Availability of prescription opioids, benzodiazepines and gabapentinoids in Australia

Introduction

Pharmaceutical drugs such as opioids, benzodiazepines and gabapentinoids have important clinical applications (for example, the management of chronic pain). However, these drugs also have the potential to cause harms including dependence and overdose. As drug-related harms are often associated with drug prescribing rates (such as described for opioids in Roxburgh et al. 2017), it is important to monitor prescription rates in the context of harm reduction. 

This page focuses on prescription drug dispensing of opioids, benzodiazepines and gabapentinoids under Australia’s Pharmaceutical Benefits Scheme (PBS). These numbers largely represent medicines being prescribed and used for their intended purposes. Opioid dispensing described on this page does not include prescriptions dispensed for the treatment of opioid dependence (opioid pharmacotherapy medicines). These data are reported separately in the National Opioid Pharmacotherapy Statistics Annual Data collection.

For related information on the non-medical use of pharmaceuticals in this report, see Pharmaceutical drugs.

What data sources are available?

Data on dispensing of prescription opioids, benzodiazepines and opioids is available via the PBS database, including information on the number of prescriptions (scripts) dispensed and the number of patients supplied at least one script within a given financial year. The PBS database includes information on a range of medicines that may be used for non-medical purposes or carry a risk of potential for harm (including opioids, benzodiazepines and gabapentinoids). Monitoring dispensing of these medicines under the PBS can provide information on the availability of these drugs among the general Australian population. The PBS also includes data on medicines that are used to help people stop or reduce their tobacco or alcohol consumption (see Availability of smoking and alcohol cessation medicines in Australia).

For more information and a full list of item codes, see Technical notes.

How many opioids, benzodiazepines and gabapentinoids are dispensed in Australia?

Data from the PBS indicate that in 2024–25:

• Around 12.6 million opioid scripts (excluding opioid pharmacotherapy medicines) were dispensed to around 2.9 million patients, a crude rate of around 46,200 scripts and 10,600 patients per 100,000 population (tables PBS1–4, Figure 1). 
• Around 4.5 million benzodiazepine scripts were dispensed to around 1.4 million patients, a crude rate of around 16,400 scripts and 5,100 patients per 100,000 population. Diazepam had the highest rates of dispensing among benzodiazepine drugs (tables PBS21–24). 
• Around 4.2 million gabapentinoid prescriptions were dispensed to around 626,000 patients, a crude rate of around 15,200 scripts and 2,300 patients per 100,000 population (tables PBS45–48).

Oxycodone had the highest crude rate of scripts dispensed of any opioid drug (around 17,200 scripts per 100,000 persons, compared with around 10,900 for codeine) in 2024–25, but more patients were dispensed codeine than oxycodone (5,100 and 4,600 per 100,000 persons, respectively). This indicates that a higher number of PBS scripts for oxycodone were dispensed per patient than for codeine (tables PBS2 and PBS4, Figure 1).

Pregabalin had the highest rates of dispensing among gabapentinoid drugs in 2024–25 (tables PBS46 and PBS48, Figure 1).

How has dispensing of opioids, benzodiazepines and gabapentinoids changed over time?

Between 2012–13 and 2024–25:

• Opioid dispensing rates generally increased between 2012–13 and 2016–17, but have since declined. This decline was consistent across most opioid drugs except tapentadol, where rates of scripts dispensed have been steadily rising following its listing on the PBS in 2013–14 (tables PBS 2 and PBS4, Figure 1).
• Benzodiazepine dispensing rates steadily declined across the period. This was consistent across most benzodiazepine drugs, except diazepam where rates initially increased before declining, and clonazepam where rates of patients and scripts dispensed have been rising since 2020–21 (tables PBS22 and PBS24).
• Gabapentinoid dispensing rates were rising up to 2017–18 but have since declined (tables PBS46 and PBS48). This varied by drug:
  • Pregabalin script dispensing rates increased by 12 times between 2012–13 to 2017–18 (from a crude rate of around 1,400 to 16,400 per 100,000), before falling to 14,700 per 100,000 in 2024–25.
  • Gabapentin script dispensing rates fell from 2012–13 to 2016–17 (from around 500 to 475 per 100,000) and have since risen to around 550 per 100,000 in 2024–25.

Dispensing of prescription opioids, benzodiazepines and gabapentinoids may have been affected by recent policy changes. For more information, see Policy context.

How many doses of opioids are being dispensed?

Opioid use can be examined using defined daily doses (also known as statistical defined daily doses or S-DDDs). A defined daily dose is a measure used for statistical purposes that represents the dose of a particular drug that is assumed to be the ‘average amount per day’ when used by adults (WHOCC 2018). S-DDDs account for variations between medicines (for example, pack size and drug strength) and are useful for examining changes in dispensing over time or comparing data between regions or populations (WHOCC 2018). S-DDDs may not match the recommended or prescribed dose and may underestimate or overestimate ‘true’ use. 

