Every day in Australia, 156 people are admitted to hospital because of drugs. Not alcohol, not tobacco. Drugs. Drug-related harm in Australia is no longer a slow burn.
New national figures put the number of drug-related hospitalisations at 56,797 for 2023-24, a 10.5% rise on the year before. Over the same period, all-cause hospitalisations went up by 4.1%. Drug harm is growing at more than twice the pace of everything else that sends people to a hospital bed.
The report, from the National Illicit Drug Indicators Project at UNSW’s National Drug and Alcohol Research Centre, counts what happens. It does not try to explain why. But numbers like this demand an explanation, and the case that a culture of permission has played its part deserves a proper hearing.
Twenty years, one direction
Across 20 years of data, drug-related harm in Australia has trended upward. The age-standardised rate of drug-related hospitalisations climbed from 197 per 100,000 people in 2004-05 to 216 in 2023-24. It rose to 2015-16, eased, then jumped again in the latest year. It is still below the peak seen between 2016-17 and 2020-21, but nobody should take comfort from a number that only just stopped being worse.
Stimulants tell the sharper story. The rate for amphetamine-type stimulants went from 17 per 100,000 in 2004-05 to 64 in 2023-24. That is close to a fourfold increase. These drugs were the principal diagnosis in 29% of drug-related hospitalisations, and methamphetamine accounted for 83% of the stimulant cases. Cocaine started from a low base, at 1.5 per 100,000, and reached 4.9. Hospitalisations linked to GHB jumped 59% in a single year.
Opioids are the one area that looks steadier. Their rate fell from 29 to 21 over the two decades. Anyone defending the current mix of harm reduction policies will point there first. The trouble is that the fastest growing problems sit elsewhere, in the drugs that many people still describe as manageable, social or “recreational”. If the approach has a success story, it is not a stimulant story.
Cannabis: the numbers and the questions
Drug harm across Australia is not one story, and cannabis is a good example.
The cannabinoid rate roughly doubled between 2004-05 and 2023-24, going from 14 to 25 per 100,000. It held flat in the latest year, and the report does not say it is surging. What it does show is where the burden lands. In remote and very remote areas, the rate was 69 per 100,000. In major cities it was 22.
Drug-induced psychotic disorder was the leading diagnosis among mental and behavioural cases, at 37%. Those are not statistics about people who simply “had a rough night”.
The report does not examine commercial cannabis markets or medicinal cannabis schemes, so none of these figures can be pinned on them. That is worth saying plainly. It is also worth asking a pointed question. A product sold for profit depends on repeat customers, and a framework that lets cannabis be labelled as medicine on thin evidence makes the drug look safer than the hospital data suggest. Regulators should be asked how they know the framework is not feeding demand. These figures cannot answer that, but they are exactly why the question matters.
Who pays
The cost of drug-related harm in Australia falls on identifiable people. Adults aged 20 to 39 made up 52% of all drug-related hospitalisations, with 26% in each of the 20s and 30s bands. Males accounted for 52% and females 47%, and both groups saw increases. Rates were also higher in areas of greater socioeconomic disadvantage and in remote and very remote communities, where amphetamine-type stimulant hospitalisations ran at 88 per 100,000 against 61 in major cities.
Then there are the people on the other side of the bed, who handle these admissions around the clock. Poisoning made up 41% of drug-related hospitalisations and almost all ICU admissions. Mental and behavioural disorders due to substance use made up the other 59%, with dependence syndrome behind 31% of those. That means emergency staff, intensive care teams, mental health nurses and ward clinicians absorbing more than 150 cases a day, week after week, with no end in sight.
The report does not measure burnout, vacancies or moral injury among health workers. It does not need to for the picture to be clear. When 10.5% more people turn up with a preventable problem and the system grew by less than half that, someone is working harder to cover the gap.
One figure deserves care. Two thirds of the poisoning hospitalisations, 67%, were intentional. That points to people in serious distress, and it is a reminder that these admissions are about far more than a party that went wrong.
What the data asks of policymakers
Normalisation is a hard thing to measure, and this report does not claim to measure it. But it is hard to read 56,797 admissions in one year and conclude that the message to the public has been working. A culture that treats drug use as a lifestyle choice, and a policy environment that keeps widening what is tolerated, are choices too. The people paying for them are young adults, remote communities and the clinicians at the bedside.
If drug harm across Australia keeps outrunning every other cause of admission, the argument for putting prevention at the front of the response gets stronger every year. Drug-related harm in Australia is a problem that starts long before the emergency department. These hospital admissions are the end of a long chain. The earlier it is interrupted, the fewer people end up in the emergency department at all.
(Source: UNSW – WRD News)