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:

  • Around 1 in 2 (48%) people who had recently used methamphetamine in 2020 reported that it was ‘easy’ or ‘very easy’ to obtain (Peacock et al. 2021) (Table S2.6).
  • Over 3 in 5 (62%) people who had recently used cocaine in 2019 reported that it was ‘easy’ or ‘very easy’ to obtain (Peacock et al. 2019). Data on cocaine availability were not updated in the 2020 IDRS.

Similarly, data from the 2020 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 (Peacock et al. 2020). Findings show that:

  • Perceived availability was the highest for crystal methamphetamine (71% of participants rated it ‘easy' or 'very easy’ to obtain), while perceived availability for other forms of methamphetamine was lower.
  • Perceived availability of ecstasy in all forms has fluctuated over the last 3 years, with the highest availability reported for capsules (84% of participants rated it ‘easy’ or ‘very easy’ to obtain), followed by crystal (80%), pills (70%) and powder forms (69%) (Peacock et al. 2020).
  • Cocaine was rated ‘easy’ or ‘very easy’ to obtain by 68% of participants who could comment (Peacock et al. 2020; Peacock et al. 2019).
  • In 2020, the main approach for arranging the purchase of any illicit or non-prescribed drugs by EDRS participants in the previous 12 months was via social networking applications (such as Facebook, WhatsApp, SnapChat, Grindr, Tinder) (75%), followed by face-to-face (67%) (Peacock et al. 2020).

In 2020, the EDRS and IDRS collections took place during the COVID-19 restriction period (April–July for the EDRS, and June–September for the IDRS). Data that relate to the previous 12 months will reflect behaviours both before and during the COVID-19 period. This should be taken into account when comparing data between 2020 and previous years.

In 2018–19, just over a third of national illicit drug seizures (38,250 or 34.0%) were for ATS (including MDMA). The number of national ATS seizures has increased by 263% over the last decade, with 38,250 seizures in 2018–19, up from 10,543 in 2009–10. In 2018–19, ATS accounted for 33% of the total weight of illicit drugs seized nationally. The total weight of ATS seized nationally has increased 1,206% over the last decade, from 671 kilograms in 2009–10 to 8,776.5 kilograms in 2018–19. The 32,021 national amphetamines seizures in 2018–19 weighed 4,418.0 kilograms and accounted for 84% of the number and 50% of the weight of ATS seized nationally this reporting period (ACIC 2020a). Recent research (ACIC 2019b) has shown the impact of seizures on consumption—see Supply reduction – Prohibited substances (ACIC 2020a; tables S1.21 and S1.22).

In 2018–19, there were 2,022 amphetamine-type stimulant (excluding MDMA) detections at the Australian border, weighing 5,148.4 kilograms. The number of MDMA (ecstasy) detections at the Australian border was 3,777 in 2018–19, while the weight of MDMA detected was 2,124.9 kilograms, the highest weight recorded in the last decade. The number of national MDMA seizures was 6,103 in 2018–19, and the total weight of MDMA seized nationally was 1,560.0 kilograms, accounting for 27% of the number and 18% of the weight of ATS seized nationally this reporting period (ACIC 2020a).

Over the last decade, the number of cocaine detections at the Australian border increased by 826%, from 291 in 2009–10 to 2,695 in 2018–19. The weight of cocaine detected has increased by 171%, from 386.8 kilograms in 2009–10 to 1,049.6 kilograms in 2018–19 (ACIC 2020a).

The number of national cocaine seizures has increased by 255% over the last decade, from 1,517 in 2009–10 to a record 5,378 in 2018–19. The weight of cocaine seized nationally increased by 315% over the same period, from 394.8 kilograms in 2009–10 to 1,638.5 kilograms in 2018–19 (ACIC 2020a).

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.

Collection of drug use data in the 2020 Ecstasy and Related Drugs Reporting System (EDRS) took place during the COVID-19 restriction period between April and July 2020. Data that relate to the previous 6-12 months will reflect behaviours both before and during the COVID-19 period. This should be taken into account when comparing data between 2020 and 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).
  • 24% of participants in the EDRS reported use of any form of methamphetamine in the previous 6 months (Peacock et al. 2020).
  • 78% of people who inject illicit 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 (Table S2.44). 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 (26% in 2011 to 12% in 2020) (Peacock et al. 2020) (Table S2.49).

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.

