Alcohol, tobacco & other drugs in Australia

Key findings

View the Meth/amphetamine and other stimulants in Australia fact sheet >

Stimulants are a group of drugs that produce stimulatory effects by increasing nerve transmission in the brain and body (Nielsen & Gisev 2017). Included in this group are:

• Amphetamines used for therapeutic purposes to treat attention deficit-hyperactivity disorder (ADHD), but may also be used non-medically.
• Methamphetamine (also referred to as methylamphetamine) – a potent derivative of amphetamine that is commonly found in 3 forms: powder (speed), base and its most potent form, crystalline (ice or crystal). Due to small structural differences, methamphetamine produces a stronger nervous system response than amphetamine (ACIC 2019).
• 3, 4-methylenedioxymethamphetamine (MDMA) – commonly referred to as ‘ecstasy’ –  is an amphetamine derivative. (Note ecstasy may contain a range of other drugs and substances and may contain no MDMA at all).
• Cocaine – produced from a naturally occurring alkaloid found in the coca plant.

The focus in this section is on the illicit use of meth/amphetamine and other stimulants (Box STIM1).

Availability

People who regularly use illicit drugs report that methamphetamine and other stimulants are easy to obtain in Australia.

Findings from the Illicit Drug Reporting System (IDRS) show that people who inject drugs commonly report it is ‘easy’ or ‘very easy’ to obtain methamphetamine and other stimulants. Specifically in 2023:

• Over 9 in 10 (94%) people who had recently used crystal methamphetamine reported that it was ‘easy’ or ‘very easy’ to obtain (Sutherland et al. 2023b, Figure 15).
• Over 2 in 3 (68%) people who had recently used cocaine reported that it was ‘easy’ or ‘very easy’ to obtain (Sutherland et al. 2023b).

Similarly, data from the 2023 Ecstasy and Related Drugs Reporting System (EDRS) show that most people who use ecstasy and other stimulants report that methamphetamine, ecstasy, and cocaine are ‘easy’ or ‘very easy’ to obtain (Sutherland et al. 2023a). Findings show that:

• Perceived availability was the highest for crystal methamphetamine (95% of participants rated it ‘easy or very easy’ to obtain), a small increase from 2022 (92%). Perceived availability for powder methamphetamine increased to 2023 (68% of participants rated availability as it ‘easy or very easy’ to obtain).
• In 2023 a significant change in the perceived availability of ecstasy in all forms was reported relative to 2022. For capsules 77% of participants rated it ‘easy’ or ‘very easy’ to obtain, an increase from 49% in 2022. Powder forms increased to 63% from 42%, crystal increased to 72% from 42%, and pills to 63% from 48% in 2022.
• Perceived availability of cocaine remained stable relative to 2022; 80% of participants in 2023 who could comment rated it ‘easy’ or ‘very easy’ to obtain.
• The main approach for arranging the purchase of any illicit or non-prescribed drugs by participants in the previous 12 months was face-to-face (72%), an increase from 69% in 2022. Social networking applications (such as Facebook, Wickr, WhatsApp, SnapChat, Grindr, Tinder) were used by 71% of participants, a small decrease from 2022 (73%) (Sutherland et al. 2023a).

Data collection for 2023 took place from April–July for the EDRS and June–July for the IDRS. Changes due to the impacts of COVID-19 resulted in EDRS and IDRS interviews in 2020-2023 being delivered face-to-face as well as via telephone and videoconference. All interviews prior to 2020 were delivered face-to-face, this change in methodology should be considered when comparing data from the 2020–2023 samples relative to previous years.

The Australian Criminal Intelligence Commission (ACIC) collects national illicit drug seizure data annually from federal, state and territory police services, including the number and weight of seizures to inform the Illicit Drug Data Report (IDDR). According to the latest IDDR, in 2020–21, around one-third of national illicit drug seizures (28,503 or 27%) were amphetamine-type stimulants (ATS) (including MDMA). Additionally:

• The number of national ATS seizures has increased by 88% over the last decade, with 28,503 seizures in 2020–21, up from 15,191 in 2011–12.
• In 2020–21, ATS accounted for 15% of the total weight of illicit drugs seized nationally. 
• The total weight of ATS seized nationally has increased 300% over the last decade, from 1,573 kilograms in 2011–12 to 6,287 kilograms in 2020–21 (ACIC 2023a, Figure 8).

