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Methadone HighMediumLow Fluctuates Very easyEasy DifficultVery difficult9National Drug and Alcohol Research Centre, UNSW Australia AbbreviationsEDRS+Ecstasy and Related Drugs Reporting System IDRSIllicit Drug Reporting SystemIQRInterquartile rangeN (or n)Number of participantsNDARC)National Drug and Alcohol Research CentreNPS New psychoactive substancesNSPNSWNew South WalesNTOTCOver-the-counterSouth AustraliaVIC VictoriaWAWestern AustraliaCrystalAny MethamphetamineBasePointGramAny useNon-prescribed useBenzodiazepinesPharmaceutical stimulantsAlcoholTobacco Past 12 monthHeard of naloxoneShared other equipment Attendance No attendanceProperty crime Drug dealingFraud Violent crime Any crimeGram Point CapOunce Bag National*% Aboriginal and/or Torres Strait Islander% Sexual identity Heterosexual Homosexual- Bisexual Other% Post-school qualification(s)^Own home (inc. renting)~ Parents /family homeBoarding house/hostelShelter/refugeNo fixed addressN=100 BuprenorphineBuprenorphine-naloxoneDrug counselling!% Injecting behaviours past monthBorrowed a needle Lent a needleN=96 Shared any injecting equipment ^Reused own needle#Injected partner/friend after self~7Somebody else injected them after injecting themselves~% Location of last injection Private homeCarStreet/car park/beach Public toilet% Recent Use (past 6 months). New drugs that mimic the effects of opioids . New drugs that mimic the effects of ecstasy = New drugs that mimic the effects of amphetamine or cocaine / New drugs that mimic the effects of cannabis 9 New drugs that mimic the effects of psychedelic drugs 5 New drugs that mimic the effects of benzodiazepinesAny of the above % GenderFemaleMale Non-binaryQueer% Current accommodation% Current employment status UnemployedFull-time work0% Past month gov't pension, allowance or benefit$Current median income/week ($; IQR) PowderMedian days (non-prescribed)Tramadol Tapentadol Pregabalin% Heroin overdose% Methadone overdose% Morphine overdose% Oxycodone overdose% Any drug overdose% Artery injection% Any nerve damage% Any thrombosis Blood clotDeep vein thrombosis% Infection/abscess Endocarditis % Dirty hit% Any injection-related problemBuprenorphine depot injection%% Drink driving% Drug drivingACT 2008 (n=43)Heroin Non-prescribed morphine 2005 (n=60) 2021 (n=79) 2004 (n=73) 2006 (n=39) 2010 (n=41)AntipsychoticsSA(N=100)(N=101) 10 (7-12)Methamphetamine 2000 (n=66) 2001 (n=55) 2002 (n=39) 2003 (n=64) 2004 (n=56) 2005 (n=61) 2006 (n=52) 2007 (n=56) 2008 (n=42) 2009 (n=65) 2010 (n=52) 2011 (n=51) 2012 (n=46) 2013 (n=48) 2014 (n=41) 2015 (n=49) 2016 (n=34) 2017 (n=46) 2018 (n=34) 2019 (n=30) 2020 (n=39) 2021 (n=21) 2000 (n=75) 2001 (n=54) 2003 (n=67) 2004 (n=62) 2005 (n=64) 2007 (n=58) 2009 (n=66) 2010 (n=53) 2011 (n=52) 2012 (n=50) 2013 (n=49) 2015 (n=51) 2016 (n=35) 2017 (n=48) 2018 (n=37) 2020 (n=43) 2021 (n=23)/ 2004 (n=35) 2005 (n=31) 2006 (n=28) 2007 (n=21) 2008 (n=23) 2009 (n=22) 2010 (n=39) 2011 (n=37) 2013 (n=53) 2014 (n=60) 2015 (n=67) 2016 (n=76) 2017 (n=69) 2018 (n=69) 2019 (n=90) 2020 (n=74) 2002 (n=42) 2003 (n=43) 2002 (n=43) 2003 (n=47) 2004 (n=36) 2005 (n=32) 2006 (n=27) 2007 (n=22) 2010 (n=38) 2011 (n=38) 2012 (n=47) 2013 (n=54) 2014 (n=57) 2015 (n=70) 2017 (n=73) 2018 (n=71) 2019 (n=91) 2020 (n=75) 2004 (n=72) 2006 (n=60) 2007 (n=30) 2008 (n=40) 2009 (n=37) 2011 (n=60) 2012 (n=48) 2015 (n=66) 2016 (n=53) 2017 (n=44) 2018 (n=38) 2019 (n=53) 2020 (n=37) 2007 (n=16) 2008 (n=21) 2009 (n=18) 2010 (n=28) 2011 (n=48) 2012 (n=38) 2013 (n=45) 2014 (n=43) 2015 (n=47) 2016 (n=32) 2017 (n=30) 2018 (n=28) 2019 (n=38) 2020 (n=19) 2005 (n=49) 2021 (n=36) 2005 (n=59) 2006 (n=61) 2007 (n=31) 2010 (n=40) 2011 (n=61) 2013 (n=51) 2014 (n=61) 2015 (n=65) 2019 (n=56) 2020 (n=36) 2021 (n=51) 2004 (n=60) 2005 (n=51) 2006 (n=38) 2009 (n=19) 2010 (n=26) 2012 (n=40) 2013 (n=44) 2015 (n=48) 2016 (n=31) 2017 (n=32) 2018 (n=29) 2019 (n=39) 2021 (n=38)N=101N=102N=106N=99N=98N=97N-101 2020 (N=100)N=10Supplementary Data TablesFKey Findings from the Illicit Drug Reporting System (IDRS) Interviews 10 (1-12)&Mean years