National Opioid Pharmacotherapy Statistics Annual Data collection

Medical personnel, including general practitioners, nurse practitioners and other medical specialists, prescribe opioid pharmacotherapy. Each state and territory has a registration process through which prescribers can undergo training and become registered or authorised to prescribe opioid pharmacotherapy to clients. For more information on registered and authorised prescribers, see Glossary.

Data on all registered or authorised prescribers are included in this report, except for New South Wales, Western Australia, and South Australia, where prescribers are included only if they are actively prescribing to at least 1 client on the snapshot day. These 3 jurisdictions have prescribers who prescribe in more than 1 location, and as such are counted more than once. This will lead to slightly reduced client to prescriber ratios (data for Western Australia were not available in 2023). For more details about the collection, refer to Table T2 in Technical notes.

What were the numbers and types of opioid pharmacotherapy prescribers?

On a snapshot day in 2023, there were 3,123 authorised prescribers of opioid pharmacotherapy drugs in Australia (excluding data for Western Australia). Of these prescribers: 

• Almost 2 in 3 (62% or 1,949 prescribers) were authorised to prescribe more than 1 type of drug.
• Over 1 in 7 (12% or 380 prescribers) were authorised to prescribe buprenorphine-naloxone only.
• Almost 1 in 10 (9.8% or 305) prescribers were authorised to prescribe methadone only (Figure PRESCRIBER1, Tables S15 and S16).

Figure PRESCRIBER1: Number of prescribers by pharmacotherapy drug type, 2011 to 2023

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. When excluding these years, there was a 121% increase in authorised prescribers between 2011 and 2020 (from 1,549 to 3,422 prescribers). This number then decreased by 13% in 2022 (the last time comparable data were available), when there were 2,982 authorised prescribers (Figure PRESCRIBER1; Table S16). Between 2011 and 2023:

• The number of prescribers authorised to prescribe more than 1 type of drug increased overall, though this fluctuated over time.
• The number of prescribers authorised to prescribe methadone only, was lower in 2023 (305 prescribers) than in 2011 (346). 

Where did opioid pharmacotherapy prescribers work?

Prescribers are classified according to the sector in which they are working when prescribing pharmacotherapy drugs to clients:

• Private prescribers work in organisations that are not part of government, such as private general practice clinics.
• Public prescribers work in organisations that are part of government or are government-controlled, such as public drug and alcohol clinics and public hospitals.
• Correctional facility prescribers work in prisons or other correctional services.

On a snapshot day in 2023, over 4 in 5 prescribers (81% or 2,518 prescribers) worked in the private sector (excluding Western Australia). The remainder worked in the public sector (14% or 435 prescribers), or correctional facilities (4.1% or 129) (Table PRESCRIBER1).

—  Nil or rounded to zero.

n.a. Not available.

Notes

1. States and territories have different guidelines and policies regarding training and registration to prescribe opioid pharmacotherapy types. 
2. In 2023, data for WA were not available. Total excludes data for WA.

Source: AIHW National Opioid Pharmacotherapy Statistics Annual Data collection. Table S15.

Of the 53,272 clients receiving pharmacotherapy treatment in 2023, almost 2 in 3 (63% or 33,761 clients) received treatment from a private prescriber. A further 25% (13,173 clients) received treatment from a public prescriber and 11% (5,841) from a correctional facility prescriber (Table S12).

Across most jurisdictions with available data, the most common prescriber type among clients receiving pharmacotherapy was private prescriber (ranging from 36% of clients in Tasmania to 89% in Victoria). The Northern Territory was the exception, all clients (100%) were treated by public prescribers (Table S3).

How many clients did opioid pharmacotherapy prescribers treat?

As at the snapshot day in 2023, prescribers treated an average of 17 clients each nationally (excluding Western Australia). Queensland had the highest number of clients per prescriber (23 clients), while Victoria had the lowest (13 clients) followed by the Northern Territory and Australian Capital Territory (15 clients each) (Figure PRESCRIBER2). 

Between 2018 and 2023, the ratio of clients per prescriber decreased in New South Wales and Queensland (all decreasing by 8-10% in each state per prescriber). 

