Australian Institute of Health and Welfare (2022) Alcohol, tobacco & other drugs in Australia, AIHW, Australian Government, accessed 09 February 2023.
Australian Institute of Health and Welfare. (2022). Alcohol, tobacco & other drugs in Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 14 December 2022, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2023 Feb. 9]. Available from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2022, Alcohol, tobacco & other drugs in Australia, viewed 9 February 2023, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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Older people make up a considerable proportion of Australia’s population. In 2017, over 1 in 7 people were aged 65 and over and the number and proportion of older Australians is expected to continue to grow (AIHW 2018). Older people have unique health circumstances including pain, co-morbidities, and social circumstances such as isolation (DoH 2017). These factors are important to consider in the context of alcohol and other drug use.
Most population data define ‘old’ as persons aged 65 and over to align with the qualifying age for the Age pension. However, this section will generally refer to people aged 50 and over in order to capture people who may be ageing prematurely due to alcohol and other drug use, and to include the ‘Baby Boomer’ cohort (AIHW 2016). The different older age cohorts are specified where relevant.
In 2018, tobacco was the leading risk factor for the burden of disease for males aged 65–80 and females aged 45–84
In 2019, people in their 50s (15.9%) were the most likely age group to smoke daily. This has changed since 2007, when people aged 25–29 were more likely to smoke daily
People in their 50s (21%) and 60s (17.4%) were more likely to exceed lifetime alcohol risk guidelines than the general population aged 14 and over (16.8%)
Lifetime alcohol risk
Recent use of any illicit drug has become more common among people aged 60 and over (from 3.9% in 2001 to 7.2% in 2019)
In 2020, people aged 45–54 had the equal highest rate of drug-induced deaths (13.0 per 100,000 population)
In 2021, almost one-third (31%) of clients who received opioid pharmacotherapy treatment were aged 50 and over. This has increased from 16% in 2011
View the Older people fact sheet >
The Australian burden of disease study 2018 found that tobacco use was one of the leading risk factors contributing to the burden of disease for older Australians. Specifically, tobacco use was the leading risk factor for males aged 65–84 and females aged 45–84 (AIHW 2021b).
Data from the 2019 National Drug Strategy Household Survey (NDSHS) showed that the proportion of people in their 60s who smoke daily is not declining at the same rate as that for younger age groups, while for people in their 50s it has increased slightly (AIHW 2020).
In 2019, people in their 50s were the most likely age cohort to smoke daily (15.9%). In 2007, the proportion of people who smoked daily was highest for people aged 25–29 (26%) (AIHW 2020, Table S.9). This effect is largely driven by a shift in the age distribution of daily smokers. Between 2016 and 2019, the proportion of daily smokers who were aged in their 50s increased from 17.7% to 21.2%, while for those in their 60s it increased from 10.6% to 12.7% (AIHW 2020, Table 8.9). This reflects an ageing cohort of daily smokers, and the tendency for younger people to not take up smoking. Notably, however, daily smoking among those aged 70 and over is lower than for people in their 50s and 60s, and decreased from 6.2% in 2016 to 5.4% in 2019 (AIHW 2020).
Data from the NDSHS showed that people in older age groups (50 and over) tend to smoke more cigarettes than people in younger age groups. In 2019:
Estimates from the NDSHS also showed that people in older age groups are the least likely to have intentions to quit smoking (AIHW 2020). In 2019:
New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the 2009 guidelines (see Box ALCOHOL1). National Drug Strategy Household Survey data relating to the updated guidelines are available in the Measuring risky drinking according to the Australian alcohol guidelines report.
Data from the 2019 NDSHS indicated that a higher proportion of people in older age groups have given up alcohol, compared with younger people. In 2019, people in their 50s (9.6%), 60s (12.7%), and those aged 70 and over (16.1%) were more likely to be ex-drinkers than were people aged 14 and over (8.9%) (AIHW 2020, Table 3.4).
However, people in older age groups who do consume alcohol are more likely to drink in quantities that exceed the lifetime risk guidelines (people in their 50s and 60s) or drink daily (those aged 70 and over) (AIHW 2020).
Estimates from the NDSHS show that the proportion of people who drink daily increases with age. In 2019:
The proportion of people in older age groups who exceed the lifetime risk guidelines for alcohol varies according to age (AIHW 2020). Estimates from the NDSHS show that, in 2019:
The figure shows that the proportion of people who recently exceeded lifetime risk for alcohol has remained relatively stable for older people (aged 50–59, 60–69 and 70 and over) since 2007.
Similar to lifetime risk, the proportion of people in older age groups who exceed single occasion risk guidelines for alcohol varies by age. Estimates from the NDSHS showed that, in 2019:
People in older age groups (50 and over) are less likely to consume 11 or more standard drinks on a single drinking occasion at least once in the past 12 months than the general population (AIHW 2020). Estimates from the NDSHS show that, in 2019:
Data from the 2019 NDSHS showed that a greater proportion of older Australians reported illicit drug use than in previous years, indicating that there is an ageing cohort of people who use illicit drugs (AIHW 2020).
