Data quality

National Drug Strategy Household Survey, AIHW

The National Drug Strategy Household Survey (NDSHS) collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia. It also surveys people’s attitudes and perceptions relating to tobacco, alcohol and other drug use. The 2019 NDSHS survey was the 13th conducted under the National Drug Strategy. The survey was first undertaken in 1985 and has been undertaken every 3 years since 1995. Key quality issues to consider for the collection include:

  • Reported findings are based on self-reported data and are not empirically verified by blood tests or other screening measures.
  • It is known from past studies of alcohol and tobacco consumption that respondents tend to underestimate actual consumption levels.
  • Estimates of illicit drug use and related behaviours are also likely to be underestimates of actual use.
  • The exclusion of persons from non-private dwellings, institutional settings, homeless people and the difficulty in reaching marginalised persons are likely to have affected estimates.
  • The response rate for the 2019 survey was 49%. Given the nature of the topics in this survey, some non-response bias is expected, but this bias has not been measured.
  • Both sampling and non-sampling errors should be considered when interpreting results.
  • The 2019 survey used a multi-mode completion methodology—respondents could choose to complete the survey via a paper form, an online form or via a telephone interview. This was the second time an online form has been used in the survey series. Changes in mode may have some impact on responses, and users should exercise some degree of caution when comparing data over time
  • Data from the questions on ‘activities undertaken while under the influence of alcohol or illicit drugs’ are not considered comparable to previous data collections, due to questionnaire changes.

The full data quality statement for the NDSHS 2019.

Alcohol and other Drug Treatment Services National Minimum Data Set, AIHW

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) is based on closed episodes of treatment provided to clients by alcohol and other drug treatment services. All in-scope service agencies are publicly funded through state, territory or Australian government programs. Key quality issues to consider for the collection include:

  • Funding programs cannot be differentiated—services are categorised according to sector, with government-funded and operated services reported as public services and those operated by non-government organisations reported as private services.
  • National data are affected by variations in service structures and collection practices between states and territories; these should be considered when making comparisons between jurisdictions.
  • The AODTS NMDS reports both main and additional treatment types. Victoria and Western Australia do not differentiate between main and other treatment types. This needs to be taken into account when comparing episodes from these states with other states and territories.

The full data quality statement for the AODTS NMDS 2017–18.

Data for each reporting period are first released as key findings. This is followed by the detailed findings report. As such, not all data on alcohol and other drug treatment services will be updated at the same time.

National Opioid Pharmacotherapy Statistical Annual Data Collection, AIHW

The main purpose of the NOPSAD collection is to aggregate standardised jurisdictional data on the number of clients accessing pharmacotherapy for the treatment of opioid dependence, the number of prescribers participating in the delivery of pharmacotherapy treatment, and quantitative information about the prescribing sector. Key quality issues to consider for the collection include:

  • Each state and territory use different methods to collect data about the pharmacotherapy used to treat those with opioid dependence. These methods are driven by differences between the states and territories in relation to legislation, information technology systems and resources. These differences may result in discrepancies and need to be considered when comparing data across jurisdictions.
  • New South Wales is unable to differentiate between clients prescribed buprenorphine and buprenorphine-naloxone.
  • Indigenous status of client is reported as a total by Victoria, i.e. a breakdown of Indigenous status by individual pharmacotherapy drug type is not available. Indigenous status of client was reported for the first time in 2018 by Western Australia.
  • In Western Australia, the number of clients receiving pharmacotherapy treatment is reported through the month of June (rather than on a snapshot day), likely resulting in an over-representation of clients in Western Australia.
  • In Tasmania, the number of clients receiving treatment in June is counted. If a client changes dosing point sites during the month they are only counted once and the dosing point that administered the greater number of doses is attributed the activity.
  • Unit record data were provided by all jurisdictions except Victoria and Queensland.

The full data quality statement for the 2019 NOPSAD.

National Health Survey, ABS

This web report contains results from the Australian Bureau of Statistics (ABS) National Health Survey (NHS) 2017–18, collected between July 2017 to June 2018.

