National Opioid Pharmacotherapy Statistics Annual Data collection

Clients attend dosing point sites regularly to take their prescribed medication under the supervision of a pharmacist or other health professional. Dosing point site types include public clinics, private clinics, pharmacies, and correctional facilities.

Where were opioid pharmacotherapy drugs provided?

In 2022–23, there were 3,082 dosing point sites across Australia (excluding Western Australia) (Table DOSING1). Over 4 in 5 sites (84% or 2,597 sites) were located in pharmacies. This was consistent across all included states and territories (Table S17).

— Nil or rounded to zero.

n.a. Not available.

Notes

1. In 2023, data for WA were not available. Total excludes data for WA.
2. The category 'Other' includes hospitals, mobile dosing sites, community health clinics, non‑government organisations, and doctors' surgeries. This category also includes “Not stated’ as the data cannot be reported separately.
3. The number of dosing point sites where clients receive treatment during the collection year (that is, the financial year).
4. Correctional facility dosing point sites in NSW are grouped as 1 site.
5. Through improved data quality initiatives, NSW identified small data errors in dosing point site data for private and public clinics, which were corrected for 2021 and 2022.

Source: AIHW National Opioid Pharmacotherapy Statistics Annual Data collection. Table S17.

Interpreting trends in the number of dosing point sites over time is difficult due to a lack of available data for Western Australia and Queensland in 2022–23 and 2020–21, respectively. When excluding these years, there appears to have been a steady rise in the number of dosing point sites (Table S17). There was a 40% increase in the number of dosing point sites between 2010–11 and 2019–20, and a further 3.4% increase between 2019–20 and 2021–22 (the last time comparable data were available). 

What was the relationship between opioid pharmacotherapy clients and dosing point sites?

On a snapshot day in 2023, most clients (59% or 31,486 clients) received pharmacotherapy treatment at a pharmacy (Table S13). This was the most common dosing point site for all pharmacotherapy drug types except for buprenorphine LAI. Among clients receiving:

• Methadone, almost 3 in 4 (73% or 18,736 clients) dosed at pharmacies and almost 1 in 10 dosed at either private clinics (9.7% or 2,515) or public clinics (9.3% or 2,406).
• Buprenorphine, over 1 in 3 (36% or 4,679 clients) dosed at pharmacies and just under 1 in 3 (29% or 3,744) dosed at public clinics.
• Buprenorphine-naloxone, over 4 in 5 (81% or 7,822 clients) dosed at pharmacies.
• Buprenorphine LAI, over 4 in 5 (42% or 2,105 clients) dosed at correctional facilities and almost 1 in 3 dosed at public clinics (29% or 1,438) (Figure DOSING1; Table S13). 

In 2023, New South Wales reported on buprenorphine formulations separately for the first time. Prior to this, New South Wales grouped all clients receiving buprenorphine-naloxone or buprenorphine LAI together with clients receiving buprenorphine. Data are not considered comparable to previous years. Refer to Table S14 for more information.

Figure DOSING1: Proportion of clients receiving pharmacotherapy on a snapshot day, by pharmacotherapy drug type and dosing point site type, 2017 to 2023

Client characteristics by dosing point site type

Client characteristics (including age, sex, and prescriber type) can differ according to the type of dosing point site where clients receive treatment. Information on client characteristics is assessed using unit record data. In 2023, unit record data were provided by all states and territories except Victoria, Queensland and Western Australia. The following sections on client age and sex are based on these data.

Age of clients: Consistent with previous years, pharmacies continued to treat an older client group than other dosing point site types, while correctional facilities treated a younger client group:

• Clients aged 50 and over were around 4 times as likely to dose at pharmacies as correctional facilities. Half of clients (49% or 5,859 clients) who dosed at pharmacies were aged 50 and over, compared with just 1 in 8 clients (12% or 371) for correctional facilities.
• People in their 40s and over accounted for around 2 in 3 clients (63% or 4,237 clients) for public clinics and over 3 in 4 (78% or 1,766 clients) for private clinics.
• People in their 30s and 40s accounted for over 2 in 3 clients (66% or 290 clients) dosed at hospitals.
• Almost 2 in 3 clients (62% or 1,983) who dosed at correctional facilities were aged in their 30s and under, compared with around 1 in 5 clients (18% or 2,196 clients) for pharmacies (Table S29).

