Dosing points

Where were opioid pharmacotherapy drugs provided?

Most opioid pharmacotherapy dosing points were located in pharmacies.

In 2020–21, there were 2,485 dosing point sites nationally (excluding data for Queensland) (Table DOSING1). Similar to previous years, around 9 in 10 sites (89% or 2,200 sites) were located in pharmacies. This was consistent across all included states and territories (Table S17).

Table DOSING1: Dosing point sites, by state/territory, 2020–21
Dosing point site type NSW Vic Qld WA SA Tas ACT NT Total Total (%)
Public clinic 36 — n.a. 1 3 1 2 2 45 1.8
Private clinic 11 — n.a. — — — — — 11 0.4
Pharmacy 887 679 n.a. 274 234 66 40 20 2,200 88.5
Correctional facility 1 16 n.a. 2 8 1 1 2 31 1.2
Other 168 20 n.a. — 7 1 — — 196 7.9
Total 1,105 715 n.a. 277 252 69 43 24 2,485 100.0
Total (%) 44.5 28.7 n.a. 11.1 10.1 2.8 1.7 1.0 100.0 . .

— Nil or rounded to zero.

n.a. Not available.

Notes

  1. See tables T1 and T2 in the Technical notes for more information about NSW.
  2. The category 'Other' includes hospitals, mobile dosing sites, community health clinics, non‑government organisations, doctors' surgeries and dosing points 'Not stated'.
  3. The number of dosing point sites where clients receive treatment during the collection year (that is, the financial year).
  4. The total for NSW includes 2 dosing point sites with dosing point site type of 'Other'.
  5. Data for Qld were not available in 2021. Totals exclude Qld.

Source: National Opioid Pharmacotherapy Statistics Annual Data collection. Table S17.
 

Between 2010–11 and 2019–20, there was a 40% increase in the number of dosing point sites. This number then decreased from 3,084 in 2019–20 to 2,485 in 2020–21, mainly because data for Queensland were unavailable in 2020–21 (Table S17).

What was the relationship between opioid pharmacotherapy clients and dosing point sites?

Pharmacotherapy drug type

Most pharmacotherapy clients received their opioid pharmacotherapy treatment at a pharmacy.

On a snapshot day in 2021, most clients (68% or 32,205 clients) received pharmacotherapy treatment at a pharmacy (excluding data for Queensland) (Table S13). This was the most common dosing point site regardless of the pharmacotherapy drug type that clients received. Among clients receiving:

  • Methadone, 7 in 10 clients (71% or 19,570 clients) dosed at pharmacies and 1 in 10 (9.8% or 2,712) dosed at public clinics.
  • Buprenorphine, around 4 in 10 (44%, or 4,815 clients) dosed at pharmacies and over 2 in 10 (25% or 2,722) dosed at public clinics.
  • Buprenorphine-naloxone, over 9 in 10 (94% or 6,778 clients) dosed at pharmacies.
  • Buprenorphine LAI, over 6 in 10 (65% or 1,042 clients) dosed at pharmacies and around 2 in 10 (23% or 370) dosed at public clinics (Figure DOSING1; Table S13).

Figure DOSING1: Proportion of clients receiving pharmacotherapy on a snapshot day, by pharmacotherapy drug type and dosing point site type, 2016 to 2021

On a snapshot day in 2021, most clients received pharmacotherapy treatment at a pharmacy. The proportion of clients who received pharmacotherapy at pharmacies ranged from 44% for buprenorphine to 94% for buprenorphine-naloxone.

Refer to the Data tables for more information.

The true proportion of clients dosed with buprenorphine-naloxone or buprenorphine LAI (reported for the first time in 2020) may be higher than reported here. This is due to the coding of pharmacotherapy drug types in New South Wales, where clients receiving these treatments are recorded as receiving buprenorphine. Refer to Table S14 for more information.

Client characteristics

Client characteristics (including age, sex and prescriber type) can differ according to the type of dosing point site where clients receive treatment.

Information on client characteristics is assessed using unit record data. In 2021, unit record data were provided by all states and territories except Victoria and Queensland. The following sections on client age and sex are based on these data.

Age of clients: Consistent with previous years, pharmacies continued to treat an older client group than other dosing point site types, while correctional facilities treated a younger client group. On a snapshot day in 2021 (excluding data for Victoria and Queensland):

  • Clients aged 50 and over were around 3 times as likely to dose at pharmacies compared to correctional facilities:
    • 4 in 10 clients (41% or 6,601 clients) who dosed at pharmacies were aged 50 and over, making it the most common age group for this dosing point site type.
    • Just 1 in 10 clients (10% or 333) at correctional facilities were aged 50 and over.
  • Around 6 in 10 clients who dosed at correctional facilities were aged 30–39 (40% or 1,271) or under 30 years (22% or 706). Comparatively, over 2 in 10 clients of pharmacies were aged 30–39 (20% or 3,233 clients) or under 30 (4.9% or 787 clients).
  • Around 3 in 10 clients who dosed at public clinics (33% or 1,909 clients), private clinics (36% or 943) or hospitals (35% or 200) were aged 40–49. This was the most common age group for each of these dosing point site types, with the proportion of clients in each age group following a similar pattern across these sites (Table S29).

