Associate Professor Peter Higgs

Reports and other work

• Transitions to Injecting and Risk of Hepatitis C Transmission among Ethnic Vietnamese Heroin Smokers in Melbourne, Australia.

  Background and Aims: To examine factors associated with transition from non-injecting to injecting routes of drug administration and testing antibody positive to hepatitis C virus (HCV) among ethnic Vietnamese heroin users in Melbourne, Australia. Methods: In a cross-sectional convenience survey, sample recruited by peer-workers using snowball sampling technique with a finger prick blood collection. Two-hundred ethnic Vietnamese heroin users were recruited and interviews conducted mainly in Footscray, an area of high ethnic Vietnamese residency with a prominent street based drug market. A structured questionnaire was administered. Measures included patterns of drug use, transition from smoking to injecting and vice versa, injection related risk behaviours and HCV sero-status. Results: Ninety-three percent of the sample commenced drug use by non-injecting routes of administration. More than a half had made the transition from smoking to injecting and almost two thirds of participants had ever injected. The factors associated with making this transition included being male and a longer duration of use. Prevalence of exposure to HCV among injectors was over 50%. Factors associated with being HCV positive were longer duration of injecting, sharing injecting equipment and being older. Conclusions: Smoking heroin is a common route of drug administration among heroin users of Vietnamese ethnicity in this study. The transition from smoking to injecting was very common in the sample. The need for targeted harm reduction initiatives is indicated, and these must take into account patterns of heroin use as well as the social context of drug use if we are to work effectively with heroin users of Vietnamese ethnicity.

  Transitions to Injecting and Risk of Hepatitis C Transmission among Ethnic Vietnamese Heroin Smokers in Melbourne, Australia.

• Manual for reducing drug related harm in Asia, 2003

  The consumption and injection of illicit drugs are on the rise globally, encompassing at least 15 million individuals across over 130 countries. Since the early 1990s, there has been rapid evolution in patterns of production, consumption, and administration of illicit drugs, and these trends persist. The most significant changes are observed in developing nations, particularly in South and South-East Asia and Latin America, involving substantial populations. While many Western countries saw epidemics of heroin injection emerge in the late 1960s, these have persisted. Similarly, Asian countries began experiencing such epidemics in the late 1980s, a trend that continues across Asia into the new millennium.

  Manual for reducing drug related harm in Asia, 2003

• The impact of a police crackdown on a street drug scene: evidence from the street.

  This article examines the repercussions of a police crackdown on a street heroin market in a suburb of Melbourne, Australia, as perceived by individuals involved in the market. While the data indicate that 'Operation Clean Heart' achieved its aim of diminishing the visible aspects of the street drug scene, they also suggest that the drug market quickly adapted to the new conditions, rendering the impact of the operation superficial and short-lived. Additionally, the article argues that the operation had several unintended negative consequences, some of which pose potential risks to public health.<br/><br/>The negative outcomes inferred from the data include the partial displacement of the drug scene to nearby metropolitan areas, the discouragement of safe injecting practices and safe disposal of needles and syringes, and an increase in incidents of violence and fraud. These outcomes may outweigh the perceived positive impacts of the operation, which were achieved at significant public expense. The article concludes that police crackdowns are not suitable responses to illicit drug problems. Instead, it advocates for approaches aligned with longstanding Australian policy, which incorporate and balance demand reduction, supply reduction, and harm reduction strategies.

  The impact of a police crackdown on a street drug scene: evidence from the street.