetamine users most commonly considered to be responsible for their drug related problems were methamphetamine (67%) and alcohol (16%) (Table 13.7). The drug types which the frequent ecstasy users most commonly considered to be responsible for their drug related problems were alcohol (55%), ecstasy (22%) and cannabis (11%). The drug types which the frequent injecting drug users most commonly considered to be responsible for their drug related problems were ‘other opiates’ (39%), Ritalin (12%) and methadone (10%).

Table 13.7: Drug type responsible for drug related incident by frequent drug user group, 2007

Drug type most Methamphetamine Ecstasy users Intravenous Combined responsible for users (MDMA) drug users (IDU) modules drug related (n=106) (n=104) (n=307) incident (n=97) Methamphetamine 67% 8% 5% 27% Alcohol 16% 55% 8% 25% Other opiates 2% 0% 39% 14% Cannabis 7% 11% 8% 8% Ecstasy (MDMA) 1% 22% 2% 8% Ritalin 2% 1% 12% 5% Methadone 0% 0% 10% 3% Amphetamine 3% 0% 2% 2% Benzodiazepines 0% 0% 7% 2% Heroin 0% 0% 3% 1% Crystal 3% 0% 0% 1% methamphetamine BZP party pills 0% 0% 4% 1% LSD 0% 1% 1% 1% Solvents 0% 1% 0% <1% Tobacco 0% 1% 0% <1% Codeine 0% 0% 1% <1%

13.4 Perceptions of the health risk of different drugs

The frequent drug users were asked to evaluate the health risk of ‘regularly’ using different drug types on a scale of 1=no risk to 5=extreme risk. In 2007, the drug types which the frequent drug users most often rated as an extreme health risk with regular use were crystal methamphetamine (52%), methamphetamine (51%), opiates (39%) and GHB (37%) (Table 13.8). Twenty percent of frequent drug users thought BZP party pills were an extreme health risk with regular use. Methamphetamine (4.3) and crystal methamphetamine (4.3) received the highest average scores for perceived health risk. GHB (4.0) and opiates (3.9) were also

Centre for Social and Health Outcomes Research and Evaluation 163 Te Runanga, Wananga, Hauora me te Paekaka considered by the frequent drug users to be high health risks. There was no statistically significant change in the average score of the health risk of any of the drug types in 2007 compared to 2006.

Table 13.8: Perceptions of the health risk of regularly using different drug types, 2007 (2006)

Drug type No risk Slight risk Moderate Great risk Extreme Average =1 = 2 risk = 3 = 4 risk = 5 score of perceived health risk

2007 (2006) Methamphetamine 1% 4% 14% 30% 51% 4.3 (4.4) (n=314) Crystal meth- 1% 3% 13% 31% 52% 4.3 (4.4) Amphetamine (n=303) GHB (n=225) 4% 7% 17% 36% 37% 4.0 (4.1)

Opiates (n=300) 3% 11% 21% 26% 39% 3.9 (3.9)

Ketamine (n=215) 3% 10% 20% 34% 33% 3.8 3.9)

Amphetamine 3% 7% 30% 33% 26% 3.7 (3.8) (n=312) LSD (n=315) 6% 17% 30% 24% 23% 3.4 (3.4)

BZP party pills 12% 26% 26% 16% 20% 3.1 (3.0) (n=298) Ecstasy (MDMA) 7% 24% 35% 21% 13% 3.1 (3.1) (n=308) Cannabis (n=321) 23% 42% 25% 5% 5% 2.3 (2.4)

13.5 Accessing health services

The frequent drug users were asked what health services, if any, they had accessed in relation to their drug use in the past six months. In 2007, the frequent methamphetamine users were statistically significantly more likely than the frequent ecstasy users to have accessed an ambulance in relation to their drug use in the previous six months (15% vs. 3%, p=0.0096) (Table 13.9). The frequent methamphetamine users were also statistically significantly more likely than the frequent ecstasy users to access a hospital Accident and Emergency Department in relation to their drug use in the past six months (17% vs. 5%, p=0.0129). The frequent ecstasy (MDMA) users were statistically significantly less likely to have been admitted to a hospital in relation to their drug use than either the frequent methamphetamine users (1% vs. 12%, p=0.0042) or the frequent injecting drug users (1% vs. 10%, p=0.0102). The frequent ecstasy (MDMA) users were less likely to have visited a General Practitioner (i.e. Doctor) than either the frequent methamphetamine users (5% vs. 38%, p<0.0001) or the frequent injecting drug users (5% vs. 37%, p<0.0001) in relation to their drug use in Centre for Social and Health Outcomes Research and Evaluation 164 Te Runanga, Wananga, Hauora me te Paekaka the past six months. The frequent methamphetamine users were more likely to have visited a counsellor in relation to their drug use than either the frequent ecstasy users (42% vs. 9%, p<0.0001) or the frequent injecting drug users (42% vs. 23%, p=0.0076). The frequent injecting drug users were more likely to have visited a drug and alcohol worker than either the frequent ecstasy users (56% vs. 6%, p<0.0001) or the frequent methamphetamine users (56% vs. 37%, p=0.0097).

Table 13.9: Health services accessed in relation to drug use in the past six months by frequent drug user group, 2007

Health service Methamphetamine Ecstasy users Intravenous Combined users (MDMA) drug users (IDU) modules (n=110) (n=105) (n=108) (n=323) Counsellor 42% 9% 23% 25% General Practitioner 38% 5% 37% 27% Drug and Alcohol 37% 6% 56% 33% worker Needle exchange 35% 6% 93% 45% After hours electronic 18% 6% 47% 24% needle dispenser Accident and 17% 5% 11% 11% Emergency Ambulance 15% 3% 9% 9% Social worker 14% 2% 12% 9% Psychologist 15% 2% 10% 9% Psychiatrist 10% 2% 12% 8% Hospital (admitted) 12% 1% 10% 8% First Aid 6% 8% 7% 7%

The frequent drug users were statistically significantly more likely to have accessed a counsellor (25% vs. 17%, p=0.0195), drug and alcohol worker (33% vs. 26%, p=0.0466) and social worker (9% vs. 4%, p=0.0061) in relation to their drug use in 2007 than in 2006.

The frequent methamphetamine users were statistically significantly more likely to have accessed an ambulance (15% vs. 3%, p=0.0014) and accident and emergency (17% vs. 6%, p=0.0351) in relation to their drug use in 2007 compared to 2006 (Table 13.10). The frequent methamphetamine users were also statistically significantly more likely to have accessed a drug and alcohol worker (37% vs. 18%, p=0.015), counsellor (42% vs. 18%, p=0.0021) and General Practitioner (38% vs. 18%, p=0.0096) in relation to their drug use in 2007 compared to 2005.

Centre for Social and Health Outcomes Research and Evaluation 165 Te Runanga, Wananga, Hauora me te Paekaka Table 13.10: Health services accessed in relation to drug use in the past six months by frequent methamphetamine users, 2005-2007

2005 2006 2007

Health service Methamphetamine Methamphetamine Methamphetamine users users users (n=73) (n=114) (n=110) Counsellor 18% 33% 42% General Practitioner 18% 27% 38% Drug and Alcohol 18% 38% 37% worker Accident and 14% 6% 17% Emergency Ambulance 10% 3% 15% Psychologist 7% 10% 15% Social worker 10% 7% 14% Psychiatrist 11% 10% 10% Hospital (admitted) 8% 4% 12% First Aid 3% 2% 6%

13.6 Help seeking for drug problems

The frequent drug users were asked if they had ‘ever wanted help to reduce their level of drug use but had not got it’. In 2007, 26% of the frequent drug users had not been able to find help to reduce their drug use when they wanted it. The frequent ecstasy users were statistically significantly less likely to have sought help and not got it than the frequent methamphetamine users (10% vs. 32%, p=0.0004) or the frequent injecting drug users (10% vs. 34%, p<0.0001).

