Chapter 2Illicit drugs in Australia—context
Introduction
2.1Before considering any of the reforms or suggestions proposed throughout the inquiry, the purpose of this chapter is to illustrate the context in which the committee’s consideration took place. It describes insights obtained regarding illicit drug supply; outlines data on illicit drug seizures; provides information on consumption trends within Australia, including emerging threats; and concludes by outlining some of the major harms arising out of the illicit drug trade.
Available data
2.2Analysing data about the illicit drug market is complex and no single data set provides a comprehensive picture of the Australian illicit drug market. As the Australian Criminal Intelligence Commission (ACIC) has noted, a thorough understanding of the illicit drug market is instead achieved by layering multiple data sets from law enforcement activity and population behaviour and preferences. This chapter draws upon key data sets, as well as evidence provided to this inquiry, to build a picture of Australia’s relationship with illicit drugs and the context within which this inquiry has taken place.
Illicit drug supply
International trade routes
2.3The ACIC advised that the vast majority of illicit drugs originate offshore and are imported, typically by transnational, serious and organised crime (TSOC) syndicates. Cannabis, however, is cultivated in Australia, along with the production of almost one third of methylamphetamine.
2.4The major drug markets are supplied from the Mekong (primarily Myanmar), Colombia, Mexico and the Netherlands. The Australian Federal Police (AFP) provided more detail on the frequently observed importation routes. It told the committee that the majority of methylamphetamine is sourced from, and manufactured in, Asia (primarily Myanmar) and North America (primarily Mexico). Chemical profiling of cocaine seizures indicates that Colombia is the dominant country of origin for cocaine in Australia, accounting for 73.6percent. Heroin is typically trafficked from Myanmar, through Southeast Asia to Australia. Small amounts of heroin seized originate in Afghanistan, Pakistan and/or Iran, and is trafficked via the Maldives and/or Sri Lanka to Australia. MDMA is frequently manufactured and trafficked out of Western Europe.
2.5The AFP observed that methylamphetamine and cocaine are typically imported through cargo shipments, while heroin and MDMA are often imported through the mail.
Seizures and border detections
2.6AFP data indicates a substantial increase in the amount of illicit drugs seized between the 2021-22 and 2022-23 financial years.
2.7In the 2022-23 financial year, the AFP seized 30 tonnes of illicit drugs and precursors domestically, resulting in $11.8 billion in avoided harm. This increased from 21.6 tonnes during the previous year, which resulted in $7.2billion in avoided harm.
2.8Further, the AFP assisted overseas police to seize 66 tonnes of illicit drugs internationally, avoiding a further $10.9 billion in harm during 2022-23. This too increased from the previous period, during which the AFP assisted overseas police to seize 20.3 tonnes of illicit drugs, amounting to $6.8 billion in avoided harm.
2.9Trends in the size of drug seizures leading up to the significant increase during the last financial year are demonstrated by Figure 2.1 below. This graph compares the total mass of cocaine, heroin, MDMA and methylamphetamine seized by the AFP during financial years 2017-18 to 2021-22. It indicates a general upward trend in relation to the amount of methylamphetamine seized, with a slight dip during the 2020-21 financial year. Cocaine and heroin seizures varied during this period, while MDMA seizures increased until 2020-21 and remained low during the post-pandemic period. The AFP attributed the lesser amounts of methylamphetamine and MDMA seized during 2020-21 to the COVID-19 pandemic and associated restrictions.
Figure 2.1AFP drug seizures of cocaine, heroin, MDMA and methylamphetamine from 2017-18 to 2021-22
Source: AFP, Submission 59, p. 4.
2.10The ACIC’s October 2023 Illicit Drug Data Reportidentified that in the financial year 2020-21, the combined weight of cannabis, heroin and cocaine detected at the border was less than that of amphetamine-type stimulants (excluding MDMA). Methylamphetamine constituted the majority of the amphetamine-type stimulants category of drugs.
