Alcohol, tobacco & other drugs in Australia

Introduction

Pharmaceutical drugs, including over-the-counter and prescription medicines, have a legitimate purpose in the treatment of illness and injury. However, their use can be associated with increased risk of harm, particularly when used for non-medical purposes. In Australia, pharmaceutical drugs that are most often used for non-medical purposes include opioids (such as oxycodone and morphine), steroids, pharmaceutical stimulants, and sedatives (such as benzodiazepines) (AIHW 2024b). In recent years, there has also been rising concern about the non-medical use of gabapentinoids (particularly pregabalin).

This page focuses on pharmaceutical drug use, treatment and harms in Australia. The reporting uses data from a range of sources, mostly national administrative and survey data. For related content on laws and policies related to pharmaceutical drugs in Australia, see Policy context.

What data sources are available?

There are a range of data sources that contain information about pharmaceutical availability, use, treatment and harms. These include self-report surveys that ask people about their use of pharmaceuticals, health administrative data sets (such as administrative data routinely collected by hospitals) and burden of disease analysis. Each data set uses a different methodology, and the language used to describe pharmaceuticals may also differ across sources.

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

What do we know about the availability of pharmaceuticals in Australia?

Illicit pharmaceuticals

Detections of pharmaceutical drugs, including benzodiazepines and opioids, at the Australian border have risen over the past decade. 

For detailed information on the availability of illicit pharmaceuticals in Australia, see Illicit drug markets and drug-related law enforcement activities.

Pharmaceutical prescriptions

Data from Australia’s Pharmaceutical Benefits Scheme (PBS) provide information about the availability of prescription opioids, benzodiazepines and gabapentinoids in Australia, including the number of prescriptions dispensed and the number of patients dispensed a script each year. Data from the PBS show that rates of dispensing for benzodiazepines, opioids and gabapentinoids have been generally declining since around 2017–18 (Tables PBS2, PBS4, PBS22, PBS24, PBS46 and PBS48; see Figure 1). 

These numbers largely represent medicines being prescribed for and used for their intended purposes. However, as drug-related harms are often associated with drug prescribing rates (Roxburgh et al. 2017), it is important to monitor prescription rates in the context of harm reduction.

Detailed information on dispensing of these drugs is available in Availability of prescription opioids, benzodiazepines and gabapentinoids in Australia.

What do we know about people who use pharmaceuticals for non-medical purposes?

How many people use pharmaceuticals for non-medical purposes and has it changed over time?

Data from the 2022–2023 National Drug Strategy Household Survey (NDSHS) showed that:

• 1 in 20 (5.3%) people in Australia aged 14 and over had used a pharmaceutical for non-medical purposes in the previous 12 months (AIHW 2024b, Table 6.3).
• About 1 in 9 (11.9%) people in Australia aged 14 and over had used a pharmaceutical for non-medical purposes in their lifetime (AIHW 2024b, Table 6.1).
• Pharmaceutical pain-killers/pain-relievers and opioids (excluding over-the-counter medications such as paracetamol) are the most common pharmaceuticals used for non-medical purposes (2.2%), followed by pharmaceutical stimulants (2.1%) and tranquilisers/sleeping pills (1.6%) (AIHW 2024b, Table 6.2).

Between 2019 and 2022–2023, there was a decrease in the use of pain-relievers for non-medical purposes in the previous 12 months (from 2.7% to 2.2%) (AIHW 2024b, Table 6.2). 

Does non-medical pharmaceutical use differ by age and gender?

Data from the 2022–2023 NDSHS showed that males and females aged 14 and over were similarly as likely to have used a pharmaceutical for non-medical purposes in the previous 12 months (5.7% and 4.8% respectively) (AIHW 2024b, Table 6.3) (Figure 1).

The types of pharmaceuticals used for non-medical purposes differed slightly by gender:

• Among males aged 14 and over, the most common types of pharmaceuticals used for non-medical purposes were pharmaceutical stimulants (2.5%) followed by pain-killers/pain-relievers and opioids (2.1%)
• Among females aged 14 and over, the most common types of pharmaceuticals used for non-medical purposes were pain-killers/pain-relievers and opioids (2.2%) followed by pharmaceutical stimulants (1.5%) (AIHW 2024b, Table 6.4).

Non-medical use of pharmaceuticals was highest among people aged 20–29 (8.3%) in 2022–2023, with pharmaceutical stimulants (4.8%) being the most common pharmaceutical used for non-medical purposes among this age group (AIHW 2024b). While people in their 60s and older were less likely to have used pain relievers and opioids for non-medical purposes in the previous 12 months than those in their 20s, they were more likely to have used them in the last month and were much more likely to have used them in the previous week (AIHW 2024b, tables 6.4 and 6.6).

Are people using pharmaceuticals with other drugs?

In 2022–2023, the NDSHS showed that just over half (54%) of people who reported the non-medical use of pain-relievers and opioids in the last 12 months said they had used another drug at the same time. The most common other drugs concurrently used were alcohol (40%), tobacco (24%) and cannabis (19.5%) (AIHW 2024b, Table 6.14).

