Meth/amphetamine and other stimulants

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 slight structural differences, methamphetamine produces a stronger nervous system response than amphetamine (ACIC 2019a).
  • 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.

Key findings

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

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

Box STIM1: Defining amphetamines and other stimulants

Data sources on methamphetamine, amphetamine and other psychostimulants contain a variety of terms; in some instances these terms cover similar, but not the same range of drugs. This can be confusing when interpreting results across different data sources.

Below is a description of each term used in these data sources and the types of drugs they encompass:

  • Amphetamine-type stimulants (ATS)—covers a large range of drugs, which includes amphetamine, methylamphetamine and phenethylamines (a class of drug that includes MDMA or ‘ecstasy’).
  • Amphetamines—refers to a broad category of substances. According to the Australian Standard Classification of Drugs of Concern (ASCDC) (ABS 2011), this includes amphetamine, methylamphetamine, dexamphetamine, amphetamine analogues and amphetamines not elsewhere classified. This is the term used in the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS).
  • Methamphetamine (also methylamphetamine) also comes in different forms, including powder/pills (speed), crystal methylamphetamine (crystal meth or ice), a sticky paste (base), and a liquid form.
  • Meth/amphetamine includes methylamphetamine and amphetamine and is the term used in the National Drug Strategy Household Survey (NDSHS).
  • Ecstasy (also MDMA) is often consumed in the form of a tablet, but can also be in powder or crystal form.
  • Cocaine is commonly consumed in powder form, which can be snorted or dissolved in water so it can be injected.
  • Psychostimulants (also stimulants) includes ecstasy, methamphetamine, cocaine and new psychoactive substances (NPS). This is the sampling criteria for participants of the Ecstasy and related Drugs Reporting System (EDRS).

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:

  • Over 4 in 5 (86%) people who had recently used crystal methamphetamine in 2021 reported that it was ‘easy’ or ‘very easy’ to obtain (Sutherland et al. 2021b, Figure 16 & 17).
  • Over 3 in 5 (68%) people who had recently used cocaine in 2021 reported that it was ‘easy’ or ‘very easy’ to obtain (Sutherland et al. 2021b).

Similarly, data from the 2021 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. 2021a). Findings show that:

  • Perceived availability was the highest for crystal methamphetamine (82% of participants rated it ‘easy or very easy’ to obtain). Perceived availability for powder methamphetamine was lower, 59% of participants rated availability as it ‘easy or very easy’ to obtain.
  • Perceived availability of ecstasy in all forms has fluctuated over the last 3 years, with the highest availability in 2021 reported for capsules (85% of participants rated it ‘easy’ or ‘very easy’ to obtain), followed by powder forms (68%), crystal (66%) and pills (61%).
  • Cocaine was rated ‘easy’ or ‘very easy’ to obtain by 77% of participants who could comment.
  • 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 over 2020 (67%), followed by social networking applications (such as Facebook, Wickr, WhatsApp, SnapChat, Grindr, Tinder) (71%) (Sutherland et al. 2021a).

Data collection for 2021 took place from April–August 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 and 2021 were delivered face-to-face as well as via telephone. This change in methodology should be considered when comparing data from the 2020 and 2021 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 2019–20, around one-third of national illicit drug seizures (39,204 or 32%) were amphetamine-type stimulants (ATS) (including MDMA).

The number of national ATS seizures has increased by 250% over the last decade, with 39,204 seizures in 2019–20, up from 11,212 in 2010–11. In 2019–20, ATS accounted for 33% of the total weight of illicit drugs seized nationally. The total weight of ATS seized nationally has increased 1,175% over the last decade, from 1,009 kilograms in 2010–11 to a record 12,865 kilograms in 2019–20.

The record 34,113 national amphetamines seizures in 2019–20 weighed a record 9,408 kilograms and accounted for 87% of the number and 73% of the weight of ATS seized nationally this reporting period (ACIC 2021a). Research (ACIC 2019b) has shown the impact of seizures on consumption—see Supply reduction – Prohibited substances (ACIC 2021a; tables S1.18 and S1.19).

In 2019–20, there were 1,377 amphetamine-type stimulant (excluding MDMA) detections at the Australian border, weighing 5,272 kilograms. The number of MDMA (ecstasy) detections at the Australian border was 2,308 in 2019–20, while the weight of MDMA detected was 1,291 kilograms. The number of national MDMA seizures was 4,981 in 2019–20, and the total weight of MDMA seized nationally was 3,214 kilograms, accounting for 13% of the number and 25% of the weight of ATS seized nationally (ACIC 2021a).

Over the last decade, the number of cocaine detections at the Australian border increased by 447%, from 486 in 2010–11 to 2,660 in 2019–20. The weight of cocaine detected has increased by 9%, from 701 kilograms in 2010–11 to 763 kilograms in 2019–20 (ACIC 2021a).

