Transitions between routes of heroin administration: a study of Caucasian and Indochinese heroin users in south-western Sydney, Australia

Aim. To examine patterns and correlates of routes of heroin use among Cauca sian and Indochinese heroin users. Design. A cross-sectional survey. Settin g and participants. Two hundred heroin users resident in South West Sydney. The sample was divided between Caucasian and Indochinese users (each n = 1 00), with half of each group on methadone maintenance. Measurements. A semi -structured interview was administered, based on previous studies of transi tions between routes of administration. Measures included patterns of drug use, transitions, social, health and legal issues and cultural correlates o f use. Findings. Almost two-thirds (61%) had smoked heroin. Smoking was mor e common among the Indochinese (40% were predominantly or Exclusively smoke rs), although injecting was the dominant route for both groups. More than o ne-quarter (29%) had made a transition from smoking to injecting, primarily due to drug effect and perceived cost-effectiveness. Reverse transitions w ere rare. Smoking appeared to be more culturally acceptable than injecting among Indochinese users. Among both groups, there was a small but significa nt risk for the transmission of HIV and other blood-borne viruses. Polydrug use and age were positively associated with having experienced a non-fatal overdose. Conclusions. This research documents the existence of smoking as a popular route of administration among both Indochinese and Caucasian her oin users in the study sample. There is an urgent need to provide smokers a nd injectors with information explaining the potential risks and ways to mi nimize harms associated with both routes of use.