Thursday, April 12, 2007

Licit & illicit drug use in Australia

What are the facts on illicit and licit drug use in Australia? The NDARC data published at the University of New South Wales is close to worthless. It is really difficult to understand why governments fund such a wasteful enterprise. By far the best available picture is the correctly sampled data provided by the Australian Institute of Health and Welfare. Its Statistics on Drug Use in Australia 2006 came out today.

This surveys almost 30,000 Australians aged 12+. There is much good news – reduced smoking rates, suggestions that problems of methamphetamine may have been exaggerated, declines in alcohol and drug use by school children. But also much bad news. The bad psychiatric outcomes associated with cannabis use stand out as do high levels of risky drinking. Problems of indigenous abuse of tobacco and alcohol remain appalling.

I summarise key aspects of this important report:

Tobacco

1. In 2004, 17% of Australians aged 14 years and over were daily smokers a decline from 24% in 1991. This decline is much greater than the decline in the number of tobacco sticks imported which has remained fairly stable at 23 billion sticks per year. One can speculate that this might reflect the fact that fewer smokers are smoking more cigarettes with reduced nicotine content.
2. In 2004–05, the government collected over $6.7 billion from the import and sale of tobacco products.
3. In 2003 about 15,500 deaths occurred due to tobacco use mainly lung cancer (6,309) followed by pulmonary disease (4,125). In terms of disability-adjusted life years lost smoking cost 205,000 DALYs mainly again associated with lung cancer.
4. Australia has one of the lowest daily smoking rates in the OECD. The US, Canada and Sweden are slightly lower

Alcohol

1. In 2004, 9% of Australians drank daily, 41% drank weekly and 34% drank less than weekly. This pattern and consumption levels have remained relatively unchanged since 1991. Australians have changed their preferred alcoholic drinks over the past 40 years but their pure alcohol consumption has remained stable at about 10 litres per year.
2. Government revenue from alcohol was $5.1 billion in 2004-05.
3. In 2004, 35% of Australians drank alcohol at levels considered risky or high risk for short-term harm and 10% at levels considered risky or high risk for long-term harm.

Illicit drugs

1. In 2004, 38% of Australians aged 14 years and over had used an illicit drug in their lifetime and 15% in the last 12 months.
2. Cannabis was the most common illicit drug used (34% had used in their lifetime).
3. Ecstasy use has grown strongly since the early 1990s and now about 3.4% of the population aged 14 years+ have recently used.
4. Illegal use of painkillers and analgesics seems to have steadied off in the last few years but remains a significant problem.
5. In 2004, 9% of Australians aged 14 years and over had used methamphetamine in their lifetime and 3% in the last 12 months. Meth use is rather uncommon and growth in its use - contrary to popular impression – has been slow since 1991. There is a lengthy discussion of meth in this report.

Pharmaceuticals

1. In 2005, 234 million prescription medications were dispensed, of which 79% were Government subsidised.
2. Blood cholesterol medications (Atorvastatin and Simvastatin) were the top two medications in terms of cost to the Australian Government, frequency of dispensing, and prescribed daily dose. In 2005 they collectively cost the Federal Government $834 million.

Drugs and health

1. In 2003, an estimated 8% of the burden of disease was attributable to tobacco, 2% to alcohol and 2% to illicit drugs.
2. In 2004, greater psychological distress was associated with cannabis users than non-users. About 23% of cannabis users aged 18-19 reported high psychological distress associated with cannabis use.
3. In 2005, 46% of injecting drug users had overdosed at some point in their lives. The overdose rate has remained relatively low following the severe decline associated with the heroin drought of 2001.

