The temporal influence of a heroin shortage on pregnant drug users and their newborn infants in Sydney, Australia

Background: Heroin availability and purity decreased precipitously in Australian markets between 2000 and 2001. This led to increased use of non-opiate drugs in the general community but whether pregnant drug users and their newborn infants were affected remains unknown. Aim: To determine if perinatal drug exposure and outcomes are affected by changes in street drug availability. Methods: Retrospective review was carried out of known drug-exposed mothers delivering live-born infants at the Royal Hospital for Women, Randwick, Australia (n = 316). Study periods were divided into preshortage (A = 1998–2000, n = 79), shortage (B = 2001–2002, n = 92) and post-shortage (C = 2003–2006, n = 122) periods. Cannabis-only users were excluded (n = 23). Results: The percentage of confined women who admitted to using heroin decreased significantly (65%(A) vs 34%(B), P