In 2007, the drug type which the frequent methamphetamine users were most commonly seeking help for when they were unable to find help was methamphetamine (57%) (Table 13.11). The drug types which the frequent ecstasy users were most commonly seeking help for when they were unable to find help were cannabis (40%) and alcohol (20%). The drug types which the frequent injecting drug users were most commonly seeking help for when they were unable to find help were ‘other opiates’ (57%) and methadone (11%).

Centre for Social and Health Outcomes Research and Evaluation 166 Te Runanga, Wananga, Hauora me te Paekaka Table 13.11: Drug type unable to find help for when seeking help for drug problems, 2007

Drug type Methamphetamine Ecstasy users Intravenous Combined users (MDMA) drug users (IDU) modules (n=35) (n=10) (n=37) (n=82) Methamphetamine 57% 0% 5% 27% Crystal 9% 0% 0% 4% methamphetamine Cannabis 9% 40% 5% 11% Alcohol 9% 20% 5% 9% Amphetamine 3% 0% 0% 1% Cant specify 3% 0% 8% 5% Other opiates 3% 0% 57% 27% Benzodiazepines 3% 0% 3% 2% Needle 1% 0% 0% <1% Ecstasy (MDMA) 0% 2% 0% 2% Heroin 0% 0% 3% 1% BZP party pills 0% 0% 3% 1% Methadone 0% 0% 11% 5% Solvents 0% 1% 0% <1% Tobacco 0% 10% 0% <1%

Finally, those who reported been unable to find help for their drug use were asked what barriers, if any, they had come across in trying to find help. In 2007, the barriers most commonly experienced by the frequent methamphetamine users were ‘fear of what might happen once contact made with service’ (55%), ‘social pressure to keep using’ (52%) and ‘fear of police’ (45%) (Table 13.12). The barriers most commonly experienced by the frequent ecstasy users were ‘service not appropriate for my type of drug use/problems’ (56%), ‘social pressure to keep using’ (44%) and ‘fear of police’ (44%). The barriers most commonly experienced by the frequent injecting drug users were ‘long waiting lists’ (53%), ‘fear of what might happen once contact made with service’ (53%) and ‘could not get an appointment soon enough/at suitable time’ (42%).

Centre for Social and Health Outcomes Research and Evaluation 167 Te Runanga, Wananga, Hauora me te Paekaka Table 13.12: Barriers experienced when trying to find help to reduce drug use, 2007

Barriers to finding help for drug use Meth- Ecstasy Intravenous Combined amphetamine users drug users modules users (MDMA) (IDU) (n=78) (n=33) (n=9) (n=36) Fear of what might happen once 55% 33% 53% 51% contact made with service Social pressure to keep using 52% 44% 31% 41% Fear of the police 45% 44% 14% 31% Fear of losing friends 39% 33% 17% 28% Long waiting lists 39% 22% 53% 44% Didn’t know where to go 39% 11% 8% 22% Could not get an appointment soon 36% 33% 42% 38% enough/at suitable time Concern about impact may have on my 36% 33% 22% 29% job/career prospects Service not appropriate for my type of 27% 56% 33% 33% drug use/problems Costs too much 27% 33% 22% 26% Had no transport to get there 27% 11% 25% 24% No local service available 27% 11% 19% 22% Fear of social welfare agencies (e.g. 24% 11% 17% 19% CYF’s) No after hours service 21% 11% 22% 21% Lack of childcare 9% 0% 0% 4%

13.7 Alcohol and driving

In 2007, 29% of the frequent drug users reported that they had driven under the influence of alcohol in the past six months. This included 35% of the frequent methamphetamine users, 32% of the frequent ecstasy users and 19% of the frequent injecting drug users. The frequent methamphetamine users were statistically significantly more likely than the frequent injecting drug users to have driven under the influence of alcohol in the previous six months (35% vs. 19%, p=0.0435). The frequent ecstasy users were also more likely than the frequent injecting drug users to have driven under the influence of alcohol (32% vs. 19%) in the past six months, and this was close to being statistically significant (p=0.0596). The extent of driving under the influence of alcohol for each of the frequent drug user groups is presented in Table 13.13.

Centre for Social and Health Outcomes Research and Evaluation 168 Te Runanga, Wananga, Hauora me te Paekaka Table 13.13: Extent of driving under the influence of alcohol by frequent drug user group, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007 Driving Meth- Meth- Ecstasy Ecstasy users Intravenous Intravenous Combined Combined under amphetamine amphetamine users (MDMA) drug users drug users modules modules influence users users (MDMA) (IDU) (IDU) (n=318) (n=324) of (n=105) (n=114) (n=110) (n=111) (n=93) (n=109) alcohol None 68% 65% 76% 68% 78% 81% 74% 71% Hardly any 17% 21% 22% 25% 14% 10% 18% 19% Some 10% 6% 3% 7% 5% 7% 6% 7% Most 4% 3% 0% 0% 0% 1% 2% 1% All 2% 4% 0% 1% 2% 1% 1% 2%

Table 13.14: Extent of driving under the influence of a drug (other than alcohol) by frequent drug user group, 2006-2007

2006 2007 2006 2007 2006 2007 2006 2007 Driving Meth- Meth- Ecstasy Ecstasy users Intravenous Intravenous Combined Combined under amphetamine amphetamine users (MDMA) drug users drug users modules modules influence users users (MDMA) (IDU) (IDU) (n=318) (n=324) of drug (n=105) (n=114) (n=110) (n=111) (n=93) (n=109) None 28% 25% 43% 49% 35% 37% 36% 37% Hardly any 15% 18% 36% 35% 11% 13% 21% 22% Some 23% 25% 15% 11% 26% 19% 21% 19% Most 20% 21% 4% 4% 14% 13% 13% 13% All 13% 11% 2% 1% 14% 18% 9% 10%

Centre for Social and Health Outcomes Research and Evaluation 169 Te Runanga, Wananga, Hauora me te Paekaka 13.8 Drug use and driving

In 2007, 64% of the frequent drug users had driven under the influence of a drug other than alcohol in the past six months. This included 72% of the frequent methamphetamine users, 57% of the frequent ecstasy (MDMA) users and 65% of the frequent injecting drug users. The extent of driving under the influence of a drug other than alcohol is presented for each of the frequent drug user groups in Table 13.14. The frequent ecstasy (MDMA) users were statistically significantly less likely to have completed ‘most’ or ‘all’ of their driving under the influence of a drug than either the frequent methamphetamine users (5% vs. 32%, p<0.0001) or the frequent injecting drug users (5% vs. 31%, p<0.0001).

In 2007, the two drug types which the frequent methamphetamine users most commonly reported driving under the influence of were methamphetamine (70%) and cannabis (66%) (Table 13.15). The two drug types which the frequent ecstasy users most commonly drove under the influence of were cannabis (72%) and ecstasy (MDMA) (43%). Seventeen percent of the frequent ecstasy users had driven under the influence of BZP party pills. For the frequent injecting drug users, the two drug types which they most commonly drove under the influence of were methadone (58%), cannabis (51%) and other opiates (49%).

Table 13.15: Drug types driven under the influence of by frequent drug user group, 2007

Drug type under Methamphetamine Ecstasy users Intravenous Combined influence of when users (MDMA) drug users (IDU) modules driving (n=82) (n=54) (n=69) (n=205) Methamphetamine 70% 6% 20% 36% Cannabis 66% 72% 51% 62% Crystal 28% 4% 0% 12% methamphetamine Ecstasy (MDMA) 16% 43% 4% 19% Opiates 15% 0% 49% 22% Methadone 11% 0% 58% 24% BZP party pills 9% 17% 7% 10% Benzodiazepines 9% 2% 19% 10% LSD 9% 13% 1% 7% Amphetamine 7% 2% 4% 5% GHB 5% 4% 0% 3% Heroin 4% 0% 0% 1% Cocaine 2% 7% 0% 3% MDA 2% 0% 0% 1% Ketamine 2% 0% 0% 1% Nitrous oxide 2% 0% 0% 1% Anti-depressants 1% 1% 3% 1% Ritalin 1% 0% 14% 5%

Centre for Social and Health Outcomes Research and Evaluation 170 Te Runanga, Wananga, Hauora me te Paekaka 13.9 Summary of drug related harm

