Heroin used more often, cocaine use up. What new data says about drug use today

When many Australians think of heroin, they picture the steep increases in use and harms of the 1990s.

But new annual data, released today, shows samples of people who use heroin are doing so more often, at a frequency not seen for decades.

Other drug trends revealed include expanding stimulant markets, rising use of illicit tobacco, and shifts in the way nitrous oxide is used.

Each year we speak to people who use drugs

Each year, our research teams speak with hundreds of people across Australia who use illegal or non-prescribed drugs. These interviews form the backbone of two long-running, national drug monitoring systems.

The Ecstasy and Related Drugs Reporting System interviews people who use ecstasy and other stimulants in each capital city.

The Illicit Drug Reporting System focuses on people who inject drugs.

Here are some of this year’s findings.

Heroin now used more often

Steep increases in heroin use and harms in the 1990s were followed by the “heroin drought” of the early 2000s, a period during which heroin became much harder to obtain.

Since then, the proportion of people in our sample who reported using heroin in the previous six months has fallen, from 79% in 2000 to 51% in 2026.

But people are using it more often. Historically, people in our survey who used heroin reported doing so around an average three days a week. In 2026, this increased to daily use, on average. This is the highest frequency since monitoring began in 2000.

Unsurprisingly, we saw a connected significant increase in the proportion of participants likely to have opioid dependence.

Our findings are consistent with wastewater monitoring data, which found record-high estimated levels of heroin consumption in 2024–25. This could reflect a number of factors, such as changes in how often people are using heroin, the amount used, or even increases in drug purity.

These findings align with broader evidence suggesting heroin-related harms may be increasing.

Opioids – heroin being one example – are still the leading cause of drug overdose deaths in Australia.

This is despite an overall decline in overdose deaths involving opioids since 2017, largely driven by reductions in deaths involving pharmaceutical opioids such as oxycodone and morphine.

Now, preliminary 2024 figures suggest overdose deaths involving heroin are approaching levels seen during previous peaks in 2018 and 2019.

Heroin-related hospitalisations increased by 26% between 2022–23 and 2023–24. Heroin-related ambulance attendances increased across most jurisdictions with available data in 2024.

We don’t know what’s behind these heroin changes. Changes in heroin market dynamics, such as decreases in the purity-adjusted price of heroin (that is, a drop in the price per gram of pure heroin), and an ageing cohort of people with long histories of heroin use may be contributing factors.

At the same time, novel synthetic opioids, such as nitazenes, continue to attract attention and remain an important risk to monitor.

Importantly, many of the same responses – including opioid dependence treatment and free take-home naloxone for people who may have, or witness, an opioid overdose – can help reduce harms associated with both heroin and novel synthetic opioids.

Read more: Naloxone can reverse opioid overdose. Here’s why you might need some at home or in your bag

Stimulant use remains common

Among people we sampled who use ecstasy and other stimulants, recent cocaine use increased three-fold between 2007 and 2021, before stabilising.

However, in 2026, we saw yet another increase with 84% of our national sample reporting recent use, the highest percentage observed in the past 20 years.

We also saw an increase in frequency, although it remained relatively low at about once a month.

Methamphetamine use – mainly crystal methamphetamine or “ice” – also remained common among people we sampled who inject drugs. Eight in ten reported using it in 2026 and did so roughly every second day.

Our findings are consistent with increasing levels of cocaine and methamphetamine manufacture globally and a growing body of evidence pointing to increases in supply, availability and stimulant-related harms in Australia.

Read more: This common antidepressant helps people cut back on methamphetamine – new study

Illicit tobacco use up

Tobacco use has remained common and relatively stable across both surveys for more than two decades. But what has changed is the source of tobacco products.

Since we first began asking about illicitly traded tobacco in 2024, reported use has increased year-on-year, mirroring broader changes in Australia’s illicit tobacco market.

However, increased use of illicit tobacco does not necessarily mean more people are smoking.

Overall, use of any type of tobacco in the past six months, and the frequency of use, remained stable among both sets of people we sampled. Daily smoking rates have also continued to decline in the general population.

Read more: Cutting the tobacco excise won’t stop the illegal trade. This is how other countries solved the problem

Nitrous oxide use changing

Overall use of nitrous oxide or nangs remained stable among our samples of people who use ecstasy and other stimulants. But for the first time, participants were more likely to report using large canisters (some containing up to 2 kilograms of nitrous oxide) than traditional smaller 8-gram bulbs.

While frequency of nitrous oxide use remained low, at around once every two months, the shift towards larger canisters is concerning. International evidence suggests this may increase the risk of very serious neurological harms. This includes nerve damage, which can have long-lasting impacts on mobility and coordination and, in some cases, result in permanent disability.

In a nutshell

When it comes to drug markets, public attention often focuses on “emerging threats”. But our findings show established drugs – such as heroin, cocaine and methamphetamine – continue to demand attention.

At the same time, increasing use of illicit tobacco and shifts in nitrous oxide products highlight how quickly drug markets can evolve in ways that may alter the nature and extent of harm, even when overall levels of use remain stable.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14, or the National Alcohol and Other Drug Hotline on 1800 250 015. In an emergency in Australia, call 000.