Marcus Clarke’s “Cannabis Indica” and Altered States of Consciousness in 19th-Century Australian Mass Media

Since Australia banned heroin in 1953 consumption of illicit drugs, deaths, crime and corruption related to drugs have steadily increased. Injecting drug use (IDU) in Australia is now a significant public health problem linked each year to approximately 500 overdose deaths and more than 6000 hepatitis C infections. At least 85% of prevalent and incident hepatitis C cases in Australia are injecting drug users (IDUs) with annual incidence estimated at 15%. Although poorly documented, increasing numbers of patients with end-stage liver disease from hepatitis C now appear to present in Australia. This reflects a heroin-injecting epidemic commencing a quarter of a century ago, the close association between drug injecting and hepatitis C and the long delay between hepatitis C infection and complications. The overall health and economic burden of hepatitis C may soon exceed HIV. Control is far more difficult to achieve for hepatitis C than HIV because of much higher baseline prevalence levels and far greater infectiousness by blood to blood spread. Transmission appears to follow minimal breaches of infection control guidelines. Hepatitis C has not yet become a priority public health issue in Australia. No national prevention strategy has been proposed. Prevention strategies (such as needle exchange or methadone) which controlled HIV among IDUs should be expanded, with the expectation of some useful reduction of spread but without achieving control of hepatitis C. Other options for control must be considered. Eradicating illicit drug use in Australia is unachievable. Virtually eradicating injecting drug use by facilitating a switch to non-injecting routes of administration (NIROA) is achievable (although difficult) and this could control hepatitis C. NIROA will have the probable additional benefit of reducing drug overdose deaths. NIROA has begun recently to replace injecting in several countries without government intervention. Powerful cultural, pharmacological and economic factors strongly reinforce drug injecting. Economic impediments to NIROA could be reduced by drug policy reform. Facilitating a switch to NIROA carries some risk of increased discrimination directed against an already marginalized population. A major obstacle to harm reduction is the common assumption that any relaxation of drug policy invariably leads to increased consumption. Switching the predominant route of administration of illicit drugs from IDU to NIROA should be the major focus of national efforts to control hepatitis C and overdose deaths in Australia.

BackgroundWhilst alcohol and drug use among young people is known to escalate during short holidays and working breaks in international nightlife resorts, little empirical data are available on the impact of longer backpacking holidays on substance use. Here we examine changes in alcohol, tobacco and drug use when UK residents go backpacking in Australia.MethodsMatched information on alcohol and drug use in Australia and the UK was collected through a cross sectional cohort study of 1008 UK nationals aged 18–35 years, holidaying in Sydney or Cairns, Australia, during 2005.ResultsThe use of alcohol and other drugs by UK backpackers visiting Australia was common with use of illicit drugs being substantially higher than in peers of the same age in their home country. Individuals showed a significant increase in frequency of alcohol consumption in Australia compared to their behaviour in the UK with the proportion drinking five or more times per week rising from 20.7% (UK) to 40.3% (Australia). Relatively few individuals were recruited into drug use in Australia (3.0%, cannabis; 2.7% ecstasy; 0.7%, methamphetamine). However, over half of the sample (55.0%) used at least one illicit drug when backpacking. Risk factors for illicit drug use while backpacking were being regular club goers, being male, Sydney based, travelling without a partner or spouse, having been in Australia more than four weeks, Australia being the only destination on their vacation and drinking or smoking five or more days a week.ConclusionAs countries actively seek to attract more international backpacker tourists, interventions must be developed that target this population's risk behaviours. Developing messages on drunkenness and other drug use specifically for backpackers could help minimise their health risks directly (e.g. adverse drug reactions) and indirectly (e.g. accidents and violence) as well as negative impacts on the host country.

