Wastewater analysis shows increasing use of opioids in regional Australia

Average consumption of prescription pharmaceutical opioids oxycodone and fentanyl was higher in regional parts of the country in August 2022 compared to capital cities. With oxycodone, consumption was almost double.

The ACT and Tasmania had the highest per capita consumption of oxycodone nationally in August 2022, according to the Australian Criminal Intelligence Commission national wastewater drug monitoring program report.

The average consumption of cannabis in regional areas was also well above that of capital cities in August 2022.

Around the country, Australians consumed an estimated $10 billion worth of methylamphetamine, cocaine, MDMA and heroin in the year leading up to August 2022.

The study is conducted annually and the findings from the 2021-2022 period can be compared to previous years. The August 2022 collection covers about 14.3 million Australians.

The study shows increases in national methylamphetamine and heroin consumption. Methylamphetamine remains the most consumed drug in Australia by a large margin, with 83 per cent of the $10 billion expenditure attributed to meth.

Methylamphetamine is also commonly known as methamphetamine.

Acting ACIC CEO Matt Rippon said that wastewater analysis provides crucial intelligence on drug markets in Australia.

"Illicit drugs and licit drugs with abuse potential are inherently harmful. Reliable drug consumption data are a key indicator of the level of harm experienced by the community," Mr Rippon said.

"This is because the level of community harm is directly related to the quantity of substances consumed."

Nationally, the research suggests drug consumption peaks around the month of December with lows in April.

Wastewater analysis is a technique for monitoring the population scale consumption of substances. Samples collected for the wastewater monitoring program are taken from multiple sites within each state and territory, from both regions and cities.

ANU senior clinical lecturer in the college of health and medicine Dr David Caldicott told ACM that wastewater drug analysis only revealed part of the picture of drug use in Australia.

"These sort of wastewater monitoring processes are most useful when they're triangulated against other points of data. On their own they can be problematic, because all we can tell from it is the volume of the drug being used and very little about who's using it or why they're using it," Dr Caldicott said.

"This is particularly useful and interesting for us in the ACT, with regards to the drug checking service that we provide, because we can look at both sources of data and then say, the people who are coming to our drug checking facility are not bringing an awful lot of oxycodone, and we haven't tested any illicit or illegal fentanyl after seven months. So where's that fentanyl coming from? Where's that oxycodone coming from?"

Canberra launched the first drug-testing site in Australia in 2022.

ACT ranked first nationally in capital city consumption of oxycodone, and second in cocaine, fentanyl and cannabis consumption and MDA excretion.

MDA is a drug in its own right and a metabolite of MDMA or ecstasy, meaning it is created when the body breaks down MDMA.

In regional Australia alcohol, nicotine, MDA, oxycodone, fentanyl and cannabis consumption exceeded city trends.

The average consumption of nicotine was higher in regional areas in August 2022 compared to capital cities, except in Tasmania. Overall alcohol consumption in regional areas was also higher than that in the capital cities in August 2022.

Northern Territory had the highest overall per capita alcohol consumption. Nationally, average alcohol consumption in both capital city and regional sites in August 2022 decreased to the lowest levels recorded by the program.

Regional NSW ranked first nationally in consumption of cocaine and heroin. Dr Caldicott said that should come as no surprise.

"As we know, Australia is a target nation for the manufacturers of cocaine, and there is an entire Pacific route devoted to shipping cocaine to Australia. And the first port of call would be NSW and Sydney," he said.

A regional site in Victoria had the highest per capita heroin consumption of any site nationally in August 2022, well above the national capital city and regional average. However on average capital cities had more than double the rates of heroin consumption than in regional areas in August 2022.

Regional South Australia ranked first nationally in consumption of methylamphetamine, MDMA and fentanyl. Regional Queensland ranked first nationally in ketamine excretion.

Regional Tasmania ranked first nationally in regional consumption of oxycodone, while regional Western Australia ranked first nationally in MDA excretion.

IN OTHER NEWS:

In the capital cities consumption of MDMA, cocaine, heroin, ketamine and methylamphetamine was greater than regional consumption.

Victoria ranked first nationally in capital city MDMA consumption. Dr Caldicott said this finding reveals Victorian consumers would benefit from an ACT-style drug checking facility as MDMA is particularly vulnerable to dangerous substitutions.

"The position that is being taken in Victoria currently is that there's no need for drug checking services, and that there is not an issue, as far as the sort of drugs are concerned. That is contradicted by these findings, because MDMA is the most significant finding in urban Victoria," he said.

"So the concern that one would have with that findings is this group of consumers is most likely to be affected by the tainted drugs that we see from drug checking. So if there's a group of consumers who are using a lot of MDMA, they're probably exposing themselves to a lot of other products that aren't being tested for in the wastewater management system."

For free and confidential advice about alcohol and other drug treatment services call the National Alcohol and Other Drug Hotline on 1800 250 015.