Sex of clients: On a snapshot day in 2021, all dosing point site types from the selected states and territories treated more males than females. This is consistent with the overall proportion of males and females receiving pharmacotherapy treatment (excluding data for Victoria and Queensland). In 2021:

  • The proportion of clients who were male ranged from 63% (10,190 clients) for pharmacies to 91% (2,906) for correctional facilities.
  • The proportion of clients who were female ranged from 8.8% (282 clients) for correctional facilities to 37% (5,908) for pharmacies.
  • Female clients were more likely to dose at pharmacies (58% of female clients, compared with 45% of male clients).
  • Male clients were almost 5 times as likely as female clients to dose in correctional facilities (13% of male clients, compared with 2.8% of female clients) (Table S30).

Prescriber type: Information on prescriber type by dosing point site type is assessed using unit record data. In 2021, unit record data were provided by all states and territories except Victoria and Queensland. Based on these data, around 1 in 2 clients (49%) received pharmacotherapy at pharmacies in 2021. Across all dosing point site types from the selected states and territories, the most common prescriber type was private prescriber (52% of clients).

  • Around 3 in 10 clients (33%) received pharmacotherapy at pharmacies from private prescribers.
  • A further 3 in 10 clients received pharmacotherapy at either pharmacies from public prescribers or public clinics from public prescribers (each 16%) (Table S31).

Number of opioid pharmacotherapy clients per dosing point site

In 2021, pharmacotherapy dosing point sites dosed an average of 19 clients each.

On a snapshot day in 2021, dosing point sites dosed an average of 19 clients each nationally (excluding data for Queensland). This represents an increase from 2020 (17 clients per site), but a decline from 2011 (21 clients).

The number of clients per dosing point site varied by site type. On average:

  • Private clinics (New South Wales only) had the highest number of clients per dosing point site (236 clients per site).
  • Pharmacies dosed 15 clients per site (Figure DOSING2; Table S23).
  • Correctional facilities dosed an average of 152 clients per site. However, this number is inflated as New South Wales and Western Australia each report all correctional dosing point sites as operating under 2 sites rather than counting individual correctional dosing point sites. This significantly increases the number of clients per site. On the snapshot day in 2021, New South Wales recorded only 1 site with clients receiving treatment. When data for New South Wales and Western Australia are excluded, correctional facilities dosed an average of 60 clients across the remaining jurisdictions that supplied data (Table S23).

Figure DOSING2: Number of clients per dosing point site, by dosing point site type, 2016 to 2021

On a snapshot day in 2021, private clinics had the highest number of clients per dosing point on average (236 clients). Between 2016 and 2021, there were overall increases in the number of clients per dosing point site for private clinics as well as correctional facilities and public clinics (152 and 132 clients per dosing point site in 2021, respectively).

Refer to the Data tables for more information.

On a snapshot day in 2021, 8 in 10 (79% or 1,965) dosing point sites treated between 1 and 20 clients: 46% treated 1–5 clients, 17% treated 6–10 clients and 17% treated 11–20 clients. Of the dosing point sites treating more than 50 clients (6.1% of all dosing point sites), most were located in New South Wales and Victoria (Table S20). In 2021, Victorian data include dosing point sites with 0 clients in the ‘1–5 clients’ category, as these categories were unable to be presented separately.

The Australian Capital Territory had the highest ratio of clients per dosing point site (25 clients per site), while the Northern Territory had the lowest (8 clients) (Figure DOSING3; Table S21).

Figure DOSING3: Number of clients per dosing point site, by state/territory, 2016 to 2021

On a snapshot day in 2021, the Australian Capital Territory had the highest number of clients per dosing point (25 clients). The Northern Territory had the lowest ratio of clients per dosing point (7.6 clients). Between 2016 and 2021, the number of clients per dosing point site increased from 18 to 19 nationally (data for 2021 exclude Queensland).

Refer to the Data tables for more information.

What was the geographic location of dosing point sites?

Across Australia (excluding data for Queensland), most opioid pharmacotherapy dosing point sites were located in Major cities.

On a snapshot day in 2021, most dosing point sites at the national level were located in Major cities (64% or 1,578 sites) (excluding data for Queensland). A further 24% (587) of sites were located in Inner regional areas, and 11% (264) were located in Outer regional areas.

In 2021, when accounting for population size:

  • Outer regional areas had the highest rate of dosing point sites (19 sites per 100,000 population), followed by Remote areas (18 per 100,000) and Inner regional areas (17 per 100,000).
  • There were 10 dosing point sites per 100,000 population in Very remote areas and 10 per 100,000 in Major cities (Table S18).

Since 2014, rates of dosing point sites per 100,000 population have increased in all remoteness areas. The largest increases have occurred in Outer regional, Remote and Very remote areas (Table S18). However, these rates do not indicate the number of clients receiving opioid pharmacotherapy treatment at each dosing point site in these areas. This information is not currently collected by the NOPSAD collection.

Figure DOSING4 shows the number of dosing point sites by Statistical Area Level 2 (SA2). The number of dosing point sites within an SA2 may be driven by a range of factors including policy and legislation in each jurisdiction, whether all dosing point sites in an SA2 reported data on the snapshot day and the size of the population in each SA2. Refer to the Glossary and Technical notes for more information.

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Figure DOSING4: Map to explore pharmacotherapy dosing point sites, by Statistical Area Level 2, 2021