HEROIN DROUGHT BOOSTS HIV RISK

AUSTRALIA faces a new wave of HIV because heroin addicts are switching to
alternative drugs and adopting more dangerous injecting habits.

Leading drug researcher Alex Wodak warned yesterday that this scenario
could be the legacy of the "drought" that had left heroin in unprecedented
short supply.

While the shortage had reduced overdose deaths, the shift to injectable
cocaine and amphetamines had the potential to cause a break-out in the
relatively stable rate of HIV, as well as other blood-borne viral infections.

Heroin had a longer-lasting "hit", meaning dependent users were likely to
inject cocaine and amphetamine more frequently, Dr Wodak said.

They were at increased risk of using dirty needles or sharing them, both
high-risk activities for HIV.

"Cocaine users who go through binges may inject up to 20 times a day, as
compared to five or six for a particularly busy heroin user," he said.

"If someone is injecting that often, keeping up with them so they are using
sterile needles is formidably difficult."

Dr Wodak is director of Sydney's St Vincent's Drug and Alcohol Services
unit, servicing the illicit drug hot spots of Kings Cross and Darlinghust.

Ten per cent of all Australian heroin overdose deaths occur within a 2km
radius of Kings Cross. The national death toll was 959 in 1999, the latest
year for which full figures are available.

Dr Wodak said preliminary data suggested that overdose deaths had fallen by
two-thirds in Melbourne and 50 per cent in Sydney since the start of the
heroin shortage last Christmas.

But the overseas experience was cautionary, Dr Wodak said.

Vancouver had undergone a similar shift in its illicit drug market in 1994,
with users switching from heroin to injectable cocaine.

Within two years, more than 25 per cent of the Canadian city's dependent
drug users were HIV positive, and the epidemic was "still raging".

"There are many examples around the world where the multiplier effect of
HIV occuring in injecting drug users is enormous for the general
population," Dr Wodak said.

He said the HIV rate in Sydney was currently "very stable", with the
infection of fewer than 2 per cent of drug users who did not have the
additional risk factor of engaging in homosexual male sex.

A study by the National Drug and Alcohol Research Council this week
highlighted the increased use of methamphetamine -- an especially potent
form of amphetamine also known as ice or shabu -- by heroin addicts unable
to secure their drug of choice.

Hospital staff, ambulance crews and police are increasingly being
confronted by violent and erratic behaviour triggered by heavy amphetamines
and cocaine.

"At least with heroin we have a drug we understand well, and ... a
treatment system that works for a majority of people for a majority of the
time," Dr Wodak said.