Illicit drug use affects individuals, families and the broader Australian community. These harms are numerous and include:

  • health impacts such as burden of disease, death, overdose and hospitalisation
  • social impacts such as violence, crime and trauma
  • economic impacts such as the cost of health care and law enforcement.

Some specific population groups are at greater risk of experiencing disproportionate harms associated with illicit drug use, including young people, people with mental health conditions and people who are gay, lesbian, bisexual, transgender or intersex (Department of Health 2017).

Definition of illicit drug use

Illicit use of drugs covers the use of a broad range of substances, including:

  • illegal drugs – drugs prohibited from manufacture, sale or possession in Australia, including cocaine, heroin and amphetamine-type stimulants
  • pharmaceuticals – drugs available from a pharmacy, over-the-counter or by prescription, which may be subject to non-medical use (when used for purposes, or in quantities, other than for the medical purposes for which they were prescribed). Examples include opioid-based pain relief medications, opioid substitution therapies, benzodiazepines, steroids, and over-the-counter codeine (not available since 1 February 2018)
  • other psychoactive substances – legal or illegal, used in a potentially harmful way – for example, synthetic cannabis and other synthetic drugs; inhalants such as petrol, paint or glue (Department of Health 2021).

Each data collection cited on this page uses a slightly different definition of illicit drug use; see the relevant report for information.

How common is illicit drug use?

According to the 2019 National Drug Strategy Household Survey (NDSHS), an estimated 9.0 million (43%) people aged 14 and over in Australia had illicitly used a drug at some point in their lifetime (including the non-medical use of pharmaceuticals), and an estimated 3.4 million (16.4%) had used an illicit drug in the previous 12 months. This was similar to proportions in 2016 (43% and 15.6%, respectively) but has increased since 2007 (38% and 13.4%, respectively) (Figure 1).

In 2019, the most common illicit drug used in the previous 12 months was cannabis (11.6%),  followed by cocaine (4.2%) and ecstasy (3.0%) (Figure 1). A number of changes were reported in the recent use of illicit drugs between 2016 and 2019, including increases in the use of:

  • cannabis (from 10.4% to 11.6%)
  • cocaine (from 2.5% to 4.2%)
  • ecstasy (from 2.2% to 3.0%)  
  • hallucinogens (from 1.0% to 1.6%)
  • inhalants (from 1.0% to 1.4%)
  • ketamine (from 0.4% to 0.9%) (Figure 1) (AIHW 2020).

Overall, in 2019, an estimated 900,000 people (4.2%) aged 14 and over used a pharmaceutical drug for non-medical purposes in the previous 12 months, a decline from 4.8% (an estimated one million people) in 2016 (AIHW 2020). Between 2016 and 2019, the proportion of people using ‘pain-killers and opioids’ for non-medical purposes declined from 3.6% to 2.7%. This decline is most likely due to a reclassification of medications containing codeine that was implemented in 2018. Under the change, drugs with codeine (including some painkillers) can no longer be bought from a pharmacy without a prescription. The proportion of people using codeine for non-medical purposes has halved since 2016, from 3.0% to 1.5% in 2019.

In 2016, pain-killers and opioids used for non-medical purposes were the second most commonly used illicit drug in the previous 12 months after cannabis, but in 2019, they were fourth, after cannabis, cocaine and ecstasy (AIHW 2020).

Due to the changes in the recent use of a number of illicit drugs between 2016 and 2019, meth/amphetamines are no longer in the top 5 illicit drugs most likely to be used in the previous 12 months. Meth/amphetamine use has been declining since it peaked at 3.4% in 2001 and stabilised in 2019 (1.4% in 2016 and 1.3% in 2019).

To better understand illicit drug use in Australia, it is important to consider the frequency of drug use and not just the proportion of people who have used a drug in the previous 12 months. Some drugs are used more often than others, and the health risks of illicit drug use increase with the frequency, type, and quantity of drugs used (Degenhardt et al. 2013). While cocaine and ecstasy were used by more people in the previous 12 months, most people used these drugs infrequently with 57% of people who used cocaine and 51% of people who used ecstasy reporting they only used the drug once or twice a year in the 2019 NDSHS. Conversely, monthly or more frequent drug use was more commonly reported among people who had used cannabis (50%) or meth/amphetamines (33%).

Figure 1: Proportion of people aged 14 and over who recently used selected illicit drugs, 2001 to 2019

The graph shows the percent of people aged 14 and over who had recently used selected illicit drugs between 2001 and 2019. The chart shows a declining trend from 2001 to 2007, in the recent use of any illicit drug (from 16.7% to 13.4%), the main driver for this is cannabis use (from 12.9% to 9.1%) which shares a similar trend. All other illicit drugs reported show similar trends yet have been always below 5%, hence not significant contributors overall.

