In the Northern Territory, most of those consulted believed that drug injecting was not currently a significant issue in remote communities. Given movement in and out of communities, however (eg by tradespeople), increased injecting was certainly a future possibility. The health risks of this could be extremely serious and therefore the situation needed to be carefully watched.

So far as they were aware, said some Alice Springs IDUs, there was currently 'nothing in the homelands' in Central Australia. However, it was again emphasised that social and environmental conditions in outlying communities (eg inadequate water supply) were such that, if drug injecting did spread further, injecting in communities was highly likely to be unhygienic and unsafe. One worker noted that if cleaning needles for re-use was 'dicey' anywhere, it was especially likely to be a problem in remote communities.

Some of those interviewed in Cairns believed that the use of speed was increasing on Cape York and in the Torres Strait, but that the drugs were not necessarily being injected. A local IDU, on the other hand, believed there were 'lots of kids injecting speed on the Cape'. There were several references to 'denial' within the communities and among AHWs on the Cape.

Obtaining clean injecting equipment on Cape York was described as difficult. Hospitals at places such as Weipa, Lockhart River and Cooktown do offer NSP services – but they are largely used by tourists, it was said. Cairns was regarded as the best source of injecting equipment for IDUs living on the Cape, which meant that people visiting Cairns could be asked to bring back sterile equipment for others: clients would on occasion come to an NSP outlet with 'a great long shopping list' for people back home. Even when visiting Cairns, however, Indigenous IDUs from the Cape might well be reluctant to 'front up' to an NSP, and might ask others to collect equipment for them – or possibly request needles and syringes from a drug dealer.

Education programs and NSP services were said by one IDU in Cairns to be 'dead set needed' on Cape York; such services needed to be delivered in people's own terms – not by some 'authority figure'. It was 'a very hard job to reach those kids' on Cape York, and it was argued that peer-based approaches had the best prospect of success.

Several possible routes were suggested for the spread of drug use and drug injecting into remote or isolated Indigenous populations – trucking in of goods, visiting tradespeople, young people returning to communities from urban areas and/or from prison, mining operations (eg in the Top End) and commercial fishing ('It's rife on the trawlers' that work in the Gulf of Carpentaria, and use of drugs on fishing boats was also mentioned in Carnarvon). 'Transients' such as long distance truck drivers and fishermen were described as a significant source of drug supply in rural and regional Australia generally. As previously noted, it was argued that irregular supply of drugs in more isolated locations meant sporadic drug injecting, which might well be associated with unsafe injecting practice.