Heroin: client demographics and treatment

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In 2023–24, heroin was reported as a drug of concern (either principal or additional) in 5.6% of all treatment episodes (12,209) (Table Drg.4).

Heroin was the fourth most common principal drug of concern:

  • In 4.3% of all treatment episodes (9,406) (Table Drg.4).
  • This has remained consistent across the 10 years to 2023–24, although the proportion of heroin-related episodes has declined from a peak of 6.1% (9,908) in 2014–15 (Table Drg.5).

In 2023–24, over 1 in 3 (39%, 3,679) heroin-related treatment episodes reported at least 1 additional drug of concern (Table Drg.2). The most common additional drugs of concern were amphetamines (35%, 2,109), cannabis (20%, 1,170) and nicotine (13%, 786) (Table Drg.3). Clients can nominate up to 5 additional drugs of concern: these drugs may not have been the subject of any treatment within the episode.

Figure HEROIN: Closed treatment episodes for own alcohol or drug use by heroin as a principal drug of concern and top 5 additional drugs of concern, 2023–24

The flow chart shows heroin as a principal drug of concern broken down by additional drugs of concern.

Note: Diagram presents the top 5 additional drugs of concern for a principal drug of concern by closed treatment episodes. Totals do not add to 100%.

Treatment for heroin use in the AODTS NMDS collection

People who receive treatment for heroin use have several options for treatment, including withdrawal programs (called detoxification) and abstinence-based treatment (for example, residential rehabilitation in a therapeutic community) (O’Brien 2004). 

In Australia, one of the most common treatments for heroin use is opioid pharmacotherapy treatment (also known as opioid agonist therapy). Opioid pharmacotherapy involves replacing opioid drugs, including heroin, with a longer-lasting, medically prescribed opioid. 

Agencies whose sole function is to prescribe or provide dosing services for opioid pharmacotherapy are excluded from the AODTS NMDS. Data from these agencies are captured in the National Opioid Pharmacotherapy Statistics Annual Data (NOPSAD) collection (AIHW 2024). For more information, please see the 2024 NOPSAD report.

For information on heroin use and harms, please see:

Client demographics

In 2023–24, 5,462 clients received treatment for heroin as the principal drug of concern. Of these clients:

  • 2 in 3 were male (68%) (Table SC.9).
  • 2 in 3 were aged either 30–39 (32%) or 40–49 (33%) (Table SC.10). This was consistent for both males and females (Figure HEROIN 1).
  • 1 in 5 were Aboriginal and Torres Strait Islander (First Nations) people (22% of clients) (Table SC.11). This represents a rate of 175 First Nations clients per 100,000 people (crude rate for clients 10 and over) (Table SCR.26).

Figure HEROIN 1: Clients with heroin as the principal drug of concern, by sex and age group, 2023–24

Butterfly chart shows the disaggregation of male and female clients receiving treatment for heroin as the principal drug of concern by age group in 2023–24.

Butterfly chart shows the disaggregation of male and female clients receiving treatment for heroin as the principal drug of concern by age group in 2023–24.

Treatment

In 2023–24, 9,406 treatment episodes were provided to clients for heroin as the principal drug of concern (Table Drg.4).

Among heroin-related treatment episodes in 2023–24:

  • Self/family (41%) was the most common source of referral into treatment followed by health services (29%) (Figure HEROIN 2, Table Drg.55).
  • The most common main treatment type was assessment only (22%), followed by pharmacotherapy (20%) and counselling (19%) (Figure HEROIN 2, Table Drg.54).

In the 10 years to 2023–24, main treatment types for heroin have fluctuated:

  • Treatment episodes for withdrawal management decreased from 15% to 7.2% (or from 1,532 to 680).
  • Conversely, pharmacotherapy episodes increased from 17% to 20% (from 1,730 to 1,835). Fluctuations in pharmacotherapy treatment episodes over time can be attributed to changes to jurisdictional coding practices and systems, resulting in under-reporting of pharmacotherapy at the national level (Table Drg.54).
  • 7 in 10 treatment episodes took place in a non-residential treatment facility (73%) (Table Drg.56).
  • The median duration of treatment episodes was around 5 weeks (32 days) (Table Drg.58).
  • 3 in 5 treatment episodes ended with a planned completion (58%), while 1 in 5 (20%) ended unexpectedly (Figure HEROIN 2, Table Drg.56).

Figure HEROIN 2: Treatment episodes with heroin as the principal drug of concern, by main treatment type, reason for cessation or source of referral, 2014–15 to 2023–24

Line graph shows the number of episodes with heroin as the principal drug of concern for main treatment type, reason for cessation, and source of referral from 2014–15 to 2023–24. Data is filtered by episodes and per cent.

Line graph shows the number of episodes with heroin as the principal drug of concern for main treatment type, reason for cessation, and source of referral from 2014–15 to 2023–24. Data is filtered by episodes and per cent.

In 2023–24, injecting remained the most common method of use in heroin-related treatment episodes (74%) (Table Drg.6). Clients reported injecting drugs in the past 3 months in nearly half of treatment episodes (46%). In a further 11% of episodes, clients reported that they last injected 3–12 months ago (Table Drg.52).

Between 2014–15 and 2023–24 the proportion of treatment episodes where clients receiving treatment for heroin as a principal drug of concern reported that they had never injected drugs increased 3-fold, rising from 6.4% (636) to 19% (1,749) (Table Drg.52).

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