• In 2007, the frequent methamphetamine users reported a mean of 12 physical problems and 11 psychological problems from their drug use in the past six months

• In 2007, the frequent injecting drug users reported a mean of 11 physical problems and nine psychological problems from their drug use in the past six months

• In 2007, the frequent ecstasy users reported fewer physical and psychological problems from their drug use than the frequent injecting drug users

• In 2007, half of the frequent methamphetamine users and frequent injecting drug users reported having no money for food or rent due to their drug use in the past six months

• In 2007, approximately three out of ten of the frequent methamphetamine users and frequent injecting drug users reported been ‘kicked out of where they were living’ as a result of their drug use in the past six months

• In 2007, 20% of the frequent methamphetamine users and 17% of the frequent injecting drug users reported overdosing on drugs in the past six months

• The frequent drug users were more likely to report ‘financial problems’ and ‘legal and police problems’ related to their drug use in 2007 compared to 2006

• The frequent methamphetamine users were more likely to report ‘financial problems’ related to their drug use in 2007 compared to 2006 and 2005

• The frequent methamphetamine users were more likely to report ‘legal/police problems’ related to their drug use in 2007 compared to 2006 and 2005

• The frequent injecting drug users were more likely to report ‘legal/police problems’ related to their drug use in 2007 compared to 2006

• In 2007, the drug types which the frequent drug users most often assessed as an ‘extreme health risk’ were crystal methamphetamine, methamphetamine, opiates and GHB

• The frequent methamphetamine users were more likely to have accessed an ambulance and accident emergency in relation to their drug use in 2007 than in 2006

• The frequent methamphetamine users were also more likely to have accessed a drug and alcohol worker, counsellor and General Practitioner in relation to their drug use in 2007 compared to 2005

• In 2007, one third of the frequent methamphetamine users and frequent injecting drug users had wanted help to reduce their drug use but had not got it

• In 2007, 29% of the frequent drug users reported that they had driven under the influence of alcohol in the previous six months

Centre for Social and Health Outcomes Research and Evaluation 171 Te Runanga, Wananga, Hauora me te Paekaka • In 2007, 64% of the frequent drug users reported they had driven under the influence of a drug other than alcohol in the past six months

• In 2007, 70% of the frequent methamphetamine users had driven under the influence of methamphetamine in the past six months

• In 2007, the drug types which the frequent drug users had most commonly drove under the influence of were cannabis, methamphetamine, methadone, ‘other opiates’ and ecstasy

Centre for Social and Health Outcomes Research and Evaluation 172 Te Runanga, Wananga, Hauora me te Paekaka 14. Drug dependency

14.1 Introduction

The frequent drug users were administered a short dependency scale (SDS) to provide a measure of their level of dependency on a drug (see Gossop et al., 1995). The SDS has previously been validated as an instrument to detect dependency among various types of drug users including amphetamine users, alcohol drinkers, cocaine users and cannabis users (Gossop et al., 1995, Martin et al., 2006, Topp and Mattick, 1997). Those scoring four or more on the combined five questions of the SDS are categorised as drug dependent. The final assessment of the SDS for each of the frequent drug user groups is presented at the end the chapter. The frequent methamphetamine users answered the SDS in relation to their methamphetamine use, the frequent ecstasy (MDMA) users answered the SDS in relation to their ecstasy (MDMA) use, and the frequent injecting drug users answered the SDS in relation to their opiate use.

14.2 Extent drug use out of control

In 2007, 19% of the frequent methamphetamine users reported that their methamphetamine use was ‘always’ out of control (Table 14.1). Nine percent of the frequent injecting drug users reported that their opiate use was ‘always’ out of control. The frequent injecting drug users were statistically significantly more likely to say their opiate use was out of control than the frequent ecstasy (MDMA) users were to say their ecstasy (MDMA) use was out of control (1.0 vs. 0.2, p<0.0001). The frequent methamphetamine users were also more likely to say their methamphetamine use was out of control than the frequent ecstasy (MDMA) users were to say their ecstasy (MDMA) use was out of control (1.0 vs. 0.2, p<0.0001).

Table 14.1: Extent that frequent drug users considered their drug use to be out of control by frequent drug user group, 2007

Drug Type Methamphetamine Ecstasy (MDMA) Opiates Extent drug use out Methamphetamine Ecstasy users Intravenous drug of control users (MDMA) users (IDU) (n=108) (n=104) (n=108) Never [0] 40% 80% 31% Sometimes [1] 34% 16% 45% Often [2] 7% 4% 14% Always [3] 19% 0% 9% Average score 1.0 0.2 1.0 (0=never – 3=always)

Centre for Social and Health Outcomes Research and Evaluation 173 Te Runanga, Wananga, Hauora me te Paekaka 14.3 Anxious about missing a dose

In 2007, 35% of the frequent injecting drug users said they were ‘always’ anxious about missing a dose of opiates (Table 14.2). Fifteen percent of the frequent methamphetamine users said they were ‘always’ anxious about missing a dose of methamphetamine. The frequent injecting drug users were statistically significantly more likely to say they were anxious about missing a dose of opiates than the frequent ecstasy (MDMA) users were to say they were anxious about missing a dose of ecstasy (MDMA) (1.6 vs. 0.3, p<0.0001). The frequent injecting drug users were also more likely to say they were anxious about missing a dose of opiates than the frequent methamphetamine users were to say they were anxious about missing a dose of methamphetamine (1.6 vs. 0.9, p<0.0001).

Table 14.2: Extent that frequent drug users were anxious about missing a dose by frequent drug user group, 2007 Drug Type Methamphetamine Ecstasy (MDMA) Opiates Anxious about Methamphetamine Ecstasy users Intravenous drug missing a dose of users (MDMA) users (IDU) drugs (n=110) (n=104) (n=108) Never [0] 45% 78% 24% Sometimes [1] 30% 16% 24% Often [2] 9% 5% 17% Always [3] 15% 1% 35% Average score 0.9 0.3 1.6 (0=never – 3=always)

14.4 Worry about your drug use

In 2007, 18% of the frequent methamphetamine users said they ‘always’ worried about their methamphetamine use (Table 14.3). Fifteen percent of the frequent injecting drug users said they ‘always’ worried about their opiate use. The frequent injecting drug users were statistically significantly more likely to say they worry about their opiate use than the frequent ecstasy (MDMA) users were to say they worry about their ecstasy (MDMA) use (1.3 vs. 0.5, p<0.0001). The frequent methamphetamine users were also more likely to say they worry about their methamphetamine use than the frequent ecstasy (MDMA) users were to say they worry about their ecstasy (MDMA) use (1.2 vs. 0.5, p<0.0001).

Centre for Social and Health Outcomes Research and Evaluation 174 Te Runanga, Wananga, Hauora me te Paekaka Table 14.3: Extent that frequent drug users worried about their drug use by frequent drug user group, 2007

Drug Type Methamphetamine Ecstasy (MDMA) Opiates Worry about your Methamphetamine Ecstasy users Intravenous drug drug use users (MDMA) users (IDU) (n=110) (n=105) (n=109) Never [0] 32% 63% 24% Sometimes [1] 37% 28% 40% Often [2] 13% 8% 21% Always [3] 18% 2% 15% Average score 1.2 0.5 1.3 (0=never – 3=always)

14.5 Wish you could stop

In 2007, 28% of the frequent injecting drug users reported that they ‘always’ wished they could stop their opiate use (Table 14.4). Twenty-two percent of the frequent methamphetamine users reported that they ‘always’ wished they could stop their methamphetamine use. The frequent injecting drug users were statistically significantly more likely to say they wished they could stop their opiate use than the frequent ecstasy (MDMA) users were to say they wished they could stop their ecstasy (MDMA) use (1.5 vs. 0.2, p<0.0001). The frequent methamphetamine users were also more likely to say they wished they could stop their methamphetamine use than the frequent ecstasy (MDMA) users were to say they wished they could stop their ecstasy (MDMA) use (1.2 vs. 0.2, p<0.0001).