The number of national cocaine seizures has increased by 372% over the last decade, from 1,217 in 2010–11 to a record 5,750 in 2019–20. The weight of cocaine seized nationally increased by 138% over the same period, from 662 kilograms in 2010–11 to 1,573 kilograms in 2019–20 (ACIC 2021a).

Consumption

For related content on meth/amphetamine and other stimulant consumption by region, see also:

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

Data collection for the EDRS for 2021 took place from April–August. Due to COVID-19 restrictions in various jurisdictions, interviews were delivered via face-to-face interview and by telephone. This change in methodology should be considered when comparing data from the 2020 and 2021 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).
  • 26% of participants in the EDRS reported use of any form of methamphetamine in the previous 6 months (Sutherland et al. 2021a).
  • 78% of people who inject drugs reported use of any form of meth/amphetamine in the previous 6 months (Peacock et al. 2019).

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 16% in 2021) (Sutherland et al. 2021a, Figure 11).

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

The figure shows the proportion of people who recently used meth/amphetamine in the last 12 months by age group from 2001 to 2019. Between 2001 and 2019, there were decreases for age groups of 14–19, 20–29, and 14 and over who had recently used meth/amphetamine. Over the same period, the proportion of people aged 30–39, and 50 and over who recently used meth/amphetamine remained stable. In 2019, people aged 20–29 (2.4%) and 30–39 (2.0%) were most likely to have recently used meth/amphetamine.

View data tables >

Ecstasy

  • 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).
  • Ecstasy and cannabis were the most common reported drug of choice for participants of the EDRS who regularly use ecstasy and other stimulants (Peacock et al. 2020).

Findings from the 774 participants indicate that when the past 6 months was compared with the previous year:

  • Ecstasy use was reported by 95% of participants, a decline from 99% of participants in 2020.
  • Cocaine use has seen a gradual increase, with 80% of participants reporting past 6 month use in 2021, the highest recorded proportion since 2003, and an increase from 68% of participants in 2020.
  • Cannabis use has remained steady since 2003, with a slight decline from 88% of participants in 2020 to 84% in 2021.
  • 58% of participants self-reported a mental health issue and 35% have seen a mental health professional in the past 6 months (Sutherland et al, 2021a).

Cocaine

  • 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 third most commonly used stimulant drug (after ecstasy and cannabis) with 80% reporting recent use in 2021, an increase from 68% in 2020 and the highest percentage of participants in the study’s history (Sutherland et al. 2021a).

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.

Methylamphetamine continued to have the highest population-weighted average consumption of any illicit drug monitored by the program (ACIC 2022b). Data from Report 16 of the NWDMP indicate that nationally:

  • In December 2021, consumption of methylamphetamine increased in both capital city and regional sites, following record low levels of consumption in August 2021.
  • In December 2021, per capita consumption in capital cities was higher than regional areas, for the first time since April 2017 (ACIC 2022b).

The estimated weight of methylamphetamine consumed increased from 8,405 kilograms in 2016–17 to 11,516 kilograms in 2018–19, before declining to 8,838 kilograms in 2020–21 (ACIC 2022a, Figure STIM2).

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, 2020 to 2021

This infographic shows that Australians consumed an estimated 8,838 kilograms of methylamphetamine in 2020–21. Methylamphetamine consumption is typically higher in regional areas than capital cities. The illicit stimulant market showed early sign of post COVID-19 increases in consumption.

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

Note: Report 15 covers 57% of the Australian population (58 wastewater treatment sites), Report 16 covers 56% of the Australian population (56 wastewater treatment sites).  

Source: AIHW, adapted from ACIC 2022a and ACIC 2022b.

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 dropping to 1,231 kilograms in 2020–21 (ACIC 2022a). Data from Report 16 of the NWDMP indicate that nationally:

  • In December 2021, the population-weighted average consumption of MDMA in capital cities was higher than regional areas for the first time since April 2017 (ACIC 2022).
  • Between August and December 2021, the population-weighted average consumption in both capital cities and regional areas increased.
  • In February 2022, capital city sites captured a decrease to record low levels of consumption of MDMA (ACIC 2022b).

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 4,711 kilograms in 2020–21 (ACIC 2022a). Data from Report 16 of the NWDMP indicate that:

  • Between August and December 2021, population-weighted average consumption of cocaine increased in both capital cities and regional areas.
  • Consumption in capital cities exceeded that in regional areas (ACIC 2022b).

