Pharmacotherapy

There are several medications (pharmacotherapies) used to treat problems with alcohol, tobacco and other drugs. These pharmacotherapies can be prescribed for a short, medium or long-term duration, depending on the person’s goals. Pharmacotherapies work in different ways. Some work by reducing cravings, others by providing an aversive (negative) reaction when used in combination with a substance. Other types of pharmacotherapy prevent withdrawal, reduce cravings and block the reinforcing effects of additional drug use. Pharmacotherapies are prescribed by approved prescribers and dispensed either through a community pharmacy or a specialist clinic (Department of Health 2019). Pharmacotherapy programs are available for a range of drugs, including alcohol and opioids. Where pharmacotherapy is used for withdrawal, it is also included in the ‘withdrawal’ category.

Only episodes where pharmacotherapy was either an additional treatment, or where it was the main treatment with an additional treatment provided, are included in the AODTS NMDS. Episodes where pharmacotherapy was the main treatment only and no additional treatment was provided are excluded. Pharmacotherapy is only available to clients receiving treatment for their own drug use. As most pharmacotherapy services are outside the scope of the AODTS NMDS, the data presented here are a substantial under‑representation. More information on opioid pharmacotherapy in Australia is available from the AIHW’s National Opioid Pharmacotherapy Statistics. The latest data indicate that on a snapshot day in 2020, over 53,300 clients received pharmacotherapy for opioid dependence, as reported in the National Opioid Pharmacotherapy Statistics Annual Data report (NOPSAD) (AIHW 2020).

For services that were in scope of the AODTS NMDS in 2019–20:

  • pharmacotherapy accounted for 2% (5,043) of total closed episodes for clients’ own alcohol or drug use.
  • of these episodes, 32% (1,620) reported pharmacotherapy as an additional treatment (tables ST.1, ST.74–75).

Client profile

In 2019–20, for clients whose main treatment was pharmacotherapy:

  • 7 in 10 (70%) clients seeking treatment for their own alcohol or drug use were male and 15% identified as Indigenous Australians
  • around two‑thirds (67%) of all clients were aged 30–49 and a further 16% of clients were aged 20–29 (Tables SC.15–SC.17).

Treatment profile

For treatment episodes involving pharmacotherapy for a client’s own alcohol or drug use:

  • almost 1 in 5 (19%) episodes lasted over 12 months, while 29% lasted 3–12 months
  • where pharmacotherapy treatment was provided as a main treatment type, the most common principal drugs of concern were heroin (44%), alcohol (14%), and amphetamines (8%)
  • when pharmacotherapy was provided as an additional treatment type, the most common principal drugs of concern were alcohol (44%), amphetamines (24%), and heroin (11%) (tables ST.79, ST.80, ST.84).

References

See reference list