Table 14.4: Extent that frequent drug users wished they could stop using drugs by frequent drug user group, 2007 Drug Type Methamphetamine Ecstasy (MDMA) Opiates Wish you could Methamphetamine Ecstasy users Intravenous drug stop users (MDMA) users (IDU) (n=109) (n=102) (n=107) Never [0] 39% 89% 22% Sometimes [1] 28% 6% 31% Often [2] 11% 1% 20% Always [3] 22% 4% 28% Average score 1.2 0.2 1.5 (0=never – 3=always)

14.6 How difficult find it to stop

In 2007, 10% of the frequent injecting drug users believed it would be ‘impossible’ for them to stop using opiates (Table 14.5). Nine percent of the frequent methamphetamine users believed it would be ‘impossible’

Centre for Social and Health Outcomes Research and Evaluation 175 Te Runanga, Wananga, Hauora me te Paekaka for them to stop using methamphetamine. The frequent injecting drug users were statistically significantly more likely to say it would be difficult for them to stop using opiates than the frequent ecstasy (MDMA) users were to say it would be difficult for them to stop using ecstasy (MDMA) (1.4 vs. 0.2, p<0.0001). The frequent injecting drug users were also more likely to say it would be difficult for them to stop using opiates than the frequent methamphetamine users were to say it would be difficult for them to stop using methamphetamine (1.4 vs. 0.9, p<0.0001).

Table 14.5: Extent that frequent drug users considered it would be difficult to stop their drug use by frequent drug user group, 2007 Drug Type Methamphetamine Ecstasy (MDMA) Opiates How difficult to Methamphetamine Ecstasy users Intravenous drug stop users (MDMA) users (IDU) (n=106) (n=104) (n=105) Not difficult [0] 48% 89% 22% Quite difficult [1] 24% 6% 26% Very difficult [2] 19% 4% 42% Impossible [3] 9% 1% 10% Average score 0.9 0.2 1.4 (0=never – 3=always)

14.7 Short Dependency Scale (SDS) scores

In 2007, 83% of the frequent injecting drug users were classified as dependent on opiates according to the SDS (Table 14.6). Fifty-five percent of the frequent methamphetamine users were classified as dependent on methamphetamine according to the SDS. Ten percent of the frequent ecstasy (MDMA) users were classified as dependent on ecstasy (MDMA) according to the SDS. The frequent injecting drug users were statistically significantly more likely to be classified as drug dependent than the frequent methamphetamine users (83% vs. 55%, p<0.0001). The frequent methamphetamine users were more likely to be classified as drug dependent than the frequent ecstasy (MDMA) users (55% vs. 10%, p<0.0001). Levels of drug dependency in the 2007 sample were similar to the levels found in 2006 sample. In 2006, 80% of the frequent injecting drug users, 59% of the frequent methamphetamine users and 9% of the frequent ecstasy users were classified as dependent using the SDS.

Centre for Social and Health Outcomes Research and Evaluation 176 Te Runanga, Wananga, Hauora me te Paekaka Table 14.6: SDS classification of dependency by frequent drug user group, 2007

Drug Type Methamphetamine Ecstasy (MDMA) Opiates Total dependency Methamphetamine Ecstasy users Intravenous drug score users (MDMA) users (IDU) (score 4 or more = (n=103) (n=100) (n=101) dependent) 0 Non-dependent 14% 45% 6% 1 20% 73% 10% 2 32% 84% 13% 3 45% 90% 17% 4 Dependent 54% 94% 23% 5 61% 94% 34% 6 66% 94% 45% 7 74% 95% 57% 8 80% 97% 72% 9 86% 99% 77% 10 90% 99% 89% 11 92% 100% 93% 12 92% 100% 97% 13 96% 100% 100% 14 99% 100% 100%

14.8 Summary of drug dependency

• In 2007, 83% of the frequent injecting drug users were classified as dependent on opiates

• In 2007, 55% of the frequent methamphetamine users were classified as dependent on methamphetamine

• In 2007, 10% of the frequent ecstasy (MDMA) users were classified as dependent on ecstasy

• Levels of drug dependency were similar in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 177 Te Runanga, Wananga, Hauora me te Paekaka 15. Injecting behaviour

15.1 Introduction

Those frequent drug users who had injected any drug in the past six months were asked additional questions about their injecting behaviour, including where they obtained their needles, the places where they injected, whether they had used a needle or injection equipment after another user and how often they had used a new sterile needle on each injecting occasion. All the frequent injecting drug users had injected a drug in the previous six months. Forty percent of the frequent methamphetamine users had used a needle to inject a drug in the past six months. Only six frequent ecstasy users (6%) had injected a drug in the past six months so they are included in the combined sample only.

15.2 Location where needles were obtained

The frequent drug users were asked to name all the different places where they had obtained needles in the past six months and were read a list of possible locations. In 2007, needle exchanges proper (89%), pharmacies (36%), after-hours electronic needle dispensers located at needle exchanges (35%) and ‘friends’ (29%) were the most common places where the frequent drug users had obtained needles (Table 15.1). Seven percent of the frequent drug users obtained their needles from their drug dealer.

Table 15.1: Location used to obtain a needle by frequent drug user group, 2007

Location where Methamphetamine Intravenous drug Combined modules needle obtained users users (IDU) (n=163) (includes (n=49) (n=108) frequent ecstasy users) Needle exchange 80% 94% 89% Pharmacy 35% 37% 36% Needle exchange 31% 37% 35% electronic dispenser Friend 18% 32% 29% Partner 12% 3% 7% Drug dealer 4% 7% 7%

Centre for Social and Health Outcomes Research and Evaluation 178 Te Runanga, Wananga, Hauora me te Paekaka 15.3 Places where drugs were injected

The frequent drug users were asked about all the different locations where they had injected drugs in the past six months and were read a list of possible locations. In 2007, private homes (i.e. own home [90%] or a friends’ home [64%]) were the most common places where frequent drug users injected drugs. However, injection also took place in public or semi public locations such as a ‘car’ (33%), ‘public toilets’ (31%), the ‘street, park or beach’ (21%) and ‘venue toilets’ (20%) (Table 15.2)

Table 15.2: Places where drug injected by frequent drug user group, 2007

Places where Methamphetamine Intravenous drug Combined modules injected users users (IDU) (n=163) ) (includes (n=49) (n=108) frequent ecstasy users) Own home 90% 90% 90% Friends’ home 67% 61% 64% Car 41% 29% 33% Public toilet 24% 33% 31% Dealers’ home 31% 26% 26% Street, park or beach 22% 19% 21% Venue toilet (e.g. 22% 19% 20% pubs/ clubs) Sex venue 8% 5% 6% Communal ‘shooting’ 8% 3% 4% room Squat 4% 5% 4% Other 4% 4% 4%

15.4 Times used a needle after someone else

The frequent drug users were asked how many times they had used a needle to inject themselves after someone else had already used it in the past six months. In 2007, 91% of the frequent drug users said they had never used a needle after someone else in the previous six months. However, 9% of the frequent drug users said they had done so to varying degrees over this time (Table 15.3). There was no statistically significant difference between the frequent methamphetamine users and the frequent injecting drug users with respect to the proportion who had never used a needle after someone else (94% vs. 91%, p=0.4713).

Centre for Social and Health Outcomes Research and Evaluation 179 Te Runanga, Wananga, Hauora me te Paekaka Table 15.3: Number of times needle was used after someone else by frequent drug user group, 2007

Times used needle Methamphetamine Intravenous drug Combined modules after someone else users users (IDU) (n=163) (includes (n=49) (n=108) frequent ecstasy users) None 94% 91% 91% 1 time 2% 3% 2% 2 times 2% 1% 1% 3-5 times 0% 3% 2% 6-10 times 2% 3% 2% >10 times 0% 0% 0%

There was no statistically significant change in the proportion of the frequent drug users who had never used a needle after someone else in 2007 compared 2006 (91% vs. 90%, p=0.6907) (Table 15.4).

