Illicit drug use

Illicit drug use can affect individuals, families and the broader Australian community. The impacts of illicit drug use are numerous and include:

• health impacts such as burden of disease, injury, overdose and death
• social impacts such as violence, crime and trauma
• economic impacts such as the cost of health care and law enforcement.

Some population groups are at greater risk of experiencing disproportionate harms associated with illicit drug use, including young people, people with mental health conditions and people who are gay, lesbian, bisexual, transgender or intersex (Department of Health 2017).

For more information, see Alcohol, tobacco and other drugs in Australia.

How common is illicit drug use?

According to the 2022–2023 National Drug Strategy Household Survey (NDSHS), an estimated 10.2 million (47%) people aged 14 and over in Australia had illicitly used a drug at some point in their lifetime (including the non-medical use of pharmaceuticals), and an estimated 3.9 million (18%) had used an illicit drug in the previous 12 months. This was similar to proportions in 2019 (43% and 16%, respectively) but has increased since 2007 (38% and 13%, respectively) (Figure 1).

In 2022–2023, among people aged 14 and over, the most common illicit drug used recently (in the previous 12 months) continues to be cannabis, 11.5%, similar to use in 2019 (11.6%), followed by cocaine (4.5%) and hallucinogens (2.4%) (Figure 1). A number of changes were reported in the recent use of illicit drugs between 2019 and 2022–2023:

• cocaine (from 4.2% in 2019 to 4.5% in 2022–2023)
• ecstasy (from 3.0% to 2.1%)
• hallucinogens (from 1.6% to 2.4%)
• ketamine (from 0.9% to 1.4%) (AIHW 2024b; Figure 1).

In 2022–2023, an estimated 1.1 million people (5.3%) aged 14 and over used a pharmaceutical drug for non-medical purposes in the previous 12 months (AIHW 2024b). Between 2019 and 2022–2023, the proportion of people using ‘pain-killers/pain-relievers and opioids' for non-medical purposes declined from 2.7% to 2.2%. This decline is most likely due to a reclassification of medications containing codeine that was implemented in 2018. Under the change, drugs with codeine (including some painkillers) can no longer be bought from a pharmacy without a prescription. The proportion of people using codeine for non-medical purposes has more than halved since 2016, from 3.0% to 1.2% in 2022–2023.

In 2022–2023, pain-killers/pain-relievers and opioids used for non-medical purposes were the fourth most commonly used illicit drug in the previous 12 months after cannabis, cocaine and hallucinogens (AIHW 2024b).

The use of hallucinogens and ketamine have both risen. In 2022–2023, 2.4% of people aged 14 and over had used hallucinogens and 1.4% had used ketamine in their lifetime (AIHW 2024b). Use of hallucinogens and ketamine in the last 12 months was most common among people aged 20–29 (6.8% and 4.2% respectively).

Recent use of methamphetamine and amphetamine was low (1.0%) while lifetime use was high (7.5%) in 2022–2023 (AIHW 2024b). The 2022–2023 NDSHS asked about recent use of ‘methamphetamine and amphetamine’, whereas prior NDSHS surveys asked about the use of ‘Methamphetamine or amphetamine’. This change represents a break in the time series; for more information, see Methamphetamine and amphetamine in the NDSHS.

Frequency of illicit drug use

To better understand illicit drug use in Australia, it is important to consider the frequency of drug use and not just the proportion of people who have used a drug in the previous 12 months. Some drugs are used more often than others, and the health risks of illicit drug use increase with the frequency, type, and quantity of drugs used (Degenhardt et al. 2013).

While cocaine and ecstasy were used by more people in the previous 12 months, most people used these drugs infrequently with 58% of people who used cocaine and 59% of people who used ecstasy reporting they only used the drug once or twice a year in the 2022–2023 NDSHS (AIHW 2024b). Conversely, monthly or more frequent drug use was more commonly reported among people who had used cannabis (51%) or methamphetamine and amphetamine (37%).

Health impact

Burden of disease

According to the Australian Burden of Disease Study 2024, illicit drug use contributed to 2.9% of the total burden of disease and injury in 2024 (AIHW 2024a). This included the impact of opioids, amphetamines, cocaine, cannabis, and other illicit drug use, as well as unsafe injecting practices. The age-standardised rate of total burden of disease and injury attributable to illicit drug use increased by 42% between 2003 and 2024 (AIHW 2024a).