BackgroundInjecting drug use is associated with considerable morbidity and mortality. Estimates of the size of the population of people who inject drugs are critical to inform service planning and estimate disease burden due to injecting drug use. We aimed to estimate the size of the population of people who inject drugs in Australia.MethodsWe applied a multiplier method which used benchmark data (number of people in opioid substitution therapy (OST) on a snapshot day in 2014) and multiplied it by a factor derived from the prevalence of current OST among people who inject drugs participating in the Australian Needle and Syringe Program Survey in 2014. Estimates of the total population of people who inject drugs were calculated in each state and territory and summed to produce a national estimate. We used the sex and age group distribution seen in datasets relating to people who inject drugs to derive sex- and age-stratified estimates, and calculated prevalence per 1000 population.ResultsBetween 68,000 and 118,000 people aged 15–64 years inject drugs in Australia. The population prevalence of injecting drug use was 6.0 (lower and upper uncertainty intervals of 4.3 and 7.6) per 1000 people aged 15–64 years. Injecting drug use was more common among men than women, and most common among those aged 35–44 years. Comparison of expected drug-related deaths based on these estimates to actual deaths suggest that these figures may be underestimates.ConclusionsThese are the first indirect prevalence estimates of injecting drug use in Australia in over a decade. This work has identified that there are limited data available to inform estimates of this population. These estimates can be used as a basis for further work estimating injecting drug use in Australia.

Preteenage drug use in Australia: The key predictors and school-based drug education

This paper reviews studies of psychotropic drug use in Australia, analyses results from the Australian Health Surveys and compares the findings with those from other countries. It identifies subpopulations with high rates of drug use, which may consequently be at greater risk of drug-related harm. The levels of consumption of psychotropic agents in Australia were estimated from the results of studies conducted in community and institutional settings between 1970 and 1986. In the absence of more recent data national prevalence rates were derived from analysis of data provided by the Australian Health Surveys (AHS) of 1977-1978 and 1983-1984, and comparisons were made with rates available from other countries. While the prevalence of current and frequent use of drugs for nervous conditions was found to have decreased in most age groups over this period, it was consistently higher in females than in males, and increased with age. An analysis of the 1983-1984 AHS data revealed that the consumption of "medicines for nervous conditions" fell by 35% but that no change occurred in the prevalence of persons taking sleeping medicines. This fall appeared to occur in both rural and urban populations. Further analysis of data relating to the consumption of hypnotic agents revealed that changes occurred in the patterns of use within age and gender subgroups. Significant differences were observed between Australian States in consumption rates of sleeping medicines (chi 2 = 282.2; df = 7; P less than 0.01) and of medicines for nervous conditions (chi 2 = 289.7; df = 7; P less than 0.01). There were high rates of use of medicines for sleep in South Australia and of medicines for nervous conditions in Queensland. The prevalence of use of both drugs for sleep (rs = 0.71; P less than 0.05) and drugs for nervous conditions (rs = 0.77; P less than 0.05) was related to the rate of consultations with doctors. Preliminary surveys of various non-British subpopulations including Aborigines were inconclusive. These results have implications for reducing the harm associated with the use of psychotropic agents, particularly hypnotics and drugs for nervous conditions, in Australia.

I shop online – recreationally! Internet anonymity and Silk Road enabling drug use in Australia

Medical Journal of AustraliaVolume 1, Issue 1 p. 50-50 Book Reviews Drugs: Drinking and Recreational Drug Use in Australia Les R. H. Drew, Les R. H. DrewSearch for more papers by this author Les R. H. Drew, Les R. H. DrewSearch for more papers by this author First published: 01 January 1981 https://doi.org/10.5694/j.1326-5377.1981.tb135310.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue1January 1981Pages 50-50 RelatedInformation

Population drug use in Australia: A wastewater analysis

This paper explores recent shifts in the meaning and culture of adolescent drug use, contrasting developments in the United Kingdom and Australia. Of particular interest will be the claim that drug use has become a normal feature of young people's life-experience. The paper draws upon Howard Parker's ‘normalization thesis’, arguing that Parker's approach has some value in accounting for the changing nature of adolescent drug use in Australia. Available epidemiological evidence indicates that young people's consumption of illicit substances has risen dramatically in Australia in the past decade, although not at quite the rates recorded in the United Kingdom. The paper also draws upon contemporary debates in sociology and cultural studies in an attempt to explain these shifts in adolescent drug use. I conclude that greater attention to consumption and identity formation within youth cultures offers important new ways of understanding recent changes in the culture and meaning of drug use for young people.