2.11The report compared data gathered in 2011-12 and 2020-21 on border detections, seizures and arrests, among other metrics. Over this time, increases were recorded in all three categories. An extract from the comparative data is set out in Figure 2.2 below:
Figure 2.2National drug market 10-year trend: comparison between 2011-12 and 2020-21
a. National border detection data reflect amphetamine-type substances (excluding MDMA). At this time, it is not possible at a national level to provide a further breakdown of drugs within the ATS (excluding MDMA) category.
b. National seizure and arrest data reflect amphetamines, which includes amphetamine, methylamphetamine, dexamphetamine and amphetamines not elsewhere classified. At this time, it is not possible at a national level to provide a further breakdown of drugs within the amphetamines category. Based on available data, methylamphetamine accounts for the majority of amphetamines seizures and arrests.
c. Heroin arrests include arrests for heroin and other opioids.
Source: ACIC, Illicit Drug Data Report 2020-21, October 2023, p. 3.
Consumption data and trends
Population-level observations
2.12As a general proposition, evidence to this inquiry indicated that the illicit drug market in Australia is, as described by the ACIC, ‘on an upward trajectory…[and] is resilient, lucrative and…fuelled by a seemingly unsatiated consumer demand’.
2.13The National Centre for Education and Training on Addiction (NCETA) characterised the illicit drug trade in Australia as ‘a multitude of heterogeneous illicit drug markets’. Drawing upon wastewater analysis, it identified some distinctions in consumption trends in different locations around Australia:
At the macro level for example, wastewater analysis over time reveals that on a per‐capita basis:
Cocaine use is much higher in Sydney than in other capital cities
Melbourne and Sydney have higher rates of heroin use than other capital cities
Darwin has higher rates of MDMA use than other capital cities
Adelaide and Perth have higher rates of methamphetamine use.
2.14NCETA added that there are substantial differences in consumption between cities, and between metropolitan and non-metropolitan areas.
Recent data
2.15The National Drug Strategy Household Survey (NDSHS) is undertaken every three years by the Australian Institute of Health and Welfare (AIHW). It collects self‑reported information on alcohol and tobacco consumption and illicit drug use among the general population in Australia. The most recent survey was undertaken in 2022-23 and the results were published on 29February 2024. This survey revealed that 3.9 million people (or 17.9 per cent of the population) had used an illicit drug in the last 12months, which was an increase from 3.4 million in the 2019 survey. This survey identified a substantial increase in the use of hallucinogens as a driver of this increase, and also noted an increase in the use of ketamine.
2.16The National Wastewater Drug Monitoring Program (NWDMP) is conducted by the ACIC. It commenced in 2016 and measures the presence of 12 illicit and licit drugs, including alcohol and nicotine, in sewage treatment plants. The latest report, number 21, was released in March 2024 and covers samples collected in August and October 2023.
2.17The August 2023 samples were collected from regional and capital city sites and covered around 57percent of the population. The October2023 samples were collected from capital city sites only and covered approximately 48percent of the population. The ACIC noted that since the previous analysis was undertaken in April 2023, average consumption of heroin, fentanyl and cannabis had increased in both regional areas and capital cities, while alcohol, MDA and ketamine had decreased. Nicotine, methylamphetamine, cocaine and MDMA usage increased in regional areas but reduced in capital cities. The reverse outcome was found with respect to oxycodone.
Longer term trends
2.18Referring to data collected through the NWDMP, the ACIC informed the committee that national consumption of methylamphetamine, cocaine, MDMA and heroin increased between 2016-17 and 2019-20. It added that while consumption declined during the peak of the COVID-19 pandemic and associated restrictions in 2020‑21, monitoring shows it is returning to pre‑COVID levels.
2.19This data was updated and included in Report 21 of the NWDMP, which includes graphs to compare wastewater detections of cocaine, heroin, MDMA, methylamphetamine, fentanyl and oxycodone since the commencement of the program in August 2016, and cannabis since August 2018. These graphs are reproduced below. Figure2.3 provides an overall picture of all seven different types of drugs (including cannabis), while Figure2.4 excludes cannabis and provides a clearer view of the trends and variations for the remaining types of drugs.
Figure 2.3Drug consumption snapshot including cannabis: Report 21 of the National Wastewater Drug Monitoring Program
Source: ACIC, Report 21 of the National Wastewater Drug Monitoring Program, 13 March 2024, p. 12.
