Q&A with Dr Timothy Piatkowski: Drug induced suicide deaths in Queensland

Drug-induced deaths are rising in Australia, with 2,231 recorded in 2021, equating to 8.7 deaths per 100,000 people, well above the global average of 5.5. While unintentional overdose deaths nearly doubled between 2002 and 2019, drug-induced suicides have also increased, particularly outside capital cities, where rates rose from 1.5 to 1.9 per 100,000 people over that period. These deaths, whether intentional or not, are shaped by overlapping structural challenges including trauma, poverty, chronic pain and inadequate service access.

Queensland faces distinct challenges. In 2021, it recorded the highest number of drug-induced suicides nationally (120 deaths), surpassing New South Wales and Victoria. Drug-induced deaths were also higher in regional areas (6 per 100,000) than in Brisbane (5.2 per 100,000), highlighting the uneven burden. Yet official statistics may still understate the scale due to misclassification - for example, treating some overdoses as “drug poisonings” rather than suicides.¹

This was a qualitative study based on in-depth interviews with 19 people living in regional Queensland who use drugs, all of whom had experienced suicidality or survived an overdose. A key challenge was that many participants had experienced significant service mistrust and trauma. Our team was led by peer researchers with lived and living experience, which was crucial to ensuring ethical engagement and richer insights.

We found that intentional overdose was rarely an isolated event; it was often bound up with long-term experiences of grief, abuse and structural disadvantage. People described using drugs to cope, but also as a way of expressing distress when support felt out of reach. Many told us they had tried to seek help, only to encounter stigma, punitive responses or inflexible systems.

While they aligned with what peer researchers and harm reduction workers have long observed, the depth of pain and exclusion described was confronting.

Co-locating mental health and harm reduction services in regional areas would help. So would increasing after-hours support, embedding peer workers, and training frontline staff to respond without judgment. Suicide prevention efforts must consider the material realities of people’s lives, particularly housing, poverty, and access to care, not just mental health in isolation.

We need better data and stories from rural and remote communities. Research that partners with people with lived and living experience can shift not only what we learn, but how we apply it.