Pharmaceutical stimulants use up since last year

Drug use trends for Australian capital cities also show alcohol falling out of favour.

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ADHD drugs such as dexamphetamine and methylphenidate and narcolepsy drug modafinil are some of the non-prescribed pharmaceuticals seeing the highest rate of use since monitoring started in 2003. 

The 2024 Ecstasy and Related Drugs Reporting System (EDRS), run by the National Drug and Alcohol Research Centre (NDARC), monitors illicit drug use trends in capital cities.  

This year, it found that more than half (54%) of the surveyed 740 people who use ecstasy and/or other illicit substances said they’d used non-prescribed stimulants compared to 47% in 2023 and 52% in 2022. 

Non-prescribed ketamine use also went up a little from 49% last year to 53% this year, the highest rate since 2003. However, the majority used it less frequently than once a month, and only one in 10 reported weekly use or more. 

“While most participants who reported non-prescribed pharmaceutical stimulant use reported swallowing these substances (94%), one-quarter (26%) reported snorting as a route of administration, a slight increase from 2023 (20%),” said Dr Rachel Sutherland, the Drug Trends Program Lead and NDARC’s deputy director.  

“This is of potential concern given that snorting these substances can not only result in physical harms such as nasal/sinus damage but can also heighten the risks associated with active forms of pharmaceutical stimulants due to a faster onset of action and higher bioavailability.” 

Ecstasy and cannabis were the most favoured drugs in this year’s survey.  

Cannabis was favoured by 25% in 2024, compared with 20% in 2023 and 12% in 2003, and 16% said they used it weekly or more frequently, compared to 13% last year. More people reported that non-prescribed cannabis was the most used drug in the previous month, 33%, than in 2023 (29%), with 46% saying they used it at least weekly.  

Ecstasy was the drug of choice for 27% of participants in 2024, compared to 24% last year and 52% in 2023. It was used weekly or more by 17%, compared with 14% last year, and 33% in 2003. Most participants had used ecstasy in the last six months (92%), mainly in the form of capsules (59%) and crystal (48%), followed by pills (43%) and powder (30%). The cost of one pill in 2024 was around $30, with 35% of participants saying they were “very easy” and 40% saying they were “easy” to obtain, compared to 28% and 35% respectively last year. 

Only 4% of participants nominated alcohol as their drug of choice in 2024, the lowest rate so far, compared to 8% in 2023. And only 13% said it was the drug used most often in the previous month, compared with 22% in 2023. 

Cocaine use remained high with 80% reporting use in the last six months, 16% naming it their drug of choice, and 10% reporting a frequency of weekly or higher.  

The number of participants who used methamphetamine weekly or more was 10% (11% last year, 10% the year before, coming down from 23% in 2004). 

Although 63% said they’d heard of opioid overdose reversal agent naloxone, only 6% had obtained it.  

“Given that substances such as cocaine and ketamine have recently been found to contain opioids, and in some cases have contributed to severe overdoses in Australia, there is a need to increase naloxone awareness and uptake among people who use these substances,” Dr Sutherland said. 

The 2024 national Illicit Drug Reporting System (IDRS), with a national sample of 884 people who regularly inject illicit drugs, found methamphetamine was the drug of choice for 42% and 82% reported recent use. This has been rising steadily since 2010, remaining stable since 2021, though with a significant increase in the Gold Coast since last year (85%; 73%) the report said. In this sample, injecting was the most common route of administration.  

Heroin was the drug of choice for 39% of participants and 51% reported recent use, with 99% injecting it, similar to the previous year. The majority of participants continued to find heroin “very easy” (55%) or “easy” (36%) to obtain. 

Cocaine use has decreased among the injecting drug use sample with only 17% reporting recent use in 2024 compared to a peak of 35% in 2001. This was injected by 444% and snorted by 61%. Recent non-prescribed cannabis use was reported by 69%. 

This year, 5% of participants said they’d used someone else’s needle, 9% said they’d shared theirs, and 35% said they had reused their own. 

Injury was common, with 29% reporting an injection-related problem, mostly infection or abscess (13%) or nerve damage (12%). One in five had experienced an overdose in the previous year, mostly from heroin (11%). All of these figures were similar to 2023.  

And 80% were aware of take-home naloxone, with 46% accessing it in the past year. 

Pharmaceutical opioid use went down in this group. Only 25% used methadone (7% non-prescribed) in 2024, compared to 31% last year. One quarter reported injecting it. Peak use was 52% in 2008.  

Buprenorphine-naloxone use has been in decline since 2015 and is now at 13%; 9% non-prescribed.  

Morphine remained at 13% (10% non-prescribed), with 82% injecting it. 

Oxycodone use has come down from a peak of 39% in 2012, gradually declining to 2019 and remaining relatively stable. It’s now at 13% (10% non-prescribed), with 47% injecting. 

2024 Ecstasy and Related Drugs Reporting System (EDRS)  

2024 national Illicit Drug Reporting System (IDRS)