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Illicit drug use is also linked to substantial adverse health and social outcomes, including mental health disorders and chronic physical morbidities. This study addresses a critical research gap by examining the association between illicit drug use and HRQoL in Australian adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study utilised data from two waves (wave 17 [2017] and wave 21 [2021]) of the Household, Income and Labour Dynamics in Australia (HILDA) Survey and analysed a pooled dataset comprising 29,811 person-year observations from 18,295 unique individuals. HRQoL was assessed using the Physical Component Summary (PCS), the Mental Component Summary (MCS), the Short-Form Six-Dimension utility index (SF-6D), and the eight dimensions of the SF-36 health survey. The study defined illicit drug use as self-reported use of any of the following six drug types in the past 12 months: marijuana\/cannabis, methamphetamine\/amphetamine, cocaine, ecstasy, hallucinogens, and any other illicit drug (e.g., heroin, GHB, ketamine, K2, and synthetics). A binary variable was created to indicate whether an individual used any of these drugs during the specified period. The random-effects generalised least squares (GLS) estimation technique was used to quantify the relationships between illicit drug use and HRQoL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After adjusting for a comprehensive set of covariates, the findings revealed a significant negative association between illicit drug use and mental health. Individuals who reported illicit drug use had markedly lower MCS scores (\u03b2 = -2.29, 95% CI: -2.68, -1.89) compared to non-users. Furthermore, illicit drug use was associated with a significant reduction in SF-6D utility values (\u03b2 = -0.022, 95% CI: -0.026, -0.018), highlighting the adverse impact on overall HRQoL among adults. Illicit drug use was associated with reduced MCS scores and SF-6D utility values across genders and age groups, with greater reduction among young adults aged 15-29 years [(MCS = -2.30, 95% CI: -2.92, -1.68) and (SF-6D = -0.021, 95% CI: -0.027, -0.015)], and male drug users [(MCS = -2.46, 95% CI: -2.93, -1.99), and (SF-6D = -0.021, 95% CI: -0.026, -0.016)].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The study findings confirmed that individuals who use illicit drugs experience significantly lower HRQoL than their peers. Additionally, the study provided a specific disutility value for illicit drug use, offering crucial data for future evaluations of the cost-effectiveness of drug harm reduction programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10198-026-01948-x","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T10:36:55Z","timestamp":1785235015000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating the health-related quality of life burden attributable to illicit drug use in Australian adults"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8747-9891","authenticated-orcid":false,"given":"Syed Afroz","family":"Keramat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rezwanul","family":"Rana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Addisu Shunu","family":"Beyene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabeya","family":"Basri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"1948_CR1","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/S0140-6736(11)61138-0","volume":"379","author":"W Hall","year":"2012","unstructured":"Degenhardt, L., Hall, W.: Extent of illicit drug use and dependence, and their contribution to the global burden of disease. 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The Human Research Ethics Committee of the University of Melbourne has approved this research project. The ethics ID number of the research project (HILDA Survey) is 1647030. The HILDA Survey is conducted under a new human research ethics approval (Project ID 31363, approved February 2025) received from The University of Melbourne. This paper uses unit record data from the HILDA conducted by the Australian Government Department of Social Services (DSS). This study did not require ethical approval as the analysis used only de-identified existing unit record data from the HILDA Survey.","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflicts of interest.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"To participate in the HILDA Survey was obtained through an information letter sent to all potential respondents. This letter described the voluntary nature of participation in The Survey and outlined that informed consent would be implied when participants agreed to be interviewed. Further, more detailed information about the purposes of the HILDA was sent after the interview to Wave 1 respondents (and any new sample members at later waves), along with further information about the way the data are being held, what is being done with the data, and how individuals can, on request (but after undergoing a range of security checks), access that information.","order":3,"name":"Ethics","label":"Informed consent","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors acknowledge the use of Gemini 2.5 Pro (https:\/\/gemini.google.com\/app) and Grammarly to enhance the academic language and readability of this manuscript. On 14 April 2026, the corresponding author used the prompt, \u201cImprove the academic tone and accuracy of language, including grammatical structures, punctuation, and vocabulary,\u201d with Gemini 2.5 Pro. The output was subsequently revised by the authors to align with the intended meaning and style. Grammarly was used for a final proofreading check. The authors retained full responsibility for the final content of this paper.","order":4,"name":"Ethics","label":"Declaration of AI assistance","group":{"name":"EthicsHeading","label":"Declarations"}}]}}