The number of Australians dying from unintentional drug overdoses has increased dramatically in the last 10 years, according to a new report.
Australia's Annual Overdose report - released by the Penington Institute on Tuesday - found there were 1,612 unintentional overdose deaths in 2017.
This figure was lower than the 1,704 in 2016, but the Pennington Institute expects the 2017 figure to exceed that once coronial decisions are finalised.
For the first time, there were also more unintentional overdose deaths resulting from four or more substances than there were from a single drug, with 445 such deaths in the year.
Penington Institute chief executive John Ryan said the data shows Australia's overdose problem is "getting worse".
"What's behind all of these numbers is devastated families and lots of people in communities around Australia, including regional and rural communities that are feeling the impact of the increased overdose toll in Australia," Mr Ryan said.
"It is a record high, it continues to grow, it's been growing all of this century and really it is a tragedy we aren't paying enough attention to."
The nation must start taking more of a health-focused approach to drug use if it wants to reduce the number of deaths, instead of focusing on crime, he believes.
"We've basically been determined to pretend that we can manage drug use in Australia by focusing mostly on law enforcement rather than focusing mostly on people," he said.
Australia's Annual Overdose report shows people are as likely to overdose from illegal drugs as they are legal. Source: AAP
Mr Ryan said Australia's overdose crisis is just as much about legal drugs, as it is about illicit drugs.
Legal pharmaceutical opioids - that's drugs like codeine and fentanyl - are still involved in over half of opioid overdose deaths.
He also said the problem is not just isolated to Australia but is becoming a global issue.
"Unfortunately, the overdose problem is not just in Australia, it is around the world," Mr Ryan said.
"Obviously, the Americas and North America have had a lot of attention in terms of its devastating overdose toll.
"But we are seeing overdose problems in Punjabi in India, in Ghana in West Africa, certainly in Scotland in the United Kingdom.
"It is an international trend and it is because we are actually not dealing with the problems."
The new report examines the types of drugs people are overdosing on and how they have changed over time.
It showed that over the last five years the use of stimulant drugs like methamphetamines and ecstasy, better known as MDMA, has tripled.
While deaths involving depressant illicit opioids like heroin and benzodiazepines has doubled.
'My friends weren't just junkies'
Having lost a partner and a close friend to overdose, Kayla Caccaviello considers herself lucky.
The Melbourne woman struggled with addiction herself for more than a decade and has survived to tell the tale, but new data shows many Australians are not so fortunate.
Ms Caccaviello's struggle began with pain medications she was prescribed as a teenager to deal with migraines, stemming from the trauma she experienced in her youngest years.
"From there, I just started seeking out drug use," the now 28-year-old told AAP.
"When I started using things like ice and heroin...it sucked me in."
Ms Caccaviello felt she needed drugs to cope but took no joy in them, watching as they gradually destroyed her life.
Part of a 903kg haul of the drug ice seized by a joint operation involving Australian Federal Police and Victoria Police in 2017. Source: AAP Image/Alex Murray
Her family turned away from her and she soon realised that she had no-one to lean on, leaving her feeling like an empty shell.
"Addiction took away more than it ever gave to me."
She had tried detoxes, rehabilitation programs and hospital visits, with no success.
But at 23, holding a family friend's baby made her want to try seeking support again.
Ms Caccaviello attended a rehabilitation program and met Aaron Short, a fellow recovering addict with whom she formed a relationship and credits with giving her hope.
"From then on, my life got better."
The pair returned to school to study the drug and alcohol sector but part-way through the course, in 2015, Aaron relapsed and died.
Years later in 2019, Ms Caccaviello also lost a best friend to an accidental overdose.
"I'm a lucky one because I'm still standing," she said.
Ms Caccaviello stressed the need to break down the stigma around addiction, as people simply don't know how to get the right help.
"My friends weren't just junkies," she said.
Safe injecting rooms
Close to 300 people visit the safe-injecting room in the inner-city suburb of Richmond in Melbourne.
It is a place where people can safely go to take drugs, with clean needles and medical professionals on hand.
It is the second safe-injecting room in Australia, with one also located in Sydney's Kings Cross.
Former Police Officer Greg Denham said the idea behind the spaces is to not only stop overdoses but help curb drug use altogether.
"When a person goes into a safe injecting facility, they are not only in a safe environment if they overdose but they also have the opportunity to build a relationship and get to know the staff there who have access to a range of services which can provide some benefits. So housing, employment and especially drug treatment programs," Mr Denham said.
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Not just a youth problem
While many people associate drug use with young people, the report showed Australians aged between 30 and 59 have the highest rate of drug deaths.
In 2017, 30-59-year-olds accounted for more than 71 per cent of overdoses, while under-30s made up just more than nine per cent.
A statistic which doesn't surprise Director of the National Centre for Neurological Treatment of Addiction, Professor Jon Currie.
He said the rise of 'polydrug' overdoses - which are deaths caused by the use of four or more substances at once- can be partially attributed to people not knowing the risk.
"Many people don't recognise the dangers of prescribed medication when they are combined together and a number of people have severe pain or they have anxiety and depression," he said.
"They take a number of medications for this, that includes; benzodiazepines, valium, opioids, but also a number of other medications that together can produce toxicity and even death."
The report showed opioids are the main cause of death amongst 40- 49-year-olds, an age group where Professor Currie said many adults develop mental and physical pain.
He said sadly many don't realise opioids can be as dangerous as "illegal" drugs if used incorrectly.
"The challenge is that opioids are effective for chronic pain but when taken in excessive numbers or particularly with other medications they can cause a reduction in the ability to be awake and alert, so they can be involved in motor vehicle accidents," he said.
"But more importantly, it also called overdose by suppressing respiration, people gradually fall asleep, they don't breathe, so it becomes similar to a heroin overdose."
Stimulants were responsible for 33 per cent of First Nations drug-deaths in 2017, compared to just over 19 per cent for non-Indigenous.
Professor Currie said a lack of medical resources in many Indigenous communities is contributing to the gap.
"The relative lack of medical services and the social deprivation which is also present," he said.
"This combination means medications are often used not for the purposes in which they might be prescribed and so what you've got is a high-risk population, with again, the information that these medications can be dangerous not disseminated."
Australian Medical Association NSW President Dr Kean-Seng Lim said that "while all of the publicity has been on party drugs such as ecstasy and methamphetamine, the biggest drug problem in Australia is, actually, not those ones, but are in fact alcohol and opioids and this report really highlights the size of that issue."
"One of the problems of opioids is that the body starts to get used to it after a while," he said.
"So people can develop a thing called tolerance and as you become tolerant to it you can actually start to use more and more of that substance to try and get the same effect, until you are not really using that opioid for its pain-relieving qualities anymore but more of less just to feed the tolerance or feed the habit.
“What this report really shows is that we need a system level approach and we need to look at this at multiple levels.
"This is not going to be an easy problem to solve, we have to acknowledge that this is a complex problem and the solutions are not going to be the same for all drugs or for all age groups."
- with additional reporting from AAP
