Treatment

What treatments do people receive?

Many types of treatment are available in Australia to assist people experiencing problematic drug use, aiming to reduce the harm of drug use through services such as counselling or education. Additionally, some treatments use abstinence-oriented interventions to aid in short-term cessation or reduction of heavy and/or prolonged alcohol or other drug use, to assist clients in developing skills to facilitate substance-free lifestyles.

In 2020–21:

  • A total of 242,094 treatment episodes were provided to people for their own or someone else’s alcohol or drug use.
  • Clients received an average of 1.7 treatment episodes nationally.
  • Treatment episodes increased by 58% since 2011–12 (from 153,668) and 1.9% from the previous year (237,545 in 2019–20).

What are the treatment types?

Counselling continues to be the most common treatment provided.

In 2020–21:

  • Counselling continued to be the most common main treatment type, comprising of almost 2 in 5 (38%) of all treatment episodes, followed by Assessment only (20%) and support and case management (15%).
  • Among people who sought support for their own drug or alcohol use, just under 2 in 5 (37%) received counselling as their main treatment and 1 in 5 received an assessment only (21%).
  • Among people who sought support for someone else’s drug use, over 2 in 5 (43%) received counselling as their main treatment and over 3 in 10 (31%) received support and case management (Figure MAINTREATMENT.1).

Nationally since 2011–12, proportions of treatment episodes for each main treatment type have changed:

  • Support and case management increased from 8.8% to 15% of all treatment episodes in 2020–21.
  • Assessment only rose from 14% to 20% over the same period.
  • Withdrawal management fell from 17% to 9.2%, and counselling declined from 43% to 38%.

More recently, decreases may be related to COVID-19 health restrictions which were introduced in early 2020 and which continued into 2021. Such restrictions may have impacted client access to alcohol and drug treatment services (Figure MAINTREATMENT.1). Please see the Alcohol and other drug treatment services NMDS Data Quality Statement, 2020–21 for further information about COVID-19 impacts on access to alcohol and drug treatment services. 

In 2020–21, across states and territories:

  • Counselling was the most common main treatment provided across most states and territories except the Northern Territory and the Australian Capital Territory. The proportion of counselling episodes ranged from 3 in 10 (27%) episodes in Victoria to 7 in 10 episodes in Western Australia (70%).
  • Information and education was the most common main treatment type in the Australian Capital Territory, comprising of around 3 in 10 (27%) episodes.
  • Assessment only was the most common main treatment type in the Northern Territory (45%). All agencies in the Northern Territory are required to complete a separate assessment only episode prior to the commencement of treatment. This is related to a policy on monitoring the volume of assessment work performed by agencies, particularly in relation to certain alcohol-related legislative-based programs. This policy was introduced during the AODTS NMDS 2017–18 collection year (Figure MAINTREATMENT.1).

Jurisdictional variation in main treatment type may reflect differences in service provision between states and territories. For example, police drug diversion referrals in South Australia may have contributed to the relatively large proportion of assessment only treatment episodes compared with other jurisdictions.

Figure TREATMENTCLIENTS.1: Closed treatment episodes, by main treatment type, client type and state and territory, 2011–12 to 2020–21

The stacked bar graph shows the closed treatment episodes for clients’ own drug use by main treatment type, client type and state and territory, from 2011–12 to 2020–21. Counselling has remained the most common treatment type in Australia in this time, with counselling being provided in 83,691 episodes (37.5%) for clients’ own drug use and 8,153 episodes (43.5%) for others’ drug use in 2020–21.

Among clients seeking treatment for their own drug use in Australia in 2020–21, assessment only (46,374 episodes, 20.8%), support and case management (30,687 episodes, 13.7%) and withdrawal management (22,296 episodes, 10.0%) were the next most common treatment types.

Among clients seeking treatment for their other’s drug use in Australia in 2020–21, support and case management (5,854 episodes, 31.2%), assessment only (1,853 episodes, 9.9%) and information and education (853 episodes, 4.5%) were the next most common treatment types.

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Treatment delivery setting

2 in 3 treatment episodes were provided in a non-residential treatment setting.

