Older people’s experiences of alcohol and other drugs

Introduction

Older people make up a considerable proportion of Australia’s population. In 2021, over 1 in 6 people were aged 65 and over and the number and proportion of older people in Australia is expected to continue to grow (ABS 2022, AIHW 2024c). Older people have unique health circumstances including pain, co-morbidities, and social circumstances such as isolation (Department of Health 2017). These factors are important to consider in the context of alcohol and other drug use. 

This page focuses on alcohol and other drug use, harms and treatment among older people in Australia. The reporting uses data from a range of sources, mostly national administrative and survey data. 

What data sources are available?

There are a range of data sources that contain information about alcohol and other drug use harms and treatment among older people. These include self-report surveys that ask people about their use of tobacco, alcohol and other drugs, and administrative data sets (such as data routinely collected by hospitals and the National Mortality Database). Each data set uses a different methodology, and the language used to describe older people may also differ across sources. 

For detailed information about each data source, see Technical notes.

What do we know about alcohol and other drug use among older people in Australia?

Tobacco smoking

Data from the 2022–2023 National Drug Strategy Household Survey (NDSHS) showed that the proportion of people in their 50s and 60s who smoke tobacco daily is declining at a much slower rate than that for younger age groups, while for people over 70 it has increased slightly (AIHW 2024b).

How many older people smoke daily?

The 2022–2023 NDSHS reported an ageing cohort of people who smoke tobacco daily. Among people who smoke tobacco daily:

• In 2022–2023, the proportion of people who smoked daily was highest among people aged 50–59 (21%, up from 14.2% in 2001). This is a change from 2001, when people who smoked daily were most likely to be aged 30–39 (25% in 2001, decreasing to 18.7% in 2022–2023).
• Between 2019 and 2022–2023, the proportion of people who smoke daily who were aged in their 50s remained stable at 21%, while for those in their 60s it increased from 12.7% to 16.2% (AIHW 2024b, Table 2.6).

How many cigarettes do older people smoke per day?

Data from the NDSHS showed that people in older age groups (50 and over) tend to smoke more cigarettes than people in younger age groups. In 2022–2023, among people who smoke tobacco:

• People in their 50s (16.5 cigarettes), 60s (17 cigarettes), and aged 70 and over (14.6 cigarettes) smoked the highest number of cigarettes per day on average (AIHW 2024b, Table 2.8).
• People in their 50s (46%), 60s (45%), and aged 70 and over (35%) were the most likely to smoke 20 or more cigarettes per day.

Vaping and e-cigarette use

Older people report lower use of e-cigarettes than people in younger age groups. Data from the 2022–2023 NDSHS showed that:

• 3.2% of people in their 50s reported they currently use e-cigarettes
• 1.6% of people in their 60s reported they currently use e-cigarettes
• *0.4% of people aged 70 and over reported they currently use e-cigarettes (*estimate has a relative standard error of between 25% and 50% and should be used with caution)
• among people aged 14 and over, 7.0% reported they currently use e-cigarettes, (AIHW 2024, Table 3.9).

While e-cigarette use among older people is uncommon, people who reported currently smoking combustible cigarettes were more likely to report current use of e-cigarettes. The 2022–2023 NDSHS found that: 

• 1 in 10 (10.4%) people aged 50–59 who reported they currently smoke also currently use e-cigarettes, while 2.0% of those who do not currently smoke use e-cigarettes.
• 1 in 16 (6.2%) of people aged 60–69 who reported they currently smoke also currently use e-cigarettes, compared with 1.0% of those who do not currently smoke.
• Among people aged 14 and over who currently smoke, 1 in 5 (22%) reported they also currently use e-cigarettes (AIHW 2024, Table 3.3).

Alcohol use

Data from the 2022–2023 NDSHS indicated that:

• A higher proportion of people in older age groups have given up alcohol, compared with younger people.
  • In 2022–2023, people in their 50s (8.7%), 60s (10.5%), and those aged 70 and over (15.5%) were more likely to be ex-drinkers than were people aged 14 and over (8.2%).
• People in older age groups who do consume alcohol are more likely to drink daily (AIHW 2024b, Table 4.4).

How many older people drink daily?

