More than 2500 Australians died from drug overdoses in 2024 – the highest ever recorded – as unintentional overdose deaths surpassed 2000 for the first time.
The results come from the Penington Institute’s latest annual overdose report snapshot.
Unintentional drug-related deaths, which totalled 2091, constituted roughly 80% of all drug-induced deaths.
At 7.6 deaths per 100,000 people, it was the highest per capita rate since the data series began in 2001.
People aged 50-59 accounted for the highest number of unintentional overdose deaths, totalling 533 – a 19% increase from the previous year. Deaths in this age group have surged by more than 300% over the past two decades.
But the increase was not confined to older Australians: deaths the 30-39 age group grew fastest, up 31.1% in a single year, from 273 to 358 deaths in 2024.
Opioids remained the most common drug involved in unintentional deaths, accounting for 2 in 5 deaths, or 1038 deaths in total.
Unintentional drug-related deaths involving alcohol, antidepressants and antipsychotics all fell from 2023 levels.
Stimulant-related unintentional deaths rose 25.1% in 2024, overtaking benzodiazepines as the second-most common drug involved in an overdose. This category that includes prescription medications used to treat ADHD, including amphetamine, dexamphetamine, lisdexamfetamine, methylamphetamine and methylphenidate.
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Dr Hester Wilson, chair of RACGP’s specific interests in addiction medicine, told The Medical Republic that older age groups in unintentional opioid-related deaths were more likely to have multimorbidity, chronic pain, or socioeconomic disadvantage and limited access to alternative non-pharmacological, psychological treatments.
“One in four Australians experiences chronic pain,” she said.
While opioids may provide short-term relief, Dr Wilson said long-term risks often outweigh benefits – “anyone can be at risk of an opioid overdose if they’re taking a high-risk medication.”
“There is a third group [of older Australians] who have a past history of opioid dependence, may be in treatment for their opioid dependence, and make a mistake with the dose,” she said.
Other health conditions, including obesity, sleep apnoea and cardiorespiratory issues, could also affect an older person’s ability to survive an opioid overdose, which can cause respiratory or cardiac arrest, she said.
Dr Wilson said GPs could underestimate risk in patients they see regularly.
“We see them regularly, and they seem fine… but we need to be reassessing that,” she said.
Dr Wilson said jurisdictional gaps in real-time prescription monitoring were a barrier to safer prescribing.
“One of the issues that we have with SafeScript is it’s jurisdictional. It would be great if we had a national database,” she said.
Dr Wilson said high-risk opioid prescribing required comprehensive assessment and regular follow-up, with resources such as Monash’s Patient Opioid Safety Toolkit and its Routine Opioid Outcome Monitoring (ROOM) tool.
GPs could also consider staged medication supply to support safe monitoring and prioritising collaborative care – “whether that be [the patient’s] counsellor, pharmacist or the community nurses that might be seeing them at home,” she said.
There is a role for GPs in flagging that take home naloxone is available, alongside discussing the common symptoms of an opioid overdose with their patients, and their family and friends.
While initiating conversations about drug use with patients could be difficult given the associated stigma, Dr Wilson said GPs were well placed.
“We have this incredible space, because we’re highly trusted,” she said.
This involved asking patients’ permission to discuss lifestyle factors like substance use, then offering “warm referrals” to alcohol and other drug (AOD) services, while making clear the conversations’ purpose was to support their health.
Dr Wilson also emphasised the importance of unscheduling naloxone to widen access and of providing more training for night-time economy venues where recreational drug use occurs
While the risk of stimulant use disorder is low, Dr Wilson said evidence shows a history of stimulant use increases cardiovascular disease risk, as stimulants increase blood pressure and constrict blood vessels.
In a separate dataset also released this week, the Australian Institute of Health and Welfare (AIHW) found that people aged 50-59 accounted for the highest number of deaths among those receiving AOD services.
Of the 2800 people who died while receiving ongoing AOD treatment, three in five deaths were from potentially avoidable causes.
Accidental poisoning was the most common underlying cause, followed by suicide and liver disease.
The Penington Institute’s full Annual Overdose Report will be released on 31 August.
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