Opioid use accounted for the largest proportion (28%) of the illicit drug use burden, followed by amphetamine use (25%), cocaine use (11%) and cannabis use (6.9%). Illicit drug use was responsible for almost all burden due to drug use and disorders (excluding alcohol) (AIHW 2024a). For more information, see Australian Burden of Disease Study 2024.

Ambulance attendances

Across reporting jurisdictions:

• The highest number and rate of ambulance attendances for illicit drugs between 2021 and 2024 were for cannabis, amphetamines (any), benzodiazepines and GHB.
• Antidepressants required a higher rate of transport to hospital than other drugs in 2024 (93% of attendances nationally). 
• The highest proportion of ambulance attendances where police co-attended involved GHB (41% of attendances) or amphetamines (any) (40% of attendances) in 2024.
• 76% of ecstasy-related ambulance attendances involved at least one other drug in 2024, the highest of any drug type (AIHW 2026b).

Hospitalisations

In 2023–24, hospitalisations with a drug-related principal diagnosis (including alcohol) accounted for 1.2% (around 146,000) of all hospitalisations. Of these, amphetamines and other stimulants (including methamphetamine and ecstasy/MDMA) accounted for 12% (over 18,100) of drug-related hospitalisations. Most of these related to methamphetamine (83% or around 15,100). 

Over the 9 years to 2023–24, the rate of drug-related hospitalisations for: 

• methamphetamine fluctuated, rising to a peak of 56 hospitalisations per 100,000 in 2023–24
• cannabinoids fluctuated, peaking at 29 per 100,000 in 2020–21 before falling to 26 per 100,000 in 2023–24 
• gamma-hydroxybutyrate (GHB) rose from 2.4 to 14 hospitalisations per 100,000 in 2023–24, the highest level since monitoring began
• cocaine rose from 3.2 to a peak of 7.0 per 100,000 people in 2020–21, before falling to 4.9 per 100,000 in 2023–24 (Figure 2).

For information on alcohol-related hospitalisations, see Alcohol.

Deaths

Drug-induced deaths are defined as those that can be directly attributable to drug use and includes both those due to acute toxicity (for example, drug overdose) and those due to chronic use (for example, drug-induced cardiac conditions) as determined by toxicology and pathology reports.

AIHW analysis of preliminary data from the National Mortality Database (NMD) show that there were 1,948 drug-induced deaths in 2024 (AIHW 2026b). The rate of drug-induced deaths has decreased since 2017 (from 8.2 to 7.1 deaths per 100,000 population), though estimates for 2023 and 2024 are expected to rise following standard revision processes (ABS 2025).

Of all drug-induced deaths in 2024:

• just over 7 in 10 (71% or 1,377) deaths were considered accidental and 1 in 5 (21% or 402) were intentional
• 2 in 3 (66% or 1,292) deaths occurred among males, compared with 1 in 3 (34% or 655) deaths among females
• the median age at death was 47.4 years (ABS 2025, Tables 13.1–13.4 and 13.9).

AIHW analysis of preliminary data from the NMD showed that in 2024:

• Opioids were present in over half (53% or 1,025) of drug-induced deaths, an age-standardised rate of 3.8 per 100,000 population. Most opioid-related deaths (80% or 819 deaths) were considered accidental.
• Benzodiazepines were present in around 1 in 3 (34% or 654) drug-induced deaths, an age-standardised rate of 2.4 per 100,000 population. Benzodiazepine-related deaths have been decreasing since 2018.
• Other drug classes commonly identified in drug-induced deaths included depressants (42% or 827 deaths) and psychostimulants (37% or 714 deaths) (AIHW 2026b, Figure 3).

Analysis by NDARC of preliminary revised data for 2023 indicated that people living in the most disadvantaged areas accounted for the highest percentage of drug-induced deaths (32% or 575 deaths among residents in quintile 1 of the Socio-Economic Indexes for Areas). This has remained relatively stable since 2018 (Chrzanowska et al. 2025). Consistent with previous years, most overdose deaths (75% or 1,324 deaths) in 2023 occurred at home (Chrzanowska et al. 2025).

Non-fatal overdose

Data from the 2025 Illicit Drug Reporting System (IDRS) and Ecstasy and related Drugs Reporting System (EDRS) include rates of self-reported overdose among people who regularly inject drugs and people who regularly use ecstasy and related stimulants, respectively. In 2025:

• Over 1 in 10 (12%) IDRS participants reported a non-fatal opioid overdose in the past 12 months, stable from 2024 (12%) (Sutherland et al. 2025b).
• Around 1 in 6 (18%) EDRS participants reported experiencing a non-fatal stimulant overdose in the past 12 months, stable from 2024 (19%) (Sutherland et al. 2025a).

