Alcohol and drug use in regional and remote Australia

In Australia, drinking (and other drug use) cultures can change depending on where you live.¹

Here we look at alcohol and other drug use in regional, rural and remote areas – what contributes to use and what are the impacts.

Alcohol use

Alcohol is the most widely used drug in Australia.

But drinking levels are higher in regional, rural and remote areas compared to cities and urban areas.^{1, 2}

People in regional and remote areas are more likely to drink frequently or at levels harmful to health.¹
Contributing to this is:

• acceptance of alcohol’s role in community and social events
• limited choices for socialising
• cultural attitudes that normalise frequent or heavy alcohol use.³

These attitudes can rub off on rural young people, who are further influenced by the availability and supply of alcohol by parents.⁴

People in their 20s in regional and remote areas are 9% more likely to drink at risky levels than those of the same age in cities.¹

Illicit drug use

We know illicit drugs use in regional and remote areas is similar to that in cities. But the type and frequency of drug use varies.

Cannabis, oxycodone and fentanyl are more frequently used in rural and remote areas.^1,9

In recent years there’s also been an increase in demand for amphetamine treatment services in rural NSW, overtaking alcohol as the most commonly treated drug of dependence.⁵

While drug-induced deaths are more common in major cities, the death rate is increasing in regional and remote areas.¹

What contributes to rural alcohol and drug use?

There are many factors that contribute to alcohol and drug use in rural and remote regions, including:

• high unemployment – particularly among youth
• lower income and education levels
• affordability and quality of housing
• distance and social isolation
• limited social activities.^{1, 3}

Limited access to alcohol and other drug treatment in regional and rural areas

Access to health services impacts people living in regional and remote areas.

Lack of access to alcohol and other drug treatment services is a barrier that prevents many people seeking help and support.¹

Long travel times to treatment centres (often 100-500 kms away) and the associated costs make alcohol and other drug treatment inaccessible for many.^1,11

Other common treatment barriers include:

• limited detox facilities
• long wait times to access services and support (3-4 months)
• concerns about privacy, stigma and confidentiality when seeking help in smaller, close-knit communities
• limited access to harm reduction support, such as needle and syringe programs, buprenorphine products to help with opioid withdrawal and cravings, and opioid reversal medicines (naloxone).^1,11

Who’s at risk?

Some people in rural and remote areas are at higher risk of harm from alcohol and other drugs.

• People who identify as male are more likely than those who identify as female to use or be dependent on alcohol or other drugs generally.¹¹
• While First Nations Australians are less likely to drink compared to non-Indigenous Australians, those that do are more likely to drink at risky levels. They also experience disproportionate health-related harms from alcohol and drug use.⁶
• Fly-in-fly-out (FIFO) workers tend to drink at risky levels, often drinking on site to socialise, or offsite during leave periods. Frequent separation from families and support networks, long working hours and variability of living conditions can contribute to alcohol and other drug use.^{7, 8}
• Rural farmers have historically been more likely to drink alcohol at risky levels. Financial stress, climate challenges and increasing rates of mental illness, such as depression and anxiety, may contribute.¹⁵

Expanding telehealth services

Telehealth services have expanded in recent years, with the COVID-19 pandemic giving more people more access to virtual health appointments.⁹

The Alcohol and Drug Telehealth Service (ADTS) at St Vincent’s Hospital offers specialist addiction services via telehealth to people located in the Murrumbidgee district of Southern NSW. This allows people in rural areas to access specialist addiction services from home, helping to address location barriers.

And a new telehealth detox service is also working to address access barriers for those in rural or remote areas. Clean Slate Clinic provides support to those wishing to detox from alcohol, safely from their own home. The service is currently available to residents of Western New South Wales, Western Queensland and Central and Eastern Sydney, and the program is hoping to expand to more areas.

Help and support

If you or someone you know lives in regional or remote Australia and is experiencing alcohol or drug dependence, there may be local or telehealth services available for you.

To find local or telehealth services you can call the National Drug and Alcohol Hotline on 1800 250 015.

Or you can use our online tool Path2Help which helps you find support and information tailored to the specific needs of yourself or a loved one.