At the long-awaited NSW Drug Summit late last year, the Minns Government delivered on an election promise: to bring politicians, health experts, police, researchers and people with lived experience together to discuss drug policy, with the aim to improve the health and wellbeing of people impacted by drugs (including families and communities).  

It is too early to tell whether all this talk will turn into action – but five key objectives should be acted on immediately and incorporated into the highly anticipated new Alcohol and Other Drug (AOD) Strategy for NSW.  

Objective 1. Treatment, prevention and harm reduction deserve a larger portion of government expenditure

According to the 2021/22 Australian Drug Budget, 64.3 per cent of government expenditure in response to illicit drugs is assigned to law enforcement, while treatment, harm reduction and prevention receive 27.4, 6.7 and 1.6 per cent respectively.  

Despite law enforcement being consistently allocated the lion’s share of the budget, nearly four million Australians reported using illicit drugs in the past year. Coupled with evidence that criminalisation does not reduce drug use but can increase drug-related harms, there is doubt as to whether law enforcement is effectively reducing the availability and accessibility of illicit drugs.  

Given that drug use is a health issue – and that treatment, prevention and harm reduction have shown efficacy in reducing the health risks associated with drug use – the NSW Government should prioritise a more equal share of investment towards evidence-based prevention and treatment. 

Objective 2. Improve access to harm reduction strategies including naloxone, drug checking and supervised injecting clinics

Drug overdose deaths have alarmingly increased over the last 20 years, with one Australian now dying every four hours. Most are due to unintentionally taking too much of a drug, or a different drug to the one that was not expected. As Associate Professor Amy Peacock explained at the Summit, the contents (e.g., purity and contaminants) of products are more unpredictable than ever before.  

Naloxone is a medicine that reverses the effects of opioids, one of the most common drugs attributed to overdose deaths. When administered immediately after an overdose, naloxone is extremely effective in preventing death. Unfortunately, a lack of pharmacist training, stigma and disrupted supply chains have been identified as barriers for those who need to access this medicine. 

Drug checking (also called pill testing) was a hot topic at the summit. It aims to prevent people from taking unusually strong or contaminated drugs by testing a sample before consumption. Increasing evidence suggests that drug checking can save lives and improve community awareness of harm reduction measures. Two weeks after the Drug Summit, the NSW Government announced a drug checking trial at music festivals from February 2025. This is a lifesaving move. However, as festival attendees make up a small portion of people using drugs, drug checking services need to be made available more widely across NSW.  

A significant outcome of the 1999 Drug Summit was the introduction of Australia’s first supervised injection clinic, the Uniting Medically Supervised Injecting Centre (Uniting MSIC) in Kings Cross. Within this service, people can inject drugs in hygienic conditions under the supervision of non-judgmental qualified staff. Since 2001, Uniting MSIC has supervised over 1.28 million injections, with 0 fatalities.  

Despite evidence that supervised injecting clinics are effective in reducing overdoses and the burden on the healthcare system, there remains only one such clinic in NSW, and a total of two across Australia. Just like drug checking services, supervised injecting clinics should be made available throughout greater NSW, in consultation with communities.  

Objective 3. Implement effective drug prevention and early intervention programs in all schools across NSW and Australia

Effective prevention and early intervention can significantly reduce the impact of drugs by halting, delaying and interrupting the onset and progression of disorders. This approach should be attractive to governments, with evidence suggesting that it is cost-effective and provides a significant return on investment by reducing later costs incurred by drug use (e.g., treatment, policing).  

Schools are an ideal setting to deliver such curriculum-aligned programs en masse, and typically prior to the development of drug use disorders. There are several evidence-based drug prevention and early intervention programs available in Australia. However, there is an implementation gap in schools. It is critically important that evidence-based prevention and early intervention programs are incorporated into the curriculum of all NSW schools. 

Objective 4. Remove barriers to effective evidence-based resources and treatments

In recent years, the Australian Government has invested in a range of evidence-based information on drug use and co-occurring mental health issues (e.g., Cracks in the Ice Toolkit, Positive Choices, Comorbidity Guidelines). These tools can help people prevent or reduce their drug use as well as seek effective treatments along with reducing the stigma associated with drug use. However, more can be done in NSW to support and promote their uptake.  

The drug treatment system can be extremely difficult to navigate, especially for those who are unwell. Waitlists can be extensive, with many people waiting months, even years, for help. To increase the quality and capacity of treatment, greater long-term investment in the AOD treatment sector is vital. Evidence-based and culturally sensitive treatment and support options must be available to NSW communities, offered through in-person, online and hybrid avenues.  

Objective 5. Invest in collecting and analysing drug trend data

Timely responses to drug trends require investment in data collection and analysis, as well as the ability to link data across the health care system. Synergy across data sources for co-occurring drug use and mental health conditions would provide key information for prevention and treatment.  

Investment in data is also critical for preparing and implementing effective prevention, treatment and harm reduction strategies. Information on both the short-term and long-term health outcomes and impacts of drugs should also be gathered and monitored.  

Turning talk into urgent action

Critically, any changes to drug policy must be co-developed with people most impacted by drug use to ensure relevant, respectful, inclusive and effective policy reform. This includes young people, those with lived experience, First Nations people, those who identify as gender and sexual diverse, and other key stakeholders. 

The 2024 NSW Drug Summit was a crucial step in the right direction towards a more compassionate and health-focused approach to drug policy. The implementation of a NSW drug-checking trial proves that the summit was not just talk. However, given the breadth and severity with which drugs affect Australians, there is much more to be done. We strongly encourage the NSW Government to urgently address the recommendations above. 

Dr Jack Wilson is a Postdoctoral Research Fellow at the Matilda Centre for Research in Mental Health and Substance Use at the University of Sydney. His research focuses on patterns of cannabis and other drug use, associated health outcomes and implications for Australian drug policy. 

Kate Ross is the Program Lead of the PREMISE Next Generation NHMRC Centre of Research Excellence and Senior Research Program Officer at the Matilda Centre. Her team strives to enhance the Centre’s policy impact by connecting stakeholders with world-class evidence and knowledge generated by our researchers and Youth Advisory Board. 

Steph Kershaw is a Research Fellow at the Matilda Centre. Steph leads an innovative program of research and translation to reduce the impact of substance use. Her research aims to improve the health outcomes for individuals, families and communities, especially among vulnerable and disadvantaged groups. 

Image credit: Liudmila Chernetska/ Getty Images