Drug supply and drug abuse
==========================

* Michael Copeman

The article by Evan Wood and colleagues1 suggesting that the seizure of 100 kg of heroin made no difference to heroin abuse in Vancouver is interesting, but its conclusions are open to doubt and its implications are cause for concern.

In Australia over the past 2 years, there has been a significant decrease in heroin overdoses (and subsequent deaths) in association with a decrease in reported abuse of heroin.2 Over the same period, law enforcement authorities here have had a series of major successes in intercepting shipments of heroin and arresting those responsible.2

Wood and colleagues1 admit that the Vancouver Injection Drug User Study was not designed to look at the effects of a large seizure of heroin on supply to addicts but rather was aimed at analyzing factors related to HIV in drug abusers. Hence, their article reports an incidental post hoc analysis. It is possible that neither the sample of drug abusers they interviewed nor the time frame in which the interviews took place was appropriate for determining changes in drug abuse after a large seizure of heroin. For example, it might be that large shipments of illicit drugs are usually stored for months before being distributed (to help avoid linking importation with subsequent distribution), so that the impact of a seizure on abuse would take months to appear.

**Michael Copeman** Visiting Pediatrician Manly Hospital Sydney, New South Wales Australia

## References

1.  1. Wood E, Tyndall MW, Spittal PM, Li K, Anis AH, Hogg RS, et al. Impact of supply-side policies for control of illicit drugs in the face of the AIDS and overdose epidemics: investigation of a massive heroin seizure. CMAJ 2003;168(2):165-9.
    
    [Abstract/FREE Full Text](http://www.cmaj.ca/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiY21haiI7czo1OiJyZXNpZCI7czo5OiIxNjgvMi8xNjUiO3M6NDoiYXRvbSI7czoyMzoiL2NtYWovMTY4LzkvMTExMy4xLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==) 

2.  2. Weatherburn D, Jones C, Freeman K, Makkai T. Supply control and harm reduction: lessons from the Australian heroin “drought.” Addiction 2003; 98(1):83-91.
    
    [CrossRef](http://www.cmaj.ca/lookup/external-ref?access_num=10.1046/j.1360-0443.2003.00248.x&link_type=DOI) 
    
    [PubMed](http://www.cmaj.ca/lookup/external-ref?access_num=12492758&link_type=MED&atom=%2Fcmaj%2F168%2F9%2F1113.1.atom) 
    
    [Web of Science](http://www.cmaj.ca/lookup/external-ref?access_num=000179986200011&link_type=ISI)