Alcohol and other drug treatment services in New South Wales 2007–08
Findings from the National Minimum Data Set 
Highlights
In New South Wales (NSW) in 2007–08, 268 government-funded alcohol and other drug treatment agencies and outlets provided 42,078 treatment episodes. This represented an increase of 6 treatment agencies and around 4,000 episodes compared to 2006–07.
The median age of persons receiving treatment for their own drug use and those seeking treatment in relation to someone else’s drug use was similar to 2006–07 (34 years and 47 years respectively). 
Alcohol was the most common principal drug of concern, rising from 45% of episodes in 2006–07 to 49% of episodes this year. Cannabis accounted for 17% and heroin for 12% of episodes. The proportion of amphetamine-related episodes fell slightly from 13% to 11%.
Main treatment types followed the 2006–07 pattern with some small changes in proportions. Counselling was the most common form of main treatment provided (29% of episodes), followed by withdrawal management (detoxification) (20%) and ‘other’ treatments (17%). 
About this bulletin 
This bulletin summarises the main findings from the 2007–08 Alcohol and Other Drug Treatment Services (AODTS) NMDS data for NSW. More detailed information about the 2007–08 collection and its findings can be found in the publication Alcohol and other drug treatment services in Australia 2007–08: report on the National Minimum Data Set (AIHW 2008). This report, together with further publications and interactive data, can be accessed online at <www.aihw.gov.au/drugs>.
Scope of the AODTS–NMDS
The agencies and clients that were in scope for the 2007–08 AODTS–NMDS collection were:
•	all publicly funded (at state, territory and/or Australian Government level) government and non-government agencies that provide one or more specialist alcohol and/or other drug treatment services 
•	all clients who had completed one or more treatment episodes at an alcohol and other drug treatment service that was in scope during the period 1 July 2007 to 30 June 2008.
It is important to note that the AODTS–NMDS collection only includes pharmacotherapy clients when they receive both pharmacotherapy and another type of treatment (from the same treatment agency). Pharmacotherapy-only clients are reported under the National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD). 
For a complete list of clients and agencies excluded from the AODTS–NMDS, see Section 1.3 of the AODTS–NMDS 2007–08 annual report (AIHW 2009).
Collection count: closed treatment episodes
The unit of measurement in this bulletin is the ‘closed treatment episode’. A closed treatment episode refers to a period of contact, with defined start and end dates, between a client and a treatment agency. It is possible that more than one treatment episode may be in progress for a client at any one time, therefore the number of closed treatment episodes captured in the AODTS–NMDS does not equate to the total number of persons in Australia receiving treatment for alcohol and other drugs.
Treatment agencies
Throughout Australia, a total of 658 government-funded alcohol and other drug treatment agencies supplied data for 2007–08. Of these agencies, 268 outlets were located in NSW, of which 201 were government agencies and 67 were non-government agencies. 
Treatment agencies in NSW were most likely to be located in Major cities (60%), followed by Inner regional (32%) and Outer regional areas (8%). 
Client profile
In NSW there were 42,078 closed treatment episodes in alcohol and other drug treatment services reported in the 2007–08 AODTS–NMDS collection. This represents an 11% increase. The increase is related to the reporting of consultation liaison services this year.
The vast majority (98%) of closed treatment episodes involved clients seeking treatment for their own drug use. The remaining 2% involved clients seeking treatment for another person’s alcohol or other drug use.
Age and sex
Males accounted for 67% of treatment episodes. This reflects the national pattern in which two-thirds of treatment episodes were provided to males. For those treatment episodes reported for someone else’s drug use in NSW, female clients accounted for the majority (72%) of episodes. 
In NSW, the median age of persons receiving treatment for their own drug use was 34 years. Of people seeking treatment in relation to someone else’s drug use, the median age was 47 years. 
Almost one-third (31%) of closed treatment episodes in NSW were for clients aged 30–39 years, while 28% were for clients aged 20–29 years and 21% were for clients aged 40–49 years.