The 2017–18 NHS is the most recent in a series of Australia-wide health surveys conducted by the ABS. It was designed to collect a range of information about the health of Australians, including:

  • prevalence of long-term health conditions
  • health risk factors such as smoking, overweight and obesity, alcohol consumption and exercise
  • use of health services such as consultations with health practitioners and actions people have recently taken for their health
  • demographic and socioeconomic characteristics.

The 2017–18 NHS collected data on children and adults living in private dwellings but excluded persons living in non-private dwellings, Very remote areas and discrete Aboriginal and Torres Strait Islander communities.

Data for the daily smoking prevalence for 2017–18 were based on the National Health Survey: First Results, 2017–18. Subsequently, the NHS dataset was weighted to produce smoking data consistent with the pooled Smoker Status dataset. Proportions calculated from both datasets will match, however the estimates will differ between the files. The ABS recommends using the pooled data estimates for reporting where this is possible. For more information, please refer to the National Health Survey Users' Guide 2017-18, particularly the Smoking section under Health risk factors. The Smoker Status data is referred to in that document as the National Health Survey And Survey of Income and Housing dataset (NHIH).

For further information, refer to the ABS National Health Survey: First Results, 2017–18.

The full data quality statement for the NHS 2017–18.

National Aboriginal and Torres Strait Islander Social Survey 2014–15, ABS

The 2014–15 NATSISS was conducted throughout Australia, including Remote areas, from September 2014 to June 2015.

  • The scope of the survey is all Aboriginal and Torres Strait Islander people who were usual residents of private dwellings in Australia. Private dwellings are houses, flats, home units and any other structures used as private places of residence at the time of the survey. People usually resident in non-private dwellings, such as hotels, motels, hostels, hospitals, nursing homes, and short-stay caravan parks were not in scope. Usual residents are those who usually live in a particular dwelling and regard it as their own or main home.
  • After screening and sample loss (due to households with no residents in scope for the survey or where dwellings proved to be vacant, under construction or derelict) 8,235 dwellings were approached for an interview. Of these eligible dwellings, 80% responded fully (or adequately) which yielded a total sample from the survey of 6,611 dwellings. An adequately responding household was defined as a household where at least one of the persons selected for the survey completed their interview.

The full data quality statement for the 2014–15 NATSISS.

Australian Aboriginal and Torres Strait Islander Health Survey 2012–13, ABS

The 2012-13 AATSIHS was conducted throughout Australia in Remote and Non-remote areas from April 2012 to February 2013. The 2012-13 AATSIHS collected information on a range of demographics from over 9,000 Aboriginal and Torres Strait Islander people of all ages.

The scope of the survey was all Aboriginal and Torres Strait Islander people who were usual residents of private dwellings in Australia. Private dwellings are houses, flats, home units and any other structures used as private places of residence at the time of the survey. People usually resident in non-private dwellings, such as hotels, motels, hostels, hospitals, nursing homes, and short-stay caravan parks were not in scope. Usual residents are those who usually live in a particular dwelling and regard it as their own or main home.

The 2012–13 AATSIHS was designed to produce reliable estimates at the national level and for each state and territory. For selected states and territories, that is New South Wales, Queensland, Western Australia and the Northern Territory, the sample for children aged 0–14 years and persons aged 15 years and over was allocated to produce estimates that have a relative standard error (RSE) of no greater than 25% for characteristics that at least 5% of these populations would possess.

The 2012–13 AATSIHS contains information from the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) core sample of around 12,900 people (a combined data file of both the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) and the National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS) for people aged 2 years and over).

Further information about the AATHIHS.

National Australian Aboriginal and Torres Strait Islander Health Survey 2018–19, ABS

The 2018–19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) was conducted between July 2018 and April 2019. It collected information from Aboriginal and Torres Strait Islander people of all ages in Non-remote and Remote areas of Australia, including discrete Indigenous communities.

The NATSIHS collected data on a broad range of health-related topics, language, cultural identification, education, labour force status, income and discrimination. Information on a number of topics was collected for the first time, including mental health conditions, medications, consumption of sugar sweetened and diet drinks, experiences of harm and a hearing test.

