This report from the AIHW presents current national data and trends on opioid use and harms in Australia and makes comparisons with Canadian data. Around 3.1 million people were dispensed opioid prescriptions in 2016-17. In 2016–17 there were 5,112 Emergency Department presentations and 9,636 hospitalisations due to opioid poisoning. This represents a 25% rise in the rate of hospitalisations due to opioid poisoning between 2007–08 and 2016–17. Eleven percent of Australians aged 14 and over had ‘ever used’ opioids for illicit or non-medical purposes in 2016. In 2016, pharmaceutical opioids were involved in more opioid deaths and opioid poisoning hospitalisations than heroin. The rate of opioid deaths increased by 62% from 2007 to 2016.