Data table
Aboriginal and Torres Strait Islander people
Most Aboriginal and Torres Strait Islander clients were treated with methadone.
In June 2020, there were 5,693 clients receiving pharmacotherapy treatment who identified as Indigenous Australians (Table S9). This is a rate of 66 clients per 10,000 Indigenous Australians.
Of those Indigenous Australian clients with pharmacotherapy type provided, over half (53%) were treated with methadone in 2020. The remaining Indigenous Australian clients were treated with buprenorphine (32%), buprenorphine naloxone (13%) or buprenorphine LAI (1%). Victoria provides pharmacotherapy type as a total for Indigenous clients (Table S9).
From 2016 to 2020, treatment with:
- methadone fell (from 67% of Indigenous clients to 53%)
- buprenorphine increased (from 22% of Indigenous clients to 32%), and
- buprenorphine-naloxone rose (from 11% of Indigenous clients to 13%).
The Australian Capital Territory had the highest rate of Indigenous clients receiving pharmacotherapy treatment on a snapshot day with 144 clients per 10,000 Indigenous Australians (or 121 Indigenous Australian clients). This was followed by Victoria with 124 clients per 10,000 Indigenous Australians (or 791 Indigneous Australian clients) and New South Wales with 122 clients per 10,000 Indigenous Australians (or 3,482 Indigenous Australian clients). The Northern Territory had the lowest rate of Indigenous clients with 4 clients per 10,000 Indigenous Australians or 34 Indigenous Australian clients (Table S.9).
What treatments did clients receive?
Methadone continued to be the most commonly prescribed pharmacotherapy drug.
On a snapshot day in 2020, 58% or 31,093 clients were treated with methadone, 21% (10,950 clients) received buprenorphine-naloxone, 19% (9,970 clients) received buprenorphine and 2% (1,303) received buprenorphine LAI (Table S4). However, it should be noted that New South Wales does not separately report clients receiving buprenorphine-naloxone or buprenorphine LAI—these clients are included in the number of clients receiving buprenorphine.
From 2011 to 2020, treatment with:
- methadone fell (from 69% of clients to 58%)
- buprenorphine-naloxone increased (from 18% of clients to 21%), and
- buprenorphine rose (from 14% of clients to 19%) (Table S4).
Previous trend data have shown that buprenorphine-naloxone prescription is replacing buprenorphine prescription. This is in keeping with the national guidelines which recommend that buprenorphine-naloxone should be preferred over buprenorphine for most clients as it is expected to have a lower risk of diversion (that is, injected by the client or sold to others to inject) (DoH 2014). On a snapshot day in 2020, the number of clients receiving methadone and buprenorphine-naloxone treatments both decreased compared with the previous year (from 61% and 23% in 2019 to 58% and 21% in 2020, respectively). Clients receiving buprenorphine increased between 2019 to 2020, from 17% to 19%. The introduction of buprenorphine LAI, reported in some jurisdictions for the first time in 2020, accounted for 2.4% of opioid pharmacotherapy treatment. Changes in treatment type between 2019 and 2020 may be impacted by this change.
The proportion of clients receiving each of the 4 pharmacotherapies varies across states and territories (Figure CLIENTS5). In 2020, methadone was the most common pharmacotherapy drug in all jurisdictions except Queensland, Tasmania and the Northern Territory where buprenorphine-naloxone was the most common pharmacotherapy drug (46%, 46% and 67% of clients, respectively). The Australian Capital Territory and New South Wales had the highest proportion of clients receiving methadone (69% and 62%, respectively). In contrast, 19% of clients in the Northern Territory were prescribed methadone. Buprenorphine-naloxone is the default treatment drug for the main pharmacotherapy program in the Northern Territory (Table S4).