The scope of the survey was all Aboriginal and Torres Strait Islander people living in private dwellings. The following people were not included in the survey:

  • non-Indigenous persons
  • visitors to private dwellings staying for less than 6 months
  • people in households where all residents are less than 18 years of age
  • people who usually live in non-private dwellings, such as hotels, motels, hostels, hospitals, nursing homes and short-stay caravan park
  • students at boarding school
  • non-Australian diplomats, diplomatic staff and members of their household
  • members of non-Australian defence forces stationed in Australia and their dependents
  • overseas visitors.

The overall coverage of the 2018–19 NATSIHS was approximately 33% of Aboriginal and Torres Strait Islander persons in Australia (based on 10,579 fully responding persons).

Further information about the NATSIHS 2018–19

Causes of Death, Australia ABS

Statistics presented in Causes of Death, Australia, 2016 and 2017 (cat. no. 3303.0) are sourced from death registrations administered by the various state and territory Registrars of Births, Deaths and Marriages. It is a legal requirement of each state and territory that all deaths are registered. In addition, the ABS supplements this data with information from the National Coronal Information System (NCIS) for those deaths certified by a coroner.

Deaths are considered “drug induced” if directly attributable to drug use (e.g. drug overdose), and “drug related” where drugs played a contributory factor (e.g. traffic accidents ).

In Australia, acute drug overdose deaths are referred to a coroner and subject to forensic pathology and toxicology. Autopsy and toxicology reports provide detailed drug information including the identification of specific drugs in the system, approximate levels of drugs in the system and the relatedness of drugs to the death. The ABS accesses this information via the NCIS and applies codes from the International Classification of Diseases, 10th Revision, to the medical text for tabulation into statistical output.

Further information on Cause of deaths, Australia.

Illicit Drug Reporting System, NDARC

The Illicit Drug Reporting System (IDRS) is a national illicit drug monitoring system intended to identify emerging trends of local and national concern in illicit drug markets. The IDRS consists of annual interviews across all Australian jurisdictions with people who inject drugs (PWID), as well as analysis and examination of indicator data sources related to illicit drugs.

  • 902 participants were recruited to the 2019 IDRS survey. The sample sizes reflect predetermined quotas.
  • Although the IDRS is well able to monitor trends in established drug markets and document the emergence of drug use among people who regularly inject drugs, it cannot provide information on drug use and harms among all groups of people who use drugs.
  • The IDRS sample is a sentinel group that provides information on patterns of drug use and market trends.

Further information about the IDRS.

Ecstasy and Related Drugs Reporting System, NDARC

The Ecstasy and Related Drugs Reporting System (EDRS) is a national monitoring system for ecstasy and related drugs that is intended to identify emerging trends of local and national interest in the markets for these drugs. The EDRS is based on the IDRS methodology and consists of 3 components: interviews with regular ecstasy and psychostimulant users; interviews with key experts, professionals who have regular contact with regular recreational users through their work; and analysis and examination of indicator data sources related to ecstasy and other related drugs. The EDRS monitors the price, purity, availability and patterns of use of ecstasy, methamphetamine, cocaine, ketamine, GHB, MDA and LSD.

  • 797 participants were recruited to the 2019 EDRS survey. The sample sizes reflect predetermined quotas.
  • The EDRS sample is a sentinel group that provides information on patterns of drug use and market trends.

In 2020, interviews were completed via phone or videoconference (instead of face-to-face) to manage risks associated with COVID-19. The interview was adapted to collect data specifically related to COVID-19 and the introduction of restrictions in Australia at the beginning of March 2020. Otherwise, the study protocol was unchanged (Peacock et al. 2020). See Impacts of COVID-19 and associated restrictions on people who use illicit stimulants in Australia: Preliminary findings from the Ecstasy and Related Drugs Reporting System 2020.

Further information about the EDRS.

National Wastewater Drug Monitoring Program, ACIC

The method underlying wastewater based monitoring of drug use in a given population is based on the principle that any given compound that is consumed (irrespective of whether it is swallowed, inhaled/smoked or injected) will subsequently be excreted (either in the chemical form it is consumed and/or in a chemically modified form that is referred to as a metabolite). The excreted compound or metabolite will eventually arrive in the sewer system.