Visualisation not available for printing

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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%) (Table S2.46).
  • 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%) (Table S2.45).
  • 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).

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%) (Table S2.47).
  • 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 (Table S2.47) (AIHW 2020).

There was a significant increase in lifetime use of cocaine between 2016 (9%) and 2019 (11.2%) (Table S2.31). 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 68% reporting recent use in 2020, the highest percentage of participants in the study’s history (Peacock et al. 2020).

Recent 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 continues to have the highest population-weighted average consumption of any illicit drug monitored by the program (ACIC 2021b). Data from the latest NWDMP report indicate that nationally:

  • In December 2020, the estimated population-weighted average consumption of methylamphetamine was higher in capital cities than regional areas for the first time since April 2017.
  • After falling to record low levels in August 2020, average consumption of methylamphetamine increased in both capital cities and regional areas between August and December 2020. This shows a gradual recovery in the market (ACIC 2021b).

Between August 2016 and August 2020, the estimated population-weighted average methylamphetamine consumption decreased in both regional areas and capital cities (ACIC 2021a). The estimated weight of methylamphetamine consumed increased from 8,405 kilograms in 2016–17 to 11,516 kilograms in 2018–19, before declining to 11,147 kilograms in 2019–20 (ACIC 2021a; 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, 2016 to 2020

This infographic shows that Australians consumed an estimated 11,147 kilograms of methylamphetamine in 2019–20. Methylamphetamine consumption is typically higher in regional areas than capital cities. Between August 2016 and August 2020, average consumption of methylamphetamine decreased in Capital cities and Regional areas.

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

Note: Data are from 56 wastewater treatment sites, covering approximately 56% of the Australian population in 2020.

Source: AIHW. Adapted from NWDMP Report 12.

MDMA consumption is low across the country, relative to other illicit drugs. The estimated weight of MDMA consumed has steadily increased from 1,162 kilograms in 2017–18 to 2,630 kilograms in 2019–20 (ACIC 2021a). Data from the latest NWDMP reports indicate that nationally:

  • In December 2020, the estimated population-weighted average consumption of MDMA was higher in regional areas than capital cities.
  • In capital cities, estimated population-weighted average consumption of MDMA increased between April and August 2020,  before decreasing between August and December.
  • In regional areas, estimated population-weighted average consumption of MDMA has increased overall from August 2016 to August 2020, but remained relatively stable between April and August 2020, before decreasing between August and December (ACIC 2021a; ACIC 2021b).

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

Cocaine consumption has shown a long-term increase. The estimated weight of cocaine consumed has steadily increased from 3,057 kilograms in 2016–17 to 5,675 kilograms in 2019–20 (ACIC 2021a). Data from the latest NWDMP reports indicate that:

  • In December 2020, the estimated population-weighted average consumption of cocaine was higher in capital cities than regional areas.
  • In capital cities, estimated population-weighted average of cocaine has increased overall from August to 2016 to August 2020, with an increase in 2020 between August and October and a further increase to December 2020.
  • In regional areas, estimated population-weighted average of cocaine has increased overall from August 2016 to August 2020, and increased in 2020 between April and August, before decreasing in December (ACIC 2021a; ACIC 2021b).

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. 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%) (Table S2.48).
  • 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). 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%) (Table S2.48).
  • 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%) (Table S2.48).
  • 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).

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).

Visualisation not available for printing

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International comparisons

The National Wastewater Drug Monitoring Program (NWDMP) recently examined average stimulant consumption (amphetamine, methamphetamine, cocaine, and MDMA) in Australia compared with 29 countries across Europe, North America, Oceania, and South Africa. In 2019:

  • Australia had the fourth highest average total stimulant consumption of all included countries at 59 doses per 1,000 people per day, following Czechia (76 doses), the United States of America (USA; 74 doses), and the Netherlands (66 doses)
  • Australia had the third highest average consumption of both methamphetamine (49 doses per 1,000 people per day, compared with 60 doses for the highest-ranked country, Czechia) and MDMA (3.1 doses, compared with 9.2 doses for the highest-ranked country, the Netherlands)
  • average cocaine consumption was lower in Australia than around half of all included countries at 6.6 doses, compared with 23 doses for the highest-ranked country (the Netherlands) and 0.63 doses for the lowest-ranked country (New Zealand).

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

  • most stimulant consumption in Australia related to methamphetamine use, which is similar to New Zealand, South Africa, Czechia, and North America. By contrast, most 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 South Africa, North America, and most European countries, but was the opposite of New Zealand (where MDMA consumption was higher than cocaine) (ACIC 2020b).

