28/03/2017 1:40 PM AEDT | Updated 28/03/2017 1:41 PM AEDT

Policymakers Are Focussing On Drugs Australians Aren't Taking

They're worried about 'bath salts', but more people are abusing 'hillbilly heroin'.

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More people are using prescription opioids such as OxyContin (oxycodone) and fentanyl than cocaine and MDMA.

Many a top cop and senior bureaucrat will be heaving a sigh of relief after the results of the Australian Criminal Intelligence Commission's 'National Wastewater Drug Monitoring Program' (NWDMP) failed to generate much media attention. There were no questions about why, after so many police operations and taskforces, ice is still widely used in Australia. Nor were they quizzed on why they've been focussing on 'bath salts' instead of 'hillbilly heroin'.

Internationally, the analysis of wastewater has become the standard for measuring drug use in communities. On Sunday, ACIC released the NWDMP report which provides an analysis of wastewater from 51 sites across Australia. According to Federal Justice Minister Michael Keenan, the report is the first of its kind in Australia and has provided new insight into what drugs are being consumed in Australia, and where.

For all the mega busts, ice is readily available in our communities.

The report confirmed that Australia has an enormous appetite for illicit drugs and that ice use is at an all-time high. Globally, as we guessed, Australians are big ice users. These results provide irrefutable proof that for all the mega busts, ice is readily available in our communities.

The good news from the report is that Australia's consumption of cocaine is relatively low, while ecstasy (MDMA) use is close to that of the European average.

One of the big surprises for law enforcement, especially the ACIC, is that the use of a family of drugs called New Psychoactive Substances (NPS) is substantially lower than expected. NPS includes items frequently sold over the counter as 'bath salts' or 'legal highs'.

Over several years, substantial Commonwealth, state and territory efforts have been directed towards reducing the NPS supply in Australia. The report reveals that NPS use is now relatively low. The argument here is that either assessments in the past overestimated NPS use, or law enforcement campaigns have been successful in reducing its availability. Regardless, our police and border force will need to question whether their efforts targeting NPS should now be reduced.

The real shock result relates to Australian's use of prescription opioids. Commonly referred to as 'hillbilly heroin' in the US, opioids such oxycodone and fentanyl are prescription painkillers typically used to manage acute, chronic and cancer-related pain.

For many years there has been some difference of opinion between front-line drug counsellors and police over the abuse of these pharmaceuticals. Drug counsellors often argued that illicit drug users had a stronger preference for prescription opioids. In contrast, our police believed that the abuse of these drugs was a minor issue.

The illegal use and over-prescription of opioid painkillers is not a problem that is unique to Australia.

According to the ACIC report, with the exception of the Northern Territory, "the consumption of oxycodone and fentanyl exceeds the use of cocaine and MDMA in all jurisdictions". Moreover, abuse of these substances was far more prominent in regional Australia with above average use of oxycodone in regional Queensland and regional Victoria.

The illegal use and over-prescription of opioid painkillers is not a problem that is unique to Australia. In recent years, the US has suffered from a staggering rise in the use of 'hillbilly heroin'. In North America, prescription opioid-dependent clients now outnumber heroin-dependent clients in rehab. And there are more deaths in the US attributed to the use of prescribed opioids than to heroin and cocaine use combined.

Clearly, the use of opiate-based prescription drugs in regional Queensland and Victoria is an area of concern that needs to be examined. ACIC has rightfully argued that the next logical step is to "explore the extent of licit and illicit oxycodone and fentanyl use".

But Australia's policymakers need to be very cautious in their approach to this new problem. Over recent years the US Drug Enforcement Administration (DEA) decided to cut production of prescription opioids by 25 percent. Arguably, this policy decision has unintentionally given rise to a nationwide heroin epidemic in the US.

Addressing the patterns of use and abuse of oxycodone and fentanyl will require a high level of collaboration between policymakers, law enforcement, and the Australian Medical Association. But to be clear, the problem is most definitely a health rather than law-enforcement issue.