Australians who live in areas outside Major cities tend to have poorer health outcomes than those living in Major cities (AIHW 2017b). This can be due to lower educational attainment and higher levels of unemployment and poorer access to, and use of, health services. It can also reflect the higher proportion of the population living outside Major cities who are Aboriginal and Torres Strait Islander (AIHW 2017a; Roche & McIntee 2017).

This report identifies trends and differences in alcohol and other drug use, harms and treatment in Major cities and Regional and remote Australia and includes online supplementary interactive maps and tables (those with a prefix of S).

People living in Regional and remote areas of Australia were more likely than people living in Major cities to have consumed alcohol at quantities that placed them at risk of harm from an alcohol-related disease or injury

  • Results from the 2016 National Drug Strategy Household Survey (NDSHS) showed that people aged 14 or older living in Regional and remote areas were significantly more likely than people living in Major cities to:
    •  consume alcohol daily (8.0% compared with 5.0%)
    • drink in excess of the lifetime risk guideline (21% compared with 15.4%) and of the single occasion risk guideline (at least monthly) (29% compared with 24%).

Levels of recent drug use were similar between remoteness areas, however the type of illicit drug used varied

  • People aged 14 or older living in Major cities and in Regional and remote areas had similar levels of drug use in the past 12 months (both 15.6%). However, those in Major cities were significantly more likely than those in Regional and Remote areas to have recently used ecstasy (2.5% compared with 1.5%) and cocaine (3.2% compared with 1.1%).

The burden of drug and alcohol use increases with remoteness

  • Remote and Very remote areas experienced 2.1 and 2.7 times, respectively, the burden of disease attributable to alcohol use, compared with Major cities in 2011.
  • Major cities experienced the highest burden for Illicit drug dependence overall in 2011, compared with other areas. However, the rate of burden due to Illicit drug use increased as remoteness increased, for Suicide and self-inflicted injuries, Chronic liver disease and Road traffic injuries—motor vehicle occupant.
  • Over the past decade, the rate of drug-induced deaths has increased at a faster rate in Regional and remote areas, up 41% since 2008, compared with a 16% increase in Major cities over the same period. As a result, the rate of drug-induced deaths was higher in Regional and remote areas than in Major cities between 2012 and 2016.

Higher rates of alcohol and other drug treatment outside of Major cities

  • In 2016–17, agencies in Regional and remote areas had a higher rate of clients who sought treatment, compared with agencies in Major cities (652 clients per 100,000 population compared with 586 clients per 100,000).
  • Of all remoteness areas, agencies in Remote and very remote areas had the highest rate of clients who sought treatment (1,294 clients per 100,000 population) in 2016–17, despite having the smallest number of clients, and smallest average number of episodes per client.

Clients who sought treatment in Regional and remote areas were more likely than clients in Major cities to travel 1 hour or longer to treatment services

  • In 2016–17, clients who sought treatment in Regional and remote areas travelled 1 hour or longer in 28% of closed treatment episodes, compared with 10% of closed treatment episodes in Major cities. This varied by principal drug of concern and main treatment type.