Concern has recently been expressed that rates of illicit drug use in regional Australia are approaching or even exceeding those observed in metropolitan areas of the country. An apparent increase in crime, and particularly property crime, in regional Australia in the past decade has been linked to the suspected increase in drug use. Between 1988 and 1998, use of illicit drugs increased in regional Australia by 77 per cent for heroin, 131 per cent for amphetamines, 37 per cent for cocaine, and 47 per cent for cannabis. Compared to metropolitan Australia, however, there were fewer drug users in regional Australia at the commencement of the decade. The subsequent rates of growth and durability of drug use since then have also been lower in regional Australia. Consequently, the gap in rates of drug use between regional and metropolitan Australia grew over the period rather than diminished. In the circumstances, it is unlikely that rates of drug use in regional Australia will contemporaneously match those found in metropolitan areas of the country in the near future. Nonetheless, illicit drug use is increasing in regional Australia; while the current levels are lower than those found in metropolitan Australia, they approximate rates observed in the cities just a few years ago. Accordingly, lessons learned from the response to drugs in metropolitan areas should be adopted early if regional Australia is to avoid the levels of drug-related social disruption evident in the cities.