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This paper aimed to examine the prevalence, correlates and nature of violent crime by, and upon, regular drug users by conduct disorder (CD) status. Interview data was collected from 299 regular psychostimulant and/or opioid users. Conduct disorder significantly increased the lifetime and past 12 month risk of violent victimization and offending. While CD did not independently predict recent violent victimization, it did predict recent violent offending. Greater alcohol dependence and involvement in drug dealing were predictors of both recent victimization and offending. The study indicates that there is significant temporal stability between childhood CD behaviors and later violent behavior among individuals with substance use problems. The study also highlights that there is heterogeneity in the risk of violence exposure in drug using populations, a finding which has implications for early intervention and for treatment interventions among dependent drug user populations.

This study is the first to examine exposure to trauma and the development of PTSD prospectively among heroin users. Participants were 309 heroin users followed up over two years as part of the Australian Treatment Outcome Study. Forty-one percent reported trauma exposure, and 5.8% developed PTSD over the follow-up period. Baseline characteristics that independently predicted trauma exposure were younger age and a history of imprisonment. Those who developed PTSD did not differ from those with a history of PTSD at baseline on any characteristics. Those who developed PTSD were, however, more likely to have a history of attempted suicide compared to those with no history of PTSD. These findings suggest that there is a need for trauma prevention programs particularly targeting younger people, those with a history of imprisonment, and those with a history of attempted suicide, who may be more susceptible to trauma exposure and the development of PTSD.

To examine long-term stability in route of administration and treatment outcomes for noninjecting (NIHU) and injecting (IHU) heroin users, a cohort of 429 heroin users were followed over 36 months. Across follow-up, 35.3% of NIHU injected heroin and a transition to primary heroin injecting was made by 8.5%. Amongst IHU, 11.1% smoked heroin and a transition to primary heroin smoking was made by 2.3%. While NIHU were less likely to be in treatment at 36 months, there were no differences in overall treatment exposure. At 36 months, there were no differences in heroin use, polydrug use, crime, physical health, or psychopathology. NIHU were, however, less likely to be injecting and to have injection-related health problems. It is concluded that there is a substantial risk of injecting occurring amongst NIHU and that route of administration does not differentially predict long-term treatment response.