Australia's Annual Overdose Report

The Australian drug overdose toll continues its deadly march, with a fatal overdose occurring every four hours. First Nations people have long been drastically overrepresented in the mounting toll, and their unintentional overdose rate is now more than triple that of the non-Indigenous population. So many Australians – 2,231 individuals in 2021 – have lost their lives to a cause we know is preventable.

Unintentional overdose death has far outpaced our population growth over the past two decades. Patterns continue to evolve: stimulants and benzodiazepines are increasingly involved in fatal overdose. Of particular concern, overdose deaths in Australia that involve dangerous synthetic opioids like fentanyl have been increasing.

We started producing Australia’s Annual Overdose Report eight years ago to make sure the people who had overdosed were counted (in every sense of the word), and that their lost lives would motivate Australia to do better to prevent unnecessary deaths into the future. Despite some positive developments, the response has been wholly inadequate compared to the scale of the problem. Repeated calls for a comprehensive evidence-based response to this crisis barely register in our policies and discourse about drugs.

Broader naloxone distribution, more careful management and monitoring of opioid prescriptions, and improved early warning systems about contaminated drug supplies are some of the important initiatives worth highlighting since the Overdose Report first held up a mirror to Australia and the then unspoken overdose toll.

However, a continuing challenge in drug policy is the ease with which supply reduction initiatives are introduced compared to harm reduction initiatives. Real time prescription monitoring might unintentionally prevent people from accessing the opioid pain medications that they so desperately need, yet it has been rolled out absent evaluation. Compare this to harm reduction measures which are typically subject to time-consuming evaluations, and then receive meagre funding for implementation, especially when it comes to workforce development and support.

The Commonwealth Government’s recent defunding of Penington Institute’s The Bulletin, notwithstanding a positive external evaluation, not only robs frontline workers around Australia of the policy and practice support and connections they need to help prevent overdose and other drug harms, but it also silences a voice of reason in relation to drug use issues.

This year, we have seen some encouraging actions from Australian governments and institutions that should reduce overdose risk and support the health of people who use drugs. These have included policy changes and funding to improve access to opioid dependence treatment medicines, particularly eliminating the devastating fees for patients; the consumption room in Melbourne becoming an ongoing overdose prevention service; and a commitment from the Western Australian Police Force for officers to carry the opioid overdose reversal drug naloxone.

Though these developments can seem piecemeal, they are certainly to be celebrated.

It is not too late to design and deliver an effective and coordinated response to address the overdose crisis we face. Let’s remember that we have both the means and the methods. What we need now is the political leadership that can take us towards the development of a comprehensive National Overdose Prevention Strategy to reduce and prevent overdose deaths.

We know overdose is preventable. This year’s report reminds us that our task now is to act.

Finally, thank you to the advisory committee and the Penington Institute team, especially Emma Richards and Dr Karen Gelb, for their dedication to the development of this year’s Overdose Report.