of school education (range) 10 (6-12) 2002 (n=24) 2003 (n=40) 2005 (n=28) 2006 (n=24) 2007 (n=28) 2009 (n=25) 2010 (n=19) 2011 (n=31) 2012 (n=39) 2014 (n=31) 2015 (n=30) 2016 (n=14) 2017 (n=11) 2019 (n=41) 2021 (n=30) 2002 (n=25) 2005 (n=30) 2006 (n=23) 2008 (n=20) 2010 (n=21) 2011 (n=32) 2013 (n=42) 2014 (n=30) 2015 (n=32) 2017 (n=12) 2018 (n=30) 2019 (n=43) 2000 (n=6) 2001 (n=10) 2002 (n=13) 2003 (n=6) 2005 (n=7) 2015 (n=10) 2018 (n=6) 2019 (n=9) 2021 (n=7) 2001 (n=11) 2002 (n=17) 2012 (n=7) 2019 (n=10) 2021 (n=6) 2021 (n=50)GHB/GBL/1,4-BDHIV test in past 6 months HIV test more than 6 months ago Lifetime HIV positive diagnosis Received treatment in past year N=94N=91N=95N=8Australian Capital Territory AIVL1Australian Injecting & Illicit Drug Users League ALPHA PVP-PyrrolidinopentiophenoneCBD CannabidiolGBLGamma-butyrolactoneGHBGamma-hydroxybutyrateHCVHepatitis C VirusHIVHuman immunodeficiency virusLSDMDA3,4-methylenedioxyamphetamineMDPVMethylenedioxypyrovaleroneNeedle and Syringe ProgramNorthern Territory PBSPharmaceutical Benefits SchemePCRPolymerase Chain ReactionPTSDPost-traumatic stress disorderRNASDStandard deviationTASTasmaniaTGA Therapeutic Goods AdministrationUNSWUniversity of New South WalesRibonucleic AcidTHCTetrahydrocannabinol(N=103)$475 (400-550)$315 (280-438) 10 (2-12)$350 (293-450) Adelaide, SA % Recent use Median days 2022 (n=32) 2022 (n=33) 2022 (n=36) 2022 (n=80) 2022 (n=37) 2022 (n=81) 2021 (n=81) 2022 (n=6) 2022 (n=7) 2022 (n=57) 2022 (n=40)Any injection# % Recent use (past 6 months).#(N=102)Non-prescribed e-cigarettes % Any opioid% Stimulant overdose% Other overdoseN=103 2022 (N=103) 2021 (N= 101)$Past year Hepatitis C antibody test &Past year Hepatitis C PCR or RNA test ZMost recent treatment was successful (among those who had received treatment in past year)N=85N=6N=87N=92N=7N=78N=76% Breath tested for alcohol% Tested for drug drivingNon-prescribed cannabisREDCap Research Electronic Data Capture% Any recent use% Non-prescribed use1,4-BD1,4-ButanediolAODAlcohol and Other DrugsCOVID-19Coronavirus 2019DSM5Diagnostic and Statistical Manual of Mental DisordersGPGeneral PractitionerNHSNational Health ServiceSDSSeverity of Dependence d-lysergic acid 48 (42-54)Median age (years; IQR) 47 (40-53) 46 (40-54) 48 (40-55)*$383 (325-500) 2023 (n=24) 2023 (n=25)Base# 2023 (n=27) 2023 (n=89) 2023 (n=28) 2023 (n=7) 2023 (n=6) 2023 (n=50) 2023 (n=33) 2023 (n=49)(n=102).# GabapentinN-102 2023 (N=102)% Any current drug treatmentN=77Median total score (IQR)2 (0-6) % score e" 4Opioid % score e" 53 (1-6)< 6 (2-9)2 (0-5)3 (1-7)5 (2-7)4 (1-6)4 (1-8) nd"5 nd"5Currently have Hepatitis C^ Moderate Very high AOD Support Any reasonEmergency departmentHospital admission (inpatient)"Medical tent (e.g., at a festival)Drug and Alcohol counsellorHospital as an outpatient0Speciliast doctor (not including a psychiatrist)DentistAmbulance attendance1Other health professional (e.g., physiotherapist) Psychiatrist Pscyhologist!Peer based harm reduction serviceOther harm reduction servicen=101"Victim of crime involving violenceHeard of take-home naloxone^$Trained in naloxone administration^^6 (1-10)4 (0-7)6 (1-8) 2019 (N=99) 2021 (N=100) 2022 (N=101) 2023 (N=101)% Yes, but not in the last year% Yes, in the last yearUnisom.** 2004 (nd"5) 2006 (nd"5) 2007 (nd"5) 2008 (nd"5) 2009 (nd"5) 2010 (nd"5) 2011 (nd"5) 2012 (nd"5) 2013 (nd"5) 2014 (nd"5) 2016 (nd"5) 2017 (nd"5) 2004 (nd"5)Codeine^Borrowed needles Lent needlesRe-used own needle(N=98)Skin abscess or cellulitisDOther serious infection (e.g., osteomyelitis/Sepsis/Septic arthritis(N=99)(N=61)(N=43)(N=37)(N=40)(N=48)(N=32)(N=75)(N=82)(N=88)(N=91)(N=90)Past year Hepatitis C test Current Hepatitis C status $Past year treatment for Hepatitis C HIV test HIV status December 20241Figure 1: Drug of choice, Adelaide, SA, 2000-2024MFigure 2: Drug injected most often in the past month, Adelaide, SA, 2000-2024_Figure 3: Weekly or more frequent substance use in the past six months, Adelaide, SA, 2000-2024TFigure 4: Past six month use and frequency of use of heroin, Adelaide, SA, 2000-2024EFigure 6: Current perceived purity