This report identifies trends and differences in alcohol and other drug use, harms and treatment in Major cities and Regional and remote Australia. The consumption of alcohol at levels placing people at risk of alcohol-related harm was higher for clients in Regional and remote Australia compared with those in Major cities. While the consumption of illicit drugs was similar for clients in Major cities and Regional and remote areas, the type of illicit drug used varied. Clients in Regional and remote areas were more likely than those in Major cities to travel 1 hour or longer to access services.