Illicit drugs: government spending lowest on prevention and harm reduction, shows new report

Proportion of spending down on prevention and harm reduction

The Australian ‘drug budget’: Government drug policy expenditure 2021/22 is the most recent report in the ‘drug budget’ series, which estimates spending on proactive responses to illicit drugs by governments across Australia.

The proportion spent on prevention, such as in-school education programs, slightly decreased since the last report in 2009/10, down from 9.5 per cent to 6.7 per cent in 2021/22. Spending on harm reduction also decreased from 2.2 per cent to just 1.6 per cent.

Spending on law enforcement remained relatively stable, slightly down from 64.9 per cent to 64.3 per cent of expenditure. Meanwhile, spending on drug treatment services rose from 22.0 per cent to 27.4 per cent.

Dr Annie Madden AO, Executive Director of Harm Reduction Australia (HRA), says the report reveals the true extent of governments’ chronic under-investment in harm reduction.

“Australian governments have continued to claim their position as a global leader in harm reduction over many decades. In this case, however, the evidence does not lie,” Dr Madden says. “We know that frontline harm reduction services such as needle and syringe programs, opioid treatment, take-home naloxone, drug consumption rooms and drug checking services reduce potential harms including drug-related deaths.

“The fact that harm reduction spending has continued to decline in the face of unprecedented evidence of impact and effectiveness is deeply concerning for many reasons, not the least of which is the undeniable fact that harm reduction saves lives.”

State and territory governments spent the most against illicit drugs, accounting for 76 per cent or $4.11 billion of the total proactive expenditure, the majority of which ($2.87 billion) was for state law enforcement. 

“The lion’s share of the investment is from state governments and continues to be in law enforcement, and that’s related to the policing of drugs, which we know is an expensive activity,” Prof. Ritter says. “At the same time, the amount that’s invested in helping people who are experiencing problems with illicit drugs is significantly less as a proportion of spending.”

Illicit drug use is a significant health, social and economic issue for Australia, with the latest National Drug Strategy Household Survey 22/23 population survey showing a small increase last year in use, Prof. Ritter says. There has also been a noticeable shift in the types of illicit drugs being used, including crystal methamphetamine and hallucinogens.

CEO of Alcohol and Drug Foundation, Dr Erin Lalor AM, says despite efforts from law enforcement, there’s been a concerning increase in the number of Australians experiencing drug-related harms, such as hospitalisations and fatal overdoses. She says prevention is a crucial part of a comprehensive approach needed to reduce the impact of drug-related harms, particularly among young people. 

“The number of drug-induced deaths in Australia is unacceptably high and has sadly been increasing since 2006,” Dr Lalor says. “These heartbreaking deaths are mostly preventable and have a ripple effect on the community, with friends and families suffering.

“We need increased, long-term funding commitments for evidence-based prevention initiatives that reduce risk factors for harmful illicit drug use and boost protective factors, as well as targeted education campaigns in populations at greater risk of harm and those that address stigma.”

While the total amount spent by governments against illicit drugs more than tripled from the last report in 2009/10 ($1.7 billion), the 2021/2022 estimate represents just 0.63 per cent of all government spending, down from 0.80 per cent in the last report.

“These figures suggest that despite a significant increase in proactive government spending on drugs since the last report, this reflects overall growth in government spending and not growth in spending on drug countermeasures,” Prof. Ritter says. “However, what’s striking is that despite the percentage reduction in proactive expenditure, there hasn’t been any significant shift in the proportion of investment amongst the four domains of drug policy.”

Impact on service providers

The Network of Alcohol and other Drugs Agencies (NADA) is the peak body for NGO AOD service providers in NSW. Its CEO, Dr Robert Stirling, says services on the frontline are suffering from the lack of growth in investment

“We have a noticeable, growing unmet demand for services in the sector from underfunding, demonstrated by increasing wait times for treatment and workforce shortages from a lack of secure working conditions,” Dr Stirling says. 

“At the NSW level, money for treatment has predominantly been spent on new services rather than investing in existing services to ensure they can deliver quality services and create healthy workplaces and conditions. 

“Meanwhile, at the Commonwealth level, funding has been going backwards, leaving services struggling to retain staff and needing to reduce services to communities.”

Emma Maiden, General Manager of Advocacy and External Relations for Uniting NSW.ACT, says governments should consider removing criminal penalties, and redirect funding towards the other pillars of drug policy. 

“To see that the largest expenditure in the latest Australian ‘drug budget’ is once again directed to law enforcement, and how that spending monsters what is spent on drug treatment, prevention and harm reduction programs, is of great concern,” Ms Maiden says. “We need our governments to have the courage to take action and invest the lion’s share of our drug budget in the things we know will make a difference.”

Prof. Ritter says the report does not assess the effectiveness of the investment across domains, and the relative value of the estimates is more important than any absolute value. 

“There is no line item in government expenditure estimates that explicitly lays out how much they spend on illicit drugs,” Prof. Ritter says. “So, there are some assumptions behind every figure, which we have accounted for in our sensitivity analysis.”

The latest National Drug Strategy Household Survey also shows Australians want roughly equal investment across education, treatment, and law enforcement in illicit drug policy.

“Most people, on average, want governments to spend equal amounts on policing, treatment and prevention,” Prof. Ritter says. “So, the current investment mix does not necessarily match how most Australians would prefer governments to allocate funding across the domains of drug policy.”