The injection of methadone syrup in New South Wales: patterns of use and increased harm after partial banning of injecting equipment.
OBJECTIVE
To describe methadone injectors and the risk practices associated with injecting methadone in New South Wales, Australia. To assess the impact on injecting drug use and risk behaviour of the withdrawal of methadone injecting equipment from government-funded needle and syringe programs.


METHODS
Cross-sectional survey, conducted in 1999, of 206 people who had injected methadone at least once in the previous month. Participants were from Central Sydney, West Sydney and rural New South Wales.


RESULTS
Of participants who had injected both methadone and other drugs in the previous month (n=162), significantly more reused their methadone injecting equipment compared with those who reused their other drug injecting equipment (60% vs. 28%, p<0.01). There was no significant difference in terms of sharing injecting equipment, with 19% reporting sharing methadone injecting equipment and 14% sharing other drug injecting equipment. However, women were more likely than men to share methadone injecting equipment. Over half of the participants had accessed diverted methadone and a substantial minority reported the use of public spaces for injecting methadone.


CONCLUSIONS
Our results suggest that the current policy has led to increased reuse of equipment for injecting methadone.


CONCLUSIONS
A range of other possible policy options, such as closer monitoring and dilution of take-home doses, increasing oral doses and implementing trials of injected methadone, may assist to reduce the prevalence of methadone syrup injection and related harms.
Hopwood
Max
M
National Centre in HIV Social Research, University of New South Wales. m.hopwood@unsw.edu.au
Southgate
Erica
E
Kippax
Susan
S
Bammer
Gabriele
G
Isaac-Toua
Geetha
G
MacDonald
Margaret
M
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D017743:Equipment Reuse; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy*; D006801:Humans; D007267:Injections / Q000706:statistics & numerical data; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D009517:New South Wales; D012309:Risk-Taking; D012737:Sex Factors; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013594:Syringes / Q000145:classification / Q000600:supply & distribution*
D008691:Methadone