Amphetamines accounted for the majority of ATS seizures in 2020–21:

• 25,745 national amphetamines seizures accounted for 90% of the total number of seizures
• 5,892 kilograms accounted for 94% of the weight of seizures (ACIC 2023). 

Nationally, in 2020–21, there were:

• 1,753 amphetamine-type stimulant (excluding MDMA) detections at the Australian border, weighing 5,290 kilograms (ACIC 2023a, Figure 1).
• 1,773 MDMA (ecstasy) detections, weighing 106 kilograms (ACIC 2023a, Figure 2). 
• 2,578 MDMA seizures (9% of total ATS seizures), weighing 249 kilograms (4% of the total weight of ATS seized) (ACIC 2023a).

Over the last decade, cocaine detections at the Australian border increased:

• from 979 detections in 2011–12 to 2,169 detections in 2020–21 (an increase of 122%). 
• The weight of cocaine detected increased by 228%, from 786 kilograms in 2011–12 to a record 2,576 kilograms in 2020–21 (ACIC 2023a, Figure 19).

The number and weight of national cocaine seizures has also increased over the last decade:

• from 1,336 seizures in 2011–12 to a record 6,452 in 2020–21 (a 383% increase).
• The weight of cocaine seized increased over the same period, from 956 kilograms in 2011–12 to 4,421 kilograms in 2020–21 (a 362% increase) (ACIC 2023a, Figure 22).

Research (ACIC 2019) has shown the impact of seizures on consumption—see Supply reduction – Prohibited substances (ACIC 2023a).

Consumption

There are differences in trends and patterns of consumption in Australia according to the type of stimulant used.

Data collection for 2023 took place from April–July for the EDRS and June–July for the IDRS. Due to COVID-19 restrictions being imposed in various jurisdictions during data collection periods for both the IDRS and the EDRS, interviews in 2020, 2021, 2022 and 2023 were delivered face-to-face as well as via telephone. This change in methodology should be considered when comparing data from the 2020–2023 samples relative to previous years.

Meth/amphetamine

• 1.3% of people aged 14 and over in Australia reported using meth/amphetamine in the last 12 months (Figure STIM1).
• 30% of participants in the EDRS reported use of any form of methamphetamine in the previous 6 months, stable relative to 2022 (31%) (Sutherland et al. 2023a). 
• 81% of participants in the IDRS reported use of any form of methamphetamine in the previous 6 months, stable relative to 2022 (81%) (Sutherland et al. 2023b).

Self-reported data on meth/amphetamine consumption in the general Australian population has been declining since it peaked at 3.4% in 2001. There was a substantial decrease in the recent use of meth/amphetamine among people aged 20–29 (from 11.2% in 2001 to 2.4% in 2019), however, there were slight increases for people aged 40 and over (AIHW 2020, Table 4.72). It is possible that self-report surveys underestimate the true extent of meth/amphetamine use, particularly in the context of the stigmas that exist around its consumption (AIHW 2020).

In 2013, ‘crystal/ice’ replaced powder as the main form of meth/amphetamine used in the previous 12 months. In 2019, this trend continued with 50% of people who used meth/amphetamine reporting that crystal/ice was the main form used in the previous 12 months (AIHW 2020). While overall recent meth/amphetamine use declined between 2013 and 2019, the proportion using crystal/ice remained relatively stable (AIHW 2020).

Participants in the EDRS reported a decrease in the use of crystal methamphetamine in the preceding 6 months (29% in 2012 to 18% in 2022) (Sutherland et al. 2022a, Figure 16).

Figure STIM1: Recentᵃ use of meth/amphetamine, cocaine or ecstasy, people aged 14 and over, by age and sex, 2001 to 2019 (per cent)

View data tables >

Ecstasy

The 2019 NDSHS found:

• 3.0% of people aged 14 and over in Australia used ecstasy in the previous 12 months, a significant increase since 2016 (2.2%) (Figure STIM1).
• A higher proportion of males than females reported recent ecstasy use in 2019 (3.9% compared with 2.0%).
• The increase in recent ecstasy use since 2016 was largely driven by a significant increase reported for males (from 2.6% in 2016 to 3.9% in 2019). In particular, there were significant increases for males aged 20–29 (from 7.4% in 2016 to 12.1% in 2019) and 30–39 (from 3.2% in 2016 to 4.9%).
• Between 2007 and 2016, recent use of ecstasy declined from a high of 3.5% in 2007 to 2.2% in 2016. However, in 2019 the proportion for the recent use of ecstasy had returned to the 2010 level (3.0%) (AIHW 2020, Table 4.63).
• There was a significant increase in lifetime use of ecstasy between 2016 (11.2%) and 2019 (12.5%). This was largely driven by significant increases for people aged 40–49 (from 14.8% to 19.4%) and 50 and over (2.4% to 3.2%) (AIHW 2020, Table 4.61).

