Alcohol and other drug treatment services in Western Australia
Findings from the National Minimum Data Set (NMDS) 2008–09
Highlights
In Western Australia (WA) in 2008–09, 44 government-funded alcohol and other drug treatment agencies provided 16,915 treatment episodes. This represented a decrease of 7 treatment agencies and around 1,800 treatment episodes compared with 2007–08. The median age of persons receiving treatment for their own drug use and those seeking treatment related to someone else’s drug use was similar to 2007–08 (30 years and 48 years, respectively). 
Alcohol (46%), amphetamines (20%) and cannabis (16%) were again the top three drugs of concern.
As in 2007–08, counselling was the most common form of main treatment provided (56% of episodes), followed by rehabilitation (14%) and withdrawal management (10%).
About this bulletin 
This bulletin summarises the main findings from the 2008–09 Alcohol and Other Drug Treatment Services (AODTS) NMDS data for Western Australia. More detailed information about the 2008–09 collection and its findings can be found in the publication Alcohol and other drug treatment services in Australia 2008–09: report on the National Minimum Data Set (AIHW 2010). This report, together with further publications and interactive data, can be accessed online at <www.aihw.gov.au/drugs>.
Scope of the AODTS–NMDS
The agencies and clients that were in scope for the 2008–09 AODTS–NMDS collection were:
•	all publicly funded (at state, territory and/or Australian Government level) government and non-government agencies that provide one or more specialist alcohol and/or other drug treatment services 
•	all clients who had completed one or more treatment episodes at an alcohol and other drug treatment service that was in scope during the period 1 July 2008 to 30 June 2009.
It is important to note that the AODTS–NMDS collection includes pharmacotherapy clients only when they receive both pharmacotherapy and another type of treatment (from the same treatment agency). Pharmacotherapy-only clients are reported under the National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD). 
For a complete list of clients and agencies excluded from the AODTS–NMDS, see Section 1.2 of the Alcohol and other drug treatment services in Australia 2008–09: report on the National Minimum Data Set (AIHW 2010).

Collection count: closed treatment episodes
The unit of measurement in this bulletin is the ‘closed treatment episode’. A closed treatment episode refers to a period of contact, with defined start and end dates, between a client and a treatment agency. It is possible that more than one treatment episode may be in progress for a client at any one time; therefore the number of closed treatment episodes captured in the AODTS–NMDS does not equate to the total number of persons in Australia receiving treatment for alcohol and other drugs.
Treatment agencies
Throughout Australia, a total of 653 government-funded alcohol and other drug treatment agencies supplied data for 2008–09. Of these agencies, 44 were located in Western Australia, of which 39 were non-government agencies. 
Treatment agencies in the state were most likely to be located in Major cities (75%). 
Client profile
In Western Australia, there were 16,915 closed treatment episodes provided by alcohol and other drug treatment services and reported in the 2008–09 AODTS–NMDS collection. The vast majority (92%) of closed treatment episodes in the state involved clients seeking treatment for their own drug use. The remaining 8% involved clients seeking treatment in relation to another person’s alcohol or other drug use.
Age and sex
The overall proportions of male and female clients in Western Australia (63% and 37%, respectively) differed slightly from the national proportions (67% and 33%, respectively). Of those treatment episodes reported for someone else’s drug use in the state, females accounted for the majority of clients (74%). 
In Western Australia, the median age of persons receiving treatment for their own drug use was 30 years. Of people seeking treatment in relation to someone else’s drug use, the median age was 48 years. 
Around 30% of all closed treatment episodes in Western Australia were for clients aged 20–29 years, and more than one-quarter (28%) were for clients aged 30–39 years.
Special population groups
The proportion of closed treatment episodes involving clients who identified as Aboriginal and Torres Strait Islander people was higher in Western Australia than nationally (20% and 12%, respectively). Treatment statistics for Indigenous people need to be interpreted with caution due to the fact that the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use specific services or primary health care services are not included in the AODTS–NMDS collection. Furthermore, Indigenous status was not stated in 1% of episodes in the state. 
The majority (83%) of closed treatment episodes in the state were for clients born in Australia and 99% of treatment episodes were for clients whose preferred language was English.