Figure 2.4Drug consumption snapshot excluding cannabis: Report 21 of the National Wastewater Drug Monitoring Program
Source: ACIC, Report 21 of the National Wastewater Drug Monitoring Program, 13 March 2024, p. 13.
2.20In the year to August 2023, the estimated national consumption of methylamphetamine, cocaine, MDMA and heroin increased by 17 per cent. The ACIC noted that while the amounts of consumption have changed over the life of the NWDMP, the hierarchy of consumption of the five major drugs (cannabis, methylamphetamine, cocaine, MDMA and heroin) has remained consistent.
Major trends—cannabis and methylamphetamine
2.21As the data above makes clear, the two major drugs in the Australian illicit drug market are cannabis, which is the most frequently used substance, and methylamphetamine. Although running second to cannabis in terms of consumption, as the discussion below illustrates, the risk profile associated with methylamphetamine renders it of greatest harm to the community.
Cannabis
2.22As demonstrated by Figure 2.3, cannabis has consistently remained the highest consumed substance. This conclusion was mirrored in other information considered by the committee. For instance, a similar conclusion was drawn by the NDSHS, which, according to survey responses, found cannabis to be the most commonly used illicit drug among survey respondents in 2022-23. Further, in its evidence to the committee, the NSW Crime Commission advised that it has observed an increase in the size and scope of domestic cultivation of cannabis crops. It stated that farms have been identified in NSW and Queensland which have in excess of 30,000 plants.
Methylamphetamine
2.23The ACIC described methylamphetamine as ‘the most significant drug in the Australian market’. In the year to August 2023, methylamphetamine accounted for approximately 64 per cent of the combined estimated consumption of the other fourmajorillicit drugs (cocaine, heroin and MDMA and methylamphetamine).
2.24The National Drug and Alcohol Research Centre (NDARC) at the University of NSW runs Australia’s two major sentinel surveys to monitor the use, market features and harms associated with illicit drug use. One of those surveys, the Illicit Drug Reporting System (IDRS), recorded an increase in methylamphetamine use amongst its participants between 2000 and 2022. It recorded that while 16 per cent of participants nominated methylamphetamine as their drug of choice in 2000, by 2022 this had increased to 46 per cent.
2.25The IDRS identified a significant change in the forms of methylamphetamine that are being consumed. While powder methylamphetamine (i.e. 'speed') was originally the most commonly used form of methylamphetamine, this declined from 58 per cent of consumption in 2000 to 11per cent in 2022. Conversely, crystal methylamphetamine has increased considerably over time, fluctuating between 2000 and 2009 (15 to 57 per cent), but increasing steadily from 2010onwards to 80 per cent in 2022.
2.26State based law enforcement and emergency service departments described to the committee the nature of methylamphetamine consumption within their respective jurisdictions. The Western Australia Police Force advised that residents of that state ‘are among the highest per capita methylamphetamine consumers in the nation’ with the market ‘supplied by importation rather than domestic production’. South Australia Police also advised that methylamphetamine ‘is a drug consumed in South Australia at rates often exceeding the national average’ and it is ‘locally manufactured, imported from overseas and trafficked into the state from other jurisdictions’. The Tasmanian Department of Police, Fire and Emergency Management advised that information provided by the Drug Investigation Service indicates that ‘in recent years there has been an increase in the use and distribution of methylamphetamine’. It observed a change in consumption patterns over the last decade, stating that during this time, ‘high-grade methylamphetamine (‘ICE’) has replaced low-grade methylamphetamine (‘speed’) as the most commonly used stimulant, with the latter substance now rarely available’.
In its 2023 Illicit Drug Data Report, the ACIC described methylamphetamine as ‘the most harmful illicit drug impacting Australia by some margin’. This sentiment was shared by Professor Donald Weatherburn from NDARC. Comparing the risk posed by cannabis to that of methylamphetamine, ProfessorWeatherburn noted that in a recent survey, three per cent of respondents indicated a willingness to use cannabis if it were legal. While expressing less concern about this figure, Professor Weatherburn stated that ‘a three per cent increase in methamphetamine consumption could be a very different story’.
Other drug trends
Heroin
2.28The ACIC reported that the heroin market ‘appears to have a level of resilience despite relatively low consumption’. Report 21 of the NWDMP recorded a reduction in heroin consumption of seven percent.
