COVID-19 impact on alcohol and other drug treatment services

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.

Key findings

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:

  • For the type of treatment provided:
    • a drop in closed episodes for both rehabilitation and information and education main treatment types in Quarter 4 (April to June) 2019–20.
  • For where the treatment was provided:
    • a drop in treatment episodes provided in residential treatment facilities in Quarter 4 2019–20, reflecting reduced client capacity in this setting and thus availability of treatment places
    • a substantial increase in treatment episodes provided in a home setting in Quarter 4 2019–20, reflecting agencies adapting to telephone/video consultations.

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.

Access to alcohol and other drug treatment

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.  

Variation in main treatment type

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).

Figure COVID1: Closed treatment episodes, by main treatment type, state and territory, quarterly data, 2018–19 to 2019–20

Nationally, main treatment types that showed variation most likely attributable to COVID-19 restrictions, included the following:  

  • The drop in the number of closed treatment episodes for rehabilitation as a main treatment type in Quarter 4 2019–20 was greater than expected compared with quarterly trends in 2018–19.
  • Similarly, information and education quarterly trend data show a substantial drop in treatment episodes for Quarter 4 2019–20, where the previous year’s quarterly treatment episodes showed relatively little variation.
  • Assessment only quarterly trend data in 2019–20 do not show the same pattern of growth seen in Quarter 2–4 in 2018–19: there was no sustained growth in treatment episodes for Quarter 4 2019–20. 
  • Quarterly treatment trends for support and case management episodes differed between the two years, however, the gradual increase in the number of treatment episodes in 2019–20 was not maintained in Quarter 4. The number of treatment episodes in Quarter 4 2019–20 was lower than the same quarter in 2018–19.
  • Counselling quarterly treatment episodes show a notable increase in Quarter 4 2019–20, where previous year’s quarterly episodes showed relatively little variability.

Variation in AOD treatment delivery settings

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).

Figure COVID2: Closed treatment episodes, by treatment delivery setting, state and territory, quarterly data, 2018–19 to 2019–20

A comparison of national quarterly trends in AOD service delivery settings in 2019–20 and 2018–19 show:

  • Residential treatment facilities: the drop in the number of treatment episodes provided in residential treatment facilities in Quarter 4 2019–20 was greater than might be expected compared with quarterly trends in 2018–19.
  • Outreach settings: the provision of treatment in an outreach setting showed a different quarterly pattern between 2018–19 and 2019–20, however there was a notable decrease in Quarter 4 2019–20 treatment episodes, greater than might be expected relative to the yearly trend.
  • Home setting: the provision of treatment in the home generally shows little variation across time with the number of episodes provided in this setting the smallest of all delivery settings. There was a substantial increase in the number of episodes provided in Quarter 4 2019–20 compared with previous time periods.

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:

  • decreases in treatment services for rehabilitation and withdrawal management, may in part be due to reduced client capacity in residential settings and thus availability of treatment places
  • the change from face-to-face to telephone or video conferencing services, for treatments such as group counselling sessions, and support and case management
  • treatment types provided by outreach services were limited in their ability to provide treatment due to the face-to-face nature of this service delivery; by contrast, non-residential services  such as home and ‘other’ increased due to access to telehealth consultations
  • the drop in information and education treatment episodes may be a consequence of COVID-19 and public health restrictions on justice system operations (police/court referrals mainly refer clients to information and education programs); availability of suitable settings for group Information and education treatment impacted delivery
  • adapting service delivery for service types such as assessment, counselling, and support and case management to better suit online or offsite (home) treatment settings.  The increased reporting of ‘other’ treatment settings may reflect agencies adapting to telephone/video conference consultations.

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: