Alcohol and illicit drug use are serious and complex issues that contribute to substantial illness, disease, injury, and deaths in Australia. Alcohol consumption is associated with an increased risk of chronic disease, injury and premature death. Illicit drug use can have severe health effects, including poisoning, mental illness, self-harm, suicide and death by accidental poisoning (overdose).
This report provides insight into the health impact of alcohol and illicit drug use in Australia, including as risk factors for other diseases and injuries. The health impact comprises fatal burden (for example, dying prematurely from Accidental poisoning) and non-fatal burden (for example, living with Alcohol dependence). The report revises and extends estimates previously published in the Australian Burden of Disease Study (ABDS) 2011 (AIHW 2016c).
This new analysis includes, for the first time, the impact of individual drugs and unsafe injecting practices on the Australian population and analysis by sub-national group. It also estimates the potential effect of alcohol and illicit drug use on disease burden in the Australian population over the next decade.
Nearly 5% of all deaths are from alcohol and illicit drug use
Together, alcohol and illicit drug use were responsible for:
- 4.5% of all deaths (6,660 deaths) in 2011
- 6.7% of the total burden of all disease and injuries in Australia in 2011 (9.1% for males and 3.8% for females). ‘Total burden’ reflects the impact of dying early and of living with disease or injury.
Burden of disease from alcohol and illicit drug use (6.7%) was less than the 9% attributed to tobacco use in the ABDS 2011 (AIHW 2016c).
One-third of road traffic injuries due to alcohol use
By itself, alcohol use was responsible for 4.6% of the total burden in 2011. One-third of this burden was due to Alcohol dependence.
Alcohol use was also responsible for almost one-third (30%) of the burden of Road traffic injuries—motor vehicle occupants and even more for motorcyclists (33%).
One-third of illicit drug use burden due to accidental poisoning
Illicit drug use (which includes opioids, amphetamines, cannabis, cocaine, other illicit drugs, as well as unsafe injecting practices) was responsible for 2.3% of total burden in 2011.
One-third (33%) of this burden was from Accidental poisoning and a further third (31%) was from Illicit drug dependence.
Opioids are the largest contributor to the illicit drug use burden
Opioids accounted for the largest proportion (41%) of the illicit drug use burden in 2011, followed by amphetamines (18%), cocaine (8%) and cannabis (7%). In addition, 18% was from diseases contracted through unsafe injecting practices.
Opioid use was responsible for around half (52%) of the total disease burden from Accidental poisoning. Amphetamine use was responsible for 17% of the total burden of Road traffic injuries. Unsafe injecting practices were responsible for about one-quarter (26%) of the burden of Chronic liver disease, and one-fifth (21%) of Liver cancer disease burden.
The burden is higher for some population groups
Males experienced around three-quarters of the total burden from alcohol use and illicit drug use in Australia in 2011. Compared to females, males experienced a greater proportion of burden due to alcohol use for most associated diseases, but most notably from Homicide and violence (27%, compared with 10% for females) and from Other unintentional injuries (23%, compared with 7.2% for females).
The burden from alcohol use and illicit drug use (calculated separately) varied according to where a person lived and their socioeconomic position. Age-standardised rates were higher in:
- the lowest socioeconomic group (1.9 times and 2.4 times as high for alcohol use and illicit drug use, respectively), when compared with the highest socioeconomic group
- Very remote areas (2.4 times as high) for alcohol use, when compared with Major cities
- Remote and Very remote areas for illicit drug use compared with Major cities and regional areas (however this varied by type of drug, with opioid burden being highest in Major cities).
Burden due to alcohol use expected to fall over time
The age-standardised rate of burden from alcohol use fell slightly between 2003 and 2011. A further reduction is expected by 2020, based on these trends.
Increases in burden by 2020 expected for amphetamines and cannabis
The age-standardised rate of burden from all illicit drug use fell slightly between 2003 and 2011. There was a large fall in the rate of burden of Road traffic injuries—motor vehicle occupants due to illicit drug use over this period, based on self-reported survey data on driving a motor vehicle under the influence of illicit drugs.
Based on trends over the last 2 decades in illicit drug use and unsafe injecting practices, between 2011 and 2020, the age-standardised rate of burden due to:
- amphetamines use is projected to rise by 14%
- cannabis use is projected to rise by 36% for females and remain steady for males
- cocaine use is projected to fall by 24% for males and remain steady for females
- unsafe injecting practices is projected to fall by 21% for males and 17% for females.
Alcohol and illicit drug use
Alcohol use in key population groups
Alcohol use over time
Illicit drug use
Illicit drug use in key population groups
Illicit drug use over time
Specific illicit drugs and unsafe injecting practices
Specific illicit drugs and unsafe injecting practices in key population groups
Specific illicit drugs and unsafe injecting practices over time
Appendix A: Methods
Appendix B: Additional tables and figures
End matter: Glossary; References; List of tables; List of figures; List of boxes; Related publications