Drugs of concern
This section reports only on the 15,570 closed treatment episodes where clients were seeking treatment for their own alcohol or other drug use in Western Australia.
Principal drug of concern 
The principal drug of concern refers to the main substance that the client states led them to seek treatment from the alcohol and other drug treatment agency. In Western Australia in 2008–09, alcohol was the most common principal drug of concern (46%), followed by amphetamines (20%) and cannabis (16%) (Table 1). Nationally, alcohol was the most common principal drug of concern (46% of treatment episodes), followed by cannabis (23%), opioids (15%, with heroin accounting for 10%) and amphetamines (9%). 
The proportion of treatment episodes related to alcohol in the state increased between 
2006–07 and 2008–09 (from 40 to 46%), and is now the same as the national average (46%). Amphetamine-related episodes have decreased in 2008–09 to 20% from 26% during 2006–07 and 2007–08. This is still substantially higher than the national average of 9%. Western Australia had a smaller proportion of episodes for cannabis (16%) than was reported nationally (23%). 
Table 1: Principal drug of concern(a), Western Australia and Australia, 2001–02 to 2008–09 (per cent)
	Western Australia	Total (Australia) 
2008–09	
Principal drug of concern	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07	2007–08	2008–09	Per cent	Number	
Alcohol	33.6	32.7	32.6	32.5	36.5	39.9	40.6	45.5	45.8	63,272	
Amphetamines	26.0	26.2	25.6	26.3	24.6	25.9	25.6	19.8	9.2	12,739	
Benzodiazepines	1.5	1.5	1.5	1.3	1.2	1.0	1.2	0.8	1.5	2,080	
Cannabis	21.8	24.5	22.0	19.1	18.8	15.7	14.2	15.9	22.5	31,100	
Cocaine	0.1	0.1	0.2	0.1	0.2	0.2	0.2	0.2	0.3	479	
Ecstasy	0.2	0.2	0.4	0.3	0.3	0.4	0.6	0.7	1.0	1,397	
Nicotine	0.7	0.8	0.4	0.5	0.5	0.4	0.8	0.7	1.8	2,461	
Opioids		
   Heroin	8.9	8.6	9.9	12.0	10.2	7.9	8.3	8.5	10.3	14,222	
   Methadone	0.9	0.6	1.6	2.3	2.1	2.1	2.3	2.1	1.5	2,136	
   Morphine	—	—	—	0.1	0.2	0.1	0.1	0.2	1.4	1,877	
  Total opioids(b)	9.8	9.3	11.7	14.7	12.9	10.4	11	11.4	15.1	20,890	
All other drugs(c)	4.9	4.1	5.3	5.1	5.0	5.9	6.1	5.1	2.6	3,609	
Not stated	1.5	0.6	0.4	—	—	—	—	—	—	—	
Total (per cent)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total (number)	13,303	12,142	12,479	14,235	14,251	16,110	17,014	15,570	 . .	138,027	
(a)	Excludes treatment episodes for clients seeking treatment for the drug use of others.
(b)	‘Total opioids’ includes the balance of opioids according to the Australian Standard Classification of Drugs of Concern (ASCDC). 
(c)	Includes balance of principal drugs of concern coded according to the ASCDC.
Age and sex
Across every age group in Western Australia in 2008–09, the most common principal drug of concern was alcohol. Alcohol was more likely to be the principal drug of concern for those aged 10–19 years (47%) than for those in the 20–29 year and 30–39 year age groups (36% and 40%, respectively). The largest proportion of clients with alcohol as their principal drug of concern was in the 60 years and over age group (89%). 
The second most common principal drug of concern varied between age groups. For clients aged 10–19 years, cannabis was the next most common principal drug of concern (36%), whereas for clients aged 20–29 years and 30–39 years, amphetamines were the next most common principal drug of concern (27% and 26%, respectively).  
Special population groups
In 2008–09, treatment episodes involving clients who identified as Aboriginal and Torres Strait Islander people in Western Australia were most likely to involve alcohol as the principal drug of concern (57%), followed by cannabis (19%) and amphetamines (14%). 
