Australian Institute of Health and Welfare (2021) Alcohol and other drug treatment services in Australia annual report., AIHW, Australian Government, accessed 01 December 2021
Australian Institute of Health and Welfare. (2021). Alcohol and other drug treatment services in Australia annual report. Retrieved from https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Alcohol and other drug treatment services in Australia annual report. Australian Institute of Health and Welfare, 16 July 2021, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare. Alcohol and other drug treatment services in Australia annual report [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Dec. 1]. Available from: https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol and other drug treatment services in Australia annual report, viewed 1 December 2021, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
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In 2019–20, pharmaceutical drugs were reported in 12% of all closed treatment episodes, either as a principal or additional drug of concern:
Pharmaceuticals are drugs that are available from a pharmacy—over the counter or by prescription—which may be subject to misuse (MCDS 2011). Results from the National Drug Strategy Household Survey showed that, in 2019, 4.2% of Australians aged 14 and over reported non-medical, or extra-medical use of a pharmaceutical in the last 12 months (including pain killers/pain-relievers and opioids, tranquillisers/sleeping pills, steroids, or methadone/buprenorphine). This represents a decline in recent use, down from 4.8% in 2016 (AIHW 2020). This decline may in part be due to the rescheduling of codeine to a schedule 4 drug in February 2018, meaning that codeine could no longer be purchased from a pharmacy or chemist without a prescription. Between 2016 and 2019, codeine use halved (from 3.0% to 1.5%).
Pharmaceuticals are not listed as a broad drug group in the Australian Standard Classification of Drugs of Concern (ASCDC) classification. In the Alcohol and Other Drug Treatment Services National Minimum Dataset report, 10 drug types were identified as making up the group ‘pharmaceuticals’ for the purposes of this analysis: codeine, morphine, buprenorphine, oxycodone, methadone, benzodiazepines, steroids, other opioids, other analgesics, and other sedatives and hypnotics. Further information corresponding to the ASCDC codes and classifications is in Technical notes. Of these drugs, the most common classes are benzodiazepines and opioids (e.g., codeine).
Opioids are a class of depressant drugs originally derived from the opium poppy, including both heroin and medicinal (pharmaceutical) opioids such as morphine and oxycodone. Pharmaceutical opioids are commonly prescribed for pain relief as they have strong analgesic effects; however, these drugs also produce effects including sedation and euphoria, and can be associated with negative health outcomes such as dependence and overdose (ADF 2020). Some people may purchase opioids illegally, or use their own medicine to become intoxicated; for example, by taking a higher dose than recommended.
Benzodiazepines are depressant drugs: they slow down the activity of the central nervous system and the speed of messages going between the brain and the body. Formerly known as ‘minor tranquillisers’, benzodiazepines are most commonly prescribed by doctors to relieve stress and anxiety, and to aid sleep. They are a drug of dependence, and are associated with fatal and non-fatal overdose among people who use opioids. Some people use benzodiazepines illegally to become intoxicated or to come down from the effects of stimulants, such as amphetamines or cocaine (ADF 2013).
Over the 10-year period, the proportion of treatment episodes with a pharmaceutical drug as the principal drug of concern decreased from 7% (10,231 of episodes) in 2010–11 to 5% (9,904 episodes) in 2019–20 (Figure PHARMS1).
In 2019–20, among treatment episodes with a pharmaceutical as the principal drug of concern:
The line graph shows that alcohol has remained the most common main principal drug of concern over this period, fluctuating from 47% in 2010–11 to 32% in 2015–16 and 34% in 2019–20. The proportion of treatment episodes for amphetamines has consistently increased over this same period, rising from 8.7% in 2010–11 to overtake cannabis as the second most common principal drug of concern in 2015–16 at 23% and reaching 28% in 2019–20. The proportion of treatment episodes for cannabis as the principal drug of concern has decreased, falling from 24% in 2014-15 to 18% in 2019–20.
This line graph shows the proportion of closed treatment episodes for 7 pharmaceutical drugs of concern between 2010–11 and 2019–20. Benzodiazepines were the most common pharmaceutical drug of concern, rising from 17% in 2015–16 to 28% in 2019–20. This was followed by methadone, dropping from 19% in 2015–16 to 11% in 2019–20 and codeine, also falling from 14% in 2015–16 to 5.3% in 2019–20.
Over the 10-year period from 2010–11 to 2019–20, among treatment episodes with a pharmaceutical drug as the principal drug of concern:
Where pharmaceuticals were the principal drug of concern in 2019–20:
In 2019–20, for clients whose principal drug of concern was a pharmaceutical drug:
In 2019–20, for treatment episodes where a pharmaceutical drug was the principal drug of concern:
The relative proportions of treatment episodes for each main treatment type by individual pharmaceuticals varied substantially (Figure PHARMS3). For example, in 2019–20:
The grouped vertical bar graph shows that within each treatment type, the selected pharmaceutical drug of concern varied substantially in 2019–20. Where counselling was a main treatment almost 1 in 10 treatment episodes were for codeine (31%) followed by benzodiazepines (29%) and morphine (24%). The principal drugs of concern where withdrawal management was the main treatment type was highest for benzodiazepines (18%), followed by oxycodone (14%) and buprenornorphine (13%).
For treatment episodes where a pharmaceutical drug was the principal drug of concern in 2019–20:
In 2019–20, for treatment episodes where benzodiazepines were the principal drug of concern:
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