Overview

Australia has one of the highest rates of illicit drug-related burden in the world. In 2018, 3% of total disease burden in Australia was attributed to illicit drug use. Use of illicit drugs is more common among Australian males than females. In 2019, an estimated 17.5% of Australian males aged 14 and above had used one of 12 illegal drugs in the past year, compared to 10.7% of females. National data also indicate that recent rises in the prevalence of use of certain drugs, such as cocaine, have been driven by increased usage rates among males.

Higher rates of drug use among males mean they experience more associated harms. In 2018, males experienced more than twice the total burden associated with illicit drug use than females aged up to 84 years. More specifically, research has shown that Australian males experience more than double the rate of disability-adjusted life years associated with drug use disorders than females, and a higher percentage die from unintentional drug-induced overdoses involving numerous drug types. Mental ill-health is also relatively common among Australian males who use drugs. In consideration of this, along with looking at illicit drug use, this chapter will also explore whether the use of cannabis - one of the most commonly used illicit drugs - is an effect on the experience of mental ill-health (specifically, experiencing depressive symptoms) over time.

The prospective design and representative nature of Ten to Men (TTM) affords novel opportunities to examine drug use patterns over time among a sample broadly reflective of Australian adult males. Furthermore, determining trajectories of drug use among certain population subgroups, and factors associated with the progression to - or maintenance of - more harmful patterns of use, could help in identifying optimal points in drug use cycles to intervene and interrupt transitions to more harmful use patterns.

This chapter aligns with Australia's current National Drug Strategy's priority relating to developing and sharing data, including the monitoring of existing and emerging drug issues to provide advice to health, law enforcement, education and social services sectors for informing individuals and the community regarding risky behaviours.

Key messages

• Prevalence of past-year cocaine use among adult Australian males rose significantly from 4% to 7% between 2013/14 and 2020/21. This change appeared to be driven by an increase in use among younger men (<35 years).

• Prevalence of past-year cannabis, ecstasy and meth/amphetamine use remained relatively stable across the same time period among adult males at 17%, 3%-5% and 3%-4%, respectively.

• Recent use of cocaine among Australian men was associated with younger age, living in major cities (vs non-metropolitan areas) and living in households with greater combined incomes.

• Frequent (weekly or more) cannabis use was associated with higher average depressive symptoms, irrespective of age and related factors, when compared to men who reported no usage in the previous 12 months.