Data on alcohol and other drug-related ambulance attendances are sourced from the National Ambulance Surveillance System (NASS), including six Australian states and territories (excludes Western Australia and South Australia). In 2024, multiple drugs were involved in most ambulance attendances related to benzodiazepines (72% of attendances) and pharmaceutical opioids (71% of attendances) (Table NASS5).

Does pharmaceutical use differ by geographic area?

In 2022–2023, the proportion of people aged 14 and over who reported non-medical use of pharmaceuticals in the previous 12 months varied across states and territories and was typically higher for people in regional and remote areas of Australia (AIHW 2024b, tables 9a.12 and 9b.46). There was no pattern of non-medical use of pharmaceuticals by socioeconomic area.

Detailed information on pharmaceutical drug use by geographic area in this report is available in State and territory data, Remoteness areas, and Socioeconomic areas.

What are the harms associated with pharmaceutical drug use?

There are a range of short and long-term health, social and economic harms associated with the non-medical use of pharmaceutical drugs (Table 1). People who use opioids for chronic pain are more likely than the general population to use pharmaceutical drugs for non-medical purposes (Currow et al. 2016; Vowels et al. 2015). Iatrogenic dependence occurs when patients become dependent on medications that they were medically prescribed for legitimate purposes. Iatrogenic dependence is an increasing concern among people living with chronic non-cancer pain.

Source: Adapted from Currow et al. 2016; DCPC 2007; Farzam et al. 2023; Nicholas et al. 2011; NSW Ministry of Health 2017.

Opioid-related burden of disease and injury

The Australian Burden of Disease Study 2024 found that opioid use (including pharmaceutical opioids and heroin) was responsible for 0.8% of the total burden of disease and injuries in Australia in 2024 and 28% of the total burden due to illicit drug use (AIHW 2024a, Table S6). 

Most of the burden due to opioid use was due to poisoning and drug use disorders (excluding alcohol). Opioid use contributed to 46% of the burden due to poisoning and 22% of the burden due to drug use disorders. A further 2.3% of the burden due to suicide and self-inflicted injuries was attributed to opioid use (AIHW 2024a).

Pharmaceutical-related ambulance attendances

In 2024, there were around 31,500 ambulance attendances involving any pharmaceutical drug among people aged 15 and over, or 171 per 100,000 population (Table NASS3). This included:

• around 9,200 attendances involving benzodiazepines (50 per 100,000 population) 
• over 4,300 attendances involving pharmaceutical opioids (24 per 100,000), noting that multiple drug types may be recorded in the same ambulance attendance.

Unlike most other drugs, ambulance attendances involving pharmaceuticals are more likely to involve females than males. In 2024, almost 3 in 5 attendances involving pharmaceutical drugs were for females (57% of total attendances). This was consistent for both benzodiazepines (53% of attendances) and pharmaceutical opioids (54%).

The highest rates of attendances for any pharmaceutical were among people aged 15–24 (295 per 100,000), followed by people aged 25–34 (201 per 100,000) (Table NASS3). This age profile differed by drug type:

• The highest rates of benzodiazepine-related attendances were for people aged 25–34 (65.5 per 100,000) and 15–24 (65.1 per 100,000).
• The highest rates of pharmaceutical opioid-related attendances were for people aged 45–54 (28 per 100,000) (Table NASS3).

Between 2021 and 2023, the number of pharmaceutical-related ambulance attendances fell from around 37,900 (220 per 100,000 population) to 34,700 (193 per 100,000 population). Over this period:

• rates of benzodiazepine-related ambulance attendances fell by 20%, from 12,700 (74 per 100,000 population) to 10,200 (57 per 100,000 population)
• rates of opioid analgesic-related ambulance attendances fell by 9%, from 5,400 attendances (31 per 100,000 population) to 4,900 (27 per 100,000 population).
• females aged 15–24 consistently had the highest rates of attendances for any pharmaceuticals, though rates have declined over time (Table NASS3).

These declines were largely driven by people aged 15–24, with a 20% decrease in attendances for any pharmaceutical across the period (from 12,100 or 473 attendances per 100,000 population to 10,000 or 346 per 100,000). This was consistent across drug types, with a 31% decrease in benzodiazepine-related attendances and a 24% decrease in opioid-related attendances for this age group (Table NASS3).

There were further declines in pharmaceutical-related ambulance attendances between 2023 and 2024, largely due to a decrease in attendances in Victoria (from around 1,300 or 24 attendances per 100,000 population to around 850 or 15 per 100,000 population). This is due to industrial action by paramedics in Victoria between March and September 2024, which resulted in fewer ambulance attendances being captured over that period. 2024 data should be interpreted with caution (Table NASS3).

Pharmaceutical-related hospitalisations

Pharmaceuticals are among the most common substances involved in alcohol and other drug-related hospitalisations. In 2023–24, non-opioid analgesics accounted for 4.2% (6,091) of all alcohol and other drug-related hospitalisations, and benzodiazepines and other sedative-hypnotics (excluding alcohol and GHB) accounted for 4.4% (6,416). Smaller numbers were reported for other pharmaceuticals such as antidepressants (2.1% or 3,032) and antipsychotics and neuroleptics (2.1% or 3,040) (Tables NHMD3 and NHMD4; see Figure 3). 

