Hidden Harms: Methamphetamine use and routes of transmission of blood borne viruses and sexually transmissible infections

Methamphetamine (meth) use is a recognised issue in Australia which has garnered much attention over recent years. The focus of media reporting has largely been on aggressive and unpredictable behaviour of people who have used the drug. This is a narrow representation of the effects of the drug. Little attention has been given to the transmission of blood borne viruses (BBVs) and sexually transmissible infections (STIs) connected to the use of meth.

Whilst meth can, and is, injected by some there needs to be recognition that other routes of administration also carry risk of BBV transmission such as the normalised sharing of pipes. Furthermore, risky sexual behaviours associated with meth use also require attention to reduce the transmission of certain communicable infections.

Not all drug use is the same and subpopulations of drug use exists. These layers of complexity need to be recognised and investigated further to ensure that appropriate harm reduction messages are developed.

Through consultation with its member organisations, the Australian Injecting and Illicit Drug Users League (AIVL) has identified a number of current policies and legislation which needs to be reviewed in terms of the unintended effects it may have on encouraging harm and riskier drug consumption behaviours. For example, whilst it is known that needle and syringe programs (NSPs) work effectively to reduce BBV transmission through injecting practices, the difficulty of obtaining a meth pipe from which to smoke the substance, means that some have turned to injecting given the greater availability and ease of obtaining the necessary equipment.

Moreover, the stigma attached to meth use must not stand in the way of evidence-based harm reduction measures being adopted. Legislation and policies need to be developed and informed by evidence and not moral judgements, which also incorporates the valuable role that peers play.