Last month, the National Illicit Drug Indicators Project (NIDIP) - which provides epidemiological data on trends over time in drug-related harms and forms part of the broader Drug Trends program - published its latest 'Trends in overdose and other drug-induced deaths in Australia, 2004-2023'.

Drug Trends Program Lead and NDARC Deputy Director, Dr Rachel Sutherland, provides an overview of this report and what it means moving forward.

Since 2002, NDARC has produced an annual report on overdose and other drug-induced deaths among Australians. Our rigorous methods align with global best practice, and we work closely with the Australian Bureau of Statistics (ABS) to ensure our report provides critical, accurate insights from the data.

Before diving into the key findings from our latest report, there are a couple of important things to clarify.

First things first: what do we mean by "drug-induced death"?

In our reporting, a drug-induced death refers to instances where the single underlying cause of death is a substance use disorder (e.g., opioid dependence), a direct drug-related harm (e.g., poisoning or overdose), or a consequence of chronic drug use (e.g., drug-induced cardiac conditions). This doesn’t include deaths where drug use may have been a factor, but not the direct cause – like a car crash involving someone under the influence.

This definition aligns with those used by the ABS and the Australian Institute of Health and Welfare, however, differs from the definition used by other organisations, such as the Penington Institute. So, if you’ve spotted differences in figures across reports, that’s likely why.

We include deaths that are directly attributable to the use of illicit drugs (e.g., heroin), prescription medicines (whether prescribed or obtained illicitly), and over-the-counter medications. However, we exclude deaths attributable to alcohol and tobacco. While these substances cause significant harm, they fall outside the scope of Drug Trends program, which primarily focuses on illicit drugs.

An important note on the numbers for 2022 and 2023:

The figures for the two most recent years, 2022 and 2023, are not final. When a death is referred to the coroner, the investigation takes time. To account for this, the ABS revises mortality data in stages over three years as more information becomes available:

• 2023 data is currently considered “preliminary revised” (only one revision so far).
• 2022 data is “revised” (two revisions).
• 2021 and earlier data are final.

We anticipate the 2023 figures will rise by around 2-3% after their first revision, and by up to 2% with the second. So, any recent figures should be interpreted with this in mind – they’ll only increase from here.

While these data might seem lagged, they are the most recent estimates as of May 2025.

So, what did we find?

In 2023, 1,762 Australians died from drug-induced causes. That’s about five deaths every day, representing 1% of all registered deaths in the country.

Over the past 20 years (2004-2023), the rate of drug-induced deaths increased by an average of 4.2% per year, peaking in 2017 at 8.2 deaths per 100,000 people. Since then, the rate has gradually been trending downwards.

The 2023 preliminary rate was 6.6 deaths per 100,000 people. That’s statistically lower than the revised 2022 rate of 7.2 per 100,000, although both these figures may increase upwards.

Which drugs are involved?

When reporting on drug type, we focus on overdose deaths – which make up about 97-99% of all drug-induced deaths – as more detailed information is available about substances involved.

Across 2004-2023, opioids have consistently been the most commonly identified drug type. They’re followed by antiepileptic, sedative-hypnotics, and anti-parkinsonism drugs (mainly benzodiazepines).

Since 2004, overdose death rates have risen across all drug types, generally peaking in 2017 and 2018 before starting to decline. That said, cocaine and amphetamine-type stimulant (ATS) deaths peaked later, in 2020. While ATS-related deaths have remained relatively stable since then, the trend for cocaine is more variable: after a decline in 2022, the preliminary data for 2023 shows a rise again, hinting at a possible return to an upward trend.

There’s also been a shift in the types of opioids involved in opioid overdose deaths. Specifically, heroin deaths have increased since 2012, while deaths involving natural and semi-synthetic pharmaceutical opioids (e.g., morphine, oxycodone) have declined since around 2017.

Who is most affected?

A few patterns stand out when we look at the characteristics of drug-induced deaths:

• Most deaths occur among males, and those aged 35-54.
• Over time, there’s been a clear shift towards middle to older age groups.
• The majority of deaths occur in major cities, though in 2023, the rate per 100,000 was highest in inner regional areas, followed by major cities, outer regional and remote locations.
• People living in the most disadvantaged areas experience higher rates of drug-induced deaths.
• Most deaths occur at home, are unintentional and involve multiple drugs.

The human cost behind the data

The key thing to remember here is that behind each of these numbers is a person, a family, a community. These deaths are not inevitable. They reinforce the importance of continued efforts to ensure that drug policies, treatment, and harm reduction services are accessible, effective, and compassionate.