COVID-19 impact on alcohol and other drug treatment services

Key findings

Alcohol and Other Drug (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 across the first three COVID-19 waves from 2018–19 to 2020–21 showed:

  • Decreases in rehabilitation during Apr-Jun 2020 continued to Jun 2021 due to continued public health restrictions which reduced availability of treatment places.
  • The initial increases in counselling between Apr and Dec 2020 were followed by declines in the subsequent first 6 months of 2021.
  • More changes in treatment episodes for rehabilitation and counselling were observed in Major Cities and Inner regional areas than other areas.
  • More changes in treatment delivered in residential, home, and outreach settings were observed in Major cities and Inner regional areas than in other areas.
  • Nationally, the general pattern of AOD treatment showed an initial drop across most main treatments in wave 1 (Apr-Jun 2020) followed by increases in subsequent months for most treatment types. This quarterly pattern is consistent with the total annual numbers of treatment episodes (242,980) and clients (139,271) remaining steady in 2020–21 compared with previous years.

In response to the COVID-19 pandemic, a range of public health regulations were introduced in Australia from mid-March 2020 to limit the spread of COVID-19. These public health regulations were extended in late March 2020 with all non-essential services ordered to temporarily close by the Australian Government.

There have been four main waves of COVID-19 in Australia (Figure COVID1):

  • the first was in March/April 2020, the beginning of the pandemic, cases were reported in all states and territories
  • the second wave started in June/July of 2020 with the majority of cases reported in Victoria
  • the third wave started in June/July of 2021 mainly impacting New South Wales, Australian Capital Territory and Victoria, lasting until the end of October 2021
  • the fourth wave started in December 2021 following the introduction of the Omicron variant affecting all states and territories.

International and domestic border restrictions and a suite of public health restrictions continued into 2022 which resulted in a slower progression of COVID-19 cases in Western Australia.

Figure COVID1: Key COVID-19 dates 2020 and 2021

The flow chart shows that Wave 1 of the COVID-19 pandemic started in March/April 2020 (affecting all states and territories), Wave 2 started in June/July 2020 and continued into September 2020 (with most COVID-19 cases in Victoria), Wave 3 started in June/July 2021 (with most cases in NSW, ACT and Victoria), and Wave 4 started in December 2021 (the Omicron variant, affecting all states and territories). The AODTS NMDS 2020–21 collection includes all closed episode data up to 30 June 2021.

Access to alcohol and other drug treatment

A total of 242,980 treatment episodes were provided to people for their own or someone else’s alcohol or drug use in 2020–21, increasing by 2.3% from the previous year (237,545 in 2019–20). The number of clients treated by publicly funded AOD treatment services was similar (139,295 clients in 2019–20  and 139,271 in 2020–21). Taking into consideration population growth, this equates to 623 clients per 100,000 people in 2019–20, falling to 618 clients per 100,000 people in 2020–21.

From March 2020 onwards, states and territories reported that specialised treatments provided by AOD services were affected by the introduction of public health regulations. This included social distancing measures, which led to a reduction in the availability of treatment as the number of people that could be accommodated or assessed in each treatment setting was reduced to comply with this public health guideline. In response to the health regulations, treatment services adapted practices, for example by expanding access to online services and telehealth appointments.

Health regulations continued into 2021, and some jurisdictions experienced localised lockdowns. Viewing quarterly trends provides insights into when and how services adapted. Nationally, the general pattern of AOD treatment showed an initial drop across most main treatments in wave 1 (Apr-Jun 2020) followed by increases in subsequent months. This quarterly pattern is consistent with the total annual numbers of treatment episodes and clients remaining steady in 2020–21 compared with previous years.

The type of main AOD treatment and where it is delivered are intricately linked. Some examples of this association are provided, to better understand how changes in one can affect the other as services adapted to delivering AOD treatment in a pandemic. For example:

  • adapting service delivery for treatment types such as assessments, 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
  • treatment types provided by outreach services were limited due to the face-to-face nature of this service delivery
  • an increase in treatment types provided in non-residential treatment settings and the decreases in other delivery settings reflects services adapting to where some treatments were being provided in different settings
  • decreases in treatment services for rehabilitation in bed-based settings were due to continued public health restrictions which reduced client capacity and thus availability of treatment places. Rehabilitation is mainly provided in residential settings
  • changes in treatment provided and where it was delivered during the first three waves of COVID-19 were more noticable in Major cities and Inner regional areas than in other areas. The greater volume of clients and services in these areas contributed to these observed changes.

Note that the trends have been identified nationally and by remoteness areas; individual jurisdiction trends may differ.

The collection period for the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) is by financial year. To examine the impact of the pandemic, closed treatment episode data from 2018–19, 2019–20 and 2020–21 were analysed by quarterly periods and compared.

Data collected for 2020–21 contains closed treatment episodes up to 30 June 2021 which provided early reporting for Wave 3 of COVID-19. Treatment episode data for Wave 4 of COVID-19 has not been collected yet.

Comparison of quarterly financial year episode data allows for data collected for the first three waves of COVID-19 to be compared across 2018–19 (prior to COVID-19), 2019–20 and 2020–21 collection periods (Figure COVID1).

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.