In 2023 ecstasy and cannabis were the most common reported drug of choice for participants of the EDRS who regularly use ecstasy and other stimulants (Sutherland et al. 2023a, Figure 1). EDRS participants indicated that when the past 6 months was compared with the previous year:

• Ecstasy use was reported by 95% of participants, an increase from 88% of participants in 2022 (Sutherland et al, 2023a).

Cocaine

The 2019 NDSHS found:

• 4.2% of people aged 14 and over in Australia used cocaine in the last 12 months, a significant increase since 2016 (2.5%)
• recent cocaine use in 2019 was higher in males (5.5%) than females (3.0%)
• recent cocaine use increased significantly between 2016 and 2019 across all age groups, except 14–19 year olds
  • the increase in recent use was largely driven by the significant increases reported for males, in particular for males aged 20–29 (from 7.3% to 14.4%) (AIHW 2020, Table 4.56)
• in 2019, the proportion of people who reported recent use of cocaine was at the highest level reported since 2001–in 2019 it was 3 times higher than the level reported in 2001 (1.3% in 2001 compared with 4.2% in 2019 (AIHW 2020, Table 4.56).

There was a significant increase in lifetime use of cocaine between 2016 (9%) and 2019 (11.2%) (AIHW 2020, Table 4.2). This was driven largely by increases for people aged 20–29 (from 13.2% to 19.5%), 40–49 (from 12.0% to 15.3%) and 50 and older (3.4% to 4.3%) (AIHW 2020).

For participants of the EDRS, cocaine was the second most commonly used stimulant drug (after ecstasy) with 81% reporting past 6 months use in 2022, remaining stable relative to 2022 (79%) (Sutherland et al. 2023a).

Geographic trends

Data from the National Wastewater Drug Monitoring Program (NWDMP) show that the population-weighted average consumption of stimulant drugs varies based on drug type and geographic area.

Data from Report 20 of the NWDMP show that methylamphetamine was the second most consumed illicit drug (behind cannabis) both nationally and across each jurisdiction. Specifically:

• In April 2023 consumption of methylamphetamine was higher in capital cites than in regional areas.
• Between December 2022 and April 2023, the population-weighted average consumption of methylamphetamine increased in both capital city and regional sites (ACIC 2023c).
• Methylamphetamine consumption gradually increased between August 2016 to April 2020. A trend then developed with lower consumption in August of each year, followed by increases in consumption in the 2 following reporting periods of April and December (ACIC 2023c). 

The estimated weight of methylamphetamine consumed increased from 8,405 kilograms in 2016–17 to 11,516 kilograms in 2018–19, before declining to 9,018 kilograms in 2021–22 (ACIC 2023b, Figure STIM2).  The total estimated consumption of methylamphetamine increased by 2% between August 2021 and August 2022 (ACIC 2023b).

For state and territory data, see the National Wastewater Drug Monitoring Program reports.

Figure STIM2: Estimated consumption of methylamphetamine in Australia based on detections in wastewater, 2021 to 2023

(a) 'Average consumption' refers to estimated population-weighted average consumption.

Note: Report 20 covers 55% of the Australian population (55 wastewater treatment sites). 

Source: AIHW, adapted from, ACIC 2023b, ACIC 2023c.

MDMA consumption is low across the country, relative to other illicit drugs and has been declining for the past 2 years. The estimated weight of MDMA consumed annually in Australia steadily increased from 1,162 kilograms in 2017–18 to 2,630 kilograms in 2019–20 before decreasing to 723 kilograms in 2021-22 (a 41% decrease from 2020–21) (ACIC 2023b). Data from Report 20 of the NWDMP indicate that nationally:

• In April 2023, the population-weighted average consumption of MDMA in capital cities was higher than in regional areas.
• Between December 2022 and April 2023, the population-weighted average consumption in both capital cities and regional areas decreased (ACIC 2023c).

For state and territory data, see the National Wastewater Drug Monitoring Program reports.

