Drug Dependence and Associated Risks Among Female Street-Based Sex Workers in the Greater Sydney Area, Australia
In: Substance use & misuse: an international interdisciplinary forum, Band 43, Heft 8-9, S. 1202-1217
ISSN: 1532-2491
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In: Substance use & misuse: an international interdisciplinary forum, Band 43, Heft 8-9, S. 1202-1217
ISSN: 1532-2491
This chapter reviews the risk factors and treatment options for sexuality and gender diverse populations. Sexuality is a person's sense of themselves as a sexual person and usually reflects their sexual attraction and sexual practice. Heterosexual people are sexually attracted to people of the opposite gender, lesbian women are sexually attracted to other women, gay men are sexually attracted to other men, bisexual people are sexually attracted to people of any gender, and queer people are sexually attracted to people of all genders (queer is also an umbrella term for sexuality and gender diverse people). Evidence from three nationally representative surveys suggests 3.2% of Australian adults report a non-heterosexual identity . Gender identity means the sense a person has of having a particular gender. Cisgender people identify with the sex they were assigned at birth, transgender people's gender does not align with the sex they were assigned at birth. Most transgender people identify as either woman/ female or man/male, however people who feel their gender does not align with either female or male, or exclusively with male or female, use the terms non-binary or gender fluid. There is no reliable evidence on the proportion of gender diverse people in Australia; a systematic review of US population-based surveys provided a population estimate of 0.5%. Establishing an evidence base for patterns of alcohol use and treatment outcomes among sexuality and gender diverse people is challenging. Sexuality and/or gender identity are rarely captured in large surveys and treatment studies, and markers are not included in the Alcohol and Other Drug Treatment Services National Minimum Data Set for all government funded alcohol and other drug treatment specialist services.
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This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data collected from regular IDU as part of the Australian Illicit Drug Reporting System (IDRS) were analysed (2001-2004). The rate of morphine prescription per person aged 15-54 years increased by 89% across Australia between 1995 and 2003 (from 46.3 to 85.9 mg per person). Almost half (46%) of IDU surveyed in 2004 reported illicit morphine use, with the highest rates in jurisdictions where heroin was less available. Recent morphine injectors were significantly more likely to be male, unemployed, out of treatment and homeless in comparison to IDU who had not injected morphine. They were also more likely to have injected other pharmaceutical drugs and to report injection related problems. Among those who had injected morphine recently, the most commonly reported injecting harms were morphine dependence (38%), difficulty finding veins into which to inject (36%) and scarring or bruising (27%). Morphine use and injection is a common practice among regular IDU in Australia. In some cases, morphine may be a substitute for illicit heroin; in others, it may be being used to treat heroin dependence where other pharmacotherapies, such as methadone and buprenorphine, are perceived as being unavailable or undesirable by IDU. Morphine injection appears to be associated with polydrug use, and with it, a range of problems related to drug injection. Further research is required to monitor and reduce morphine diversion and related harms by such polydrug injectors.
BASE
This paper examines population trends in morphine prescriptions in Australia, and contrasts them with findings from annual surveys with regular injecting drug users (IDU). Data on morphine prescriptions from 1995 to 2003 were obtained from the Drug Monitoring System (DRUMS) run by the Australian Government Department of Health and Ageing. Data collected from regular IDU as part of the Australian Illicit Drug Reporting System (IDRS) were analysed (2001-2004). The rate of morphine prescription per person aged 15-54 years increased by 89% across Australia between 1995 and 2003 (from 46.3 to 85.9 mg per person). Almost half (46%) of IDU surveyed in 2004 reported illicit morphine use, with the highest rates in jurisdictions where heroin was less available. Recent morphine injectors were significantly more likely to be male, unemployed, out of treatment and homeless in comparison to IDU who had not injected morphine. They were also more likely to have injected other pharmaceutical drugs and to report injection related problems. Among those who had injected morphine recently, the most commonly reported injecting harms were morphine dependence (38%), difficulty finding veins into which to inject (36%) and scarring or bruising (27%). Morphine use and injection is a common practice among regular IDU in Australia. In some cases, morphine may be a substitute for illicit heroin; in others, it may be being used to treat heroin dependence where other pharmacotherapies, such as methadone and buprenorphine, are perceived as being unavailable or undesirable by IDU. Morphine injection appears to be associated with polydrug use, and with it, a range of problems related to drug injection. Further research is required to monitor and reduce morphine diversion and related harms by such polydrug injectors.
BASE