Australian Institute of Health and Welfare 2021. Alcohol and other drug treatment services in Australia annual report. Cat. no. HSE 250. Canberra: AIHW. Viewed 24 July 2021, https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare. (2021). Alcohol and other drug treatment services in Australia annual report. Retrieved from https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Alcohol and other drug treatment services in Australia annual report. Australian Institute of Health and Welfare, 16 July 2021, https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare. Alcohol and other drug treatment services in Australia annual report [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Jul. 24]. Available from: https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol and other drug treatment services in Australia annual report, viewed 24 July 2021, https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia
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In response to the COVID-19 pandemic, a range of measures were introduced in Australia in mid-March 2020 to limit the spread of COVID-19. These measures were extended in late March 2020 with all non-essential services ordered to temporarily close by the Australian Government. Restrictions eased in most jurisdictions over the mid-year period, with the exception of Victoria, which continued with lockdown measures into November 2020.
AOD treatment services reported changes in service usage and impacts on treatment provision in response to the COVID-19 pandemic. Nationally, a comparison of quarterly trends in AOD treatment episodes over 2018–19 and 2019–20 showed:
This section explores access to alcohol and other drug treatment services by examining the type of alcohol and other drug treatments provided and the delivery settings in which these occurred. Comparison of quarterly financial year episode data allows for the period of lock down (April-June) to be compared across the 2019–20 year and with previous years’ data.
Quarterly reporting of Alcohol and other drug treatment services data
The collection period for the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) is by financial year. In order to examine the impact of the pandemic, which began mid-way through the collection period, closed treatment episode data from 2019–20 are analysed quarterly and compared with the equivalent data from the previous collection year. Financial year data include treatment episodes that ended within the period and excludes those that were ongoing or new (not closed) within the reporting year. This will lead to an underestimation of the number of treatment episodes presented in this analysis. Quarters are presented as financial year quarters in this analysis; Q1=Jul-Sep, Q2=Oct-Dec, Q3=Jan-Mar, Q4=Apr-Jun. See Key terminology and glossary.
The COVID-19 restrictions introduced new challenges for both clients accessing alcohol and other drug (AOD) treatment and AOD service providers. The aim for services across Australia was to support flexible AOD treatment delivery and maintain the health and safety of clients and service providers. The restrictions caused a number of AOD services to either suspend treatment or operate in new or different ways in 2020. From March 2020 onwards, states and territories reported specialised treatments provided by AOD services were affected by the introduction of social distancing measures, reducing availability of treatment places. In response, a number of treatment services adapted practices by expanding access to online services and telehealth appointments.
Note that the trends below have been identified nationally and individual jurisdiction trends may differ.
Nationally, between 2018–19 and 2019–20 there were some notable changes in main treatment service types, particularly treatment services involving groups of people or requiring tailored physical settings. Analysis of the number of closed treatment episodes shows that some changes in main treatment type trends are likely to be associated with the COVID-19 pandemic restrictions (Figure COVID1).
Nationally, main treatment types that showed variation most likely attributable to COVID-19 restrictions, included the following:
Some types of treatment provided to AOD clients require specific settings. For example, withdrawal (detox) and rehabilitation treatment service types are mostly provided in residential settings whereas counselling, support and case management can be provided in most settings. Some delivery settings were impacted more than others in the last quarter of 2019–20 (Figure COVID2).
A comparison of national quarterly trends in AOD service delivery settings in 2019–20 and 2018–19 show:
The type of main AOD treatment and where it is delivered are intricately linked. The identified changes in the number of treatment episodes for some treatment types and some treatment delivery settings over the COVID-19 period likely reflect this association. For example:
COVID–19 impact on state and territory AOD treatment services
Summary information provided by states and territories, regarding the AODTS NMDS data collection for 2019–20:
COVID–19 restrictions impacted delivery of services including withdrawal management and residential rehabilitation. Some services closed for a short period of time, and adapted service operations once they re-opened, due to limited bed capacity in accordance with social distancing guidelines. Face-to-face services were reduced and services transitioned to the use of telehealth (primarily telephone or video conference), group counselling sessions were moved online.
Increases in AOD service demand during COVID may have been due to:
Decreases in AOD services may have been affected by:
COVID-19 restrictions impacted the main treatment types including withdrawal management (detoxification) and residential rehabilitation, as bed-based units were operating at reduced capacity to ensure social distancing guidelines were met; bed-based occupancy decreased compared to pre-COVID occupancy.
The number of treatment referrals decreased, and the number of admission cancellations increased for residential withdrawal and rehabilitation services.
The majority of AOD service providers moved to a telehealth model and discontinued face-to-face contact with clients unless the client received withdrawal or residential rehabilitation services. Due to reduced capacity for residential services, wait times between referrals and admissions increased.
There was an overall decrease in closed treatment episodes across all treatment types for the period of March-June 2020. The treatment types of counselling and information and education decreased from March to June 2020 compared to the same period in the previous year.
During the March to June 2020 period, diversion episodes (both public and private) decreased. Diversion treatment that is provided as part of police and court diversion has been steadily declining since 2015–16, but experienced a large decrease in 2019–20 due to the impact of COVID-19 and public health restrictions. Specifically, the public health restrictions substantially reduced and restricted the operation of Magistrates Courts between March 2020 and June 2020. From March to August 2020, most police and court diversion appointments were scheduled to occur by telephone, with only a few providers offering face-to-face appointments.
As a result of COVID–19 restrictions, services offered more telehealth appointments and decreased bed capacity across residential services, reducing the amount of people accessing AOD services.
As a result of COVID–19 restrictions, AOD services offered more telehealth appointments in place of face-to-face treatment. Group treatment sessions were cancelled and telehealth appointments were offered instead. Medically Assisted Treatment for Opioid Dependence prescription review periods were increased from 3 to 6 months during COVID restrictions.
There was an overall reduction in the number of closed AOD treatment episodes in Tasmania, from April 2020 as a result of COVID-19 restrictions. The main treatment types of rehabilitation and counselling declined over the April to June 2020 period and face-to-face outreach services moved to providing telehealth services.
As a result of COVID-19 restrictions, non-residential face-to-face and group treatment changed to telehealth services. There was also decreased bed capacity in residential rehabilitation and withdrawal services, as well as decreased intake of new clients to residential and non-residential services.
As a result of COVID-19 restrictions, there was a decrease in the number closed treatment episodes for treatment provided in residential rehabilitation to ensure social distancing guidelines were adhered to. Outreach services increased to compensate for reduced residential services.
For the April to June 2020 period, closed episodes where main treatment type was residential rehabilitation decreased compared to the same period in the previous year.
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