Journal de l'alcoolisme et de la toxicomanie
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Illicit Fentanyl use in Rural Australia - An Exploratory Study

Allan J

Introduction and Aims: Australia has seen an increase in the non-medical use of fentanyl transdermal patches (FTP) and associated deaths, with an over-representation of deaths in rural areas. Non-medical use of FTP involves high risk preparation and administration methods. However, no rural Australian drug user-focused research has been published to date. Frontline workers are without up-to-date harm reduction information. This study aimed to explore the perceptions and experiences of individuals using FTP for non-medical purposes. Design and method: Interviews were conducted with adult participants (n=12) who had injected FTP twice or more and resided in regional/rural NSW or Victoria. The thematic data analysis identified key points around participant’s harm reduction practices, perceptions and experiences with using FTP. Results: Fentanyl was easily obtained in rural locations. Study participants described high risk preparation and administration methods. Misinformation shared across peer networks was likely to contribute to overdose. Discussion and Conclusion: Beliefs and practices about obtaining and using fentanyl are transmitted and reproduced across groups of illicit drug users, amplifying and distorting information about methods and harms of fentanyl use. However, fentanyl injectors were experienced illicit drug users who perceived they had good knowledge of ways to use fentanyl safely in spite of knowing people who had died from overdose. It is unlikely this group would seek out harm reduction information. Peer networks are critical sites of harm reduction action that are challenging to infiltrate in the rural context where dispersed populations, distance and risks associated with disclosing illicit drug use are significant barriers to disseminating harm reduction information. Peer-to-peer education is a costeffective method of disseminating correct health information and harm reduction messages in dispersed and isolated populations.