Cocaine consumption in Australia steadily increased from 3,057 kilograms in 2016–17 to 5,675 kilograms in 2019–20, before declining to 3,385 kilograms in 2021-22 (a 28% decrease from 2020–21) (ACIC 2023b). Data from Report 20 of the NWDMP indicates that:

• In April 2023, the population-weighted average consumption of cocaine was higher in regional areas than in capital city areas.
• Between December 2022 and April 2023, consumption decreased in capital cities and increased in regional areas (ACIC 2023c).

For state and territory data, see the National Wastewater Drug Monitoring Program reports.

Data from the 2019 NDSHS showed that:

• There was a significant increase in the proportion of people aged 14 and over who reported recent use of meth/amphetamine in New South Wales between 2016 and 2019 (from 0.7% to 1.1%), while for South Australia, there was a significant decrease (from 1.9% to 1.0%) (AIHW 2020, Table S.38).
• Similar proportions of people living in Major cities, Inner regional and Remote and very remote areas recently used meth/amphetamine in 2019 (1.4%, 1.3% and 1.4%, respectively). A lower proportion (0.8%) of people living in Outer regional areas reported recent use of meth/amphetamine (Figure STIM3). These findings were still apparent after adjusting for differences in age (AIHW 2020, Tables 7.15 and 7.18). Note, the estimate for Remote and very remote areas has a relative standard error of 25% to 50% and should be used with caution.  
• There was little variation in the recent use of meth/amphetamine for those living in the lowest socioeconomic areas compared with those living in the highest socioeconomic areas (1.4% and 1.5%, respectively) (Figure STIM3). This finding was still apparent after adjusting for differences in age (AIHW 2020).
• There were significant increases in the recent use of cocaine between 2016 and 2019 in New South Wales (from 3.4% to 5.0%), Victoria (from 2.5% to 5.2%) and Queensland (from 2.1% to 3.6%) (AIHW 2020, Table S42).
• There were also significant increases in the recent use of ecstasy between 2016 and 2019 in New South Wales (from 1.9% to 3.1%) and Victoria (from 2.4% to 3.7%).
• Cocaine and ecstasy use were higher among those who lived in Major cities or the highest socioeconomic areas (Figure STIM3). These findings were still apparent after adjusting for differences in age (AIHW 2020, Table S36).

Figure STIM3: Recent^a use of meth/amphetamine, cocaine or ecstasy, by remoteness area or socioeconomic area, people aged 14 and over, 2010 to 2019 (percent)

View data tables >

International comparisons

The National Wastewater Drug Monitoring Program (NWDMP) recently examined average stimulant consumption (amphetamine, methylamphetamine, cocaine, and MDMA) in Australia compared with 24 countries across Europe, Oceania and Asia; also included was 1 city in the United States of America. In March-May 2022:

• Australia had the 6^th highest average total stimulant consumption of all included countries at 44 doses per 1,000 people per day, lower than the USA (110 doses per day), Czechia (73 doses), Sweden (68 doses) Belgium (54 doses) and the Netherlands (50 doses).
• Australia had the 3^rd highest average consumption of methylamphetamine (42 doses per 1,000 people per day), lower than the USA (85 doses per day) and Czechia (57 doses).
• Cocaine consumption in Australia ranked 18^th of 27 countries at 4.0 doses, compared with 35 doses for the highest-ranked country (Belgium) and 0.43 doses for the lowest-ranked countries (New Zealand; 0.43 doses and South Korea; 0.01 doses).
• Australia ranked 21^st of 27 reporting countries in MDMA consumption at 1.5 doses per 1,000 people per day, compared with the Netherlands (6.1 doses), New Zealand (4.3 doses) and Portugal (3.6 doses).
• Australia ranked 6^th of 16 reporting countries in cannabis consumption at 120 doses per 1,000 people per day, behind the USA (790 doses), Switzerland (160 doses) and the Netherlands (150 doses).

When examining each drug type as a proportion of total combined stimulant consumption:

• Most stimulant consumption in Australia related to methylamphetamine use, which is similar to New Zealand, Czechia, the USA, South Korea, Latvia, Cyprus and Turkey. Finland, Sweden, Poland and the United Kingdom had higher use of amphetamine and the remaining locations predominantly featured cocaine consumption.
• Average consumption in Australia was proportionally higher for methamphetamine than MDMA, which is consistent with most other countries.
• Cocaine consumption in Australia was proportionally higher than the use of MDMA. This was consistent with most participating countries but was the opposite of New Zealand (where MDMA consumption was higher than cocaine) (ACIC 2023c).

