Cocaine and methamphetamine data shows us why we need to focus on harms not use
August 2023
The new AIHW report reanalysing a range of drug trend indicator data over the past 10 years was released this month.
Since 2001 there has been yearly increases in the use of cocaine. Between 2001 and 2019, cocaine use in Australia more than tripled. In 2019, 4.2% of Australians had used cocaine in the past 12 months, compared with 2.1% in 2012 and 1.3% 2001.
In the same time period, use of amphetamines decreased by almost 40% with 1.3% of Australians reported using them at least once in the past 12 months in 2019 compared with 2.1% in 2013. And the burden of disease attributable to amphetamines was more than double that of cocaine use in 2018.
Curiously we haven’t seen the kind of moral panic we saw with methamphetamine a few years ago. Why? Well, for a start cocaine is a drug mostly used by people in higher socioeconomic bands (but that’s another story)… also we haven’t really seen the significant harms we saw with methamphetamine use.
So we have one drug (cocaine) increasing in prevalence but little obvious harms and another (methamphetamine) decreasing in prevalence but the potency, purity and the way it is used creating significant harms.
One of the key indicators is treatment presentations. You might expect that this huge increase in cocaine use would correlate to higher rates of people accessing treatment. And that a decline in amphetamines use might correlate to lower rates of people accessing treatment. But recent data from the AIHW has revealed the opposite. In 2021–22, only 1% of treatment episodes were for cocaine use, compared with 24% for amphetamines. In line with increases in cocaine use, people accessing treatment for cocaine has slightly increased, but it still only represents 1% of treatment episodes. Interestingly, even though use of amphetamines has declined, the proportion of treatment episodes for amphetamines more than doubled in the past 10 years.
Almost half (47%) of people who use ice or crystal methamphetamine use it monthly and 29% use it daily or weekly. In contrast, 16% of people who use cocaine use it at least monthly. Australia’s cocaine is generally of a low purity and our crystal methamphetamine is very high purity.
So it isn’t always as simple as ‘increased use = increased harm’.
In reality, there are a multitude of factors that contribute to drug use patterns and associated health outcomes. While use-focused data like prevalence data and wastewater data are important in our understanding of drug related harms and trends, they can’t be viewed in isolation. After all, the reason drugs are considered a problem is because of the harms they cause, so if we can focus on harms and reducing them, drugs naturally become less of a problem.
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