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Publicly-funded alcohol and other drug treatment services are available to people seeking treatment for their own drug use and people seeking treatment for someone else's drug use.

The main source of data on alcohol and other drug treatment services is the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS). This data set contains data on publicly-funded alcohol and other drug treatment services and the treatment episodes provided by these services. Data are available from 2003–04 to 2015–16.

About the data

Under a Memorandum of Understanding with the Australian Government Department of Health (DoH), the Australian Institute of Health and Welfare (AIHW) is responsible for the management of the AODTS NMDS. The AODTS NMDS is a collection of data from publicly-funded treatment services in all states and territories, including those directly funded by DoH. Publicly-funded alcohol and other drug treatment agencies collect the agreed data items and forward this information to the appropriate health authority as arranged.

For most states and territories, the data provided for the national collection are a subset of a more detailed jurisdictional data set used for planning at that level.

The AODTS NMDS presents data about alcohol and other drug treatment services, their clients, drugs of concern and the types of treatment received. The counting unit for the AODTS NMDS is completed treatment episodes.

Scope

Data on agencies

The AODTS NMDS contains information on publicly-funded alcohol and other drug treatment services. Agencies are excluded from the AODTS NMDS if they:

  • do not receive any public funding
  • provide accommodation as their main function (including half-way houses and sobering-up shelters)
  • are located in prisons or detention centres
  • are located in acute care or psychiatric hospitals and provide treatment only to admitted patients
  • have the sole function of prescribing or providing dosing for opioid pharmacotherapy (these agencies are excluded because of the multi-faced nature of service delivery in this sector).

Australian Government-funded primary health care services and substance-use services are in scope for the AODTS NMDS but most of these agencies do not contribute to the collection as they currently provide data to the Online Services Report (OSR) collection. To minimise reporting burden, agencies reporting to the OSR do not usually also report to the AODTS NMDS; however, there is some overlap. See Aboriginal and Torres Strait Islander health organisations: alcohol and other drug treatment report for further information.

For each agency in the AODTS NMDS, data are collected on the geographical location of the agency.

DoH funds a number of alcohol and other drug treatment services under the National Illicit Drug Strategy Non-Government Organisation Treatment Grants Program (NGOTGP). These agencies are required to collect data (according to the AODTS NMDS specifications) to facilitate the monitoring of their activities and to provide quantitative information to the Australian Government on their activities.

In addition to NGOTGP agencies, a small number of agencies funded under the DoH Substance Misuse Service Delivery Grants Fund (SMSDGF) reported data to the AIHW.

Reported numbers for each state and territory in the AODTS NMDS annual report include services provided under the National Illicit Drug Strategy's NGOTGP and SMSDGF.

Data on treatment episodes

The AODTS NMDS contains information on all treatment episodes provided by in-scope agencies where the episode was closed in the relevant financial year. A treatment episode is considered closed where any of the following occurs:

  • the treatment is completed or has ceased
  • there has been no contact between the client and treatment provider for 3 months
  • there is a change in the main treatment type, principal drug of concern or delivery setting.

Treatment episodes are excluded from the AODTS NMDS if they:

  • are not closed in the relevant financial year
  • are for clients who are receiving pharmacotherapy and not receiving any other form of treatment that falls within the scope of the collection
  • include only activities relating to needle and syringe exchange
  • are for a client aged under 10.

For each treatment episode in the AODTS NMDS, data are collected on:

  • the client: sex, date of birth, Indigenous status, country of birth, preferred language, source of referral and injecting drug status
  • whether the client is receiving treatment for their own drug use or someone else's drug use
  • the drugs of concern (principal drug of concern and up to 5 additional drugs of concern)
  • the method of use for the principal drug of concern
  • types of treatment (main treatment type and up to 4 additional treatment types)
  • the start and end dates of the episode and the reason the episode was closed.

Data on drugs of concern

'Principal drug of concern' refers to the main substance that the client stated led them to seek treatment from the alcohol and other drug treatment agency. In this report, only clients seeking treatment for their own substance use are included in analyses involving principal drug of concern because it is assumed that only substance users themselves can accurately report their own principal drug of concern.

'Additional drugs of concern' refers to any other drugs reported by the client, in addition to the principal drug of concern. Clients can nominate up to 5 additional drugs of concern.

'All drugs of concern' refers to all drugs reported by clients, including the principal drug of concern as well as any additional drugs of concern reported.

Data on clients

The AODTS NMDS does not contain a unique identifier for clients and information about clients is collected at the episode level. For the 2012–13 collection, a statistical linkage key (SLK) was introduced. While the SLK is not a unique identifier, it enables the number of clients receiving treatment to be counted while continuing to ensure the privacy of these individuals receiving treatment.

Because SLK data are not available for all clients, an imputation strategy has been developed to adjust the data to account for this. Further information about the imputation methodology applied to these data can be found in Appendix B of the Alcohol and other drug treatment services in Australia 2013–14 report.

