Alcohol and other drug treatment services in Australia: early insights

Key terminology

Closed treatment episode

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.

A treatment episode is considered closed where any of the following occurs:

• treatment is completed or has ceased
• there has been no contact between the client and treatment provider for 3 months, or
• there is a change in the main treatment type, principal drug of concern or delivery setting.

Treatment episodes are excluded from the AODTS NMDS for a reporting year if they:

• are not closed in the relevant financial year
• are for clients who are receiving pharmacotherapy (through an opioid substitution therapy program) and not receiving any other form of treatment that falls within the scope of the collection
• include only activities relating to needle and syringe exchange, or
• are for a person aged under 10.

Drugs of concern

The principal drug of concern is the main substance that the client stated led them to seek treatment from the AOD treatment agency. In this report, only clients seeking treatment for their own substance use are included in analyses of principal drug of concern. It is assumed that only the person using the substance themselves can accurately report principal drug of concern; therefore, these data are not collected from those who seek treatment for someone else’s drug use.

Additional drugs of concern refers to any other drugs the client reports using in addition to the principal drug of concern. Clients can nominate up to 5 additional drugs of concern, but these drugs are not necessarily the subject of any treatment within the episode.

All drugs of concern refers to all drugs reported by clients, including the principal drug of concern and any additional drugs of concern.

Reasons for cessation

The reasons for a client ceasing to receive a treatment episode from an AOD treatment service include:

• expected/planned completion: episodes where the treatment was completed, or where the client ceased to participate at expiation or by mutual agreement
• ended due to unplanned completion: episodes where the client ceased to participate against advice, without notice or due to non-compliance
• referred to another service/change in treatment mode: episodes that ended due to a change in main treatment type, delivery setting or principal drug of concern, or where the client was transferred to another service provider.
• other: episodes that ended due to the client returning to court or jail due to non-compliance with a drug court program or sanctioned by court diversion service, imprisoned (other than drug court sanctioned), died, or reasons not elsewhere classified.

Treatment types

Treatment type refers to the type of activity used to treat the client’s alcohol or other drug use. Rehabilitation, withdrawal management (detoxification) and pharmacotherapy are not available for clients seeking treatment for someone else’s drug use.

The main treatment type is the principal activity that is determined at assessment by the treatment provider to be necessary for the completion of the treatment plan for the client’s alcohol or other drug use for their principal drug of concern. One main treatment type is reported for each treatment episode. ‘Assessment only’, 'support and case management' and 'information and education' can be reported only as main treatment types.

In 2019–20, changes were made to categories under Main Treatment; the word ‘only’ was removed from support and case management and information and education. The removal of the word ‘only’ from support and case management and information and education, changed reporting rules for agencies; allowing agencies to be able to report and more accurately capture these items as an additional treatment in conjunction with a main treatment type.

Other treatment types refer to other treatment types provided to the client, in addition to their main treatment type. Up to 4 additional treatment types can be reported.

Note that Victoria and Western Australia do not supply data on additional treatment types. In these jurisdictions, each type of treatment (main or additional) results in a separate episode.

Glossary

additional drugs: Clients receiving treatment for their own drug use nominate a principal drug of concern that has led them to seek treatment and additional drugs of concern, of which up to 5 are recorded in the AODTS NMDS. Clients receiving treatment for someone else’s drug use do not nominate drugs of concern.

additional treatment type: Clients receive 1 main treatment type in each episode and additional treatment types as appropriate, of which up to 4 are recorded in the AODTS NMDS.

agency: agencies included in the Alcohol and Other Drug Treatment Services National Minimum Data Set (AODTS NMDS) are publicly funded (at state, territory, or Australian Government level) government and non-government agencies that provide one or more specialist alcohol and other drug treatment services, whether residential or non-residential. Acute care hospitals or psychiatric hospitals are also included if they have specialist alcohol and other drug units that provide treatment to non-admitted patients (for example, outpatient services), as are Indigenous or mental health services if they provide specialist alcohol and other drug treatment.

alcohol: A central nervous system depressant made from fermented starches. Alcohol inhibits brain functions, dampens the motor and sensory centres and makes judgement, coordination and balance more difficult.

amphetamines: Stimulants that include methamphetamine, also known as methylamphetamine. Amphetamines speed up the messages going between the brain and the body. Common names are speed, fast, up, uppers, louee, goey and whiz. Crystal methamphetamine is also known as ice, shabu, crystal meth, base, whiz, goey or glass.