Health impact

Deaths

Drug-induced deaths are defined as those that can be directly attributable to drug use and includes both those due to acute toxicity (for example, drug overdose) and those due to chronic use (for example, drug-induced cardiac conditions) as determined by toxicology and pathology reports (see glossary).

The 2022 data on causes of death have been updated in this release sourced from the ABS (2023a). Additional analysis undertaken by AIHW and NDARC will be updated in early 2024.

The ABS preliminary data on causes of death show that of the 1,693 drug-induced deaths in 2022:

  • The age-standardised rate of 6.5 deaths per 100.000 was the fifth consecutive decrease since 2017 (8.2 deaths per 100,000).
  • 64% were males (1,082 deaths) and 36% were females (611 deaths). 
  • The median age at death was higher for females than males (50.0 and 45.4 years, respectively).

Over two-thirds (69%) were considered accidental (1,175 deaths) and 24% (402 deaths) were considered intentional (ABS 2023a).

Analysis of the AIHW National Mortality Database (Figure 2) showed that in 2021:

  • Opioids continue to be the most common drug class present in drug-induced deaths over the past decade (3.8 per 100,000 population in 2021). Opioids include the use of a number of drug types, including heroin, opiate-based analgesics (such as codeine and oxycodone) and synthetic opioid prescriptions (such as tramadol and fentanyl). 
  • Benzodiazepines were the most common single drug type present in drug-induced deaths (2.9 per 100,000 population) (benzodiazepines are included in the drug class ‘depressants’).
  • Over the past decade there has been a substantial rise in deaths involving psychostimulants. The rate has increased from 0.7 per 100,000 population (163 deaths) in 2012 to 1.8 (431 deaths) in 2021.

Figure 2: Drug-induced deaths, by selected drug type and drug class and rate, 1997 to 2021

The graph shows the rate of drug-induced deaths by drug class from 1997 to 2021, including antidepressants, depressants, antipsychotics, non-opioid analgesics and opioids. The chart shows the rate of drug-induced deaths declined between 1999 and 2002 (9.1 to 4.8 deaths per 100,000 population). This decrease was largely driven by a fall in drug-induced deaths where an opioid was present (6.5 to 2.6 deaths per 100,000 population). Since 2006, the rate of drug-induced deaths has started to increase, this increase is primarily driven by opioids, depressants and antidepressants.

Burden of disease

According to the Australian Burden of Disease Study 2018, illicit drug use contributed to 3% of the total burden of disease and injury in 2018 (AIHW 2022). This included the impact of opioids, amphetamines, cocaine, cannabis and other illicit drug use, as well as unsafe injecting practices. The rate of total burden of disease and injury attributable to illicit drug use increased by 35% between 2003 and 2018 (AIHW 2022).

Opioid use accounted for the largest proportion (31%) of the illicit drug use burden, followed by amphetamine (24%), unsafe injecting practices (18%), cocaine (11%) and cannabis (10%) use. Illicit drug use was responsible for almost all burden due to drug use and disorders (excluding alcohol) (AIHW 2022). For more information, see Burden of disease.

Hospitalisations

In 2021–22, hospitalisations with a drug-related principal diagnosis accounted for 1.3% of all hospitalisations (135,000). Amphetamines and other stimulants accounted for 9.0% (12,200) of drug-related hospitalisations and most of these related to methamphetamines (82% or 10,100).

In 2021–22, drug-related hospitalisations for:

  • Amphetamines and other stimulants decreased to 47 hospitalisations per 100,000 people from 59 hospitalisations per 100,000 people in 2020–21.
  • Opioids decreased to 23 hospitalisations per 100,000 people from 26 hospitalisations per 100,000 people in 2020–21 (Figure 3).

Non-opioid analgesics saw a decrease from 32 hospitalisations per 100,000 people in 2020–21 to 28 hospitalisations per 100,000 people in 2021–22.

For information on drug-related hospitalisations where alcohol was the drug, see Alcohol.

Figure 3: Hospitalisations by selected drug-related principal diagnosis, number and crude rate, 2015–16 to 2021–22

The graph shows the rate of hospitalisations by drug of concern between 2015­­–16 and 2021–22. This includes amphetamines and other stimulants, antiepileptic, sedative-hypnotic and antiparkinsonism drugs, antipsychotics and neuroleptics, cannabinoids, cocaine, non-opioid analgesics, opioids. The chart shows that the rate of drug-related hospitalisations for amphetamines and other stimulants has decreased since 2015–16. All other rates of hospitalisations have remained fairly stable since 201516. 

