In 1996, a small Sydney research team set out to do something simple but badly needed: ask people who inject drugs what they were using and how they were getting it. That pilot study became the foundation of drug use monitoring in Australia that has now run for 30 years. NDARC’s Drug Trends programme has grown into one of the most comprehensive illicit drug trends surveillance systems in the world, and in 2026 it marks three decades of tracking drug markets, emerging substances and drug-related harms across the country.

The anniversary arrives at a telling moment. At the 2025 NDARC Annual Symposium, researchers and policy experts gathered to take stock of where things stand, what the data now shows, and what needs to change to protect progress that took a generation to build.

How Drug Use Monitoring in Australia Began

The Australian Government funded and launched the Drug Trends programme in 1996. Researchers started the Illicit Drug Reporting System (IDRS) in Sydney, running surveys with people who inject drugs alongside expert interviews and existing data analysis. The initial focus covered heroin, amphetamine, cocaine and cannabis.

Results came quickly. By 1997, the IDRS had expanded to Adelaide and Melbourne. By 2000, researchers ran the programme in every state and territory.

Three Decades of Illicit Drug Trends Surveillance

Drug Trends steadily broadened its scope. The Ecstasy and Related Drugs Reporting System (EDRS) launched in 2003 to capture stimulant use trends. The National Illicit Drug Indicators Project (NIDIP) started in 2002 to provide national data on drug-related harms. Then in 2012, the Drugs and New Technologies (DNeT) project began watching online drug markets, including dark web cryptocurrency platforms.

Today, partners at the National Drug Research Institute, Burnet Institute, University of Tasmania and University of Queensland all feed into the programme. Data now comes from wastewater analysis, hospitalisation records, drug-induced death statistics, treatment episodes and regular snapshots of dark web crypto markets.

“We strive to detect shifts in drug use and markets before they translate into widespread harm, identifying populations most affected or at greatest risk, and generating the evidence required to design and evaluate policies that improve health outcomes and equity for people who use drugs,” said Associate Professor Amy Peacock, Program Lead for Drug Trends.

What Drug Use Monitoring in Australia Found in 2025

Dr Rachel Sutherland, Senior Research Fellow at NDARC and deputy programme lead, presented the 2025 IDRS and EDRS findings at the symposium. Some things have stayed stable. Others are shifting in ways that deserve attention.

Heroin Markets Hold Steady Despite Global Pressure

The Taliban’s opium cultivation ban in Afghanistan sparked fears of major supply disruption globally. In Australia, though, the heroin market barely moved. Most Australian heroin comes from South-East Asia, where supply reportedly still meets local demand. The street price of heroin actually fell in 2025, dropping back to around $50 per point, the same level as 2019 and before. Meanwhile, prices in Afghanistan and neighbouring countries have tripled.

Synthetic Opioids Shift: Nitazenes Rise as Fentanyl Falls

Novel synthetic opioid detections in Australia peaked around 2021 and 2022, then started to ease. That drop has been driven largely by fewer fentanyl and fentanyl analogue detections. But nitazenes are filling the gap, with nearly 40 nitazene-related drug alerts recorded across Australia over the past few years. Most nitazene exposure appears unintentional, turning up in counterfeit oxycodone, benzodiazepines, ketamine, cocaine and MDMA.

Illicit Drug Trends Surveillance Spots a Naloxone Win

This year’s illicit drug trends surveillance delivered one clear piece of good news: naloxone awareness and access are growing. Among people who inject drugs, uptake has climbed steadily year after year. More striking is what happened among people who use ecstasy and stimulants, a group that does not typically seek out opioids. One in five had still obtained naloxone in the past year, reflecting their real and growing exposure to adulterated substances.

Methamphetamine Consumption Exceeds Pre-COVID Levels

Crystal methamphetamine remains widely used and easy to obtain. Wastewater data now shows estimated consumption has not just recovered from the pandemic dip but pushed past pre-COVID levels. Harms appear to have stabilised after rising sharply between 2010 and 2020, though treatment demand stays high.

Vaping Rules Are Not Working as Intended

The 2024 legislation banning disposable vape imports and pushing sales to pharmacies has changed very little in practice. Virtually nobody in the survey sample bought vapes from a pharmacy. Nearly two-thirds sourced them from convenience stores as before. Disposable vapes remain the product of choice, and nicotine pouches have not stepped in to replace them.