Table 15.4: Number of times needle was used after someone else by combined frequent drug users, 2006- 2007 2006 2007 Times used needle Combined modules Combined modules after someone else (n=134) (includes (n=163) (includes frequent ecstasy frequent ecstasy users) users) None 90% 91% 1 time 6% 2% 2 times 1% 1% 3-5 times 1% 2% 6-10 times 0% 2% >10 times 1% 0%

15.5 Injecting equipment used after someone else

The frequent drug users were also asked what injecting equipment, if any, they had used after someone in the past six months. In 2007, 63% of the frequent drug users had never used injection equipment after someone else in the past six months (Table 15.5). There was no statistically significant difference in the proportion of frequent methamphetamine users and frequent injecting drug users who had never used injection equipment after someone else (p=0.792).

Centre for Social and Health Outcomes Research and Evaluation 180 Te Runanga, Wananga, Hauora me te Paekaka Table 15.5: Injecting equipment used after someone else by frequent drug user group, 2007

Injecting equipment Methamphetamine Intravenous drug Combined modules used after users users (IDU) (n=163) (includes someone (n=49) (n=108) frequent ecstasy users) None 61% 64% 63% Spoons/ mixing 27% 28% 28% container Tourniquet 22% 22% 23% Water 6% 8% 8% Wheel filter 8% 7% 7% Dregs 2% 6% 5% Drug (taste) 2% 5% 4%

There was no statistically significant change in the proportion of the frequent drug users who had never used injecting equipment after someone else in 2007 compared to 2006 (63% vs. 55%, p=0.1918) (Table 15.6).

Table 15.6: Injecting equipment used after someone else by combined frequent drug users, 2006-2007

2006 2007 Injecting equipment Combined modules Combined modules used after (n=134) (includes (n=163) (includes someone frequent ecstasy frequent ecstasy users) users) None 54% 63% Spoons/ mixing 37% 28% container Tourniquet 28% 23% Water 13% 8% Wheel filter 13% 7% Dregs 15% 5% Drug (taste) 6% 4%

15.6 Frequency used a new sterile needle

The frequent drug users were asked how often over the past six months did they use a ‘new’ sterile needle and syringe when injecting a drug. In 2007, 70% of the frequent drug users had always used a new sterile needle and syringe when injecting over the previous six months (Table 15.7).

Centre for Social and Health Outcomes Research and Evaluation 181 Te Runanga, Wananga, Hauora me te Paekaka Table 15.7: Number of times a new sterile needle was used by frequent drug user group, 2007

Frequency used a Methamphetamine Intravenous drug Combined modules new sterile needle users users (IDU) (n=162) (includes and syringe (n=49) (n=107) frequent ecstasy users) All injections 80% 64% 70% Most of the time 18% 27% 24% Half of the time 2% 7% 5% Some of the time 0% 1% 1% Hardly ever 0% 0% 0% Never 0% 0% 0%

There was no statistically significant difference in the proportion of frequent drug users who had used a new sterile needle on ‘all’ occasions in 2007 compared to 2006 (70% vs. 65%, p=0.454) (15.8).

Table 15.8: Number of times a new sterile needle was used by combined frequent drug users, 2006-2007

Frequency used a Combined modules Combined modules new sterile needle (n=133) (includes (n=162) (includes and syringe frequent ecstasy frequent ecstasy users) users) All injections 65% 70% Most of the time 31% 24% Half of the time 3% 5% Some of the time 1% 1% Hardly ever 0% 0% Never 0% 0%

15.7 Summary of injecting behaviour

• In 2007, ‘private homes’ (90%) and a ‘friends home’ (64%) were the most common places were drugs were injected. Injection also took place in semi public locations such as ‘cars’ (33%), ‘public toilets’ (31%), the ‘street, park or beach’ (21%) and ‘venue toilets’ (20%)

• In 2007, 91% of frequent drug users had never used a needle after someone else. However, 9% had done so to varying degrees in the past six months

• There was no statistically significant change in the proportion of frequent drug users who had never used a needle after someone else in 2007 compared to 2006

• In 2007, 63% of the frequent drug users had never used injection equipment after someone else in the previous six months

• There was no statistically significant change in the proportion of frequent drug users who had never used injection equipment after someone else in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 182 Te Runanga, Wananga, Hauora me te Paekaka • In 2007, 70% of the frequent drug users had always used a new sterile needle and syringe when injecting drugs in the previous six months

• There was no statistically significant difference in the proportion of frequent drug users who had always used a new sterile needle and syringe in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 183 Te Runanga, Wananga, Hauora me te Paekaka 16. Sexual health

16.1 Introduction

All the frequent drug users interviewed were asked a number of questions about their sexual health including their number of sexual partners and the extent to which they used safe sex practices in the past six months.

16.2 Number of sexual partners

The frequent drug users were asked how many different people have they had penetrative sex with in the previous six months. In 2007, only 14% of the frequent drug users had had no sexual partners in the past six months (Table 16.1). Thirty-two percent of the frequent drug users had had three or more sexual partners in the past six months, and 8% had had more than 10 sexual partners in the past six months. A higher proportion of the frequent methamphetamine users than the frequent ecstasy and frequent injecting drug users had had sex with six or more sexual partners in the past six months, and this was close to being statistically significant (p=0.054).

Table 16.1: Number of sexual partners in the past six months by frequent drug user group, 2007

Number different Methamphetamine Ecstasy users Intravenous drug Combined sexual partners users (MDMA) users (IDU) modules (n=311) (n=106) (n=102) (n=103) None 8% 7% 26% 14% 1 person 42% 33% 39% 38% 2 people 11% 21% 14% 15% 3-5 people 16% 25% 11% 17% 6-10 people 10% 7% 5% 7% >10 people 12% 7% 6% 8%

16.3 Safe sexual practices with regular partners

In 2007, 78% of the frequent drug users who had sex in the previous six months had done so with a ‘regular partner’. This included 81% of the frequent methamphetamine users, 71% of the frequent ecstasy users and 83% of the frequent injecting drug users. There was no statistically significant difference between the groups of frequent drug users with respect to the proportion who had had sex with a regular partner in the past six months (p=0.1278). Those frequent drug users who had a regular sexual partner in the previous six months were asked how often they used ‘condoms/dams or gloves’ when having sex with their ‘regular partner’. In 2007, 56% of the frequent drug users had ‘never’ used ‘condoms/dams or gloves’ when having sex with their

Centre for Social and Health Outcomes Research and Evaluation 184 Te Runanga, Wananga, Hauora me te Paekaka regular partner over this time (Table 16.2). The frequent ecstasy (MDMA) users were statistically significantly less likely to have ‘rarely’ or ‘never’ used ‘condoms/dams or gloves’ when having sex with their ‘regular partner’ than the frequent methamphetamine users (45% vs. 65%, p=0.0422) or the frequent injecting drug users (45% vs. 70%, p=0.0102).

Table 16.2: Number of times used ‘condoms/dams or gloves’ when having sex with a ‘regular partner’ by frequent drug user group, 2007

Times used Methamphetamine Ecstasy users Intravenous drug Combined protection with users (MDMA) users (IDU) modules (n=218) regular partner (n=82) (n=69) (n=67) Every time 21% 25% 21% 22% Often 5% 16% 4% 8% Sometimes 10% 14% 4% 10% Rarely 4% 6% 4% 5% Never 61% 39% 66% 56%

There was a statistically significant increase in the proportion of the frequent drug users who ‘never’ used ‘condoms/dams or gloves’ with a regular partner in 2007 compared to 2006 (56% vs. 45%, p=0.0354) (Table 16.3).

Table 16.3: Number of times used ‘condoms/dams or gloves’ when having sex with a ‘regular partner’ by combined frequent drug users, 2006-2007

2006 2007 Times used Combined Combined protection with modules modules regular partner (n=219) (n=218) Every time 20% 22% Often 16% 8% Sometimes 11% 10% Rarely 8% 5% Never 45% 56%

16.4 Safe sexual practices with casual partners

In 2007, 54% of the frequent drug users who had sex in the previous six months had done so with a ‘casual partner’. This included 52% of the frequent methamphetamine users, 62% of the frequent ecstasy users and 48% of the frequent injecting drug users. There was no statistically significant difference between the groups of frequent drug users with respect to the proportion who had sex with a casual partner in the past six months (p=0.14). Those frequent drug users who had a casual sexual partner in the previous six months were asked how often over the previous six months they used ‘condoms/dams or gloves’ when having sex with their ‘casual partner(s)’. In 2007, 12% of the frequent drug users had ‘never’ used ‘condoms/dams or gloves’ Centre for Social and Health Outcomes Research and Evaluation 185 Te Runanga, Wananga, Hauora me te Paekaka when having sex with casual partners over this time (Table 16.4). There was no statistically significant difference in the proportion of frequent drug users who ‘rarely’ or ‘never’ used ‘condoms/dams or gloves’ when having sex with a ‘casual partner’ between the three groups of frequent drug users (p=0.2738).

