Alcohol and other drug use is linked to increased risk of injury, mental illness, preventable disease, road trauma and death (AIHW 2021a). Alcohol and other drug treatment services in Australia assist people experiencing problematic drug use, with an aim to reduce the harm of drug use, some treatments specifically aim to help clients develop skills that facilitate drug-free lifestyles and prevent relapse; these typically use abstinence-oriented interventions in a structured, substance-free setting. Treatment services include detoxification, rehabilitation, counselling and pharmacotherapy, and are delivered in residential and non-residential settings.

See Alcohol risk and harm and Illicit drug use for information on use of alcohol and other drugs.

Data sources

  • Information on publicly funded alcohol and other drug treatment services in Australia, and the people and drugs treated, is collected through the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS).
  • The National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection contains information on pharmacotherapy treatment—that is, opioid substitution therapy (OST)—provided to people dependent on opioid drugs.
  • Agencies whose sole function is to prescribe or provide dosing services for opioid pharmacotherapy are excluded from the AODTS NMDS, as data from these agencies are captured in the NOPSAD collection (AIHW 2021b and AIHW 2021c).

Who uses alcohol and other drug treatment services?

In 2019–20, the AODTS NMDS reported that around 139,000 clients aged 10 and over received just over 237,500 closed treatment episodes from 1,258 publicly funded alcohol and other drug treatment agencies.

Clients of alcohol and other drug treatment services were more likely to be male (64%) than female (35%), and most likely to be aged 20–39 (53%). Around 1 in 6 (17%) clients identified as Aboriginal or Torres Strait Islander people, representing a rate of 3,606 clients per 100,000 population.

Between 2015–16 and 2019–20, the estimated number of clients who received treatment increased by 4% (from approx. 134,000 clients to 139,000). However, when taking into consideration population growth, the rate of clients accessing service has not increased—the rate was 624 clients per 100,000 people in 2019–20, compared with 629 clients per 100,000 in 2015–16.

Who receives opioid pharmacotherapy treatment?

The NOPSAD collection reported that more than 53,300 clients received opioid pharmacotherapy treatment at more than 3,084 dosing points across Australia on a snapshot day in mid-2020.

These clients had broadly similar characteristics to the clients receiving alcohol and other drug treatment services, but were more likely to be older with a median age of 44 years. Pharmacotherapy clients were more likely to be male (67%) than female, and most likely to be aged 30–49 (61% of clients). Around 1 in 10 (11%, or 5,693) clients identified as Indigenous Australians.

For which drugs do people seek treatment?

In 2019–20, the AODTS NMDS indicated that alcohol was the principal drug of concern (PDOC) that led the largest percentage of clients to seek alcohol and other drug treatment services. Between 2015–16 and 2019–20, the proportion of closed treatment episodes for alcohol rose from 32% to 34%. By contrast, the proportion of closed treatment episodes attributable to amphetamines rose from 23% to 28% (Figure 1).

Between 2015–16 and 2019–20, the proportion of closed treatment episodes varied by selected principal drug of concern (PDOC) (alcohol, amphetamines, cannabis and heroin). The proportion of closed treatment episodes where alcohol was the PDOC increased (from 32% in 2015–16 to 34% in 2019–20). The proportion of closed treatment episodes where amphetamines was the PDOC increased (from 23% in 2015–16 to 28% in 2019–20). The proportion of closed treatment episodes for heroin and cannabis remained relatively stable.

In 2020, the NOPSAD collection reported that heroin continued to be the most common (37%) opioid drug of dependence for clients receiving opioid pharmacotherapy treatment. However, almost 2 in 5 (38%) clients did not state their opioid drug of dependence (Figure 2).

Between 2016 and 2020, the proportion of clients receiving pharmacotherapy varied by opioid drug of dependence. The graph shows that heroin was the most common opioid drug of dependence for clients receiving opioid pharmacotherapy treatment (40% in 2016 and 37% in 2020). There was a high proportion of not stated/not reported responses (rising from 36% in 2016 to 38% in 2020). All other opioid drugs of dependence, ranging between 1% and 6%, have remained relatively stable.

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How do treatment patterns vary across age groups?

The AODTS NMDS reported that clients of different age groups sought treatment for different drugs of concern. In 2019–20:

  • where cannabis was the principal drug of concern, most clients were aged 10–19 (32%) or 20–29 (36%)
  • where amphetamines were the principal drug of concern, most clients (70%) were aged 20–39
  • where alcohol was the principal drug of concern, most clients were comparatively older—53% were aged 40 and over and only 4.9% were aged 10–19 (Figure 3).

The most common principal drugs of concern (PDOC) for clients in 2019–20 included alcohol, amphetamines, cannabis and heroin. Around two-thirds (67.9%) of clients were aged 10–29 where cannabis was the PDOC. Where alcohol was the PDOC, most clients were comparatively older (53% of clients were aged 40+). Where amphetamines or heroin were the PDOC, most clients were aged 20–39 (70% and 54%, respectively).

Type of treatment and management

In 2019–20, the AODTS NMDS indicated that counselling continued to be the most common main treatment type provided to clients accessing alcohol and other drug treatment services for their own drug use (37% of treatment episodes), followed by assessment only (19%) (Figure 4).

Counselling remained the most common main treatment type, accounting for 35% of closed treatment episodes in 2015–16 and 37% of closed treatment episodes in 2019–20. This was followed by assessment only (198.9% of closed treatment episodes in 2019–20). The proportion of closed treatment episodes has fluctuated slightly for support and case management  (from 14% in 2015–16 to 11% in 2018–19 and 15% in 2019–20).

In 2020, the NOPSAD collection reported that methadone remained the most common (58%) form of opioid pharmacotherapy treatment provided to clients.

Where do I go for more information?

For more information on alcohol and other drug treatment services, see:

Visit Alcohol & other drug treatment services for more on this topic.

References

AIHW (Australian Institute of Health and Welfare) 2021a. Alcohol, tobacco & other drugs in Australia. Cat. no. PHE 221. Canberra: AIHW.

AIHW 2021b. Alcohol and other drug treatment services in Australia 2019–20. Cat. no. HSE 230. Canberra: AIHW.

AIHW 2021c. National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) 2020. Cat. no. PHE 266. Canberra: AIHW. Viewed 18 May 2021