Alcohol, tobacco & other drugs in Australia

Introduction

Australia has adopted a harm minimisation approach for addressing a range of issues associated with the use of tobacco, alcohol, and other drugs since 1985. This is reflected in the National Drug Strategy 2017–2026, the national policy for alcohol and other drug use. Harm reduction measures that aim to reduce the harm associated with drug use among people who use drugs, their family and friends, and the broader community, include:

• reducing risks associated with alcohol and other drug use in particular contexts, including creating safer settings
• safe transport and sobering up services
• protecting children from other people’s drug use
• protecting the community from infectious disease, including blood borne viruses
• reducing driving while under the influence of alcohol or other drugs
• ensuring the availability of opioid treatment programs (Department of Health 2017).

This page provides an overview of harm reduction programs and initiatives in Australia, use of harm reduction services among people who use drugs, and community support for these measures. For related content on alcohol and other drug treatment in this report, see Treatment.

What data sources are available?

There are a limited number of data sources that contain information about measures to reduce harms from alcohol and other drugs in Australia. The data sources that do exist include administrative data from health services and self-report surveys that ask people what they think about harm reduction measures. Each data set uses a different methodology, and the language used to describe harm reduction measures varies.

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

Drug checking services

Drug checking, also known as pill testing, is a harm reduction service that allows people who are thinking about using drugs to submit their drugs for testing by a chemist at designated sites. These sites can be either mobile (for example, at a music festival) or at a fixed site (for example, a health service). Drug checking services also provide an opportunity for service users to discuss drug use and harm reduction strategies with a health professional or peer worker (ADF 2025). Some drug checking services also release public drug alerts based on drug checking results.

Drug checking services vary by state and territory:

• Australia’s first fixed-site health and drug checking service, CanTEST, has been operating in the Australian Capital Territory since July 2022. Drug notifications and reports about the services provided are available on the CanTEST website.
• Queensland piloted a drug checking service, CheQpoint, from April 2024–April 2025. The service included two fixed-site locations and mobile services at festivals (QuIHN 2024).
• Drug checking trials have been under way in New South Wales from early 2025 and Victoria from late 2024:
  • The New South Wales trial is a 12-month pilot involving mobile sites at selected music festivals (NSW Health 2025).
  • The Victorian trial involves a combination of mobile services at festivals and events combined with a fixed-site service that is expected to open in mid-2025 (YSAS 2025).

Almost 2 in 3 (64%) people in Australia aged 14 and over supported drug checking in 2022–2023, an increase from 57% in 2019 (AIHW 2024, Table 11.13). Over 4 in 5 (83%) people who had recently used drugs supported drug checking, compared with 55% of those who had never used drugs. Support was highest among people: 

• aged 18–24 (74%), and decreased to 55% in those aged 70+
• in Major cities (66%) and decreased with increased remoteness (54% in Remote and very remote areas)
• in the most advantaged socioeconomic areas (73%) and lowest in the most disadvantaged areas (59%) (AIHW 2024, Table 11.12).

Data from the Ecstasy and Related Drugs Reporting System (EDRS) show that nearly 2 in 5 (39%) people who regularly use stimulants reported that they or someone else had tested their illicit drugs in the past year in 2025. Over 2 in 5 (43%) of these people reported that they had submitted drugs for testing at a drug checking service, most often a fixed-site service (Sutherland et al. 2025a).

Drug alerts

Drug alerts or warnings are public notices issued by state and territory government agencies, community, and harm reduction agencies to notify the community of substances of public health concern detected in the illicit drug supply (Kypri et al. 2025). Drug alerts aim to provide accurate and timely risk information and encourage people who use drugs to engage in a range of harm reduction behaviours.

As of August 2025, six of the eight Australian states and territories have established processes for issuing public drug alerts or warnings, excluding Western Australia and Tasmania (Kypri et al. 2025). Drug alerts issued are monitored and shared via the Prompt Response Network (PRN), which aims to enhance public health decision-making and responses to emerging drugs across Australia (Kypri et al. 2025). The PRN re-publishes all public drug alerts released across Australia via The Know.

Between July and September 2025, 13 unique drug alerts were republished via The Know website. All of these alerts included information about detections of unexpected substances, with nine alerts relating to detections of novel psychoactive substances (Kypri et al. 2025). No alerts were issued for high-dose MDMA/ecstasy tablets, unlike previous reports (Kypri et al. 2025).

For detailed and timely information on drug alerts across Australia, see The Know.

Needle and syringe programs

Needle and syringe programs (NSPs) are designed to reduce the sharing of injecting equipment through the provision of sterile needles and syringes to people who inject drugs. NSPs are a cost-effective measure that have successfully prevented the spread of blood-borne viruses such as human immunodeficiency virus (HIV) and Hepatitis C infection. NSPs also provide counselling services and actively encourage clients into drug treatment programs (Wodak and Cooney 2004).

