Alcohol treatment in Australia: Client characteristics and patterns of service use, 2013–14 to 2022–23

The Alcohol and Other Drug Treatment National Minimum Data Set (AODTS NMDS) includes information about the principal drug of concern (PDOC) that the client stated led them to receive treatment. In this report, the criteria include clients who have received treatment only for alcohol, or for alcohol and another PDOC across multiple episodes between 2013–14 and 2022–23. For further information see Technical notes – Overview of analysis variables and inclusion criteria.

Process analysis of non-recurring treatment pathways for alcohol

Between 2013–14 and 2022–23, 185,054 clients received 336,318 treatment episodes in fewer than 3 years (non-recurring treatment) (noting these do not have to be consecutive). Process analysis describes the flow of treatment provided to these clients whose PDOC was alcohol, by key treatment characteristics. The analysis includes all treatment episodes provided to clients in the non-recurring cohort between 2013–14 and 2022–23. For more information, see What is process analysis?

Principal drug of concern

Process analysis by PDOC for non-recurring treatment indicated that nearly half (46%) of all clients received an initial treatment episode for alcohol. However, there were many different PDOC combinations in the treatment sequences for clients who received treatment for alcohol and another PDOC. 

In Figure Non-recurring treatment 1 treatment episodes are ranked according to the number of episodes for each PDOC (left-hand side column).  The probability of the subsequent episode involving treatment for the same or a different PDOC is shown by the intensity of colour across the row. For example, alcohol ranked the highest (most treatment episodes involved this PDOC) and the next most common treatments involved either exiting treatment (34%) or another episode of treatment for alcohol (29%). 

Of all treatment sequences provided to clients who received non-recurring treatment for alcohol and another PDOC:

• Nearly 3 in 10 (29%, or 12,721) treatment episodes provided for alcohol as a PDOC involved a subsequent treatment episode for alcohol.
• Alcohol was the most common PDOC in a subsequent episode after a treatment episode was provided for cannabis (42%), followed by pharmaceuticals (37%), and amphetamines (33%) (see Figure non-recurring treatment 1, Table alcohol treatment 16). 

Figure non-recurring treatment 1: Non-recurring treatment pathways for clients who received treatment for alcohol and another principal drug of concern, by principal drug of concern, 2013–14 to 2022–23

Main treatment

For clients who received non-recurring treatment for alcohol only or alcohol and another PDOC, around 2 in 5 initial episodes involved counselling (47% and 40%, respectively). Where clients did not receive an initial treatment episode for counselling, around 1 in 4 initial episodes involved assessment only for alcohol only or alcohol and another PDOC (22% and 24%, respectively). 

Process analysis by main treatment type for non-recurring treatment indicated that treatment sequences were similar for clients who received treatment for alcohol only or alcohol and another PDOC.

Of all the treatment sequences of clients who received non-recurring treatment for alcohol only:

• After receiving any main treatment, the most common subsequent activity was to exit treatment (ranging from 49%, or 14,276 of episodes for withdrawal management to 76%, or 10,367 of episodes for information and education). 
• If clients did not exit treatment, the next most common activity: 
  • after receiving an episode of either assessment only, withdrawal or pharmacotherapy was to receive an episode of counselling (ranging from 15%, or 7,317 of episodes for assessment only to 20%, or 316 of episodes for pharmacotherapy).
  • after receiving an episode of information and education, rehabilitation, or support and case management, the most common subsequent episode was to receive the same main treatment type (ranging from 11%, or 1,474 of episodes for information and education to 15%, or 3,499 of episodes for support and case management) (Figure non-recurring treatment 2, Table alcohol treatment 13).

Of all treatment pathways provided to clients who received non-recurring treatment for alcohol and another PDOC:

• After receiving any main treatment, the next most common activity was to exit treatment, similar to clients who received treatment for alcohol only, but the proportions of clients who exited treatment for this cohort were much smaller (ranging from 25% for both support and case management (3,195 episodes) and withdrawal management (2,340 episodes) to 39% for counselling (13,615 episodes).
• If clients did not exit treatment, the next most common subsequent activity for counselling, assessment only, information and education, rehabilitation, and pharmacotherapy was to receive a treatment episode for counselling. For all other treatment types, the same main treatment type was the next most common (Figure non-recurring treatment 2, Table alcohol treatment 13).

Figure non-recurring treatment 2: Non-recurring treatment pathways for clients who received treatment for alcohol only or alcohol and another principal drug of concern, by main treatment, 2013–14 to 2022–23

Trace analyses display the most common pathways among clients who received non-recurring treatment for alcohol, by key treatment characteristics. The traces represent sequences of treatment episodes in the order in which clients received non-recurring treatment between 2013-14 and 2022–23. For more information, see What is process analysis?

