Alcohol, tobacco & other drugs in Australia

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.

See here for the full data quality statement for the AODTS NMDS 2021–22.

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.

Alcohol-related injury: hospitalisations and deaths, 2019–20

This report aims to count the number of hospitalisations and deaths due to alcohol-related and alcohol-induced injuries from 1 July 2019 to 30 June 2020. It includes patients who had both an injury condition and an alcohol-related condition recorded in their hospital record, or an injury-related and an alcohol-related cause of death recorded.

The report uses data from the National Hospital Morbidity Database (NHMD). However, this data does not contain text fields, therefore diagnosis and external-cause-of-injury information is restricted to International Statistical Classification of Diseases and Related Health Problems Tenth Revision Australian Modification (ICD-10-AM) codes. The data quality therefore depends on the extent to which hospital staff record the involvement of alcohol and the completeness with which those notes are coded by hospital coders.

The deaths data used in this report comes from the National Mortality Database (NMD), which contains information on all deaths certified by a doctor or coroner. The NMD, like the hospitalisations data, contains coded fields, meaning the cause of death and external cause of injury information is restricted to the ICD-10 classification system coding (ABS 2020).

The report does not include information on cases that did not result in hospitalisation or death. For each hospitalisation or death there are many more cases that are treated by emergency departments, general practitioners, allied health professionals or outpatient clinics.

See further information on Alcohol-related injury: hospitalisations and deaths, 2019–20.

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.

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 people 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.

Australian Burden of Disease Study: Aboriginal and Torres Strait Islander people, AIHW

Burden of disease estimates for the Aboriginal and Torres Strait Islander population provide evidence on the diseases and injuries currently contributing most to Indigenous mortality and ill health, and on the largest gaps in disease burden between Indigenous and non-Indigenous Australians. This information will be important in assisting governments and service providers to develop interventions that can reduce the incidence of risk factors and other main contributors to the burden of disease and injury in the Indigenous population.

The Australian Burden of Disease Study 2018: key findings for Aboriginal and Torres Strait Islander people report contains key findings for Aboriginal and Torres Strait Islander people from the forthcoming Australian Burden of Disease Study (ABDS) 2018. Full results, including more detailed reports and interactive data visualisations, are planned for release in early 2022.

The ABDS2018 Aboriginal and Torres Strait Islander study includes 219 diseases, as well as estimates of the burden attributable to 39 individual risk factors, such as alcohol use and smoking. The study includes results for 2003 and 2011 for comparison, as well as estimates for selected states and territories, by remoteness area and socioeconomic groups.

Australian Burden of Disease Study, AIHW

Burden of disease analysis measures the impact of diseases and injuries on the population of Australia. It looks at the fatal and non-fatal burden – both premature deaths and living with health impacts from disease or injury. These measures combined are referred to as ‘total burden’. Burden of disease measures the difference between a population’s actual health and its ideal health (that is, if everyone lived as long as possible and no one lived with illness or injury)

Disease burden is measured using the summary metric of disability-adjusted life years (DALY). One DALY is one year of healthy life lost to disease and injury. DALY caused by living in poor health (non-fatal burden) are known as ‘years lived with disability’ (or YLD). DALY caused by premature death (fatal burden) are known as ‘years of life lost’ (YLL) and are measured against an ideal life expectancy.

The 2018 Study was the 5^th Australian study, with previous studies being undertaken in 1996, 2003, 2011 and 2015.

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. Participants were invited to complete an initial online survey, that included data for Wave 1 (29 April to 15 June 2020) as well as the initial ‘February 2020’ time point. Follow-up waves of the survey were then completed:

• Wave 2 – 29 June to 22 September 2020
• Wave 3 – 29 October 2020 to 13 January 2021
• Wave 4 – 29 April to 20 July 2021

There were 197 participants who participated in all 4 waves of the survey.

The ADAPT Study is not considered representative of all people who use drugs. While the age range of the sample was 18–67 years, among participants who completed all 4 survey waves:

• Half (50%) were female, 47% were male and 4% were non-binary
• Most were young (median age of 27 years)
• Over two-thirds (67%) had completed a tertiary/university qualification
• Over three-quarters (79%) lived in capital cities.

See Key findings from the ‘Australians’ Drug Use: Adapting to Pandemic Threats (ADAPT)’ Study. ADAPT Bulletin no. 4.

Further information about the ADAPT Study.

Causes of Death, Australia, ABS

Statistics presented in Causes of Death, Australia (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 (for example, drug overdose or due to chronic use such as drug-induced cardiac conditions), and “drug related” where drugs played a contributory factor (for example, 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.

CBA Card Spend, Commonwealth Bank of Australia

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.

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 police detainees across 5 locations throughout Australia annually. In 2021, 2,223 detainees participated in the DUMA program. There are 2 core components involved in the DUMA program:

1. A self-report survey, which captures a range of criminal justice, demographic, drug use, drug market participation and offending information.
2. Voluntary provision of a urine sample, tested via urinalysis at an independent laboratory to detect the presence of licit and illicit drugs. 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 compliance rate is high (75% of detainees in 2021).