Poly drug use

Poly drug use is defined as the use of mixing or taking another illicit or licit drug whilst under the influence of another drug. In 2019, the NDSHS showed that only 8.1% of people who reported using meth/amphetamine in the last 12 months said they did not use any other illicit drug. The most common other drugs concurrently used were cannabis (78%) and cocaine (57%). More than three-quarters exceeded the alcohol single occasion risk guideline at least monthly (76%) and over half (54%) exceeded the lifetime risk guideline (AIHW 2020, Table 1.3).

People who reported recent use of ecstasy and cocaine also reported concurrent use of cannabis (77% and 69%, respectively) and 8 in 10 exceeded the alcohol single occasion risk guideline at least monthly (83% and 82%, respectively).

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS). Monthly data are currently available for New South Wales, Victoria, Queensland, Tasmania, and the Australian Capital Territory from 2021. 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 2022, the proportion of amphetamine-related ambulance attendances where multiple drugs were involved (excluding alcohol) ranged from 34% of attendances in Queensland to 52% of attendances in Victoria (Table S1.11).

For related content on multiple drug involvement see Impacts: Ambulance attendances.

Harms

The short and long-term effects associated with the use of methamphetamine and other stimulants are provided in Table STIM1.

Source: Adapted from ACIC 2019a; Darke, Kaye & Duflou 2017; NSW Ministry of Health 2017.

Burden of disease and injury

The Australian Burden of Disease Study, 2018, found that amphetamine use was responsible for 0.7% of the total burden of disease and injuries in Australia in 2018 and 24% of the total burden due to illicit drug use (AIHW 2021b) (Table S2.5).

Of the burden due to amphetamine use, drug use disorder (excluding alcohol) contributed 32%, poisoning 17% and suicide and self-inflicted injuries 5.4%. Other contributors to the burden due to amphetamine use included road traffic injuries–motor vehicle occupants and motorcyclists (3.0% each) (AIHW 2021b).

Cocaine use contributed 0.3% of the total burden of disease and injuries in 2018 and 10.9% of the total burden due to illicit drug use (Table S2.5). Of the burden due to cocaine use, suicide and self-inflicted injuries accounted for 6.4% and drug use disorder (excluding alcohol) 10.6% (AIHW 2021b).

Ambulance attendances

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS Monthly data are presented 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 presented from 2022.

For the 6 jurisdictions where amphetamine-related ambulance attendances data are available, in 2022:

• Rates of attendances ranged from 49.0 per 100,000 population in Tasmania to 81.4 per 100,000 population in Queensland.

In New South Wales, Victoria, and Queensland (age and sex disaggregations for Tasmania and the Australian Capital are too small to report):

• Almost 2 in 3 (64%) of total attendances were for males
• The highest rates of attendances were in people aged 25–34:
  • Queensland (1,300 attendances, 178.0 per 100,000 population)
  • Victoria (1,600 attendances, 155.7 per 100,000 population) (Table S1.10).

For the 5 jurisdictions where monthly data from 2021 is available, between 2021 and 2022:

• Rates of amphetamine-related ambulance attendances have decreased across all jurisdictions, with the exception of Queensland and Tasmania. 
• In Queensland and Tasmania, amphetamine-related ambulance attendance rates have increased from 2021 to 2022 (73.5 to 81.4 per 100,000 population in Queensland and 46.9 to 75.9 per 100,000 population in Tasmania).

Figure STIM4: Ambulance attendances for amphetamines (any), cocaine and ecstasy, by age, sex and selected states and territories, 2021 to 2022

Hospitalisations

Drug-related hospitalisations are defined as hospitalisations with a principal diagnosis relating to a substance use disorder or direct harm relating to use of selected substances (AIHW 2018).

AIHW analysis of the National Hospital Morbidity Database (NHMD) showed that, among all drug-related hospitalisations in 2021–22:

• Almost one in 10 were for amphetamines and other stimulants (9.0% or 12,200 hospitalisations). Within this category, over 4 in 5 hospitalisations were for methamphetamine (82% or 10,100 hospitalisations)
• Less than 1% were for cocaine (0.9% or 1,300 hospitalisations) (Table S1.12c).

This is a rate of 39.1 hospitalisations per 100,000 population for methamphetamine and 4.9 per 100,000 for cocaine (Table S1.12c). 