This report examines potential sources for a data system to serve as an 'early' warning of changes in drug use in the community. The system would measure changes in drug use to allow the managers of drug and alcohol programmes to adapt their services to meet the changing needs of their clients. The topic was addressed by identifying the 'dimensions of drug use' relevant to early warning. Three criteria for inclusion in an early warning network were identified: timeliness, volume of data, and complementarity with other indicators. Each indicator was evaluated against the early warning criteria and dimensions of drug use issues. The result was a list of six indicators which could form an early warning network in Australia: a collection based on general hospital casualty reports, ambulance officer reports of drug overdoses, telephone advice service data, data from key informants, profiles of clients in drug dependence treatment centres and the users of needle exchange centres.

Drug Use in Australia —a Survey

To estimate the prevalence of drug use in a representative Australian community. Using a Census district sampling framework supplied by the Australian Bureau of Statistics, we randomly selected dwellings for our survey. A household was defined as all those people living permanently at the postal address. All eligible members of each household, 15 years and older, were asked to participate. The data were collected in the context of a large scale general population survey of health practices and attitudes, conducted in the Greater Newcastle area of New South Wales, during 1987 and 1988. Seventy-two per cent of eligible individuals approached (2623) agreed to participate in the survey. Participants were asked about their use of a number of drug types: medically prescribed drugs, non-prescription drugs, tobacco, alcohol and illicit drugs. For alcohol, only the results for use at a hazardous level according to the National Health and Medical Research Council guidelines are reported here. Seventy-eight per cent (95% confidence interval, 76%-80%) of the community sample reported having recently consumed at least one of these drug types. There were significant age and sex differences in drug use. A greater proportion of women and the older age groups (over 45 years) reported the use of both non-prescription and prescription medications than did men and the younger age groups. Conversely, a significantly greater proportion of men and the younger age groups reported the use of social and illicit drugs. The importance of regular, representative, methodologically comparable community studies of drug use is stressed, particularly in view of the inadequacy of the current routine sources of epidemiological data on drug use.

The exponential rate of development in science and technology in recent decades has had a profound social impact. In particular, computing and the Internet have indelibly altered the world's social, economic, and intellectual landscapes. The Information Age has transformed leisure, employment, business, and financial systems, and modified historical approaches to organizing and executing political and social action. A concomitant revolution in communications has blurred the boundaries that historically demarcated work from play; for many people today, including academics, employment and leisure are remote and wireless.So, how has escalating scientific and technological change affected the health and quality of life of people in marginalized communities? How is evolving and sometimes conflicting knowledge put into practice, particularly by people living with chronic illness or at risk of blood-borne viral infections? What harm reduction practices and treatment strategies are currently recommended or could be recommended, and why? Reflecting on these questions, the organizers of the 11th HIV, Hepatitis and Related Diseases conference, which was hosted by Australia's National Centre in HIV Social Research during its twentieth anniversary, devised the theme evolving knowledge and practice to promote analysis of progress in scientific knowledge, biomedical technologies, and research methods. The conference theme invited presenters to explore how communities at risk of HIV and/or hepatitis C make sense of and negotiate developments in the production of knowledge and technologies. We were interested in highlighting the potential impact of such developments on people's everyday sexual, drug use, and health management practices. We also invited consideration of how researchers, educators, policy makers, health professionals, and lawyers respond to new scientific advances, innovative theory, and improved models of best practice in the prevention of blood-borne viruses like HIV and viral hepatitis, and sexually transmissible infections. The research articles selected for this special issue of Contemporary Drug Problems are drawn largely from those presentations at the conference that explored contemporary understandings of injecting drug use, hepatitis C prevention, and treatment. Two extra articles were commissioned in order to cover a range of methodological, theoretical, and empirical topics.Each year in Australia there are approximately 10,000 new hepatitis C infections with around 90% of these occurring among people who inject drugs (MACASHH, 2006). Hepatitis C prevention in 2010 remains a significant challenge given the population prevalence of the virus, the natural history of infection, a legislative framework of drug prohibition, and the not uncommon phenomenon of hepatitis C-related stigma and discrimination. Similarly, despite improvements over the past decade in the efficacy of treatment to suppress infection, strategies aimed at increasing hepatitis C treatment uptake have had little impact. Today in Australia, our health system is confronting an epidemic of hepatitis C-related liver disease.This collection of articles highlights the multidisciplinary nature of social research on hepatitis C and illicit drug use, with contributions from anthropology, sociology, epidemiology, and social psychology. The guest editorial team aimed to showcase rigorous and innovative research that we believe represents an evolution in knowledge and practice in these areas. For example, the article by Paquette, Bryant, and De Wit is unique in this issue because it advances our understanding of the research processes that allow us to study hepatitis C and injecting drug use in Australia. The authors show how the relatively new method of respondent-driven sampling can be used successfully in an Australian setting to recruit people who inject drugs (PWID); however, as they argue, the capacity of respondent-driven sampling to produce population estimates remains unclear. …