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 (Table S2.68).

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 for Alcohol and Other Drug Misuse and Overdose. Data for 2020 are currently available for New South Wales, Victoria, Queensland, Tasmania and the Australian Capital Territory. Data are presented for 4 snapshot months per year, specifically March, June, September and December. Please see the data quality statement for further information.

The proportion of meth/amphetamine-related ambulance attendances where multiple drugs were consumed ranged from 30% of attendances in Queensland to 44% of attendances in Victoria (Table S2.81).

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 – Key findings report was released in August 2021. Full results from the Study, including more detailed reports, methods and interactive data visualisations, are planned for release in November 2021.

The Australian Burden of Disease Study, 2015, found that amphetamine use was responsible for 0.6% of the total burden of disease and injuries in Australia in 2015 and 21% of the total burden due to illicit drug use (AIHW 2019b) (Table S2.69).

Of the burden due to amphetamine use, drug use disorder (excluding alcohol) contributed 28%, poisoning 5% and suicide and self-inflicted injuries 4.3%. Other contributors to the burden due to amphetamine use included road traffic injuries—motorcyclists (3.2%) and road traffic injuries—motor vehicle occupants (2.5%) (AIHW 2019b).

Cocaine use contributed 0.3% of the total burden of disease and injuries in 2015 and 11.4% of the total burden due to illicit drug use (Table S2.69). Of the burden due to cocaine use, suicide and self-inflicted injuries accounted for 6.2% and drug use disorder (excluding alcohol) 11% (AIHW 2019b).

Ambulance attendances

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System for Alcohol and Other Drug Misuse and Overdose.

In 2020, for meth/amphetamine-related ambulance attendances (including crystal methamphetamine):

  • Rates of attendances ranged from 10.7 per 100,000 population in Tasmania to 27.4 per 100,000 population in Victoria.
  • The majority of attendances were for males, ranging from 62% in Tasmania to 69% of attendances in the Australian Capital Territory.
  • The median age of patients was similar across jurisdictions, ranging from 28 years in Tasmania to 34 years in New South Wales.
  • Meth/amphetamine-related attendances where multiple drugs (excluding alcohol) were present ranged from 30% in Queensland to 44% in Victoria (Table S2.81).

The characteristics of meth/amphetamine-related ambulance attendances varied by region in 2020:

  • Higher rates were reported in metropolitan areas than regional areas in Victoria (29.4 per 100,000 population metropolitan and 21.3 regional) and Tasmania (13.3 per 100,000 population metropolitan and 7.6 regional).
  • In Queensland, similar rates were reported in metropolitan and regional areas (26.5 per 100,000 population metropolitan and 26.2 regional).

  • New South Wales reported higher regional rates of attendance (19.7 per 100,000 population in regional areas and 17.2 in metropolitan).
  • Proportions of meth/amphetamine-related attendances resulting in transport to hospital in metropolitan and regional areas varied across reporting jurisdictions and the Australian Capital Territory (metropolitan only), from 76% to 87% of attendances (Table S2.81).

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). In 2019–20, methamphetamines accounted for 1 in 10 (10.0%) drug-related hospitalisations. Less than 1% (0.9%) of drug-related hospitalisations were for cocaine (Table S1.8b).

AIHW analysis of the National Hospital Morbidity Database (NHMD) showed an increase in the number of hospitalisations related to methamphetamines and cocaine in recent years.

  • Methamphetamine-related hospitalisations increased from 9,317 (38.8 per 100,000 population) in 2015–16 to 14,053 (55.0 per 100,000) in 2019–20.
  • Cocaine-related hospitalisations also increased, rising from 776 (3.2 per 100,000) hospitalisations in 2015–16 to 1,275 (5.0 per 100,000) in 2019–20 (Table S1.8b).

Similarly, analysis by the National Drug and Alcohol Research Centre (NDARC) showed that, taking into account 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) (Man et al. 2021).

In 2019–20, over 2 in 3 (69%) methamphetamine-related hospitalisations occurred in Major cities. In Australia, the rates of hospitalisations for methamphetamines and cocaine are typically higher in Major cities and Regional areas than in Remote or very remote areas (Man et al. 2021). AIHW analysis of the NHMD showed that, in 2019–20:

  • The rate of methamphetamine-related hospitalisations in Major cities was 52.9 per 100,000 population (9,683 hospitalisations).
  • The rate of cocaine-related hospitalisations in Major cities was 6.2 per 100,000 population (1,138 hospitalisations) (Table S1.8c).

