In relation to substance-use issues, Aboriginal and Torres Strait Islander primary health-care services provide:

  • health care, including extended care roles (for example, diagnosis and treatment of illness and disease, 24-hour emergency care, dental/hearing/optometry services)
  • preventive health care (for example, health screening for children and adults),
  • health-related community support (for example, school-based activities, transport to medical appointments)

Information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services are available from the Online Services Report (OSR) data collection. While the number of treatment episodes for Aboriginal and Torres Strait Islander people is reported through the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS), it does not represent all alcohol and other drug treatments provided to Indigenous people in Australia. The OSR and AODTS NMDS have different collection purposes, scope and counting rules (see Box 1 for details).

Key data from the 2016–17 OSR relevant to substance-use issues are provided below.

Substance use issues

The most common substance-use issues reported by organisations providing substance-use services that reported to the OSR in 2016–17, in terms of staff time and organisational resources, were alcohol, cannabis and amphetamines (Table 1). In 2016–17, all of the 80 organisations reported alcohol as one of the  most common substance-use issues and almost all (95%) reported cannabis. Organisations reporting amphetamines as a common substance-use issue increased from 70% in 2014–15 to 79% in 2015–16, and slightly increased again to 80% in 2016–17.

Table 1: Number of organisations reporting common substance-use issues, by remoteness area, 2016-17

Substance-use issue

Major cities

Inner regional

Outer regional

Remote

Very remote

Total

Alcohol

16

12

21

19

12

80

Cannabis/marijuana

13

12

20

19

12

76

Amphetamines

14

12

21

10

7

64

Tobacco/nicotine

6

8

15

13

11

53

Multiple drug use

10

8

14

10

6

48

Note: Organisations were asked to report on their 5 most important substance-use issues in terms of staff time and organisational resources.

Source: OSR Data Table S6.4

Substance-use services

In 2016–17, OSR substance-use services provided:

  • 197,671 episodes of care
  • to 39,448 clients
  • by 80 organisations (Table 2).

Remoteness area

  • Around half of the organisations were located in Outer regional areas (26%) and Remote areas (24%), in comparison to organisations in Major cities (20%).
  • Organisations in Outer regional areas provided services to around 6,229 (16%) clients, while organisations in Very remote areas provided services to around 4,634 (12%) clients.

Table 2: Number of substance-use organisations, clients and episodes, by remoteness area, 2016–17

 

Organisations: number

Organisations: per cent

Clients: number

Clients per cent

Episodes: number

Episodes: per cent

Major cities

16

20.0

13,802

35.0

72,362

36.6

Inner regional

12

15.0

1,981

5.0

13,743

7.0

Outer regional

21

26.3

6,229

15.8

33,033

16.7

Remote

19

23.8

12,802

32.5

30,495

15.4

Very remote

12

15.0

4,634

11.7

48,038

24.3

Total

80

100.0

39,448

100.0

197,671

100.0

Source: Derived from multiple OSR Data Tables; S6.2, S6.12, S6.20

Substance use treatment

Substance-use organisations provide treatment and assistance through residential treatment programs, sobering-up services and non-residential programs. In 2016–17:

  • over half of clients (56%) receiving treatment were male
  • most episodes of care (89%) were for non-residential services (e.g. counselling), and male and female clients were equally likely to seek this type of treatment
  • around 19,400 (10%)  episodes of care were provided to clients accessing sobering-up services (overnight residential care, with no formal rehabilitation)
  • 6% of clients received treatment in a residential service (temporary live-in accommodation for formal substance-use treatment and rehabilitation) (Table 3).

Table 3: Estimated number of clients and episodes of care, by sex and treatment type, 2016–17

Treatment type

Males: number

Males: per cent

Females: number

Females: per cent

Unknown: number

Unknown: per cent

Total: number

Total: per cent

Clients

               

Residential

2,090

7.6

867

4.0

5

1.3

2,962

6.0

Sobering-up

5,304

19.2

5,100

23.8

0

0.0

10,404

21.0

Non-residential

20,275

73.3

15,472

72.2

390

98.7

36,137

73.0

Total

27,669

55.9

21,439

43.3

395

0.8

49,503

100.0

Episodes

               

Residential

2,316

2.1

1,018

1.2

5

0.1

3,339

1.7

Sobering-up

10,193

9.4

9,197

10.7

0

0.0

19,390

9.8

Non-residential

95,826

88.5

75,680

88.1

3,436

99.9

174,942

88.5

Total

108,335

54.8

85,895

43.5

3,441

1.7

197,671

100.0

Note: Client numbers will differ to those presented in Table 2 as clients may be counted more than once if they attended multiple programs. In addition, data from some organisations have been excluded due to data quality issues.

Source: Derived from multiple OSR Data Tables; S6.14, S6.17, S6.18, S6.22-S6.24

In 2016–17 there was minimal change to the services provided for substance-use issues compared to 2015–16 (Figure 1). Most organisations have continued to provide services for the same substance issues with minimal variation between years, with the exception of other substance use services.

The number of substance-use issues reported for both benzodiazepines and petrol use declined in 2016–17; with the former (services for benzodiazepine use) declining steadily; from 2014–15 (24%), to  2016–17 (20%), while services for petrol use have continued to range between 15% to16% over the last three years.  

Figure 1: Proportion of substance-use issues treated by organisations, 2015–16 and 2016–17

This bar chart shows the proportion of substance-use issues treated by organisations by type of issue in 2015–16 and 2017–18. Alcohol and cannabis/marijuana were the most common issues, and morphine and ecstasy the least common.

Note: Organisations were asked to report on their 5 most important substance-use issues in terms of staff time and organisational resources. For 2015–16 n=80;  For 2016–17: n=80

Source: OSR Data Table S6.5

Box 1: Comparison of treatment episode definitions in the OSR and AODTS NMDS

The OSR definition of ‘episodes of care’ starts at admission and ends at discharge (for residential treatment/rehabilitation and sobering-up/respite). Non-residential programs/follow –up/after care ‘episodes of care’ are defined to include contact with clients through counselling, assessment, treatment, education, support or follow up from residential services. In contrast to the definition of ‘closed treatment episode’ used in the AODTS NMDS, the definition used in this collection does not require agencies to begin a new ‘episode of care’ when the main treatment type (‘treatment type’) or primary drug of concern (‘substance/drug’) changes. It is therefore likely that this concept of ‘episode of care’ produces smaller estimates of activity than the AODTS NMDS concept of ‘closed treatment episode’.

The OSR collection, managed by the AIHW, records information about clients of any age, whereas the AODTS NMDS reports only about clients aged 10 and over.

These differences mean that the two collections are not directly comparable.

Reference

  1. Australian Institute of Health and Welfare (AIHW) 2018. Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2016–17. Aboriginal and Torres Strait Islander health services report No. 9. Cat. no. IHW 196. Canberra: AIHW.