of heroin, Adelaide, SA, 2000-2024KFigure 7: Current perceived availability of heroin, Adelaide, SA, 2000-2024_Figure 11: Median price of methamphetamine crystal per point and gram, Adelaide, SA, 2002-2024WFigure 13: Current perceived purity of methamphetamine crystal, Adelaide, SA, 2002-2024VFigure 16: Past six month use and frequency of use of cocaine, Adelaide, SA, 2000-2024GFigure 17: Current perceived purity of cocaine, Adelaide, SA, 2000-2024MFigure 18: Current perceived availability of cocaine, Adelaide, SA, 2000-2024Figure 19: Past six month use and frequency of use of non-prescribed cannabis and/or cannabinoid-related products, Adelaide, SA, 2000-2024Note. % calculated out of total IDRS 2024 sample. The horizontal bars represent the per cent of participants who reported use of each drug class on the day preceding interview; the vertical columns represent the per cent of participants who used the combination of drug classes represented by the blue circles. Participants who did not report use of any of the four drug classes depicted are not shown in the figure but are counted in the denominator.  Stimulants includes methamphetamine, cocaine, MDA, MDMA and/or pharmaceutical stimulants.  Opioids includes heroin, methadone, morphine, oxycodone, buprenorphine, buprenorphine-suboxone, fentanyl, other pharmaceutical opioids (codeine, tapentadol, tramadol, etc). Use of benzodiazepines, opioids and stimulants could be prescribed or non-prescribed use. The response option  Don t know was excluded from analysis. Y axis reduced to 40% to improve visibility of trends."South Australian Drug Trends 2024:$Table 1. Guide to Table/Figure Notes2Question not asked in respective year (for tables)PMissing data points indicate question not asked in respective year (for figures).Statistical significance between 2023 and 2024(N=884)(N=106) 48 (40-54)% Born in Australia)% English primary language spoken at home 10 (4-12)Part time/casual Self-employed$400 (350-500)$424 (350-550)2024**2024*Methamphetamine crystalMethamphetamine powder- Note. Computed of the entire sample regardless of whether they had used the substance in the past six months. Prior to 2021, we did not distinguish between prescribed and non-prescribed cannabis, and as such it is possible that 2017-2020 figures include some participants who were using prescribed cannabis only (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low. Further, from 2022, we captured use of  cannabis and/or cannabinoid-related products , while in previous years questions referred only to  cannabis . (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   { Note. Participants could only endorse one substance. Substances listed in this figure are the primary endorsed; a nominal per cent endorsed other substances. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.! ", -8 9@ Note. ^Includes trade/technical and university qualifications. ~Up until and including 2019,  own home included private rental and public housing; in 2020, these were separated out. (.) Per cent suppressed due to small cell size (nd"5 but not 0). / denotes that this item was not asked in these years. Statistical significance for 2023 versus 2024 among the Adelaide sample presented in table; *p<0.050;< **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   9**a Note. Median days computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    Note. Among those who commented. No participants reported purchasing a gram of heroin in 2023. Between 2009-2017 a cap was referred to as cap/point; in 2018 these measures were separated as their own response options. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.] ^h it u 2024 (n=21)4 Note. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    2024 (n=22)}Figure 8: Past six month use of any methamphetamine, and of methamphetamine powder, base and crystal, Adelaide, SA, 2000-2024 Note.  Any methamphetamine includes crystal, powder, base and liquid methamphetamine combined from 2000-2018, and crystal, powder and base methamphetamine combined from 2019 onwards. Figures for liquid not reported historically due to small numbers. