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

The Alcohol and Other Drug Treatment National Minimum Dataset (AODTS NMDS) includes government publicly funded alcohol and other drug treatment specialist services across Australia, including government and non-government agencies.

Data has been reported annually since 2003–04, with collection periods beginning on 1 July and ending on 30 June of the following year (financial years). It collects data on the number of closed treatment episodes (see glossary) provided to clients in a collection period (financial years), noting that the same client may receive multiple treatment episodes within or across collection periods. This report includes data on closed treatment episodes provided between 2013–14 to 2022–23, however, data coverage differs by variable (see historical data element changes).

In 2012–13, a statistical linkage key (SLK) was introduced to enable counting of individual clients who received treatment across collection periods. The SLK is constructed from information about the client’s date of birth, sex and selected letters of their name. 2012–13 was the pilot collection year for SLK-581 and has data quality issues (see the relevant Data Quality Statements for previous collection years for more detail). 

Analysis of the SLK data showed that approximately 98% of national data contained a valid SLK in 2022–23, reflecting high response rates and improved SLK quality for all jurisdictions. An SLK in the AODTS NMDS is considered valid when all components are present and there are no missing/unknown components.

Although the AODTS NMDS collection covers the majority of publicly funded AOD treatment services, including government and non-government organisations, it is difficult to fully quantify the scope of AOD services in Australia and quantification does not provide a complete picture. Qualitative data such as narratives, and case examples are also required to gain a full sense of the experiences and pathways through treatment (The Department of Health and Aged Care 2019).

In 2013–14, it was estimated that AOD treatment comprised 1.6 million treatment episodes, services or contacts each year. Of these, the AODTS NMDS accounts for an estimated 10% of episodes, and between 20–30% of individual clients who received AOD treatment in Australia (Ritter et al 2014). 

Further details on scope, coverage and data quality are available from the AODTS NMDS Data Quality Statement and via the AIHW’s Metadata Online Registry (METEOR).

Overview of analysis variables and inclusion criteria

Table 1 provides an overview of variables included in this report and their relevant analysis criteria.

AOD use

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) captures whether a client received a treatment episode for their own alcohol and other drug (AOD) use or another person’s AOD use.

Treatment episodes where a client received treatment for another person’s AOD use were excluded from analysis.

Client age and sex

Client sex is derived from the first treatment episode a client received when they began treatment between 2013–14 to 2022–23. The AODTS NMDS records sex information as ‘male,’ ‘female,’ ‘another term,’ or ‘not stated’. Due to concerns about data reliability, clients whose sex was recorded as ‘another term’ or ‘not stated’ are excluded from analysis.

The AODTS NMDS captures clients aged 10 and older at the time of their first treatment episode. Age is calculated as at the start of the first closed treatment episode for a client between 2013–14 and 2022–23. 

Excludes 4,524 closed treatment episodes where age or sex of client was unknown/not stated or where client sex was another term.

Note that most clients receive multiple treatment episodes, and that their treatment may span several years.

Counting clients in the AODTS NMDS

Clients are identified using a statistical linkage key (SLK-581). Every client in the AODTS NMDS is assigned a statistical linkage key (SLK-581). For more information, refer to the supplementary table footnotes and the SLK-581 guide for use [PDF 271kB].

Defining closed treatment episodes

An episode of treatment for alcohol and other drugs is the period of contact, with defined dates of commencement and cessation, between a client and a treatment provider or team of providers in which there is no change in the main treatment type or the principal drug of concern, and there has not been a non-planned absence of contact for greater than 3 months.

For further information, please refer to Alcohol and other drug treatment services in Australia annual report, Key terminology and glossary.

Duration

Duration is calculated in whole days, and only for closed episodes.

Key terminology and glossary

See Alcohol and other drug treatment services in Australia annual report: Key terminology and glossary.

