Alcohol and other drug treatment services in Australia annual report

In 2021–22, 351 publicly funded alcohol and other drug treatment agencies in Victoria provided 87,630 treatment episodes to 36,375 people (tables Agcy.1, SCR.21).

Victoria reported:

• a 2.6% decrease in treatment episodes (from 90,000 in 2020–21 to 87,600 in 2021–22). Factors contributing to this decrease include, general and administrative impacts on services and data collection (e.g. changes in funding for services, partial reporting of data during the financial year, and services with no closed treatment episodes as treatment was ongoing).
• a 55% increase (56,400 episodes) in treatment episodes since 2012–13 (Table ST VIC.2)
• more clients are using AOD services in 2021–22 than 2013–14, after adjusting for population growth (631 clients per 100,000 population compared with 580 per 100,000, respectively)
• a 13% increase in clients from 2017–18 (33,000) peaking in 2019–20 (37,400), then decreasing by 2.7% (36,400) in 2021–22 due to COVID-19 impacts and state-wide system changes. Client numbers increased gradually from 2013–14 (29,500) (Table SCR.21).

In 2021–22, nearly 7 in 10 (71%) clients in Victoria attended 1 agency and received an average of 2.4 treatment episodes, which is higher than the national average of 1.8 treatment episodes (tables SCR.21, SCR.23). This is due to the methods used in Victoria’s data collection system, where each type of treatment (regardless of main or additional treatment) results in a separate treatment episode (see Data Quality Statement for further information).

Client demographics

In 2021–22:

• over 8 in 10 (83% or 30,300) clients in Victoria received treatment for their own alcohol or drug use, of which over 1 in 2 (56%) people were male (Figure VIC 1, tables SC VIC.1, SCR.27)
• 2.7% (960) of all clients reported sex as ‘other’, the highest proportion reported across all states and territories in the collection period. This category was collected for the first time in 2018–19 (Table SC VIC.1)
• nearly 3 in 5 (56%) of all people were aged 20–39 years
• 10% of all clients identified as Indigenous Australians, which is lower than the national proportion (18%)
• the majority (82%) of all clients were born in Australia and mostly (95%) reported English as their preferred language (tables SC VIC.1–3, SC.4, SC VIC.21–22).

Patterns of service use

Over the period 2017–18 to 2021–22, 113,700 people received treatment in Victoria. Of these clients, the majority received treatment in a single year (64% or 73,200):

• 17,800 (16%) received treatment for the first time in 2021–22
• a further 55,400 (49%) received treatment in only one of the five collection periods (excluding 2021–22) (Table SCR.28).

Drugs of concern

In 2021–22 for clients in Victoria receiving treatment for their own alcohol or drug use:

• alcohol was the most common principal drug of concern, accounting for 39% (27,900) of treatment episodes
• amphetamines (26% or 19,100 episodes) were the second most common principal drug of concern, followed by cannabis (19% or 13,500) (Figure VIC 2, Table ST VIC.6).

In 2021–22, for clients receiving treatment for their own use of amphetamines:

• methamphetamine was reported as a principal drug of concern in over 3 in 5 (65%) of treatment episodes (Figure VIC 3a)
• smoking was the most common method of use in 58% of episodes where methamphetamine was the principal drug of concern, followed by injecting (18%) (Figure VIC 3b).

Victoria is working with service providers to encourage more specific reporting of amphetamine use (for example, to reduce the use of ‘amphetamines not further defined’ code where possible).

In 2019–20, Victoria reported comparatively high incidences of ‘Not stated drugs’ (15%) as the drug of concern. This proportion decreased in 2020–21 (2.1%), due to work with service providers by the Victorian Agency for Health Information to encourage more specific reporting of drug of concern. In 2021–22, this remains low, 4.7% of treatment episodes. For more information see the Data quality statement.

Clients can nominate up to 5 additional drugs of concern; these drugs are not necessarily the subject of any treatment within the episode (see technical notes). In 2021–22, when the client reported additional drugs of concern, cannabis was the most common (9.5% of episodes), followed by nicotine and alcohol (7.6% and 6.7%, respectively) (Table ST VIC.7).

Over the period 2012–13 to 2021–22:

• alcohol was the most common principal drug of concern for treatment episodes except in 2019–20 when amphetamines were the most common principal drug of concern (28% and 29% respectively):
  • the proportion of episodes ranged from 42% in 2012–13 to 28% in 2019–20, before increasing to 39% in 2021–22
  • the number of episodes fell 26% from 21,500 in 2012–13 to 15,800 in 2014–15, rising to 27,900 episodes in 2021–22 (Figure VIC 2, Table ST VIC.7).
• amphetamines were the second most common principal drug of concern (26% or 19,100 episodes). The proportion of episodes with a principal drug of concern for amphetamines increased from 13% in 2012–13 to peak at 30% in 2018–19, decreasing in 2021–22 (26%):
  • within the amphetamines group, methamphetamine was reported as the principal drug of concern for the first time in 2014–15 (2.2% of episodes). This was followed by a large increase in 2018–19 (43%) and 2021–22 (65%) (Figure VIC 3a)
  • the rise in episodes for methamphetamine is due mainly to improvements in agency coding practices for methamphetamines, although some of the increase in episodes could be related to increases in funded treatment services.
• the proportion of treatment episodes for cannabis decreased from 22% in 2012–13 to 19% in 2021–22 (Figure VIC 2, Table ST VIC.7).

Treatment

In 2021–22, counselling was the most common treatment type (25% of episodes) followed by support and case management (23%) (Figure VIC 4, Table ST VIC.13).

The majority of services who submit AODTS NMDS data use the Victorian Alcohol and Drug Collection (VADC), which does not differentiate between main and other treatment types. A small proportion of services who submit AODTS NMDS data use their own data collection systems, which do differentiate between main and other treatment types.

Over the period from 2012–13 to 2021–22:

• counselling remained one of the most common main treatments for all episodes in 2021–22 (25%), though this proportion has halved since 2012–13 (53%)
• support and case management as a main treatment increased from 13% in 2012–13, peaking in 2015–16 (30%) and falling to 23% in 2021–22 
• withdrawal management decreased from 21% to 11% and ‘other’ treatment increased from 0.6% to 16% over the same period (Figure VIC 4, Table ST VIC.13).

Agencies

In 2021–22, in Victoria:

• only 3 of the 351 AOD agencies that received public funding were government treatment agencies
• over 6 in 10 (61%) treatment agencies were located in Major cities, followed by Inner regional areas (29%) (Figure VIC 5; Table Agcy.3)
• Victoria does not have any areas classified as Remote or Very remote.

In the period from 2012–13 to 2021–22, the number of publicly funded treatment agencies in Victoria increased from 129 in 2012–13 to 404 in 2018–19, dropping to 351 in 2021–22 (Table Agcy.1).

The increase in agency numbers over time in Victoria is attributed to counting each location of a service delivery outlet, which may be located in different areas for a single agency.