‘A mystery’: The men fuelling Victoria’s record drug overdose toll

Fatal overdoses among Gen X men have increased by almost 50 cent in Victoria in a single year, driving the state’s drug-related deaths to their highest levels since the heroin glut of the late 1990s.

A new Coroner’s Court report shows 632 overdose fatalities were recorded in Victoria last year – the highest number since the court began collecting data in 2000.

Men aged 45 to 54 were more likely to die from a drug overdose than any other age group, with the number of deaths in this cohort rising from 106 in 2024 to 156 last year – a rise of 47 per cent.

The report said it was not known what was driving the rise among this age group.

“An increase of 50 [fatal overdoses] in a single cohort in one year has not been observed in any other group for the reporting period,” the report said.

John Ryan, chief executive of drug policy organisation the Penington Institute, said the unprecedented rise in deaths among Gen X men was “a bit of a mystery” that needed further investigation.

Ryan said he suspected that GPs becoming more cautious about prescribing addictive drugs, as well as real-time prescription monitoring, had led to middle-aged men previously addicted to pharmaceutical drugs being pushed into Victoria’s illicit drug market.

“There’s a possibility that people have shifted from pharmaceutical misuse to illicit drug use. This is much more risky because they don’t know the quality or quantity of what they’re consuming,” he said.

“There hasn’t been enough support for off-ramping people out of pharmaceutical drugs.”

Ryan said a shortage of Victorian GPs who prescribe medication to treat addiction also made it difficult for users to access treatment such as methadone.

“This is a story of great tragedy,” he said. “It’s not just about the people who are lost, it’s about the people who are left behind to suffer.”

The top contributing drugs to the fatal overdoses were heroin (261 deaths), methamphetamine (249 deaths) and the prescription medication diazepam, widely known by the brand name Valium (232 deaths). Many deaths involved multiple drugs.

Three-quarters of overdose deaths over the past decade were unintentional, while about 19 per cent were suicides, and 6 per cent of cases were unknown.

Men were on average twice as likely as women to die from overdose.

The Victorian Alcohol and Drug Association described the situation as a public health crisis and called for greater investment in harm reduction initiatives.

“The fact that the annual overdose deaths have now surpassed 600 should be an immediate call to action,” said the organisation’s interim chief executive.

“This is more than double Victoria’s road toll. There are more and more families impacted by this.”

There is record demand for alcohol and drug treatment services in Victoria, with more than 5122 people currently on waiting lists, according to a recent survey from the association.

While about three-quarters of all overdose deaths unfolded in metropolitan Melbourne, for the first time in the report’s history Greater Geelong was the local government area with the highest number of fatal overdoses (45 deaths). It was followed by the City of Melbourne, which recorded 41 fatal overdoses.

In August, Victorian coroner Simon McGregor called for a safe injecting room in Geelong following a damning finding into the December death of a 33-year-old Geelong woman whose mother found her unresponsive in her bedroom following a drug overdose involving heroin.

The state government rejected the coroner’s call.

Victoria’s only medically supervised injecting room is in North Richmond. The contentious facility opened in 2018 as part of a five-year trial and was made permanent by state government legislation in 2023. Then-premier Daniel Andrews pledged he would open a second injecting room in Melbourne’s CBD, but the plan was dumped by his successor Jacinta Allan in 2024.

Last year, there were 32 drug overdose fatalities in the City of Yarra – the municipality where the injecting room is located, up from 27 the year before. To date, there has not been a single fatality in the injecting room.

The overdose death rate of 8.9 deaths per 100,000 people in Victoria remained relatively stable over the past decade. Though this was an increase from 8.5 deaths in 2024, the coroner’s report found the increase over time was related to the state’s population growth.

State Coroner Judge Liberty Sanger said the “deeply concerning” deaths highlighted the need for a strong public health response.

“Drug-related harms are complex and affect communities all across Victoria – it is vital that vulnerable people can access appropriate supports, treatment and education,” Sanger said.

Health Minister Ingrid Stitt said the government acknowledged there is more to do.

“Every overdose death is a preventable tragedy – and I extend my sympathies to the friends and families impacted by the loss of a loved one to overdose,” Stitt said.

“Whether it’s introducing pill testing, installing naloxone dispensing machines, or expanding access to rehabilitation beds across the state - we’re getting on with the job of addressing and reducing drug harms in our community.”

The minister said the government would continue to roll out its $95 million statewide action plan that aims to increase access to opioid pharmacotherapy across community health services, target health and social supports, and introduce the state’s first alcohol and drug-related strategy – a 10-year plan for a holistic approach to reduce alcohol and other drug-related harm and stigma.

Stitt also said Labor had doubled the number of residential rehabilitation beds since coming to government in 2014, with a focus on regional and rural areas.

“The majority of these increases have been in rural and regional Victoria with brand-new facilities delivered for Corio, Wangaratta, and Traralgon – collectively providing care and support to an additional 900 Victorians a year. A brand new 32-bed rehabilitation facility is under construction in Mildura.”

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