The Illicit Drug Reporting System (IDRS) has been conducted annually since 2000. The IDRS is a national drug monitoring system, designed to identify and track emerging trends of local and national concern in illicit drug use and markets. The IDRS forms part of the broader Drug Trends program.

This bulletin explores trends in self-reported past 12-month opioid overdose amongst samples of people who regularly inject drugs recruited annually between 2015-2025 for the IDRS.

Key findings

Among IDRS participants who reported past six month use of any prescribed or non-prescribed opioids (including heroin, pharmaceutical opioids, and OAT):

• Past 12-month non-fatal overdose almost doubled between 2015 and 2018 before subsequently declining and stabilising at ~16% of the sample.
• The peak in 2018 was mostly driven by an increase in Melbourne.
• However, past-year non-fatal overdose is now observed at similar levels across multiple capital cities.
• These trends mirror patterns in other opioid-related harms and heroin market indicators.

Discussion

The trends observed in non-fatal opioid overdose amongst the IDRS sample align with trends of other opioid-related harms in Australia. Non-fatal overdoses increased to a peak in 2018 before subsequently declining and then stabilising, mirroring the national trend in fatal overdose rates. The trend observed in the Melbourne sample also aligns with trends in heroin-related ambulance and emergency department attendances, and the purity-adjusted price of heroin which declined from 2014 to a low in 2019. Heroin overdose deaths were also found to be highest in Melbourne in 2018 compared to any other capital city or regional area in Australia. These findings highlight the importance of monitoring non-fatal opioid overdose amongst people who inject drugs as a potential lead indicator of opioid related harms that can inform harm reduction strategies.

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Recommended citation

Wilson, J., Boelen, F., Cowman, M., Raffaele, D., & Dietze, P. Trends in self-reported non-fatal opioid overdose amongst samples of people who inject drugs in Australia, 2015-2025. Drug Trends Bulletin Series. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney; 2026. Available from: https://doi.org/10.26190/unsworks/32615

Funding and copyright

Drug Trends is supported by funding from the Australian Government Department of Health, Disability and Ageing under the Drug and Alcohol Program.

©NDARC, UNSW SYDNEY 2026 

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• Trends in self-reported non-fatal opioid overdose amongst samples of people who inject drugs in Australia, 2015-2025

Contact

For further information, contact Paul Dietze at paul.dietze@burnet.edu.au

Research areas