Geographic trends
The National Wastewater Drug Monitoring Program (NWDMP) indicates that heroin consumption in Australia is relatively low, but has fluctuated over time. The estimated weight of heroin consumed steadily increased from 750 kilograms in 2017–18 to 1,021 kilograms in 2019–20 before declining to 984 kilograms in 2020–21 (ACIC 2022a; Figure HEROIN2).
Data from Report 17 of the NWDMP show that nationally:
- Heroin consumption in capital cities exceeded consumption in regional areas.
- With consumption in capital cities double, on average, that of regional sites.
- Between December 2021 and April 2022 heroin consumption increased in regional areas and remained relatively stable in capital cities (ACIC 2022b).
For state and territory data, see the National Wastewater Drug Monitoring Program reports.

(a) “Average consumption” refers to estimated population-weighted average consumption.
Note: Report 15 covers 57% of the Australian population (58 wastewater treatment sites), Report 17 covers 56% of the Australian population (57 wastewater treatment sites).
Source: AIHW. Adapted from ACIC 2022a and ACIC 2022b.
Poly drug use
Heroin
Poly drug use is defined as the use of mixing or taking another illicit or licit drug whilst under the influence of another drug. The 2019 NDSHS showed that cannabis (86%) was the most common substance used concurrently with heroin. Other drugs commonly used were tobacco (79%), pharmaceuticals (66%) and alcohol (65% exceeded the single occasion risk guideline at least monthly) (AIHW 2020, Table 1.3).
Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). Monthly data for 2021are currently available for New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory It should be noted that some data for Tasmania and the Australian Capital Territory have been suppressed due to low numbers. Please see the data quality statement for further information.
In 2021, multiple drugs (excluding alcohol) were involved in at least 3 in 10 heroin-related ambulance attendances, ranging from 33% in the Australian Capital Territory to 43% in Queensland (Table S1.10).
For related content on Multiple drug involvement see Impacts: Ambulance attendances.
Harms
For related content on illicit opioid (including heroin) impacts and harms, see also:
Heroin is a central nervous system depressant. Like other opioids, it binds to receptors in the brain, sending signals to block pain and slow breathing.
Heroin may be snorted, swallowed or smoked, but is most commonly melted from a powder or rock form and injected. Injection comes with a range of additional harms associated with the unsanitary sharing of injecting equipment, such as the transmission of blood borne viruses like Hepatitis C and HIV (Table HEROIN1).
Table HEROIN1: Short and long-term effects of heroin use
Short-term effects |
Long-term effects |
- Analgesia
- Cough suppressant
- Euphoria
- Dry mouth
- Heavy feeling in hands and feet
- Nausea and vomiting
- Severe itch
- Drowsiness
- Respiratory depression resulting in fatal and non-fatal overdose, especially when used in conjunction with other sedative substances including benzodiazepines and alcohol
|
- Severe constipation
- Tooth decay (from lack of saliva)
- Irregular menstrual periods in females
- Impotence in males
- Loss of appetite and weight
- Neurochemical changes in the brain
- Memory impairment
- Mental health issues including depression
- Physical dependence and associated withdrawal, which manifest as flu-like symptoms
|
Source: Adapted from ACIC 2019a; Nielsen & Gisev 2017; NSW Ministry of Health 2017.
Burden of disease and injury
The Australian Burden of Disease Study 2018 found that opioid use was responsible for 0.9% of the total burden of disease and injuries in Australia in 2018 and 32% of the total burden due to illicit drug use (Table S2.5).
Most of the burden due to opioid use was due to 2 linked diseases: poisoning and drug use disorders (excluding alcohol). Poisoning contributed to 42%, and drug use disorders (excluding alcohol) to 28%, of the total burden due to opioid use. A further 2.9% of the burden due to opioid use was attributable to suicide and self-inflicted injuries (AIHW 2021b).
Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). Monthly data are presented for 2021 for people aged 15 years and over for New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory. Attendance numbers for Tasmania and the Australian Capital Territory are reported at the total state level due to small numbers in other categories.
In 2021, for heroin-related ambulance attendances in these jurisdictions:
- Rates of attendances ranged from 2.5 per 100,000 population in Tasmania to 45.8 per 100,000 population in the Australian Capital Territory.
In 2021, for heroin-related ambulance attendances in New South Wales Victoria and Queensland:
- 7 in 10 (69%) of attendances were for males.
- Rates of attendance are typically higher in the older age groups. The highest rates of attendances were in people aged 35–44, in:
- Victoria (808 attendances, 86.5 per 100,000 population).
- New South Wales (394 attendances, 35.3 per 100,000 population).
- Queensland (132 attendances, 19.1 per 100,000 population) (Table S1.9).