Australian Institute of Health and Welfare (2021) Alcohol and other drug treatment services in Australia annual report., AIHW, Australian Government, accessed 28 January 2022
Australian Institute of Health and Welfare. (2021). Alcohol and other drug treatment services in Australia annual report. Retrieved from https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Alcohol and other drug treatment services in Australia annual report. Australian Institute of Health and Welfare, 16 July 2021, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare. Alcohol and other drug treatment services in Australia annual report [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2022 Jan. 28]. Available from: https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol and other drug treatment services in Australia annual report, viewed 28 January 2022, https://pp.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
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A number of drugs make up a small proportion of closed treatment episodes. These drugs may be less prominent in treatment services because they are relatively uncommon, or people who use them may be less likely to seek treatment than people who use other substances. Information about treatment for nicotine, ecstasy and cocaine is included in this section, not just because of their prevalence among the population, but also the increased harms that these substances bring to an individual and/or the community.
Nicotine is the stimulant drug in tobacco smoke. It is highly addictive and causes dependency (ADCA 2013). Tobacco use (9.3%) was the highest risk factor contributing to the total burden of disease and injury in Australia in 2015 (AIHW 2019). The health effects of smoking include premature death and tobacco-related illnesses such as cancer, chronic obstructive pulmonary disease and heart disease.
Ecstasy is the popular street name for a range of drugs said to contain the substance 3, 4 methylenedioxymethamphetamine (MDMA): an entactogenic stimulant with hallucinogenic properties. Ecstasy is usually sold in tablet or pill form, but is sometimes found in capsule or powder form. The short-term effects of ecstasy include euphoria, feelings of wellbeing and closeness to others, and increased energy. Harms include psychosis, heart attack and stroke. Little is known about the long-term effects of ecstasy use, but there is some research linking regular and heavy use of ecstasy to memory problems and depression (ADCA 2013).
Cocaine is a stimulant drug, originally derived from the leaves of the coca plant, that is typically snorted or injected. The effects of cocaine have a rapid onset, generally appearing within seconds or minutes, and dissipate within about 30 minutes after consumption. The acute effects of cocaine include euphoria and increased alertness, as well as undesirable outcomes including insomnia, cardiac arrhythmia, and stroke. Chronic use is associated with both psychological and physical health problems, including erosion of the nasal cavity, anxiety, psychosis, and cardiac arrest (ADCA 2013).
Results from the National Drug Strategy Household Survey (AIHW 2020) showed that in 2019:
The selected drugs of concern—nicotine, ecstasy and cocaine—were more likely to be reported as an additional drug of concern rather than a principal drug of concern (tables AODTS Selected drugs.1, SD.8). For example, in 2019–20 nicotine was reported as a principal drug of concern in only 1.1% of treatment episodes, but was listed as an additional drug of concern in 13.1% of episodes.
(a) Based on valid SLK client data.
(b) The proportion of clients for Indigenous status may not sum to the total, due to missing or not reported data.
(c) Includes support and case management, pharmacotherapy, other and rehabilitation.
(d) Includes where treatment is delivered in the client’s own home or usual place of residence or in an outreach setting.
(e) Includes administrative cessation.
Sources: Tables SC.6–8, SD.9, SD.66, SD.69, SD.73, SD.76–79, SD.117–118, SD.121–127, SD.130, SD.133–134, SD.137–143.
The proportion of episodes with nicotine, ecstasy or cocaine as the principal drug of concern has remained stable at around 1%–2% for each drug each year since 2014–15 (Table SD.9). Typically, these 3 principal drugs of concern have together contributed around 2%–3% of the total number of treatment episodes each year since 2014–15.
In 2019–20, nicotine was reported in 14% of all closed treatment episodes, either as a principal or additional drug of concern:
The low proportion of episodes in which nicotine was the principal drug of concern likely relates to the wide availability of support and treatment for nicotine use within the community. For example, general practitioners, pharmacies, helplines, and web services all offer support for nicotine use. Additionally, people might view AOD treatment services as being most appropriate for drug use that is beyond the expertise of general practitioners. However, therapy to quit smoking is becoming an integral part of some AOD services as a parallel treatment with other drugs of concern.
Where nicotine was the principal drug of concern:
For treatment episodes where nicotine was the principal drug of concern in 2019–20:
In 2019–20, ecstasy was reported in 3% of all closed treatment episodes, either as a principal or additional drug of concern:
Where ecstasy was the principal drug of concern:
For treatment episodes where ecstasy was the principal drug of concern in 2019–20:
Cocaine was reported in 3% of all closed treatment episodes, either as a principal or additional drug of concern:
Analysis of AODTS NMDS data from 2002–2003 to 2017–2018 similarly found treatment episodes where cocaine was the principal drug of concern were increasing, the rate was higher among males than females (10 per 100,000 compared with 1.7 per 100,000 among females) across all years and since 2015–16 higher among people aged 20–29 (Man et al. 2021). State/territory, main treatment type and referral sources were investigated to determine whether these factors may be driving increases in treatment episodes; analyses indicated these variables did not drive increases in 2016–2017 and 2017–2018 (Man et al. 2021).
Where cocaine was the principal drug of concern:
For treatment episodes where cocaine was the principal drug of concern in 2019–20:
See reference list.
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