The crisis is already here
Alcohol, drugs and gambling are major contributors to the burden of disease in Australia and globally, with costs exceeding $55 billion annually. They are also leading preventable causes of injury, chronic disease and death.
One in five Australians meet criteria for an alcohol, drug or gambling disorder in their lifetime, yet fewer than one quarter of those affected seek professional help. There are many barriers to accessing care, which are even greater in rural settings, compounded by high levels of stigma and a lack of community confidence in treatment.
As a result, people seek treatment between one and two decades after first experiencing problems, resulting in significant health and social harms, including poor physical and mental health, fractured relationships, homelessness and unemployment.
Heroin and pharmaceutical opioids contribute to 1,000 lives lost every year in Australia, almost doubling over the past decade, and approaching record levels not seen since the late 1990s. The number of deaths involving methamphetamine and other stimulants has also increased rapidly over this period, with four times more lives lost in 2018 than 1999. Worryingly, hospital admissions for methamphetamine-related mental health problems have also increased, yet the stigma associated with methamphetamine use remains the primary barrier to accessing treatment.
The costs associated with opioids and other drugs, while substantial, still trail those of alcohol.
Alcohol is the sixth leading risk factor for disease burden in Australia. It is causally linked to more than 60 medical conditions, including multiple cancers. Alcohol contributes to over 4,000 deaths and 70,000 hospital admissions across Australia each year, as well as up to one third of suicides. Yet the harms of alcohol extend further than the health of the drinker, with estimates suggesting that 13,660 Australians are hospitalised and 367 die due to another person’s drinking every year.
While rates of smoking are steadily decreasing, tobacco use remains the leading preventable cause of death and disease in Australia. In 2015, 21,000 deaths were attributed to smoking-related causes – equating to 1 in every 8 fatalities, or over 50 deaths every day. Quitting at any age significantly lowers the risk of long-term health problems, with greater benefits the earlier you quit. People who stop smoking before the age of 40 reduce their risk of dying from a smoking-related illness by up to 90%.
A similar course is evident when we consider the impact of other addictions, such as gambling. Australians lose more than $25 billion a year, with a gambling spend per person greater than any other country in the world. Unfortunately, this is largely from those who can least afford it, with gambling a major driver of household debt, and family and personal dysfunction.
In Australia, we cannot continue to choose to ignore the significant implications of these alarming statistics, and allow a two-decade delay in treatment-seeking, at a time when prevention and early intervention of other medical conditions are core principles of healthcare. We must act.