All drugs of concern 
All drugs of concern refers to all drugs reported by clients, including the principal drug of concern and all other drugs of concern (up to five). Over half (52% or 8,074) of all treatment episodes in Western Australia involved at least one other drug of concern (in addition to the principal drug of concern). From these episodes, 14,965 instances of ‘other drugs of concern’ were recorded. 
A breakdown of all drugs of concern by drug type is presented in Figure 1. For example, nicotine was reported as the principal drug of concern in less than 1% of episodes, but was reported as a drug of concern (either principal or other) in 16% of treatment episodes.
Figure 1: Principal drug of concern and all drugs of concern, Western Australia, 2008–09.
Horizontal bar chart showing, for principal and all drugs of concern reported, drug type on y-axis and proportion of closed treatment episodes 9%) on x-axis.
Alcohol
In Western Australia, alcohol was the most common principal drug of concern for which treatment was sought, accounting for 46% of closed treatment episodes in 2008–09. When all drugs of concern are considered (that is, the principal drug of concern and all other drugs of concern nominated by the client), 61% of episodes included alcohol. 
Of the 7,088 episodes where alcohol was the principal drug of concern in 2008–09, the client, drug and treatment profiles were as follows:
Client profile
•	The majority (68%) of episodes were for male clients. 
•	The median age of clients receiving treatment was 33 years (males 32 years; females 36 years).
•	Around one quarter (26%) of episodes involved clients who identified as Aboriginal and Torres Strait Islander people.
•	Self-referral was the most common source of referral (33% of episodes), followed by referrals from alcohol and other drug treatment services (17%). 
Drug profile
•	44% of episodes included at least one other drug of concern. From these episodes, 5,182 instances of other drugs of concern were recorded—36% were for cannabis, 22% for nicotine and 17% for amphetamines.   
•	The majority (69%) of episodes involved clients who reported never having injected drugs. Another 7% of episodes involved clients who reported as currently injecting, while 16% involved clients who reported they had injected drugs in the past. 
Treatment profile
•	Counselling was the most common main treatment type received (58% of episodes), followed by rehabilitation (17%) and withdrawal management (10%).
•	Treatment was most likely to take place in a non-residential treatment facility (74% of episodes), followed by a residential treatment facility (12%).  
•	The median number of days for a treatment episode was 19.
Amphetamines 
In Western Australia, amphetamines were the second most common principal drug of concern for which treatment was sought, accounting for 20% of closed treatment episodes in 2008–09. Amphetamines were reported in 33% of all episodes (as either the principal or other drug of concern). 
Of the 3,076 episodes where amphetamines were the principal drug of concern in 2008–09, the client, drug and treatment profiles were as follows:
Client profile
•	The majority (64%) episodes were for male clients. 
•	The median age of clients receiving treatment was 29 years (males 30 years; females 29 years).
•	15% of episodes involved clients who identified as Aboriginal and Torres Strait Islander people.
•	Self-referral was the most common source of referral (39% of episodes), followed by referrals from court diversion (14%). 
Drug profile
•	Injecting was the most common usual method of use (72%), followed by smoking (17%) and ingestion (8%). 
•	61% included at least one other drug of concern. From these episodes, 3,886 instances of other drugs of concern were recorded—31% were for cannabis and 24% for alcohol.  
•	The majority (52%) of episodes involved clients who reported as currently injecting, while 28% involved clients who reported they had injected drugs in the past (15% between 3 and 12 months ago and 13% for 12 or more months ago). The remaining 17% of episodes involved clients who reported never having injected drugs.   
Treatment profile
•	Counselling was the most common main treatment type received (57% of episodes), followed by rehabilitation (21%). 
•	Treatment was most likely to take place in a non-residential treatment facility (68% of episodes), followed by ‘other’ settings (13%).  
•	The median number of days for a treatment episode was 29.
Cannabis 
In Western Australia, cannabis was the third most common principal drug of concern for which treatment was sought, accounting for 16% of closed treatment episodes in 2008–09.
When all drugs of concern are considered (including the principal drug of concern and all other drugs of concern nominated by the client), 40% of episodes included cannabis.
Of the 2,477 episodes where cannabis was the principal drug of concern in 2008–09, the client, drug and treatment profiles were as follows:
Client profile
•	The majority (71%) of episodes were for male clients. 
•	The median age of clients receiving treatment was 23 years (males 22 years; females 25 years).