Collectively, waste products in the sewer system arrive at a wastewater treatment plant (WWTP) where wastewater samples are collected over a defined sampling period. Measuring the amount of target compound in the wastewater stream allows for a back-calculation factor to be applied to determine the amount of drug that was used over the collection period. The method is non-invasive and is done on a population-scale level, so individuals are not targeted and privacy is respected.

Wastewater consists of highly complex mixtures that derive from toilets, bathrooms, kitchen and laundry appliances, as well as all other domestic, industrial or commercial plumbed structures. To obtain an estimate of drug use, representative samples are collected over a given period (typically 24 hours) using autosamplers that collect time or flow proportional samples. Wastewater treatment plant operators provide assistance with collecting the samples from the influent autosampler (where the wastewater enters the treatment plants). Pertinent information on the volume of wastewater entering the WWTP (flow volume) that is associated with a given sample is also collected by local operators. It should be noted that rain events may, for example, cause an increase in the volume of wastewater that enters a treatment plant but providing that the flow volume is available for each sampling period, this will not affect the overall estimate of the amount of drugs that has been used by the population that contributed to this wastewater.

The study focuses on 13 licit and illicit drugs, including nicotine from tobacco, ethanol from alcohol intake, pharmaceutical opioids with abuse potential, illicit substances such as methylamphetamine, MDMA and cocaine, as well as a number of new psychoactive substances (NPS) including mephedrone and methylone.

The measurement of cannabis consumption was included for the first time in the August 2018 collection. It should be noted that the specific marker for cannabis consumption, tetrahydrocannabinol (THC), is excreted in extremely small amounts and detection is affected by surface adsorption. Sewer design and collection method may influence the levels detected and samples must be preserved to avoid degradation, without using acidification. This is one reason why cannabis consumption is not reported on a regular basis in other countries where wastewater analysis is routinely conducted (as acidification is a common preservation technique). For the NWDMP, separate samples are collected each day and preserved specifically for analysis.

Cannabis was not included in the comparison of the highest consumed drugs as there is variation in dose sizes and using an averaged dose was not deemed appropriate for the purposes of the study. The dose of cannabis depends on several factors, such as the part of the plant, strain, or whether an extract was used. This will be included when an appropriate dose becomes available.

One of the limitations of the National Wastewater Drug Monitoring Program is that it cannot differentiate between the medical and non-medical use of pharmaceutical drugs such as oxycodone and fentanyl. In addition, the measurement of tobacco uses 2 nicotine metabolites. Wastewater analysis cannot distinguish between nicotine intake from tobacco or e-cigarettes and nicotine replacement products (such as gums and patches). As such, it is important that other data sources such as general population and sentinel surveys are also used to estimate the consumption of licit and illicit drugs. As a collective, these data inform our understanding of drug markets and how we can best respond to reduce supply, demand and harm.

A number of factors may influence interpretations of the results, including uncertainties in population estimates in an area over a 24-hour period due to work movements etc. and the variation in excretion rates (i.e. some people may metabolise a drug faster than others).

Fifty-three wastewater treatment sites participated nationally in the December 2019 collection (18 sites were located in capital cities and 35 in regional locations) covering 43% of the Australian population, which equates to about 10 million people.

For the comparison of NWDMP wastewater data with international data from the Sewage Core Group Europe (SCORE), Australian data were taken from the December 2019 collection of the NWDMP. Data for all other countries were listed in the SCORE wastewater report for March 2019. SCORE data (measured raw loads in sewers) was converted to doses using the same method as for the NWDMP data.

SCORE data has several key limitations. Some countries that have been otherwise identified as having reasonably high methamphetamine consumption (e.g., parts of Asia and the Americas) do not participate in the SCORE study. Further, the SCORE report often includes data from only a single site per country and is unlikely to be representative of drug use in that country as a whole.

Illicit Drug Data Report, ACIC

This report brings together illicit drug data from a variety of sources including law enforcement, forensic services, health and academia. Data used to inform the Illicit Drug Data Report is provided by all Australian state and territory police agencies, the Australian Federal Police, the Department of Home Affairs, Australian Border Force, the Australian Institute of Criminology and forensic laboratories. Data collected and presented in the report includes arrest, detection seizure, purity, profiling and price data. The statistics and analysis in the report are primarily used in to inform understanding of the Australian illicit drug market and the development of drug supply and harm reduction strategies.

