OBJECTIVES: To determine the characteristics and population rates of barbiturate-related hospitalisations, treatment episodes, and deaths in Australia, 2000-2018.

DESIGN, SETTING: Analysis of national data on barbiturate-related hospitalisations (National Hospital Morbidity Database, 1999-2000 to 2017-18), drug treatment episodes (Alcohol and Other Drug Treatment Services National Minimum Data Set, 2002-03 to 2017-18), and deaths (National Coronial Information System, 2000-01 to 2016-17).

MAIN OUTCOME MEASURES: Population rates directly age-standardised to the 2001 Australian standard population; average annual percentage change (AAPC) in rates estimated by Joinpoint regression.

RESULTS: We identified 1250 barbiturate-related hospitalisations (791 cases of deliberate self-harm [63%]), 993 drug treatment episodes (195 cases with barbiturates as the principal drug of concern [20%]), and 511 deaths during the respective analysis periods. The barbiturate-related hospitalisation rate declined from 0.56 in 1999-2000 to 0.14 per 100 000 population in 2017-18; the declines in hospitalisations related to accidental poisoning and intentional self-harm were each statistically significant. Despite a drop from 0.67 in 2002-03 to 0.23 per 100 000 in 2003-04, the drug treatment episode rate did not decline significantly. The population rate of barbiturate-related deaths increased from 0.07 in 2000-01 to 0.19 per 100 000 population in 2016-17; the rate of intentional self-harm deaths increased, but not that of accidental deaths.

CONCLUSIONS: While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.