2.29NDARC told the committee that its analysis indicates a reduction in heroin use over time. In 2000, 79per cent of participants in the IDRS indicated that they had used heroin in the last six months, compared to 50 per cent in 2021. Similarly, NDARC noted that the proportion of the IDRS sample who endorsed heroin as their preferred drug choice gradually declined over time (from 63 per cent in 2000 to 39 per cent in 2022) and was overtaken by methylamphetamine in 2021 and 2022.
Cocaine
2.30Cocaine usage was on an upward trajectory prior to the COVID-19 pandemic and, according to the 2019 NDSHS, reached its highest level of consumption during that period since 2001. NWDMP analysis recorded a drop in cocaine use during and after the pandemic, with it reaching a record low in August 2022. However, the three latest NWDMP reports (reports 19 to 21) noted increases in the national consumption of cocaine. Report 19 stated that there was a ‘considerable increase in cocaine consumption between August and December 2022, following the record low level in August 2022’. Reports 20 and 21 recorded decreases in consumption in the capital cities, but increases in regional areas which resulted in overall increases.
2.31The 2022-23 NDSHS also observed an upwards trajectory in the number of people that had both recently used and ever used cocaine. This increase, which the survey has tracked since 2001, is illustrated in Figure 2.5 below.
Figure 2.5National Drug Strategy Household Survey 2022-23: Use of cocaine in Australia, people aged 14 and over, 2001 to 2022-23
Source: AIHW, 'Use of illicit drugs', National Drug Strategy Household Survey 2022-23, 29 February 2024, Figure 16.
2.32The 2022-23 NDSHS noted that while recent use of cocaine remained stable among males, there was an increase among females from 3 per cent in 2019 to 3.7 per cent in 2022-23.
MDMA/Ecstasy
2.33MDMA (also known as ecstasy) use was significantly impacted by the COVID‑19 pandemic, but recent data suggests that use of this substance is rebounding.
2.34Report 20 of the NWDMP, which recorded usage in April and June 2023, advised that MDMA was one of the lowest consumed drugs monitored by the program. At the time, the ACIC advised that ‘MDMA consumption is now at record low levels nationally and has been decreasing since December 2019 (i.e.prior to the start of COVID restrictions)’. The ACIC reported that in Europe, ‘there are reports that manufacturing is switching from MDMA to methylamphetamine, which likely explains the domestic trend’. However, the most recent NWDMP report recorded a 33 per cent increase in consumption over the year to August 2023. The ACIC noted, however, that this was from a low base and less than one tonne of MDMA was consumed nationally.
2.35The 2022-23 NDSHS recorded the lowest level of recent MDMA use since 2004, however, the figures for lifetime use reached record highs. The survey indicated that disruptions in the supply chain and the COVID-19 pandemic may have impacted recent use. The survey noted, however, that patterns detected during fieldwork, particularly towards the conclusion of data collection, demonstrate early signs that MDMA consumption is rebounding and returning to pre‑COVID 19 levels.
International comparisons
2.36International analysis confirms that Australian consumption of illicit drugs is high when compared to data on usage from other jurisdictions.
2.37Internationally, the United Nations Office on Drugs and Crime (UNODC) reported that Australia’s demand for illicit drugs is well above global averages. The 2023 World Drug Report stated that the ‘past-year use of cocaine in the subregion of Australia and New Zealand remains the highest worldwide’. UNODC also report that ‘[p]ast-year use of “ecstasy” in the subregion of Australia and New Zealand remains by far the highest worldwide; this is consistent with MDMA levels found in wastewater analysis’. Further, ‘[c]annabis use is significantly higher than the global average, with prevalence of use exceeding 10 per cent in the subregion of Australia and New Zealand’.
2.38Drawing on data from the Organisation for Economic Cooperation and Development (OECD), the 2022-23 NDSHS observed that 2019 estimates for cocaine use in Australia ‘were among the highest available for all available countries’. Noting that trends in recent use remained stable between 2019 and 2022-23, and that lifetime use continued to increase, the 2022-23 NDSHS observed that Australia’s comparable position regarding cocaine use is likely to have remained consistent.
