Aboriginal and Torres Strait Islander (First Nations) people

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Overview Client profile Profile of new and returning clients Principal drug of concern Main treatment Australian Government-funded Aboriginal and Torres Strait Islander (First Nations) people AOD reporting

In 2023–24, Aboriginal and Torres Strait Islander (First Nations) people accounted for 18% (24,967) of people aged 10 and over who received treatment or support for their own or someone else’s alcohol or drug use (Table SCR.26).

Nationally, the rate of First Nations people who received treatment remains high:

  • The rate of First Nations people who received treatment for alcohol or drug use has increased over time, from 2,800 per 100,000 people in 2016–17 to 3,078 in 2023–24 (crude rate for clients aged 10 and over).
  • In 2023–24, First Nations people were more than 6 times as likely to receive treatment for alcohol or drug use as non-Indigenous Australians after adjusting for differences in age structure (3,121 per 100,000 people compared with 485 per 100,000, age standardised rates for clients aged 10 and over) (Figure FIRST NATIONS 1, Table SCR.26).

Figure FIRST NATIONS 1: Estimated number and rate of clients, by Indigenous status, 2016–17 to 2023–24

Line graph shows that between 2013–14 to 2023–24, the age-standardised rate of clients was consistently higher for First Nations people than non-Indigenous Australians. Data is filtered by age-standardised rate and number of clients.

Line graph shows that between 2013–14 to 2023–24, the age-standardised rate of clients was consistently higher for First Nations people than non-Indigenous Australians. Data is filtered by age-standardised rate and number of clients.

Client profile

In 2023–24:

  • Of all clients who received treatment for their own alcohol or drug use, around 1 in 5 were First Nations clients (23,283 or 19%).
  • Of all clients who received treatment for someone else’s alcohol or drug use, around 1 in 10 (989 or 11%) were First Nations clients. 

In 2023–24, among First Nations clients aged 10 and over:

  • 3 in 5 (58%) were male and 2 in 5 (38%) were female.
  • 3 in 4 (77%) were aged 20 to 49 years.
  • Indigenous status was not reported for 2.8% (3,637) of clients (Figure FIRST NATIONS 2, tables SC.5–SC.8).

Figure FIRST NATIONS 2: Proportion of First Nations clients by Indigenous status, sex and age group (10 years and over), 2023–24

Butterfly chart shows the disaggregation of First Nations clients by sex age group in 2023–24. Data can be disaggregated by sex, age group and client type for 2013–14 to 2023–24.

Butterfly chart shows the disaggregation of First Nations clients by sex age group in 2023–24. Data can be disaggregated by sex, age group and client type for 2013–14 to 2023–24.

Profile of new and returning First Nations clients 

Treatment is an important part of reducing the harms associated with alcohol and drug use and it is crucial that those seeking treatment can access services that best meet their needs (The Department of Health and Aged Care 2019a). Some individuals may seek lifelong treatment and ongoing support to achieve long-term changes. For other people, early intervention and treatment may suffice, while some may only seek intermittent access to treatment as required (The Department of Health and Aged Care 2019b).

Of the First Nations clients who received treatment for the first time in 2023–24 (new clients), 2 in 5 (39%, 9,474) had not previously received treatment since 2013–14.

Of the First Nations clients in 2023–24, who had previously received AOD treatment (returning clients), 3 in 5 (61%, 14,798) had previously received alcohol and other drug treatment from a service at some point since 2013–14, when client reporting was enabled.

Principal drug of concern

The main principal drugs of concern that First Nations people received treatment for were alcohol (36% of clients), amphetamines (27%), cannabis (20%), and heroin (5.1%) (Figure FIRST NATIONS 3, Table SC.11).

National trends in the main drugs of concern have changed over time:

  • The crude rate of First Nations people who received treatment for alcohol has fluctuated but has risen steadily from 1,018 per 100,000 people in 2016–17 to 1,134 in 2023–24.
  • The crude rate of First Nations people who received treatment for amphetamines increased from 733 per 100,000 people in 2016–17 to 915 per 100,000 people in 2023–24, after peaking in 2019–20 at 943 (Table SCR.26).

