Methamphetamine consumption is the "biggest challenge" for regional Australia, a new report has found.
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Methamphetamine use in the regions is at "record levels" and per capita levels far outstrip Australian cities, except in the NT.
Cannabis use was also significantly higher in the regions but was of less concern because it was a "less harmful drug", experts say.
The data is revealed in the latest National Wastewater Drug Monitoring Program report by the Australian Crime Intelligence Commission (ACIC) on July 10.
Nicotine and alcohol aside, cannabis is the most consumed drug by a large margin nationwide.
In December 2023, cannabis use was 3.6 times higher than the consumption of methylamphetamine and 18.6 times higher than the consumption of cocaine.
There has been a considerable increase in cocaine use since the record low level in August 2022 to a record high level in December 2023.
Despite a tangible increase in MDMA use, it remains lower than other illicit stimulants.
In the ACT there was an increase in cocaine and methamphetamine use but a decrease in MDMA, fentanyl and ketamine.
'Concerning'
ACIC principal advisor for drugs Shane Neilson told ACM some of the results were "certainly concerning".
"Any increase in consumption is a concern in regional areas because of resources (law enforcement and health treatment) being more thinly spread in regional areas," he said.
Mr Neilson noted the "biggest challenge" in regional Australia was methamphetamine consumption.
Australia had the second highest methylamphetamine consumption per capita in the world.
Nicotine
Consumption has generally been higher in regional Australia.
Regional consumption of nicotine has been increasing since August 2022 and is now at a record-high level.
Alcohol
Average consumption of alcohol in capital cities exceeded regional consumption for the first time since 2018.
Alcohol consumption has been decreasing in many states and territories and nationally over the past 2 years.
Methylamphetamine
Consumption has generally been increasing, reaching its highest levels in regional areas of each jurisdiction bar the NT during the past 2 years.
Cocaine
Consumption has been higher on average in the capital cities than in regional areas.
Consumption has been increasing in most jurisdictions since the record lows in August 2022.
In December 2023, the national average consumption for capital cities and regional areas was at the highest level since reporting began in August 2016.
MDMA
MDMA consumption levels have generally been increasing since April 2022.
Heroin
Overall consumption remains relatively steady and is substantially higher in capital cities than in regional areas.
Many sites particularly in regional areas have levels below the detection limits.
Cannabis
Consumption is substantially higher on average in regional areas than in capital cities.
Several capital cities have reached their lowest levels of cannabis consumption in the past 2 years.
National average consumption estimates have been relatively stable over the past year.