Australian Institute of Health and Welfare (2022) National Opioid Pharmacotherapy Statistics Annual Data collection, AIHW, Australian Government, accessed 18 August 2022.
Australian Institute of Health and Welfare. (2022). National Opioid Pharmacotherapy Statistics Annual Data collection. Retrieved from https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
National Opioid Pharmacotherapy Statistics Annual Data collection. Australian Institute of Health and Welfare, 30 March 2022, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare. National Opioid Pharmacotherapy Statistics Annual Data collection [Internet]. Canberra: Australian Institute of Health and Welfare, 2022 [cited 2022 Aug. 18]. Available from: https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
Australian Institute of Health and Welfare (AIHW) 2022, National Opioid Pharmacotherapy Statistics Annual Data collection, viewed 18 August 2022, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/national-opioid-pharmacotherapy-statistics
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Around 47,500 people received opioid pharmacotherapy treatment in 2021.
On a snapshot day in 2021, 47,563 people were receiving pharmacotherapy treatment for their opioid dependence across Australia (excluding data for Queensland). This is a rate of 23 pharmacotherapy clients per 10,000 people (Figure CLIENTS1; Tables S1 and S2).
Between 2011 and 2020, the number of clients receiving treatment increased by 14% (from 46,446 to 53,316 clients) (Table S1). Adjusting for population growth, the rate of clients remained relatively stable nationally over the same period (between 20 and 21 clients per 10,000 people each year). The lower client number and higher client rate in 2021 are likely due to the exclusion of Queensland data, as data were unavailable at the time of reporting. Refer to the Technical notes for information on the impacts of COVID-19 on population estimates and effects on rates in 2021.
On a snapshot day in 2021, 23 clients per 10,000 population received pharmacotherapy treatment in Australia (excluding data for Queensland). This ranged from 7 clients per 10,000 population in the Northern Territory to 30 clients per 10,000 in New South Wales.
Refer to the Data tables for more information.
In 2021, consistent with previous years:
Client numbers have fluctuated over time within jurisdictions (Table S1). Variation in client numbers may be influenced by system changes, coding practices and changes in treatment policies or capacity within jurisdictions.
In both 2020 and 2021, there were increases in client numbers in New South Wales. These increases may be due to the introduction of buprenorphine LAI, particularly in correctional facilities, which may have contributed to additional prescribing of buprenorphine in correctional facilities. Some New South Wales Local Health Districts also reported an increased capacity to take on new patients following the introduction of buprenorphine LAI.
The median age of opioid pharmacotherapy clients was 44 years.
On a snapshot day in 2021, the median age of clients across all pharmacotherapy drug types in Australia was 44 years (excluding Queensland). This remained stable from 2020, but is an increase from 38 years in 2011. Clients in Western Australia and South Australia had the highest median age (45 years), while clients in Tasmania had the lowest median age (42 years) (Table S5).
In 2021, just over 1 in 3 clients (36% or 16,963 clients) were aged 40–49 years, the highest proportion of any age group. A further 24% (11,479 clients) were aged 30–39 years and 22% (10,276) were aged 50–59 years (Figure CLIENTS2; Table S6).
Since 2011, the proportion of clients aged under 30 or 30–39 has decreased (from 15% and 40% in 2011 to 8.0% and 24% in 2021, respectively). Conversely, the proportion of clients in the older age groups (40–49, 50–59 and 60 and over) has increased since 2011 (Figure CLIENTS2; Table S6).
On a snapshot day in 2021, most clients were aged 40–49 years (36% of clients), 30–39 years (24%) or 50–59 years (22%). Between 2011 and 2021, there was an increase in the proportion of clients aged 40 and over. In the same period, there was a decline in the proportion of clients aged 39 years and under.
The increases in client median age since 2011 and the growing proportion of clients in older age groups continues the trend of an ageing cohort in opioid pharmacotherapy treatment. This is consistent with the pattern observed in other drug treatment services (AIHW 2021). This may be due to:
While methadone was the most commonly prescribed pharmacotherapy drug across all age groups, the proportion of clients who received methadone increased with age. The median age was also higher for clients receiving methadone (46 years) compared to overall (44 years) (Table S5). Conversely, the proportion of clients who received buprenorphine decreased with age (Figure CLIENTS3).
