Stigma, and factors associated with experiencing stigma, while visiting health-care services among samples of people who use illegal drugs in Australia.

INTRODUCTION: People who inject drugs experience stigma across multiple settings, including when accessing health-care services, however, comparatively little is known about experiences of stigma towards other groups of people who use illegal drugs. This paper examines experience of, and factors associated with, stigma among two samples of people who use illegal drugs when visiting both specialist alcohol and other drug (AOD) and general health-care services. METHODS: Australians who regularly (i.e., ≥monthly) inject drugs (n = 879; illicit drug reporting system [IDRS]) or use ecstasy and/or other illegal stimulants (n = 700; ecstasy and related drugs reporting system [EDRS]) were surveyed between April and July 2022 about past 6-month experience of stigma in the above services. Multi-variable regression analyses were performed to determine the socio-demographic, drug use and health factors associated with stigma. RESULTS: Experiences of stigma in general health-care services were more common among IDRS (40%) than EDRS (24%; p < 0.001) participants, however, experiences were comparable in specialist AOD health-care settings (22% and 20%, respectively; p = 0.687). Gender identity and experiencing high psychological distress were associated with experiencing stigma across both samples. Past-year overdose was associated with experiencing stigma among the IDRS sample, while unstable housing and incomplete high school education were associated with experiencing stigma in the EDRS sample. DISCUSSION AND CONCLUSIONS: Experiences of stigma when accessing health-care services are relatively common across different populations of people who use illegal drugs. Our findings highlight the multiple and intersecting dimensions of stigma and provide further support for recent calls for a universal precautions approach to stigma in health care.

Comparing police use of drug detection dogs amongst injecting and non-injecting groups of people who regularly use drugs in Australia.

INTRODUCTION: Drug detection dogs are utilised across multiple settings, however existing literature focuses predominantly on festival-based encounters. We compare drug dog encounters in non-festival settings among two samples of people who regularly use drugs, and investigate factors associated with witness only versus stop and/or search encounters. METHODS: Australians who regularly (i.e., ≥monthly) use ecstasy and/or other illegal stimulants (n = 777; Ecstasy and Related Drugs Reporting System (EDRS)) or inject illegal drugs (n = 862; Illicit Drugs Reporting System (IDRS)) were surveyed between April-June, 2019. Univariable regression analyses were used to test for differences in drug dog encounters between samples, and to identify factors associated with a more intensive drug dog encounter (namely those that involved a stop and/or search). RESULTS: People who inject drugs were less likely to witness drug dogs than those who regularly use ecstasy and/or other illegal stimulants (odds ratio (OR) 0.46; 95 % CI 0.30-0.69). They were significantly more likely than EDRS participants to report being stopped and searched (3.29; 1.68-6.44) however. Among those carrying drugs at their last stop and/or search encounter, the majority of both samples reported that their drugs were not detected by police. IDRS participants aged 35-49 were more likely to report a stop and/or search encounter than those aged 17-34; no significant associations were found among the EDRS sample. CONCLUSIONS: Despite participants who use ecstasy and/other stimulants being more likely than those who regularly inject drugs to report encountering drug dogs in non-festival settings, participants who inject drugs were more likely to report an intensive or invasive drug dog encounter and/or receiving a formal criminal justice consequence. This study reinforces questions about the efficacy and appropriateness of drug dog operations.