Drug-related harms are changing, and so should GPs’ response to them, NDARC says.
The National Drug and Alcohol Research Centre’s (NDARC) latest annual report found that there were 2005 deaths in 2024, approximately 5.5 deaths per day from drug overdoses.
It’s a record high over the 20-year monitoring period.
While opioids remained the leading drug class in overdose deaths, accounting for 56%, their share gradually declined since their 2017 peak.
Amphetamine-type stimulant deaths reached an all-time high of 2.9 deaths per 100,000 people, a 29% increase from 2.2 deaths per 100,000 in 2023.
Cocaine related deaths, while less common than opioid or amphetamine overdoses, increased exponentially over the past 10 years.
In 2024, cocaine-related deaths also reached a record high, up 40% on the previous year – driven almost entirely by men, particularly those aged 25 to 35, and concentrated in more advantaged areas.
That demographic pattern held across drug-induced deaths overall, with men accounting for two-thirds of deaths.
However, when it came to socioeconomic background, the largest share of drug-induced deaths (30%) occurred in the most disadvantaged areas.
Most drug-induced deaths occurred at home (72%), and the large majority were unintentional (74%), with 22% classified as suicide-related.
Polydrug use was the norm rather than the exception – 73% of overdose deaths between 2020 and 2024 involved two or more drug classes.
Between 2000 and 2025, almost one quarter of the 70 Australians who died from novel psychoactive stimulants and hallucinogens appeared unaware they’d taken anything other than MDMA, methamphetamine or LSD.
Associate Professor Rachel Sutherland, deputy lead of the Drug Trends program at NDARC, told The Medical Republic there were three main factors contributing to the increase in drug-related harms.
Namely, these were the increased availability of methamphetamine and cocaine, a growing number of poly-substance users, and ageing populations with more chronic health conditions who used methamphetamine.
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The research also pointed to a clear generational shift in overdose mortality, with rates among those aged 65 to 74 reaching the highest level recorded during the two-decade monitoring period.
Among decedents aged 75 and over, the most frequently recorded risk factor was disability limiting daily activities, present in a quarter of deaths.
“We know stimulants increase heart rate and blood pressure and may contribute to fatal cardiovascular complications, including arrhythmias and myocardial infarction, particularly in people with pre-existing cardiovascular disease,” Professor Sutherland said.
Accessing treatment and disclosing one’s drug use, however, can often be difficult, she said, highlighting the need for GPs to build trust and rapport with their patients.
“We don’t have equivalent options [like pharmacotherapy] for stimulants, and we do know there’s difficulties accessing treatment as well, including stigma, long waiting lists, and barriers to accessing treatment,” she said.
She told TMR more investment in research was necessary to expand treatment options and improve access to care for drug-related harms.
NDARC’s data also shed light on the circumstances contributing to these deaths.
Self-harm history was the single most common psychosocial risk factor, recorded in 12% of all drug-induced deaths.
But it was almost twice as common among women (17%) as men (9.1%).
Among men, the next most common risk factors were issues with other legal circumstances (6.1%) or family disruption due to separation and divorce (5.3%).
For women, relationship problems with a spouse or partner (8.3%) and the loss or disappearance of a family member (7.7%) ranked second and third.
“It’s a trend that’s remained fairly consistent since 2017, but it highlights the importance of health professionals building relationships with their patients, understanding the complexities of these issues, and recognising that warning signs may vary between patients depending on age, gender and drug type,” Professor Sutherland said.
RACGP addiction medicine special interest group chair Dr Hester Wilson told TMR stigma and discrimination meant there was not enough sense of urgency around the issue.
“The rise in methamphetamine use is interesting. It’s because it’s easily available, cheap, produced locally, and it’s also had increased purity,” she said.
Dr Wilson said it was good practice for GPs to ask about potential drug use or a history of stimulant use when assessing an older patient’s cardiovascular health.
Opioid dependence, by contrast, may begin as a form of chronic pain management, she said.
“If we can have conversations with people early in their drug-taking career, we can help them have a better trajectory,” Dr Wilson said.
“Drugs have meaning, and people’s choice to use them is rational and has meaning for them. We need to ensure the care people can access is appropriate for them.”
This is especially pertinent for people with complex lives and social and welfare needs, she said.
“Women need a different kind of care to men, and Indigenous people need culturally informed and appropriate care.”
This includes helping patients understand why they’re using illicit drugs and facilitating access to harm-minimisation information and evidence-based resources on the health risks of different drugs, she told TMR.
Separately, the researchers identified 56,797 drug-related hospitalisations, excluding alcohol and tobacco, in 2023 and 2024, a 10.5% increase from the previous year.
Drug-related hospitalisations grew faster than overall hospital admissions, at more than double the 4.1% increase in overall admissions.
Of these, amphetamine-type stimulants accounted for the largest share of drug-related hospitalisations (29%), with most involving methamphetamine.
Dr Wilson said the greater prevalence of drug-related hospitalisations poses two possibilities.
It could reflect a genuine rise in overdoses, or growing awareness of the risks, with people feeling more comfortable calling an ambulance and getting to hospital, she said.
For more resources, see Health Direct, Alcohol and Drug Foundation and Positive Choices.
Read the NDARC’s full drug-induced death report here and the drug-related hospitalisations report here.
