Substance Use and STI Transmission: The Crisis Behind the Numbers: Research across multiple developed nations reveals a clear crisis: substance use is systematically driving sexually transmitted infection rates upward, yet prevention strategies remain inadequate. The evidence demonstrates that drug consumption fundamentally compromises sexual health decision-making, creating infection pathways that current approaches fail to address.

Analysis of 55,690 young adults aged 18-25 in the United States provides stark evidence of this connection. Those using illicit drugs face 3.10 times higher odds (95% CI: 2.77-3.47) of contracting sexually transmitted infections compared to non-users. This represents one of the strongest statistical associations documented in public health research, yet prevention strategies targeting this relationship remain underdeveloped.

The data shows that some groups are more at risk than others. Men are more than twice as likely as women to get STIs. Young adults aged 22–25 have a higher risk than those aged 18–21. The greatest concern lies with individuals who have a history of delinquency, as they are more than twice as likely to become infected. These patterns highlight how risky behaviours are often interconnected, underscoring the need for prevention strategies that address these issues holistically.

How Substance Use Compromises Sexual Health Protection: Research from Dutch STI clinics involving 11,714 young people shows how drug use undermines infection prevention. Alcohol was used during sex by 45.3% of attendees, with men more likely than women to report this (49.5% vs 43.2%, p<0.001). Drug use during sex was reported by 22.0% of attendees, again more common among men (30.7%) than women (17.6%, p<0.001).

The most commonly reported substances were cannabis (17.9%), ecstasy/MDMA (6.9%), and cocaine (4.7%). Critically, the research demonstrates that drug use during sex correlates directly with risky sexual behaviours: inconsistent condom use (aOR: 2.5, 95% CI 1.9 to 3.2) and having four or more sexual partners within six months (aOR: 3.2, 95% CI 2.8 to 3.6).

Dr Andrady, sexual health consultant for Betsi Cadwaladr University Health Board, explains the clinical reality: “We have definitely seen a rise in people coming into the clinic after having sex whilst under the influence of drugs and alcohol, and they regret what they have done. People forget about protection when they are under the influence of drugs and alcohol.”

Why Current Approaches Fail: The Treatment-Focused Limitation

Healthcare System Responses Prove Inadequate: Analysis of low-barrier substance use disorder programmes reveals why treatment-focused approaches cannot solve drug-related STI prevention challenges. Among 393 patients initiating care, 84.7% completed screening tests, revealing substantial infection burdens: current or past hepatitis C in 38.4%, HIV in 2.3%, and chronic hepatitis B in 0.5%.

Despite identifying 61 new active infections—including HIV, syphilis, gonorrhoea, chlamydia, and hepatitis cases—treatment linkage remained problematic. Only 33.3% of hepatitis C cases achieved care connection, whilst 37.8% of patients remained non-immune to hepatitis B and 43.9% to hepatitis A.

Professor Jason Ong, director of Australia’s largest public sexual health clinic, explains the fundamental problem: “hardly anyone was using condoms and this had led to increased rates of STIs. It is for a variety of reasons, predominantly driven by things like people are no longer in fear of getting HIV. They also think an STI is curable so they don’t mind getting it. So they drop the condoms.”

Infrastructure Cannot Compensate for Behavioural Risk: Even comprehensive healthcare infrastructure proves insufficient when substance use compromises decision-making. Professor Ong notes: “in Victoria, the Melbourne Sexual Health Centre is the only sexual health clinic for the whole of Victoria, so we are meant to be serving around five million people which is almost impossible. Whereas NSW has about 30 sexual health clinics.”

Kirby Institute epidemiologist Skye McGregor identifies additional barriers: “people dropped off getting tested during Covid and they haven’t seen it rebound. It’s hard to get an appointment quickly with the GP, it’s very hard to get an appointment at sexual health clinics that have free or very-low cost testing.”

Yet even when healthcare access improves, fundamental behavioural risks persist. Longitudinal research following 447 men who have sex with men through 1,854 visits found cumulative STI incidence reached 55%. Despite some behavioural modifications after STI diagnosis—methamphetamine use declining from 50% to 35% and median sexual partners reducing from 5 to 2—STI and HIV incidence remained high. (Complete article WRD News)

Breaking News from Australia shows unprecedented success in tackling youth vaping epidemic as government reports peak vaping rates behind them

Australia has achieved a remarkable milestone in youth substance abuse prevention, with border authorities seizing over 10 million vapes since implementing world-leading import controls in January 2024. The comprehensive crackdown has successfully turned the corner on what was described as “one of the most significant public health challenges” facing Australian communities.

Vaping Rates Plummet as Enforcement Delivers Results

Health Minister Mark Butler confirmed that “the peak of vaping is behind us,” with research showing fewer young people are now vaping and fewer young people are smoking. When the current government took office three years ago, vaping was “exploding as a public health menace,” with year-on-year increases at “alarming rates”.