Special population groups
The proportion of closed treatment episodes involving clients who identified as being of Aboriginal and/or Torres Strait Islander origin in NSW was similar to the national figure (10% and 11% respectively). It is important to keep in mind that the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services and primary health care services are not included in the AODTS–NMDS collection.
The majority (87%) of closed treatment episodes in NSW were for clients born in Australia and 98% of treatment episodes were for clients whose preferred language was English.
Drugs of concern
This section reports on the 41,277 treatment episodes where clients were seeking treatment for their own alcohol or other drug use in NSW.
Principal drug of concern 
The ‘principal drug of concern’ refers to the main substance that the client states led them to seek treatment from an alcohol and drug treatment agency. In NSW in 2007–08, alcohol was the most common principal drug of concern in closed treatment episodes (49%), followed by cannabis (17%), heroin (12%) and amphetamines (12%) (Table 1). The national patterns were similar to NSW with alcohol also the most common principal drug of concern (44% of treatment episodes), followed by cannabis (22%), opioids (14%, with heroin accounting for 10%) and amphetamines (11%). 
The proportion of treatment episodes for each drug type has been reasonably stable over time in NSW. The proportion of cannabis-related episodes increased until 2005–06, and has dropped over the subsequent two years. Heroin-related episodes have also decreased in the last two years. Alcohol-related episodes have increased as a proportion of treatments provided.
Table 1: Closed treatment episodes(a) by principal drug of concern, NSW and Australia, 
2001–02 to 2007–08 (per cent)
	New South Wales		Total (Australia) 
2007–08	
Principal drug of concern	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07(b)	2007–08	Per cent	Number	
Alcohol	42.7	42.1	41.2	41.5	43.0	45.0	49.3	44.5	65,702	
Amphetamines	10.7	10.9	10.9	11.3	11.2	13.3	10.8	11.2	16,588	
Benzodiazepines	2.7	2.4	2.5	2.1	2.2	2.0	2.0	1.7	2,487	
Cannabis	14.3	15.4	16.1	17.4	20.2	19.0	17.1	21.6	31,864	
Cocaine	1.8	0.5	0.4	0.6	0.6	0.7	0.6	0.3	457	
Ecstasy	—	0.3	0.3	0.3	0.3	0.4	0.4	0.9	1,321	
Nicotine	1.9	1.2	1.3	1.3	1.2	0.7	1.1	1.7	2,548	
Opioids										
    Heroin	18.7	21.4	21.4	20.1	15.6	13.0	12.0	10.5	15,571	
    Methadone	3.4	2.5	2.5	2.4	2.2	2.0	1.0	1.6	2,296	
    Morphine	—	0.3	0.5	0.7	0.8	1.1	2.5	0.9	1,390	
  Total opioids(c)	23.7	25.4	25.5	24.5	20.2	17.8	17.7	14.5	21,380	
All other drugs(d)	2.2	0.5	0.4	1.1	1.0	1.1	1.1	3.6	5,374	
Not stated	—	1.3	1.4	—	—	—	—	—	—	
Total (per cent)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total (number)	38,111	40,002	41,426	41,789	42,589	36,967	41,277	 . .	147,721	
(a)	Excludes treatment episodes for clients seeking treatment for the drug use of others.
(b)	New South Wales encountered collection system issues that affected a number of Area Health Services, which in turn caused a reduction in the total collection for this year.
(c)	Total includes balance of opioids.
(d)	Includes balance of principal drugs of concern coded according to the Australian Standard Classification of Drugs of Concern.

Age and sex
The principal drug of concern nominated by clients varied by age in NSW. For clients aged 10–19 years, cannabis was the most common principal drug of concern (41% of episodes). For clients aged 20–29 years, the principal drugs of concern were more evenly distributed with alcohol being the most commonly nominated drug (33% of episodes), followed closely by cannabis (26%). For clients aged 30 years and over, alcohol was the most common principal drug of concern—highest for clients 60 years and over (88% of episodes).
All drugs of concern 
‘All drugs of concern’ refers to all drugs reported by clients including the principal drug of concern and all other drugs of concern (clients can report up to five other drugs of concern). Over half (52%) of all treatment episodes in NSW involved at least one other drug of concern in addition to the principal drug.