In 2021–22, for methamphetamine-related hospitalisations:

•  7 in 10 hospitalisations involved an overnight stay (70% or 7,000).
• Most hospitalisations involved males (64% or 6,500 hospitalisations).
• Over 2 in 5 were people aged 25–34 (42% or 4,200 hospitalisations) (Table S1.12a–12c).

In 2021–22, for cocaine related hospitalisations:

• Around 2 in 3 ended with a same-day discharge (67% or 840 hospitalisations).
• Most hospitalisations involved males (71% or 900 hospitalisations).
• Almost 3 in 4 were people aged 25–44 (74% or 900 hospitalisations).

In 2021–22, most hospitalisations occurred in Major cities for both methamphetamine (72% or 7,200 hospitalisations) and cocaine (92% or 1,200 hospitalisations) (Table S1.14).

• Accounting for differences in population size, the rates of hospitalisations for methamphetamine were similar in Major cities and Remote and very remote areas (39.2 and 35.3 hospitalisations per 100,000 population, respectively).
• The rate of hospitalisations for cocaine was highest in Major cities (6.3 per 100,000 population, compared with 1.0 and 0.9 per 100,000 in Outer regional and Inner regional areas, respectively) (Table S1.14).

In the 7 years to 2021–22:

• The number of methamphetamine-related hospitalisations increased between 2015–16 (9,300 hospitalisations or 38.8 per 100,000 population) and 2019–20 (14,100 hospitalisations or 55.1 per 100,000), before falling to 10,100 in 2021–22 (39.1 per 100,000).
• The rate of methamphetamine-related hospitalisations increased in Major cities between 2015–16 (38.1 per 100,000) and 2019–20 (52.8 per 100,000), then declined in 2021–22 (39.2 per 100,000).
• The number of cocaine-related hospitalisations steadily increased between 2015–16 (780 hospitalisations or 3.2 per 100,000 population) and 2020–21 (1,800 hospitalisations or 7.0 per 100,000). In 2021–22, hospitalisations returned to pre-pandemic levels (1,300 or 4.9 per 100,000). 
• The rate of cocaine-related hospitalisations has increased in Major cities from 2015–16 (4.2 per 100,000) to 2021–22 (6.3 per 100,000) (Table S1.14; Figure IMPACT4).

The finding for cocaine is consistent with analysis of the NHMD by the National Drug and Alcohol Research Centre (NDARC). This analysis showed that, accounting for population growth and ageing, the rate of cocaine-related hospitalisations increased almost 6-fold between 2010–11 (0.8 per 100,000 population) and 2018–19 (4.5 per 100,000 population). A significant increased was also observed between 2019–20 (4.8 per 100,000 population) and  2020–21 (6.7 per 100,000 population) (Chrzanowska et al. 2022a).

Deaths

Drug-induced deaths are determined by toxicology and pathology reports and are defined as those deaths that can be directly attributable to drug use. This includes deaths due to acute toxicity (for example, drug overdose) and chronic use (for example, drug-induced cardiac conditions) (ABS 2021).

The rate of drug-induced deaths related to methamphetamine and other stimulants has increased rapidly in recent years. 

See also Health impacts: Drug-induced deaths for more information.

• AIHW analysis of the AIHW National Mortality Database shows that the death rate for all psychostimulants (including amphetamines, methamphetamine, ecstasy/MDMA and caffeine) in 2021 was almost 4 times higher than that in 2000 (1.8 deaths compared with 0.5 deaths per 100,000 population, respectively). Over the same period, the rate of drug-induced deaths involving cocaine increased from 0.1 deaths to 0.3 deaths per 100,000 population (Table S1.1).
• Estimates by the National Drug and Alcohol Research Centre (NDARC) showed that, in 2021, there were 451 drug-induced deaths involving amphetamines – a rate of 1.8 deaths per 100,000 people. This is an increase from 104 deaths (0.5 deaths per 100,000) in 2011 (Chrzanowska et al. 2023).
• Recent research examining methamphetamine-related deaths in isolation from other stimulants found that mortality rates have almost doubled during a period of 7 years between 2009 and 2015. The most common manner of methamphetamine-related death was accidental drug toxicity; however, natural disease (e.g. coronary disease, stroke, kidney disease, and liver disease), suicide and accidents comprised more than half of the deaths (Darke, Kaye & Duflou 2017).