Drug Use Monitoring in Australia Program, AIC

The Drug Use Monitoring in Australia (DUMA) program is an ongoing illicit drug use monitoring program that captures information on approximately 2 400 police detainees per year, across 5 locations throughout Australia. There are 2 core components: a self-report survey and voluntary provision of a urine sample that is subjected to urinalysis at an independent laboratory to detect the presence of licit and illicit drugs. The self-report survey captures a range of criminal justice, demographic, drug use, drug market participation and offending information. Urinalysis serves as an important objective method for corroborating self-reported drug use. Not all detainees who respond to the self-report survey agree to provide a urine sample when requested, although the urine compliance rate is high.

National Mortality Database, AIHW

The AIHW NMD contains information supplied by the registrars of Births, Deaths and Marriages and the National Coronial Information System—and coded by the ABS—for deaths from 1964 to 2018. Registration of deaths is the responsibility of each state and territory Registry of Births, Deaths and Marriages. These data are then collated and coded by the ABS and are maintained at the AIHW in the NMD.

For further information about the AIHW NMD.

The data quality statements underpinning the AIHW NMD can be found on the following ABS internet pages: ABS Deaths, Australia and Causes of death, Australia.

National Hospital Morbidity Database, AIHW

The National Hospital Morbidity Database (NHMD) includes almost all public hospitals that provided data for the NHMD in 2017–18, with the exception being an early parenting centre in the Australian Capital Territory. Similarly, the majority of private hospitals also provided data for the NHMD, the exceptions being the private freestanding day hospital facilities and 2 overnight private hospitals in the Australian Capital Territory.

Further information can be found in Admitted patient care 2017–18: Australian hospital statistics.

Drug-related hospital separations include legal, accessible drugs such as alcohol and tobacco, drugs that are available by prescription or over the counter, such as analgesics and antidepressants, and drugs that are generally not obtained through legal means, such as heroin and ecstasy. Therefore, a proportion of the separations reported here may result from harm arising from the therapeutic use of drugs, and this inclusion may mean the burden on the hospital system appears larger than expected.

Australians' Drug Use: Adapting to Pandemic Threats (ADAPT) Study

The ADAPT Study is an online survey of Australians who regularly (i.e. at least once a month) used illicit drugs in 2019. Wave 1 was conducted between 29 April to 15 June 2020 with participants invited to complete follow-up surveys in 2 months, 4 months, 6 months, 12 months, 2 years and 3 years. Participants could opt to complete the Wave 1 survey only.

This ADAPT Study is not considered representative of all people who use drugs. While the age range of the sample was 18–67 years, the sample mostly comprised young (median age of 25 years), well-educated (62% completed tertiary/university qualification) people who lived in capital cities (Sutherland et al. 2020.

See Key findings from the ‘Australians’ Drug Use: Adapting to Pandemic Threats (ADAPT)’ Study. ADAPT Bulletin no. 1.

Further information about the ADAPT Study.

Alcohol Sales and Use During COVID-19, FARE

The Foundation for Alcohol Research and Education (FARE) commissioned YouGov Galaxy to conduct polling of Australians to understand their purchasing and consumption of alcohol during the COVID-19 outbreak in Australia.

The polling was conducted online between 3-5 April 2020. The questionnaire consisted of three questions asking about:

  • Household purchasing of alcohol during the COVID-19 outbreak compared to usual purchasing behaviour
  • Individual consumption of alcohol during the COVID-19 outbreak compared to usual consumption
  • Patterns and reasons for alcohol consumption during the COVID-19 outbreak.

Further information about Alcohol sales and use during COVID-19.

ANUpoll: Alcohol consumption during the COVID-19 period: May 2020, ANU Centre for Social Research and Methods

The 34th ANUpoll collected information from 3,219 respondents aged 18 years and over across all Australian states and territories between 12–24 May 2020. Results were weighted to have a similar distribution to the Australian population across key demographic and geographic variables. While data for the majority of respondents was collected online, a small proportion was collected over the phone.

Respondents were asked several specific questions related to changes in alcohol consumption during COVID-19:

  • Since the spread of COVID-19 in Australia, are you drinking more or less alcohol?

