Objective: Injecting use of non- or not-as-prescribed opioids has been increasing internationally and in many Australian jurisdictions over the past decade. Similar to patterns in America, such use of morphine or oxycodone has traditionally been more popular among regular injecting drug users in Australian jurisdictions in which there has been a paucity of heroin, such as Tasmania, however, these drugs have recently become more popular in other Australian jurisdictions. This paper will examine prevalence of use of heroin, oxycodone and morphine among 2008 Illicit Drug Reporting System (IDRS) participants from two different jurisdictional drug markets.

Method: The IDRS is a survey that serves as a strategic early warning system, identifying emerging trends of local and national concern in illicit drug markets, through a combination of interviews with regularly injecting drug consumers, key experts, and an examination of related data sources. This is carried out on an annual basis, in all Australian capital cities.

Results: Comparisons are drawn between Tasmania - a state with very low levels of heroin use and high levels of non-prescribed use of pharmaceutical opioids - and New South Wales, a jurisdiction with notably higher rates of heroin use and lower rates of pharmaceutical opioid use. Distinct patterns of motivation for use of pharmaceutical opioids were identified between the jurisdictions.

Conclusion: Understanding trends in opioid use among this group can assist policy makers and clinicians to target harm reduction and treatment interventions more effectively. Similarly, a better understanding of injecting drug users’ motivations for use of non-prescribed pharmaceutical opioids can assist in improving health outcomes for this population