Impact of alcohol and illicit drug use on the burden of disease and injury in Australia

173 Pages·2017·2.57 MB·English

Stronger evidence,
better decisions,
improved health and welfare
Impact of alcohol and
illicit drug use on the
burden of disease
and injury in
Australia
This report quantifies the health impact that
alcohol and illicit drug use place on Australia,
including as risk factors for other diseases and
Australian Burden
injuries. It estimates that alcohol and illicit
drugs were collectively responsible for 6.7% of of Disease Study
Australia’s disease burden in 2011. The report
highlights that health inequalities exist, with 2011
lower socioeconomic groups and more remote
areas generally experiencing higher rates of
disease burden due to alcohol and illicit drug use.
aihw.gov.au
Stronger evidence,
better decisions,
improved health and welfare

AUSTRALIAN BURDEN OF DISEASE STUDY SERIES
Number 17
Impact of alcohol and illicit drug use on
the burden of disease and injury in
Australia
Australian Burden of Disease Study 2011
Australian Institute of Health and Welfare
Canberra
Cat. no. BOD 19
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create authoritative and accessible information and statistics that inform decisions and
improve the health and welfare of all Australians.
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ISSN 2204-4108 (PDF)
ISSN 2006-4508 (Print)
ISBN 978-1-76054-316-7 (PDF)
ISBN 978-1-76054-317-4 (Print)
Suggested citation
Australian Institute of Health and Welfare 2018. Impact of alcohol and illicit drug use on the burden of
disease and injury in Australia: Australian Burden of Disease Study 2011. Australian Burden of
Disease Study series no. 17. Cat. no. BOD 19. Canberra: AIHW.
Australian Institute of Health and Welfare
Board Chair Director
Mrs Louise Markus Mr Barry Sandison
Any enquiries relating to copyright or comments on this publication should be directed to:
Australian Institute of Health and Welfare
GPO Box 570
Canberra ACT 2601
Tel: [phone]
Email: [email protected]
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Please note that there is the potential for minor revisions of data in this report.
Please check the online version at <www.aihw.gov.au> for any amendments.
Contents
Acknowledgments ................................................................................................................ v
Abbreviations ...................................................................................................................... vi
Symbols ............................................................................................................................. viii
Summary .............................................................................................................................. ix
1 Introduction ...................................................................................................................1
1.1 Aims of this report ..................................................................................................... 1
1.2 Alcohol use in Australia ............................................................................................ 3
1.3 Illicit drug use in Australia ......................................................................................... 4
1.4 Policy context ........................................................................................................... 5
1.5 What is burden of disease? ...................................................................................... 7
1.6 Key developments since the Australian Burden of Disease Study 2011 .................... 8
1.7 Where do the data come from?............................................................................... 10
1.8 Future directions ..................................................................................................... 12
1.9 Structure of this report ............................................................................................ 13
2 Alcohol and illicit drug use ......................................................................................... 14
2.1 Burden from alcohol and illicit drug use .................................................................. 14
3 Alcohol use .................................................................................................................. 16
3.1 Burden from alcohol use ......................................................................................... 16
3.2 Burden from alcohol use by linked disease ............................................................. 19
3.3 Burden of alcohol dependence ............................................................................... 26
4 Alcohol use in key population groups ....................................................................... 32
4.1 Burden from alcohol use by state and territory ........................................................ 32
4.2 Burden from alcohol use by remoteness ................................................................. 36
4.3 Burden from alcohol use, by socioeconomic groups ............................................... 40
5 Alcohol use over time ................................................................................................. 44
5.1 Changes in burden from alcohol use between 2003 and 2011 ................................ 44
5.2 Potential burden from alcohol use in 2020 and 2025 .............................................. 47
6 Illicit drug use .............................................................................................................. 49
6.1 Burden from illicit drug use ..................................................................................... 49
6.2 Overview of burden from illicit drug use by linked disease ...................................... 51
6.3 Burden of illicit drug dependence ............................................................................ 57
7 Illicit drug use in key population groups ................................................................... 60
7.1 Burden from illicit drug use by state and territory .................................................... 60
iii
7.2 Burden from illicit drug use by remoteness ............................................................. 63
7.3 Burden from illicit drug use by socioeconomic group .............................................. 66
8 Illicit drug use over time ............................................................................................. 69
8.1 Changes in burden from illicit drug use between 2003 and 2011 ............................ 69
9 Specific illicit drugs and unsafe injecting practices ................................................. 74
9.1 Contribution of specific drugs and practice to illicit drug use burden ....................... 74
9.2 Burden from opioid use ........................................................................................... 79
9.3 Burden from amphetamine use ............................................................................... 80
9.4 Burden from cocaine use ........................................................................................ 82
9.5 Burden from cannabis use ...................................................................................... 84
9.6 Burden from other illicit drug use ............................................................................ 85
9.7 Burden from unsafe injecting practices ................................................................... 86
10 Specific illicit drugs and unsafe injecting practices in key population groups ...... 88
10.1 Burden by state and territory ................................................................................ 88
10.2 Burden by remoteness ......................................................................................... 90
10.3 Burden by socioeconomic group .......................................................................... 91
11 Specific illicit drugs and unsafe injecting practices over time ................................ 94
11.1 Changes in burden from specific illicit drugs and practices between 2003 and
2011 ..................................................................................................................... 94
11.2 Changes in non-fatal burden of specific illicit drug dependencies between 2003
and 2011 .............................................................................................................. 96
11.3 Potential burden from specific illicit drugs and practices in 2020 and 2025 ........... 99
Appendix A: Methods ...................................................................................................... 102
Appendix B: Additional tables and figures .................................................................... 131
Glossary ............................................................................................................................ 146
References ........................................................................................................................ 147
List of tables ..................................................................................................................... 152
List of figures ................................................................................................................... 156
List of boxes ..................................................................................................................... 159
Related publications ........................................................................................................ 160

