Drug Users Strive for Safety Amid Political Tensions

People who use drugs are increasingly trying to reduce harm - by obtaining the life-saving drug naloxone and testing their drugs - according to new data .

But they're doing this in an always risky and unpredictable environment, where access to some harm-reduction services, such as drug testing, is limited or politicised.

These are some of the key take-home messages from annual survey data released today.

Here's what else we and our colleagues found after speaking with hundreds of Australians who use drugs.

Each year, researchers from the National Drug and Alcohol Research Centre at UNSW Sydney, and partner organisations, speak with hundreds of people across Australia who use illegal or non-prescribed drugs.

These surveys form a key part of two long-running national studies, one focusing on people who use ecstasy and other stimulants, the other on people who inject drugs.

Naloxone access up …

The Ecstasy and Related Drugs Reporting System surveyed 690 people who regularly use ecstasy and other stimulants, such as cocaine and methamphetamine, across all Australian capital cities.

Overall, patterns of drug use and market indicators - such as perceived availability and price of drugs - were relatively stable compared to 2024.

However, these surveys only capture substances people intended to use - that is, what they believed they were buying and taking. We cannot monitor when people unknowingly take adulterated substances.

Drug alerts have detected potent synthetic opioids, such as nitazenes in drugs sold as MDMA, ketamine and cocaine . These substances can cause overdose even in very small amounts, and people who use stimulants may not realise they're at risk.

That's why it's so encouraging to see an increase in awareness and uptake of naloxone - a medication available without a prescription that can reverse opioid overdoses.

Among people who use ecstasy and other stimulants, 73% had heard of naloxone (up from 63% in 2024). Some 19% had obtained it in the past year - a significant jump from just 6% the year before.

You can search an online version of this map to find out where you can access naloxone in Australia. You can also access the full list of drug alerts issued in Australia.

… and drug checking is common

We also saw continued engagement with drug checking, with 39% reporting they had tested their drugs in the past year.

Of those who had tested their drugs, 71% used personal testing kits, including reagent test kits and testing strips. But these offer limited information on the substances contained and their purity.

Meanwhile, 43% of those who had engaged in drug checking in the past year accessed more comprehensive testing through a drug checking service. This is despite drug checking not being available in many parts of Australia, and where it is available, services may be limited.

If these services were more widely accessible, it's likely even more people would use them to reduce the risk of harm.

This makes recent political decisions - such as the Queensland government's move to ban drug checking services - especially concerning.

What about people who inject drugs?

The Illicit Drug Reporting System conducted surveys with 865 people in 2025. This focuses on people who inject drugs, many using heroin and other opioids.

In 2025, 80% of participants had heard about naloxone, up from 73% in 2024 - the highest level since monitoring began. Some 65% reported having obtained naloxone at least once in their lifetime, up from 54% in 2024. Some 55% had done so in the past year, up from 46% in 2024.

This shows what an evidence-based drug policy can achieve. In 2022, the Australian government made naloxone free for all Australians at risk of experiencing or witnessing an opioid overdose.

In 2025, 32% of the people who inject drugs we spoke to said they had resuscitated someone using naloxone at least once in their lifetime. This was up from 27% in 2024. Some 18% had done so in the past year.

What else did we find?

These surveys also track trends in legal and non-prescribed substances.

One striking finding is the continued high rate of tobacco use among both groups - a trend that hasn't shifted much in more than 20 years.

But what has changed is the source. Most people who smoke are now using illicit tobacco , and this has increased significantly since last year.

Among people who inject drugs, 63% reported recent use of illicit tobacco, up from 46% in 2024. Among people who use ecstasy and other stimulants, 46% reported recent illicit tobacco use, up from 27% in 2024.

This increasing trend in illicit tobacco use is one we plan to explore further, as we and others are increasingly concerned about the implications for public health.

Vaping is another area of interest. Recent legislative changes have banned the importation of disposable vapes and have restricted sales to pharmacies. But very few participants who use ecstasy and other stimulants reported obtaining vapes through pharmacies. Instead, 65% said they were obtaining vapes from other sources, including convenience stores, and mostly disposable ones. This suggests current regulations to restrict access may not be working.

Looking ahead

If we want to reduce drug-related harm in Australia, we need to support the people most affected.

This means expanding access to drug checking services, not restricting them. It means recognising people who use drugs are already taking steps to protect themselves - and that policy should help them do so more safely.

The success of the national naloxone program shows what's possible when governments invest in harm reduction.

For free and confidential advice about alcohol and other drugs call the National Alcohol and Other Drug Hotline on 1800 250 015.

Drug Trends, including the Illicit Drug Reporting System and the Ecstasy and Related Drugs Reporting System, is funded by the Australian Government Department of Health, Disability and Ageing. Rachel Sutherland currently receives funding from the National Health and Medical Research Council, and the Australian Government Department of Health, Disability and Ageing.

Drug Trends, including the Illicit Drug Reporting System and the Ecstasy and Related Drugs Reporting System, is funded by the Australian Government Department of Health, Disability and Ageing. Amy Peacock receives funding from the National Health and Medical Research Council, Medical Research Future Fund, New South Wales Ministry of Health, Queensland Health, Australian Capital Territory Department of Health, and the Australian Government Department of Health, Disability and Ageing. She was involved in the independent evaluations of the National Take Home Naloxone Pilot Program, the Queensland Drug Checking Services, and the ACT CanTEST Health and Drug Checking Service Program.