Treatment

Amphetamines

In 2021–22, where amphetamines were the principal drug of concern:

• 3 in 5 (61%) of clients were male and 1 in 5 (20%) clients were Indigenous Australians (AIHW 2023, tables SC.9 and SC.11).
• Most clients (58%) were aged 20–39 (AIHW 2023, Table SC.10).
• The most common source of referral for treatment was self/family (37% of treatment episodes), followed by health services (26%) (AIHW 2023, Table Drg.37).
• The most common main treatment type was counselling (38% of treatment episodes), followed by assessment only (23%) (AIHW 2023, Table Drg.36; Figure STIM5).
• Counselling has remained the most common main treatment type across the 10-year period to 2021–22 (AIHW 2023).

Figure STIM5: Treatment provided for own use of amphetamines, 2021–22

Source: AIHW 2023, tables Drg.1, SC.11 and Drg.36.

In 2016–17, where the principal drug of concern was amphetamines, the proportion of people living in Regional and remote areas who travelled 1 hour or longer to treatment services was higher than in Major cities (31% compared with 10%) (AIHW 2019).

Ecstasy

In 2020–21, ecstasy was the principal drug of concern in less than 1% (0.3%) of closed treatment episodes provided for clients’ own drug use (AIHW 2022, Table Drg.5). Treatment episodes for ecstasy remained relatively stable over the 10-year period to 2020–21.

In 2020–21, where ecstasy was the principal drug of concern:

• 2 in 3 (66%) clients were male and 8% were Indigenous Australians (AIHW 2022, tables SC.9 and SC.11).
• Over 4 in 5 (85%) clients were aged 10–29 (AIHW 2022, Table SC.10).
• The most common source of referral was diversion from the criminal justice system (31%) followed by self/family (25%) (AIHW 2022, Table Drg.73).
• The most common main treatment type was counselling (51%), followed by assessment only (17%) (AIHW 2022, Table Drg.72).

Cocaine

In 2020–21, cocaine was the principal drug of concern in 1.1% of closed treatment episodes provided for clients’ own drug use (AIHW 2022, Table Drg.5). The proportion of treatment episodes for cocaine has remained low over the 10-year period to 2020–21, increasing from 0.3% of episodes in 2011–12 (AIHW 2022).

In 2020–21, where cocaine was the principal drug of concern:

• Over 4 in 5 (85%) clients were male and 5.4% were Indigenous Australians (AIHW 2022, tables SC.9 and SC.11).
• 1 in 2 (50%) clients were aged 20–29, and 28% were aged 30–39 (AIHW 2022, Table SC.10).
• The most common source of referral was self or family (37% of closed treatment episodes), followed by health services (24%) (AIHW 2022, Table Drg.82).
• Counselling was the most common main treatment type (49% of closed treatment episodes), followed by assessment only (21%) (AIHW 2022, Drg.81).

At-risk groups

The use of meth/amphetamine and other stimulants can be disproportionately higher for specific population groups.

• Aboriginal and Torres Strait Islander people were more than 2 times as likely to report the recent use of meth/amphetamine than non-Indigenous Australians. However, the estimate for Indigenous Australians has a relative standard error of 25% to 50% and should be used with caution.
• More than half of police detainees and prison entrants recently used methamphetamine.
• People with a mental health condition were more than 2 times as likely to report recent meth/amphetamine use than people who had not been diagnosed or treated for a mental health condition.
• Methamphetamine is the most commonly injected drug in Australia.

Policy context

Public perceptions and policy support

The NDSHS found that between 2016 and 2019, more people associated meth/amphetamine with a drug problem (46% compared with 49%) and thought it caused the most deaths (19.2% compared with 20%) (AIHW 2020, tables 9.1 & 9.3). Meth/amphetamine was reported to be the drug of most concern to the community by 2 in 5 (40%) people (AIHW 2020, Table 9.5).

National Ice Action Strategy 2015

In April 2015, the Australian Government established a National Ice Taskforce, to provide advice on the development of a National Ice Action Strategy (NIAS).

The objectives of the NIAS are to ensure that:

• families and communities have better access to information, support and tools to help them to respond to ice (methamphetamine);
• prevention messages are targeted at high-risk populations and accurate information about ice is more accessible;
• early intervention and treatment services are better tailored to respond to ice and meet the needs of the populations they serve;
• law enforcement efforts are better targeted to disrupt the supply of ice; and
• better evidence is available to drive responses to the effects of ice in our community (Department of Health 2017).