Alcohol and other drug treatment services in Australia annual report

Pharmaceuticals: client demographics and treatment

In 2020–21, pharmaceuticals were reported as a drug of concern (either principal or additional) in 11% of all treatment episodes (24,200 episodes) (Table Drg.87).

• Pharmaceuticals was the principal drug of concern in 4.8% of treatment episodes (10,800 episodes) (Table Drg.87). This proportion relative to all drugs of concern has declined from 7.7% in 2011–12 (11,300 episodes).
• Consistent with previous years, pharmaceuticals were more likely to be reported as an additional rather than principal drug of concern (13,400 episodes or 6.0%) (Table Drg.87). The most common additional drugs of concern reported with pharmaceuticals were amphetamines (16% or 1,700 episodes), cannabis (15% or 1,600 episodes) and alcohol (12% or 1,300 episodes) (Figure DRUGS1; Table Drg.89).

Pharmaceuticals by drug type

In 2020–21, opioids and benzodiazepines accounted for 3 in 4 episodes provided for a pharmaceutical drug as the PDOC (74% or 8,000 episodes) (Table Drg.87). ‘Opioids’ includes codeine, morphine, buprenorphine, oxycodone, methadone and other opioids.

• Opioids as a group, were a principal drug of concern in 2.1% of all treatment episodes and an additional drug of concern in 1.7% (4,800 and 3,700 episodes, respectively). Buprenorphine (1,200 episodes), methadone (910) and oxycodone (890) were the most common drug types recorded in opioid-related treatment episodes.
• Benzodiazepine was a principal drug of concern in 1.5% of treatment episodes and an additional drug of concern in 2.7% (3,300 and 6,000 episodes, respectively).

Over the 10 years to 2020–21:

• The number of treatment episodes with pharmaceuticals as the principal drug of concern decreased slightly, from 11,300 to 10,800 episodes. Proportionally, episodes for pharmaceuticals fell from 7.7% to 4.8%.

• The number of treatment episodes for benzodiazepines initially decreased from 2,500 episodes from 2011–12 to 1,700 episodes in 2015–16, increasing to 3,300 in 2020–21.
• The number of episodes for opioids peaked at 7,700 in 2013–14 before falling to 4,800 episodes in 2020–21 but fluctuated over time by drug type (Figure PHARMS1; Table Drg.90).

Figure PHARMS1: Treatment episodes with pharmaceuticals as the principal drug of concern, relative to most common principal drugs of concern or by selected pharmaceutical drug types, 2011–12 to 2020–21 (number or per cent)

Client demographics

In 2020–21, around 6,200 clients received treatment for any pharmaceutical drug as the principal drug of concern (Table SC.30). Of these clients:

• Around 3 in 5 were male (62% of clients). The proportion of male clients ranged from 48% for codeine to 94% for steroids (Table SC.30).

• Over 1 in 2 were aged 20–29 (26% of clients) or 30–39 (28%). The proportion of clients in each age group varied by PDOC:
  • Clients receiving treatment for benzodiazepines had the highest proportion of people aged 10–19 (22% of clients).
  • Most clients receiving treatment for opioids were aged either 30–39 or 40–49, ranging from 51% for oxycodone to 66% for methadone (Table SC.31).
• Around 1 in 7 were Indigenous Australians (14% of clients). The proportion of Indigenous clients was highest for buprenorphine (24% of clients) (Table SC.32).

 Treatment

In 2020–21, around 10,800 treatment episodes were provided to clients for pharmaceuticals as the principal drug of concern (Table Drg.87).

• The most common sources of referral were health services (42% of episodes) and self/family (40%). This was relatively consistent across drug types, but diversion was the most common referral source for steroid-related treatment episodes (38% of episodes) (Table Drg.92).
• The most common main treatment types were counselling (24% of episodes) and assessment only (23%) (Figure PHARMS2; Table Drg.91). Counselling was the most common main treatment across most drug types, although assessment only was the most common main treatment in treatment episodes for most opioid drugs (except codeine).
• Most episodes took place in non-residential treatment facilities (71% of episodes); this was the most common treatment setting across drug types (Figure PHARMS2; Table Drg.94).
• Almost 3 in 5 treatment episodes ended with a planned completion (58% of episodes, ranging from 46% for morphine as the PDOC to 69% for steroids). One in 5 episodes ended unexpectedly (20%) (Figure PHARMS2; Table Drg.93).

Figure PHARMS2: Treatment episodes with selected pharmaceutical drugs as the principal drug of concern, by main treatment type, reason for cessation or treatment delivery setting, 2020–21 (per cent)