National Opioid Pharmacotherapy Statistics Annual Data collection

How many people received opioid pharmacotherapy treatment?

On a snapshot day in 2023, 53,272 people were receiving pharmacotherapy treatment for their opioid dependence across Australia (excluding Western Australia). This is a rate of 22 pharmacotherapy clients per 10,000 people (Figure CLIENTS1; Tables S1–S2). 

Interpreting trends in the total number of prescribers over time is difficult due to a lack of available data for Western Australia and Queensland in 2023 and 2021, respectively. Excluding these years, the number of clients receiving treatment increased by 20% between 2011 and 2022 (from 46,446 to 55,741 clients) (Table S1). Adjusting for population growth, the rate of clients remained relatively stable nationally over the same period (between 20 and 21 clients per 10,000 people each year). In 2023, the lower client number (53,272 clients) and slightly higher rate (22 clients per 10,000) are likely due to the exclusion of data for Western Australia, which were unavailable at the time of reporting. See Technical notes for more information on rates.

Figure CLIENTS1: Clients receiving pharmacotherapy treatment on a snapshot day, by state/territory, 2011 to 2023

In 2023, consistent with previous years:

• New South Wales had the highest rate of opioid pharmacotherapy clients receiving treatment (29 clients per 10,000 people, or 24,475 clients), followed by Victoria (22 clients per 10,000 people, or 15,106 clients).
• The Northern Territory remained the jurisdiction with the lowest rate of clients (7 per 10,000 people, or 185 clients) (Figure CLIENTS1; Table S2).

Client numbers have fluctuated over time within jurisdictions (Table S1). Variation in client numbers may be influenced by system changes, coding practices, and changes in treatment policies or capacity within jurisdictions.

Who received opioid pharmacotherapy treatment?

On a snapshot day in June 2023, the median age of clients across all pharmacotherapy drug types was 45 years (excluding Western Australia). This represents an increase from 38 years in 2011. Clients in the Australian Capital Territory and the Northern Territory had the highest median age (46 years) (Table S5).

Around 1 in 3 clients (35% or 18,590 clients) were aged 40–49 years, the highest proportion of any age group. A further 23% (12,297 clients) were aged 30–39 years and 22% (11,954) were aged 50–59 years (Figure CLIENTS2; Table S6). Since 2011, there has been a decrease in the proportion of clients aged in their 30s or under and an increase for those in older age groups (40–49, 50–59, and 60 and over) (Figure CLIENTS2).

Figure CLIENTS2: Proportion of clients receiving pharmacotherapy treatment on a snapshot day, by pharmacotherapy drug type and age group, 2011 to 2023

The increases in client median age since 2011 and the growing proportion of clients in older age groups continues the trend of an ageing cohort in opioid pharmacotherapy treatment. This is consistent with the pattern observed in other drug treatment services (AIHW 2024a). This may be due to:

• Methadone treatment being available in Australia for more than 40 years.
• Pharmacotherapy treatment reducing the risk of premature death, resulting in some clients remaining in treatment for decades.
• Clients seeking treatment for the first time at an older age.
• Declines in heroin use among people who inject drugs and the general population in Australia since the early 2000s (AIHW 2024b; Sutherland et al. 2023).
• Australia’s ageing population and the emergence of an ageing cohort of people who use drugs (AIHW 2024b; Nicholas and Roche 2014; NSW Ministry of Health 2015).

While methadone was previously the most commonly prescribed pharmacotherapy drug across all age groups, clients aged in their 30s and under were more likely to receive a buprenorphine formulation than methadone in 2023 (Figure CLIENTS3; Table S6). However, methadone continued to be more common than buprenorphine formulations among clients aged in their 40s and over. Around 1 in 5 clients (20%) aged under 30 received methadone, compared with 1 in 3 (63%) aged 60 and over (Figure CLIENTS3; Table S6). Clients who received methadone as pharmacotherapy also had a higher median age (48 years) than those receiving a buprenorphine formulation (ranging from 41 to 44 years, depending on the formulation) (Table S5). 

Figure CLIENTS3: Proportion of clients receiving pharmacotherapy treatment on a snapshot day, by age group and pharmacotherapy drug type, 2017 to 2023

On a snapshot day in 2023, over 2 in 3 clients (67% or 35,843 clients) receiving pharmacotherapy treatment were male (excludes Western Australia). This has remained stable since 2011 and was similar for each of the 4 pharmacotherapy drug types (methadone, buprenorphine, buprenorphine-naloxone and buprenorphine LAI) (Table S7). The sex classification of ‘Another term’ was included in the NOPSAD collection for the first time in 2021 however is not reported in text due to small numbers and concerns with data reliability. See Technical notes for more information.

The rate of clients receiving pharmacotherapy treatment was highest for people in their 40s, peaking at 46 years for males and 45 years for females. Notably, the peak rate for males (79 clients per 10,000 people) was more than twice as high as the peak for females (36 per 10,000) (Figure CLIENTS4; Table S24). This analysis is based on unit record data and excludes data for Victoria and Queensland. Data for Western Australia were unavailable in 2023 and these data are excluded from totals.

