Alcohol: client demographics and treatment

In 2019–20, alcohol was reported as a drug of concern in almost half (45%) of all closed treatment episodes, either as a principal or additional drug of concern:

  • alcohol was the most common principal drug of concern in over one-third (34% or 75,005) of treatment episodes
  • additional drugs of concern reported with alcohol, included cannabis (34%) or nicotine (30%) but these drugs are not necessarily the subject of any treatment within the episode (Figure DRUGS1; tables SD.6–8).

Alcohol dependence and harm

Alcohol is a central nervous system depressant that inhibits brain functions, dampens the motor and sensory centres, and makes judgment, coordination and balance more difficult (NDARC 2010).

The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) developed by the World Health Organisation identifies people whose substance use may be causing them harm. High scores indicate a possible substance dependence issue while moderate scores indicate substance use that maybe harmful or hazardous to the person’s health. The ASSIST-Lite is an abridged version of the ASSIST and was incorporated into the NDSHS in 2019 to estimate how many people show signs of substance dependence or a pattern of use which may be hazardous to their health.

Results from the 2019 National Drug Strategy Household Survey (NDSHS) (AIHW 2020) showed that:

  • 77% of Australians aged 14 and over drank alcohol in the previous 12 months
  • ASSIST-Lite scores indicated, of those Australians who had an alcoholic drink in the previous 12 months, 9.9% were likely to meet the criteria for alcohol dependence. Males (13.5%) were more likely to receive this score compared to females (6.3%).
  • A further 29% of this population were using alcohol to a hazardous or harmful extent with males (36%) more likely to meet this threshold than females (22%).
  • Of the Australian population aged 14 and over, this equates to 7.5% who may be experiencing alcohol dependence and would benefit from specialist treatment and a further 22% who are likely to be using alcohol in a harmful way (AIHW 2020).

Client demographics

In 2019–20, 42,426 clients received treatment for alcohol as a principal drug of concern; around two-thirds of these clients were male (65%) and 1 in 6 were Indigenous Australians (18%) (tables SC.6, SC.8).

For clients whose principal drug of concern was alcohol:

  • clients were most likely aged 40–49 (26% clients), followed by 30–39 (25%) (Figure ALCOHOL1; Table SC.7).
  • the rate of Indigenous Australian clients receiving treatment remains high, fluctuating over the years from 1,140 per 100,000 people in 2015–16 to 1,209 in 2019–20 (Table SCR.26).

Figure ALCOHOL1: Clients with alcohol as a principal drug of concern, by sex and age group, 2019–20 (%)

The butterfly bar graph shows clients with a principal drug of concern of alcohol were most likely to be aged 30–49 in 2019–20. This pattern was similar for both male (51%) and female (50%) clients.

Treatment

Over the 10-year period to 2019–20 where alcohol was the principal drug of concern (Figure ALCOHOL2):

  • the number of episodes increased from 68,167 in 2010–11 to 75,005. However, proportionally, treatment for alcohol in relation to all other drugs has decreased from 47% to 34%, although remains the most common
  • counselling, withdrawal management and assessment only have remained the most common main treatment types:
    • counselling accounted for 38% (28,226) of treatment episodes in 2019–20, decreasing from 42% in 2010–11
    • assessment only accounted for 18% (13,498) of episodes, increasing from 15% 
    • withdrawal management accounted for 14% (10,197) of episodes, decreasing by 5 percentage points over this period (Table SD.26).
  • 2 in 3 (66%) treatment episodes for withdrawal management were for clients aged 40 and over (Table SD.25).
  • the most common source of referral has remained self/family (42% in 2019–20), followed by a health service (41%) increasing from 30% over the 10-year period.
  • source of referral from the criminal justice system (diversion) fell from 11% in 2010–11 to 2% in 2019–20 (Table SD.17). 

Figure ALCOHOL2: Closed treatment episodes with alcohol as a principal drug of concern, by main treatment type, reason for cessation or source of referral, 2010–11 to 2019–20 (%)

The line graph shows that where alcohol was the principal drug of concern, counselling remained the most common main treatment type, fluctuating from 42% in 2010–11 to 45% in 2013–14 and 38% in 2019–20. Withdrawal management was the second most common main treatment type across most years, ranging from 16% in 2010–11 to 18% in 2017–18. Assessment only replaced Withdrawal management as the second most common main treatment type in 2019–20 and 2018–19. .

Treatment setting and reason for cessation varied somewhat by treatment type and source of referral. For alcohol-related treatment episodes in 2019–20 (Table SD.28):

  • almost 2 in 3 treatment episodes took place in a non-residential treatment facility (63%), with about 1 in 6 (16%) occurring in a residential treatment facility
  • counselling as the main treatment type most commonly (86%) took place in a non-residential treatment facility
  • in contrast, withdrawal management and rehabilitation as main treatment types most commonly occurred in a residential facility (60% and 73%, respectively) (Table SD.28)
  • 3 in 10 (30%) closed treatment episodes lasted 2 days to 1 month, and 24% lasted 1–3 months (Table SE.25)
  • the median duration of episodes was just under 4 weeks (26 days) (Table SD.33)
  • around 6 in 10 (62%) episodes ended with a planned cessation, while about 1 in 5 (19%) ended unexpectedly; that is, the client ceased to participate against advice, without notice or due to non-compliance.

For more information on the groupings for reasons for cessation of treatment, see Technical notes.

References

See reference list.