There were 62,486 drug-related hospitalisations (excluding alcohol and tobacco) among Australians in 2020-21, equivalent to 0.53% of all hospitalisations in Australia and an average of 171 hospitalisations per day.
The age-standardised rate of drug-related hospitalisations was relatively stable between 1999-00 and 2009-10. It subsequently increased from 199 to 272 hospitalisations per 100,000 people from 2010-11 to 2016-17, before declining to 250 hospitalisations per 100,000 people in 2017-18. This rate has remained relatively stable in 2018-19, 2019-20 and 2020-21 (251, 253 and 255 hospitalisations per 100,000 people, respectively).
Age-standardised rate per 100,000 people of drug-related hospitalisations among the total Australian population and for males and females, 1999-00 to 2020-21.
The COVID-19 pandemic and associated restrictions on gathering and movement have impacted drug supply and demand, with concern about changes in drug-related harms. The rate of drug-related hospitalisations was higher in Q3 and Q4 of 2020 as compared to Q1 2020 (prior to onset of COVID-19), however these findings should be treated with caution as there are other factors which might contribute to the shifts observed, and more sophisticated analyses and over a longer time period are required.
In 2020-21, males and females had a similar rate of drug-related hospitalisations (254 versus 256 hospitalisations per 100,000 people, respectively). This represented a recent increase in the rate of drug-related hospitalisations among females (243 hospitalisations per 100,000 people in 2019-20) and decrease in the rate among males (264 hospitalisations per 100,000 people in 2019-20).
In 2020-21, the highest rates of drug-related hospitalisations continued to be observed among the 20-29 and the 30-39 age groups. The crude rate of drug-related hospitalisations increased across most age groups from 1999-00 to 2020-21 except for the 20-29 age group, which saw a decline in the rate of hospitalisations in the early 2010s before subsequently rising.
Crude rate per 100,000 people of drug-related hospitalisations among the female (A), male (B) and total (C) Australian population, by age group, 1999-00 to 2020-21.
When studying the two most recent years of data, the greatest increase in rate was recorded in the youngest age group (i.e., 10-19; 251 to 302 hospitalisations per 100,000 people in 2019-20 and 2020-21, respectively), largely driven by the significant increase in drug-related hospitalisations among females in this age group.
The aforementioned decrease in the rate of drug-related hospitalisations among males between 2019-20 and 2020-21 was driven by significant decreases in the rates among males aged 30-39, 40-49 and 60-69.
Remoteness Area of Usual Residence
In 2020-21, the majority of drug-related hospitalisations were among people residing in major city areas (75% of hospitalisations where remoteness was coded), although the age-standardised rate of drug-related hospitalisations was highest in remote and very remote areas of Australia (275 hospitalisations per 100,000 people).
From 2019-20 to 2020-21, there was a significant increase in the rate of drug-related hospitalisations in major city areas (243 versus 250 hospitalisations per 100,000 people, respectively) and a significant decrease in rate in inner and outer regional areas (236 to 223 and 289 to 271 hospitalisations per 100,000 people, respectively).
Rate per 100,000 people of drug-related hospitalisations among the Australian population, by remoteness, 2018-19 to 2020-21.
Drug-related hospitalisations are typically coded as related to ‘mental and behavioural disorders due to psychoactive substance use’ or ‘poisoning’. In 2020-21, 53% of all drug-related hospitalisations had a principal diagnosis of mental and behavioural disorder due to substance use, while 47% had a principal diagnosis of drug poisoning.
There are specific diagnoses within these two categories. Drug-induced psychotic disorder was the leading diagnosis among hospitalisations related to mental and behavioural disorders due to psychoactive substance use (34%), followed closely by dependence syndrome (33%).
In 2020-21, 71% of hospitalisations due to drug poisoning were intentional. While the rate of intentional poisoning hospitalisations has varied over time, the rate of unintentional poisoning hospitalisations has remained relatively stable.
In 2020-21, the largest proportion of drug-related hospitalisations was attributable to amphetamine-type stimulants (23%, 70 hospitalisations per 100,000 people), followed by antiepileptic, sedative-hypnotic and antiparkinsonism drugs (e.g., benzodiazepines; 16%), non-opioid analgesics (e.g., paracetamol, 13%), cannabinoids (12%) and opioids (11%).
Age-standardised rate per 100,000 people of drug-related hospitalisations among the Australian population, by drug identified in the principal diagnosis, 1999-00 to 2020-21.
A decrease in the rate of opioid-related hospitalisations has been observed since 2016-17, including a further decrease from 2019-20 (29 hospitalisations per 100,000 people) to 2020-21 (26 hospitalisations per 100,000 people).
In 2020-21, natural and semi-synthetic opioids (e.g., oxycodone, morphine) were responsible for over half (53%) of all hospitalisations due to opioid poisoning. The rate of hospitalisations related to natural and semi-synthetic opioids more than doubled from 1999-00 to 2017-18 (3.5 to 9.1 hospitalisations per 100,000 people, respectively) but then declined (6.0 hospitalisations per 100,000 people in 2020-21).
Age-standardised rate per 100,000 people of opioid poisoning-related hospitalisations among the Australian population, by opioid type, 1999-00 to 2020-21.
Despite the overall decrease in opioid-related hospitalisations between 2019-20 and 2020-21, the 20-29 age group recorded a significant increase in the rate of opioid-related hospitalisations over this period.