Figure CLIENTS4: Crude rate of clients receiving pharmacotherapy treatment on a snapshot day, by sex and age, selected states and territories, 2017 to 2023

Aboriginal and Torres Strait Islander (First Nations) people

On a snapshot day in June 2023, there were 6,465 Aboriginal and Torres Strait Islander (First Nations) clients receiving pharmacotherapy treatment in Australia (excluding Western Australia) (Table S9). This represents 12% of all clients and is a rate of 81 clients per 10,000 First Nations people. 

Of those First Nations clients whose pharmacotherapy drug type was reported, over 1 in 3 (35% or 2,205 clients) received methadone as pharmacotherapy. The remaining First Nations clients received buprenorphine (41% or 2,615 clients), buprenorphine-naloxone (12% or 737 clients) or buprenorphine LAI (12% or 775 clients) (Table S9). 

By jurisdiction, New South Wales had the highest rate of First Nations opioid pharmacotherapy clients (141 clients per 10,000 First Nations people, or 4,274 clients), followed by Victoria (117 clients per 10,000 First Nations people, or 806 clients). The Northern Territory had the lowest rate of First Nations clients (6 clients per 10,000, or 50 clients) (Table S9). See Technical notes for more information on rates based on Indigenous status for First Nations clients in 2023.

What opioid pharmacotherapy treatments did clients receive?

On a snapshot day in June 2023, half of all clients (50% or 26,458 clients) received a buprenorphine formulation as pharmacotherapy treatment (excluding data for Western Australia). For the first time in NOPSAD reporting, this was higher than the number of clients receiving methadone (47% or 25,133 clients) (Figure CLIENTS4; Table S4). This continues a long-term trend where the proportion of clients receiving methadone has fallen and the proportion receiving buprenorphine drug formulations has risen.

Figure CLIENTS5: Proportion of clients receiving pharmacotherapy treatment on a snapshot day, by state/territory and pharmacotherapy drug type, 2017 to 2023

By individual medication type, methadone continued to be the most common pharmacotherapy drug in most states and territories except for Queensland, South Australia, and the Northern Territory. Buprenorphine-naloxone was the most common pharmacotherapy drug in Queensland and South Australia (38% and 24% of clients, respectively), while buprenorphine LAI was the most common in the Northern Territory (44%) (Figure CLIENTS5; Table S4).

How did clients interact with the opioid pharmacotherapy treatment system?

Clients interact with the pharmacotherapy treatment system in a number of ways. A client’s status may differ according to whether they are:

• receiving treatment for the first time in the 12 months since the previous snapshot day (new)
• re-entering treatment after previously ceasing an episode of care (re-admission)
• continuing treatment (ongoing)
• transferring from another state or territory (interstate transfer).

In 2023, client status data were available for Victoria, Tasmania, the Australian Capital Territory, and the Northern Territory. New South Wales, Queensland and South Australia were unable to provide client status data for 2023 due to the implementation of new systems. In these states, all clients are presented as ‘Not reported’. Data for Western Australia were not available for the 2023 NOPSAD collection.

Across the 4 jurisdictions with available data, clients were most commonly continuing treatment. Over half of clients (54% or 9,038) were classed as ongoing, while a further 28% (4,650 clients) were new to treatment in 2023, and 18% (3,084) were re-entering treatment (Table S11). The proportion of clients re-entering treatment ranged from 0.9% in Tasmania to 28% in the Australian Capital Territory (Figure CLIENTS6; Table S11). 

Figure CLIENTS6: Proportion of clients receiving pharmacotherapy treatment on a snapshot day, by state/territory and client status, selected states and territories, 2017 to 2023

What drug of dependence did clients receive opioid pharmacotherapy treatment for?

Clients can receive pharmacotherapy treatment for a range of opioid drugs. These include illicit opioids (such as heroin), and pharmaceutical opioids (such as oxycodone) available by prescription or through illicit means. From 1 February 2018, all over-the-counter (non-prescription) codeine-containing medicines for pain relief, cough and colds became available by prescription only.

In 2023, around 1 in 3 clients (34% or 18,030 clients) reported heroin as their opioid drug of dependence (excluding Western Australia). Buprenorphine (6.5% or 3,451 clients) and oxycodone (5.0% or 2,665 clients) were the next most commonly reported drugs of dependence (Figure CLIENTS7; Table S10). 

Figure CLIENTS7: Proportion of clients receiving pharmacotherapy treatment on a snapshot day, by opioid drug of dependence, 2017 to 2023

Over 3 in 5 clients (58% or 31,122 clients) reported an opioid drug of dependence in 2023, while the remainder (42%) were ‘Not stated/not reported’. This proportion ranged from <0.5% of clients in South Australia to 61% in New South Wales (Table S10). 

Heroin was the most common drug of dependence in all states and territories with available data, except Tasmania and the Northern Territory. Morphine was the most common drug of dependence in Tasmania, while in the Northern Territory it was ‘other pharmaceutical opioids’ (Table S10).