Special populations

1. Use of tobacco and alcohol declined among secondary students 1999-2005. The use of various illicit drugs either declined or remained stable.
2. Births in mothers with opioid, stimulant or cannabis diagnoses were associated with several negative birth outcomes. For example, there was a substantially higher percentage of low birthweight babies born to mothers with opioid (28%) or cannabis (29%) diagnoses compared with those without such diagnoses (10%).
3. In 2004–05, around half of Aboriginal and Torres Strait Islander peoples (52%) were current smokers, 23% had used marijuana/cannabis and 28% an illicit substance in the last 12 months. About 16% drank alcohol at risky or high risk levels.
4. 59% of prisoners had a history of injecting drugs in 2004. These prisoners were more likely to test positive to hepatitis C (56%) and hepatitis B (27%) than non-injecting drug users in prison.
5. Patterns of alcohol consumption were closely linked to the prevalence of negative work-related behaviours and absenteeism in 2001.

Treatment services

1. In 2004–05, alcohol was the most common principal drug of concern in treatment episodes (37%), followed by cannabis (23%) and heroin (17%). More sought treatment for cannabis use than for heroin.
2. There were 39,000 clients receiving pharmacotherapy treatment as at 30 June 2005: 72% were methadone maintenance clients and 28% buprenorphine clients.

Crime and law enforcement

1. Marijuana/cannabis accounted for 71% of illicit drug arrests in 2004–05.
2. In 2005, one in 10 prisoners was imprisoned for drug-related offences.
3. In 2003–04, 88% of juvenile detainees had used an illicit substance 6 months prior to arrest and 70% were intoxicated at the time of offence.

Hat tip to US-based Tanya for alerting me to publication of this Australian data.

2 comments:

Francis Xavier Holden said...

Australians have changed their preferred alcoholic drinks over the past 40 years but their pure alcohol consumption has remained stable at about 10 litres per year.

Yet smoking rates have decline pretty dramatically since 1991 and Im assuming even more so in the same last 40 years.

Might it be that 10 litres a head per annum isn't bad thing and reflects some sort of homeostasis?

Cannabis usage at 34% in lifetime is a bloody large percentage of population if you consider flouting the law issues. Clearly bad laws if so many break them.

Yet we have the following:
Marijuana/cannabis accounted for 71% of illicit drug arrests in 2004 - 05

These two sets of cannabis figures should start us wondering about police priorities and efficiencies.

In 2004, 9% of Australians aged 14 years and over had used methamphetamine in their lifetime and 3% in the last 12 months. Meth use is rather uncommon and growth in its use - contrary to popular impression has been slow since 1991.


I'm not surprised and I'd suggest it might even be less than that given the well known tendency for the 14 - 20 group to claim usage of what ever seems in the news.

Blood cholesterol medications (Atorvastatin and Simvastatin) were the top two medications in terms of cost to the Australian Government, frequency of dispensing, and prescribed daily dose. In 2005 they collectively cost the Federal Government $834 million.

I haven't read the report but I'm guessing on QALYs saved we might still be ahead on the statins?

Interesting to note that smoking is a huge problem with ATSI peoples at 52% compared to 17% (presumably of all including ATSI but I'm guessing taking ATSI smokers away wouldn't lower the 17%). The rate of respiratory disease figures I've seen in ATSI populations is also a frightening reminder of the smoking problem which dwarfs alcohol as a health problem (but perhaps not as a social disrupter).

Use of tobacco and alcohol declined among secondary students 1999-2005. The use of various illicit drugs either declined or remained stable.

No headlines above for the talkback jocks and fearmongers there I'll bet.

hc said...

fxh, I agree a lot of this news will not appeal to shock jocks - the NDARC stuff is more alarmist but less reliable. It is just so important that people are accurately informed.

On marijuana I agree that usage and arrest figures are high. I still think on the basis of the problems I have identified its a real problem. I assume no-one is jailed for possession?

The ARSI figures are appalling. I agree with aboriginal leaders who suggest that restricting alcohol would markedly improve ATSI health. I have no specific suggestions on fags - just more on information regarding health costs specifically targeting ATSI. More Quit clinics and more freely available NRT. My guess is that such measures would pay for themselves in reduced health costs.