Table 16.4: Number of times used ‘condoms/dams or gloves’ when having sex with a ‘casual partner’ by frequent drug user group, 2007

Times used Methamphetamine Ecstasy users Intravenous Combined protection with users (MDMA) drug users modules casual partner (n=52) (n=60) (IDU) (n=150) (n=38) Every time 52% 50% 53% 51% Often 10% 28% 13% 18% Sometimes 27% 12% 13% 17% Rarely 2% 2% 0% 1% Never 10% 8% 21% 12%

There was no statistically significant difference in the proportion of frequent drug users who ‘always’ used ‘condoms/dams or gloves’ when having sex with a ‘casual partner’ in 2007 compared to 2006 (55% vs. 51%, p=0.2738) (Table 16.5).

Table 16.5: Number of times used ‘condoms/dams or gloves’ when having sex with a ‘casual partner’ by combined frequent drug users, 2006-2007

2006 2007 Times used Combined Combined protection with modules modules casual partner (n=149) (n=150) Every time 55% 51% Often 15% 18% Sometimes 10% 17% Rarely 5% 1% Never 15% 12%

Centre for Social and Health Outcomes Research and Evaluation 186 Te Runanga, Wananga, Hauora me te Paekaka 16.5 Summary of sexual health

• In 2007, 8% of the frequent drug users had more then 10 sexual partners in the past six months

• In 2007, 56% of the frequent drug users had ‘never’ used ‘condoms/dams or gloves’ when having sex with a regular partner in the past six months

• There was a statistically significant increase in the proportion of the frequent drug users who ‘never’ used ‘condoms/dams or gloves’ when having sex with a regular partner in 2007 compared to 2006

• In 2007, 12% of the frequent drug users had ‘never’ used ‘condoms/dams or gloves’ when having sex with a casual partner in the past six months

• There was no statistically significant change in the proportion of the frequent drug users who always used ‘condoms/dams or gloves’ when having sex with a casual partner in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 187 Te Runanga, Wananga, Hauora me te Paekaka 17. Blood borne virus vaccination and testing

17.1 Introduction

All the frequent drug users were asked a number of questions about vaccination and testing for the blood borne viruses Hepatitis B and C, and HIV.

17.2 Vaccination for Hepatitis B

The frequent drug users were first asked if they had ever been vaccinated against hepatitis B. In 2007, 52% of the frequent drug users had not, and a further 11% did not know if they had been vaccinated against the virus (Table 17.1).

Table 17.1: Vaccination against Hepatitis B by frequent drug user group, 2007

Vaccinated against Methamphetamine Ecstasy users Intravenous Combined hepatitis B users (MDMA) drug users modules (IDU) (n=322) (n=110) (n=105) (n=107) No 53% 57% 48% 52% Yes, didn’t finish 11% 3% 11% 8% schedule Yes, completed 30% 28% 27% 28% schedule Don’t know 6% 12% 13% 11%

There was no statistically significant change in the proportion of the frequent drug users who had never been vaccinated for Hepatitis B in 2007 compared to 2006 (52% vs. 54%, p=0.8123) (Table 17.2).

Table 17.2: Vaccination against Hepatitis B by combined frequent drug users, 2006-2007

2006 2007 Vaccinated Combined Combined against hepatitis modules modules B (n=317) (n=322) No 54% 52% Yes, didn’t finish 5% 8% schedule Yes, completed 31% 28% schedule Don’t know 11% 11%

Centre for Social and Health Outcomes Research and Evaluation 188 Te Runanga, Wananga, Hauora me te Paekaka 17.3 Tested for Hepatitis B

The frequent drug users were also asked whether they had ever, or recently, been tested for Hepatitis B. In 2007, the frequent ecstasy (MDMA) users were statistically significantly less likely to have been ever tested for Hepatitis B than either the frequent methamphetamine users (30% vs. 73%, p<0.0001) or the frequent injecting drug users (30% vs. 83%, p<0.0001) (nb. the ‘Don’t know’ responses were removed for the purposes of the statistical test) (Table 17.3). The frequent ecstasy (MDMA) users were also statistically significantly less likely to have been tested for Hepatitis B in the past year than either the frequent methamphetamine users (17% vs. 51%, p<0.0001) or the frequent injecting drug users (17% vs. 54%, p<0.0001).

Table 17.3: Ever tested for Hepatitis B by frequent drug user group, 2007

Tested for Methamphetamine Ecstasy users Intravenous Combined hepatitis B users (MDMA) drug users modules (n=323) (IDU) (n=110) (n=105) (n=108) No 26% 69% 16% 37% Yes, in the last year 50% 17% 51% 36% Yes, more than 1 21% 12% 27% 20% year ago Don’t know 3% 2% 6% 4%

There was no statistically significant difference in the proportion of the frequent drug users who had never been tested for Hepatitis B in 2007 compared to 2006 (37% vs. 38%, p=0.8064) (Table 17.4).

Table 17.4: Ever tested for Hepatitis B by combined frequent drug users, 2006-2007

2006 2007 Tested for Combined Combined hepatitis B modules modules (n=317) (n=323) No 38% 37% Yes, in the last 36% 36% year Yes, more than 1 22% 20% year ago Don’t know 4% 4%

Those who had been tested for Hepatitis B were asked what the outcome of their test was. In 2007, 75% of those frequent drug users who had been tested for Hepatitis B said they received a negative result (i.e. they did not have Hepatitis B).

Centre for Social and Health Outcomes Research and Evaluation 189 Te Runanga, Wananga, Hauora me te Paekaka Table 17.5: Outcome of test for Hepatitis B by frequent drug user group, 2007

Result of Methamphetamine Ecstasy users Intravenous drug Combined hepatitis B test users (MDMA) users (IDU) modules (n=193) (n=78) (n=31) (n=84) Negative (I don’t have hep 72% 84% 74% 75% B) I am immune to 14% 10% 13% 13% hep B Don’t know/ didn’t get result/ not 12% 6% 4% 7% sure I have had hep B 3% 0% 5% 3% in the past I am a hep B 0% 0% 5% 2% carrier

There was no statistically significant difference in the proportion of the frequent drug users who were Hepatitis B carriers in 2007 compared to 2006 (2% vs. 2%, p=1) (Table 17.6).

Table 17.6: Outcome of test for Hepatitis B by combined frequent drug users, 2006-2007

2006 2007 Result of Combined Combined hepatitis B test modules modules (n=193) (n=193) Negative 84% (I don’t have hep 75% B) I am immune to 9% 13% hep B Don’t know/ didn’t 3% get result/ not 7% sure I have had hep B 1% 3% in the past I am a hep B 2% 2% carrier

17.4 Tested for Hepatitis C

The frequent drug users were asked whether they had ever been tested for Hepatitis C. In 2007, the frequent ecstasy (MDMA) users were statistically significantly less likely to have been ever been tested for Hepatitis C than either the frequent methamphetamine users (24% vs. 70%, p<0.0001) or the frequent injecting drug users (24% vs. 93%, p<0.0001) (nb. the ‘Don’t know’ responses were removed for the purposes of the statistical test) (Table 17.7). The frequent methamphetamine users were statistically significantly less likely to have been tested for Hepatitis C than the frequent injecting drug users (70% vs. 93%, p<0.0001). The frequent ecstasy users were also less likely to have been tested for Hepatitis C in the past year than either the Centre for Social and Health Outcomes Research and Evaluation 190 Te Runanga, Wananga, Hauora me te Paekaka frequent methamphetamine users (15% vs. 49%, p<0.0001) or the frequent injecting drug users (15% vs. 55%, p<0.0001).