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, new psychoactive substances, ketamine, and LSD.

• 700 participants were recruited to the 2022 EDRS survey, and 774 in the 2021 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 2022, interviews were completed from April to July, either face-to-face or via phone,  to manage risks associated with COVID-19. This change in methodology should be considered when comparing data from the 2020, 2021 and 2022 samples relative to previous years.

Further information about the EDRS.

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.

Eight fortnightly surveys were conducted between 1 April and 10 July 2020. The third fortnightly 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 seventh survey was conducted between 24 and 29 June 2020 and had 990 respondents (85.5% response rate from the original panel).

Surveys were moved to a monthly cycle in August 2020, and the sample was increased in November 2020. The January 2021 survey was the sixth monthly survey. It was conducted between 18 and 31 January 2021 and had 3,004 participants (88% response rate from the original panel of 1,369 from August 2020 plus 2,031 from November 2020).

The panel selection methodology was not a random sample for the fortnightly surveys (up until August 2020), but was a random sample for the monthly surveys (from August 2020 onwards). Panel data for the fortnightly surveys were weight adjusted using the ABS Estimated Residential Population as at the end of March 2020, while for monthly surveys data were adjusted using ABS ERP projections as at August 2020.

In all surveys (fortnightly and monthly), coverage included all Australian geographies excluding Very remote locations. Adjustments were made based on the number of people living in the household and the education level of the selected person.

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

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.

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.

• 879 participants were recruited to the 2022 IDRS survey, and 888 in the 2021 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.
• Due to COVID-19 restrictions being imposed in various jurisdictions during data collection periods, interviews in 2020, 2021 and 2022 were delivered face-to-face as well as via telephone. This change in methodology should be considered when comparing data from the 2020, 2021 and 2022 samples relative to previous years.

Further information about the IDRS.

National 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 people
• 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 people in Australia (based on 10,579 fully responding people).

Further information about the NATSIHS 2018–19.

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 people selected for the survey completed their interview.

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

National Ambulance Surveillance System for Alcohol and Other Drug Misuse and Overdose, Turning Point

The National Ambulance Surveillance System (NASS-AOD) is a surveillance system derived from ambulance service records to examine misuse and overdose of heroin, alcohol, pharmaceutical drugs and other illicit substances. The NASS is a partnership between Monash University, Turning Point, and state and territory ambulance services across Australia.

Data are published for each jurisdiction when that data has been made available. Currently data has not been available for South Australia and Western Australia due to system constraints. The data utilised for this project are extracted from electronic data collection systems used by paramedics to record the details of all emergency cases they attend. Trained clinical coders manually examine each record to identify the substance involve and to determine alcohol and drug misuse based on paramedic observation, patient self-report, information provided by third parties, and other evidence on the scene.

Historically, data have been reported on snapshot months, specifically the third month of each fiscal quarter, commencing with March. Since 2021, data are reported monthly. From time to time, there may be particular reporting issues within a jurisdiction, this will be footnoted within the data.

Further information on collection methods and data quality can be found on the PLOS website.

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 people from non-private dwellings, institutional settings, homeless people and the difficulty in reaching marginalised people 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.

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 people 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.

The National Health Survey 2020–21 was collected online during the COVID-19 pandemic and is a break in time series. Data should be used for point-in-time analysis only and cannot be compared to previous years.

For further information, refer to the National Health Survey: First Results methodology.

National Hospital Morbidity Database, AIHW

The 2020–21 National Hospital Morbidity Database (NHMD) includes data from all public hospitals and all private hospitals. Further information can be found in the NHMD Data Quality statement.

For the purposes of this report, drug-related hospitalisations are defined as hospitalisations with a principal diagnosis relating to a substance use disorder or direct harm relating to use of selected substances. This includes legal, accessible drugs such as alcohol and tobacco, drugs that are available by prescription or over-the-counter (for example, analgesics and antidepressants), and drugs that are generally not obtained through legal means (for example, heroin and cocaine). A proportion of the hospitalisations 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.

National Mortality Database, AIHW

The AIHW National Mortality Database (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 2021. 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.

As part of the National Suicide and Self-harm Monitoring Project the AIHW funded the Australian Bureau of Statistics (ABS) to identify and code (using ICD-10) psychosocial risk factors for deaths referred to a coroner, including drug-induced deaths. Following on from a pilot study (ABS 2019), the ABS reviewed and coded psychosocial risk factors through a review of police, toxicology and pathology reports and coronial findings held by the National Coronial Information System. Psychosocial risk factors, now included in the National Mortality Database, are defined as social processes and social structures which can have an interaction with individual thought, behaviour and/or health outcomes (ABS 2019). See the Technical notes for the list of ICD-10 codes used for reporting.