Sex of clients: On a snapshot day in 2023, all dosing point site types from the selected states and territories treated more males than females. This is consistent with the overall proportion of males and females receiving pharmacotherapy treatment: 

• The proportion of clients who were male ranged from 64% (7,601 clients) for pharmacies to 92% (2,951) for correctional facilities. 
• Female clients were more likely than males to dose at pharmacies (49% of female clients, compared with 36% of male clients). 
• Male clients were almost 5 times as likely as female clients to dose in correctional facilities (14% of male clients, compared with 3.0% of female clients) (Table S30). 

Prescriber type: Information on prescriber type by dosing point site type is assessed using unit record data. In 2023, unit record data were provided by all states and territories except Victoria, Queensland and Western Australia. Based on these data, 2 in 5 clients (40%) received pharmacotherapy at pharmacies. Across all dosing point site types from the selected states and territories, the most common prescriber type was private prescriber (48% of clients).

• Almost 1 in 3 clients (28%) received pharmacotherapy at pharmacies from private prescribers.
• A further 1 in 3 clients received pharmacotherapy at either pharmacies from public prescribers (12%) or public clinics from public prescribers (20%) (Table S31).

Number of opioid pharmacotherapy clients per dosing point site

On a snapshot day in 2023, dosing point sites dosed an average of 17 clients each nationally (excluding Western Australia). The number of clients per dosing point site varied by site type (Figure DOSING2). On average:

• Private clinics (New South Wales, Queensland and South Australia only) had the highest number of clients per dosing point site (68 clients per site). 
• Pharmacies dosed 12 clients per site. 
• Correctional facilities dosed an average of 124 clients per site. However, this number is inflated as New South Wales reports all correctional dosing point sites as operating under a ‘single’ site rather than counting individual correctional dosing point sites. This significantly increases the number of clients per site. On the snapshot day in 2023, New South Wales recorded only 1 site with clients receiving treatment (Table S23). 

Figure DOSING2: Number of clients per dosing point site, by dosing point site type, 2017 to 2023

On a snapshot day in 2023, 7 in 10 (73% or 2,238) dosing point sites treated between 1 and 20 clients: 

• 39% treated 1–5 clients.
• 18% treated 6–10 clients.
• 16% treated 11–20 clients (Table S20). 

Of the dosing point sites treating more than 50 clients (5.7% of all dosing point sites), most were located in New South Wales, Victoria and Queensland (Table S20). The Australian Capital Territory had the highest ratio of clients per dosing point site (22 clients per site), while the Northern Territory had the lowest (8.4 clients) (Figure DOSING3; Table S21). 

Figure DOSING3: Number of clients per dosing point site, by state/territory, 2017 to 2023

What was the geographic location of dosing point sites?

Across jurisdictions with available data, most dosing point sites were located in Major cities (63% or 1,467 sites) on the snapshot day in 2023. A further 25% (583) of sites were located in Inner regional areas, and 9.9% (229) were located in Outer regional areas. Dosing point location data for Queensland and Western Australia were not available.

Since 2014, rates of dosing point sites (per 100,000 population) in state and territory remoteness areas have generally increased. Larger increases have occurred mainly in more regional areas (e.g. Outer regional, Remote and Very remote areas) (Table S18). However, these rates do not indicate the number of clients receiving opioid pharmacotherapy treatment at each dosing point site in these areas. This information is not currently collected by the NOPSAD collection. 

Caution should be used when comparing rates due to missing data and the effect of border closures due to the COVID-19 pandemic on Australian Estimated Residential Population (ERP) estimates in 2020–21. See 'Technical notes' for further information.

Figure DOSING4: Map to explore pharmacotherapy dosing point sites, by Statistical Area Level 2, 2023