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.~   |Figure 9: Frequency of use of any methamphetamine, and of methamphetamine powder, base, and crystal, Adelaide, SA, 2000-2024 Note. Median days computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. Frequency of use data was not collected in 2020 for base methamphetamine. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.Q R\ ]h i^Figure 10: Median price of methamphetamine powder per point and gram, Adelaide, SA, 2001-2024) Note. Among those who commented. Price data not collected in 2000 and 2001. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    2024 (n=14)VFigure 12: Current perceived purity of methamphetamine powder, Adelaide, SA, 2002-2024 Note. Methamphetamine asked separately for the three different forms from 2002 onwards. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.+ ,6 7B C 2024 (n=96)* Note. Methamphetamine asked separately for the three different forms from 2002 onwards. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.* +5 6A B\Figure 14: Current perceived availability of methamphetamine powder, Adelaide, SA, 2002-2024 2024 (n=15) Note. Methamphetamine asked separately for the three different forms from 2002 onwards. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 is presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.- .8 9D E]Figure 15: Current perceived availability of methamphetamine crystal, Adelaide, SA, 2002-2024 2024 (n=97) 2024 (n=9)3 Note. Data not provided for years where fewer than six participants (nd"5) responded. (.) < Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in figure; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    2024 (n=10)2 Note. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    Note. Median days computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. Prior to 2021, we did not distinguish between prescribed and non-prescribed cannabis, and as such, it is possible that 2017-2020 figures include some participants who were using prescribed cannabis only (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low (in 2022, no participants reported use of prescribed cannabis only). Further, in 2022, we captured use of  cannabis and/or cannabinoid-related products , while in previous years questions referred only to  cannabis . (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes., -7 8C DK HydroponicBushHashishHash oil THC extract CBD extractCommerically prepared edibles2 Note. Prior to 2021, we did not distinguish between prescribed and non-prescribed cannabis, and as such it is possible that 2018-2020 figures include some participants who were using prescribed forms of cannabis (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.Figure 20: Past six month use of different forms of non-prescribed cannabis and/or cannabinoid-related products, among those who reported recent use, Adelaide, SA, 2018-2024' Note. Among those who commented. No participants reported purchasing an ounce of bush cannabis in 2023. From 2003 onwards hydroponic and bush cannabis data collected separately. Data from 2022 onwards refers to non-prescribed cannabis only: prior to 2022, we did not distinguish between prescribed and non-prescribed cannabis, and as such it is possible that 2017-2021 figures include some participants who are reporting on the price of prescribed cannabis (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   lFigure 21 (A): Median price of non-prescribed hydroponic cannabis per ounce and bag, Adelaide, SA, 2003-2024fFigure 21 (B): Median price of non-prescribed bush cannabis per ounce and bag, Adelaide, SA, 2003-2024fFigure 22 (A): Current perceived potency of non-prescribed hydroponic cannabis, Adelaide, SA 2004-2024aFigure 22 (B): Current perceived potency of non-prescribed bush cannabis, Adelaide, SA, 2004-2024 2024 (n=59) 2024 (n=38) Note. Hydroponic and bush cannabis data collected separately from 2004 onwards. Data from 2022 onwards refers to non-prescribed cannabis only: prior to 2022, we did not distinguish between prescribed and non-prescribed cannabis, and as such it is possible that 2017-2021 figures include some participants who are reporting on the potency of prescribed cannabis (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Data not provided for years where fewer than six participants (nd"5) responded. Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   lFigure 23 (A): Current perceived availability of non-prescribed hydroponic cannabis, Adelaide, SA, 2004-2024fFigure 23 (B): Current per< ceived availability of non-prescribed bush cannabis, Adelaide, SA, 2004-2024 Note. Hydroponic and bush cannabis data collected separately from 2004 onwards. Data from 2022 onwards refers to non-prescribed cannabis only: prior to 2022, we did not distinguish between prescribed and non-prescribed cannabis, and as such it is possible that 2017-2021 figures include some participants who are reporting on the availability of prescribed cannabis (with medicinal cannabis first legalised in Australia in November 2016), although we anticipate these numbers would be very low. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   Figure 24: Past six month use (prescribed and non-prescribed) and frequency of use of non-prescribed methadone, Adelaide, SA, 2000-2024 Note. Includes methadone syrup and tablets except where otherwise specified. Non-prescribed use not distinguished 2000-2002. Median days computed among those who reported recent use (maximum 180 days). Median days r      !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijlmnopqrstuvwxyz{|}~ounded to the nearest whole number. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.~   Figure 25: Past six month use (prescribed and non-prescribed) and frequency of use of non-prescribed buprenorphine-naloxone, Adelaide, SA, 2006-2024 Note. From 2006-2011, participants were asked about the use of buprenorphine-naloxone tablet; from 2012-2016, participants were asked about the use of buprenorphine-naloxone tablet and film; from 2017 onwards, participants were asked about the use of buprenorphine naloxone film only. Median days of non-prescribed use computed among those who reported recent use (maximum 180 days), and is only reported from 2012 onwards to capture film use. Median days rounded to the nearest whole number. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.p q{ |  Note. Median days of computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. Non-prescribed use not distinguished in 2001-2005. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.= >H IT UFigure 26: Past six month use (prescribed and non-prescribed) and frequency of use of non-prescribed morphine, Adelaide, SA, 2001-2024Figure 27: Past six month use (prescribed and non-prescribed) and frequency of use of non-prescribed oxycodone, Adelaide, SA, 2005-2024 Note. From 2005-2015, participants were asked about recent use and frequency of use for any oxycodone; from 2016-2018, recent use and frequency of use for oxycodone was broken down into three types: tamper resistant ( OP ), non-tamper proof (generic) and  other oxycodone (median days non-prescribed use missing from 2016-2018). From 2019, recent use for oxycodone was broken down into four types: tamper resistant ( OP ), non-tamper proof (generic),  other oxycodone and oxycodone-naloxone, while frequency of use was asked for any oxycodone. Median days of non-prescribed use computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.: ;E FQ RFigure 28: Past six month use (prescribed and non-prescribed) and frequency of use of non-prescribed fentanyl, Adelaide, SA, 2013-2024 Note. Data on fentanyl use not collected from 2000-2012; from 2013-2017, the IDRS did not distinguish between prescribed and non-prescribed use. Median days computed among those who reported recent use (maximum 180 days). Median days rounded to the nearest whole number. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Sta< tistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   ETable 3: Past six month use of other opioids, Adelaide, SA, 2019-2024, Note. ^ Includes high and low dose. #Of those who reported past six month use. