Drug use in Australia and its health impact
Introduction
The Australian Institute of Health and Welfare is currently preparing first releases in a new series of publications about tobacco, alcohol and illicit drug use and its health impact in Australia. The publications will present results of two separate studies. The first is the 1998 National Drug Strategy Household Survey, which the Institute is managing on behalf of the Commonwealth Department of Health and Aged Care. The second is an analysis of data on deaths and hospital episodes, updating available estimates of mortality and morbidity attributable to drug usage.
This release is designed to provide early access to the main findings from these two studies.
Main findings
In 1998 the drugs most commonly used in the Australian community were alcohol, tobacco and marijuana/cannabis. Respectively, 81%, 26% and 18% of people aged 14 years and over had used these drugs in the past 12 months. For both tobacco and marijuana/cannabis, the most used illicit drug, significantly higher proportions of the population (65% and 39% respectively) reported use at some time in the past, not necessarily recent.
Around 60% of people identified either marijuana/cannabis or heroin as the drug primarily associated with a drug 'problem'. Between 1995 and 1998 there was a substantial shift in public perceptions of these drugs, reflected in an increase from 30% to 37% of persons primarily associating heroin with a drug 'problem' and a decline from 32% to 21% of persons identifying marijuana/cannabis. In both years, 14% of persons identified alcohol and around 5% identified tobacco as primarily associated with a drug 'problem'.
In 1998, alcohol (61% of people), tobacco (40%) and marijuana/cannabis (26%) ranked highest as substances whose regular use by adults is considered acceptable. Regular use of other illicit drugs is considered acceptable by much smaller proportions of people, for instance adult regular heroin use is acceptable to 2 per cent of the population. Between 1995 and 1998, the level of acceptance of adult regular use increased for many drugs, including marijuana/cannabis (up from 23% to 26%).
In 1998, 22% of the adult population were regular tobacco smokers, down from 24% in 1995. The highest prevalence of regular smoking in 1998 was among 20-29 year olds (males 31% and females 30%).
Also in 1998, 49% of the population aged 14 years and over regularly consumed alcohol, up from 44% in 1995. Of those that had consumed in the past 12 months, 35% usually did so at hazardous or harmful levels. Over two thirds of 14-19 year olds consumed at hazardous or harmful levels when they drank alcohol.
Based on the 1998 survey results, around 2.7 million people are estimated to have used marijuana/cannabis in the past 12 months, or 18% of the population aged 14 years or more. This figure has increased from 13% in 1995. In the younger age groups-those aged 14-19 years and 20-29 years-the proportion exceeds one third.
Similarly from the 1998 survey, around 113,000 adults living in households are estimated to have used heroin in the past 12 months. Heroin use estimates for individual age groups may not be reliable because of sample error, but the survey suggests that a high proportion of users are in the 20-29 years age group. Prevalence of heroin use among males appears to be roughly double that of females. The estimates also indicate a likely increase in heroin use from 1995 to 1998.
Around 108,000 adults are estimated to have injected drugs in the past 12 months. As for heroin use, age dissections are less reliable, but again, the majority of users appear to be in the 20-29 years age group and there are more males than females.
The use of tobacco, alcohol and illicit drugs produces a significant health burden on the Australian community. In 1997, just over 22,700 deaths were attributable to drug use, representing around 18% of all deaths. Of these, the vast majority were attributable to tobacco use (18,200), with 3,700 attributable to hazardous and harmful alcohol consumption and the remainder (around 800) due to illicit drug use.
In the age group 20-29 years, over 40% of male deaths and over one quarter of female deaths are attributable to the use of tobacco, alcohol or illicit drugs, with the latter two substance groups dominant. Proportions attributable to alcohol and, especially, illicit drugs, decline with age but proportions of deaths attributable to tobacco use peak in the 50-59 years age group, where they account for 26% of male deaths and 15% of female deaths.
Almost 260,000 hospital episodes in 1996-97 were attributable to drug use. As for deaths, the bulk of the burden lies with tobacco use (59% of drug-related hospital episodes), followed by alcohol (37%) and illicit drugs (4%).