Illicit Tobacco Has Become the Norm Among Drug Users

Illicit tobacco use has climbed sharply among people who use drugs. The majority of tobacco users across both the IDRS and EDRS samples now report using illicit products. Most pick up branded cigarette packs from tobacconists or convenience stores for $13 to $16 for a packet of 20, around a third of the legal retail price. Almost everyone surveyed gave the same reason: it is simply far cheaper.

Drug Use Monitoring in Australia: The Policy Debate at 40 Years

The symposium also hosted a panel discussion on four decades of national drug policy, moderated by Dr Norman Swan. He was joined by Professor Mel Miller (Chair, NDARC Advisory Board), Associate Professor Robert Ali AO, Dr Mary Harrod (CEO, NUAA) and Associate Professor Michael Doyle from the University of Sydney.

The conversation was direct. Australia’s harm minimisation framework drew broad support, but panellists were clear-eyed about what has been lost: national governance structures, consistent implementation and the political will to fund what actually works.

Why Harm Reduction Funding Remains Critically Low

“Harm minimisation is a perfectly great framework, but harm reduction receives an absolutely minuscule amount of funding, around 1.6 per cent, while nearly everything goes into enforcement,” said Dr Harrod. “There is still a lot of stigma in the way we implement policies, and support gets taken away very easily.”

Associate Professor Ali pushed back against any sense of complacency. Australia holds some of the lowest HIV rates among people who inject drugs anywhere in the world. That did not happen by accident. “We have seen a systematic degradation of our commitment,” he said. “The national strategy is a shell game where we cherry-pick examples of excellence but fail to get a unified commitment for implementation.” For context: every dollar invested in a needle and syringe programme returns $27 in measurable benefits.

First Nations Communities Are Being Left Behind

Associate Professor Doyle pointed directly to the 2015 abolition of the National Indigenous Drug and Alcohol Committee (NIDAC) as a lasting damage to the sector. “Aboriginal people do not feel like they own part of the national drug strategy,” he said. “If you do not feel ownership, how can you possibly be expected to work in that direction?”

Aboriginal and Torres Strait Islander people make up around one in five presentations to specialist drug and alcohol services nationally. Funding does not come close to matching that level of need. The burden of disease from alcohol, other drugs and tobacco runs at nearly double the national rate in First Nations communities.

The Collapse of Cross-Portfolio Governance

The panel agreed on one uncomfortable reality: no state, territory or federal government currently runs a cross-portfolio governance structure dedicated to alcohol and other drugs. The new national strategy is already delayed. The Australian CDC has left alcohol and other drugs outside its remit, despite those conditions carrying a heavier disease burden than many of the infectious diseases it does cover.

Professor Miller pointed to a revealing historical contrast. “A conservative Queensland government ran needle exchanges through Sister Angela Mary Doyle,” he said. “They were socially pragmatic. The role of science in public policy was easier to prosecute back then.” He argued that rebuilding public sector policy capacity, something both state and federal governments have recently signalled commitment to, offers the most realistic path forward.

Thirty Years of Drug Use Monitoring in Australia Worth Protecting

It is easy to lose sight of what has actually been achieved. When the Hawke government came to power in the 1980s, ministers initially leaned towards a US-style drug war, built on zero tolerance and abstinence. A visit to New York changed things. Parts of that city carried HIV transmission rates comparable to sub-Saharan Africa, with almost no needle exchange infrastructure. The harm reduction approach Australia adopted in response put the country among the world leaders in evidence-based drug policy and helped build institutions like the Kirby Institute.

Thirty years of drug use monitoring in Australia sat underneath all of that, providing the intelligence that shaped funding decisions and public health responses at every step. When COVID-19 hit and disrupted both drug markets and harm reduction services between 2020 and 2022, the Drug Trends programme shifted quickly to track what was changing and get that intelligence back to the people making decisions.

What Comes Next for Illicit Drug Trends Surveillance in Australia

The symposium sent emerging researchers away with a clear message: get embedded in the systems that shape policy, build relationships across sectors and communities, and learn to translate data into arguments that land with decision-makers who do not already share your assumptions.

“Governments do not want to invest unless you can demonstrate a return on investment,” said Associate Professor Ali. “We need to be more open and better advocates for that.”

The Drug Trends programme heads into its next 30 years with the same mission it started with: catch shifts in drug use before they turn into crises, keep the surveillance infrastructure running that gives Australia its early-warning edge, and make sure the evidence actually reaches the people who most need to act on it.

Source: unsw.edu