iv
Acknowledgments
This report was authored by Vanessa Prescott, Wendy Ho, Melanie Dunford and
Melissa Goodwin of the Burden of Disease and Mortality Unit at the Australian Institute of
Health and Welfare (AIHW), under the guidance of Michelle Gourley, Lynelle Moon and
Moira Hewitt.
Cathy Claydon, David Whitelaw, Matthew James and Bill Watson from the AIHW as well as
Stella Serafino, Laura Miller and Jennifer Girschik from the Western Australian Department
of Health Epidemiology Branch provided constructive comments and review. Their
contributions are gratefully acknowledged.
The authors would like to acknowledge the methodological advice provided by members of
the NDSHS Technical Advisory Group: Tanya Chikritzhs from the National Drug Research
Institute and Alison Ritter from the National Drug and Alcohol Research Centre.
The Department of Health funded this report. The authors acknowledge the valuable
comments from individual staff members at the department.
v
Abbreviations
ABDS Australian Burden of Disease Study
ABS Australian Bureau of Statistics
ACT Australian Capital Territory
AIHW Australian Institute of Health and Welfare
ASR age-standardised rate
COAG Council of Australian Governments
DALY disability-adjusted life years
GBD Global Burden of Disease Study
GHB gamma hydroxybutyrate
LSD lysergic acid diethylamide
ICD-10 International Statistical Classification of Diseases and Related Health
Problems, Tenth Revision
NAS National Alcohol Strategy
NDS National Drug Strategy
NDSHS National Drug Strategy Household Survey
NHMD National Hospital Morbidity Database
NHMRC National Health and Medical Research Council
NSW New South Wales
NSMHW National Survey of Mental Health and Wellbeing
NT Northern Territory
PAF Population Attributable Fraction
Qld Queensland
SA South Australia
SEIFA Socio-Economic Indexes for Areas
RR Relative risk
vi
Tas Tasmania
TMRED theoretical minimum risk exposure distribution
Vic Victoria
WA Western Australia
YLD years lived with disability
YLL years of life lost
vii
Symbols
% per cent
. . not applicable
+ plus / and over
– minus
< less than
> greater than
≤ less than or equal to
≥ greater than or equal to
g gram
n.p. not publishable because of small numbers, confidentiality or other concerns
about the quality of data
viii