Alcohol and other drug treatment services in Australia 2018–19: key findings

In 2018–19, 440 publicly funded alcohol and other drug treatment agencies in New South Wales provided 52,563 closed treatment episodes to 30,814 clients (Tables SA.1 and SCR.21). NSW reported an increase of 6,739 closed treatment episodes compared with 2017–18 (45,824 closed episodes) (Table SE NSW.3).

In 2018–19, most (77%) clients in New South Wales attended 1 agency, and received an average of 1.7 closed treatment episodes, which is similar to the national average of 1.6 episodes (Tables SCR.21 and SCR.23).

Client demographics

In 2018–19:

• nearly all (97%) clients in New South Wales received treatment for their own alcohol or drug use, of which, most were male (66%) (Figure 1; Table SC NSW.1)
• clients who received treatment or support for someone else’s alcohol or drug use were more likely to be female (68%)
• over half (52%) of all clients were aged 20–39 years (Table SC NSW.2)
• over 1 in 6 (16%) clients identified as Indigenous Australians (Table SC NSW.3). This is consistent with the national proportion (17%) (Table SC.4)
• the majority (87%) of clients were born in Australia and nearly all (97%) reported English as their preferred language (Tables SC NSW.21 and SC NSW.22).

Patterns of service use:

In New South Wales, of the 30,814 clients who received treatment in 2018–19:

• 58% (17,875) received treatment in 2018–19 only
• 13% (3,944) received treatment in both 2017–18 and 2018–19
• 4.3% (1,338) received treatment in each year from 2016–17 to 2018–19
• 2.1% (641) received treatment in each year from 2015–16 to 2018–19
• 1.8% (551) received treatment in all years, from 2014–15 to 2018–19.

Over the period 2014–15 to 2018–19, 96,634 clients received treatment in New South Wales. Of those:

• 73% (70,459) received treatment in only a single year
• 18% (17,872) received treatment in any 2 of the 5 years
• 6.1% (5,867) received treatment in any 3 of the 5 years
• 2.0% (1,885) received treatment in any 4 of the 5 years
• 0.6% (551) received treatment in all 5 collection years.

Drugs of concern

In 2018–19, for clients in New South Wales receiving treatment episodes for their own alcohol or drug use:

• alcohol was the most common principal drug of concern (39% of episodes) (Figure 2; SE NSW.10)
• amphetamines as a principal drug of concern accounted for over one-quarter of episodes (26%), followed by cannabis (16%), and heroin (8%). This is consistent with the national picture (Table SD.1); where amphetamines were the principal drug of concern, the most common method of use was smoking (47%), followed by injecting (42%)
• within the amphetamines code group, methamphetamine was reported as a principal drug of concern in over half (62%) treatment episodes; in nearly half of the treatment episodes where methamphetamine was the principal drug of concern (48%) smoking was the most common method of use. This was followed by injecting (42%) (Figure 2b).

Some jurisdictions are working with service providers to encourage more specific reporting of amphetamine use (i.e. to reduce the use of ‘amphetamines not further defined’ code where possible).   

Clients can nominate up to 5 additional drugs of concern, these drugs are not necessarily the subject of any treatment within the episode (see Technical notes).

In 2018–19, when the client reported additional drugs of concern:

• nicotine was the most common additional drug of concern (13% of episodes), followed by cannabis (12%), amphetamines (8%), and alcohol (7%) (Table SE NSW.11).

Over the period 2014–15 to 2018–19:

• alcohol remained the most common principal drug of concern in treatment episodes provided to clients, even though the proportion of these episodes declined (from 42% to 39%)
• amphetamines replaced cannabis in 2014–15 as the second most common principal drug of concern in New South Wales, and has increased since 2014–15 (from 21% to 26%)
• within the amphetamines code group, methamphetamine was reported as the principal drug of concern in over half of episodes (55%) in 2014–15, rising to 56% in 2015–16 and 2016–17, 63% in 2017–18 and 62% in 2018–19 (Figure 2a); the rise in episodes could be related to an increase in funded treatment services and/ or improvement in agency coding practices for methamphetamines
• cannabis is now the third most common principal drug of concern, decreasing from 19% to 16% in 2018–19
• These trends are consistent with the national picture (Table SD.2).

Treatment

In 2018–19, the majority of closed treatment episodes for all clients in New South Wales, included:

• counselling as the most common main treatment provided (39% of episodes), followed by assessment only (15%) and withdrawal management (15%), and support and case management only (13%) (Figure 3; Table SE NSW.20)
• where an additional treatment was provided as a supplementary to the main treatment, ‘other’ treatment (9%) was the most common followed by counselling (7%).

Over the period 2014–15 to 2018–19:

• counselling remained the most common main treatment type for all episodes, significantly decreasing from 42% in 2016–17 to 37% in 2017–18, then rising to 39% in 2018–19 (Table SE NSW.20)
• withdrawal management remained stable from 2014–15 (17%) to 2016–17 (17%), then decreasing (15%) in 2018–19.

Agencies

In 2018–19, in New South Wales:

• almost two-thirds (64%) of AOD agencies were government treatment agencies
• the majority (64%) of the 440 publicly funded treatment agencies were located in Major cities, followed by Inner regional areas (28%) (Figure 4; Table SA.3)
• agencies located in Major cities provided 66% of all closed treatment episodes (Table SA.4)
• less than 1% of treatment agencies were located in Remote areas
• across all remoteness areas, the majority of agencies were government agencies, ranging from 60% in Remote areas to 64% in Major cities.

In the period 2009–10 to 2018–19, the number of publicly funded treatment agencies in New South Wales rose from 258 to 440 (Table SA.1).