Australian Standard Geographical Classification (ASGC): Common framework defined by the Australian Bureau of Statistics for collection and dissemination of geographically classified statistics. The ASGC was implemented in 1984 and the final release was in 2011. It has been replaced by the Australian Statistical Geography Standard (ASGS).

Australian Statistical Geography Standard (ASGS): Common framework defined by the Australian Bureau of Statistics for collection and dissemination of geographically classified statistics. The ASGS replaced the ASGC in July 2011.

benzodiazepines: Also known as minor tranquillisers, these drugs are most commonly prescribed by doctors to relieve stress and anxiety, and to help people sleep. Common names include benzos, tranx, sleepers, downers, pills, serras (Serepax®), moggies (Mogadon®) and normies (Normison®).

client: an individual who is assessed and/or accepted for treatment for their own or someone else’s alcohol or other drug use from an in-scope agency and who is aged 10 or older at the start of the treatment episode.

client type: The status of a person in terms of whether the treatment episode concerns their own alcohol and/or other drug use or that of another person. Clients may seek treatment or assistance concerning their own alcohol and/or other drug use, or treatment and/or assistance in relation to the alcohol and/or other drug use of another person.

client counts: Every client in the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS NMDS) is assigned a statistical linkage key (SLK-581). 

Clients are counted based on the number of SLK-581s in the AODTS NMDS. 

National counts are based on the first time a client’s SLK-581 appears in the AODTS NMDS. All clients are counted once.

State and territory counts are based on counting all SLK-581s for each client in the AODTS NMDS. This may result in clients being counted more than once. This is most common among clients who travel interstate for treatment. For example, clients who reside in Queanbeyan, NSW and travel to Canberra, ACT for treatment. This means that the total number of clients at the state or territory level can be greater than the national total.

This report uses both national and state and territory counts to describe trends at both national and jurisdictional levels, as well as movements between jurisdictions. For more information, refer to the supplementary table footnotes and the SLK-581 guide for use.

closed treatment episode: A period of contact between a client and a treatment provider, or team of providers. An episode is closed when treatment is completed, there has been no further contact between the client and the treatment provider for 3 months, or when treatment is ceased (see reason for cessation).

cocaine: A drug that belongs to a group of drugs known as stimulants. Cocaine is extracted from the leaves of the coca bush (Erythroxylum coca). Some of the common names for cocaine include C, coke, nose candy, snow, white lady, toot, Charlie, blow, white dust and stardust.

diversion client type: Clients who received at least 1 AOD treatment episode during a collection year resulting from a referral by a police or court diversion program. The 2 subtypes in this group are:

• diversion only clients – received treatment as a result of diversion referrals only
• diversion client with non-diversion episodes – received at least 1 treatment episode resulting from a diversion referral, but also received at least 1 treatment episode resulting from a non-diversion referral in a collection year.

ecstasy (MDMA): The popular street name for a range of drugs containing the substance 3, 4-methylenedioxymethamphetamine (MDMA) –ma stimulant with hallucinogenic properties. Common names for ecstasy include Adam, Eve, MDMA, X, E, the X, XTC and the love drug.

GHB: stands for gamma hydroxybutyrate, which is a central nervous system depressant. Common names for GHB include, G, Grievous Bodily Harm, fantasy, liquid E, liquid ecstasy and blue nitro.

government agency: An agency that operates from the public accounts of the Australian Government or a state or territory government, is part of the general government sector and is financed mainly from taxation.

heroin: One of a group of drugs known as opioids, which are strong painkillers with addictive properties. Heroin and other opioids are classified as depressant drugs. Common names for heroin include smack, skag, dope, H, junk, hammer, slow, gear, harry, big harry, horse, black tar, China white, Chinese H, white dynamite, dragon, elephant, boy, home-bake or poison.

illicit drug use: Includes:

• the use of illegal drugs – drugs that are prohibited from manufacture, sale or possession in Australia, such as cannabis, cocaine, heroin and MDMA (ecstasy)
• misuse, non-medical or extra-medical use of pharmaceuticals – drugs that are available from a pharmacy, over-the-counter or by prescription, which may be subject to misuse, such as opioid-based pain relief medications, opioid substitution therapies, benzodiazepines, over-the-counter codeine and steroids
• use of other psychoactive substances – legal or illegal, potentially used in a harmful way, such as kava, or inhalants such as petrol, paint or glue (but not including tobacco or alcohol).

licit drug use: The use of legal drugs in a legal manner, including tobacco smoking and alcohol consumption.

main treatment type: The principal activity that is determined at assessment by the treatment provider to treat the client’s alcohol or other drug use for the principal drug of concern.

median: The midpoint of a list of observations ranked from the smallest to the largest.

