Source of referral for AOD treatment
Treatment referrals aim to reduce the immediate or short-term harms of alcohol and other drug (AOD) use, as well as to engage, support, and connect people to treatment services where needed. Clients can enter or be referred to AOD treatment via numerous sources. The Alcohol and Other Drug Treatment National Minimum Data Set (AODTS NMDS) includes information about the referral source for each treatment episode, including corrections, drug diversion programs, health services, self/family, and other.
AODTS NMDS data reported annually consistently show that referrals via drug diversion programs account for a substantial proportion of treatment episodes provided to clients for their own use of cannabis (AIHW 2023). Almost half (48%) of all clients who received treatment for cannabis between 2013–14 and 2021–22 were referred via diversion at some point during the period (Table 3.6). This was higher than for clients who received treatment for other principal drugs of concern, such as alcohol (14% of episodes) or amphetamines (31%), noting that some clients may have received treatment for multiple principal drugs of concern. For more information on diversion programs, see below.
Referral to AOD treatment via drug diversion programs
In Australia, drug diversion treatment programs (‘diversion programs’) divert people who have been apprehended or sentenced for a minor drugs offence from the criminal justice system to drug treatment agencies. Diversion has several objectives, including:
- Preventing negative labelling and stigma associated with criminal conduct and contact with the criminal justice system.
- Preventing further offences by minimising a person’s contact with, and progression through, the criminal justice system.
- Reducing courts and prisons caseloads, lowering costs and delays of court processes and incarceration.
- Reducing unnecessary social controls.
- Providing appropriate interventions to offenders who are in need of treatment or other services.
Treatment services for clients referred via diversion programs range from short-term assessment (for example, information or education sessions) to longer-term treatments (for example, counselling, withdrawal management). Two key types of diversion programs are captured in AODTS NMDS data. Police diversion occurs when an offence is first detected by a law enforcement officer. This typically applies for minor drug offences (for example, drug possession or use), often relating to cannabis. The offender may receive a caution or fine and will sometimes be required to attend mandatory drug assessment or education sessions. Court diversion occurs after a charge has been laid, usually for offences where criminal behaviour was related to drug use (for example, burglary or public order offence). Bail-based programs generally involve drug assessment and treatment, while pre– and post–sentence programs (such as drug courts) are aimed at repeat offenders and may involve more intensive treatment (AIHW 2023). States and territories have different diversion programs and policies:
- New South Wales: Magistrates Early Referral into Treatment
- Victoria: Diversion Services
- Queensland Court Illicit Drug Diversion
- Western Australia Court Diversion Programs
- South Australia: Magistrates Court Treatment Intervention Court
- Tasmania: Court Mandated Diversion and Drug Treatment Orders
- Australian Capital Territory: Police and Court Drug Diversion Service
- Northern Territory Youth Diversionary Program
Process analysis by episode source of referral
Process analysis describes the flow of treatment episodes provided to clients who received treatment for cannabis, by key treatment characteristics. This includes all treatment episodes provided to clients, including those who received multiple episodes over the study period. For more information, see What is process analysis?
Process analysis by source of referral indicated that referral pathways into treatment differed depending on whether clients received treatment for cannabis only or cannabis and another PDOC (Table 3.7).
Of treatment episodes provided to clients who:
- Only received treatment for cannabis, almost half (47%) of all clients’ initial episodes involved a referral via diversion. For clients following this path through the AOD system, most treatment ceased at this point and there were no subsequent episodes (82% of initial diversion episodes).
- Received treatment for cannabis and another PDOC, the most common referral for a client’s initial treatment episode was self/family (31%), followed by a health service (24%) or diversion (22%). For clients whose initial episodes were self/family, half (50%) of these episodes were followed by a subsequent episode with self/family as the referral source (Table 3.7).
Trace analysis of referral pathways
Traces display the most common treatment pathways among clients who received treatment for cannabis, by key treatment characteristics. The traces represent sequences of treatment episodes in the order in which clients received treatment within the study period. For more information, see What is trace explorer analysis?.
Trace analysis indicated that there were around 21,100 unique sequences by referral source among clients who received treatment for cannabis between 2013–14 and 2021–22. The most common sequences varied by cohort (Figure 11; Table 3.8).
Figure 11: Treatment pathways for clients who received treatment for cannabis, by referral source, cohort, and age group, sex, or remoteness area, 2013–14 to 2021–22
This figure shows traces for AODTS clients who received treatment for cannabis from 2013-14 to 2021-22 by source of referral. The 5 most common pathways are broken down by age, sex, and remoteness. A toggle is available to view the traces by the different cohorts, "Cannabis ever", "Cannabis only", and "Cannabis and other" and different measures, "Number of clients", "Per cent", and "Cumulative per cent".
For clients who received treatment for cannabis only, around 2 in 5 (41%) clients received either one or 2 diversion referral episodes. This pathway was consistent across most age groups but differed by sex and remoteness area (Figure 11; Table 3.8).
- For males (44% of clients) and those living in Remote or Very remote areas (43%), the 2 most common treatment referral pathways followed the overall pattern (that is, one or 2 episodes referred by diversion).
- For females (37% of clients) and those living in Major cities (56%), Inner regional areas (52%), or Outer regional areas (52%), the 2 most common referral pathways involved one diversion referral episode or one from a health service.
For clients who received treatment for cannabis and another PDOC, the most common referral pathway involved 2 diversion referral episodes. However, this pathway accounted for just 1 in 30 (3.4%) clients and varied across client groups.
- The most common referral pathway for males involved 2 diversion referral episodes (3.9%), whilst for females the most common pathway was 2 episodes referred by health services (2.9%).
- The most common referral pathway for those aged 10–19 and 20–29 was 2 diversion episodes (5.5% and 3.1%, respectively), whilst for those aged 30–39 and 40–49 it was 2 episodes referred from self/family (3.0% and 3.7%, respectively), and for those aged 50 and over was 2 episodes referred from health services (4.3%).
- The most common referral pathway for those living in Major cities and Inner regional areas involved 2 diversion referral episodes (4.2% and 3.1%, respectively), while for those in Outer regional areas and Remote and Very remote areas the most common pathway was 2 episodes referred from self/family (3.3%) and 2 episodes referred by health services (3.3%), respectively.
AIHW (Australian Institute of Health and Welfare) (2023) Alcohol and other drug treatment services in Australia annual report, AIHW, Australian Government, accessed 1 March 2024.