Alcohol and other drug treatment services is an Australia's health topic

Alcohol and other drug (AOD) use is linked to increased risk of injury, mental illness, preventable disease, road trauma and death (AIHW 2023). AOD treatment agencies across Australia provide a range of services and support to people who received treatment for their own drug use, as well as their families and friends. 

There are many treatment types available in Australia to assist people with drug and alcohol use. Most treatments aim to reduce harm, coordinate care, and provide intensive interventions, for example:

  • withdrawal management (detoxification)
  • psycho-social counselling
  • rehabilitation
  • pharmacotherapy. 

Reducing harm from alcohol, tobacco and other drugs may include ceasing use, reducing use, or changing use patterns to be less harmful (including reducing the severity of dependence) (Department of Health 2019).

Opioid pharmacotherapy (see glossary) is a type of treatment that can reduce drug cravings and other withdrawal symptoms in people experiencing opioid drug dependence (such as codeine or heroin dependence).

For information on use of alcohol and other drugs, see Alcohol and Illicit use of drugs.

Data sources

  • Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS): provides information about publicly funded alcohol and other drug treatment services in Australia, the people they treat, and the treatment provided. 
  • National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection: provides information about people receiving opioid pharmacotherapy for their opioid dependence in Australia, as well as health professionals who prescribe opioid pharmacotherapy and dosing points (such as pharmacies) where clients receive treatment.

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 2024a, 2024b).

Who uses alcohol and other drug treatment services?

Data from the AODTS NMDS indicate that around 131,500 clients aged 10 and over received AOD treatment in 2022–23. These clients received just over 235,500 closed treatment episodes (see glossary) from 1,280 publicly funded AOD treatment agencies.

In 2022–23:

  • 3 in 5 (60%) clients of AOD treatment services were male and half (50%) were aged 20–39 years.
  • Just under 1 in 5 (18%) clients were Aboriginal and Torres Strait Islander (First Nations) people.
  • Over 9 in 10 (94%) clients received treatment for their own drug use.

The number of people who received treatment from publicly funded AOD treatment agencies increased by 15% between 2013–14 (114,436 or 564 per 100,000 people) and 2022–23 (131,516 or 568 per 100,000). Between 2020–21 and 2021–22, the number of clients decreased by 6% (from 139,271 to 130,525) before slightly increasing by 0.8% in 2022–23 (131,516).

Who receives opioid pharmacotherapy treatment?

Data from the NOPSAD collection showed that around 53,300 clients received opioid pharmacotherapy treatment from just under 3,100 dosing point sites, across Australia on a snapshot day in mid–2023 (excluding Western Australia). Data for Western Australia were not available for the 2023 NOPSAD collection.

Opioid pharmacotherapy clients had broadly similar characteristics to clients of publicly funded AOD treatment agencies, but there was a higher proportion of people in older age groups. On a snapshot day in 2023:

  • 2 in 3 (67%) opioid pharmacotherapy clients were male, and nearly 3 in 5 (58%) were aged 30–49. 
  • Just over 1 in 10 clients (12%) were First Nations people.

Between 2011 and 2022, the number of clients receiving opioid pharmacotherapy treatment increased by 20% (from around 46,400 clients to 55,700). Across the same period, after adjusting for population growth, the rate of clients accessing opioid pharmacotherapy treatment remained stable at around 21 clients per 10,000 population. In 2023, the total rate of clients was 22 per 10,000 population, including all states and territories except Western Australia.

What drugs do people seek treatment for?

Data from the AODTS NMDS indicate that for clients who received treatment for their own alcohol or drug use, alcohol continued to be the most common principal drug of concern (PDOC) (see glossary) in 2022–23.

Between 2013–14 and 2022–23: 

  • The proportion of closed treatment episodes provided for alcohol as a PDOC decreased from 40% in 2013–14 to 32% in 2015–16 before increasing to 43% in 2022–23 (in relation to all PDOCs). 
  • The second most common PDOC in 2022–23 was amphetamines. The proportion of closed treatment episodes for amphetamines rose from 17% in 2013–14 to 24% in 2022–23 (Figure 1).

Figure 1: Proportion of closed treatment episodes for clients’ own drug use, by most common principal drugs of concern, 2013–14 to 2022–23  

The stacked bar graph shows that from 2013–14 to 2022–23. Alcohol, amphetamines, cannabis, and heroin have remained the 4 most common principal drugs of concern across the period.

In 2022–23, 43% of closed treatment episodes were for alcohol as the principal drug of concern, 24% were for amphetamines, 17% were for cannabis and 4.5% were for heroin.

Notes

  1. SA reports a high proportion of treatment episodes where amphetamines are the principal drug of concern due to the SA Police Drug Diversion Initiative (PDDI). In addition, adult cannabis offences are not included in the PDDI due to the SA Cannabis Expiation Notice legislation. 
  2. Victoria reported relatively high incidences of ‘All other drugs’ due to service provider reporting practices and limitations with the data reporting system. This system was replaced in 2019–20. In 2019–20 and 2020–21, Victoria continued to report high levels of miscellaneous episodes coded as ‘Other drugs’ or ‘Not stated’ as principal drugs of concern due to service provider reporting practices with the new data reporting system. 
  3. In Queensland, the level of cannabis reported as the principal drug of concern is a result of the police and illicit drug court diversion programs operating in the state.
  4. In the Australian Capital Territory, data collection improvements at government-operated services resulted in fewer ‘Not stated’ responses in the 2022–23 collection. Removal of criminal penalties for possession of small quantities of cannabis in the ACT at the end of January 2020 reduced the number of cannabis-related diversions recorded as treatment episodes to low levels (mainly under-18s). One large ACT program discontinued reporting in the second half of 2022–23 which may influence trend comparisons.
  5. The AODTS NMDS also collects data on a client's additional drugs of concern, but this variable is not included in these data visualisations. 
  6. Data are subject to minor revisions over time. 
  7. Components of tables may not sum to totals due to rounding.