PBS data indicate that 72.8 million defined daily doses were dispensed in 2024–25 for all opioids, a rate of 7.3 S-DDDs/1,000 population/day. Oxycodone (1.8 S-DDDs/1,000/day), codeine (1.5) and tramadol (1.3) had the highest rates of dispensing (tables PBS17–18).

Between 2012–13 and 2024–25, the total rate of S-DDDs dispensed for opioids fell from around 13 S-DDDs/1,000 population/day in 2012–13 (Table PBS18). This varied by drug type:

• Rates of dispensing have remained stable or decreased for most opioid drugs.
• For tapentadol, there was a steady increase in the rate of S-DDDs dispensed, rising from <0.1 to 1.3/1,000 population/day between 2013–14 and 2024–25 (Table PBS18).

Decreased rates of opioid dispensing measured in terms of S-DDDs may be related to several recent policy changes, including the de-listing of some medicines, increased restrictions on prescribing some opioids, and the introduction of smaller pack sizes for some PBS-listed immediate-release opioid formulations in June 2020. For more information, see Policy context.

Who is being dispensed opioids, benzodiazepines and gabapentinoids?

Opioid, benzodiazepine and gabapentinoid dispensing varied by the age and sex of patients. Across all drug categories:

• Crude rates of dispensing increased with increasing age and were highest for people aged 80 and over (Figure 2). 
• Females had higher crude rates of dispensing than males. This was similar over time and across most age groups (Figure 2).

How many people are dispensed scripts for both opioids and benzodiazepines?

Due to the compounding effects of respiratory depression, patients using opioids and benzodiazepines at the same time may be at higher risk of harm (Boon et al. 2020; RACGP 2022). Data from the PBS indicate that most opioid scripts are dispensed to patients who have not received a recent supply of a benzodiazepine, and vice versa. Rates of concomitant dispensing of opioids and benzodiazepines (that is, dispensing at the same time or almost the same time) have fallen over time, though concomitant dispensing is not uncommon (tables PBS37–44). 

In 2024–25:

• Around 2.1 million opioid scripts were dispensed to patients who had already received a PBS supply of a benzodiazepine in the past 30 days, and around 329,000 patients who were dispensed an opioid had also received a benzodiazepine (a crude rate of around 7,800 scripts and 1,200 patients per 100,000 population) (tables PBS37–40).
• Around 1.3 million benzodiazepine scripts were dispensed to patients who had received a PBS supply of an opioid in the past 30 days, and around 325,000 patients who received a benzodiazepine had received an opioid (a crude rate of around 4,900 scripts and 1,200 patients per 100,000) (tables PBS41–44).

How much opioid dispensing relates to cancer treatment and palliative care?

Opioids are effective for managing strong cancer pain and in the context of palliative care. However, there is limited evidence that opioid medicines are beneficial for the long-term treatment of non-cancer pain conditions (for example, back pain). Long-term opioid use is also linked to increased risk of harm such as overdose (RACGP 2020). Australian clinical guidelines recommend that opioids only be used for chronic non-cancer pain if a patient is experiencing moderate/severe pain that is not adequately managed with other treatments (RACGP 2020).

PBS data indicate that most opioid dispensing in Australia is not related to cancer or palliative care. In 2024–25, around 2.8 million scripts were dispensed in relation to palliative care (around 10,400 scripts per 100,000 population) and around 779,000 scripts were dispensed in relation to cancer treatment (around 2,900 scripts per 100,000). By comparison, around 9.3 million scripts were dispensed not in relation to palliative care or cancer treatment (around 34,200 scripts per 100,000) (tables PBS19–20). 

Between 2017–18 and 2024–25, the crude rate of opioid dispensing for:

• palliative care peaked in 2022–23 at a rate of around 10,700 prescriptions per 100,000 persons
• cancer treatment peaked in 2018–19 at a rate of around 3,200 prescriptions per 100,000 persons
• neither palliative care nor cancer treatment steadily declined from around 52,500 to 34,200 per 100,000 persons (Table PBS20). 

The number of opioid prescriptions related to palliative care and cancer may be underestimated, as some palliative care patients may not have received any PBS items from the Palliative Care Schedule, and some patients receiving treatment for cancer may not have received cancer treatment-related drugs through the PBS. Additions to PBS listings for palliative care were made on 1 June 2021 (AMA 2021). 

Does dispensing vary by geographic area?

Rates of dispensing for opioids, benzodiazepines and gabapentinoids are typically highest in regional areas of Australia and vary across states and territories. 

Detailed information on alcohol and drug-related PBS dispensing by geographic area is available in State and territory data and Remoteness areas.

Where do I go for more information?

• Pharmaceutical Benefits Scheme prescriptions: monthly data
• The Pharmaceutical Benefits Scheme