A breakdown of all drugs of concern by drug type is presented below (Figure 1). For example, nicotine was reported as the principal drug of concern in 1% of episodes, but was reported as a drug of concern (either ‘principal’ or ‘other’) in 19% of treatment episodes.

Figure 1: Closed treatment episodes by principal drug of concern and all drugs of concern, NSW, 2007–08
Horizontal bar chart showing drugs of concern on y-axis and proportion of closed treatment episodes on x-axis.

Alcohol
In NSW, alcohol was the most common principal drug of concern for which treatment was sought, accounting for almost half (49%) of closed treatment episodes in 2007–08. When all drugs of concern are considered (that is, the principal drug and all other drugs of concern nominated by the client), 60% of episodes included alcohol. 
Of the 20,338 episodes where alcohol was nominated as the principal drug of concern in 2007–08:
Client profile
•	The majority (70%) of episodes were for male clients. 
•	The median age of persons receiving treatment was 39 years (males 39 years; females 40 years).
•	Around 9% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin.
•	Self-referral was the most common source of referral (39% of episodes), followed by referrals from a medical practitioner (15%). 
Drug profile
•	44% of episodes included at least one other drug of concern. In these episodes, 34% of other drugs were cannabis, 33% nicotine, and 12% amphetamines.  
•	The majority (72%) of episodes involved clients who reported never having injected drugs. About 6% involved current injectors. Around 8% of episodes did not record injecting drug use status. 
Treatment profile
•	Counselling was the most common main treatment type received (31% of episodes), followed by withdrawal management (detoxification) (22%) and assessment only (16%). 
•	Treatment was most likely to occur in a non-residential treatment facility (57% of episodes), followed by a residential treatment facility (39%). 
•	The median number of days for a treatment episode was 8.
Cannabis
In NSW, cannabis was the second most common principal drug of concern for which treatment was sought, accounting for 17% of closed treatment episodes in 2007–08. When all drugs of concern are considered (that is, the principal drug of concern and all other drugs of concern nominated by the client), 37% of episodes included cannabis. 
Of the 7,045 episodes where cannabis was nominated as the principal drug of concern in 2007–08:
Client profile
•	The majority (70%) of episodes were for male clients. 
•	The median age of persons receiving treatment was 28 years (males 27 years; females 28 years).
•	Around 13% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin. 
•	Self-referral was the most common source of referral (34% of episodes), followed by referrals from court diversion programs designed to direct people charged with 
drug-related offences into treatment (14%). 
Drug profile
•	Smoking was the most common usual method of use (almost 100% of episodes).
•	58% of episodes included at least one other drug of concern—35%were for alcohol, 23% nicotine and 21% amphetamines.  
•	Around two-thirds of all episodes involved clients who reported never having injected drugs. 
Treatment profile
•	Counselling was the most common main treatment type received (33% of episodes), followed by assessment only (18%) and withdrawal management (detoxification) (15%). 
•	Treatment was most likely to occur in a non-residential treatment facility (73% of episodes), followed by a residential treatment setting (23%). 
•	The median number of days for a treatment episode was 15.
Heroin
In NSW, heroin was the third most common principal drug of concern for which treatment was sought, accounting for 12% of closed treatment episodes in 2007–08. When all drugs of concern are considered (that is, the principal drug of concern and all other drugs of concern nominated by the client), 15% of episodes included heroin, a substantial reduction from the previous year when 24% of episodes included heroin. 
Of the 4,942 episodes where heroin were nominated as the principal drug of concern in 2007–08:
Client profile
•	The majority (68%) of episodes were for male clients. 
•	The median age of persons receiving treatment was 31 years (males 32 years; females 30 years).
•	About 10% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin. 
•	Self-referral was the most common source of referral (45% of episodes). Around 20% of referrals were from the criminal justice system through diversion programs and correctional services. 
Drug profile
•	Injecting was the most common method of use (91% of episodes), followed by smoking (7%). 