Deaths

Drug-induced deaths are defined as those that can be directly attributable to drug use, as determined by toxicology and pathology reports (ABS 2017). The rate of drug-induced deaths related to methamphetamine and other stimulants has increased rapidly in recent years.

  • AIHW analysis of the AIHW National Mortality Database shows that the death rate for all psychostimulants (including amphetamines, methamphetamine, ecstasy/MDMA and caffeine) in 2019 was 4 times higher than that in 2000 (2.0 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 S1.1a).
  • Estimates by the National Drug and Alcohol Research Centre (NDARC) showed that, in 2019, there were 478 drug-induced deaths involving amphetamines—a rate of 2.0 deaths per 100,000 people, this is an increase from 107 deaths (0.50 deaths per 100,000) in 2011 (Chrzanowska et al. 2021).
  • 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

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 Alcohol and Other Drug Treatment Services National Minimum Data Set (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 2nd most common principal drug of concern in closed treatment episodes provided to clients in 2019–20. Amphetamines were the principal drug of concern in 28% of closed treatment episodes for clients’ own drug use—the same proportion as 2018–19 (Figure STIM4). Almost 4 in 5 (78%) amphetamine treatment episodes were for methamphetamine (AIHW 2021).

In 2019–20, where amphetamines were the principal drug of concern:

  • Two-thirds (66%) of clients were male and around 1 in 6 (18%) clients were Indigenous Australians (tables S2.77 and S2.78).
  • Most clients (70%) were aged 20–39.
  • The most common source of referral for treatment was self/family (36% of treatment episodes), followed by health services (30%) (Table S2.79).
  • The most common main treatment type was counselling (41% of treatment episodes), followed by assessment only (21%) (Table S2.80; Figure STIM4). Counselling has remained the most common main treatment type across the 10-year period to 2019–20 (AIHW 2021).

Figure STIM4: Treatment provided for own use of amphetamines, 2019–20 (per cent)

This figure shows that amphetamines were the 2nd most common principal drug of concern, accounting for 28%25 of closed treatment episodes provided for clients’ own drug use in 2019–20. Around 1 in 6 clients were Indigenous Australians. The most common main treatment type provided to clients for their own amphetamine use was counselling (2 in 5 treatment episodes).

Source: AIHW. Supplementary tables S2.76, S2.78 and S2.80.

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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 2019a).

Ecstasy

In 2019–20, ecstasy was the principal drug of concern in less than 1% (0.6%) of closed treatment episodes provided for clients’ own drug use (Table S2.76). Treatment episodes for ecstasy remained relatively stable over the 10-year period to 2019–20.

In 2019–20, where ecstasy was the principal drug of concern:

  • 3 in 4 (75%) clients were male and 5% were Indigenous Australians (tables S2.77 and S2.78).
  • Over half (53%) of clients were aged 20–29 and 39% were aged 10–19 (AIHW 2021).
  • Almost 1 in 2 (49%) closed treatment episodes had a source of referral of police or court diversion (Table S2.79).
  • The most common main treatment type was information and education (39%), followed by counselling (26%) (Table S2.80).

Cocaine

In 2019–20, cocaine was the principal drug of concern in 1% of closed treatment episodes provided for clients’ own drug use (Table S2.76). The proportion of treatment episodes for cocaine has remained low over the 10-year period to 2019–20, but the number of episodes increased by over 300% from 2010–11 (501 episodes) to 2019–20 (2,086 episodes) (AIHW 2021).

In 2019–20, where cocaine was the principal drug of concern:

  • Almost 9 in 10 (88%) clients were male and 5% were Indigenous Australians (tables S2.77 and S2.78).
  • 1 in 2 (50%) clients were aged 20–29, and 30% were aged 30–39 (AIHW 2021).
  • The most common source of referral was self or family (39% of closed treatment episodes), followed by health services (23%) (Table S2.79).
  • Counselling was the most common main treatment type (45% of closed treatment episodes), followed by assessment only (18%) (Table S2.80) (AIHW 2021).

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%)(tables S2.36 and S2.70). Meth/amphetamine was reported to be the drug of most concern to the community by 2 in 5 (40%) people (Table S2.37).

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).