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 recurring treatment pathways for alcohol

Process analysis describes the flow of treatment provided to clients whose PDOC was alcohol, by key treatment characteristics. The following analysis includes all treatment episodes (fewer than 13) provided to clients in the recurring cohort between 2013–14 and 2022–23.  For more information, see What is process analysis?

Principal drug of concern

Between 2013–14 and 2022–23, 49,489 clients received 300,323 treatment episodes in at least 3 years (noting that these do not need to be consecutive). Process analysis by PDOC for recurring treatment indicated that while around 2 in 5 (44%) clients received an initial treatment episode for alcohol, there were many different PDOC combinations in the treatment sequences for clients who received treatment for alcohol and another PDOC.

In Figure 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 treatment involved another episode of treatment for alcohol (52%).

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

• Around half (52%, or 43,428) of treatment episodes provided for alcohol as a PDOC involved a subsequent treatment episode for alcohol.
• Initial treatment episodes for cannabis (22%), amphetamines (17%), other drugs of concern (9.1%), pharmaceuticals (4.8%) or heroin (3.0%) involved a subsequent treatment episode for the same PDOC initially treated (ranging from 24%, or 3,517 of episodes for other drugs of concern to 51%, or 21,612 of episodes for amphetamines).
• Treatment episodes for alcohol were a common subsequent treatment after episodes were provided for other drugs of concern (38% or 5,564), cannabis (29%, or 9,161), pharmaceuticals (26%, or 2,223), and amphetamines (20%, or 21,612) (Figure recurring treatment 1, Table alcohol treatment 15).

Figure recurring treatment 1: 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 recurring treatment for alcohol only (45%) or alcohol and another PDOC (44%) over 2 in 5 initial episodes involved counselling. This was followed by assessment only and withdrawal management as the main treatment.

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

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

• Clients who received rehabilitation, counselling, assessment only, and withdrawal management as a main treatment type commonly received a subsequent episode for the same main treatment type (ranging from 22% or 2,038 for rehabilitation to 45% or 20,622 for counselling). 
• For clients who received information and education, other treatment, pharmacotherapy, and support and case management, the most common subsequent episode was counselling (ranging from 23%, or 1,044 of episodes for other treatment to 29%, or 355 of episodes for pharmacotherapy).
• Where clients received the same main treatment type in a subsequent episode, the next most common treatment was counselling (ranging from 20%, or 1,917 of episodes for rehabilitation to 25%, or 4,929 of episodes for assessment only) followed by exiting treatment (ranging from 13%, or 2,598 of episodes for withdrawal management to 19%, or 8,823 of episodes for counselling) (Figure recurring treatment 2, Table alcohol treatment 12).

Of all the treatment sequences of clients who received recurring treatment for alcohol and another PDOC:

• Clients who received withdrawal management, counselling, support and case management, and rehabilitation as a main treatment type most commonly received a subsequent episode for the same main treatment type (ranging from 22%, or 2,886 of episodes for rehabilitation to 43%, or 31,762 of episodes for counselling).
• Clients who received assessment only, information and education, other, and pharmacotherapy most commonly received a subsequent episode for counselling (ranging from 19%, or 1,541 of episodes for other treatment to 33%, or 2,342 of episodes for information and education).
• If clients didn’t receive the same main treatment type in a subsequent episode, the next most common treatment was similar to clients who only received treatment for alcohol only, where it was counselling or the same main treatment type they initially received, followed by exiting treatment (Figure recurring treatment 2, Table alcohol treatment 12).

Figure recurring treatment 2: 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 recurring treatment for alcohol, by key treatment characteristics. The traces represent sequences of treatment episodes in the order in which clients received recurring treatment between 2013–14 and 2022–23. For more information, see What is process analysis?

Principal drug of concern

Trace analysis indicated that there were around 10 unique sequences by PDOC among clients who received recurring treatment for alcohol only between 2013–14 and 2022–23. For clients who received recurring treatment for alcohol and another PDOC, there were around 12,300 unique treatment sequences.

For clients who received recurring treatment for alcohol only, the most common pathway for clients involved at least 3 treatment episodes (in at least 3 years between 2013–14 and 2022–23) for alcohol and this was similar for all age groups when clients first received treatment (ranging from 19% (1,806 clients) for clients aged 40–59, to 32% (131 clients) aged 10–19), client sex (19% (1,406 clients) for females and 21% (2,636 clients) for males ), and remoteness area of client (ranging from 19% (2,177 clients) in Major cities to 26% (610 clients) in Outer regional areas) (Figure recurring treatment 3, tables alcohol treatment 23–25).

For clients who received recurring treatment for alcohol and another PDOC, because there were so many unique pathways, there was not a predominant pathway. For example, the two most common pathways for clients by sex involved an initial episode for cannabis, followed by episode/s for cannabis or for alcohol, accounting for 1% of clients (ranging from 88–302 clients). This also differed by client age and 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 subsequent episodes for either cannabis or alcohol (ranging from 1.3% to 3.5%, or 56–153 clients).  
• For clients aged 30–39 the 2 most common pathways involved an initial episode for amphetamines or alcohol followed by a subsequent episode of amphetamines or alcohol (1%, ranging from 88–89 clients).
• For clients aged 40-49 and 50-59 the 2 most common pathways involved an initial episode for cannabis or alcohol followed by subsequent episodes for alcohol or amphetamines (ranging from 0.8% to 1%, or 12 to 51 clients).
• the top 2 most common pathways involved initial episodes for cannabis followed by alcohol for clients who lived in Major cities (ranging from 1.1% to 1.2%, or 177–191 clients), Inner regional (ranging from 1.2% to 1.6%, or 66–84 clients), Outer regional (ranging from 1.6% to 1.8%, or 53–60 clients) or Remote/Very remote areas (ranging from 2.1% to 2.8%, or 31–42 clients) (Figure recurring treatment 3, tables alcohol treatment 23–25).

Figure recurring treatment 3: 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 10,500 unique sequences by main treatment type among clients who received recurring treatment for alcohol only between 2013–14 and 2022–23. For clients who received treatment for alcohol and another PDOC, there were more, around 17,300 unique treatment sequences.

The pathways for clients who received recurring treatment for alcohol only and alcohol and another PDOC were similar: 

• For clients who received recurring treatment for alcohol only, the most common pathway for clients involved at least 3 treatment episodes for counselling and this was similar for all age groups (when clients first received treatment) (ranging from 3.6% (55 clients) for clients aged 60+ to 11% aged 10–19 (289 clients)), client sex (4.9% (367 clients) for females and 5.5% (677 clients) for males), and remoteness area of client (ranging from 4.2% (471 clients) for Major cities to 11.0% (191 clients) for Remote/Very remote areas) (Figure recurring treatment 4, tables alcohol treatment 26–28).
• Similarly, for clients who received recurring treatment for alcohol and another PDOC, the most common pathway for clients involved at least 3 treatment episodes for counselling and this was similar for all age groups (ranging from 2.1% (32 clients) for clients aged 50–59 to 4.4% (192 clients) aged 10–19), sex (2.8% (242 clients) for females and 3.4% (706 clients) for males) and remoteness area (ranging from 2.9% (472 clients) in Major cities to 8.2% (122 clients) in Remote/Very remote areas).
• For clients aged over 60 when they first received treatment the most common pathway involved 5 treatment episodes for counselling followed by 3 treatment episodes for assessment only (1.7% or 6 clients) (Figure recurring treatment 4, tables alcohol treatment 26–28).

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