•	63% of episodes included at least one other drug of concern—25% were for cannabis, 18% amphetamines and 15% nicotine. 
•	The majority (73%) of episodes involved clients who reported being current injectors.
Treatment profile
•	Withdrawal management (26%) was the most common main treatment type received, followed by support and case management only (18%) and ‘other’ main treatments (17%).
•	Treatment was most likely to occur in a non-residential treatment facility (64% of episodes), followed by a residential treatment facility (33%). 
•	The median number of days for a treatment episode was 14.
Treatment programs
‘Main treatment type’ is the principal activity that the treatment provider considers necessary for the client to complete their treatment plan for the principal drug of concern. Data presented in this section relate to clients seeking treatment for their own or someone else’s alcohol or other drug use (apart from the section on principal drug of concern, which does not apply to clients seeking treatment in relation to someone else’s drug use).
Of all closed treatment episodes in NSW, counselling was the most common form of main treatment provided (29% of episodes), followed by withdrawal management (20%) and other main treatment types (17%) (Table 2). Nationally, counselling was the most common treatment episode (38%), followed by withdrawal management (detoxification) (16%) and assessment only (14%).
The proportion of treatment episodes involving each treatment type has been reasonably stable over time in NSW. There was a large increase in the proportion of ‘other’ main treatment types this year, related to the reporting of services not included in the previous year. 
Table 2: Closed treatment episodes by main treatment type, NSW and Australia, 
2001–02 to 2007–08 (per cent)
	New South Wales		Total (Australia) 
2007–08	
Main treatment type	2001–02	2002–03	2003–04	2004–05	2005–06	2006–07(a)	2007–08(b)	Per cent	Number	
Withdrawal management (detoxification)	21.0	22.6	23.3	22.2	20.9	21.0	19.7	16.2	24,999	
Counselling	27.1	37.9	28.9	34.3	32.5	32.0	29.1	37.3	57,470	
Rehabilitation	8.9	9.0	10.0	10.4	10.2	9.7	8.8	7.2	11,099	
Support & case management only	1.9	6.0	8.3	8.4	9.8	9.7	8.4	8.0	12,279	
Information and education only	13.0	2.8	2.0	2.3	1.6	1.6	1.2	9.8	15,086	
Assessment only	23.0	17.3	22.3	16.0	20.6	19.0	16.2	14.3	21,976	
Other(c)	5.1	4.4	5.1	6.4	4.4	7.0	16.5	7.2	11,089	
Total (per cent)	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	. .	
Total (number)	39,348	41,166	42,529	43,079	43,798	37,945	42,078	. .	153,998	
(a)	New South Wales encountered collection system issues that affected a number of Area Health Services, which in turn caused a reduction in the total collection for this year.
(b)	In NSW, the ‘Other’ category includes outreach services provided to hospital patients by community-based alcohol and other drug treatment agencies. These ‘consultation liaison’ activities were excluded from the data in 2006–07. Consultation liaison was included in earlier years of the collection but has increased substantially in 2007–08.
(c)	‘Other’ includes treatment episodes where the main treatment type was reported as pharmacotherapy.
Counselling
Counselling was the most common main treatment type reported in NSW in 2007–08, accounting for 29% of closed treatment episodes. Of the 12,248 episodes where counselling was nominated as the main treatment type received: 
Client profile
•	The vast majority (95%) of episodes were for clients seeking treatment for their own drug use. 
•	Over half (65%) of episodes were for male clients.
•	The median age of persons receiving treatment was 35 years (males 34 years; females 36 years). 
•	Around 7% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin. 
•	Self-referral was the most common source of referral (46% of episodes).
Treatment profile
•	The majority (95%) of episodes occurred in a non-residential treatment facility.
•	Approximately half of episodes (52%) ended because the treatment was completed. The next most common reason for episodes to end was that the client ceased to participate without notifying the service provider (31% of episodes ended this way). 
•	The median number of days for a treatment episode was 54 (an increase from 42 in 2006–07).
