The Illicit Drug Reporting System (IDRS) interviews are conducted annually with a sentinel group of people who regularly inject drugs, recruited from all capital cities of Australia (N=902 in 2019). The results from the IDRS interviews are not representative of all people who consume drugs, but this is not the aim of the study, instead intended to provide evidence indicative of emerging issues that warrant further monitoring. These results should be interpreted alongside analyses of other data sources for a more complete profile of emerging trends in illicit drug use, market features, and harms in Australia.

The IDRS sample in 2019 (N=902) predominantly identified as male (68%) with a mean age of 44, consistent with the national profile in previous years. Nearly half of the participants (44%) reported that their drug of choice was heroin. Methamphetamine and heroin were the drugs injected most often in the past month (42% and 40%, respectively).

• Heroin - Recent (i.e., past six month) use of heroin remained stable in 2019 (55%) compared to 2018 (54%), although there was large jurisdictional variation (e.g., <5% of participants in the NT sample versus 85% in the VIC sample). Median frequency of use in 2019 was 90 days in the past six months. Consistent with 2018, 88% reported heroin to be ‘easy’ or ‘very easy’ to obtain.
• Methamphetamine - Recent use of any methamphetamine has fluctuated over the years. In 2019, three in four participants (78%) reported recent use. This was driven by the use of crystal methamphetamine (76%), with 23% and 9% reporting recent use of powder and base forms, respectively. A lower median price was observed for one gram of crystal methamphetamine relative to the previous few years. Crystal methamphetamine was perceived to be easier to obtain than base or power methamphetamine.
• Cocaine - Recent use of cocaine and frequency of use has generally decreased amongst the national sample since the beginning of monitoring (35% in 2001, 13% in 2019).
• Cannabis - Recent use of cannabis remained largely stable in 2019, though a small decline in use has been observed since monitoring began in 2000, with three in four participants (74%) reporting recent use in 2019. Nearly half of consumers (46%) reported using cannabis daily.
• Pharmaceutical opioids - Non-prescribed use of most forms of pharmaceutical opioids has remained stable or significantly declined since monitoring of each opioid first began. In 2019, morphine was the most common pharmaceutical opioid used in a non-prescribed context (18%), with nonprescribed morphine use highest in the NT sample (40%). One in ten participants reported recent non-prescribed fentanyl use (9%) and non-prescribed codeine use (9%) in 2019.
• New psychoactive substances (NPS) and other drugs - Use of NPS has remained low and stable over the period of monitoring, with one in ten participants (11%) reporting recent use. Use of ‘new’ drugs that mimic the effects of opioids were reported by 2% of all participants. Two in five participants (18%) reported recent nonprescribed pregabalin use, one in three (32%) non-prescribed benzodiazepine use and one in ten (9%) non-prescribed antipsychotic use.