In 2023–24, among hospitalisations related to benzodiazepines and other sedative-hypnotics, antidepressants, antipsychotics and neuroleptics, and non-opioid analgesics:

• Around 2 in 3 involved an overnight stay (72% or 4,380 for non-opioid analgesics, 68% or 4,348 for benzodiazepines and other sedative-hypnotics, 66% or 1,994 for antidepressants and 73% or 2,230 for antipsychotics and neuroleptics), while the remainder ended in same-day discharge.
• Over half were for females (74% or 4,524 for non-opioid analgesics, 54% or 3,442 for benzodiazepines and other sedative-hypnotics, 70% or 2,127 for antidepressants, 67% or 2,034 for antipsychotics and neuroleptics).
• People aged 15–34 accounted for around half of hospitalisations for non-opioid analgesics (53% or 3,236), antidepressants (50% or 1,531), and antipsychotics and neuroleptics (50% or 1,505), and almost 2 in 5 hospitalisations for benzodiazepines and other sedative-hypnotics (37% or 2,404).
• Females aged 15–24 had substantially higher rates of hospitalisation for non-opioid analgesics (115.6 per 100,000 population), than any other age and sex group for any pharmaceutical drug (Tables NHMD1–NHMD3). 

Pharmaceutical opioids and illegal opioids such as heroin together accounted for 4.2% (5,614) of all drug-related hospitalisations in 2022–23 (Table NHMD3). 

Analysis by the National Drug and Alcohol Research Centre indicates that most opioid poisoning hospitalisations are for pharmaceuticals, largely natural and semi-synthetic opioids (such as oxycodone and morphine). These drugs accounted for over half (55%) of all opioid poisoning hospitalisations in 2022–23, compared with 20% for heroin, 14% for synthetic opioids (such as tramadol and fentanyl), 6.6% for methadone and 4.9% for other opioids (Chrzanowska et al. 2025). 

Deaths involving pharmaceutical drugs

Data from AIHW analysis of the National Mortality Database shows that benzodiazepines were the single most common drug type in drug-induced deaths (654 deaths) in Australia in 2024. Furthermore, in 2024 there were:

• 635 deaths (2.3 per 100,000 population) induced by all opioids (excluding heroin) 
• 295 deaths (1.1 per 100,000 population) induced by antipsychotics
• 119 deaths (0.4 per 100,000 population) induced by non-opioid analgesics (Table NMD2, Figure 2).

Males had higher numbers of deaths than females for benzodiazepines, opioids excluding heroin, antipsychotics and non-opioid analgesics in 2024 (Table NMD13). 

Deaths related to pharmaceutical drugs have broadly declined over the past decade: 

• The rate of benzodiazepine-induced deaths rose from 1.9 per 100,000 population in 1997 to 4.4 per 100,000 in 2018 before declining to 2.4 deaths per 100,000 in 2024.
• The rate of opioid-induced deaths (excluding heroin) has declined from a high of 4.3 per 100,000 in 2016 and 2017 to 2.3 per 100,000 in 2024.
• The rate of all antidepressant-induced deaths has declined from a high of 2.9 per 100,000 in 2017 and 2018 to 1.6 in 2024.
• The rate of non-opioid analgesic-induced deaths has declined from a high of 1.5 per 100,000 in 2018 to 0.4 in 2024 (Table NMD2, Figure 2).

These estimates are expected to rise with standard revision processes. 

In recent years, there have been rapid and dramatic increases in opioid-related deaths associated with rising use in North America (CDC 2024). Similar increases in harm have not been observed in Australia, with declines in the rate of deaths involving pharmaceutical opioids since around 2017 (Table NMD2, Figure 2). While Australia and the US previously had similar rates of non-medical opioid use, this has declined in Australia in recent years (UNODC 2021). In addition, rates of dispensing of prescription opioids have been declining following the introduction of several policies that aim to reduce harm from prescription opioid medicines. For more information on these policies, see Policy context.

How many people receive treatment for pharmaceutical use?

Of treatment episodes for pharmaceuticals in 2023–24, nearly 2 in 3 (63% or 8,144 episodes) involved either opioids (40% of episodes, or 5,265) or benzodiazepines (22% or 2,879) as the principal drug of concern (AIHW 2025, Table Drg.87).

Of the 7,344 clients who received treatment for pharmaceuticals as their principal drug of concern in 2023–24:

• Around 3 in 5 (61% of clients) were male (AIHW 2025, Table SC.30).
• Nearly 3 in 5 were aged either 20–29 (26% of clients) or 30–39 (32%), but this varied by drug type (AIHW 2025, Table SC.31).
• Around 1 in 7 (16%) were Aboriginal and Torres Strait Islander (First Nations) people (AIHW 2025, Table SC.32).

Where do I go for more information?

• Non-medical use of pain-relievers and opioids in the NDSHS
• Non-medical use of pharmaceutical stimulants in the NDSHS
• Pharmaceuticals: client demographics and treatment
• Pharmaceutical Benefits Scheme prescriptions: monthly data