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Abstract: Background: This paper documents the operation of Australia''s Ecstasy and Related Drugs Reporting System (EDRS), using multiple data sources to document trends in gamma-hydroxybutyrate (GHB) use in Sydney, Australia between the years 2000–2006. Method: The EDRS monitors trends in ecstasy and related drug markets by means of a triangulation of data from interviews with regular ecstasy users (REU), surveys with key experts (KE), and analysis of secondary indicator data sources. Results: The proportion of REU reporting lifetime GHB use increased from 5% in 2000 to 40% in 2006 and the proportion reporting recent use increased from 1% in 2000 to 21% in 2006. KE reports suggest GHB use may be a concern amongst specific drug user subcultures. REU and KE data suggest a change in the locations in which GHB is used, with a shift from dance venues and events to private homes and parties. There is a lack of indicator data from both health and law enforcement data collection systems concerning GHB. Conclusions: The EDRS has effectively monitored the increase in GHB amongst REU over the past seven years in Sydney, Australia. This increase is unlikely to have been as readily identified by other surveillance systems. [Copyright &y& Elsevier]

Abstract: Background: In Australia, sterile needles are distributed to people who inject drugs through formal services for the purposes of limiting the transmission of blood borne viruses (BBV). Secondary exchange (SE) involves people acquiring needles from formal services and redistributing them to others. This paper describes the extent, patterns and contexts of SE in south east Sydney, Australia and examines whether SE is independently associated with BBV risk practices. Methods: Quantitative and qualitative data were collected through a cross-sectional study using surveys and in-depth interviews. Respondents were people using community-based pharmacies to obtain sterile needles and syringes. Results: Data were collected from 229 survey respondents, over half of whom (54%) reported SE in the previous month. Of these, 40% engaged in distribution only, 25% in receipt only and 36% in both. Respondents reported passing on 21.7% of their needles to others in the last month, most commonly to friends (51.6%) and partners (27.4%). Recipients of SE were four times more likely than non-secondary exchangers to report borrowing used syringes in the last month. Respondents reported supplying sterile equipment to others to prevent reuse and to reduce risks associated with unplanned drug use. Conclusion: SE is a common activity in south east Sydney but does not appear to be highly organised, usually taking place in small networks of friends and/or partners for altruistic reasons. Harm reduction programs could capitalise on the prevalence of SE to reach injecting drug users who do not use formal distribution services. [Copyright &y& Elsevier]