Alcohol and other drug treatment services in Australia annual report

Alcohol and other drugs treatment services clients

Clients may receive treatment for their own or someone else’s alcohol or drug use (see Key terminology and glossary). Characteristics of all clients are described below, including client's principal drugs of concern by age group and clients receiving treatment in multiple collection years.

Characteristics of clients

The number of clients treated by publicly funded alcohol and other drug treatment agencies increased from 133,895 in 2015–16 to 139,295 in 2019–20. While the number of clients has increased by 4% over this period, when taking into consideration population growth, the rate of clients accessing services has not increased. In 2019–20 the rate was 624 clients per 100,000 population, similar to the rate of 629 five years earlier (Table AODTS Clients.1).

In 2019–20, 131,076 clients received treatment for their own alcohol or drug use and 13,884 received treatment in relation to someone else’s alcohol or drug use. A small proportion (4.1% or 5,665 closed treatment episodes) of clients sought treatment for their own alcohol or drug use as well as for someone else’s alcohol or drug use (Table SCR.30).

The Alcohol and Other Drug Treatment Services (AODTS) collection captures information on treatment services accessed by clients. It does not measure the underlying need for treatment or level of problematic alcohol or drug use in the community. Changes in client numbers may be due to clients’ access to treatment, treatment availability and/or funding available for alcohol and other drug treatment services.

Note: Based on records with a valid statistical linkage key (SLK-581).

(a) In 2015–16 client numbers were imputed due to low response rates for valid SLK-581.

Source: Alcohol and Other Drug Treatment Services National Minimum Data Set Table SCR.21.

Client profile

In 2019–20:

• most clients (93%) received treatment for their own alcohol or drug use and were likely to be male (66% of clients)
• in contrast, clients who received treatment for someone else’s alcohol or drug use (7%) were more likely to be female (50%) (Tables SC.1–2)
• the rate of clients receiving AOD services was highest for those that lived in Very remote areas (1,865 clients per 100,000 population), followed by Remote areas (1,382 clients per 100,000) and Outer regional areas (887 clients per 100,000; Table SCR.29)
• almost 4 in 5 (79%) clients received treatment at a single agency, 14% at 2 agencies, and 7% of clients received treatment at 3 or more agencies (Table SCR.23).

Client service use over multiple years

Nationally, an estimated 469,059 Australians have sought AOD treatment, receiving one or more closed treatment episodes since 2015–16 (Figure CLIENT1; Table SCR.28).

Of these clients, over the 5 years to 2019–20:

• The majority received treatment in a single year (72%):
  • 17% 77,571) received treatment for the first time in 2019–20
  • A further 55% (259,884) received treatment in only one of the four collection periods (excluding 2019–20).
• Of the 139,300 clients aged 10 and over that received treatment in 2019–20; over 2 in 5 (44%) clients had previously sought treatment by an AOD service in one or more years since 2015–16.

Figure CLIENTS1: Client service use over multiple years, 2015–16 to 2019–20 (%)

Source: AIHW Alcohol and Other Drug Treatment Services National Minimum Data Set Table SCR.28.

Age and sex

Clients who received treatment for their own alcohol or drug use tended to be younger than those who received treatment for someone else’s alcohol or drug use.

In 2019–20, client characteristics revealed:

• the majority of all clients were male (64%)
• two thirds (66%) of clients receiving treatment for their own alcohol or drug use were aged under 40 years, compared with half (51%) of those who received treatment for someone else’s alcohol or drug use
• clients aged 60 and over accounted for 4% of clients who received treatment for their own alcohol or drug use, compared with 12% of clients who received treatment for someone else’s alcohol or drug use (Figure CLIENTS2, Table SC.3).

 Figure CLIENTS2: Proportion of clients by client type, sex and age group (years), 2019–20

Closed treatment episodes from 2010–11 to 2019–20 revealed:

• the median (midpoint) age from all treatment episodes rose from 33 to 35 years
• for episodes related to another’s alcohol or drug use; clients were generally older than those receiving treatment for their own drug use, with the median age fluctuating from 41 years in 2010–11 down to 39 years in 2014–15, rising to 44 years in 2016–17 and 2017–18, then dropping to 39 years in 2019–20 (Table SE.8).