See 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 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 the jurisdiction's particular legislation, information technology systems and resources.
  • New South Wales is unable to differentiate between clients prescribed buprenorphine, buprenorphine-naloxone or buprenorphine long acting injections (LAI) in its reporting.
• 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.
• In Western Australia, the number of clients receiving pharmacotherapy treatment is usually reported through the month of June (rather than on a snapshot day), likely resulting in an over-reporting 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 activity is attributed to the dosing point that administered the greater number of doses.

Unit record data were provided by all jurisdictions except Victoria and Queensland.

See here for the full data quality statement for the 2022 NOPSAD.

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. WWTP 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 12 licit and illicit drugs, including nicotine from tobacco (including cigarettes, e-cigarettes, gum and patches), ethanol from alcohol intake, pharmaceutical opioids with abuse potential, illicit substances such as methylamphetamine, MDMA and cocaine.

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 National Wastewater Drug Monitoring Program (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.

Ketamine was included in monitoring from December 2020. The amount of ketamine excreted following consumption is not known. Therefore, results for ketamine are reported as the amount (mg) of drug excreted per day per 1,000 people.

One of the limitations of the NWDMP is that it cannot differentiate between the medical and non-medical use of pharmaceutical drugs such as oxycodone, fentanyl and ketamine. 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-eight wastewater treatment sites participated nationally in the August 2022 collection (22 sites were located in capital cities and 36 in regional locations) covering 57% of the Australian population, which equates to about 14.3 million people (Report 18 of the NWDMP). This report incorporates population estimates from the 2021 Census.

For the most recent comparison of NWDMP wastewater data with international data from the Sewage Core Group Europe (SCORE), data for all participating countries were taken from March and April 2021. With the exception of cannabis, 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.

Pharmaceutical Benefits Scheme (PBS) data collection, Australian Government Department of Health

The Pharmaceutical Benefits Scheme (PBS) data collection contains information on prescription medicines that qualify for a benefit under the National Health Act 1953, and for which a claim has been processed. PBS administrative data are managed and maintained by the Department of Health and contain information on subsidised PBS prescriptions and under co-payment data.

PBS data are sufficiently large and captures a significant proportion of the population, however, may underestimate total dispensing. Key limitations to consider for the collection include:

• Data do not capture medicines bought over-the-counter, such as from pharmacies and supermarkets.
• Data do not capture private prescriptions (that is, prescriptions for medicines that are not subsidised by the PBS).
• Medicines dispensed public hospital inpatients are not captured, nor are PBS- subsidised medicines dispensed to day-admitted patients and patients upon discharge from public hospitals in New South Wales and the Australian Capital Territory.
• Some medicines supplied under section 100 of the National Health Act 1953, including those supplied directly for Remote Area Aboriginal Health Services and for the Opioid Dependence Treatment Program, are not included in the PBS data collection.
• PBS medicines and PBS items are listed on or deleted from the PBS regularly. These changes may cause the apparent dispensing of drugs to change over time, and trends should be interpreted in this context.
• Some PBS dispensing records do not include patient information and are not included in tables which examine patients or combinations of prescribed drugs.

Private Lives, LaTrobe University

Private Lives is a national survey series on the health and wellbeing of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people. Private Lives 3 (PL3) is the third iteration of The Private Lives survey series with previous releases in 2005 and 2011. The survey was conducted by the Australian Research Centre in Sex, Health and Society (ARCSHS) at La Trobe University.

In 2020, 6,835 participants were recruited to the survey through paid Facebook advertising and via LGBTIQ community organisations and their networks. The survey was completed online, with paper copies of the survey available on request. The survey was provided in English and was restricted to participants who resided in Australia at the time of the survey who were aged 18 years and above. Questions in the PL3 survey were not compulsory and the total sample size for questions therefore varies slightly. Further information on collection methods can be found on the LaTrobe University  website.

Retail Trade, Australia, ABS

Statistics presented in Retail Trade, Australia are compiled from the monthly Retail Business Survey and these monthly estimates are presented in current price terms. The survey covers employing retail trade businesses who predominantly sell to households.

Retail turnover includes retail sales, online sales and wholesale sales. The survey uses the Australian and New Zealand Standard Industrial Classification (ANZSIC) to define the industry group and subgroups reported.

For further information, refer to the Retail Trade, Australia methodology.

Writing Themselves In, LaTrobe University

Writing Themselves In is a national survey series on the health and wellbeing among LGBTQA+ young people in Australia. This is the fourth iteration in the Writing Themselves In survey series with previous releases in 1998, 2004 and 2010. The survey was conducted by the Australian Research Centre in Sex, Health and Society (ARCSHS) at La Trobe University.

In 2019, 6,418 participants were recruited to the survey, through promotion of still images and a short video distributed via paid advertising on Facebook and Instagram, online networks of community organisations working with and for LGBTIQA+ young people and promotional posters provided to community organisations. The survey was designed for online completion and was provided in English and restricted to participants who resided in Australia at the time of the survey, who were 14 to 21 years of age, and identified as LGBTIQA+ (or used a synonymous term). Further information on collection methods can be found on the LaTrobe University website.