Main treatment types

Main treatment type refers to the type of activity used to treat the client’s AOD use. Each treatment episode has one main treatment type, which is the principal treatment type identified by the AOD service to address the client’s PDOC. For further information on how main treatment type is collected, refer to the Alcohol and drug treatment services in Australia annual report.

Other variables

Other variables included for analysis include source of referral, reason for cessation, treatment delivery setting and treatment duration. For further information on these variables, refer to the Data and methods and Key terminology and glossary pages of the Alcohol and other drug treatment services in Australia annual report.

Population rates

In this publication, crude rates were calculated using the ABS’s estimated resident population based on the 2021 Census at the midpoint of the data range: that is, rates for 2022–23 data were calculated using the estimated resident population at 31 December 2022.

The COVID-19 pandemic and the resulting Australian Government closure of the international border from 20 March 2020 caused significant disruptions to the usual Australian population trends. This report uses Australian Estimated Resident Population (ERP) estimates that reflect these disruptions.

In the year July 2020 to June 2021, the overall population growth was much smaller than the years prior and, in particular, there was a relatively large decline in the population of Victoria. ABS reporting indicates these were primarily due to net-negative international migration, for further information, refer to National, state and territory population, June 2021.

Note that this change in the usual population trends may affect interpretation of statistics calculated from these ERPs. For example, rates and proportions may be greater than in previous years due to decreases in the denominator (population size) of some sub-populations.

Principal drugs of concern

The Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) contains data on principal drugs of concern (PDOC) that are coded using the ABS’s Australian Standard Classification of Drugs of Concern (ASCDC) (ABS 2011).

The principal drug of concern (PDOC) is the main substance that the client stated as leading them to receive treatment from a specialised AOD treatment agency. PDOCs include alcohol as well as other drugs such as amphetamines, heroin, pharmaceuticals, ecstasy, and cocaine. Clients can only receive treatment for one PDOC per treatment episode, but clients may also receive multiple treatment episodes for different PDOCs.

In this report, only clients who received treatment for their own alcohol use between 2013–14 and 2022–23 from specialist government-funded AOD services are included in analyses, with some exclusions, as listed in table 1.

Analysis of this report was limited to investigating patterns of service use for clients who ever reported receiving treatment for their own alcohol use. This was disaggregated into 2 categories:

• clients who received treatment for alcohol only, and
• clients who received treatment for alcohol as well as other PDOCs (amphetamines, cannabis, heroin, pharmaceuticals and other PDOCs). For further information, refer to the Alcohol and other drug treatment services in Australia annual report.

Refer to Longitudinal client cohort who, at any point, received treatment for alcohol, between 2013–14 and 2022–23 for further information on the counting methodology for identifying clients who, at any point, received treatment for alcohol as a PDOC.

Remoteness area

This report uses the Australian Bureau of Statistics’ (ABS) Australian Statistical Geography Standard (ASGS) Edition 3 2021 Remoteness Structure to examine the distribution of clients receiving AOD treatment by remoteness area (ABS 2021).

This structure allows areas that share common characteristics of remoteness to be classified into broad geographic regions of Australia. These areas are:

• Major cities 
• Inner regional 
• Outer regional 
• Very remote
• Remote

The remoteness structure divides each state and territory into several regions based on road distance to population centres of various sizes. This allows a proxy to be created for relative access to services.

Examples of urban centres in each remoteness area are:

• Major cities: Canberra, Newcastle
• Inner regional: Hobart, Bendigo
• Outer regional: Cairns, Darwin
• Remote: Katherine, Mount Isa
• Very remote: Tennant Creek, Meekatharra.

For this report, the remoteness area is derived from the postcode of the client's last known home address before starting treatment. Where a postcode area covers multiple remoteness areas, the remoteness area with the highest proportion of the postcode donated is assigned. Due to small counts, data for Remote and Very remote regions were aggregated.

Client location is derived from postcode of the client’s last known address before receiving treatment, which was collected for the first time in 2013–14. Postcode was calculated based on the first closed treatment episode for a client between 2013–14 and 2022–23.