Introduction
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Introduction Alcohol consumption Patterns of AOD service use What does this report examine?Tobacco, alcohol, and illicit drug use contribute to increased chronic disease, injury, poisoning and premature death and are among the leading risk factors contributing to the total disease burden in Australia (AIHW 2024a).
The Australian Burden of Disease Study 2024 found that alcohol use was the sixth highest risk factor contributing to the burden of disease in Australia and was responsible for 4.1% of the total burden of disease and injury. Alcohol use was the leading risk factor for males aged 15–44 (10%), for females it was the second leading risk factor (4.2%). The disease burden for alcohol included alcohol dependence, cancers, cardiovascular diseases, chronic liver disease, and injuries (AIHW 2024a).
Alcohol consumption
Most people in Australia aged 14 and older have consumed alcohol in their lifetime and most of these people drink within the recommended guidelines. The 2022–2023 National Drug Strategy Household Survey (NDSHS) found that, of the population aged 14 and over:
- Over three-quarters (77%) had consumed alcohol in the previous 12 months.
- About 1 in 3 people (31% or 6.6 million people) consumed alcohol in ways that put their health at risk (drank alcohol at levels above the guideline recommendations).
In the 2022–2023 NDSHS, alcohol-related risk is calculated using questions from the ASSIST-Lite. 'High risk' scores may indicate substance dependence, while 'moderate risk' scores indicate use that may be hazardous or harmful. People who receive a high-risk score are likely to require specialist assessment and treatment for their substance use (AIHW 2024b).
In 2022–2023, of the people who consumed alcohol and had a medium-risk score for alcohol consumption in the previous 12 months:
- Nearly 9 in 10 (88%) did not participate in a tobacco, alcohol or drug treatment program. Just over 1 in 10 (11.7%) participated in a tobacco, alcohol or other drug treatment program in the previous 12 months (4.5%) or more than 12 months ago (7.4%).
In 2022–2023, of the people who consumed alcohol and had a high-risk score for alcohol consumption in the previous 12 months:
- Nearly 3 in 4 (74%) did not participate in a tobacco, alcohol or drug treatment program. Just over 1 in 4 (26%) participated in a tobacco, alcohol, or other drug treatment program in the previous 12 months (12.5%) or more than 12 months ago (13.2%).
Treatment is an important part of reducing the harms associated with alcohol use and it is crucial that those seeking treatment can access services that best meet their needs (The Department of Health and Aged Care 2019a). Some individuals may seek lifelong treatment and ongoing support to achieve long-term changes. For other people, early intervention and treatment may suffice, while some may only seek intermittent access to treatment as required (The Department of Health and Aged Care 2019b).
Patterns of AOD service use
Support and services for people who use alcohol and other drugs, as well as their families and friends, are available through specialised alcohol and other drug (AOD) treatment services. When entering AOD treatment, clients and services identify the clients’ goals and develop a treatment plan accordingly. AOD treatment can often involve multiple episodes of care, with some clients receiving more intensive treatment (more episodes over a number of years) than others. Factors such as principal drug of concern (PDOC) and treatment type are associated with treatment success and, potentially, number of treatment episodes (Kelly et al. 2019, Lubman et al. 2014).
Understanding the patterns of service use for clients who receive treatment for alcohol contributes to an understanding of how clients interact and engage with AOD services. Previous AIHW analysis has examined patterns of service use for clients, including those receiving intensive treatment, using data from the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) (AIHW 2019, AIHW 2021, AIHW 2023). Analyses highlighted distinctive patterns of service use for clients interacting with AOD services, revealing that clients often receive multiple episodes of treatment over time, as well as more episodes of treatment to achieve their goals.
The National Drug Strategy (NDS) 2017–2026 provides a framework that identifies national priorities relating to alcohol, tobacco and other drugs, guides action by governments – in partnership with service providers and the community – and outlines a national commitment to harm minimisation through balanced adoption of effective demand, supply, and harm reduction strategies.
The NDS recognises that maintaining access to high-quality treatment and support services is effective in reducing harms associated with AOD use. Accordingly, research that supports evidence-informed approaches has been identified as a priority action under the NDS 2017–2026 (The Department of Health and Aged Care 2017).
The National Framework for Alcohol, Tobacco and Other Drug Treatment 2019–2029 aims to ensure that all Australians have access to evidence-based treatment. The framework focuses on treatment interventions for AOD use and provides an overview of effective treatment principles. The framework describes intensive treatment interventions as those with a key focus on ‘changing behaviour, enhancing physical and mental health, and social and emotional wellbeing’ (The Department of Health and Aged Care 2019b).
Intensive interventions can be broadly characterised as those that are likely to require ongoing support and continued contact with a client (The Department of Health and Aged Care 2019b). Understanding the service use patterns of clients who receive treatment for alcohol as a PDOC will help to inform the policy decisions and the development, implementation, and evaluation of programs that reduce AOD-related harm, and better support client needs. This is important because people receiving AOD treatment often require ongoing support to implement lasting change and achieve their treatment goals (The Department of Health and Aged Care 2019b).
The complex and ongoing nature of AOD treatment requires longitudinal analysis approaches to capture a more complete picture of clients’ pathways through treatment services.
What does this report examine?
This report aims to explore whether defined patterns of AOD service use influence the treatment pathways of clients whose PDOC is alcohol (either receiving treatment for alcohol only or alcohol and another PDOC).
This report uses data from the AODTS NMDS and builds upon previous AIHW analyses, examining the characteristics and identifying the patterns of service use for clients who received treatment for alcohol as a PDOC. Patterns of service use will be examined using previously established client cohorts (clients who received intensive, recurring, and non-recurring treatment) (AIHW 2019, AIHW 2021, AIHW 2023). The analysis will include additional years of AODTS NMDS data, covering the 10-year period from 2013–14 to 2022–23, and focus on the treatment characteristics of clients who received treatment for alcohol.
AIHW (Australian Institute of Health and Welfare) (2019). Patterns of alcohol and other drug treatment service use in Australia, 1 July 2014 to 30 June 2018 AIHW, Australian Government, accessed 9 September 2024.
AIHW (2021). Patterns of intensive alcohol and other drug treatment service use in Australia 1 July 2014 to 30 June 2019 AIHW, Australian Government, accessed 9 September 2024.
AIHW (2023). Completion of alcohol and drug treatment in Australia, 2011–12 to 2020–21: differences by drugs of concern and treatment characteristics AIHW, Australian Government, accessed 9 September 2024.
AIHW 2024a. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2024, AIHW, Australian Government, accessed 7 January 2025.
AIHW (2024b). National Drug Strategy Household Survey 2022–2023 AIHW, Australian Government, accessed 10 September 2024.
The Department of Health and Aged Care (2017). National Drug Strategy 2017–2026. Canberra: Commonwealth of Australia.
The Department of Health and Aged Care (2019a). National Alcohol Strategy 2019–2028. Canberra: Commonwealth of Australia.
The Department of Health and Aged Care (2019b). National Framework for Alcohol, Tobacco and Other Drug Treatment 2019–2029. Canberra: Commonwealth of Australia.
Kelly JF, Greene MC, Bergman BG, White WL & Hoeppner BB 2019. How many recovery attempts does it take to successfully resolve an alcohol or drug problem? Estimates and correlates from a national study of recovering U.S. adults. Alcoholism: Clinical & Experimental Research 43(7):1533–44.
Lubman D, Manning V, Best D, Berends L, Mugavin J, Lloyd B et al. 2014. A study of patient pathways in alcohol and other drug treatment: Patient Pathways National Project. Fitzroy, Vic: Turning Point.