Source: AIHW 2024a.

AODTS NMDS data indicate that there is variation in treatment episodes across age groups in terms of the most common PDOC. In 2022–23: 

  • Cannabis was the most common PDOC for young people, accounting for 64% of episodes provided to clients aged 10–19 and 30% for clients aged 20–29. 
  • Amphetamines was the most common PDOC for people aged 20–29 and 40–49 (25% each) and 30–39 (32%). 
  • Alcohol was the most common PDOC for older people, accounting for 48% of episodes for those aged 40–49, 63% for those aged 50–59, and 77% for those aged 60 and over.

Data from the NOPSAD collection show that in 2023, heroin remained the most common opioid drug of dependence among opioid pharmacotherapy clients (34%). Consistent with previous years, there was a high proportion of clients with ‘Not stated/not reported’ as the opioid drug of dependence (42%) (Figure 2).

Figure 2: Proportion of clients receiving opioid pharmacotherapy treatment on a snapshot day, by opioid drug of dependence, 2016 to 2023

The stacked bar graph shows that between 2016 and 2023, heroin was the most common opioid drug of dependence among pharmacotherapy clients (excluding ‘Not stated/not reported’). In 2023, 34% of clients reported heroin as their drug of dependence. Across the period, there was a high proportion of ‘Not stated/not reported’ responses (42% in 2023). Data for 2023 exclude Western Australia.

Notes

  1. 'Not stated/not reported' also includes 'Inadequately described' responses.
  2. Prior to 2023, NSW counted ‘buprenorphine-naloxone’ and ‘buprenorphine LAI’ as ‘buprenorphine’. In 2023, these formulations were reported separately for the first time. Trend data are not comparable.
  3. In 2020 and 2021, the increase in NSW client numbers could be attributed to the introduction of buprenorphine LAI (reported in the NOPSAD collection for the first time in 2020). Additional prescribing of buprenorphine occurred in correctional facilities, with the introduction of depot buprenorphine LAI during the year contributing to an increase in access to treatment. Some NSW Local Health Districts also reported having capacity to increase the number of new patients due to buprenorphine LAI.
  4. In 2020, the increase in Vic client numbers may have been influenced by the implementation of the Victorian Governments SafeScript initiative. SafeScript has identified people with risky prescription opioid use who were previously undetected.
  5. In 2021, changes to coding practices in Vic may have led to a decreased number of clients with 'Not stated/not reported' as the drug of dependence, and corresponding increases for some other drug categories (for example, heroin).
  6. In 2021, data for Qld were not available. Total excludes Qld. 
  7. In 2023, data for WA were not available. Total excludes WA.

Source: AIHW 2024b.

What types of treatment do people receive?

Data from the AODTS NMDS indicate that counselling continues to be the most common main treatment type for clients accessing AOD treatment. Among clients who received treatment for their own alcohol or drug use, 34% of treatment episodes in 2022–23 involved counselling as a main treatment and 23% involved an assessment only (Figure 3).

Figure 3: Proportion of closed episodes for clients’ own drug use, by main treatment type, 2013–14 to 2022–23

The stacked bar graph shows the closed treatment episodes for clients’ own drug use by main treatment type, from 2013–14 to 2022–23. In 2022–23, counselling was the most common main treatment type (34% of closed treatment episodes), followed by assessment only (23%) and support and case management (13%).

Notes

  1. 'Other' includes pharmacotherapy.
  2. Rehabilitation, withdrawal management (detoxification), and pharmacotherapy are not available for clients who received treatment for someone else’s alcohol or other drug use.
  3. In 2019–20, changes were made to categories under Main Treatment; the word ‘only’ was removed from support and case management and information and education. The removal of the word ‘only’ from support and case management and information and education, changed reporting rules for agencies; allowing agencies to be able to report and more accurately capture these items as an additional treatment in conjunction with a main treatment type.
  4. The AODTS NMDS also collects data on a client's other treatment types, as well as main treatment type, however, this variable is not included in these data visualisations. 
  5. SA reports a high proportion of Assessment only treatment episodes due to legislated client assessments under the state’s Police Drug Diversion Initiative and child protection programs. 
  6. Data are subject to minor revisions over time. 
  7. Components of tables may not sum to totals due to rounding.

Source: AIHW 2024a.

Data from the NOPSAD collection show that buprenorphine opioid drug formulations have now overtaken methadone as the most common opioid pharmacotherapy treatment provided to clients (see glossary). On a snapshot day in 2023, 50% of clients received a buprenorphine formulation as pharmacotherapy treatment and 47% received methadone (excluding Western Australia). Between 2013 and 2023, the proportion of clients receiving methadone has fallen from 67% to 47% and the proportion receiving a buprenorphine formulation has risen from 33% to 50%. This in part reflects the availability of new buprenorphine formulations such as buprenorphine long-acting injections.

Where do I go for more information?

For more information on alcohol and other drug treatment services and opioid pharmacotherapy in Australia, see:

For more on this topic, visit Alcohol & other drug treatment services.