School communities had reported vaping as their “number one behavioural concern,” with suspensions climbing and schools implementing extraordinary measures including “rostering teachers to stand inside school toilets during recess and lunchtimes” to combat the crisis.

Young Australians Recognise They Were “Sold a Lie”

Professor Becky Freeman from the University of Sydney, who leads the landmark Gen Vapes research study, revealed the dramatic shift in youth attitudes: “Young people were sold a lie. They were told that vapes were harmless, they were fun, they were part of a young person’s lifestyle”.

The research shows young people’s attitudes have fundamentally changed. Freeman noted: “They’re almost ashamed of the fact that they’re addicted. They can’t believe that something that they were just using at parties for fun on the weekends… Now their wellbeing is being impacted. They’re waking up with a vape under their pillow”.

Coordinated Government Response Targets Criminal Networks

The comprehensive strategy included banning imports of disposable vapes and outlawing retail sales outside therapeutic settings. Previously, “nine out of 10” vape stores were located “in walking distance of schools because they knew that was their target market”.

Assistant Commissioner Tony Smith from the Australian Border Force emphasised the criminal elements involved: “Every vape and every cigarette that is illegally purchased fuels the black market… and sends profits into the hands of organised crime”.

Border Force officers now make “on average 120 detections a day,” contributing to the 10 million vapes seized alongside “2.5 billion cigarette sticks and 435 tonnes of illicit tobacco”.

South Australia Leads Enforcement Excellence

South Australia has emerged as the national leader in enforcement, receiving top marks in an independent assessment. The state has seized over 100,000 vapes worth $4.5 million in just 12 months.

Minister Andrea Michaels revealed the state now has “the ability to shut stores for 28 days” and has already “closed almost 20 stores for 28 days” since the enhanced powers took effect in June 2025. Penalties for violations can reach up to $6.6 million for repeat offences.

Research Confirms Gateway Effect Prevention

Critical research findings demonstrate that vaping serves as a gateway to smoking, with “young people who vape are at five times the risk of going on to smoke”. As one young participant in the study explained: “when I was a young teen, I absolutely hated smoking… And then I tried vaping, and it sort of loosened me up. And I thought, oh, well, if I’m going to vape, maybe I could smoke too”.

The success in reducing both vaping and smoking rates simultaneously addresses earlier concerns that restricting vapes might drive young people toward cigarettes instead.

International Partnerships Disrupt Supply Chains

Australia has deployed Border Force officers internationally, including to “the UK, to Thailand and also through to Hong Kong” to work with international partners to stem the flow of vape products. Recent referrals contributed to the seizure of “over 630,000 vapes from reaching our borders”.

The products are arriving from multiple countries including “China, from the UAE, Singapore” and “other locations such as the UK as well”, often using “mis-declaration or mis-description of goods” to evade detection.

Ongoing Challenges Acknowledged

Despite the remarkable progress, officials stressed the fight continues. Minister Butler acknowledged: “We know it’s going to be a tough fight. We know there’s a lot more to do… We’re up against two very strong opponents, Big Tobacco on the one hand and serious organised crime”.

Professor Freeman emphasised the need for sustained action: “We always have to be mindful of the tobacco industry tactics and what product they’re going to bring in next. We know that they are not going to give up on this market”.

Global Implications for Youth Protection

Australia’s comprehensive approach demonstrates that decisive government action can successfully combat youth substance abuse epidemics. The combination of import controls, retail restrictions, enforcement measures, and international cooperation provides a blueprint for other nations grappling with similar challenges.

The transformation from a crisis where vaping was “exploding year on year” to confirmed evidence that “the peak of vaping is behind us” offers hope for communities worldwide seeking effective prevention strategies.

Source: WRD News

Abstract

The evolving crisis of drug addiction and its intersection with the criminal justice system has prompted critical reassessment of punitive legal models. This paper argues that meaningful rehabilitation is best achieved through judicially guided diversion rather than decriminalisation alone. Drawing from case studies such as Unit 104 at the Kenton County Detention Center, Portsmouth’s city-wide recovery initiatives, the Dalgarno Institute's advocacy for the "Judicial Educator" model, and innovative rehabilitative programs including animal-assisted therapy and financial literacy initiatives, this paper explores the integration of restorative justice, individualised treatment, and community-based alternatives to incarceration. By synthesising field-based innovations with a progressive vision for reform, the paper illustrates how shifting from punishment to rehabilitation promotes long-term public safety, reduces recidivism, and restores human dignity.

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New allegations have emerged about China’s role in the global fentanyl supply chain, highlighting the complex nature of international drug trafficking and the urgent need for comprehensive prevention strategies.