In 2023–24, after adjusting for differences in age-structure, First Nations people were:

  • Eight times as likely to receive treatment for heroin (age standardised rate ratio) as non-Indigenous Australians (194 per 100,000 compared with 23 per 100,000).
  • Seven and eight times as likely to receive treatment for alcohol or amphetamines (respectively) as non-Indigenous Australians.
  • Seven times as likely to receive treatment for cannabis as non-Indigenous Australians (574 per 100,000 compared with 85 per 100,000) (Figure FIRST NATIONS 3, Table SCR.26).

Figure FIRST NATIONS 3: Proportion and rate of First Nations AODTS clients, by Indigenous status and principal drug of concern, 2016–17 to 2023–24

Dashboard with a stacked horizontal bar chart and line chart shows the age-standardised rate and proportion of principal drug of concern by Indigenous status.

Dashboard with a stacked horizontal bar chart and line chart shows the age-standardised rate and proportion of principal drug of concern by Indigenous status.

Main treatment

For the 23,283 First Nations people who received treatment for their own alcohol or drug use, counselling was the most common main treatment type (36% of clients), followed by assessment only (25%). Similarly, for First Nations people who received treatment for another person’s alcohol or drug use (989), counselling was the most common treatment type (45%), followed by support and case management (33%, Table SC.20). Clients can also receive one or more treatment episodes within the reference year.

The referral into treatment and the setting for treatment varied by treatment type for First Nations clients:

  • 1 in 3 referrals for First Nations clients into treatment were from a family member or a self-referral (32%).
  • 3 in 10 (28%) of all referrals for First Nations clients into treatment were from a health service and 1 in 5 (18%) of referrals into treatment were from a correctional service.
  • First Nations clients who received either withdrawal management (54%) or pharmacotherapy (53%) as a treatment type for their own drug use, were most likely to be referred by a family member or a self-referral.
  • The most common treatments provided in a non-residential setting for First Nations clients were counselling (87%) or pharmacotherapy (94%).
  • Rehabilitation (81%) and withdrawal management (68%) were the most common treatment types provided in residential settings for First Nations clients (Figure FIRST NATIONS 4 and First Nations 5, tables SC.21 and SC.22).

Figure FIRST NATIONS 4: Proportion of First Nations AODTS clients, by Indigenous status, main treatment type and referral source for all clients, 2023–24

Stacked horizontal bar chart shows main treatment type by source of referral for First Nations clients in 2023–24.

Stacked horizontal bar chart shows main treatment type by source of referral for First Nations clients in 2023–24.

Figure FIRST NATIONS 5: Proportion of First Nations AODTS clients, by Indigenous status, main treatment type and delivery setting for all clients, 2023–24

Stacked horizontal bar chart shows main treatment type by non-residential treatment settings in 2023–24. 

Stacked horizontal bar chart shows main treatment type by non-residential treatment settings in 2023–24. 

Australian Government-funded First Nations AOD reporting

The Australian Government funds primary healthcare services and substance use services specifically for First Nations people. These services may be in scope for the AODTS NMDS, but not all of the services report to the NMDS. Substance use services previously reported via the First Nations Online Services Report (OSR) data collection up to 2017–18 (AIHW 2024). The substance use services program was transferred to the Indigenous Affairs Group within the Department of Prime Minister and Cabinet in September 2013 and then to the National Indigenous Australians Agency in July 2019 (Australian National Audit Office 2017, National Indigenous Australians Agency 2024). Since the cessation of substance use services data being collected by the OSR, the number of substance use services for First Nations people, that are considered in-scope and reporting to the AODTS NMDS has gradually increased. 

The National Agreement on Closing the Gap noted that funding for Aboriginal and Torres Strait Islander (First Nations) Alcohol and Other Drugs (AOD) services and support will increase by up to $66 million to 2024–25, in addition to current funding. First Nations’ AOD Treatment Services funded under the Indigenous Advancement Strategy (IAS) currently assists more than 65 providers to deliver AOD activities (Department of Prime Minister and Cabinet 2024). The Commonwealth also provides AOD treatment services and prevention, research and communication activities through the Drug and Alcohol Program (DAP) and funding to Primary Health Networks (PHNs), with nearly 30% of PHN funding allocated for First Nations specific treatment services (National Indigenous Australians Agency 2022).

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