Those who said that their alcohol consumption had increased were subsequently asked:

  • Approximately how many more standard drinks are you drinking per week in comparison to your usual weekly drinking consumption, prior to COVID-19?’
  • ‘Why do you think your consumption of alcohol has increased?’ (seven potential responses were provided, as well as an ‘other’ category and respondents were able to answer yes to more than one option).

Respondents were also asked how often, if at all, they currently smoked tobacco and whether they feel that their level of usage of illicit drugs has increased.

Further information about Alcohol consumption during the COVID-19 period: May 2020.

Commonwealth Bank of Australia, CBA Card Spend

The Commonwealth Bank’s weekly CBA card spend data indicates how households are changing what they spend their money on. It is derived from transaction authorisations to provide a near real-time up-to-date view as the Coronavirus affects the economy (Aird 2020. Commonwealth Bank of Australia, Global Economic & Markets Research report: CBA Card Spend – week ending 20 March 2020).

The following caveats should be noted when using the data:

  • CBA credit and debit card spending is tracked weekly. However, weekly data are volatile. As such, comparisons are generally made to the same period in the previous year rather than week on week. The overall spending on alcohol is the sum of the value of sales at bottle shops and venues where the primary service is alcohol. The percentage change is the difference between the spending in the current period compared with the same time in the previous year.
  • There has been a general increase in spending on cards compared with the previous year, with an increased use of payWave (a contactless method of payment). This inflates the card spending levels when compared with the previous year, however, the extent is not known. Overall card spending was 7% higher before COVID-19 restrictions (January and February 2020) when compared with the previous year. For alcohol specifically, card spending was 8% higher, possibly due to the increased use of payWave at pubs. This change is higher than the change in consumer spending and indicates a shift from cash to card spending. Many businesses did not accept cash during COVID-19 restrictions and this has also inflated card spending levels, to an unknown extent.
  • An increase in spending on alcohol does not necessarily equate to an increase in the consumption of alcohol.
  • The ‘alcohol services’ category is broadly defined as where the primary service is alcohol (with alcohol consumed on premises). For pubs and clubs, this can include spending on food. It may not be possible to determine the amount spent on alcohol as distinct from spending on food in some premises and the proportion would vary depending on the premises—some alcohol services would be primarily spending on alcohol (e.g. nightclubs). However, the same methodology is used across years which allows the overall trend to be measured (i.e. the percentage change in the dollars spent compared with the previous year).
  • The volume of units is not considered. Bottle shops tend to have cheaper prices than pubs and clubs so the overall volume could be greater for a similar spend. However, it is difficult to draw conclusions regarding volume so only the change in dollars spent is measured (G Aird 2020, pers. comm., 14 May).

For factors that may influence card spending data, see also Clifton 2020. Commonwealth Bank of Australia, Global Economic & Markets Research report: CBA Card Spend – week ending 15 May 2020.

Household Impacts of COVID-19 Survey, ABS

The Household Impacts of COVID-19 Survey is a new series designed to provide a quick snapshot about how people in Australian households are faring in response to the changing social and economic environment caused by the COVID-19 pandemic.

The third survey was conducted between 29 April and 4 May 2020 and had 1,022 respondents (88.3% response rate from the original 1,158 panel). The panel selection methodology was not a random sample. However, the coverage included all Australian geographies (excluding very remote locations). Panel data was weight adjusted using the ABS Estimated Residential Population as at the end of March 2020 and adjustments were made based on the number of persons living in the household and the education level of the selected person.

Further information about the Household Impacts of COVID-19 Survey.

SuperMIX: Impact of COVID-19, Burnet Institute

Since 2008, the Burnet Institute has conducted the Melbourne Injecting Drug User Cohort Study (MIX) and its extension, SuperMIX. This involves annual interviews with a sample of around 1,300 people who inject drugs.

The SuperMIX questionnaire was modified to collect additional information specific to COVID-19 restrictions. Interviews were conducted with 60 SuperMIX members between 29 March and 1 May 2020. Information from participants collected before, during and after the COVID-19 restrictions can also be compared to examine their impacts on people who use/inject drugs.

Further information about the Impact of COVID-19 on people who inject drugs in Melbourne.