•	25% of episodes involved clients who identified as Aboriginal and Torres Strait Islander people.
•	Self-referral was the most common source of referral (26% of episodes), followed by referrals from court diversion programs (23%). 
Drug profile
•	Smoking was the most common usual method of use (97% of episodes).  
•	60% included at least one other drug of concern. Alcohol constituted 39%, amphetamines 20% and nicotine 19% of other drugs of concern.   
•	The majority (59%) of episodes involved clients who reported never having injected drugs. Another 10% of episodes involved clients who reported as currently injecting, while 18% involved clients who reported they had injected drugs in the past. 
Treatment profile
•	Counselling was the most common main treatment type received (64% of episodes), followed by rehabilitation (10%). Withdrawal management and information and education only both accounted for 7% of episodes. 
•	Treatment was most likely to take place in a non-residential treatment facility (78% of episodes). 
•	The median number of days for a treatment episode was 22.
Treatment programs
The main treatment type is the principal activity, as judged by the treatment provider, which is necessary for completing the treatment plan for the principal drug of concern. Data presented in this section relate to clients seeking treatment for their own or someone else’s alcohol or other drug use, except for the sub-sections relating to principal drug of concern and treatment programs (which only include episodes for people seeking treatment for themselves). 
Of all closed treatment episodes in Western Australia, counselling was the most common form of main treatment provided (56% of episodes), followed by rehabilitation (14%) and withdrawal management (10%) (Table 2). The treatment types provided in the state have remained relatively stable over time. 
Western Australia provided more counselling and rehabilitation as a proportion of all treatments than was provided nationally in 2008–09. On the other hand, the state provided proportionately less withdrawal management, support and case management only, information and education only, and assessment only.
Table 2: Main treatment type, Western Australia and Australia, 2001–02 to 2008–09 (per cent)
	Western Australia	Total (Australia) 
2008–09	
Main treatment type	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07	2007–08	2008–09	Per cent	Number	
Withdrawal management (detoxification)	11.8	9.7	6.6	9.1	9.4	8.2	10.6	10.2	16.4	23,599	
Counselling	61.4	58.0	50.2	54.8	57.1	54.0	54.6	56.4	37.4	53,787	
Rehabilitation	8.5	6.1	16.4	12.2	14.1	15.0	14.6	13.8	6.7	9,667	
Support and case management only	0.3	0.7	1.1	2.8	1.4	2.3	3.0	3.1	8.9	12,740	
Information and education only	6.6	13.8	9.7	6.8	5.8	4.3	2.7	3.6	9.2	13,283	
Assessment only	6.5	9.5	9.8	7.4	5.2	10.4	10.3	7.6	14.7	21,172	
Other(a)	4.9	2.1	6.1	6.8	6.9	5.7	4.4	5.3	6.6	9,424	
Total (per cent)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	..	
Total (number)	15,232	14,122	14,256	16,092	16,342	17,802	18,705	16,915	..	143,672	
(a)	‘Other’ includes treatment episodes where the main treatment type was reported as pharmacotherapy.
Counselling
Counselling was the most common main treatment type reported in Western Australia in 2008–09, accounting for 56% of closed treatment episodes. Of the 9,539 episodes where counselling was nominated as the main treatment type received, the client, drug and treatment profiles were as follows: 
Client profile
•	The majority (87%) of episodes were for clients seeking treatment for their own drug use. 
•	Over half (62%) of episodes were for male clients.
•	The median age of persons receiving treatment was 30 years (males 29 years; females 33 years). 
•	26% of episodes involved clients who identified as Aboriginal and Torres Strait Islander people. 
•	Self-referral was the most common source of referral (33% of episodes), followed by referrals from court diversion programs (18%).
Treatment profile
•	Treatment was most likely to occur in a non-residential treatment facility (84% of episodes). 
•	About 43% of episodes ended because the treatment was completed. The next most common reason for episodes to end was that the client ceased to participate without notifying the service provider (29% of episodes ended this way). 
•	The median number of days for a treatment episode was 29.
Principal drug profile
•	Alcohol was the most common principal drug of concern reported (50% of episodes) by people who received counselling for their own drug use, followed by amphetamines (21%) and cannabis (19%). 
