Alcohol and illicit drugs are to blame for one in every 20 deaths in Australia, according to new analysis by the Australian Institute of Health and Welfare.
The report, based on 2011 data, paints a troubling picture of Australia's drug and alcohol problem, with men more than twice as likely as women to suffer their health consequences.
While the ACT recorded Australia's lowest burden of disease related to both alcohol and illicit drugs, it also had the third highest rate of opioid dependence in the country.
Drugs and alcohol were responsible for 4.5 per cent of all Australian deaths in 2011, but the total disease burden, including years of healthy life lost due to injury or disease, was 6.7 per cent.
This compares to nine per cent from tobacco smoking and 2.6 per cent from physical inactivity.
AIHW spokeswoman Dr Lynelle Moon said alcohol use was responsible for almost one-third of road traffic injuries across Australia.
But while drinking continued to play a "significant" part in Australia's disease burden, Dr Moon said its impact was actually reducing.
"The burden from alcohol use fell by around seven per cent between 2003 and 2011 and further reductions are expected by 2020 based on these trends," Dr Moon said.
Yet the same story is not true of most illicit drugs.
By 2020, the burden from the use of amphetamines is expected to rise by 13 per cent and the cannabis burden is tipped to surge by 36 per cent for women.
Opioids accounted for almost half of the total disease burden for illicit drugs in 2011, and pharmaceuticals caused more deaths than illegal drugs in 2016.
The ACT trailed only NSW and then Victoria for opioid dependence, but recorded a lower overall disease burden for drugs and alcohol compared to other jurisdictions.
An AIHW survey released late last year found Canberrans on average smoked less, drank less and used fewer illicit drugs than other Australians.
Nationally, opioid use was higher in major cities, while those in remote areas were more likely to be impacted by alcohol.
The disease burdens of both cocaine and unsafe injecting practices were also tipped to fall in the coming years, Dr Moon said.
AIHW chief executive Barry Sandison said more data was now needed to understand the links between alcohol, drug use and mental health problems as well as the health impact of fetal alcohol syndrome.
"Using multiple data sources to understand these links and their impacts on people is critical to responding to people's needs," he said.
If this story raises concerns for you, contact Lifeline on 13 11 14.
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