The 2 most commonly used drugs by older people are cannabis and pharmaceutical drugs when used for non-medical purposes.
The figure shows that, between 2001 and 2019, recent illicit drug use has increased among people aged 50–59 (6.7% in 2001 and 13.1% in 2019) and 60+ (3.9% in 2001 and 7.2% in 2019).
People in older age groups continue to be less likely to use cannabis than the general population aged 14 and over (AIHW 2020). However, the proportion of older people who have recently used cannabis has increased over time. Specifically, the 2019 NDSHS showed that:
Data from the NDSHS suggest that older people are also more likely to use cannabis for medical purposes than people in younger age groups. In 2019, 43% of people who had recently used cannabis for medical purposes only were aged 50 and over, while 16% of people who used cannabis for non-medical reasons were aged 50 and over (AIHW 2020).
Data from the Pharmaceutical Benefits Scheme (PBS) provide information on the number of prescriptions dispensed and the number of patients dispensed supplied at least one script under the PBS within a given financial year. The PBS database includes information medicines that may be used for non-medical purposes, including opioids, benzodiazepines and gabapentinoids. These numbers largely represent medicines being prescribed for and used for their intended purposes, but monitoring dispensing of these drugs is important in the context of harm reduction (see Box PHARMS1). Refer to the Technical notes and Box PHARMS2 for more information.
Data from the PBS indicate that rates of dispensing of opioids, benzodiazepines and gabapentinoids (such as pregabalin) increase with increasing age, and are highest for people in their 60s, 70s and 80 and over (Figure PHARMS2; tables PBS6, PBS8, PBS26, PBS28, PBS50 and PBS52). In 2020–21:
People in older age groups consistently had the highest rates of dispensing for opioids, benzodiazepines and gabapentinoids between 2012–13 and 2020–21. However, rates of dispensing of benzodiazepines and opioids declined over time for these age groups. Conversely, gabapentinoid dispensing rates increased across the period, but have stabilised since 2017–18 (Figure PHARMS2; tables PBS6, PBS8, PBS26, PBS28, PBS50 and PBS52).
Similar to cannabis, non-medical use of pharmaceutical drugs is generally lower among older age groups than the general population aged 14 and over. However, pharmaceuticals are the second most common drug used by older people.
For related content on health and harms, see also:
National Drug and Alcohol Research Centre (NDARC) analysis of the National Hospital Morbidity Database of drug-related hospitalisations (excluding alcohol) showed that, in 2020–21, people aged 20–29 and 30–39 had the highest rates of drug-related hospitalisations of any age group. However, this rate has been increasing among older age groups. From 1999–2000 to 2020–21:
Alcohol-induced deaths are defined as those that can be directly attributable to alcohol use, as determined by toxicology and pathology reports (for example, chronic conditions such as alcoholic liver cirrhosis or acute conditions such as alcohol poisoning). Alcohol-related deaths include deaths directly attributable to alcohol use and deaths where alcohol was listed as an associated cause of death (for example, a motor vehicle accident where a person recorded a high blood alcohol concentration) (ABS 2018a).
In 2021, ABS Causes of Death data reported 1,559 alcohol-induced deaths and the majority (86%) of these deaths were in people aged 45 years and over (1,334 deaths) (ABS 2022, Table 13.12). Nine in 10 (91%) alcohol-induced deaths were due to the chronic affects of alcohol (1,413 deaths) and these deaths were predominantly in people aged 45 years and over (87%) (ABS 2022, Table 13.16). People aged 55–64 had the highest age-specific rate (15.5 deaths per 100,000 population), accounting for 3 in 10 alcohol-induced deaths (30% or 468). Additionally:
Australian Institute of Health and Welfare (AIHW) analysis of the AIHW National Mortality Database showed that of the reported 1,452 alcohol-induced deaths in 2020, the highest age-specific rates for alcohol-induced deaths were for older people:
In comparison, the lowest rates of alcohol-induced deaths were for young people aged 15–24 years—there were no alcohol-induced deaths for people aged 15–19 and the rate was 0.1 per 100,000 population for those aged 20–24 years.
Higher rates of alcohol-related deaths were also recorded for the older age groups (ranging from 32.1 deaths per 100,000 population for those aged 50–54 to 37.0 per 100,000 population for those aged 60–64) (Table S1.5). This compares with the lowest rate of 4.1 per 100,000 population for people aged 15–19 years.
Drug-induced deaths are defined as those that can be directly attributable to drug use and include both those due to acute toxicity (for example, drug overdose) and chronic use (for example, drug-induced cardiac conditions) as determined by toxicology and pathology reports (ABS 2022).
In 2021, ABS Causes of Death data reported 1,704 drug-induced deaths. Of these deaths, 55% were in people aged 45 years and over (945 deaths). Overall, the highest rate was in the 45–54 year age group, with an age-specific rate of 13.5 deaths per 100,000 population; this age group was also the highest for both males and females (17.3 and 7.8 per 100,000 population, respectively). Additionally, for the older age groups:
AIHW analysis of the National Mortality database shows that in 2020, people aged 65 years and over were the only age group to not have personal history of self-harm as the most frequently occurring psychosocial risk factor. Personal history of self-harm was the second most frequently occurring risk factor, behind limitation of activities due to disability (17.4% of drug-induced deaths in this age group) (Table 2.71b).
