A Smoky Rise: Drug Use in Victoria and What It Means for Your Smile

Victoria is facing a troubling surge in drug use. Wastewater analysis between August 2023 and August 2024 shows sharp increases in national drug consumption—heroin use in particular rose by 14%News.com.au. In 2024, Victoria recorded the highest number of fatal drug overdoses in a decade, with 584 deaths, many tied to opioids like heroinHerald Sun. Regions like Geelong and inner Melbourne are hit especially hard, with heroin deaths on the riseHerald Sun+1. In Richmond, Melbourne’s heroin epicentre, nearly 500 kg of heroin was estimated to have been consumed in 2023News.com.au.

When Opiates Take Over — What Happens to the Smile

1. Neglect and Self-Care Decline

Long-term opiate use often leads to neglect of oral hygiene—patients may stop brushing, flossing, or seeing a dentistAmeritasBioMed Central. This neglect accelerates plaque buildup, decay, and tooth loss.

2. Dry Mouth (Xerostomia)

Opiates reduce saliva flow. Saliva is our natural defense — it neutralises acids, washes away food particles, and repairs enamel. Without it, teeth are far more vulnerableAmeritasBetter Health Channel.

3. Dietary Havoc

Users often crave sugary foods or drinks, often paired with an overall poor diet, compounding decay and gum diseaseFrontiersNatureBioMed Centralbicyclehealth.com.

4. Bruxism and Physical Wear

Opiate use can make people grind or clench their teeth (bruxism), wearing down enamel, leading to cracks or weakened tooth structuresAmeritasbicyclehealth.com.

5. Impaired Pain Perception

Because opiates dull pain, individuals may not notice oral issues—cavities, abscesses, or gum disease may go untreated until severeAmeritasNature.

6. Compromised Immunity & Oral Diseases

Opiate use, along with treatments like methadone, can suppress salivary and immune function—dentition, periodontal health, and healing take a hitNatureNCBI.

7. Tooth Loss and Decay Patterns

Statistics show a clear correlation between opioid use and oral decline. For example, those with long-term use average nearly 7 missing teeth, compared to just 3 among short-term or non-usersNCBI.

8. “Heroin Teeth”: A Distressing Term

Long-term heroin users may develop what’s colloquially known as “heroin teeth” — marked by blackened, decaying, or missing teeth, gum disease, and abscessesbicyclehealth.com.

Putting It All Together: Oral Health at Risk

When opiates are in the picture, oral collapse is not just likely — it becomes nearly inevitable. Neglect, dry mouth, poor diet, bruxism, and impaired awareness of dental pain all compound to create the perfect storm for cavities, gum disease, and tooth loss.

A Call for Compassionate Care and Recovery

If you or someone you know is struggling with opioid use, remember this is more than a smile—it's about holistic health. Here's what can help:

• Early dental intervention is crucial — don’t wait until damage is advanced.

• Address addiction and oral health together, through integrated care and harm reduction services

• Safe injecting and support services, like the Richmond injecting room, can reduce harm and encourage pathways to help

Final Thought: The rise in heroin and opioid use across Victoria isn’t just a public health crisis—it’s a dental one. Every smile affected tells a deeper story of struggle and the need for integrated support.