Supporting families, friends, and significant others (hereafter 'families') affected by a loved one's (hereafter 'Person's') alcohol and drug (AOD) use can improve family wellbeing. However, little is known about families' help-seeking patterns. This study aimed to describe characteristics and explore correlates of accessing support among affected families. An online cross-sectional survey conducted between September-2023 and August-2024 of N = 1756 English-speaking Australian residents, aged > 18, identifying as affected by a loved one's AOD use. Data collected included sociodemographics, psychological wellbeing indicators, and help-seeking, analysed using summary statistics and logistic regressions. Participants (1433/1569; 91.3 % female), were mostly partners (621/1756; 35.4 %). Seventy-one percent (1159/1633) were concerned about their Person's alcohol use, followed by methamphetamines (n = 210; 12.9 %). Participants reported being concerned about their Person's AOD use for a median of 9.5 years (SD=10.1). Fifty-four percent (816/1510) of participants (affected families) reported high-very high psychological distress, 22.7 % (345/1521) reported recent suicidal ideation, 14.8 % (192/1299) reported risky alcohol use and 19.7 % (257/1305) recently used illicit drugs. Participants who accessed specialised family-AOD support (419/1228; 34.1 %) were more likely older (65 +; Adj.OR=1.47; 95 %CI[1.03, 2.10]), less likely to reside with their Person (Adj.OR=0.72; 95 %CI[0.55, 0.96]) and to report their own risky drinking (Adj.OR=0.53; 95 %CI[0.35, 0.80]), and more likely to report their Person accessed AOD treatment (Adj.OR=1.85; 95 %CI[1.33, 2.56]). The results highlight elevated distress, suicidality and substance use among affected families and their delayed access to predominantly non-specialised support. Greater investment in community-health campaigns and specialised services is required to ensure provision of timely and tailored support.

Cross-sectional surveys of adolescent drug use in the United States and elsewhere have consistently shown three types of association between cannabis use and the use of other illicit drugs, such as heroin and cocaine (Morral et al., 2002). First, American adolescents during the 1970s and 1980s showed a typical sequence of involvement with licit and illicit drugs in which almost all who tried cocaine and heroin had first used alcohol, tobacco and cannabis (Kandel, 1975; Kandel, 2002). The sole exception to this generalisation has been found in samples of inner city youth for whom a wide range of illicit drugs are more readily available (Golub and Johnson, 2002). Second, during the same period there was a strong relationship between regular cannabis use and the later use of heroin and cocaine. Kandel (1984), for example, found that only 7% of American youth who had never used cannabis reported using another illicit drug. This figure was 33% among those who had used cannabis, and 84% among current daily cannabis users. The same relationships have been observed in surveys of drug use in Australia (Donnelly and Hall, 1994). Third, the earlier the age at which any drug was first used, the more likely the user was to use the next drug in the sequence (Kandel, 1978; Donovan and Jessor, 1983; Kandel, 1984, 1988; Kandel, 2002). So those who begin to use alcohol and tobacco at an early age were the most likely to use cannabis; early cannabis users, in turn, were more likely to use hallucinogens and ‘pills’ (amphetamines and tranquillisers); and early users of ‘pills’ were, in turn, the ones most likely to use cocaine and heroin. The relationships between cannabis and heroin use found in the cross-sectional studies have also been reported in longitudinal studies of drug use. In one of the first such studies (Robins et al., 1970) followed-up 222 African-American adolescents identified from school records until age 33 and interviewed them about their drug use in adolescence and young adulthood. They found that young men who had used cannabis before the age of 20 were more likely to use heroin than those who had not.