Aboriginal and Torres Strait Islander (First Nations) people

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Overview Client profile Profile of new and returning clients Principal drug of concern Main treatment Australian Government-funded Aboriginal and Torres Strait Islander (First Nations) people AOD reporting

In 2022–23, Aboriginal and Torres Strait Islander (First Nations) people accounted for 18% (23,928) of people aged 10 and over who received treatment or support for their own or someone else’s alcohol or drug use (Table SCR.26). 

Nationally, the rate of First Nations people who received treatment remains high: 

  • The rate of First Nations people who received treatment for alcohol or drug use has increased over time, from 2,829 per 100,000 people in 2013–14 to 3,373 in 2022–23 (crude rate for clients aged 10 and over).
  • In 2022–23, First Nations people were more than 6 times as likely to receive treatment for alcohol or drug use as non-Indigenous Australians after adjusting for differences in age structure (3,370 per 100,000 people compared with 496 per 100,000, age standardised rates for clients aged 10 and over) (Figure FIRST NATIONS 1, Table SCR.26).

Figure FIRST NATIONS 1: Estimated number and rate of clients, by Indigenous status, 2013–14 to 2022–23

The line graph shows that between 2013–14 to 2022–23, the age-standardised rate of clients was consistently higher for First Nations people than non-Indigenous Australians. In 2022–23, the age-standardised rate of clients was 3,370 per 100,000 population for First Nations people, compared with 496 per 100,000 for non-Indigenous Australians. A filter allows the user to view data for age-standardised rate, crude rate or number of clients.

Client profile

In 2022–23, among First Nations clients aged 10 and over:

  • Close to 1 in 5 (18% or 22,371) received treatment for their own alcohol or drug use.
  • Around 1 in 10 (11% or 887) received treatment for someone else’s alcohol or drug use.
  • Around 3 in 5 (59%) were male and close to 2 in 5 (38%) were female.
  • 7 in 10 (70%) were aged 10 to 39 years.
  • Indigenous status was not reported for 2.8% (3,675) of clients (Figure First Nations 2, tables SC.5–SC.8).

Figure FIRST NATIONS 2: Proportion of First Nations clients by Indigenous status, sex and age group (10 years and over), 2022–23

The butterfly bar chart shows that the most common age group for both male and female First Nations clients in 2022–23 was 30–39 (29.0% of males and 30.1% of females), followed by 20–29 (28.6% of males and 28.0% of females). Buttons allow the user to navigate to a stacked bar chart presenting trend data disaggregated by Indigenous status and client type. 

Profile of new and returning First Nations clients 

AOD use is often complex and clients accessing AOD treatment services may return to receive further support and treatment over one or more years to achieve their goals. In 2022–23:

  • 3 in 5 (60% or 13,968) of First Nations people had previously received alcohol and other drug treatment from a service at some point since 2013–14 when client reporting was enabled.
  • Around 2 in 5 (40% or 9,327) of First Nations people were new clients, who had not previously received treatment since 2013–14 (Table SCR.28) (see Key terminology and glossary).

Principal drug of concern

The main principal drugs of concern that First Nations people received treatment for were alcohol (37% of clients), amphetamines (25%), cannabis (23%), and heroin (5.2%) (Figure FIRST NATIONS 3, Table SC.11).

National trends in the main drugs of concern have changed over time:

  • The crude rate of First Nations people who received treatment for alcohol has fluctuated but has risen steadily from 1,072 per 100,000 people in 2015–16 to 1,270 in 2022–23. 
  • The rate of First Nations people who received treatment for amphetamines more than doubled, from 399 per 100,000 people in 2013–14 to 909 per 100,000 people in 2022–23, after peaking in 2019–20 at 1,054 (Table SCR.26). 

In 2022–23, after adjusting for differences in age-structure, First Nations people were:

  • Nine times as likely to receive treatment for heroin (age standardised rate ratio) as non-Indigenous Australians (214 per 100,000 compared with 23 per 100,000).
  • Seven and 8 times as likely to receive treatment for alcohol or amphetamines (respectively) as non-Indigenous Australians.
  • Seven times as likely to receive treatment for cannabis as non-Indigenous Australians (702 per 100,000 compared with 102 per 100,000) (Figure FIRST NATIONS 3, Table SCR.26).

