Use of the opioid medication oxycodone has continued to rise across Tasmania in the past three years, with Hobart easily the largest user in Australia while use in the state's regional areas is above the national average.
Use of the highly addictive pain reliever in Tasmania, which is a significant cause of opioid overdose and dependence in Australia, was highlighted in the Australian Criminal Intelligence Commission's latest national wastewater drug monitoring program.
"Sites in capital city Tasmania and the Australian Capital Territory measured among the highest consumption of the drug," the report reads.
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"However, since mid-2018, regional Tasmanian sites, as well as sites across Queensland and Victoria, have become prominent.
"A feature of oxycodone use in Australia is the very high regional levels compared to the capital cities."
Tasmania is one of the only jurisdictions in Australia that only offers the anti-opioid overdose drug Naloxone through pharmacies, rather than through community health providers, meaning its uptake has been minimal and the risk of overdose among those dependent on oxycodone is higher.
The ACIC report also found that use of methylamphetamine had risen faster in Tasmania than any other state or territory, almost doubling in the years from 2016 to 2019.
Use of cannabis in Tasmania remained well above the national average, although the wastewater monitoring technique is not considered an overly accurate measure for cannabis.
Besides the Northern Territory, Tasmania recorded the highest usage of legal drugs alcohol and nicotine.
Alcohol remained the drug most likely to cause harm, according to the Alcohol Tobacco and Other Drugs Council Tasmania.
Chief executive officer Alison Lai said there was a need for a holistic approach to drugs and alcohol as harm continued to rise.
"We get ourselves in a tangle about illicit substances, but alcohol continues to be the number one substance for which people are seeking support," she said.
"After that is cannabis, but crystal methamphetamine is pushing up into second place.
"We know that pharmaceutical medication is a leading reason for accidental overdose in Tasmania."
The ATDC has renewed its push for the decriminalisation of the possession and use of drugs in Tasmania, claiming it would result in better health and justice outcomes.
But this was disputed by Rural Health Tasmania chief executive officer Robert Waterman, who said decriminalisation would result in increased drug usage - like with alcohol.
"What you've got is a scenario where people are using drugs, they're not afraid to use drugs because they're not going to get charged for possession, and there's no sanctions for non-compliance," he said.
"What we need is more early intervention, prevention and community education, better resources for law enforcement and border security, provide better access to evidence-based rehabilitation and recovery-oriented programs in the community and prisons, and the provision of evidence-based family support services.
"Unfortunately the government has an ad hoc approach. They fund treatment, but not early intervention and prevention. They seem to shift funding from one to the other, but never properly fund the entire suite."