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ID: 785

Type of submission: Oral

Conference track: Research

Topics: Harm Reduction for Non-Injectors and/or Stimulant Users; Peer-Driven Treatment, Care and Harm Reduction

Presenting author: Peter Higgs

Presenting author biography:

No biography entered.

Methamphetamine and heroin ‘cocktail’ injecting as harm reduction: Qualitative findings from a community-recruited cohort of people who inject drugs in Melbourne, Australia

Anna Palmer, Nick Scott, Paul Dietze, Peter Higgs

Background: Since 2009, reported use of crystal methamphetamine by people who inject drugs (PWID) has increased in Australia, part of what has been referred to as an “ice epidemic”. In the wake of this there is emerging evidence that Melbourne PWID are mixing heroin and methamphetamine in the same injection, a phenomenon described as “cocktailing”. Previous literature describing the phenomenon of cocktailing has predominantly focussed on negative outcomes such as overdose or hospital admission, with few studies focussing on positive implications of this practice from the perspective of PWID who undertake this behaviour.

Methods: Fourteen in-depth interviews with purposively selected participants from the Melbourne Injecting Drug User Cohort Study (MIX) explored reasons why participants decided to undertake cocktailing.

Results: Participants reported undertaking cocktailing regularly, with many reporting no longer using methamphetamine or heroin on their own. There were two main reasons which emerged as to why participants engaged in “cocktailing”, (1) to mitigate some of the harmful effects of crystal methamphetamine by utilising the depressant effects of heroin, and (2) to prolong the effects of heroin and thus extend the time before starting to experience withdrawal symptoms.

Conclusion: Participants predominantly reported cocktailing as an indigenous form of harm reduction minimising the most negative consequences of crystal methamphetamine use and prolonging the time before opioid withdrawal.

Implications: Cocktailing of heroin and methamphetamine by people who inject drugs is seen largely as a risky practice but may represent a form of harm reduction.