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

It is important to note that the NWDMP does not measure all drug types and cannabis (the drug found to have the highest self-reported level of recent consumption in the 2019 NDSHS) was not included in the comparison of the highest consumed drugs monitored by the program because a reliable dose figure is not available. For further information, see Box HARM2 and Data quality for the National Wastewater Drug Monitoring Program.

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: Recenta use of meth/amphetamine, cocaine or ecstasy, by remoteness area or socioeconomic area, people aged 14 and over, 2010 to 2019 (per cent)

This figure shows the proportion of recent cocaine use for people aged 14 and over by remoteness area for 2010, 2013, 2016 and 2019. Recent cocaine use trends differed across all 4 remoteness areas between 2010 and 2019. In 2019, recent cocaine use was more common in Major cities (5%) than in Outer regional and Remote and very remote areas (1.4% and 1.7%, respectively).

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 28 countries across Europe, Oceania, and Asia. In March/April 2021:

  • Australia had the highest average total stimulant consumption of all included countries at 48 doses per 1,000 people per day, followed by Czechia and the Netherlands (both 44 doses), and Belgium (40 doses)
  • Australia had the highest average consumption of methylamphetamine (41 doses per 1,000 people per day), followed by Czechia (36 doses) and Latvia (19 doses)
  • Cocaine consumption in Australia ranked 15th of 26 countries at 5.0 doses, compared with 26 doses for the highest-ranked country (Belgium) and 0.61 doses for the lowest-ranked country (New Zealand).
  • Australia ranked 5th in MDMA consumption at 1.5 doses per 1,000 people per day, behind the Netherlands, France, Poland and Portugal (ranging from 4.8 doses to 1.5 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, South Korea, Slovakia, Czechia, Latvia and Turkey. Most other European countries had higher use of amphetamine and cocaine.
  • 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 2022b).

Poly drug use

Poly drug use is defined as the use of more than 1 illicit drug or licit drug in the previous 12 months. 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 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, the proportion of amphetamine-related ambulance attendances where multiple drugs were involved (excluding alcohol) ranged from 33% of attendances in Queensland to 48% of attendances in Victoria (Table S1.10).

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

Harms

For related content on meth/amphetamine and other stimulant impacts and harms, see also:

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

Table STIM1: Short and long-term effects associated with the use of methamphetamine and other stimulants
Drug type Short-term effects Long-term effects

Methamphetamine (includes powder, base and crystal/ice)

  • Increased energy
  • Sense of euphoria and wellbeing
  • Increased attention and alertness
  • Increased talkativeness
  • Increased heart rate, breathing and body temperature
  • Decreased appetite
  • Jaw clenching and teeth grinding
  • Nausea and vomiting
  • A dry mouth
  • Changes in libido
  • Nervousness, anxiety and paranoia
  • Aggression and violence
  • Mood and anxiety disorders
  • Cardiovascular problems
  • Haemorrhagic stroke
  • Poor concentration and memory
  • Psychotic symptoms such as paranoia and hallucinations
  • Weight loss
  • Chest pains

Ecstasy/MDMA

  • Sense of euphoria and wellbeing
  • Feelings of intimacy with others
  • Confidence
  • Lack of inhibitions
  • Nausea
  • Sweating
  • Increased blood pressure and pulse rate
  • Jaw clenching and teeth grinding
  • Depression
  • Anxiety
  • Memory and cognitive impairment

Cocaine

  • Sense of euphoria and wellbeing
  • Increased blood pressure, heart rate and body temperature
  • Increased alertness and energy
  • Sexual arousal
  • Loss of appetite
  • Sleep disorders
  • Sexual problems such as impotence
  • Nose bleeds, sinusitis and damage to the nasal wall from snorting
  • Cardiovascular problems
  • Stroke
  • Paranoia, depression and anxiety
  • Cocaine-induced psychosis

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 in 2021 for people aged 15 years and over for New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory.

In 2021, for amphetamine-related ambulance attendances (including crystal methamphetamine) in these jurisdictions:

  • Rates of attendances ranged from 49.3 per 100,000 population in Tasmania to 85.2 per 100,000 population in Victoria.

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

  • 3 in 5 (63%) of total attendances were for males.
  • The highest rates of attendances were in people aged 25–34:
    • Victoria (1,714 attendances, 164.4 per 100,000 population
    • Queensland (1,040 attendances, 143.0 per 100,000 population) New South Wales (1,515 attendances, 126.0 per 100,000 population) (Table S1.9).

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

This figure shows amphetamine-related ambulance attendances in NSW. The highest number of attendances were for males aged 25-34. There is a filter to select state/territory, drug and measure (number of attendances or rate per 100,000 population).

 

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 2020–21:

  • One in 10 were for amphetamines and other stimulants (10% or 15,100 hospitalisations). Within this category, over 4 in 5 hospitalisations were for methamphetamine (82% or 12,400 hospitalisations)
  • Just over 1% were for cocaine (1.2% or 1,800 hospitalisations) (Table S1.13).

