Addiction treatment services leaking a third of clients

Australians reached for the bottle during lockdowns, with significant numbers needing help to kick the habit post-lockdown.

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The number of Australians using alcohol and other drug treatment services dropped by 6% between 2020-21 and 2021-22, but over a third of treatment episodes ended without a satisfactory conclusion, according to new data.

In a new report, the Australian Institute of Health and Welfare said that between 2013–14 and 2020–21, the estimated number of clients receiving alcohol and other drug (AOD) treatment rose by 22%, before decreasing by 6% between 2020–21 and 2021–22.

“Around 131,000 clients aged 10 and over received AOD treatment in 2021–22. These clients received just over 228,000 closed treatment episodes from 1274 publicly funded AOD treatment agencies,” said the report.

Only 62% of treatment episodes led to “a planned completion”, said the report, while 20% ended unexpectedly (“the client ceased to participate against advice, without notice or due to non-compliance”).

Alcohol remains the leading drug of concern, accounting for 49% of all treatment episodes, a situation that has remained unchanged since 2012-13. There was an overall increase in the number of alcohol-related treatment episodes (from 63,700 to 87,300 episodes), between 2012–13 and 2021–22.

“In 2021–22, at least one additional drug of concern was recorded in 22% of alcohol-related treatment episodes (19,500 episodes),” said the AIHW.

“The most common additional drugs of concern were cannabis (37% or 10,300 episodes), nicotine (27% or 7,400 episodes) and amphetamines (17% or 4,800 episodes). These drugs may not have been the subject of any treatment in the episode.”

Among alcohol-related treatment episodes in 2021–22 the most common source of referral was self or family (41% or 36,000 episodes), followed by health services (39%).

“Across the 10 years to 2021–22, referral from a health service increased while referral from the criminal justice system (diversion) fell,” said the AIHW.

“The most common main treatment type was counselling (35% or 30,800 episodes), followed by assessment only (22%) and withdrawal management (14%). Counselling, withdrawal management and assessment only remained the most common treatment types across the 10 years to 2021–22, although the proportion of episodes for each treatment type varied over time.”

Almost two in three episodes were provided in non-residential treatment settings (66% of episodes). A further 17% were provided in residential treatment settings and 6.8% were provided in outreach settings.

The median duration of treatment episodes was just over 4 weeks (29 days). One in 3 (34%) treatment episodes lasted 2 days to 1 month, and 26% lasted 1–3 months.

In 2021–22 six in 10 clients of AOD treatment services were male (60% of clients), and around 5 in 10 were aged 20–39 years (52% of clients), just under two in 10 clients (18%) identified as being an Aboriginal and/or Torres Strait Islander person, and 93% of clients sought treatment for their own drug use.

The AIHW attributed the decrease in the estimated number of clients between 2020–21 and 2021–22 to several possible factors, including client ability to access AOD services during public health restriction, impacts on the workforce with service staff becoming either unwell with covid or restrictions because of others’ covid status; or changes in funding for AOD services.

Associate Professor Yvonne Bonomo, director of addiction medicine at St Vincent’s Hospital in Melbourne told the media that as covid restrictions lifted, people had realised they couldn’t stop drinking.

“What they’re saying is ‘I used to be able to give myself a break from drinking, and it was fine. Now, if I stop drinking, I feel sick. I’m nauseated, I’m sweaty, I feel really irritable or agitated, I can’t sleep’, which are the early signs of the body having adapted to alcohol,” Bonomo was quoted as saying.

“We’re seeing middle-aged women, many of whom are either stay-at-home moms, or working … Once dinner is sorted, and the kids are off in bed or doing their homework, that’s when they find they can’t not have that drink, because they feel so awful.”