Using multiple data sources to understand the opioid crisis in Australia

Opioid misuse represents a growing global public health crisis, contributing substantially to mortality, particularly in North America and Canada. In Australia, opioid-related harm is increasingly complex and concerning. Over the past decade, opioid overdose deaths have more than doubled, and Australia now ranks among the highest per-capita consumers of opioids worldwide. Beyond prescription-related harms, non-medical opioid use remains prevalent, affecting approximately 2.2% of the population. Alarmingly, non-medical opioid use among adolescents and young adults increased threefold between 2019 and 2023. In response to rising opioid-related harms, Australia has implemented a range of regulatory and prevention strategies, particularly aimed at reducing pharmaceutical opioid prescribing through the Pharmaceutical Benefits Scheme (PBS). While opioid-related harms in Australia remain lower than those observed in North America, recent trends underscore the urgent need for comprehensive monitoring systems capable of capturing both licit and illicit opioid use and evaluating the effectiveness of national regulatory policies. The PBS provides detailed information on subsidised opioid dispensing; however, it reflects dispensing rather than actual consumption. In contrast, wastewater-based epidemiology (WBE) offers an objective measure of total community drug consumption, both licit and illicit use. Existing wastewater surveillance initiatives, including the National Wastewater Drug Monitoring Program (NWDMP), generate data on spatiotemporal patterns of community opioid consumption. To achieve a more comprehensive understanding of opioid use in Australia, a key priority is the integration of multiple data sources to strengthen regulatory and public health responses. This PhD thesis aims to determine the levels and drivers of opioid use, both legal and illegal, by triangulating validated wastewater data (total consumed) and PBS data (total dispensed) across all Australian states and territories, which represent approximately 56% of the national population. By integrating disparate datasets within a multidisciplinary framework, this project, for the first time, seeks to leverage the strengths of each data source to provide a more complete understanding of opioid use. The findings are expected to provide scientific evidence to inform public health policy and contribute to more effective opioid surveillance and control strategies in Australia.

Please note, this is a student progress review presentation by Hieu Ngo