2.39Report 19 of the NWDMP was published on 12 July 2023 and considered samples taken in December 2022 and February 2023. It compared Australian average consumption against data from the Sewage Core Group Europe which ‘covered 161 cities from 28 countries in Europe, Asia, North America and Oceania’. It found that for illicit stimulants, Australian drug consumption ranked sixth. For methylamphetamine alone, Australia had the third highest consumption per capita, compared with 24 other countries. For cannabis, Australia ranked sixth out of 16 countries.
Other consumption trends
2.40The committee received evidence about emerging trends in types of drugs and/or consumption habits. The following paragraphs discuss three of these, namely:
non-medical use of pharmaceuticals;
new psychoactive substances (NPS); and
adulterated substances.
Non-medical use of pharmaceuticals
2.41Illicit pharmaceuticals, including diverted or genuine pharmaceuticals and counterfeit drugs, were highlighted to the committee as a consumption threat posing a particular risk of harm.
2.42Drugs within this category include opioids (such as oxycodone, fentanyl, morphine, methadone, pethidine and codeine), benzodiazepines (such as diazepam, temazepam and alprazolam), other analgesics (such as paracetamol and ibuprofen, combined with codeine) and performance and image enhancing drugs (such as anabolic steroids, phentermine and human growth hormones).
2.43NCETA submitted that illicit pharmaceuticals represent a major threat going forward, and suggested that it is likely to be the future of the illicit drug market in Australia. NCETA explained that these drugs don’t require many of the resources that naturally-based products do, such as land (which exposes the operations to law enforcement interest), sufficient sunshine and other requirements necessary for production. Rather, illicit pharmaceuticals ‘can be manufactured virtually anywhere in the world, require no natural inputs and production is limited only by the availability of precursors and the skill of the producers’.
2.44South Australia Police reported that ‘[i]n line with global trends, South Australia is now experiencing an increase in the use of non-medical benzodiazepines predominantly detected in counterfeit pharmaceutical tablets’. It explained:
These tablets are manufactured so as to be almost indistinguishable from the registered pharmaceuticals they mimic, but may contain one or more substances which have not been approved for human use in Australia. In some parts of Australia similar tablets have been found to contain both non‑medical benzodiazepines and synthetic opioids, a particularly dangerous mixture which increases the risk of overdose. These tablets have recently become readily available in Australia and their use appears to be mainly concentrated amongst young people.
2.45Pharmaceutical opioids remain a major cause of fatal overdose in Australia. According to Penington Institute, in 2021 there were:
287 unintentional drug–induced deaths involving oxycodone, morphine or codeine;
186 unintentional drug–induced deaths involving methadone; and
134 unintentional drug‐induced deaths involving fentanyl/pethidine/tramadol.
2.46The illicit consumption of fentanyl, which is legally used for medical purposes, was highlighted as posing a particular risk of harm. Evidence in this regard pointed to the impact fentanyl has had in North America where significant harms have been observed in connection with its consumption. In the United States, overdose deaths driven by the use of fentanyl reached unprecedented levels during the COVID‑19 pandemic with 91,799 overdose deaths recorded in 2020. The ACIC explained how this situation developed:
The North American fentanyl epidemic evolved from a situation in which there was significant legitimate supply of pharmaceutical oxycodone and then fentanyl which created a market for nonmedical use of pharmaceutical opioids. [Serious organised crime] groups took advantage of this opportunity to undercut the price of the pharmaceutical formulations when regulation was tightened in the United States (US), leading to a situation in US and Canada whereby fentanyl manufactured in Mexico and Canada is causing significant public health problems and many other illicit drugs are laced with fentanyl.
2.47The ACIC pointed out the differences between the situation in the US and Australia but noted this could change:
The differences in Australia are that pharmaceutical companies are more tightly controlled than in North America in the 1990s and, to date, imported powder fentanyl and domestically manufactured fentanyl are yet to be a significant feature of the organised crime landscape (this may change with evolving or changing environmental factors). Moreover, the illicit market for pharmaceutical opioids has not yet developed to the extent that it has in North America.
2.48The AFP is aware of fentanyl as an emerging threat. In February 2022 the AFP reported that it seized the largest shipment of fentanyl ever detected in Australia following a joint operation with the Australian Border Force. More than 11kilograms of pure powdered fentanyl and 30 kilograms of methylamphetamine were identified, which, the AFP explained, amounts to more than five million potentially lethal doses of the drug. Prior to that seizure fentanyl had only been detected in minor amounts which were all less than 30grams.