What We Know About Project Zero

According to Yuan Hongbing, a former Chinese academic now living in Australia, sources within Beijing’s political circles have described a coordinated effort called “Project Zero.” This alleged initiative represents one aspect of the broader China fentanyl crisis that has contributed to America’s ongoing opioid epidemic.

Yuan’s claims suggest that some Chinese officials view the current drug crisis through the lens of historical grievances, particularly the 19th-century Opium Wars. Whether accurate or not, these allegations underscore the complexity of the Chinese fentanyl trade and its impact on communities worldwide.

The Evolution of Supply Routes

The China fentanyl crisis has evolved significantly since 2019, when Beijing officially banned fentanyl production under international pressure. Rather than ending the problem, this led to a shift in tactics within the Chinese fentanyl trade.

Companies began focusing on precursor chemicals instead of finished products. These substances travel from manufacturing facilities to Mexico, where they’re processed into fentanyl before reaching American markets. This indirect approach complicates efforts to address the China fentanyl crisis at its source.

Impact on Communities

The human cost of the ongoing crisis is staggering. More than 107,000 Americans died from drug overdoses in 2023, with synthetic opioids like fentanyl being the primary cause. These deaths represent families torn apart and communities struggling with the consequences of widespread addiction.

The China fentanyl crisis affects people from all backgrounds. Parents lose children, children lose parents, and entire neighbourhoods face increased crime and social instability. Understanding these impacts is crucial for developing effective Chinese fentanyl trade prevention strategies.

Government Responses and Investigations

Congressional investigations have revealed concerning patterns in how some aspects of the Chinese fentanyl trade operate. The House Select Committee found evidence that certain companies receive government benefits for exporting precursor chemicals, raising questions about official oversight.

These findings suggest that addressing the China fentanyl crisis requires diplomatic engagement alongside enforcement measures. The complexity of international trade makes it challenging to distinguish between legitimate chemical exports and those intended for illicit use.

Economic Measures and Trade Relations

The current trade tensions between the US and China reflect broader concerns about the Chinese fentanyl trade. Recent tariffs include specific measures targeting fentanyl-related commerce, with most Chinese goods facing increased duties.

These economic responses acknowledge that the China fentanyl crisis extends beyond traditional criminal justice approaches. However, trade measures alone cannot solve the underlying issues that drive demand for these substances in affected communities.

International Cooperation Challenges

Addressing the Chinese fentanyl trade requires unprecedented international cooperation. Different legal systems, varying enforcement capabilities, and complex diplomatic relationships all complicate efforts to tackle the China fentanyl crisis effectively.

Success depends on finding common ground between nations with different perspectives on regulation, enforcement, and prevention. This includes sharing intelligence, coordinating investigations, and developing consistent approaches to precursor chemical controls.

The Role of Prevention

Prevention remains the most effective long-term response to the China fentanyl crisis. Community-based programmes that educate young people about the dangers of substance use can reduce demand for these deadly drugs.

Effective prevention strategies address the root causes that make individuals vulnerable to addiction. This includes mental health support, educational opportunities, and strong community connections that provide alternatives to substance use.

When communities invest in prevention, they create protective factors that help people resist the appeal of drugs, regardless of their source. The Chinese fentanyl trade thrives where demand exists, making prevention efforts crucial for breaking this cycle.

Treatment and Recovery

For those already affected by the China fentanyl crisis, accessible treatment services provide hope for recovery. Evidence-based approaches that combine medical treatment with psychological support offer the best outcomes for people struggling with addiction.

Recovery programmes that involve families and communities tend to be more successful than those focusing solely on individual treatment. This holistic approach recognises that addiction affects entire social networks, not just individual users.

The Path to Prevention and Recovery

The allegations about Chinese involvement in fentanyl trafficking highlight the need for sustained international cooperation on drug prevention. Whether through diplomatic channels, trade measures, or community-based initiatives, addressing this crisis requires coordinated action.

Prevention must remain at the centre of any effective response to the China fentanyl crisis. By reducing demand through education and community support, we can address the root causes that make these supply chains profitable in the first place.

The Chinese fentanyl trade represents a complex challenge that requires nuanced solutions. Success will depend on combining international cooperation with strong local prevention efforts that protect vulnerable individuals and strengthen community resilience.

Only through sustained commitment to prevention, treatment, and community support can we hope to reduce the devastating impact of the China fentanyl crisis on families and communities worldwide.(Source: The Epoch Times)

Victoria is in the news seeking to open a fixed pill testing site as Pill Testing Australia operatives have shifted their focus from their ineffective and harm-escalating** pill testing narrative to one that now includes testing all manner of illicit drugs in a new operation they call ‘drug checking’.

