Australia's annual overdose report 2019

The number of Australians who die from unintentional drug overdose each year continues its long-term rise. This report examines drug-induced deaths, where the death is directly attributable to the drug use, with a focus on unintentional-drug induced deaths. This report presents key statistics about unintentional drug-induced deaths in Australia from 2001 to 2017, with a snapshot of 2017 data provided in Figure 1.

Opioids (including both pharmaceutical opioids and heroin) continue to be the primary drug group associated with unintentional drug-induced deaths, though there have been significant changes in the types of opioids since 2001. While deaths involving pharmaceutical opioids have continued to rise, and comprise the largest proportion of deaths involving opioids, there have been dramatic rises in deaths involving heroin since 2012.

Benzodiazepines remain the second most common group of drugs identified in unintentional drug-induced deaths, behind opioids, though these are predominantly identified in poly-substance overdose deaths. Since 2013 there has been a significant increase in unintentional drug-induced deaths involving benzodiazepines in both Western Australia and Victoria, and to a lesser extent, New South Wales.

There has been a sharp rise in deaths involving stimulants (including methamphetamine) in Australia since 2012, which is seen in both regional and urban areas.

Deaths involving other prescription medications – such as anti-convulsant medications used as treatment for neuropathic pain, and anti-psychotics – have increased markedly in the last few years, although they account for only a small proportion of all unintentional drug-induced deaths.

Drug-induced death is not confined to either illegal drugs or those taken as medicines; alcohol may also be involved in unintentional drug-induced deaths. When used in conjunction with other drugs, alcohol may contribute to a fatal overdose, or rarely, be the sole cause of an unintentional drug-induced death. Up until recently, alcohol was the third most common drug involved in unintentional drug-induced deaths, though it has recently been surpassed by stimulants.

While a single drug may be identified in an unintentional drug-induced death, it is rare for a death to be attributable to toxicity from a single drug; deaths involving multiple drugs are the norm rather than the exception. Poly-drug deaths involving four or more substances have increased significantly in recent years.

While drug use is commonly associated with younger people, this report shows that it is middle-aged Australians (30-59 years) who have the highest incidence of unintentional drug-induced mortality. Further, the gap between this middle-aged cohort and Australians under-30 or over-60 has expanded in the last fifteen years and continues to widen. Unintentional drug-induced deaths overall are more prevalent among men, with the number of deaths for males increasing more rapidly than for women in recent years. Similarly, the rate of unintentional drug-induced death remains higher for Aboriginal Australians than for non-Aboriginal Australians, and this gap is widening. Finally, unintentional drug-induced deaths occur across all socio-economic areas, with small differences in prevalence observed between the most advantaged neighbourhoods and the most disadvantaged neighbourhoods.

Drugs and overdose also tend to be associated with urban areas; the data, however, reveal that the highest growth in unintentional drug-induced deaths is occurring in regional settings, away from capital cities. This trend poses significant challenges for responding to overdose, as regional areas tend to have less access to drug treatment and support services and may have longer delays in ambulance attendance.

Penington Institute has compiled this report based on data from the Australian Bureau of Statistics (ABS).