Data analysis on causes of death in Australia by the National Drug and Alcohol Research Centre (NDARC) show that the age profile of people with drug-induced deaths has changed over the last 2 decades:
Between 2019 and 2020, the rate of opioid-induced deaths continued to decrease for people aged 55-64 (5.9 per 100,000 population to 5.3), and people aged 75–84 (1.5 per 100,000 population to 1.4). There was an increase in opioid-induced deaths for people aged 65–74 (1.9 per 100,000 in 2019 to 2.3 in 2020) (Chrzanowska et al. 2022).
The 2020–21 Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) annual report shows that 11% of clients receiving treatment were aged 50–59 and 5.1% were aged 60 and over (AIHW 2022a).
Data collected for the AODTS NMDS are released twice each year—a key findings report in April and a detailed report mid-year.
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 AIHW’s AODTS NMDS and National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collections indicate that, in the last 11 years, an ageing cohort of Australians receiving drug and alcohol treatment has emerged.
NOPSAD data indicate that:
Data from the AODTS NMDS show that 16% of clients who received treatment for their own or someone else’s alcohol or other drug use in 2020–21 were aged 50 and over. This has increased from 13% in 2014–15 (AIHW 2022a).
In 2020–21, among clients who sought treatment for their own AOD use:
The AODTS data were matched with the Specialist Homelessness Services (SHS) collection to identify clients who use both services (matched clients) and compared characteristics between the groups (AIHW 2016). Older clients were identified as one of 4 vulnerable cohorts in the analysis (along with clients with a current mental health issue, clients who experienced family and domestic violence and young clients aged 15–24). The analysis found that matched clients aged 50 and over (when compared to the other vulnerable cohorts) were more likely to be:
Older clients had similar patterns of alcohol and other drug treatment types, regardless of whether they were in the matched group or AODT-only group, with counselling being the most commonly provided treatment type for all older clients (AIHW 2016).
Data from the Pharmaceutical Benefits Scheme (PBS) provide information on the number of prescriptions dispensed and the number of patients supplied at least one script under the PBS within a given financial year. The PBS database includes information about medicines that are used to help people stop their smoking or alcohol consumption (smoking and alcohol cessation medicines).
Some smoking cessation medicines, such as Nicotine Replacement Therapies (NRT; for example, nicotine patches and gums), are available over-the-counter (OTC) as well as via a prescription. OTC NRT data are not captured in the PBS data as OTC medicines are not subsidised under the PBS. Refer to the Technical notes and Box PHARMS2 for more information.
Data from the PBS indicate that rates of dispensing of smoking and alcohol cessation medicines are consistently highest for people aged in their 40s, 50s and 60s (tables PBS66, PBS68, PBS82 and PBS84). In 2020–21:
Between 2012–13 and 2020–21, people in their 40s, 50s and 60s consistently had the highest dispensing rates for smoking and alcohol cessation medicines of any age group.
ABS (Australian Bureau of Statistics) 2018a. Deaths Due to Harmful Alcohol Consumption in Australia. ABS cat no. 3303.0. Canberra: ABS, accessed 22 November 2022.
ABS 2018b. National Health Survey, First Results, 2017-18. ABS cat. no. 4364.0.55.001. Canberra: ABS. Viewed 21 December 2018.
ABS 2022. Causes of Death, Australia, 2021. ABS cat. no. 3303.0. Canberra: ABS. Viewed 2 November 2022.
AIHW (Australian Institute of Health and Welfare) 2016. Exploring drug treatment and homelessness in Australia. Cat. No. CSI 23. Canberra: AIHW. Viewed 10 January 2018.
AIHW 2018. Older Australia at a glance. Canberra: AIHW. Viewed 14 November 2018.
AIHW 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW. Viewed 16 July 2020.
AIHW 2021b. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018, AIHW, Australian Government. doi:10.25816/5ps1-j259
AIHW 2022a. Alcohol and other drug treatment services in Australia annual report. Cat. No. HSE 250. AIHW, Australian Government, accessed 27 July 2022.
AIHW 2022b. National Opioid Pharmacotherapy Statistics Annual Data collection. Cat. no. PHE 266. Canberra: AIHW. Viewed 7 March 2022.
Chrzanowska, A, Man, N, Sutherland, R, Degenhardt, L & Peacock, A (2022). Trends in overdose and other drug-induced deaths in Australia, 1997-2020. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney. DOI: 10.26190/ke9y-4731
Chrzanowska A, Man N, Akhurst J, Sutherland R, Degenhardt L & Peacock A 2022a. Trends in drug-related hospitalisations in Australia, 1999–2021. Drug Trends Bulletin Series. Sydney: National Drug and Alcohol Research Centre, UNSW, accessed 2 November 2022.
DoH (Department of Health) 2017. National Drug Strategy 2017-2026. Canberra: Australian Government. Viewed 12 January 2018.
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