ABC has been posting warnings about more potent opioids such as fentanyl and nitazenes, inferring that their higher potencies create higher death ratios amongst opioid users.  But Drug Free Australia demonstrates that this is most certainly untrue.  The ABC posts say, 

“Non-prescription drug overdose deaths in the ACT have doubled since the start of 2024 to 20.  Police have renewed warnings to users about the dangers of highly potent substances being increasingly detected in illicit drugs, such as fentanyl and nitazines.”

But it takes only two graphs from Australia’s official 2024 opioid overdose report to falsify this misinformation.

The first shows that deaths from the use of ALL opioids have risen at very similar rates since the 2007 Federal Government scrapped Tough on Drugs, which had kept opioid deaths at around 360 per annum between 2001 and 2007.  Deaths from all opioid types increased sharply post-2007, with deaths from the more potent Fentanyl increasing in line with the other opioids.

Just like pill testing, where Pill Testing Australia falsely** implied that most pill deaths came from other drugs or contaminants mixed into the pills, the new ‘drug checking’ narrative comes from the same playbook now used for decades in Australia.  They used to say that our masses of heroin fatalities were from criminals putting toxic contaminants in the powders or from wildly variable purities but the science demonstrated that this was simply false (p xiii).  It later emerged that just as many died from strictly uncontaminated and purity-controlled pharmaceutical opiates as from  criminal-supplied heroin, both at roughly 1% of dependent users per year.  In fact, the vast majority of opiate overdoses have had the same unifying cause – using opioids with other drugs such as alcohol and benzodiazepenes as the second graph below very clearly demonstrates.  NOTE CAREFULLY THE BOTTOM-MOST RED LINE – that is the one that includes deaths from Fentanyl alone.  And it says the very opposite of what ABC and their ilk infer.

The fact that Australian overdose reports show no major change in the ratio of polydrug-use deaths against opiates used alone suggests, despite the increased potency of Fentanyl and Nitazenes, that drug users accommodate for the increased potency of these newer substances.  When opiate deaths peaked at 1,116 in 1999, 1% of dependent heroin users were dying.  Very recent fatal overdose rates for countries with heavy Fentanyl use, which is 50 times stronger, show the same 1% dying again - pointing an accusing finger at polydrug use for BOTH opiate types.   We would expect similar user accommodation with Nitazenes which can be similar to, or stronger than Fentanyl, where weakened physiology of long-term opiate users and polydrug use are moreso causal in most fatalities.

Across Australia opiate users experience 72 non-fatal overdoses (p59) and two - three opiate fatalities per day, so these already troubling statistics can be alarmingly manipulated by media, and more made of these deaths than is warranted.   Drug Free Australia does not deny that criminal-manufactured pills with high potency opioids masquerading as lower potency opioids will cause some unexpected fatalities, but much more evidence is needed to show that these are anything but the tiny minority of fatalities.

Balanced against this are the massive number of opiate deaths caused by the harm reductionist messaging which teaches the ‘safe use of illicit drugs’, of which drug checking is seminally a part.  This messaging quadrupled opiate deaths between 1984 (below 250 for 15-44 year olds) and 1,116 for 15-54 year olds in 1999.  The prevention and rehabilitation priorities of Tough on Drugs made opiate deaths plummet by 67% (or a massive 750 opiate deaths per year), where they stayed for 7 years until a new Federal Government scrapped them.  In the decade following, with the ‘safe use of drugs’ message again prioritised, opiate deaths skyrocketed 260% with other contributing polydrug-use illicit drug deaths increasing 210-590% as can be very clearly seen in the graph above.  Harm Reduction’s ‘safe use of drugs’ ideology has very demonstrably added many, many thousands of opiate deaths to Australian mortality tolls and heavily weights any set of balances against a few lives saved by ‘drug checking’.  Drug Free Australia has no problem with law enforcement continuing to publicise contaminants or adulterants in seized drugs, maintaining the message that drug use is not acceptable, rather than allowing drug-normalisating NGOs to take that role. 

Gary Christian
PRESIDENT
Drug Free Australia
0422 163 141

This email is sent on the understanding that it is every Australian organisation’s right to inform and petition their political representatives.

** Of the 392 MDMA related deaths between mid-2000 and mid-2018 in Australia, pill testing fails to address the real causes of such pill deaths in this country.  Pill testing cannot identify those who will die from allergic-like reactions (14%), or those who will co-use ecstasy with other legal or illegal drugs (48% of deaths), or those who are accident-prone while intoxicated (29% of deaths).  There have only been 3 ‘bad batch’ deaths over those years, implicating MDMA as the drug responsible for almost every Australian ecstasy death. Yet Pill Testing GREENLIGHTS (p 11) MDMA in a pill, giving the thumbs-up to a killer drug.  This will keeping adding to our mortality toll.