Table 17.7: Ever tested for Hepatitis C by frequent drug user group, 2007

Tested for Methamphetamine Ecstasy users Intravenous drug Combined hepatitis C users (MDMA) users (IDU) modules (n=323) (n=110) (n=105) (n=108) No 29% 73% 6% 36% Yes, in the last year 46% 14% 55% 39% Yes, more than 1 20% 9% 38% 22% year ago Don’t know 5% 4% 1% 3%

There was no statistically significant difference in the proportion of the frequent drug users who had never been tested for Hepatitis C in 2007 compared to 2006 (36% vs. 37%, p=0.8697) (Table 17.8).

Table 17.8: Ever tested for Hepatitis C by combined frequent drug user group, 2006-2007

Tested for Combined Combined hepatitis C modules modules (n=317) (n=323) No 37% 36% Yes, in the last 39% 39% year Yes, more than 1 21% 22% year ago Don’t know 4% 3%

Those frequent drug users who had been tested for Hepatitis C were asked what the outcome of their test was. In 2007, 54% of the frequent injecting drug users and 21% of the frequent methamphetamine users who had taken the test for Hepatitis C reported that they had tested positive for the virus (Table 17.9).

Table 17.9: Outcome of test for Hepatitis C by frequent drug user group, 2007

Result of Methamphetamine Ecstasy users Intravenous Combined hepatitis C test users (MDMA) drug users modules (n=73) (n=24) (IDU) (n=197) (n=100) Negative 74% 88% 38% 57% (I don’t have hep C) Positive 21% 0% 54% 35% (I have hep C) Don’t know/ didn’t 4% 12% 8% 7% get result/ not sure

Centre for Social and Health Outcomes Research and Evaluation 191 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the proportion of the frequent drug users who tested positive for Hepatitis C in 2007 compared to 2006 (35% vs. 28%, p=0.1242) (Table 17.10).

Table 17.10: Outcome of test for Hepatitis C by combined frequent drug user group, 2006-2007

2006 2007 Result of Combined Combined hepatitis C test modules modules (n=189) (n=197) Negative (I don’t have hep 69% 57% C) Positive 28% 35% (I have hep C) Don’t know/ didn’t get result/ not 3% 7% sure

17.5 HIV

The frequent drug users were then asked whether they had ever been tested for HIV. In 2007, the frequent ecstasy users were statistically significantly less likely to have been ever tested for HIV than either the frequent methamphetamine users (30% vs. 72%, p<0.0001) or the frequent injecting drug users (30% vs. 90%, p=0.0003) (nb. the ‘Don’t know’ responses were removed for the purposes of the statistical test) (Table 17.11). The frequent injecting drug users were statistically significantly more likely to have ever been tested for HIV than the frequent methamphetamine users (90% vs. 72%, p=0.0016). The frequent ecstasy users were also less likely to have been tested for HIV in the past year than either the frequent methamphetamine users (20% vs. 46%, p=0.00024) or the frequent injecting drug users (20% vs. 44%, p=0.0004).

Table 17.11: Ever tested for HIV by frequent drug user group, 2007

Tested for Methamphetamine Ecstasy users Intravenous drug Combined HIV users (MDMA) users (IDU) modules (n=323) (n=110) (n=105) (n=108) No 27% 70% 10% 35% Yes, in the last year 45% 20% 44% 37% Yes, more than 1 year 26% 10% 44% 27% ago Don’t know 1% 1% 2% 1%

Centre for Social and Health Outcomes Research and Evaluation 192 Te Runanga, Wananga, Hauora me te Paekaka There was no statistically significant difference in the proportion of the frequent drug users who had never been tested for HIV in 2007 compared to 2006 (35% vs. 37%, p=0.6226) (Table 17.12).

Table 17.12: Ever tested for HIV by combined frequent drug users, 2006-2007

2006 2007 Tested for Combined Combined HIV modules modules (n=317) (n=323) No 37% 35% Yes, in the last 39% 37% year Yes, more than 1 22% 27% year ago Don’t know 2% 1%

Those who had been tested for HIV were asked what the outcome of their test was. In 2007, less than 1% of the frequent drug users reported they had tested positive for HIV. However, 4% of the frequent drug users had been tested for HIV but said they did not know or were unsure of the results of their test (Table 17.13).

Table 17.13: Outcome of test for HIV by frequent drug user group, 2007

Result of Methamphetamine Ecstasy users Intravenous drug Combined HIV test users (MDMA) users (IDU) modules (n=205) (n=79) (n=31) (n=95) Negative 92% 90% 99% 95% (I don’t have HIV) Positive 1% 0% 0% <1% (I have HIV) Don’t know/ didn’t get 6% 10% 1% 4% result/ not sure

There was no statistically significant difference in the proportion of the frequent drug users who tested negative for HIV in 2007 compared to 2006 (95% vs. 97%, p=0.448) (Table 17.13).

Centre for Social and Health Outcomes Research and Evaluation 193 Te Runanga, Wananga, Hauora me te Paekaka 17.6 Summary of blood borne virus vaccination and testing

• In 2007, 37% of the frequent drug users had never been tested for hepatitis B

• There was no statistically significant change in the proportion of the frequent drug users who had never been tested for Hepatitis B in 2007 compared to 2006

• In 2007, 36% of frequent drug users had never been tested for Hepatitis C

• There was no statistically significant change in the proportion of the frequent drug users who had never been tested for Hepatitis C in 2007 compared to 2006

• In 2007, 54% of the frequent injecting drug users who had been tested for Hepatitis C had tested positive for the virus

• In 2007, 21% of the frequent methamphetamine users who had been tested for Hepatitis C had tested positive for the virus

• There was no statistically significant change in the proportion of the frequent drug users who tested positive for Hepatitis C in 2007 compared to 2006

• In 2007, 35% of frequent drug users had never been tested for HIV

• There was no statistically significant change in the proportion of the frequent drug users who had never been tested for HIV in 2007 compared to 2006

• In 2007, approximately 70% of the frequent ecstasy users had never been tested for Hepatitis B, Hepatitis C or HIV

• In 2007, of those frequent drug users who had been tested for HIV, less than 1% had tested positive for the virus and 4% did not know the results of their test

• There was no statistically significant change in the proportion of the frequent drug users who tested negative for HIV in 2007 compared to 2006

Centre for Social and Health Outcomes Research and Evaluation 194 Te Runanga, Wananga, Hauora me te Paekaka 18. Secondary data sources on drug use

18.1 Introduction

This chapter reviews a number of secondary data sources on drug use in New Zealand to further place the findings of the interviews of the frequent drug users and KE in greater context. In previous chapters we reviewed trends in drug seizure statistics and findings from recent national household drug surveys. The secondary data sources presented here include calls to the Alcohol and Drug Help-line, hospital admissions for drug related illness and admissions to drug treatment services.

18.2 Alcohol and Drug Help-line

The Alcohol and Drug Help-line is a free 0800 telephone information service run by the Alcohol Drug Association of New Zealand (ADANZ) (ADANZ, 2006; 2007). It provides confidential information, service referral and support concerning drug related problems, both for drug users and concerned third parties, such as family members and friends of drug users. The call statistics from the help-line provide led indicators of changes in drug use and drug related problems.

In 2006/07, there was a 3% increase in the total number of telephone calls received by the service, from 14,763 calls in 2005/06 to 15,180 calls in 2006/07. The number of telephone calls received in 2006/07 was 21% higher than the number of calls received in 2002/03 (12,529 calls).

In 2006/07, 64% of the telephone calls to the service concerned alcohol related problems. The proportion of total calls related to alcohol problems fell from 79% in 2002/03 to 62% in 2003/04, and has remained fairly consistent at this level over recent years (Figure 18.1). Over this time, the number of telephone calls related to cannabis problems increased from 1,010 calls in 2002/03 to 2,108 calls in 2006/07 (+108%). Similarly, the number of telephone calls for amphetamine problems increased from 736 calls in 2002/03 to 1,824 calls in 2006/07 (+148%). There was some decline in the number of calls for amphetamine problems in recent years, down from 2,124 calls in 2005/06 to 1,824 calls in 2006/07 (-14%). There was also some decline in the number of calls for cannabis problems in recent years, down from 2,244 calls in 2005/06 to 2,108 calls in 2006/07 (-6%).