Coverage

It is difficult to fully quantify the scope of alcohol and other drug services in Australia, in particular the number of clients, as, until recently, the national collection has been based on counts of treatment episodes. In addition, there are a variety of settings in which people receive treatment for alcohol or other drug-related issues that are not in scope for this collection, such as in hospital, from general practitioners or in pharmacies (where a large proportion of opioid pharmacotherapy treatment is provided).

In the most recent reporting year, 2015–16, 90.9% of in-scope agencies submitted data to the AODTS NMDS (Table 1).

Table 1: In-scope agencies, AODTS NMDS 2015–16
State/territory Agencies that submitted data Agencies in-scope % that submitted data % point difference 2014–15 to 2015–16
NSW 283 351 80.6 –11.5
Vic 129 136 94.9 –3.7
Qld 152 153 99.4 –0.7
WA 77 77 100.0 0.0
SA 66 66 100.0 0.0
Tas 23 24 95.8 9.4
ACT 15 15 100.0 0.0
NT 23 23 100.0 5.3
DoH 28 31 90.3 –6.7
Total 796   876   90.9   –5.4

Note: Agencies in scope for DoH submit data directly to AIHW. Some agencies in scope for DoH however, submitted data via their state health authorities, not directly to AIHW. These agencies are included in the relevant state count rather than the DoH count.

Several factors can contribute to changes in the number of agencies reporting between years. As well as changes in the actual numbers of agencies, some jurisdictions may change data collection approaches, for example, moving from collecting data at an administrative or management level to a service outlet level.

Data are affected by variations in service structures and collection practices between states and territories and care should be taken when making comparisons between them. In addition, the AODTS NMDS has been implemented in stages, so comparisons across years, particularly the earlier years of the collection, need to be made with caution.

The AODTS NMDS reports on both main and additional treatment types. However, Victoria and Western Australia do not differentiate between main and other treatment types. Caution should be used in comparing episodes from these states with those of other states and territories. Despite variations in reporting practices between jurisdictions, there is very little difference between the proportions for principal drug of concern and all drugs of concern when these 3 jurisdictions are excluded from analysis. For example, the top 4 drugs of concern retain their size and their order.

Further information on coverage and data quality is available in the Alcohol and other drug treatment services NMDS, 2013–14 data quality statement.

Data quality

Data are reported by each state and territory regardless of funding type. Because all services are publicly funded, they receive at least some of their funding through a state, territory or Australian government program. The actual funding program cannot be differentiated, however services are categorised according to their sector, with government funded and operated services reported as public services and those operated by non-government organisations reported as private services.

As a unit of measurement, the 'closed treatment episode' used in the AODTS NMDS cannot provide information on the number of clients who access publicly funded alcohol and other drug treatment, nor can it provide information on the extent of concurrent, sequential or recurrent service use. This is because it is possible for a single individual to access more than 1 service at a time, for different treatments and for different substance-use problems.

However, in 2012–13, the AODTS NMDS implemented a statistical linkage key (SLK) for the first time. This linkage key enables the number of clients receiving treatment to be counted while continuing to ensure the privacy of these individuals, in addition to reporting on closed treatment episodes.

With the introduction of the SLK, a number of client-based analyses are possible including:

  • estimating the number and rate of clients receiving treatment and the remoteness and socioeconomic distribution of the client in the annual reports from 2012–13
  • more complex analyses on patterns of drug use and pathways through treatment, as data with unique client counts accumulate over time.

The AODTS NMDS was initially developed from 1996–2001 and the first report containing data from the data set was published in 2002. The data specifications were significantly altered for the 2003–04 collection and data from 2000–01 to 2002–03 are not comparable with data from later years.

In 2011, the Australian Bureau of Statistics (ABS) updated the standard geography used in Australia for most data collections from the Australian Standard Geographical Classification (ASGC) to the Australian Statistical Geography Standard (ASGS). Also updated at this time were remoteness areas based on the 2011 ABS Census of Population and Housing. The new remoteness areas (RA) will be referred to as RA 2011 and the previous remoteness areas as RA 2006.

Data for previous years reported by remoteness are reported for RA 2006. Data for 2012–13 are reported for RA 2011. The AIHW considers the change from RA 2006 to RA 2011 to be a series break when applied to data supplied for this indicator; therefore remoteness data for 2011–12 and previous years are not comparable to remoteness data for 2012–13 and subsequent years.

State and territory specific issues

  • Victoria only provides information about non-government agencies that receive public funding.
  • Care should be taken when interpreting principal drug of concern over time for Queensland, as Queensland did not provide data consistent with the AODTS NMDS specifications in 2001–02.
  • In Western Australia, clients are able to access treatment services from multiple sites within a single episode depending on client needs and appointment availability.
  • Services in Western Australia are not directly comparable with other states, or previous years, because of the growth of integrated services that include government and non‑government service providers.
  • Western Australia reviews the geographical demographics of their clients regularly throughout the year and adjusts the locations of their service delivery outlets accordingly to meet the demands of the population. Therefore, variation between Remote and Very remote locations exists between years.