Indigenous Australians

Despite comprising 2.6% of the Australian population aged 10 and over in 2019–20 (ABS 2019a), clients who identified as Aboriginal and/or Torres Strait Islander continue to be overrepresented among AODTS clients.

In 2019–20 Indigenous clients accounted for 17% of all clients (an estimated 23,333 clients) treated by publicly funded AOD services. Nationally, this equates to a rate of 3,606 clients per 100,000 Indigenous Australians. Indigenous status was not reported for 5% of AODTS clients (tables SCR.4, SCR.26).

Aboriginal and/or Torres Strait Islander people were overrepresented in both client groups:

• 1 in 6 (17% or 22,187) clients receiving treatment for their own alcohol or drug use
• 1 in 10 (11% or 1,146) clients receiving treatment for someone else’s alcohol or drug use (Table SC.4).

In 2019–20, the main drugs that led Indigenous clients to seek treatment were alcohol, amphetamines, cannabis, heroin and volatile solvents.

Clients and drugs of concern

AOD treatment services provide treatment for the client’s drug that is of most concern for them, this is referred to as their principal drug of concern.

Different age groups sought treatment for different principal drugs of concern. For clients who received treatment for their own alcohol or drug use in 2019–20:

• Alcohol was the most common principal drug of concern in the older age groups: almost 3 in 5 clients aged 50–59 (58%) and over 7 in 10 clients aged 60 and over (74%) received treatment for alcohol as a principal drug of concern.
• Cannabis was the most common principal drug of concern in young clients: 3 in 5 clients aged 10–19 (59%) received treatment for cannabis as a principal drug of concern.
• Amphetamines were the most common principal drug of concern in the middle age groups: almost 2 in 5 clients aged 30–39 (38%) and 3 in 10 clients aged 20–29 (31%) received treatment for amphetamines as a principal drug of concern (Figure CLIENTS3, Table SC.7).

Figure CLIENTS3: Clients who received treatment for their own drug use, by age group (years), and principal drug of concern, 2013–14 to 2019–20

The age and sex profiles of the clients for the different principal drugs of concern varied. For clients who received treatment for their own alcohol or drug use in 2019–20:

• where heroin was the principal drug of concern, treatment was more common for clients aged over 30 (83% of clients); primarily clients aged 30–39 (39%) and 40–49 (32%), compared with 0.8% of clients aged 10–19 (Table SC.7)
• over half (51%) of all clients receiving treatment for codeine as the principal drug of concern were female clients
• males were seven times more likely to receive treatment for cocaine as a principal drug of concern than females (88% of episodes for males and 12% for females; Table SC.6)
• over 8 in 10 (84%) clients receiving treatment for volatile solvents as the principal drug of concern were Indigenous clients (Table SC.8).

Usual accommodation type for client

The collection of information about a client’s usual type of accommodation where they lived prior to the start of their episode of AOD treatment enables AOD services to identify clients who may be vulnerable, such as clients from custodial settings or clients at risk of homelessness. This information may help identify clients living in a public place or homeless, supporting the ‘no exit to homelessness’ policy where agencies can only discharge a client to safe, stable housing (Department of Social Services 2020).

Usual accommodation type for the client prior to treatment is reported for selected jurisdictions: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory. As data quality improves additional jurisdictional data will be reported. The following analysis includes 59% of all closed treatment episodes (141,250) (Figure CLIENTS4).

In 2019–20, closed treatment episodes regarding the usual accommodation type for AODTS clients from New South Wales, Queensland, Western Australia, South Australia and the Northern Territory revealed:

• the most common usual accommodation prior to the start of the AOD treatment episode in all selected jurisdictions was Independent residential accommodation (e.g. private residences, boarding houses, private hotels and informal housing)
  • Independent residential accommodation ranged from 67% in the Northern Territory to 84% in Queensland and Western Australia.
• the Northern Territory reported of the highest proportion of episodes with usual accommodation types custodial (Prison/remand centre/youth training centre) and supported independent living (Figure CLIENTS4; Table SE.28).

Figure CLIENTS4: Closed episodes by clients accommodation type prior to treatment service, selected states and territories, 2019–20