Geographic trends
Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.
Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) (ABS 2016, Table 2.3).
Exposure to second-hand smoke
The Aboriginal and Torres Strait Islander Health Performance Framework report 2020 found that in 2018–19:
- 1 in 10 (10% or 83,900) Indigenous Australians lived in household with a daily smoker who smoked indoors
- almost 1 in 7 (15% or 23,900) of Indigenous children aged 0–14 lived in a household with someone who smoked indoors (AIHW 2020a).
Smoking reduction or cessation
In 2018–19, over half of Indigenous Australian smokers aged 15 and over (52%) had tried to quit smoking in the previous 12 months. In 2014–15, 30% of Indigenous current smokers had tried to quit smoking in the previous 12 months, 18% had tried to reduce their smoking and 21% had tried to do both (AIHW 2017; AIHW 2020a; DoH 2017a).
Indigenous Australians smoked a median of 10 cigarettes a day in 2018–19, a decrease from 12 cigarettes a day in 2008 (AIHW 2020a; DoH 2017a).
Almost 1 in 2 Indigenous Australians with a mental health condition were daily smokers (46%) and about 2 in 5 (39%) have used substances in the last 12 months. This was higher than for Indigenous Australians with other long-term health conditions (33% and 24%, respectively) or those with no long-term health condition (39% and 29%, respectively) (ABS 2016) (ABS 2019, Table 19.3).
Alcohol-related deaths
Over the 2013 to 2017 period–on average the rate of alcohol-related deaths was 23.8 per 100,000 population compared with 4.7 per 100,000 population for non-Indigenous Australians (ABS 2018).
The Aboriginal and Torres Strait Islander Health Performance Framework (AIHW 2020a) reports that the rate of alcohol-related deaths among Indigenous Australians was 18 deaths per 100,000 population in 2018. This is a decrease of 40% from 2008 (31 deaths per 100,000).
Drug-related deaths
The Penington Institute’s annual overdose report highlights that in 2020 the rate per capita of unintentional drug-related deaths per 100,000 population was 3 times higher for Indigenous Australians than for non-Indigenous Australians (18.1 compared with 5.6). Between 2001 and 2020, the rate of unintentional drug-induced deaths among Indigenous Australians has fluctuated, decreasing from 19.3 deaths per 100,000 in 2001 to 9.5 in 2009 before peaking to 21.9 in 2019. However, it should be noted that:
- Rate calculations can be volatile due to smaller numbers of Indigenous deaths.
- These data are reported for New South Wales, Queensland, Western Australia, South Australia and the Northern Territory only, which are considered to have adequate levels of Indigenous identification in the mortality data (Penington Institute 2022).
For more information, see Health impacts: Box IMPACT1.
The 2021–22 Alcohol and Other Drug Treatment Services Early Insights Report shows that Indigenous Australians accounted for 18% (23,169) of people aged 10 and over receiving treatment or support for their own or someone else’s alcohol or other drug use.
The rate of Indigenous Australians receiving treatment for their own drug use has increased from 2,829 per 100,000 population in 2013–14 to 3,354 per 100,000 in 2020–21 (AIHW 2023a).
Data collected for the AODTS NMDS are released twice each year—an early insights report in April and a detailed report mid-year. Detailed information will be updated in June 2023.
Data from the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS NMDS) showed that Indigenous Australians accounted for 17% (24,328) of all clients of AOD treatment services in 2020–21 (AIHW 2022a).
The crude rate of Indigenous clients who received treatment for their own drug use where:
- Alcohol was the principal drug of concern was 1,260 clients per 100,000 population.
- Amphetamines was the principal drug of concern was 981 clients per 100,000.
- Cannabis was the principal drug of concern was 929 clients per 100,000 population.
- Heroin was the principal drug of concern was 185 per 100,000 (AIHW 2022a, Table SCR.26).
In 2016–17, Indigenous clients travelled 1 hour or longer to their treatment service in about 1 in 4 (26%) closed treatment episodes. About 1 in 8 (13%) closed treatment episodes for non-Indigenous clients had a travel time of 1 hour or longer (AIHW 2019b).
Indigenous clients who sought treatment in Regional and remote areas travelled 1 hour or longer to the treatment service in 37% of closed treatment episodes, compared with 13% of closed treatment episodes for Indigenous clients in Major cities (AIHW 2019b).
It should be noted that as remoteness areas increase (become more remote), the accuracy of time travel/distance estimates decrease, due to the larger size of Remote areas (AIHW 2019b).
People who experience dependence on opioid drugs (including codeine, heroin, and oxycodone) can receive opioid pharmacotherapy treatment. This involves replacing the opioid drug of dependence with a longer-lasting, medically prescribed opioid (such as methadone or a buprenorphine formulation). The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. In June 2022:
- 6,318 clients who received pharmacotherapy treatment identified as Indigenous Australians (71 per 10,000 clients).
- The proportion of Indigenous clients receiving treatment with methadone fell from 54% in 2017 to 43% in 2022.
- By comparison, the proportion of Indigenous clients receiving treatment with a buprenorphine formulation has increased from 40% in 2020 to 55% in 2022 (AIHW 2023b, Table S.9).
- Buprenorphine long acting injectable was reported in the collection for the first time in 2020 (0.9% of Indigenous clients) (excludes data from NSW). The proportion of Indigenous clients receiving this treatment has increased to 7% in 2022 (AIHW 2023b, Table S.9).
Data from the Online Services Report (OSR) show that in 2016–17, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 39,400 Aboriginal and Torres Strait Islander clients (AIHW 2018). The OSR data also shows that:
- All 80 organisations reported that alcohol was one of the top 5 common substance-use issue, followed by cannabis (95%) and amphetamines (80%)
- Treatment episodes were more likely to occur in non-residential settings (89%)
- One quarter of all treatment episodes were in Very remote areas (24%) and the highest proportion of clients were located in Major cities (37%).
Policy context
The Aboriginal and Torres Strait Islander Health Performance Framework
The Aboriginal and Torres Strait Islander Health Performance Framework (HPF) monitors progress in Aboriginal and Torres Strait Islander health outcomes, health system performance and the broader determinants of health. The HPF consists of 68 performance measures across 3 tiers:
- Tier 1–health status and outcomes
- Tier 2–determinants of health
- Tier 3–health system performance.
In December 2020, the HPF was released on a new website. The website brings together information from numerous sources to provide up-to-date determinants of health designed to inform policy planning, program development and research (AIHW & NIAA 2020).
National Aboriginal and Torres Strait Islander Peoples Drug Strategy 2014–2019
The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2026. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs on individuals, families and their communities (IGCD 2014).
Access the National Aboriginal and Torres Strait Islander Peoples Drug Strategy 2014–2019 >