Principal drug profile
•	Alcohol was the most common principal drug of concern reported (55% of episodes) by people seeking counselling for their own drug use, followed by cannabis (20%) and amphetamines (10%).
Withdrawal management (detoxification)
Withdrawal management (detoxification) was the second most common main treatment type reported in NSW in 2007–08, accounting for almost 20% of closed treatment episodes. Of the 8,292 episodes where withdrawal management was nominated as the main treatment received in 2007–08:
Client profile
•	Given the nature of the treatment, all episodes were for clients seeking treatment for their own drug use.
•	The majority (69%) of episodes were for male clients. 
•	The median age of persons receiving treatment was 36 years (males 37 years; females 36 years). 
•	Around 9% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin. 
•	Self-referral was the most common source of referral (58% of episodes), followed by referrals from alcohol and other drug services (13%).
Treatment profile
•	Treatment was most likely to take place in a residential treatment facility (81% of episodes), followed by a non-residential treatment facility (16%). 
•	The majority (67%) of episodes ended because the treatment was completed. The next most common reason for ending a treatment episodes was that the client ceased to participate without notice (16% of episodes ended this way). 
•	The median number of days for a treatment episode was 6.
Principal drug profile
•	Alcohol was the most common principal drug of concern reported (53% of episodes), followed by heroin (15%) and cannabis (13%). 
Other main treatment types
Other treatment types, including pharmacotherapy, replaced assessment only as the third largest treatment category provided in NSW this year. Other treatment types accounted for 17% of closed treatment episodes in 2007–08. Of the 6,959 episodes where other treatment types were nominated as the main treatment type received in 2007–08: 
Client profile
•	Almost all episodes were for clients seeking treatment for their own drug use.
•	The majority (64%) of episodes were for male clients.
•	The median age of persons receiving treatment was 38 years (males 39 years; females 36 years). 
•	Around 6% of episodes involved clients who identified as being of Aboriginal and/or Torres Strait Islander origin.
•	Referral from medical practitioners was the most common source of referral (45% of episodes), followed by referrals from hospitals (19%).
Treatment profile
•	Around 10% of other treatment provided was pharmacotherapy. The remaining 90% was treatment not otherwise defined in the collection (See Table 2 for the defined main treatment types).
•	Treatment was most likely to occur in a residential treatment setting (68% of episodes) followed by a non-residential setting (30%). 
•	The majority (67%) of episodes ended because the treatment was completed. The next most common reason for ending a treatment episode was the client was transferred to another service provider (19% of episodes ended this way). 
•	The median number of days for a treatment episode was 1.
Principal drug profile
•	Alcohol was the most common principal drug of concern reported by people who received an other treatment type for their own drug use (54% of episodes), followed by heroin (12%) and cannabis (10%). 
How to find out more
If you would like more detailed data about NSW’s alcohol and other treatment services please contact the AIHW to discuss your needs. The document Alcohol and other drug treatment services NMDS Specifications 2009–10 outlines the process to be followed for unpublished data requests. This document is available from the AIHW website at <www.aihw.gov.au/publications/index.cfm/title/10726>.
Reference
AIHW 2009. Alcohol and other drug treatment services in Australia 2007–08: report on the national minimum data set. Drug treatment series no. 9. Cat. no. HSE 73. Canberra: AIHW.

© Australian Institute of Health and Welfare 2009
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This publication is part of the Australian Institute of Health and Welfare’s Bulletin series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. 

Cat. no. HSE 77
ISBN 978 1 74024 978 2
Acknowledgment
The AIHW would like to acknowledge the input of data providers and the IGCD AODTS–NMDS Working Group, as well as the funding provided by the Australian Government Department of Health and Ageing for this project. 
Suggested citation
AIHW (Australian Institute of Health and Welfare) 2009. Alcohol and other drug treatment services in New South Wales 2007–08: findings from the National Minimum Data Set. Cat. no. HSE 77. Canberra: AIHW.
Australian Institute of Health and Welfare
Board Chair					Director
Hon. Peter Collins, AM, QC			Penny Allbon

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