Treatment

The Alcohol and other drug treatment services in Australia: early insights report shows amphetamines, cannabis and heroin are among the most common illicit drugs for which people receive specialist drug treatment. In 2024–25, methamphetamine accounted for 24% of treatment episodes (around 50,900 episodes) provided to clients for their own drug use, followed by cannabis (14%, or around 30,300 episodes) and heroin (4.3%, or around 9,200 episodes) (AIHW 2026a). 

Feature analysis of data from the Alcohol and Other Drug Treatment Services National Minimum Data Set indicates that people receiving treatment for heroin and pharmaceutical drugs have a higher mortality rate than people receiving treatment for other drugs such as alcohol, amphetamines and cannabis (AIHW 2025). 

Among all people who received specialist treatment for their own drug use between 2012–13 and 2022–23, people who died and received treatment in their last year of life accounted for:

• around 1 in 20 (4.9%) of all clients who were treated for heroin and another drug throughout their treatment history
• around 1 in 22 of all clients treated for pharmaceuticals and another drug (4.6%)
• around 1 in 26 of all clients treated for either pharmaceuticals only (3.8%) or heroin only (3.8%) (AIHW 2025).

For more information, see Alcohol and other drug treatment services and People who received specialist Alcohol and Other Drug Treatment Services in their last year of life.

For more information on the classification of amphetamines in this data set, see Australian Standard Classification of Drugs of Concern, 2011 | Australian Bureau of Statistics.

Social impact

The social impacts of illicit drug use are pervasive and include criminal activity, engagement with the criminal justice system and victimisation. For example:

• Around 2 in 5 participants in the 2025 IDRS (44%) and EDRS (37%) reported participating in criminal activities, stable relative to 2024. The most common criminal activities were property crime and selling drugs for cash profit (Sutherland et al. 2025a; Sutherland et al. 2025b).
• In 2022–2023, 1 in 10 (10.1%) people aged 14 and over had been a victim of an illicit drug-related incident (experiencing verbal abuse, physical abuse or being put in fear) in the previous 12 months, remaining stable since 2019 (10.5%) (AIHW 2024b).
• In 2020–21, almost one-quarter of victims (23%) and 9% of offenders had consumed illicit drugs or non-therapeutic levels of pharmaceutical drugs before a homicide incident (Bricknell 2023).

Priority populations

The National Drug Strategy 2017–2026 specifies priority populations who have a high risk of experiencing direct and indirect harm as a result of drug use, including young people, people with mental health conditions and people who are gay, lesbian, bisexual, transgender or intersex (Department of Health 2017).

Young people

Young people are susceptible to permanent damage from alcohol and other drug use as their brains are still developing, which makes them a vulnerable population (Department of Health 2017).

As a group, young people aged 14–29 in 2022–2023 were less likely to have used an illicit drug in the previous 12 months than people of the same age in 2001. Drug use and trends in young people, however, vary considerably within this age range. For example:

• In 2001, 28% of 14–19-year-olds had used an illicit drug in the previous 12 months, but by 2022–2023, this had decreased to 19% (AIHW 2024b).
• In 2022–2023, people aged 20–29 were the most likely to have used an illicit drug in the previous 12 months (33%), a similar proportion to 2019 (31%).
• There have been significant changes in the types of drugs used by people in their 20s (Figure 4):
  • Ecstasy use among people in their 20s declined from 9.8% in 2019 to 7.5% in 2022–2023. This was likely driven by a reduction in supply and opportunities to use ecstasy following COVID-19 related public health measures and event restrictions.
  • Cocaine use among people in their 20s has increased steadily since 2001. Much of the rise in cocaine use among people in this age group occurred between 2016 and 2019 – from 6.9% in 2016 to 12% in 2019 where it remained stable in 2022–2023.
  • Hallucinogen use among people in their 20s has increased steadily since 2001. Between 2016 and 2022–2023, hallucinogen use in this age group more than doubled – from 3.1% in 2016 to 6.8% in 2022–2023 (AIHW 2024b).

For more information, see Health of young people.

People with mental health conditions

Mental health conditions and alcohol and other drug use disorders often co-occur. The presence of a mental health condition may directly or indirectly lead to a drug use disorder, or vice versa. For example, some people may develop a drug use disorder due to repeated use to relieve or cope with mental health symptoms or other factors related to certain mental health conditions (for example, unemployment) (Marel et al. 2022). Alternatively, mental health conditions and substance use disorders may come about due to the presence of a shared risk factor that could be biological, psychological, social or environmental (Marel et al. 2022).