On a snapshot day in 2021, the proportion of opioid pharmacotherapy clients receiving methadone was higher for older age groups. Over 3 in 4 clients (77%) aged 60 and over received methadone as pharmacotherapy, compared to 42% of clients aged under 30. By comparison, 41% of clients aged under 30 received buprenorphine as pharmacotherapy compared to 17% of clients aged 60 and over.
More males than females received opioid pharmacotherapy treatment.
On a snapshot day in 2021, over 2 in 3 clients (68% or 32,576 clients) receiving pharmacotherapy treatment were male (excluding data for Queensland). This proportion was similar for each of the 4 pharmacotherapy drug types (methadone, buprenorphine, buprenorphine-naloxone and buprenorphine LAI). This has remained stable since 2011 (Table S7). The sex classification of ‘Other’ was included in the NOPSAD collection for the first time in 2021, but was not reported in text due to small cell sizes. Refer to the Technical notes for more information.
The rate of clients receiving pharmacotherapy treatment was highest among those aged between 40 and 49, peaking at 41 years for males and 42 for females (excluding data for Victoria and Queensland). Notably, the peak rate for males (97 clients per 10,000 people) was more than twice as high as the peak for females (45 per 10,000) (Figure CLIENTS4; Table S24).
On a snapshot day in 2021, the rate of pharmacotherapy clients per 10,000 population peaked at the age of 41 years for males (96 clients per 10,000 population) and 42 years for females (45 clients per 10,000 population).
Almost half of all Aboriginal and Torres Strait Islander clients receiving opioid pharmacotherapy treatment were treated with methadone.
On a snapshot day in June 2021, there were 5,715 Aboriginal and Torres Strait Islander clients receiving pharmacotherapy treatment in Australia (excluding data for Queensland) (Table S9). This represents 12% of all clients and is a rate of 90 clients per 10,000 Indigenous Australians.
Of those Indigenous Australian clients whose pharmacotherapy drug type was reported (82% or 4,679 clients), almost half (48% or 2,267 clients) were treated with methadone in 2021 (excluding data for Queensland and Victoria). The remaining Indigenous Australian clients were treated with buprenorphine (43% or 2,026 clients), buprenorphine-naloxone (7% or 305 clients) or buprenorphine LAI (2% or 81 clients). Victoria provides the total number of clients receiving opioid pharmacotherapy but does not provide pharmacotherapy drug type by Indigenous status (Table S9).
From 2016 to 2021, the proportion of Indigenous clients receiving treatment with:
In 2021, Victoria had the highest rate of Indigenous opioid pharmacotherapy clients (159 clients per 10,000 Indigenous Australians, or 1,036 clients) followed by New South Wales (133 clients per 10,000 Indigenous Australians, or 3,880 clients). The Northern Territory had the lowest rate of Indigenous clients (6 clients per 10,000 Indigenous Australians, or 44 clients) (Table S9). Refer to the Technical notes for more information on rates of Indigenous clients in 2021.
Methadone continued to be the most commonly prescribed opioid pharmacotherapy drug, but the proportion of pharmacotherapy clients receiving buprenorphine is rising.
On a snapshot day in 2021, around 6 in 10 clients (58% or 27,732 clients) received methadone as pharmacotherapy treatment (excluding data for Queensland). A further 23% (10,991 clients) received buprenorphine (Table S4). The number of clients receiving buprenorphine may be inflated, as New South Wales includes clients receiving buprenorphine-naloxone or buprenorphine LAI in the number of clients receiving buprenorphine.
The proportion of clients receiving each of the pharmacotherapies varies across states and territories (Figure CLIENTS5; Table S4). This may be driven by jurisdictional differences in pharmacotherapy guidelines. In 2021:
On a snapshot day in 2021, almost 2 in 5 (58%) clients received methadone as pharmacotherapy across Australia (excluding data for Queensland). The next most common pharmacotherapy drug type was buprenorphine (23% of clients), followed by buprenorphine-naloxone (15%) and buprenorphine LAI (3.4%). Methadone has remained the most common pharmacotherapy drug type since 2016.
Over the past decade, the proportion of clients receiving methadone has fallen, while for buprenorphine it has increased. From 2011 to 2021, treatment with:
The number of clients receiving buprenorphine may be inflated, as New South Wales includes clients receiving buprenorphine-naloxone or buprenorphine LAI in the number of clients receiving buprenorphine.