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   STable 4: Past six month use of new psychoactive substances, Adelaide, SA, 2013-2024 Note. #In 2017, participants were asked about use of  new drugs that mimic the effects of ecstasy or psychedelic drugs , thus the same value appears in both  new drugs that mimic the effects of ecstasy and  new drugs that mimic the effects of psychedelic drugs. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    Note. Non-prescribed use is reported. Antipsychotics was asked as  Seroquel from 2011-2018. Pharmaceutical stimulants were separated into prescribed and non-prescribed from 2006 onwards, and benzodiazepines were separated into prescribed and non-prescribed in 2007. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   ]Figure 29: Past six month use of non-prescribed pharmaceutical drugs, Adelaide, SA, 2006-2024OFigure 30: Past six month use of licit and other drugs, Adelaide, SA, 2000-2024KavaNicotine PouchesNon-prescribed steroids Note. Regarding e-cigarette use, on 1 October 2021, legislation came into effect requiring people to obtain a prescription to legally import nicotine vaping products. Data from 2022 onwards refers to non-prescribed e-cigarettes only. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.noyzFigure 31: Use of opioids, stimulants, benzodiazepines and cannabis on the day preceding interview and most common drug pattern profiles, Adelaide, SA, 2024Past six month bingeyFigure 32: Past six month use of drugs for 48 hours or more continuously without sleep ('binge'), Adelaide, SA, 2018-2024 Note. Participants were first asked about bingeing in 2018. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.HFigure 33: Past 12 month non-fatal any overdose, Adelaide, SA, 2000-202427***2 Note. Estimates from 2000-2005 refer to heroin and morphine non-fatal overdose only. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   OTable 5: Past 12-month non-fatal overdose by drug type, Adelaide, SA, 2015-2024N=10510* Note. Participants reported on whether they had overdosed following use of the specific substances; other substances may have been involved on the occasion(s) that participants refer to. From 2015-2018, the stimulant overdose percentage represents participants who reported that they had consumed a stimulant drug prior to their most recent past 12-month  other drug overdose and therefore may be an underestimation. (.) Per cent suppressed due to small cell size (nd"5 but not 0). N is the number who responded (denominator). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.R S] ^i jtTable 6: AUDIT-C total scores and per cent of participants scoring above recommended levels, Adelaide, SA, 2010-2024MenMean AUDIT-C score (SD)Score of e"4 (%)WomenScore of e"3 (%) 3.6 (3.9) 4.2 (3.9) 2.8 (3.7) 3.9 (4.0) 4.3 (4.0) 5.5 (3.4) 5.4 (3.8) 3.7 (3.6) 3.4 (3.6) 3.2 (3.6) 4.1 (3.5) 5.1 (4.3) 3.5 (3.5) 3.1 (2.9) 2.5 (3.2) 3.2 (3.4) 3.9 (4.1) 3.3 (3.5) 3.8 (3.8) 4.1 (3.0) 4.6 (3.8) 2.9 (3.5) 5.2 (3.6) 4.7 (2.7) 2.4 (3.3)x Note. Monitoring of AUDIT-C commenced in 2010. Computed from the entire sample regardless of whether they had consumed alcohol in the past twelve months. (.) Per cent suppressed due to small cell size (nd"5 but not< 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.  ) * 5 6 66* Note. ^Wording of this question changed from  Have you heard about take home naloxone programs (after receiving a blurb about what these programs entailed: 2013-2022) to  Are you aware that naloxone is available for people to take home in 2023. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.z {  bFigure 34: Lifetime awareness of naloxone and naloxone take-home programs, Adelaide, SA, 2013-2024Obtained naloxone( Note. ^^Wording of this question changed from  Have you ever been through a naloxone training course? This may include brief advice, brief education or more extensive training (2020-2022) to  Have you ever been taught how to use naloxone? This may include brief advice, brief education or more extensive training (2023 onwards). (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   JTable 7: Injecting equipment access in past month, Adelaide, SA, 2023-2024.