The ABS National Study of Mental Health and Wellbeing reports prevalence estimates of 12-month mental disorders as the number of people who met the diagnostic criteria for a mental disorder at some time in their life and had sufficient symptoms of that disorder in the previous 12 months. The 2020–2022 study found:

• 3.3% of Australians (647,900 people) aged 16–85 had symptoms of a 12-month substance use disorder.
• 4.4% of males reported a 12-month substance use disorder, compared with 2.1% of females (ABS 2023).

In 2022–2023, the NDSHS showed that the proportion of people self-reporting a mental health condition was higher among people aged 18 and over who reported the use of illicit drugs in the previous 12 months (29%) than those who had not used an illicit drug over this period (16%) (AIHW 2024b). For example, mental health conditions were reported by:

• 44% of people who recently used methamphetamine and amphetamine (compared with 18% of people who did not use methamphetamine)
• 27% of people who recently used hallucinogens (compared with 18% of those who did not use hallucinogens)
• 30% of people who recently used cannabis (compared with 16%)
• 25% of people who recently used ecstasy (compared with 18%)
• 26% of people who recently used cocaine (compared with 18%) (AIHW 2024b).

More than half of the participants in the 2024 IDRS (55%) and EDRS (57%) self-reported mental health conditions in the previous 6 months, stable from 2023 (Sutherland et al. 2025a; Sutherland et al. 2025b). For more information, see Physical health of people with mental illness.

Lesbian, gay, bisexual, transgender, gender diverse, and queer people

People who are lesbian, gay, bisexual, transgender, gender diverse or queer can be at an increased risk of licit and illicit drug use. These risks can be increased by a number of issues such as stigma and discrimination, familial issues, fear of discrimination and fear of identification (Department of Health 2017). The NDSHS provides substance use estimates by sexual orientation for people who are lesbian, gay or bisexual, as well as estimates for people who are transgender or gender diverse (AIHW 2024b).

The NDSHS has consistently shown that the proportion of people reporting illicit drug use has been higher among people who are lesbian, gay or bisexual than among heterosexual people – 47% compared with 16%, had used an illicit drug in the previous 12 months in 2022–2023. After adjusting for differences in age, in comparison to heterosexual people, lesbian, gay or bisexual people were:

• 8.6 times as likely to have used inhalants in the previous 12 months, likely due to the use of nitrites during sexual activity by men who have sex with men (Vaccher et al. 2020), although use was high among all gay, lesbian and bisexual people
• 6.6 times as likely to have used methamphetamine and amphetamine in the previous 12 months
• 3.4 times as likely to have used ecstasy in the previous 12 months 
• 2.7 times as likely to have used cocaine in the previous 12 months (AIHW 2024b). 

The types of illicit drugs people had used in the last 12 months varied quite considerably by a person’s sexual orientation and it is important to note that there are differences in substance use between people who are gay or lesbian and people who are bisexual (AIHW 2024b).

The Writing Themselves In National Report describes findings from the national survey of health and wellbeing among lesbian, gay, bisexual, trans, queer, asexual (LBGTQA+) young people in Australia. The survey was conducted from September to October 2019 and participants needed to be aged between 14 and 21 years. The survey showed that in the previous 6 months:

• 27% of participants aged 14–17 and 43% of participants aged 18–21 reported using any drug for non-medical purposes
• 28% of participants reported using cannabis
• 7.0% of participants reported using ecstasy/MDMA (Hill et al. 2022a).

The Private Lives survey is Australia’s largest national survey of the health and wellbeing of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people, with the age of participants ranging from 18 to 88 years. The survey showed that 44% of participants reported using one or more drugs for non-medical purposes in the previous 6 months. Of this, cannabis was the highest at 30%, followed by ecstasy/MDMA at 13.9%.

Within the past 6 months, 14% of participants reported experiencing a time when they had struggled to manage their drug use or where it negatively impacted their everyday life (Hill et al. 2022b).

Where do I go for more information?

For more information on illicit drug use, see:

• Alcohol, tobacco & other drugs in Australia
• National Drug Strategy Household Survey 2022–2023
• Alcohol and other drug treatment services in Australia annual report
• Australian Burden of Disease Study 2024: interactive data on risk factor burden
• National Drug and Alcohol Research Centre

For more on this topic, see Illicit use of drugs.