Ambulance attendances

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). Monthly data are available from 2021 for people aged 15 years and over for New South Wales, Victoria, Queensland, Tasmania, and the Australian Capital Territory. Monthly data for Northern Territory are available from 2022.

Across reporting jurisdictions:

  • The highest number and rate of ambulance attendances for illicit drugs were for cannabis, amphetamines (any) and heroin.
  • 'Any type of pharmaceutical drug’ required a higher rate of transport to hospital than other drugs, ranging from 85% of attendances in the Australian Capital Territory to 92% of attendances in Queensland.
  • The highest proportion of ambulance attendances where police co-attended involved Amphetamines (any). This was less likely where a pharmaceutical drug was involved.

Over half (55%) of any pharmaceutical drug-related attendances involved at least one other drug (excluding alcohol) (AIHW 2023b).

Non-fatal overdose

Data from the 2023 Illicit Drug Reporting System (IDRS) and Ecstasy and related Drugs Reporting System (EDRS) include rates of self-reported overdose. In 2023:

  • 1 in 10 (11%) IDRS participants reported a non-fatal opioid overdose in the past 12 months (Sutherland et al. 2023b).
  • 1 in 7 (15%) EDRS participants reported experiencing a non-fatal stimulant overdose in the past 12 months; this was stable relative to 2020 (18%) (Sutherland et al. 2023a).

Treatment

Amphetamines were the most common principal illicit drug of concern in 2021–22. The Alcohol and other drug treatment services in Australia annual report for 2021–22 reported that amphetamines accounted for 24% of treatment episodes, followed by cannabis at 19% then heroin at 4.5% (AIHW 2023a).

Between 2012–13 and 2021–22, treatment episodes for amphetamines as a principal drug of concern increased from 22,300 to 49,700 and increased for cannabis from 36,600 to 40,200 episodes (AIHW 2023a).

For more information, see Alcohol and other drug treatment services.

Social impact

The social impacts of illicit drug use are pervasive and include criminal activity, engagement with the criminal justice system and victimisation. For example:

  • Just under 2 in 5 participants of the 2023 IDRS (38%) and 2023 EDRS (35%) reported participating in criminal activities. The most common criminal activities were property crime and selling drugs for cash profit (Sutherland et al. 2023a, 2023b).
  • In 2019, 1 in 10 (10.5%) people aged 14 and over had been a victim of an illicit drug-related incident (experiencing verbal abuse, physical abuse or being put in fear) in the previous 12 months, an increase from 9.2% in 2016 (AIHW 2020).
  • In 2020–21, almost one-quarter of victims (23%) and 9% of offenders had consumed illicit drugs or non-therapeutic levels of pharmaceutical drugs before a homicide incident (Bricknell 2023). 

Priority populations

The National Drug Strategy 2017–2026 specifies priority populations who have a high risk of experiencing direct and indirect harm as a result of drug use, including young people, people with mental health conditions and people who are gay, lesbian, bisexual, transgender or intersex (Department of Health 2017).

Young people

Young people are susceptible to permanent damage from alcohol and other drug use as their brains are still developing, which makes them a vulnerable population (Department of Health 2017).

Young people (aged 14–29) in 2019 were less likely to have used an illicit drug in the previous 12 months than young people in 2001 – with a particularly large difference seen among teenagers and people in their 20s. For example, in 2001, 28% of 14–19 year olds had used an illicit drug in the previous 12 months, but by 2019, this was 16% (AIHW 2020).

In 2019, people aged 20–29 were the most likely to have used an illicit drug in the previous 12 months (31%), a similar proportion to 2016 (28%). There have been significant changes in the types of drugs used by people in their 20s. Ecstasy use among people in their 20s declined from 12.0% in 2004 to 7.0% in 2016 then rose again to 9.8% in 2019. This was the first time an increase was reported in ecstasy use for people in this age group in over a decade, with use returning to a similar level reported in 2001 (10.4%) (Figure 4). Cocaine use among people in their 20s was at its highest level in 2019. Much of the rise in cocaine use among people in this age group occurred between 2016 and 2019 – from 4.3% in 2001 to 6.9% in 2016 and up to 12.0% in 2019. On the other hand, use of methamphetamines among people in their 20s is at its lowest level since 2001 (declined from 11.2% in 2001 to 2.4% in 2019) (AIHW 2020).

For more information, see Health of young people.

