In May 2026, the National Drug and Alcohol Research Centre (NDARC) marked thirty years of its Drug Trends program with a quiet announcement and a new bulletin series. NDARC framed the launch as a milestone: three decades of monitoring Australia’s drug markets, a commitment to drawing together multiple data sources, and a new series designed to make evidence more accessible to policymakers and health services. Yet for anyone watching Australian drug prevention policy, the milestone carries an uncomfortable weight.
The first bulletin the program produced, a detailed snapshot of cocaine in Australia, is among the more damning indictments of drug policy published in recent years. Not because NDARC intended it that way, but because the numbers tell a story the framing does not. Cocaine use among Australians aged 14 and over has grown from 1% in 2004 to 4.5% in 2022–23. Wastewater analysis recorded the highest cocaine consumption in Australian history in 2024–25. Deaths have risen fivefold since 2000. Hospitalisations have tripled since 2011. Cocaine is now the second most commonly used illicit drug in Australia. The market is, in the bulletin’s own words, “growing and more established.”
Thirty years of monitoring and every indicator moving in the wrong direction.
The question worth asking at this anniversary is not whether Drug Trends has done its job. It has, on its own terms. The real question is what job its designers intended it to do, and what that choice has meant for Australian drug prevention policy over three decades.
What Drug Trends Was Built to Measure
The anniversary announcement describes the four monitoring systems that make up the Drug Trends program in plain terms. The Illicit Drug Reporting System (IDRS) monitors “trends in illicit drug markets” through annual interviews with people who inject drugs. The Ecstasy and Related Drugs Reporting System (EDRS) tracks “emerging trends” in ecstasy and stimulant markets through interviews with people who regularly use those substances. The National Illicit Drug Indicators Project (NIDIP) disseminates “trends in the epidemiology of drug-related harms.” The Drugs and New Technologies project monitors online drug marketplaces and dark web availability.
Every one of these systems focuses on people already using drugs, markets already operating, and harms already occurring. None of them measure whether fewer Australians are choosing to use drugs in the first place. The word ‘prevention’ does not appear in any of their frameworks, let alone as something to track or evaluate. Nor does any system ask whether the policy environment is discouraging uptake among people who have not yet begun.
This is not a criticism of the researchers who built and operate these systems. Monitoring markets and harms is necessary work. However, the architecture of Drug Trends reflects a set of assumptions about what Australian drug prevention policy is fundamentally for, and preventing uptake is not among them. Over thirty years, that architecture has shaped what evidence researchers generate, what questions they ask, and what policy responses policymakers receive.
The Drift Toward Harm Reduction
Australia’s shift toward harm reduction as the dominant policy framework did not happen at once, and it did not begin recently. When the Hawke government launched the National Campaign Against Drug Abuse in 1985, harm minimisation was introduced as the organising principle from the start. Every iteration of the National Drug Strategy since then, through 1993, 1998, 2004, 2010, and 2017, has carried the same overarching commitment to harm minimisation across three pillars: supply reduction, demand reduction, and harm reduction. Prevention of uptake was folded into demand reduction, never given its own pillar, and never given proportionate funding. A 2024 UNSW report found that of the $5.45 billion Australian governments spent on illicit drug countermeasures in 2021-22, just 7% went to prevention. Law enforcement consumed 64%. Treatment took 27%. Prevention, the only pillar directly aimed at stopping people from starting, received $363 million in a $5.45 billion budget.
By the time Drug Trends reached its thirtieth year, harm reduction had become the dominant logic of most public health responses to illicit drug use in Australia. Drug checking services now operate in the ACT and Victoria. Needle and syringe programmes proliferate nationally. Supervised consumption facilities have ended their so-called trials and opened for business in two states with disastrous community outcomes. Over those decades, the language shifted from discouraging use to managing damage more ‘safely’.
The cocaine bulletin reflects this orientation precisely. Its policy recommendations identify three priorities: continued monitoring of cocaine markets and harms; expansion of drug checking and public risk communication systems; and improved access to treatment and early intervention services.
Notably, the word “prevention” does not appear in the policy implications section. The bulletin makes no recommendation directed at reducing the number of Australians who begin using cocaine. It sets no target for reducing uptake. It offers no acknowledgement that the fourfold increase in cocaine use over two decades represents a failure that warrants a different kind of response.
This absence is not accidental. It is where a monitoring framework arrives after thirty years of progressively redefining success. Success no longer means fewer people using drugs. The framework was supposed to mean fewer people dying or ending up in hospital per unit of drug use, but with increasing use these relative numbers also increase, though the ‘spin’ may be that we are seeing ‘less’ such incidences. These are different goals, and pursuing one does not automatically serve the other.
Harm Reduction’s Real Limits
The cocaine bulletin documents that drug checking services in the ACT and Victoria found some samples sold as cocaine contained opioids, a contamination risk that kills people. Multiple drug alerts between 2024 and 2026 flagged opioids in cocaine samples across NSW, ACT, and Victoria. In that specific context, drug checking has a clear purpose. Even so, consumption of ‘uncontaminated’ substances does not slow.
Harm reduction as a primary policy framework, rather than one tool among many, carries consequences the bulletin’s own data make visible. Across thirty years of Drug Trends monitoring, cocaine use has grown every decade. The market has become more established, not less. Perceived availability among people who regularly use ecstasy and other stimulants reached over 40% in 2025, with many reporting cocaine was “very easy to obtain.” The domestic price, at $300 to $350 per gram, remains among the highest in the world, not because supply is constrained, but because demand is strong enough to sustain it.