Estimates from the NDSHS show that the proportion of people who drink daily increases with age. In 2022–2023:

• People aged 70 and over continued to be the most likely to drink daily (11.7%), followed by people in their 60s (8.5%) and 50s (6.5%).
• A higher proportion of males than females were daily drinkers for people in their 50s (8.3% compared with 4.7%), 60s (11.2% and 6%), and aged 70 and over (15.3% and 8.5%) (AIHW 2024b, Table 4.4).

How many older people drink at risky levels?

The proportion of people in older age groups who exceed the guidelines for alcohol varies according to age (AIHW 2024b). Estimates from the NDSHS show that, in 2022–2023:

• around 1 in 3 people in their 50s (32%) and 60s (33%) drank alcohol at risky levels, compared with 1 in 4 (25%) of those aged 70 and over (AIHW 2024b; Figure 1). This is similar to most other age groups, but higher than people aged 14–17 (5.5%) and lower than those aged 18–24 (42%)
• males aged 50 and over were more likely to drink at risky levels than females (AIHW 2024b, Table 4.28).

People in older age groups (50 and over) are less likely to have consumed 11 or more standard drinks in a single day at least once in the past 12 months than the general population (AIHW 2024b).

Estimates from the NDSHS show that, in 2022–2023: 

• people in their 50s (12%), 60s (6.2%) and aged 70 and over (3.5%) were less likely to have consumed 11 or more standard drinks in a single day at least once a year than all other adults aged 18 and over
• the proportion of people in older age groups (50 and over) who consumed alcohol at these levels at least yearly and at least monthly has remained stable from 2019 to 2022–2023 (AIHW 2024b, Table 4.32).

Illicit drug use

Use of illicit drugs is generally lower among older people than people in other age groups. However, data from the 2022–2023 NDSHS showed that the age distribution of people who have used drugs in the past 12 months has shifted over time, indicating that there is an ageing cohort of people who use illicit drugs (AIHW 2024b). In 2001, 6.1% of people who had recently used an illicit drug were in their 50s and 4.4% were aged 60 and over. In 2022–2023, this increased to 11.3% and 11.6%, respectively (AIHW 2024b, Table 5.12).

Additionally:

• The proportion of people aged 60 and over who had used illicit drugs in their lifetime increased significantly between 2019 (29%) to 2022–2023 (34%). There were significant increases for both males (from 34% to 39%) and females (24% to 30%) (AIHW 2024b, Table 5.4).
• Between 2001 and 2022–2023, recent use of any illicit drug has doubled among people in their 50s (from 6.7% to 13.6%), with similar increases among both males (from 8.1% to 16.1%) and females (5.2% and 11%) (AIHW 2024b, Table 5.8).
• Recent illicit drug use has also increased among those aged 60 and over, from 3.9% in 2001 to 7.8% in 2022–2023 (AIHW 2024b, Table 5.8).
• The difference in the proportion of recent illicit drug use between people in older age groups (50 and over) and the general population (14 and over) continues to decrease (Figure 2).

Cannabis

People in older age groups continue to be less likely to use cannabis than the general population aged 14 and over (AIHW 2024b). However, cannabis is the most commonly used illicit drug by older people and recent use of cannabis has increased over time. Specifically, the 2022–2023 NDSHS showed that:

• Recent use of cannabis has been increasing since 2001 among people in their 50s and those aged 60 and over (Figure 2).
• Between 2019 and 2022–2023, recent use of cannabis increased among those aged 60 and over (2.9% to 3.6%) (AIHW 2024b, Table 5.50).
• Older people are more likely to use cannabis for medical purposes than people in younger age groups, with 39% of people who had recently used cannabis for medical purposes only being aged 50 and over compared with 18% of people who used cannabis for other reasons (AIHW 2024b, Table 8.5).

Non-medical use of pharmaceuticals

Similar to cannabis, non-medical use of pharmaceutical drugs is generally lower among older age groups than the general population aged 14 and over. However, pharmaceuticals are the second most common drug used by older people. 