Figure FIRST NATIONS 3: Proportion and rate of First Nations AODTS clients, by Indigenous status and principal drug of concern, 2013–14 to 2022–23

The visualisation includes 2 charts. The top chart is a stacked horizontal bar chart that shows the most common principal drug of concern among First Nations clients in 2022–23 was alcohol (36.8%), followed by amphetamines (24.7%). The bottom chart is a line chart that shows that alcohol has remained the most common principal drug of concern among First Nations clients across the period 2013–14 to 2022–23. Two filters for the bottom chart allow the user to view data for First Nations people or non-Indigenous Australian clients and as a crude or age-standardised rate.

Main treatment

For the 22,371 First Nations people who received treatment for their own alcohol or drug use, counselling was the most common main treatment type (38% of clients), followed by assessment only (26%). Similarly, for First Nations people who received treatment for another person’s alcohol or drug use (887), counselling was the most common treatment type (41%), followed by support and case management (39%, Table SC.20). Clients can also receive one or more treatment episodes within the reference year.

The referral into treatment and the setting for treatment varied by treatment type for First Nations clients:

  • Most referrals for First Nations clients into treatment were from a family member or a self-referral (32%).
  • Over one-quarter (27%) of all referrals for First Nations clients into treatment were from a health service.
  • First Nations clients who received either withdrawal management (54%) or pharmacotherapy (62%) as a treatment type were most likely to be referred by a family member or a self-referral.
  • The majority of First Nations clients received counselling (87%) or pharmacotherapy (95%) in a non-residential setting.
  • Nearly 4 in 5 (79%) of First Nations clients received rehabilitation and 3 in 4 (74%) received withdrawal management in residential settings (Figure FIRST NATIONS 4 and FIRST NATIONS 5, tables SC.21 and SC.22).

Figure FIRST NATIONS 4: Proportion of First Nations AODTS clients, by Indigenous status, main treatment type and referral source for all clients, 2022–23

The stacked horizontal bar chart shows that the 2 most common sources of referral for First Nations AODTS clients were self/family and health service. This was consistent across all main treatment types. The proportion of clients who were referred via self/family ranged from 20.9% of clients receiving information and education as the main treatment type to 61.7% for clients receiving pharmacotherapy. The proportion of clients who were referred via a health service ranged from 17.8% for clients receiving pharmacotherapy to 49.1% for clients receiving information and education.

Figure FIRST NATIONS 5: Proportion of First Nations AODTS clients, by Indigenous status, main treatment type and delivery setting for all clients, 2022–23

The stacked horizontal bar chart shows that non-residential treatment settings were the most common delivery setting among First Nations clients receiving counselling, support and case management, assessment only, pharmacotherapy, information and education, or ‘Other’ as the main treatment type in 2022–23 (ranging from 45.8% to 94.9% of clients). Residential treatment settings were the most common delivery setting for clients receiving withdrawal management or rehabilitation (73.9% and 79.3% of clients, respectively).

Australian Government-funded First Nations AOD reporting

The Australian Government funds primary healthcare services and substance use services specifically for First Nations people. These services may be in scope for the AODTS NMDS, but the majority of the services currently do not report to the NMDS. Substance use services previously reported via the First Nations Online Services Report (OSR) data collection up to 2017–18 (AIHW 2024). The substance use services program was transferred to the Indigenous Affairs Group within the Department of Prime Minister and Cabinet in September 2013 and then to the National Indigenous Australians Agency in July 2019 (Australian National Audit Office 2017, National Indigenous Australians Agency 2024). Since the cessation of substance use services data being collected by the OSR, the number of substances use services for First Nations people in-scope and reporting to the AODTS NMDS has gradually increased. 

The National Agreement on Closing the Gap noted that funding for Aboriginal and Torres Strait Islander (First Nations) Alcohol and Other Drugs (AOD) services and support will increase by up to $66 million to 2024–25, in addition to current funding. First Nations’ AOD Treatment Services funded under the Indigenous Advancement Strategy (IAS) currently assists more than 65 providers to deliver AOD activities (Department of Prime Minister and Cabinet 2024). The Commonwealth also provides AOD treatment services and prevention, research and communication activities through the Drug and Alcohol Program (DAP) and funding to Primary Health Networks (PHNs), with nearly 30% of PHN funding allocated for First Nations specific treatment services (National Indigenous Australians Agency 2022).

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