People who use drugs are trying to stay safe in politicised world, our surveys show

Sydney, Sep 27 (The Conversation) 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 the 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 per cent had heard of naloxone (up from 63 per cent in 2024). Some 19 per cent had obtained it in the past year – a significant jump from just 6 per cent 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 per cent reporting they had tested their drugs in the past year.

Of those who had tested their drugs, 71 per cent 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 per cent 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 that 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 per cent of participants had heard about naloxone, up from 73 per cent in 2024 – the highest level since monitoring began. Some 65 per cent reported having obtained naloxone at least once in their lifetime, up from 54 per cent in 2024. Some 55 per cent had done so in the past year, up from 46 per cent 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 per cent 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 per cent in 2024. Some 18 per cent 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 per cent reported recent use of illicit tobacco, up from 46 per cent in 2024. Among people who use ecstasy and other stimulants, 46 per cent reported recent illicit tobacco use, up from 27 per cent 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 per cent said they were obtaining vapes from other sources, including convenience stores, and mostly disposable ones. This suggests that 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. (The Conversation) SKS SKS