The effect of a reduction in heroin supply on fatal and non-fatal drug overdoses in New South Wales, Australia.
OBJECTIVE
To examine the impact of a sudden and dramatic decrease in heroin availability, concomitant with increases in price and decreases in purity, on fatal and non-fatal drug overdoses in New South Wales, Australia.


METHODS
Time-series analysis was conducted where possible on data on overdoses collected from NSW hospital emergency departments, the NSW Ambulance Service, and all suspected drug-related deaths referred to the NSW Coroner's court.


METHODS
The number of suspected drug-related deaths where heroin and other drugs were mentioned; ambulance calls to suspected opioid overdoses; and emergency department admissions for overdoses on heroin and other drugs.


RESULTS
Both fatal and non-fatal heroin overdoses decreased significantly after heroin supply reduced; the reductions were greater among younger age groups than older age groups. There were no clear increases in non-fatal overdoses with cocaine, methamphetamines or benzodiazepines recorded at hospital emergency departments after the reduction in heroin supply. Data on drug-related deaths suggested that heroin use was the predominant driver of drug-related deaths in NSW, and that when heroin supply was reduced overdose deaths were more likely to involve a wider combination of drugs.


CONCLUSIONS
A reduction in heroin supply reduced heroin-related deaths, and did not result in a concomitant increase, to the same degree, in deaths relating to other drugs. Younger people were more affected by the reduction in supply.
Degenhardt
Louisa J
LJ
National Drug and Alcohol Research Centre, University of New South Wales, Sydney. l.degenhardt@unsw.edu.au
Conroy
Elizabeth
E
Gilmour
Stuart
S
Hall
Wayne D
WD
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000428:Alcohol Drinking / Q000453:epidemiology; D000928:Antidepressive Agents / Q000506:poisoning; D003042:Cocaine / Q000506:poisoning; D062787:Drug Overdose / Q000453:epidemiology; D005260:Female; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D013287:Illicit Drugs / Q000600:supply & distribution*; D008297:Male; D008694:Methamphetamine / Q000506:poisoning; D009026:Mortality; D009517:New South Wales / Q000453:epidemiology; D017678:Sex Distribution
D000928:Antidepressive Agents; D013287:Illicit Drugs; D008694:Methamphetamine; D003932:Heroin; D003042:Cocaine