Changes in the proportions of clients receiving each pharmacotherapy drug type likely relate to factors such as clinical guidelines and the availability of new pharmacotherapy drug formulations.
Most opioid pharmacotherapy clients were continuing pharmacotherapy treatment.
Clients interact with the pharmacotherapy treatment system in a number of ways. A client’s status may differ according to whether they are:
In 2021, client status data were available for New South Wales, Victoria, Western Australia, Tasmania, the Australian Capital Territory and the Northern Territory (data for Queensland are excluded). Western Australia was not able to record the number of clients who were classed as ongoing or re-entering treatment in 2021 due to system changes; these clients are presented as ‘Not stated’ in this report.
Across jurisdictions with available data, over 2 in 3 clients (68% or 30,132) were classed as ongoing. A further 17% (7,473 clients) were new to treatment in 2021, and 8.7% (3,865) were re-entering treatment (Table S11). The proportion of clients re-entering treatment ranged from 3.7% in New South Wales to 22% in the Australian Capital Territory (Figure CLIENTS6; Table S11).
On a snapshot day in 2021, most clients were ongoing in all states and territories except Western Australia. This ranged from 84% in Tasmania to 61% in Victoria. Data were only available from New South Wales, Victoria, Western Australia, Tasmania, the Australian Capital Territory and the Northern Territory.
Heroin was the most commonly reported opioid drug of dependence for pharmacotherapy clients.
Clients can receive pharmacotherapy treatment for a range of opioid drugs. These include illicit opioids (such as heroin), and pharmaceutical opioids (such as oxycodone) available by prescription or through illicit means. From 1 February 2018, all over-the-counter (non-prescription) codeine-containing medicines for pain relief, cough and colds became available by prescription only.
Data for opioid drug of dependence should be used with caution due to the high proportion of clients with ‘Not stated/not reported’ as their opioid drug of dependence (35% of clients in 2021). In New South Wales, patients who transfer from one program to another (for example, by changing opioid pharmacotherapy drug or prescriber) have a higher rate of ‘Not stated/not reported’ than those clients who do not have program changes.
Pharmacotherapy drugs may be subject to misreporting if a client’s treatment drug is reported instead of the opioid drug of dependence which led to the client seeking treatment.
Nationally, around 4 in 10 clients (44% or 21,058 clients) reported heroin as their opioid drug of dependence (excluding data for Queensland). Oxycodone (4.7% or 2,228 clients) was the next most commonly reported drug of dependence, followed by buprenorphine (4.3% or 2,024 clients) and methadone (3.3% or 1,582 clients) (Figure CLIENTS7; Table S10).
Between 2016 and 2021, heroin was the most common opioid drug of dependence among pharmacotherapy clients (excluding Not stated/not reported). The proportion of clients with heroin as the drug of dependence declined from 40% in 2016 to 37% in 2020, before increasing to 44% in 2021. Across the period, there was a high proportion of Not stated/not reported responses (35% in 2021). All other opioid drugs of dependence remained relatively stable.
These proportions include ‘Not stated/not reported’ but were similar among the 65% of clients (31,026 clients) with a reported opioid drug of dependence (Table S10). In 2021, high rates of ‘Not stated/not reported’ were recorded in New South Wales (60% of clients), Tasmania (16%) and Western Australia (15%).
Heroin was the most common drug of dependence in all states and territories with available data, except Tasmania and the Northern Territory. In these jurisdictions, morphine was the most common drug of dependence (Table S10).
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NSW Ministry of Health (2015) Older People’s Drug and Alcohol Project – Full Report, NSW Ministry of Health, NSW Government, accessed 14 January 2022.
Gowing L, Ali R, Dunlop A, Farrell M and Lintzeris N (2014) National guidelines for medication-assisted treatment of opioid dependence, DoH for National Drug Strategy, accessed 3 December 2021.
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Sutherland R, Uporova J, Chandrasena U, Price O, Karlsson A, Gibbs D, Swanton R, Bruno R, Dietze P, Lenton S, Salom C, Daly C, Thomas N, Juckel J, Agramunt S, Wilson Y, Woods E, Moon C, Degenhardt L, Farrell M and Peacock A (2021) Australian Drug Trends 2021: Key findings from the National Illicit Drug System (IDRS) interviews, National Drug and Alcohol Research Centre, University of New South Wales, accessed 14 January 2022.
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