2.49In its 2022 World Drug Report, the UNODC warned that the ‘spread of fentanyls could occur rapidly if market dynamics were to result in the shortage of the main opioid used in any of the markets’.
2.50The 2022-23 NDSHS indicated a reduction in the consumption of non-medical use of opioids, which declined ‘substantially’ between 2019 and 2022-23, particularly in relation to non-medical use of codeine, oxycodone and tramadol. The survey recorded non-medical use of pharmaceutical stimulants, such as methylphenidate (e.g. Ritalin, Concerta) and lisdexamfetamine (e.g.Vyvanse) for the first time. Consumption of these substances was comparable to other drugs: lifetime usage was similar to that of inhalants, while the recent usage statistics were similar to the figures for recent use of MDMA.
New psychoactive substances
2.51New psychoactive substances (NPS) ‘are substances that may be structurally or functionally similar to a parent compound which is a prohibited or scheduled drug and are referred to as analogues’.
2.52NCETA reported NPS that have arrived in the Australian market include: synthetic cannabinoids; novel benzodiazepines; phenthylamines; synthetic cathinones; dissociative anaesthetics; novel synthetic opioids; and gamma hydroxybutyrate.
2.53Harm Reduction Australia (HRA) advised that there has been a ‘six-fold increase in identification of novel [or new] psychoactive substances (NPS) globally, with new substances also being reported in Australia’. HRA notes that the ‘detection of novel benzodiazepines and novel opioids (including fentanyl analogues and nitazenes)…in Australian drug markets have the potential to cause immense harm to the community’.
2.54The UNODC also noted that NPS opioids ‘are among the most harmful groups of NPS’ with the number found on markets worldwide growing from ‘just one substance in 2009 to 86 substances in 2020’.
2.55The Attorney-General’s Department advised that NPS ‘are often ordered over the internet and brought in through the international mail system’. The latest Illicit Drug Data Report, which covered the period 2020-21, recorded a 113percent increase in border detections of NPS during this reporting period, from 609 in 2019-20 to 1,299 in 2020-21.
2.56The Department of Home Affairs submitted that NPS ‘create challenges for law enforcement agencies globally due to the absence of a universally accepted definition’ and due to NPS not being controlled substances under international conventions. However, as noted above, the Criminal Coderegulates psychoactive substances based on their effect rather than chemical structure.
2.57NDARC further highlighted the ways in which NPS are being used in Australia:
…other drug sources show that NPS are still being used to adulterate illegal/non-prescribed drugs. For example, analyses of drugs submitted to the drug checking facility in Canberra (CanTEST) reported a ketamine sample that was found to contain fluorexetamine, a ketamine derivative for which there is almost no scientific information. Similarly, analyses of ‘street’ benzodiazepine products have shown that counterfeit products are now prevalent, with many found to contain more potent ‘novel’ benzodiazepines.
Adulterated substances
2.58The committee also heard evidence related to the emerging risk of adulterated substances. In particular cases, individuals may believe that they are purchasing a particular drug but that drug could have previously been adulterated with a higher risk drug, such as fentanyl. Adulterated substances pose a serious emerging threat and contribute to the risk of overdose deaths. The Alcohol and Drug Foundation submitted that adulteration of the North American drug supply with fentanyl has decreased average life expectancy for Americans for the first time since World War Two.
Drug-related harms
2.59Australia’s high consumption of illicit drugs drives a number of health, social and economic harms, including direct harm to those who use drugs and their friends and families, associated criminal activity, community level harm and a significant burden on Australia’s health system. The National Drug Strategy 2017–2026 (discussed further in chapter 3) outlines the types of harm caused by drugs:
Health harms such as:
Injury
Chronic conditions and preventable diseases
Mental health problems
Road trauma.
Social harms including:
Violence and other crime
Engagement with the criminal justice system more broadly
Unhealthy childhood development and trauma
Intergenerational trauma
Contribution of domestic and family violence
Child protection issues
Child/family wellbeing.