• In 2022–2023, 4.0% of people in their 50s and 3.7% of those aged 60 and over reported recent use of a pharmaceutical for non-medical purposes, compared with 5.3% of all people aged 14 and over (AIHW 2024b, Table 6.3). 
• In 2022–2023, recent non-medical use of pain-killers/pain relievers and opioids among people aged 50 and over was 2.1% compared with 2.2% of all people aged 14 and over (AIHW 2024b, Table 6.9). 
• In 2022–2023, recent non-medical use of pharmaceutical stimulants among people aged 50 and over was 0.6% compared with 2.1% of all people aged 14 and over (AIHW 2024b, Table 6.19).

Data from the Australian Government’s Pharmaceutical Benefits Scheme (PBS) indicate that older people are dispensed certain medicines (opioids, benzodiazepines and gabapentinoids) at higher rates than younger people. For detailed information by drug type and age group, see Availability of prescription opioids, benzodiazepines and gabapentinoids in Australia.

What do we know about health and harms for older people who use alcohol and other drugs?

Burden of disease

The Australian Burden of Disease Study found that tobacco use was one of the leading risk factors contributing to the burden of disease for older Australians in 2024. Specifically, tobacco use was the leading risk factor for females aged 55–64 and 65–84 and second highest risk factor for males aged 55–64 and 65–84 (AIHW 2024a).

In 2024, tobacco use contributed: 

• 10.5% of the total burden of disease among people aged 55–64
• 12% of the total burden of disease among people aged 65–84 (AIHW 2024a).

Alcohol and other drug-related hospitalisations

People in older age groups have typically accounted for a lower number of drug-related hospitalisations than people in middle-aged and younger age groups. However, there has been a recent shift in the age profile of drug-related hospitalisations. Between 2003–04 to 2022–23:

• There was an increase in the proportion of drug-related hospitalisations among people aged 50–59 (from 6.8% to 9.6% of all hospitalisations), 60–69 (from 2.4% to 4.4%), and 70 and over (from 2.6% to 3.7%).
• By contrast, the proportion of drug-related hospitalisations decreased for people aged 20–29 (from 30% to 26%).
• The rate of all opioid-related hospitalisations among people aged 60–69 increased from 7.7 to 19 per 100,000 population, though this has declined since 2018–19 (31 per 100,000).
• The rate of all opioid-related hospitalisations among people aged 70 and over increased from 6.8 to 15 per 100,000 population, though this has declined since 2018–19 (20 per 100,000) (Chrzanowska et al. 2025a).

Deaths involving alcohol and other drugs

Deaths due to harmful alcohol consumption

Most deaths involving alcohol occur among people aged 45 and over, and these deaths are primarily due to the chronic effects of alcohol. Preliminary data from the ABS indicate that 3 in 5 (60% or 1,055 deaths) alcohol-induced deaths in 2024 occurred among people aged 55 years and over (ABS 2025, Table 13.12). Among these deaths:

• over 9 in 10 (94% or 991 deaths) were due to chronic conditions such as alcoholic liver cirrhosis
• over 3 in 4 (77% or 815 deaths) occurred among males
• people aged 55–64 had the highest age-specific death rate (16.3 deaths per 100,000 population, compared with 11.8 per 100,000 for people aged 65 and over) (ABS 2025, Tables 13.12 & 13.16).

AIHW analysis of the National Mortality Database (NMD) indicates that over 2 in 3 (68% or 3,426) alcohol-related deaths in 2024 were among people aged 50 and over (Table NMD1). The highest rate of alcohol-related deaths was for people aged 55–59 (614 deaths, or 40.0 per 100,000 people).

Drug-induced deaths

The age profile of drug-induced deaths has shifted since the early 2000s, when deaths most often occurred among young and middle-aged adults (Chrzanowska et al. 2025b). Drug-induced deaths have since risen among people in older age groups.

Preliminary data from the ABS indicate that just under 1 in 3 (31% or 594 deaths) drug-induced deaths in 2024 occurred among people aged 55 years and over (ABS 2025, Table 13.2). Among these deaths:

• 3 in 5 (60% or 357 deaths) were among males
• more than half (56% or 334 deaths) were accidental, while around 1 in 3 (32% or 189) were intentional
• almost half (47% or 189) of all intentional deaths were among people aged 55 and over (ABS 2025, Tables 13.2–13.4). 