There were 4,708 NSPs operating across Australia in June 2024, including 3,220 NSPs in pharmacies and 458 syringe dispensing machines (Heard et al. 2024). The number of NSPs (excluding syringe dispensing machines) across Australia has increased by around 10% since 2020, while the number of syringe dispensing machines has risen by 24%. Around 54.6 million needles and syringes were distributed to 72,984 people in 2023–24, or 749 needles per person (Heard et al. 2024).

In 2025, over half (55%) of the Illicit Drug Reporting System (IDRS) participants were recruited via NSPs. The IDRS also showed that NSPs were by far the most common source of needles and syringes used by people who regularly inject drugs in the past month (used by 84% of participants), followed by NSP vending machines (22%) (Sutherland et al. 2025b). This is supported by the findings of the 2022–2023 NDSHS that NSPs were the most reported source of needles and syringes (45%), followed by chemists (31%) (AIHW 2024b, Table 5.110). This is likely to reflect the different sampling of the two surveys whereby the NDSHS is targeted at the general population, while the IDRS specifically recruits people who inject drugs and are mostly recruited through NSPs.

Over 2 in 3 (68%) people in Australia supported needle and syringe programs in 2022–2023, up from 64% in 2019 (AIHW 2024, Table 11.19). Support was highest among people who had recently injected drugs (83%, compared with 68% of people who had never injected drugs) (AIHW 2024, Table 11.21).

Take-home naloxone

Opioid overdose represents a significant and ongoing problem for Australia’s public health. Naloxone is a medication that reverses the effects of opioids and is an important means of responding to the harms associated with opioid overdose (including death) (Penington Institute 2018). Take-home naloxone programs enable those people at risk of opioid overdose or adverse reaction, and their friends and family members to access naloxone at community and hospital-based pharmacies, alcohol and drug treatment centres and NSPs. Given in a timely manner, naloxone can reverse the effects of opioid overdose (Department of Health 2021).

Around 3 in 5 (61%) people in Australia supported take-home naloxone in 2022–2023, up from 56% in 2019 (AIHW 2024, Table 11.19). Support was highest among people who had recently injected drugs (88%, compared with 61% of people who had never injected drugs) (AIHW 2024, Table 11.21).

Awareness of take-home naloxone is increasing among people who regularly inject drugs interviewed via the IDRS. In 2025:

• Over 4 in 5 (86%) participants had heard of naloxone (up from 80% in 2024), and 4 in 5 (80%) had heard of take-home naloxone programs (up from 73% in 2024).
• Almost 2 in 3 (65%) people had obtained naloxone in their lifetime, up from 54% in 2024. Around 3 in 5 (60%) of these people said they last accessed naloxone from an NSP.
• Over half (55%) of people had accessed naloxone in the past year, up from 46% in 2024. 
• 1 in 3 (32%) people reported using naloxone to resuscitate someone at least once in their lifetime and 18% had done so in the past year (Sutherland et al. 2025b).

Data from the EDRS indicate that naloxone awareness and access among people who regularly use stimulants is also rising. In 2025, almost 3 in 4 (73%) participants had ever heard of naloxone and over 1 in 4 (27%) had obtained it in the past year (up from 63% and 10%, respectively, in 2024) (Sutherland et al. 2025a).

Supervised drug consumption rooms

Supervised drug consumption rooms and medically supervised injecting centres (MSIC) are places where people can use and inject drugs under the supervision of registered nurses, counsellors, and health education professionals. These services aim to prevent injury and death by being present when someone injects in order to provide immediate medical assistance as required. Kings Cross in Sydney has been home to a MSIC since 2001 (Uniting 2017) and a second opened in Richmond, Victoria, in July 2018. In 2025, 11% of IDRS participants in Melbourne and 6% of those in Sydney reported that they last injected at a supervised injecting facility (Sutherland et al. 2025b, Table 22).

Just over half (53%) of people in Australia supported supervised drug consumption rooms in 2022–2023, up from 47% in 2019 (AIHW 2024, Table 11.13). Nearly three-quarters (72%) of people who had recently used drugs supported this measure, compared with 45% of people who had never used drugs. Additionally, support was highest:

• among people aged 18–24 (64%) compared with those aged 70 and over (44%)
• in Major cities (56%) and decreased with increased remoteness (38% in Remote and very remote areas)
• among people in the most advantaged socioeconomic areas (63%) and lowest among people in the 2^nd most disadvantaged areas (47%)
• among people with a bachelor degree or higher (72%) and lowest among people who had completed year 11 or less (55%) (AIHW 2024, Table 11.12).

Where do I go for more information?

• Pill testing in Australia
• Support for alcohol and other drug-related policies
• Take Home Naloxone program
• The Know