Amphetamine-type stimulant-related hospitalisations
After 10 years of relative stability, the rate of amphetamine-type stimulant-related hospitalisations increased sixfold from 12 hospitalisations per 100,000 people in 2009-10 to a peak of 70 hospitalisation per 100,000 people in 2019-20. A decline was observed in 2020-21 to 60 hospitalisations per 100,000 people, observed for both males and females and among nearly all age groups.
From 1999-00 to 2020-21, cannabinoid-related hospitalisations increased nearly three-fold from 11 to 30 hospitalisations per 100,000 people.
In the last six years, there was an increase in the rate of cannabinoid-related hospitalisations among young females, particularly those aged 20-29 years, from 33 to 64 hospitalisations per 100,000 people in 2014-15 and 2020-21, respectively.
The rate of cocaine-related hospitalisations has continued to increase over time, from 0.82 in 2010-11 to 5.0 hospitalisations per 100,000 people in 2019-20, with a further increase in 2020-21 (7.1 hospitalisations per 100,000 people).
The 20-29 age group recorded the biggest increase in the rate of cocaine-related hospitalisations in this period and in 2020-21 accounted for 55% of all cocaine-related hospitalisations.
Other drug-related hospitalisations
The rate of hospitalisations with a principal diagnosis related to antiepileptic, sedative-hypnotic and antiparkinsonism drugs (e.g., benzodiazepines) declined from a peak of 56 hospitalisations per 100,000 people in 2000-01 to 37 hospitalisations per 100,000 people in 2018-19, then increased in 2019-20 and remained similar in 2020-21 (41 and 40 hospitalisations per 100,000 people, respectively).
The rate of non-opioid analgesic-related hospitalisations, after three years of continuous decline from a peak in 2016-17, increased again between 2019-20 and 2020-21 (27 to 34 hospitalisations per 100,000 people, respectively).
Although, the rate of hallucinogen-related hospitalisations remained lowest of all drug types, it has been steadily increasing since 2013-14, from 0.86 to 1.9 hospitalisations per 100,000 people in 2020-21.
From 2019-20 to 2020-21, the age-standardised rate of drug-related hospitalisations: increased in Victoria; decreased in New South Wales, the Northern Territory, South Australia, and Western Australia; and remained similar in the Australian Capital Territory, Tasmania and Queensland.
For summary of findings on trend in drug-related hospitalisations for each jurisdiction, please see the full report or go to the jurisdictional summary reports:
- Australian Capital Territory
- New South Wales
- Northern Territory
- South Australia
- Western Australia
Important differences in age-standardised rate of drug-related hospitalisations by sex, age group, remoteness and drug type for each jurisdiction are also reported and available in our publicly-accessible online interactive visualisation.
The Drug Trends program is funded by the Australian Government Department of Health and Aged Care under the Drug and Alcohol Program.
We would like to acknowledge the Australian Institute of Health and Welfare for data from the National Hospital Morbidity Database.
We would like to acknowledge the contribution of those who have been involved in past reporting on drug-related hospitalisations by Drug Trends, specifically: A/Prof Timothy Dobbins, Dr Amanda Roxburgh, and A/Prof Lucinda Burns.
We thank Dr Louise Tierney and her team from the Tobacco, Alcohol and Other Drugs Unit at the Australian Institute of Health and Welfare for reviewing the report.
We acknowledge the traditional custodians of the land on which the work for this report was undertaken. We pay our respects to Elders past, present, and emerging.
- Hospitalisations data visualisations: https://drugtrends.shinyapps.io/hospital_separations
- Hospitalisations methods document: https://ndarc.med.unsw.edu.au/resource-analytics/trends-drug-related-hos...
- For other Drug Trends publications on drug-related hospitalisations and drug-induced deaths in Australia, go to: https://ndarc.med.unsw.edu.au/project/national-illicit-drug-indicators-p...
- For more information on NDARC research, go to: http://ndarc.med.unsw.edu.au/
- For more information about the AIHW and NHMD, go to: https://www.aihw.gov.au/
- For more information on ICD coding go to: http://www.who.int/classifications/icd/en/ https://www.ihacpa.gov.au/resources/icd-10-amachiacs-eleventh-edition
- For more research from the Drug Trends program go to: https://ndarc.med.unsw.edu.au/program/drug-trends
This report was prepared by researchers from the National Drug and Alcohol Research Centre for the Drug Trends program. The Drug Trends program is coordinated by the National Drug and Alcohol Research Centre, UNSW Sydney and undertaken in partnership with the Burnet Institute, National Drug Research Institute, University of Queensland, and University of Tasmania.
This work is copyright. You may download, display, print and reproduce this material in unaltered form only (retaining this notice) for your personal, non-commercial use or use within your organisation. All other rights are reserved. Requests and enquiries concerning reproduction and rights should be addressed to NDARC, UNSW Sydney, NSW 2052, Australia.
Recommended citation: Chrzanowska, A., Man, N., Akhurst, J., Sutherland, R., Degenhardt, L. & Peacock, A. (2022). Trends in drug-related hospitalisations in Australia, 1999-2021. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney. DOI: 10.26190/wrsv-3b78
Please note that as with all statistical reports there is the potential for minor revisions to data in this report. Please refer to the online version at Drug Trends.
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Related resources: National Illicit Drug Indicators Project (NIDIP) Reports