This represents a rate of 48.4 hospitalisations per 100,000 population for methamphetamine and 7.0 per 100,000 for cocaine (Table S1.13). Around 2 in 3 hospitalisations for cocaine ended with a same-day discharge (67% or 1,200 hospitalisations). By contrast, around 7 in 10 hospitalisations for methamphetamine involved an overnight stay (71% or 8,800) (Table S1.12).

In 2020–21, most hospitalisations occurred in Major cities for both methamphetamine (71% or 8,800 hospitalisations) and cocaine (94% or 1,700 hospitalisations) (Table S1.14).

  • Accounting for differences in population size, the rates of hospitalisations for methamphetamine were similar in Remote and very remote areas and in Major cities (48.4 and 47.2 hospitalisations per 100,000 population, respectively).
  • The rate of hospitalisations for cocaine was highest in Major cities (9.0 per 100,000 population, compared with 1.5 and 0.9 per 100,000 in Inner regional and Out regional areas, respectively) (Table S1.14).

In the 6 years to 2020–21:

  • 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 55.0 per 100,000), then declined in 2020–21
  • the number of cocaine-related hospitalisations steadily increased between 2015–16 (780 hospitalisations or 3.2 per 100,000 population) and 2018–19 (1,200 hospitalisations or 4.8 per 100,000). These figures stabilised in 2019–20 (1,300 hospitalisations or 5.0 per 100,000), before increasing further in 2020–21 (1,800 or 7.0 per 100,000) (Table S1.13; 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 aging, the rate of cocaine-related hospitalisations increased almost 6-fold between 2010–11 (0.8 per 100,000 population) and 2018–19 (4.7 per 100,000 population) then stabilised in 2019–20 (5.0 hospitalisations per 100,000) (Chrzanowska et al. 2021).

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 2020 was 4 times higher than that in 2000 (2.1 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 2020, there were 524 drug-induced deaths involving amphetamines –a rate of 2.1 deaths per 100,000 people. This is an increase from 104 deaths (0.5 deaths per 100,000) in 2011, and the highest rate recorded across the monitoring period (Chrzanowska et al. 2022).
  • 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

The 2020–21 Alcohol and Other Drug Treatment Services in Australia annual report shows that amphetamines were the principal drug of concern in 24% of treatment episodes provided for clients’ own drug use (AIHW 2022).

These are similar proportions to 2019–20 (28% of closed treatment episodes for amphetamines and 1.5% for cocaine and MDMA) (AIHW 2021a).

Data collected for the AODTS NMDS are released twice each year—an Early Insights report in April and a detailed report mid-year.

Amphetamines

Data from the AIHW Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) for amphetamines correspond to the Australian Standard Classification of Drugs of Concern (ASCDC) code for the general ‘amphetamines’ classification, in which methamphetamine is a sub-classification. Specific coding for methamphetamine episodes have not previously been available due to the nature of the coding structure. This has improved over time, due to improved workforce training and new system updates (AIHW 2021).

The AODTS NMDS provides information on treatment provided to clients by publicly funded AOD treatment services, including government and non-government organisations. Data from the AODTS NMDS showed that amphetamines were the second most common principal drug of concern in closed treatment episodes provided to clients in 2020–21. Amphetamines were the principal drug of concern in 24% of closed treatment episodes for clients’ own drug use – a similar proportion to 2019–20 (28%). Almost 4 in 5 (79%) amphetamine treatment episodes were for methamphetamine (AIHW 2022).

In 2020–21, where amphetamines were the principal drug of concern:

  • Almost 2 in 3 (64%) of clients were male and around 1 in 5 (19%) clients were Indigenous Australians (AIHW 2022, tables SC.9 and SC.11).
  • Most clients (69%) were aged 20–39 (AIHW 2022, Table SC.10).
  • The most common source of referral for treatment was self/family (36% of treatment episodes), followed by health services (29%) (AIHW 2022, Table Drg.37).
  • The most common main treatment type was counselling (41% of treatment episodes), followed by assessment only (20%) (AIHW 2022, Table Drg.36; Figure STIM5).
  • Counselling has remained the most common main treatment type across the 10-year period to 2020–21 (AIHW 2022).

Figure STIM5: Treatment provided for own use of amphetamines, 2020–21 (per cent)

This infographic shows that Australians consumed an estimated 8,838 kilograms of methylamphetamine in 2020–21. Methylamphetamine consumption is typically higher in regional areas than capital cities. The illicit stimulant market showed early sign of post COVID-19 increases in consumption.

Source: AIHW 2022, 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 (DoH 2017).