Nationally, in 2020–21:

  • Around 2 in 3 treatment episodes were provided in a non-residential treatment setting (66% of episodes), such as community-based Non-Government Organisations (NGOs) and hospital outpatient services.
  • The next most common settings were residential treatment settings (13%), which allow clients to stay in a facility that is not their home or usual place of residence, and outreach settings (8.6%) (such as mobile/outreach alcohol and other drug treatment service providers) (Figure TREATMENTDELIVERY.1).

Figure TREATMENTDELIVERY.1: Closed treatment episodes, by main treatment type, delivery setting and state and territory, 2011–12 to 2020–21

The horizontal stacked bar graph shows the number of closed treatment episodes by main treatment type, delivery setting and state and territory. Most treatment episodes were delivered in non-residential treatment settings.

In 2020–21, the most common treatments by setting in Australia were: counselling (78,146 episodes, 48.6%) in non-residential settings; withdrawal management (14,313 episodes, 45.1%) was most common in residential settings; assessment only (5,247 episodes, 64.5%) in home settings; counselling (6,338 episodes, 30.5%) in outreach settings; and support and case management (6,720 episodes, 32.5%) in other settings.

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Across all treatment episodes in 2020–21, counselling was the most common main treatment type for treatments delivered in a non-residential setting (49%) or outreach setting (31%) (Figure TREATMENTDELIVERY.1).

In 2020–21, treatment provided varied among people receiving treatment for their own drug use:

  • Non-residential treatment settings were the most common where the principal drug of concern was heroin (71% of episodes), cannabis (71%), alcohol (64%) or amphetamines (64%).
  • Residential treatment settings were the next most common setting for people receiving treatment for heroin (13%), alcohol (17%) or amphetamines (15%) as a principal drug of concern. Outreach settings were a common setting for those receiving treatment for cannabis (11%) as a principal drug of concern.
  • Withdrawal management was the most common main treatment delivered in a residential setting, consisting of almost half (46%) of all episodes.

Treatment provided also varied among people receiving treatment for another person’s drug use:

  • Counselling was the most common main treatment delivered in home settings, consisting of half of all episodes (53%). This was followed closely by counselling delivered in non-residential settings (52%) and home settings (41%).
  • Counselling was also the most common main treatment delivered in outreach settings (41%).

Length of treatment

Clients whose principal drug of concern was amphetamines spent longer in treatment, with a median duration of 36 days.

In 2020–21, the median treatment duration across all treatment episodes was 4 weeks (28 days). For each client type the following was reported:

  • Among clients receiving treatment for their own drug use, the median duration of treatment was 27 days, similar in 2019–20 (26 days).
  • Among clients receiving support for someone else’s drug use, the median duration was 37 days, a small increase from 2019–20 (35 days), and more than double the median duration in 2018–19 (14 days).

The duration of treatment episodes varied by main treatment type and principal drug of concern:

  • Among all clients, the median duration was 64 days for clients receiving counselling, 43 days for rehabilitation, 29 days for support and case management, 8 days for withdrawal management, and 1 day for assessment only.
  • Among the four most common principal drugs of concern, median treatment duration was longest for amphetamines (36 days), followed by heroin (27 days), alcohol (26 days) and cannabis (20 days). Since 2011–12, the median duration of heroin treatment episodes fell from 32 days to 27 days and the median duration of amphetamine treatment increased from 26 days to 36 days.

What are the common reasons for ceasing treatment?

In 2020–21, almost 3 in 5 (59%) of all treatment episodes ended in a planned or expected completion, and 1 in 5 (20%) treatment episodes ended due to an unplanned completion (Figure REASONCESSATION.1). These figures have remained relatively constant over the 10 years from 2011–12.

Reasons for ceasing treatment varied based on main treatment type. For example, 36% of treatment episodes where rehabilitation was the main treatment type ended due to unplanned completion, while 72% of treatment episodes where withdrawal management was the main treatment type ended in a planned or expected completion.

Figure REASONCESSATION.1: Closed treatment episodes, by reason for cessation and main treatment, 2011–12 to 2020–21 

The stacked bar graph shows closed treatment episodes, by reason for cessation and main treatment, 2011–12 to 2020–21. Expected/planned completion has consistently remained the most common reason for cessation for all treatments in this time, increasing from 100,506 episodes (65.4%) in 2011–12 to 143,674 episodes (59.3%) in 2020–21.

Ending due to unplanned completion has remained the next most common reason for cessation for all treatments, increasing from 31,455 episodes (20.5%) to 48,323 episodes (20.0%).

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