Principal drug of concern

There were around 36 unique sequences by PDOC among clients who received non-recurring treatment for alcohol only between 2013–14 and 2022–23. For clients who received non-recurring treatment for alcohol and another PDOC, there were around 3,000 unique treatment sequences.

For clients who received non-recurring treatment for alcohol only, the most common pathway involved one treatment episode for alcohol. This was similar across all age groups (ranging from 62% (23,194 clients) aged 40–49 to 82% (10,430 clients) aged 10–19), client sex (65% or 33,742 for females, 68% or 70,864 for males) and remoteness area of client (ranging from 66% (58,001, and 20,094 clients) for Major cities and Inner regional areas to 71% (14,134 clients) for Outer regional areas) (Figure non-recurring treatment 3, tables alcohol treatment 17–19).

For clients who received non-recurring treatment for alcohol and another PDOC, the two most common pathways for both males and females involved an initial episode for either cannabis or alcohol, followed by a second episode for either alcohol or cannabis. accounting for 22% (4,368) and 19% (1,503) of clients, respectively after which the pathways diverged. Pathways differed by the age group when clients first received treatment and by remoteness area of client:

• For clients aged 10–19 the top 4 of the 5 most common pathways involved an initial episode for cannabis followed by a subsequent episode for either cannabis or alcohol, or vice versa (ranging from 3% to 22%, or 147–1,001 clients).  
• For clients aged 20–49 the top 4 of the 5 most common pathways involved an initial episode for either cannabis, alcohol or amphetamines followed by a subsequent episode for either cannabis, alcohol or amphetamines (ranging from 7% to 13%, or 291–1,110 clients). 
• For clients aged over 50 the top 4 of the 5 most common pathways involved an initial episode for either another drug of concern, alcohol or cannabis, followed by a subsequent episode for either another drug of concern, alcohol or cannabis (ranging from 4% to 11%, or 31–171 clients) 
• 4 of the 5 most common pathways involved an initial episode for either alcohol, cannabis or amphetamines followed by a subsequent episode for any of these PDOCs for clients who lived in Major cities (ranging from 6% to 11%, or 925–1,809 clients), Inner regional (ranging from 6% to 12%, or 318–642 clients), Outer regional (ranging from 6% to 16%, or 184–519 clients) and Remote/Very remote areas (ranging from 6% to 17%, or 82–241 clients) (Figure non-recurring treatment 3, tables alcohol treatment 17–19). 

Figure non-recurring treatment 3: Non-Recurring treatment pathways for clients who received treatment for alcohol, by age group, sex, or remoteness area, 2013–14 to 2022–23 

Main treatment

Trace analysis indicated that there were around 4,700 unique sequences by main treatment type among clients who received non-recurring treatment for alcohol only between 2013–14 and 2022–23. A similar number were identified for clients who received treatment for alcohol and another PDOC (around 4,500 unique treatment sequences).

For clients who received non-recurring treatment for alcohol only:

• The 2 most common pathways for clients involved 1 treatment episode for counselling or 1 treatment episode for assessment only. This was similar for all client age groups with these pathways together accounting for 44–51% of clients, client sex (47% or 49,697 of males and 44% or 22,925 of females), and remoteness area of client (44–51% of clients).
• However, for clients aged 10–19 the 2 most common pathways involved either 1 episode for counselling or 1 episode for information and education which together accounted for 50%, or 6,384 of clients (Figure non-recurring treatment 4, tables alcohol treatment 20–22).

For clients who received non-recurring treatment for alcohol and another PDOC:

• The most common pathway for clients involved 2 treatment episodes for counselling and this was similar for all age groups (ranging from 9.1% (190 clients) for those aged 50–59 to 16% (1,327) for those aged 20–29) and sex (13% (986) females and 14% (2,807) for males). 
• For clients who lived in Major cities, Inner regional or Outer regional areas the 2 most common pathways involved an initial episode for counselling or assessment only followed by a subsequent episode for counselling (which together accounted for between 17–23% of clients). For clients who lived in Remote and very remote areas the 2 most common pathways involved treatment episodes for counselling (accounting for 33% (470) of clients) (Figure non-recurring treatment 4, tables alcohol treatment 20–22).

Figure non-recurring treatment 4: Non-recurring treatment pathways for clients who received treatment for alcohol, by main treatment, age group, sex, or remoteness area, 2013–14 to 2022–23