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Professor Paul Dietze, Burnet’s Program Director of Behaviours and Health Risks, has spent more than 20 years at the coalface of alcohol and other drug research and says it’s satisfying to see Australian rates of injecting drug use (IDU) starting to fall.
“It does look to be the case that injecting drug use in Australia seems to be declining,” he said.
“Basically the cohort of people who use drugs is getting older, and they’re not being replaced. Some people are just stopping drug use, and there’s lots of indications across the board that young people in Australia are not using substances to the same extent as previous generations.”
However, Professor Dietze said the current increase in methamphetamine (ice) purity was fuelling a rise in related harms.
Professor Dietze and his research team recently received a National Health and Medical Research Council project grant of AUD$1.2 million to investigate the dynamics of cessation (ceasing drug taking) and relapse, in a five-year extension of longitudinal study SuperMIX.
The SuperMIX study has already followed 757 participants since late 2008, exploring why cessation occurs and in what circumstances.
Although in the early stages, Professor Dietze said indications were that cessation was enhanced by factors that enabled stability, such as housing and employment, and hindered by stressors such as arrest or law enforcement involvement.
Professor Dietze started his research career with a PhD on techniques to improve the way investigations were carried out around child eyewitness memory. He then took a year off to travel, and has been working in alcohol and other drug research ever since, drawn by the realisation that people were dying unnecessarily from drug use.
“I could see that we had responses available to prevent these deaths, but they either weren’t being implemented at all or were only being implemented in a sub-optimal way,” he said.
So what drives him to continue breaching new frontiers in this field? Like most Burnet researchers, it is a deeply held desire to help others.
“I’m motivated by the recognition that most of the people affected by drug and alcohol issues have relatively meagre means and poor socio-economic backgrounds, with lots of histories of things connected to my PhD, like child abuse,” he said.
He said one frustration of working with alcohol and other drug research was ‘scaremongering’ about illicit drug use, which could block the progress of proven-to-work, evidence-based initiatives – such as a planned trial of prescription heroin in 1996, called off after a spate of sensationalist media coverage.
That said, he pointed to signs of positive change.
“There has been a major shift in knowledge about research and what research can do,” he said.
Image: Burnet research assistant Arthur Truong carries out field work for the SuperMIX study.
“There are also signs of a reduction in teen drinking that I think we can be positive about.
“We’ve built up a much more sophisticated understanding of patterns and prevalence of overdose over time.
“I’m proud … we (at Burnet) helped take-home naloxone (THN) to happen … and of pioneering some work that led to the more widespread use of intranasal naloxone, rather than injected.”
Professor Dietze was part of a group that worked to establish the first THN program in the ACT, and was involved in two randomised trials of intranasal naloxone. He is currently involved in another trial involving intranasal naloxone in Sydney, and Burnet convenes the National Naloxone Reference Group through the Centre for Research Excellence into Injecting Drug Use.
Professor Dietze said his two decades of alcohol and other drug research had seen some valuable policy changes.
“Subsidising naloxone on the PBS (Pharmaceuticals Benefits Scheme) is one example – this has meant that the costs to people who are able to obtain naloxone on prescription are reasonable. Further, naloxone has now been rescheduled so that it is now available over the counter in Australia. This change really does allow for much greater access,” he said.
Professor Dietze hoped that understandings gleaned from the SuperMIX study would help in evaluating the services and interventions provided for people who used drugs.