4.5% of Australians Used Cocaine; 25% of Users Had Mental Illness

For Australian clinicians and health system planners, the numbers embedded in John Hanscombe's column are a diagnostic warning: 4.5% of people aged 14 and over recently used cocaine, and a quarter of those users had already been diagnosed or treated for a mental health condition. It means stimulant use can no longer be viewed as a purely criminal justice problem—it is a dual-diagnosis challenge for GPs, emergency departments, and community mental health teams.

An opinion column by John Hanscombe, published simultaneously across Australian regional outlets including Port Macquarie News, The Northern Daily Leader and The Irrigator on 25 August 2026, uses a personal story about a cocaine allergy to argue that any serious attempt to fix Australian culture must confront rising cocaine use. The column is framed as opinion, but it embeds data from the Australian Institute of Health and Welfare's National Drug Strategy Household Survey 2022-2023 that gives the argument a public-health spine. Hanscombe recounts being told by a doctor 40 years ago that he was allergic to the drug and lucky, then observes that people he saw using cocaine became 'loud, boastful, reckless, inflated and inconsiderate.' He connects that behavioural observation to national statistics: 4.5 per cent of Australians aged 14 and over had recently used cocaine, most users were men in their 20s and 30s, and one quarter of people who used the drug had been diagnosed or treated for a mental health condition. The Australian Federal Police's record seizure of 2.7 tonnes of cocaine—equivalent to roughly three million street deals—is cited as evidence of the scale of demand.

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The Australian Federal Police's record seizure of 2.7 tonnes of cocaine—equivalent to roughly three million street deals—is cited as evidence of the scale of demand.

The 4.5 per cent prevalence figure is not just a criminal justice statistic. If applied to the national population aged 14 and over, it translates to roughly one million recent users, although the column itself does not make that extrapolation. That scale is consistent with Australia being described as among the highest countries globally for per capita consumption of illicit cocaine. For health systems, the implication is that cocaine-related presentations are no longer rare events limited to a marginal population. Emergency departments, general practices and addiction services are likely to encounter stimulant-related chest pain, arrhythmias, seizures, agitation and psychosis with increasing frequency. The column's subjective observation that users became 'pumped up with pharmaceutical self-importance' aligns with the clinical understanding that cocaine produces intense dopaminergic stimulation, which can drive disinhibition, grandiosity and impaired judgement.

The most clinically significant statistic in the column is that a quarter of people who had used cocaine were diagnosed or treated for a mental health condition. This does not establish causation. Cocaine use may be a form of self-medication for underlying depression, anxiety or trauma, or it may precipitate or worsen psychiatric symptoms through neurochemical dysregulation and life destabilisation. Either way, the association signals a substantial dual-diagnosis burden. Health services that treat substance use in isolation from mental health, or vice versa, are poorly matched to this population. The 2022-2023 survey period predates the column by several years, so if cocaine use continued rising, the current comorbidity burden may be larger than the cited figure suggests.