Rehabilitation 
Rehabilitation was the second most common main treatment type reported in Western Australia in 2008–09, accounting for 14% of closed treatment episodes. Of the 2,326 episodes where rehabilitation was nominated as the main treatment received in 2008–09, the client, drug and treatment profiles were as follows:
Client profile
•	All episodes were for clients seeking treatment for their own drug use.
•	The majority (71%) of episodes were for male clients. 
•	The median age of persons receiving treatment was 31 years (males 31 years; females 32 years). 
•	11% of episodes involved clients who identified as Aboriginal and Torres Strait Islander people.
•	Self-referral was the most common source of referral (42% of episodes), followed by referrals from alcohol and other drug treatment services (19%).
Treatment profile
•	Treatment was most likely to occur in a non-residential treatment facility (48% of episodes), followed by a residential treatment facility (39%). 
•	Around a third (36%) of episodes ended because the treatment was completed. The next most common reason for ending a treatment episode was that the client ceased to participate without notifying the service provider (26% of episodes ended this way). 
•	The median number of days for a treatment episode was 35.
Principal drug profile
•	Alcohol was the most common principal drug of concern reported (50% of episodes), followed by amphetamines (27%) and cannabis (11%).  
Withdrawal management (detoxification)
Withdrawal management was the third most common main treatment provided in Western Australia, accounting for 10% of closed treatment episodes in 2008–09. Of the 1,731 episodes where withdrawal management was nominated as the main treatment type received in
2008–09, the client, drug and treatment profiles were as follows: 
Client profile
•	Due to the nature of withdrawal management, all episodes were for clients seeking treatment for their own drug use. 
•	The majority (62%) of episodes were for male clients.
•	The median age of persons receiving treatment was 34 years (for both males and females). 
•	9% of episodes involved clients who identified as Aboriginal and Torres Strait Islander people.
•	Self-referral was the most common source of referral (46%) of episodes, followed by referrals from alcohol and other drug treatment services (21%).
Treatment profile
•	Treatment was most likely to occur in a non-residential treatment facility (45% of episodes), followed by a residential treatment facility (38%). 
•	43% of episodes ended because the treatment was completed, while another 41% ended because the client ceased to participate without notice. 
•	The median number of days for a treatment episode was 8.
Principal drug profile
•	Alcohol was the most common principal drug of concern reported (42%) by people who received withdrawal management, followed by heroin (23%) and amphetamines (12%).  
Symbols
—	nil or rounded to zero
. .	not applicable
How to find out more
If you would like more detailed data about Western Australia’s alcohol and other treatment services please contact the AIHW to discuss your needs. The document Alcohol and other drug treatment services NMDS Specifications 2010–11 outlines the process to be followed for unpublished data requests. This document is available from the AIHW web site at
<http://www.aihw.gov.au/publications/index.cfm/title/11461>.
Reference
Australian Institute of Health and Welfare 2010. Alcohol and other drug treatment services in Australia 2008–09: report on the National Minimum Data Set. Drug treatment series no. 10. Cat. no. HSE 92. Canberra: AIHW.

© Australian Institute of Health and Welfare 2010
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This publication is part of the Australian Institute of Health and Welfare’s Bulletin series. A complete list of the Institute’s publications is available from the Publications Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601, or via the Institute’s web site (www.aihw.gov.au).
ISBN 978-1-74249-105-9
Acknowledgment
The AIHW would like to acknowledge the input of data providers and the IGCD AODTS–NMDS Working Group, as well as the funding provided by the Australian Government Department of Health and Ageing for this project. 
Suggested citation
Australian Institute of Health and Welfare 2011. Alcohol and other drug treatment services in Western Australia 2008–09: findings from the National Minimum Data Set. Cat. no. HSE 95. Canberra: AIHW. Australian Institute of Health and Welfare
Board Chair Hon. Peter Collins, AM, QC						
Director David Kalisch

Any enquiries or comments on this publication should be directed to:
Dr Rob Hayward
Australian Institute of Health and Welfare
GPO Box 570
Canberra ACT 2601 
Phone (02) 6244 1000
Email: rob.hayward@aihw.gov.au

Published by the Australian Institute of Health and Welfare