500+ overdose deaths five years running in NSW

Penington Institute

As new data shows that more than 500 New South Wales residents lost their lives to overdoses for the fifth consecutive year, Penington Institute is calling on decision makers to do more to stem the overdose crisis in Australia’s largest state.

In total, 524 NSW residents lost their lives to unintentional overdoses in 2018, the equivalent of approximately one person dying every 18 hours.

Contrary to other states where illicit drugs like heroin and ice are most often implicated in overdose deaths, it is pharmaceutical opioids and benzodiazepines, the latter of which has previously been described by Penington Institute as “Australia’s silent killer”, which are driving overdose deaths in New South Wales.

Benzodiazepines, commonly used to treat anxiety and insomnia, are the drug type most often detected in unintentional overdose deaths in NSW with 198 deaths in 2018 alone.

Since 2010, rural and regional New South Wales has experienced higher rates of unintentional overdose deaths than Greater Sydney. As of 2018, rural and regional NSW had a rate of 7.9 unintentional overdose deaths per 100,000 compared with 6 per 100,000 in Greater Sydney.

In regional and rural New South Wales, benzodiazepines are showing a significant upward trend, overtaking pharmaceutical opioids in 2017 and continuing to have the highest rate of involvement in unintentional drug-induced deaths (3.1 deaths per 100,000 people in 2018).

Further still, this year’s Report reveals massive five-year totals of unintentional overdose deaths for some of the most common drugs in NSW homes and communities, including:

• 863 unintentional overdose deaths involving benzos in the 5 years from 2014-18

• 865 unintentional overdose deaths involving pharmaceutical opioids in the 5 years from 2014-18

• 570 unintentional overdose deaths involving stimulants in the 5 years from 2014-18

• 419 unintentional overdose deaths involving heroin in the 5 years from 2014-18.

These findings not only underscore the importance of access to drug treatment services and harm reduction services including Opioid Substitution Treatment, Take Home Naloxone and Needle and Syringe Programs, but also the need to continue to raise awareness about drug use and how to reduce harms.

Overall, Australia’s Annual Overdose Report 2020 paints a deeply concerning picture of unacceptably high numbers of overdose deaths in our largest state, and far too little being done to reduce the toll of this eminently preventable health crisis.

As stated by Mr John Ryan, CEO of Penington Institute:

“It’s absolutely unacceptable that for five years running, more than 500 people in NSW have passed away because of overdoses. The persistence of these numbers suggests one thing above all: we are not doing enough to lessen the harms of drugs in our largest state.”

“Not enough Australians understand the potential risks of drugs you can get from your doctor or from the pharmacy around the corner and importantly the dangers of combining drugs.”

“We know there are currently critical shortages of anti-depressants in Australia and we know it’s at least partly because of increased demand as people try to cope with the stress of COVID-19.”

“That tells us that, in addition to the many other long-term effects of the pandemic, we may see increased harms involving anti-depressants and anti-anxiety medications in the years to come.”

“The persistently higher rates of overdose deaths in country New South Wales bring home the importance not only of access to services, but also the veil of silence that often surrounds drug use and overdose. Stigma isn’t commonly understood as a contributing factor to problematic drug use and overdose – but it is.”

“This is Australia’s hidden health crisis. By releasing this Report with the most up-to-date data, we’re looking to start a conversation, bring overdose out of the shadows and ultimately reduce harms.”

“Penington Institute is releasing this year’s Annual Overdose Report on International Overdose Awareness Day, the world’s largest annual campaign to end overdose, remember those who have died without stigma and acknowledge the grief of the family and friends left behind.”

“International Overdose Awareness Day was first observed in Melbourne in 2001. This year is the 20th IOAD and it is being recognised with events around the world, including Newcastle Town Hall being lit purple in support of the campaign.”


Drug types

Common examples

Illicit opioids


Pharmaceutical opioids

Oxycodone, Codeine, Fentanyl


Methamphetamine (“ice”), Ecstasy (MDMA)


CBD, Synthetic cannabis, Hashish


Diazepam, Temazepam


Zoloft, Prozac, Lexapro


Quetiapine, Olanzapine, Risperidone


Pregabalin, Gabapentin

About Penington Institute

Penington Institute connects lived experience and research to improve community safety in relation to drugs, including alcohol and pharmaceuticals.



/Public Release.