Figure PRESCRIBER2: Number of clients per prescriber, by state/territory, 2017 to 2023

Nationally (excluding data for Western Australia), the ratio of clients to prescribers varied by sector:

• On average, prescribers working in the public sector had about twice as many clients as prescribers in the private sector (30 and 13 clients per prescriber, respectively) (Table S22). 
• Client to prescriber ratios in private sectors remained relatively stable between 2019 and 2023 (Table S22). In 2023, private prescribers had a lower average number of clients than public prescribers in all jurisdictions except Queensland. Victoria had no public prescribers, and the Northern Territory had no private prescribers.
• Prescribers working in correctional facilities had an average of 45 clients each in 2023. This varies widely at the state and territory level, from 2 clients per prescriber in Queensland to 81 in Victoria (Table PRESCRIBER2).

 In the public sector, South Australia had the highest ratio of clients to prescribers (52 clients) followed by the Australian Capital Territory (39). In the private sector, Queensland had the highest ratio of clients to prescribers (26 clients per prescriber). 

— Nil or rounded to zero.

n.a. Not available.

Notes

1. This ratio was calculated using the formula: number of clients by prescriber type and state/territory (Table S3) divided by registered prescribers by prescriber type and state/territory (Table S15).
2. WA and SA have prescribers who prescribe in more than 1 location, and as such are counted more than once. This will lead to slightly deflated client to prescriber ratios in these jurisdictions.
3. In 2023, data for WA were not available. Total excludes data for WA.

Source: AIHW National Opioid Pharmacotherapy Statistics Annual Data collection. Table S22.

On a snapshot day in 2023, over 6 in 10 prescribers (61% or 1,917 prescribers) treated 1–5 clients (excluding Western Australia). Just over 1 in 10 prescribers (11% or 345) treated more than 50 clients. Most of these prescribers were in New South Wales and Victoria (Table S19). 

Across states and territories, the proportion of pharmacotherapy prescribers treating 1–5 clients ranged from 32% (117 prescribers) in Queensland to 73% (159 prescribers) in South Australia. Around 4% of prescribers were not treating any clients on the snapshot day; prescribers with 0 clients were reported for Queensland and the Australian Capital Territory in 2023 (Tables PRESCRIBER3 and S19).

— Nil or rounded to zero.

n.a. Not available.

Notes

1. Prescribers classified as treating '0 pharmacotherapy clients' on a snapshot day must have held an authority to prescribe and had a client who was receiving treatment during the collection year.
2. In 2023, data for WA were not available. Total excludes data for WA.

Source: AIHW National Opioid Pharmacotherapy Statistics Annual Data collection. Table S19.

Did pharmacotherapy drug treatment vary with prescriber types?

Pharmacotherapy treatment type

In 2023, methadone was the most commonly prescribed drug across all prescriber types. However, there were some differences in the proportion of clients receiving each pharmacotherapy drug type by prescriber type: 

• A higher proportion of clients of private prescribers were prescribed methadone (53% or 17,983 clients) compared to clients of public prescribers (43% or 5,645 clients) and clients in correctional facilities (23% or 1,337 clients). 
• A higher proportion of clients in correctional facilities were prescribed buprenorphine LAI (24% or 1,388 clients) compared to clients of public (8% or 993 clients) or private prescribers (6% or 1,894 clients) (Table S12). 

In 2023, New South Wales were able to separate buprenorphine formulations into separate categories for the first time. Prior to this reporting of clients receiving buprenorphine nationally may be overestimated.

Client characteristics by prescriber type

In 2023, unit record data was available for 5 states and territories (excluding data for Victoria, Queensland and Western Australia). These data indicate that, compared to clients of public or private prescribers, clients of prescribers in correctional facilities were more likely to be younger and male:

• Correctional facilities treated clients aged under 30 at 3.9 times the rate of public prescribers and 4.5 times that of private prescribers. 
  • Correctional facilities treated clients aged 30–39 years at 1.8 times the rate of public prescribers and 2.2 times the rate of private prescribers. This has remained relatively stable since 2016.
  • Over 1 in 10 (11%) clients treated in correctional facilities were aged 50 years and over, compared to over 1 in 3 clients treated by public prescribers (35%) and over 2 in 5 by private prescribers (42%) (Table S27). 
• Correctional facilities treated about 12 males for every female. Public and private prescriber types each treated about twice as many males as females (Table S28).