method of use for principal drug of concern: The client’s usual method of administering the principal drug of concern as stated by the client. Includes: ingests, smokes, injects, sniffs (powder), inhales (vapour), other and not stated.

nicotine: The highly addictive stimulant drug in tobacco.

non-government agency: An agency that receives some government funding, but is not controlled by the government, and is directed by a group of officers or an executive committee. A non-government agency may be an income tax-exempt charity.

principal drug of concern: The main substance that the client stated led them to seek treatment from an alcohol and drug treatment agency.

reason for cessation: The reason the client ceased to receive a treatment episode from an alcohol and other drug treatment service. The client can have:

• completed treatment – where the treatment was completed as planned
• a change in the main treatment type
• a change in the delivery setting
• a change in the principal drug of concern
• been transferred to another service provider – including where the service provider is no longer the most appropriate, and the client is transferred or referred to another service. For example, transfers could occur for clients between non-residential and residential services, or between residential services and a hospital – excludes situations where the original treatment was completed before the client transferred to a different provider for other treatment
• ceased to participate against advice – here the service provider is aware of the client’s intention to stop participating in treatment, and the client ceases despite advice from staff that such action is against the client’s best interest
• ceased to participate without notice
• ceased to participate involuntarily – where the service provider stops the treatment due to non-compliance with the rules or conditions of the program
• ceased to participate at expiation – where the client has fulfilled their obligation to satisfy expiation requirements (for example, participation in a treatment program to avoid having a criminal conviction being recorded against them) as part of a police or court diversion scheme and chooses not to continue with further treatment
• ceased to participate by mutual agreement – where the client ceases participation by mutual agreement with the service provider, even though the treatment plan has not been completed. This may include situations where the client has moved out of the area
• been to a drug court or sanctioned by court diversion service – where the client is returned to court or jail due to non-compliance with the program
• been imprisoned (other than sanctioned by a drug court or diversion service)
• died.

The grouped categories used in the report for reason for cessation:

• referred to another service/change in treatment mode: includes episodes that ended due to a change in main treatment type, delivery setting or principal drug of concern, or where the client was transferred to another service provider
• ended due to planned completion: Includes episodes where the client completed treatment – ceased to participate at expiation or by mutual agreement
• ended due to unplanned completion: Includes episodes where the client ceased to participate against advice, without notice, or due to non-compliance.

referral source: The source from which the client was transferred or referred to the alcohol and other drug treatment service.

standard drink: Contains 10 grams of alcohol (equivalent to 12.5 millilitres of alcohol). Also referred to as a full serve.

tobacco: A plant, Nicotiana tabacum, whose leaves are dried and used for smoking and chewing and in snuff. Its major pharmacologically active substance is the alkaloid nicotine (see nicotine).

treatment delivery setting: The main physical setting in which the type of treatment that is the principal focus of a client's alcohol and other drug treatment episode is actually delivered to a client (irrespective of whether or not this is the same as the usual location of the service provider).

treatment episode: The period of contact between a client and a treatment provider or a team of providers. Each treatment episode has 1 principal drug of concern and 1 main treatment type. If the principal drug or main treatment changes, then a new episode is recorded.

treatment type: The type of activity that is used to treat the client’s alcohol or other drug use, which includes:

• assessment only – where only assessment is provided to the client (service providers would normally include an assessment component in all treatment types)
• counselling – can include cognitive behaviour therapy, brief intervention, relapse intervention and motivational interviewing
• information and education – where information and education is provided to the client (service providers would normally include an information and education component in all treatment types)
• pharmacotherapy – where the client receives another type of treatment in the same treatment episode and includes drugs such as naltrexone, buprenorphine and methadone used as maintenance therapies or relapse prevention for people who experience dependence on certain types of opioids. Where a pharmacotherapy is used for withdrawal, it is included in the withdrawal category. Due to the complexity of the pharmacotherapy sector, this report provides only limited information on agencies whose sole function is to provide pharmacotherapy
• rehabilitation – focuses on supporting clients in stopping their drug use, and to prevent psychological, legal, financial, social and physical consequences of problematic drug use. Rehabilitation can be delivered in several ways, including residential treatment services, therapeutic communities and community-based rehabilitation services
• support and case management – support includes helping a client who occasionally calls an agency worker for emotional support, while case management is usually more structured than ‘support’. It can assume a more holistic approach, taking into account all client needs (including general welfare needs) and it includes assessment, planning, linking, monitoring and advocacy
• withdrawal management (detoxification) – includes medicated and non-medicated treatment to help manage, reduce or stop the use of a drug of concern.