Decline in needle exchange use in Vancouver, Canada coincides with the Australian heroin shortage

Abstract

t e i t i a s C It has recently been demonstrated that a number of indiators of heroin use have declined in Vancouver, Canada oinciding with the Australian heroin shortage (Wood, Stoltz, ontaner, & Kerr, 2006b; Wood, Stoltz, Li, Montaner, & err, 2006a). These findings have important implications for he debate regarding the causes of the Australian heroin shortge. Identification of a contemporaneous decline in the heroin arket of a separate country, which traditionally receives its upply from the same source country (Burma), challenges he perspective that the shortage was precipitated by unique ocal factors, such as law enforcement initiatives. However, uestions have been raised regarding whether Vancouver has ctually experienced a heroin shortage, and there have been alls for further evidence to support this claim (Caulkins & euter, 2006; Smithson, 2006). A reduction in syringe exchange activity in Australia has een documented to coincide with the onset of the Australian eroin shortage (Day, Degenhardt, Gilmour, & Hall, 2004), hich is believed to have begun in approximately January 001. Since measures of syringe exchange were noted to ecline in Australia coinciding with the Australian shortge, we sought to examine if syringe exchange activity data eclined in Vancouver coinciding with the Australian heroin hortage. Consideration of longitudinal measures of Vancouver neele exchange data requires consideration of local policy hanges. Subsequent to the emergence of an explosive HIV pidemic among IDU in Vancouver in 1997 (Strathdee et al., 997), significant efforts were made to expand existing neele exchange programmes as difficulty accessing needles was ound to be a primary factor driving needle sharing locally Wood, Tyndall, Spittal, Li, Hogg, O’Shaughnessy, et al.,