Centre for Social and Health Outcomes Research and Evaluation 195 Te Runanga, Wananga, Hauora me te Paekaka Figure 18.1: Percentage of calls received for alcohol versus other drugs, 2002-2007

100% 6% 11% 13% 10% 10% 90% 9% 6% 14% 15% 14% 80% 14%

70% 13% 12% 13% 14% 60% Other drug Cannabis 50% Amphetamine 40% 79% Alcohol 64% 30% 62% 60% 61%

20%

10%

0% 2002/3 2003/4 2004/5 2005/6 2006/7

Source: Alcohol and Drug Association of New Zealand (2006, 2007)

A closer look at the composition of calls for drug related problems other than alcohol, shows that there was an increase in the number of calls related to methamphetamine problems, from 548 calls in 2002/03 to 1,695 calls in 2006/07 (+209%) (Figure 18.2). There also an increase in the number of calls for problems related to the use of benzodiazepines (from 187 calls in 2002/3 to 557 calls in 2006/07) (+197%) and for problems related to the use of opiates (from 272 calls in 2002/3 to 673 calls in 2006/07) (+147%). In more recent years there have been a growing number of calls to the service for problems related to BZP party pills (from 81 in 2004/05 to 256 in 2006/07) (+216%). There was a recent decrease in the number of calls related to methamphetamine, down from 1,941 calls in 2005/06 to 1,695 calls in 2006/07 (-13%), and a recent decrease in the number of calls for amphetamine sulphates, down from 183 in 2005/06 to 129 calls in 2006/07 (-30%).

Centre for Social and Health Outcomes Research and Evaluation 196 Te Runanga, Wananga, Hauora me te Paekaka Figure 18.2: Percentage of calls received for drugs other than alcohol, 2002-2007 0% 0% 1% 3% 5% 100% 8% 6% 8% 6% 5% 90% 5% 10% 4% 6% 5% 3% 2% 1% 5% 80% 11% 12% 10% 12% 2% 12% BZP 70% 8% 5% 3% 2% 6% Benzodiazepines 60% Solvents 33% 23% 31% 30% Cocaine 50% 27% Opioid 40% Amphetamine Methamphetamine 30% Cannabis

20% 42% 39% 37% 34% 37% 10%

0% 2002/3 2003/4 2004/5 2005/6 2006/7

Source: Alcohol and Drug Association of New Zealand (2006, 2007)

18.3 Odyssey house drug treatment services

Odyssey House operates a range of programmes for people experiencing serious difficulties with substance abuse (Odyssey House, 2006; 2007). New clients to Odyssey drug treatment programmes are asked to nominate the drug type which is their main substance use problem and the top three substances they have problems with. For adult clients in 2006/07, the drug types most commonly nominated as the main substance problem were alcohol (37%), methamphetamine (24%) and cannabis (19%) (Figure 18.3). For youth clients in 2006/07, the drug types most commonly mentioned as the main substance problem were alcohol (30%) cannabis (24%), tobacco (22%) and methamphetamine (15%).

Centre for Social and Health Outcomes Research and Evaluation 197 Te Runanga, Wananga, Hauora me te Paekaka Figure 18.3: Drug types nominated by Odyssey clients as their main substance problem, 2006/07

25 Youth 20 Adult Total 15

Percentage of Odyssey clients Odyssey of Percentage 5

s e e y ne es n s in i on nts LSD o d e drug iat sta enic a r p c her g alcohol h e o orphi e nicot solv h ino cocaine cannabi sedativesgambling ot m c omebake met lu h amphetamine hal er h methamphetamine ot

Source: Odyssey House (2007)

Figure 18.4 presents the drug types nominated by new Odyssey House clients in 2006/07 as one of their three main substance use problems. For youth clients, cannabis (100%) was the drug type most commonly mentioned, followed by alcohol (70%), tobacco (63%), methamphetamine (26%) and solvents (11%). For adult clients, alcohol (64%) and cannabis (64%) were the drug types most commonly mentioned, followed by tobacco (44%), methamphetamine (44%) and amphetamine (12%).

Centre for Social and Health Outcomes Research and Evaluation 198 Te Runanga, Wananga, Hauora me te Paekaka Figure 18.4: Drug types nominated by Odyssey clients as one of their three main substance problems, 2006/07

100 90 80 70

60 Youth 50 Adult Total 40 30

Percentage of Odyssey clients Odyssey of Percentage 20 10 0

s g g s D e is e n ne u S ab in li o L nic ake ain cohol dr phine b nn l ad er r heroinoge a nicotine solvents opiate o ecstasy coc ca etam etaminesedative gamb eth m h ph oth cin home m llu am ha ethamp ther m o

Source: Odyssey House (2007)

18.4 Community Alcohol and Drug Services (CADS)

The Community Alcohol and Drug Service (CADS) provide free alcohol and other drug services to the people of the Auckland region. The statistics presented in this section are from CADS six monthly reports for the first six months of the year (i.e. January-June) for 2006 and 2007 (CADS, 2006; 2007).

New clients to CADS programmes are routinely administered an alcohol and other drug screening package to elicit a range of information related to the clients alcohol and drug use. The CADS screen package is comprised of six individual screening instruments that explore six different drug types (i.e. alcohol; cannabis; amphetamine; opiates; benzodiazepines; and other drugs). A positive screen indicates probable problematic and/or dependent alcohol or drug use according to screen specific criteria. A single new client can return a positive screen for more than one drug type. In 2007, approximately 27% of new CADS clients screened positive for two or more drug types.

There was a decrease in the number of drug screens completed for new clients from 1,311 in the first six months of 2006 to 1,193 in the first six months of 2007 (-9%). There were some changes in the composition of positive screens by drug type between 2007 and 2006 (Figure 18.5). In 2007, there were 908 positive screens for alcohol compared to 870 positive alcohol screens in 2006 (+4%). Positive screens for cannabis

Centre for Social and Health Outcomes Research and Evaluation 199 Te Runanga, Wananga, Hauora me te Paekaka decreased from 371 in 2006 to 306 in 2007 (-18%). There was also a decrease in the number of positive screens for amphetamine, down from 226 in 2006 to 171 in 2007.

Figure 18.5: Percentage of positive screens by drug type, 2005-2007

100% 3% 3% 3% 2% 2% 2% 5% 4% 4% 90% 11% 13% 14% 80%

70% 20% 24% 23% Other 60% Benzodiazepines Opiates 50% Amphetamine 40% Cannabis Alcohol 30% 60% 54% Percent of positive screens 52% 20%

10%

0% 2005 2006 2007

Source: Community Alcohol and Drug Services (2005; 2006; 2007)

18.5 Summary of secondary data sources on drug use

• There has been a 21% increase in the number of calls to the Alcohol and Drug Help-line in 2006/07 compared to 2002/03

• There have been increased calls to the Alcohol and Drug Help-line in 2006/07 compared to 2002/03 for problems related to methamphetamine (+209%), benzodiazepines (197%) and opiates (+147%)

• There has been a growing number of calls to the Drug Help-line for BZP party pills since 2004/05

• In 2007, the drug types most commonly nominated as the main substance use problem by new adult clients to Odyssey drug treatment services were alcohol (37%), methamphetamine (24%) and cannabis (19%)

• In 2007, the greatest number of positive screens (indicating problematic use) for new clients for CADS drug treatment programmes in 2006 were for alcohol (908 positive screens), cannabis (306 positive screens) and amphetamines (171 positive screens)

Centre for Social and Health Outcomes Research and Evaluation 200 Te Runanga, Wananga, Hauora me te Paekaka References

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Centre for Social and Health Outcomes Research and Evaluation 203 Te Runanga, Wananga, Hauora me te Paekaka