Harm reduction does not reduce demand. In fact, it can paradoxically increase it, not least by normalising engagement with addictive substances. It manages the consequences of demand that already exists, but when demand grows, as it has in Australia across thirty years, the harm reduction burden grows with it. Hospitalisations multiply. Treatment episodes balloon, having quadrupled for cocaine over the past decade alone. Ambulance attendances climb with them.
That is not a system succeeding. It is a system absorbing the consequences of a problem its designers never intended it to prevent.
Where Did Prevention Go?
Prevention exists on paper, but little more than that. Reducing the number of people who initiate drug use has all but disappeared from Australian drug policy in practice. Governments have progressively marginalised and underfunded it, and much of public health discourse treats it with scepticism.
Some of that scepticism has legitimate roots. School-based drug education programmes of the 1980s and 1990s produced mixed results, mostly because of a lack of volume, consistency, and follow-through. Mass media campaigns have a complicated evidence base, depending heavily on who scripts the messaging. Consequently, those experiences generated real caution about prevention as a category.
Caution, however, became abandonment. The monitoring infrastructure Drug Trends built over thirty years reinforced that abandonment, because it generated no evidence about prevention outcomes. You cannot make the case for investment in something you have no data on. The IDRS interviews people who inject drugs. The EDRS interviews people who regularly use ecstasy and stimulants. Neither system asks how those people came to begin using, what might have changed that trajectory, or what keeps non-users from starting.
The cocaine bulletin contains a figure that should be at the centre of any serious prevention conversation. Only 3% of people who used cocaine in 2022–23 did so weekly or more frequently. A full 97% used occasionally. The shift to more harmful, more entrenched patterns of use is not yet widespread at population level. There is a large cohort of occasional users who have not crossed into frequent use, and a broader population of non-users who have not started at all.
The bulletin itself acknowledges that “increased availability and, as a result, potential reductions in price may contribute to broader uptake and more frequent use over time.” It then recommends drug checking and treatment access. It spots the window and walks straight past it.
What the Numbers Say About Policy
The cocaine data in this bulletin covers a period during which Australia maintained one of the world’s most sophisticated drug monitoring systems, spent heavily on law enforcement, including record seizures of 5.6 tonnes in 2023–24 and a single operation that netted 2 tonnes in November 2024, and progressively expanded harm reduction services. Throughout that same period, cocaine use grew fourfold.
The bulletin is careful about causality, noting that researchers conducted no statistical testing to support statements about change over time. Fair enough. Still, what can be said is that the current framework has not produced a reduction in cocaine use, or in cocaine-related harm at population level. Cocaine already accounts for 11% of the burden of disease attributable to illicit drug use in Australia, within a broader context where illicit drug use contributes 2.9% of total disease burden. As use grows, that share will grow further.
A monitoring system that tracks harms but not prevention outcomes will produce evidence that supports harm reduction responses. That is not a conspiracy. It is simply how evidence framing works. The questions you ask determine the answers you get, and the answers you get determine the policies that follow. For Australian drug prevention policy to change direction, researchers and policymakers must first change the questions they ask.
What Needs to Change
Any serious prevention complement to the existing Drug Trends framework would need to do things the current systems do not. It would need to understand the social and cultural factors driving cocaine uptake among the specific populations the bulletin identifies: young, employed, city-dwelling Australians with tertiary education, and gay, lesbian, and bisexual Australians, who report use at 15.1%, more than three times the general population rate. Furthermore, it would need to develop and evaluate targeted prevention approaches for these groups, rather than treating prevention as a spent category.
Policymakers would need to set and measure explicit targets for reducing uptake, not just death rates per user. Researchers would need to build prevention outcome data into the monitoring system, so that after another thirty years there is actually evidence on which to base prevention investment.
None of this requires dismantling what Drug Trends has built. A framework that measures harms without measuring whether fewer people are choosing to use drugs is, though, an incomplete one. The cocaine bulletin, read carefully, makes that incompleteness impossible to ignore.
Conclusion
NDARC’s thirty-year anniversary marks a genuine achievement in Australian public health research. The Drug Trends program has built a sustained, rigorous evidence base that the sector depends on.
The anniversary also marks, however, thirty years in which cocaine use grew from a marginal issue to the second most commonly used illicit drug in Australia. It marks thirty years in which the monitoring framework watching that growth never asked whether anyone could have stopped it. Above all, it marks thirty years in which harm reduction expanded and prevention contracted, without anyone explicitly deciding that this was the right direction for Australian drug prevention policy to travel.
The bulletin series NDARC has launched is titled Trends in Drug Markets, Use and Health Impacts in Australia. It is an accurate title. Markets, use, and health impacts are what Drug Trends measures. After thirty years, it is reasonable to ask whether a system that does not measure prevention can ever produce the evidence needed to achieve it.
This article draws on the NDARC announcement ‘Marking 30 Years of Drug Trends: Introducing a New Bulletin Series’ (28 May 2026) and the associated bulletin ‘Trends in Drug Markets, Use and Health Impacts in Australia: Cocaine’ (May 2026). WRD News provides prevention-focused analysis of drug policy and public health in Australia.
Author DALGARNO INSTITUTE
(Source: WRD News)