AIHW analysis of the NMD shows that in 2024, the most common psychosocial risk factor among people aged 65 years and over was limitation of activities due to disability (16% of drug-induced deaths in this age group) (Table NMD12).

How many older people intend to quit smoking or receive treatment for alcohol and other drug use?

Intentions to quit smoking

Estimates from the NDSHS showed that people in older age groups are the least likely to have intentions to quit smoking (AIHW 2024b). In 2022–2023:

• The proportion of people who currently smoke who were not planning on quitting smoking was higher among people in their 50s (38%), 60s (41%), and aged 70 and over (57%) compared with all people who currently smoke (33%) (AIHW 2024b, Table 2.40).
• The main reason that people in older age groups did not intend to quit was because they enjoy smoking (ranging from 59% for people in their 50s to 70% for those aged 70 and over). This was consistent with other age groups (AIHW 2024b, Table 2.42).

Smoking and alcohol cessation medicines

The PBS database includes information about medicines that are used to help people stop their smoking or alcohol consumption (smoking and alcohol cessation medicines). 

Data from the PBS indicate that rates of dispensing for alcohol cessation medicines are generally highest among people in their 40s and 50s, while for smoking cessation medicines (excluding over-the-counter medicines) dispensing rates are highest among those in their 50s and 60s (tables PBS66, PBS68, PBS82 and PBS84). In 2024–25:

• People aged 50–59 and 60–69 had the highest rates of patients and smoking cessation medicine scripts dispensed. Males in these age groups had the highest patient rate (around 1,400 per 100,000 for both groups) of any group, while males aged 60–69 had the highest rate of scripts dispensed (around 3,300 scripts per 100,000) of any group.
• People aged 40–49 and 50–59 had the highest rates of patients and alcohol cessation scripts dispensed. Males in these age groups had the highest patient rate (around 470 patients per 100,000 for males aged 40–49 and around 430 patients per 100,000 for males aged 50–59) and rate of scripts dispensed (around 1,200 scripts per 100,000 population for both groups) of any group (tables PBS66, PBS68, PBS82 and PBS84).

Between 2012–13 and 2024–25:

• Rates of alcohol cessation medicine scripts dispensed and patients who received a supply of an alcohol cessation medicine broadly increased across the period for people in older age groups (tables PBS66, PBS68, PBS82 and PBS84).
• Rates of dispensing for smoking cessation medicine scripts decreased over time for most age groups but remained overall stable among people in their 60s and overall increased among people in their 70s and 80s. Patient rates overall decreased for all age groups except for those in their 80s, where patient rates overall increased. This may be due to factors including a corresponding decrease in rates of smoking among the general population and disruptions to the global distribution of Varenicline in 2021 (AIHW 2024, TGA 2021).

Specialist alcohol and other drug treatment

Health administrative data indicate that an ageing cohort of people in Australia receiving drug and alcohol treatment has emerged over the past decade. 

In 2023–24, among clients aged 50–59 and 60 and over who received treatment for their own alcohol or drug use:

• Around 3 in 5 were male (61% of clients aged 50–59 and 60% of those aged 60 and over) (AIHW 2025, Table SC.4).
• Alcohol was the most common principal drug of concern (61% of clients aged 50–59 and 75% of clients aged 60 and over), followed by amphetamines (16% and 5.1%, respectively) (AIHW 2025, Table SC.10).

Opioid pharmacotherapy treatment

Data from the National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection indicate that the median age of clients who received opioid pharmacotherapy treatment has increased from 38 years in 2011 to 46 in 2025 (AIHW 2026b, Table S5). On a snapshot day in 2025, nearly 2 in 5 (38%) clients who received opioid pharmacotherapy treatment were aged either 50–59 (24% of clients) or 60 and over (14%), up from 16% in 2011 (15% aged 50–59 and 1.4% aged 60 and over). Methadone was the most common opioid pharmacotherapy treatment for clients aged 50 and over, whereas younger clients aged in their 30s and under were more likely to receive a buprenorphine formulation (AIHW 2026b, Table S6).

Where do I go for more information?

• Alcohol and other drug treatment services in Australia
• Older people’s use of alcohol, tobacco, e-cigarettes and other drugs