Economic harms associated with:
Healthcare and law enforcement costs
Decreased productivity
Associated criminal activity
Reinforcement of marginalisation and disadvantage.
Health harms
2.60As reported by Penington Institute in August 2023, there were 2,231drug‑induced deaths reported in Australia in 2021, representing 66,792years of life lost, with an average of 32 years of life lost per death. Penington Institute reported that since 2001, while the national population has increased by 32.9percent, the number of unintentional drug-induced deaths grew by 70.7per cent.
2.61The Department of Health and Aged Care reported that in 2021, 1,704 people died of a drug-induced death (1069 males and 635 females). In 2020-21 there were 152,000 drug-related hospitalisations. Amphetamines and other stimulants accounted for 10 per cent of the total drug-induced hospitalisations, with methylamphetamine accounting for 12,400 hospitalisations, or 82 per cent of the total amphetamine-related hospitalisations.
2.62The Department of Health and Aged Care also reported that in 2018:
…illicit drug use contributed to 3.0% of the total burden of disease in Australia. Opioid use accounted for the largest proportion (31%) of the illicit drug use burden, followed by amphetamine use (24%), cocaine (10.9%) and cannabis (10.2%). In addition, 17.8% of the burden was from diseases contracted through unsafe injecting practices.
Social harms
2.63In addition to the harms to life and burden on the health system caused by drugs, evidence to the committee identified the extended social impacts caused by the illicit drug trade. The AFP stated that the trade itself, and the criminal activities that support it cause harms that ‘ripple out into the broader community’. Mr Michael Barnes, Commissioner, New South Wales Crime Commission provided a stark summary of the level of violence and human cost that exists within the supply chain:
…the beautiful people in Double Bay, Carlton, New Farm and other places need to be made more acutely aware that, when they buy cocaine and post Snapchat pics of themselves and their glamorous friends using, they are participating in this vile web. The tradies and their mates in the less affluent suburbs who consume tonnes of methylamphetamine each year need to focus on how many people are harmed by the criminal network they support and provide custom to. It's problematic when so many opinion-makers seem inclined to ignore that. Pop stars, professional sportspeople and even members of the royal family, by their comments and actions, seem to endorse illicit drug use in a way that normalises it. They're rightly concerned to ensure that the supply lines of their coffee and chocolate or their linen resort-wear don't involve child slavery. Well, I can assure them: there's no fair-trade cocaine.
2.64Elsewhere in evidence, the NSW Crime Commission told the committee that ‘much of the state’s most serious violence, including gun crimes and murders, derive from the offenders’ (and often the victims’) involvement in the supply of illicit drugs’. It stated that from 2018 to 2022, it commenced 23 homicide investigations with the NSW Police Force, 13 of which originated in conflict over illicit drugs. Further, the NSW Crime Commission added:
Besides these well-defined offences, which have come to the attention of law enforcement and prompted dedicated investigations, many assaults, robberies and threats of violence are identified during homicide and organised crime investigations which point to an endemic culture of violence extending from addicts to importers.
2.65The AFP told the committee that Operation IRONSIDE ‘revealed an alarming level of violence being used by transnational, serious and organised crime syndicates to protect their drug operations’. In the course of that operation, 149firearms were seized, and 29threats to life were disrupted. The AFP told the committee that one planned homicide that it disrupted involved the use of a fully automatic submachine gun at a busy cafe strip.
Economic harms
2.66The illicit drug trade and its impact is estimated to cost Australians billions of dollars each year.
2.67The ACIC estimated that between August 2022 and August 2023, Australians spent an estimated $12.4 billion on methylamphetamine, cocaine, MDMA and heroin. Methylamphetamine accounted for $10.5 billion, or 85 per cent of this total.
2.68The Australian Institute of Criminology estimated that serious and organised crime cost Australia up to $60.1billion in 2020-21, of which $16.5 billion was specific to illicit drug activity.
2.69The total cost of drug addiction in 2021 was estimated by Rethink Addiction and KPMG to amount to $12.9 billion. Of that amount, $5.8 billion or 45per cent was attributed to the cost of law enforcement and $3.9 billion or 30percent was lost workplace and household productivity. The value of lost life during this year was estimated at $2.4 billion according to the retrospective approach and $4.9 billion according to the future-focused approach.