Australia’s Annual Overdose Report 2020 reveals that for the fifth year running, more than 2,000 Australians lost their lives to overdose in a single calendar year.

It is a grim landmark – and a brutal indictment of our governments’ narrow focus on controlling the supply of substances while failing to care enough for those who are already consuming and at risk of multiple harms including fatal overdose.

Because of the careful but slow work of classifying drug-related deaths, the empirical effects of COVID-19 on our overdose toll will not be seen until the Annual Overdose Report 2022 – and for several years beyond that. But, as evidence from overseas shows, COVID-19 is accelerating trends and exacerbating risk factors which are already detectable in this year’s Report.

Vulnerable people risk losing the supports they rely on to stay connected and healthy. But these risk factors for overdose were present in Australia long before the pandemic.

People turn to drugs for many reasons. Some are motivated by curiosity, pleasure or the promise of new experiences. For many others, drug use is a response to mental or physical traumas, such as workplace, sport or road accidents. Mental health drivers are important, like anxiety and depression. Some people turn to drugs to distract them from despair or isolation, while some are people with little hope for their futures, including the financially insecure and those who have lost their jobs.

Drug use risks are driven by alcohol and pharmaceutical drugs as well as the illicit drugs that are the subjects of whispered conversations. All these drugs contribute to overdose and death.

The Annual Overdose Report 2020 contains a wealth of findings that should prompt a shift in our approach, to drug policies which are based on evidence and respectful of the personal experiences of those living through the overdose epidemic in Australia.

There are no simple solutions. Real-time prescription monitoring has been claimed as a silver bullet and is an easy-to-understand supply side intervention. But a technological fix is not enough to solve this complex problem. Prescription monitoring can lead to people being excluded from the care they need, increasing overdose risk and curtailing access to essential pain care.

A comprehensive national overdose strategy would be a good start if it had clear indicators to end overdose, as would expanding the Take Home Naloxone Pilot from three states to every jurisdiction in Australia. There is much more to be done – but at a minimum, we need an overdose educated and empowered community.

John Ryan

Putting this Report together is a big job. I would like to convey my deepest thanks to the hard-working team at Penington Institute, the Advisory Committee whose thoughtful contributions improved the final product, and the Australian Bureau of Statistics for their assistance.

Thanks also are due to the courageous men and women who tell their own stories of overdose. Their pain is reflected in every number on every page of this report.

The Annual Overdose Report 2020 tells the truth about fatal overdose – a tragedy we can prevent.

John Ryan, CEO, Penington Institute


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