Drug Trends in Australia: 30 Years of Tracking Substance Use and Shaping Policy

It began as a one-year trial in Sydney in 1996. A clipboard, a set of survey questions, and a handful of people willing to talk honestly about substance use in Australia. Three decades on, the Illicit Drug Reporting System has grown into one of the most comprehensive drug monitoring networks in the world. Its findings have shaped some of the most significant public health decisions in Australian history.

The Drug Trends programme is run by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney. It marks its 30th anniversary in 2026. Its archive of data reads less like a research catalogue and more like a social history of a country grappling, often painfully, with how to respond to drug use without abandoning the people caught up in it.

From Heroin Epidemic to Harm Reduction

The story starts in the 1980s, as so many Australian drug policy stories do. Heroin had become a fixture in the national conversation. Not just in marginalised communities, but in the highest offices in the land. In 1984, Prime Minister Bob Hawke spoke publicly about his daughter’s heroin dependence. The moment shifted public debate in ways that policy papers alone could not.

By the late 1990s, Australia was losing more than 1,000 people a year to heroin overdoses. Against this backdrop, the IDRS launched its Sydney pilot in 1996. It tracked drug use patterns through interviews with people who inject drugs, expert consultations and analysis of existing data. The system expanded to Adelaide and Melbourne in 1997. It reached every state and territory by 2000.

The timing proved critical. When heroin availability collapsed suddenly in 2001, Drug Trends in Australia was the first to capture what became known as the “heroin drought.” Its data showed prices rising and purity falling. The drug became increasingly difficult to source. Overdose deaths dropped. But as heroin use fell, methamphetamine and morphine use rose to fill the gap. It was an early warning about displacement, and it proved prescient.

The Ice Age and What Drug Trends Data Revealed

By the mid-2000s, crystal methamphetamine had moved to the centre of Australia’s drug crisis. A 2006 Four Corners report titled “The Ice Age” brought the issue to mainstream audiences. But Drug Trends researchers had been watching the shift for years.

In 2015, data from the programme played a central role in the National Ice Taskforce’s Final Report. It identified critical gaps and laid the groundwork for a National Ice Action Strategy. Three years on, NDARC Director Professor Michael Farrell appeared as the opening witness at the NSW Special Commission of Inquiry into Ice. Drug Trends data served as a cornerstone of the evidence base.

The Inquiry produced 109 recommendations. The NSW Government committed $500 million to treatment and support services. Behind that headline figure was a decade of careful, consistent data collection on substance use in Australia.

Pharmaceutical Opioids and the Art of Targeted Policy

Not all of Drug Trends’ most consequential work has involved illicit substances. One of the programme’s clearest examples of research driving targeted intervention came with the reformulation of OxyContin in 2014.

Controlled-release oxycodone had become increasingly misused, particularly through injection. On 1 April 2014, a tamper-resistant version was introduced. It was designed to resist crushing, cutting, chewing or dissolving. Drug Trends’ annual surveys with people who inject drugs contributed directly to evaluating the change.

The findings were clear. Among people who inject drugs, use and tampering both fell significantly. There was no evidence that people shifted to other opioids as an alternative. Population-level use of controlled-release oxycodone remained broadly stable. More recent data suggests non-prescribed use of pharmaceutical opioids remains low.

It was a policy intervention that worked, and evidence confirmed it.

Naloxone: How Substance Use in Australia Research Saved Lives

Perhaps no story from Drug Trends’ 30-year history illustrates its real-world impact more directly than the campaign to widen access to naloxone. Naloxone is the medication that reverses opioid overdose.

Since 2013, the programme’s surveys have tracked naloxone uptake across states and territories. This built an evidence base supporting successive expansions of access. The evaluation of the 2019 to 2022 Take-home Naloxone Pilot found increased access and use of naloxone. Crucially, there was no corresponding rise in risky opioid use. That finding addressed one of the most common objections to wider availability.

The evidence helped underpin the Federal Government’s decision to make naloxone available nationwide, free of charge. The rollout was backed by $19.6 million in funding and began in 2022.

“Opioid overdoses can be prevented, and take-home naloxone is a proven way to save lives,” said Dr Rachel Sutherland, Deputy Programme Lead for Drug Trends.

A Changing Landscape for Drug Trends in Australia

Thirty years of substance use data in Australia reveal a drug landscape that has grown significantly more complex. Supply chains are more volatile. Street drugs are more frequently adulterated. Cocaine and ketamine are more widely available than ever before.

Novel synthetic opioids and designer benzodiazepines have entered Australian markets. The boundaries between illicit and medicinal use are blurring too. Cannabis, MDMA, LSD and ketamine are now regulated for certain therapeutic conditions, following a world-first TGA decision in 2023.

Structural challenges remain. Harms fall disproportionately on Aboriginal and Torres Strait Islander people and other marginalised communities. Regional and rural areas face rising harm rates but limited services. An ageing cohort of people who use drugs is placing increasing pressure on health systems.

The 2020s also brought new questions around information access. Before fixed-site drug checking services existed, Drug Trends research found widespread reliance on at-home reagent test kits. These were frequently inaccurate and used without expert guidance. That evidence helped drive advocacy for formal, evidence-based checking services. Australia’s first fixed-site drug checking service, CanTEST, opened in Canberra in 2022.

“We strive to detect shifts in drug use and markets before they translate into widespread harm,” said Associate Professor Amy Peacock, Programme Lead for Drug Trends. “We identify populations most affected or at greatest risk. Then we generate the evidence needed to design and evaluate policies that improve health outcomes.”

What Three Decades of Substance Use in Australia Tells Us

The arc of drug trends in Australia over 30 years is not a story of victory or defeat. Heroin deaths have fallen sharply since their peak around 2000. Needle and syringe programmes, rolled out nationally by 1993, helped Australia avoid the scale of HIV transmission seen in the United States. Take-home naloxone is now freely available nationwide. Drug checking services are expanding.

At the same time, drug-induced deaths driven by opioids and benzodiazepines have been climbing. Methamphetamine use remains a significant public health challenge. New synthetic substances keep emerging faster than regulatory frameworks can respond.

What Drug Trends has provided, year after year, is the evidence needed to respond to these shifts before they become crises. That may be its most durable contribution. Not any single finding, but the discipline of watching, measuring and reporting what is actually happening on the ground.

Source: unsw.edu