Figure 4: Proportion of people aged 20–29 who recently use ecstasy, cocaine, or meth/amphetamine, 2001 to 2019

The graph shows the proportion of people aged 20–29 that recently used cocaine, ecstasy and meth/amphetamine between 2001 and 2019. The chart shows a decline in recent ecstasy use by people aged 20–29 between 2007 and 2016 (from 11.2% to 7.0%) and an increase in 2019 (9.8%). Recent cocaine use by people aged 20–29 was highest in 2019, the largest increase was between 2016 and 2019 (from 6.9% to 12.0%). Recent meth/amphetamine use by people aged 20–29 was at its lowest in 2019, declining from a peak of 11.2% in 2001 to 2.4% in 2019.

People with mental health conditions

The presence of a mental health condition may lead to a drug use disorder, or vice versa. In some cases where there is a comorbidity, the person who uses drugs can develop a drug use disorder as a consequence of repeated use to relieve or cope with mental health symptoms (Marel et al. 2016).

The ABS National study of mental health and wellbeing reports 12-month mental disorders as the number of people who met the diagnostic criteria for a mental disorder at some time in their life and had sufficient symptoms of that disorder in the previous 12 months. The 2020–2022 study found:

  • 3.3% of Australians (647,900 people) aged 16–85 years had symptoms of a 12-month Substance Use disorder.
  • 4.4% of males reported a 12-month Substance Use disorder, compared with 2.1% of females (ABS 2023b).

In 2019, the NDSHS showed that the proportion of people self-reporting a mental health condition was higher among people aged 18 and over who reported the use of illicit drugs in the previous 12 months (26%) than those who had not used an illicit drug over this period (15.2%) (AIHW 2020). For example, mental health conditions were reported by:

  • 31% of people who recently used meth/amphetamines (compared with 16.6% of non-users)
  • 27% of people who recently used cannabis (compared with 15.4% of non-users)
  • 22% of people who recently used ecstasy (compared with 16.7% of non-users)
  • 22% of people who recently used cocaine (compared with 16.6% of non-users) (AIHW 2020).

Just over half of the participants in the 2023 IDRS (53%) and 2023 EDRS (58%) self-reported mental health conditions in the previous 6 months. The IDRS saw an increase from 2022 (47%) and the EDRS was stable relative to 2022 (62%) (Sutherland et al. 2023a, 2023b). For more information, see Physical health of people with mental illness.

Lesbian, gay, bisexual, transgender, intersex or queer people

People who are lesbian, gay, bisexual, transgender, intersex or queer can be at an increased risk of licit and illicit drug use. These risks can be increased by a number of issues such as stigma and discrimination, familial issues, fear of discrimination and fear of identification (Department of Health 2017). The NDSHS provides substance use estimates by sexual identity for people who are gay, lesbian or bisexual, however it does not include estimates for people identifying as transgender or intersex (AIHW 2020).

The NDSHS has consistently shown that the proportion of people reporting illicit drug use has been higher among people who are gay, lesbian or bisexual than among heterosexual people – 40% compared with 15.4%, had used an illicit drug in the previous 12 months in 2019. After adjusting for differences in age, in comparison to heterosexual people, gay, lesbian or bisexual people were:

  • 9.0 times as likely to use inhalants in the previous 12 months
  • 3.9 times as likely to have used meth/amphetamines in the previous 12 months
  • 2.6 times as likely to have used ecstasy in the previous 12 months (AIHW 2020).

The types of illicit drugs people had used in the last 12 months varied quite considerably by a person’s sexual orientation and it is important to note that there are differences in substance use between people who identified as gay or lesbian and people who identified as bisexual (AIHW 2020). 

The Writing Themselves In National Report describes findings from the national survey of health and wellbeing among lesbian, gay, bisexual, trans, queer, asexual (LBGTQA+) young people in Australia. The survey was conducted from September to October 2019 and participants needed to be aged between 14 and 21 years. The survey shows that in the previous 6 months:

  • 27% of participants aged 14 to 17 years and 43% of participants aged 18 to 21 years reported using any drug for non-medical purposes
  • 28% of participants reported using cannabis
  • 7.0% of participants reported using ecstasy/MDMA (Hill et al. 2022a).

The Private Lives survey is Australia’s largest national survey of the health and wellbeing of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people, with the age of participants ranging from 18 to 88 years. The survey showed that 44% of participants reported using one or more drugs for non-medical purposes in the previous 6 months. Of this, cannabis was the highest at 30%, followed by Ecstasy/MDMA at 13.9%. 

Within the past 6 months, 14.0% of participants reported experiencing a time when they had struggled to manage their drug use or where it negatively impacted their everyday life (Hill et al. 2022b).

Where do I go for more information?

For more information on illicit drug use, see:

For more on this topic, see Illicit use of drugs.