% Location of needle/syringe access past monthNSP vending machineChemistFriend/PartnerDealerHospitalOutreach/peer worker*Medically supervised injecting centre/room3% Difficulties accessing filters^ in the past month;% Difficulties accessing needles/syringes in the past month% Equipment used past monthSpoons/mixing containers TourniquetSwabsWater Any filters87**18*d Note.^Filters included wheel filters, Sterifilt basic filters, sterifilt plus filters and commercial cotton filters (e.g., Stericups). (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.   ! "yFigure 36: Borrowing and lending of needles and sharing of injecting equipment in the past month, Adelaide, SA, 2000-2024X Note. Borrowed (receptive): used a needle after someone else. Lent (distributive): somebody else used a needle after them. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    *Medically supervised injecting Centre/Room Note. Borrowed (receptive): used a needle after someone else. Lent (distributive): somebody else used a needle after them.^ Includes spoons, water, tourniquets and filters; excludes needles/syringes. ~ With a new or used needle. (.) Per cent suppressed due to small cell size (nd"5 but not 0). N is the number who responded (denominator). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.lTable 8: Injecting behaviours in the past month, and location of last injection use, Adelaide, SA, 2015-2024LTable 9: Injection-related issues in the past month, Adelaide, SA, 2020-2024 2024 (N=106) Note. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes. =Table 10: Any current drug treatment, Adelaide, SA, 2015-2024 SatisfiedNeutral Dissatisfied 2019 (n=17) 2020 (n=38) 2021 (n=22) 2022 (n=25) 2023 (n=16)gFigure 37: Treatment satisfaction amongst those who reported current treatment, Adelaide, SA, 2019-2024 Note.  Too early to say excluded from analysis. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.!!!Table 11: Total opioid and methamphetamine SDS scores and per cent of participants scoring above cut-off scores indicative of dependence, among those who reported past six month use, Adelaide, SA, 2017-2024(N=38)3 (0-6)4 (2-7) % score = 0 Note. Severity of Dependence scores calculated out of those who used opioids/methamphetamine recently (past 6 months). A cut-off score of e"5 and e"4 is used to indicate screening positive for potential opioid and methamphetamine dependence, respectively. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Imputation used for missing scale scores. Statistical significance for 2023 versus 2024 presented in table; *p<0.050; *< *p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.kRe-tested with a PCR or RNA test to determine re-infection (among those who underwent successful treatment)N=71 Note. ^This includes people who had not been tested for HCV. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Timeframes for HCV and HIV differ; i.e., HCV questions focus on lifetime and past year; HIV questions focus on lifetime and past six months. Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.M N X Y d e l DTable 12: HCV and HIV testing and treatment, Adelaide, SA, 2018-2024uFigure 38: Self-reported mental health problems and treatment seeking in the past six months, Adelaide, SA, 2004-202427* Note. The combination of the per cent who report treatment seeking and no treatment is the per cent who reported experiencing a mental health problem in the past six months. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.1 2 < = H I NHS 2022-23pFigure 39: K10 psychological distress scores, Adelaide, SA, 2007-2024 and among the general population, 2022-23 { Note. Data from the National Health Survey are a national estimate from 2022-23 for adults 18 or older. Imputation used for missing scale scores (IDRS only). (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.!",-89@ AOD supportTable 14: Types of health services accessed for alcohol and other drug reasons and for any reason in the past six months, Adelaide, SA, 2022-2024% accessing health servicesPharmacy Note. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.Figure 41: Self-reported testing, and driving over the (perceived) legal limit for alcohol or within three hours following illicit drug use, among those who had driven in the last six months, Adelaide, SA, 2007-2024h Note. Computed of those who had driven a vehicle in the past six months. Questions about driving behaviour were first asked about in 2007. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.    % & VFigure 42: Lifetime and past year engagement in drug checking, Adelaide, SA, 2019-2024 Note. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes. UFigure 43: Self-reported criminal activity in the past month, Adelaide, SA, 2000-2024` Note.  Any crime comprises the per cent who report any property crime, drug dealing, fraud and/or violent crime in the past month (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.      XFigure 44: Victim of crime involving violence in the past month, Adelaide, SA, 2019-2024@ Note. Questions regarding being the victim of a crime involving violence were first asked in 2019. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.Lifetime incarcerationPast 12 month arrest0Past 12 month drug-related encounter with policeFigure 45: Lifetime incarceration, and past 12 month arrest and drug-related encounters with police that did not result in arrest, Adelaide, SA, 2003-2024 Note. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes."""NTable 15: Purchasing approaches in the past 12 months, Adelaide, SA, 2023-2024/% Purchasing approaches in the last 12 months^# Face-to-face Surface webDarknet market,Social networking or messaging applications`Text messaging Phone callGrew/made my ownDNote. ^ participants could endorse multiple responses. #This refers to people arranging the purchase of illicit or non-prescribed drugs. ` This captures participants who messaged friends or known dealers on Facebook Messenger or WhatsApp, for example, to organise the purchase of illicit or non-prescribed drugs, which may have then been picked up in perso<n. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.      QFigure 5: Median price of heroin per cap, gram and point, Adelaide, SA, 2000-2024G Per cent suppressed due to small cell size (nd"5 but not 0) (for tables),*p<0.050; **p<0.010; ***p<0.001# # #aTable 2: Demographic characteristics of the sample, nationally, 2024, and Adelaide, SA, 2020-2024p Note. The response option  Don t know was excluded from analysis. Data not provided for years where fewer than six participants (nd"5) responded. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.  ! ,- 4 Note. Among those who commented. Price data for powder not collected in 2020. No participants reported on the price of a gram in 2023. (.) Per cent suppressed due to small cell size (nd"5 but not 0). The response option  Don t know was excluded from analysis. Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes. H IS T_ `;Table 13: Sexual health behaviours, Adelaide, SA, 2022-2024Of those who responded#:,% Any sexual activity in the past four weeksPOf those who reported any sexual activity in the past four weeks and responded#:T% Engaged in sexual activity in exchange for money, drugs or other goods or services2% Had a sexual health check in the last six months-% Had a sexual health check in their lifetimeH% Diagnosed with a sexually transmitted infection in the last six monthsC% Diagnosed with a sexually transmitted infection in their lifetimen=100n=99n=60n=102W Note. # Due to the sensitive nature of these items, there is missing data for some participants who chose not to respond. (.) Per cent suppressed due to small cell size (nd"5 but not 0). Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. Please refer to Table 1 for a guide to table/figure notes.      WHOWorld Health OrganizationLegendrFigure 35: Past 12 month education in naloxone administration, and obtainment of naloxone, Adelaide, SA, 2020-2024Note. Statistical significance for 2023 versus 2024 presented in table; *p<0.050; **p<0.010; ***p<0.001. 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