Participation in Australian drug treatment programs for individuals engaging in high-risk substance use: Data from a nationally representative sample.

INTRODUCTION: Substance use, including drugs, alcohol and smoking have a significant health, social and economic impact. We aim to assess the rate and factors associated with treatment access among individuals with high-risk substance use. METHOD: This study is a cross-sectional analysis of the 2019 Australian National Drug Strategy Household Survey (N = 22,015). Participants were persons with high-risk substance use based on the Alcohol, Smoking and Substance Involvement Screening Test-Lite (ASSIST-Lite) and current smokers. We measured self-reports of past 12-month engagement in a tobacco, alcohol or other drugs treatment program. RESULTS: Overall, 0.4% had high-risk drug use (0.3% cannabis, 0.1% meth/amphetamine or 0.1% opioids), 7.4% had high-risk alcohol use, and 14.0% currently smoked. Among high-risk users, past 12-month treatment access rates were 50.6% [22.3-78.9%] for opioids, 27.1% [8.1-46.1%] for meth/amphetamine, 14.5% [4.3-24.7%] for cannabis, 9.6% [8.1-11.0%] for alcohol and 11.7% [10.6-12.9%] for current smoking. The primary source of treatment support was information and education (12.7% drugs, 4.6% alcohol, 4.0% smoking), followed by counselling (6.7% drugs, 4.5% alcohol, 3.0% smoking). Online or internet support was accessed by 5.9% (drug) and 1.6% (alcohol) people with high-risk use. Psychological distress was associated with treatment access (drugs: odds ratio 3.03 [0.77-11.95], p = 0.111; alcohol: odds ratio 3.16 [2.20-4.56], p ≤ 0.001; smoking: odds ratio 1.95 [1.52-2.49], p ≤ 0.001). DISCUSSION AND CONCLUSIONS: The proportion of people engaging in risky substance use who had used treatment programs remains low, especially for alcohol. Public health strategies to scale up treatment access are warranted.

Non-medical use of pharmaceutical opioids with and without other illicit substances in Australia: Prevalence and correlates.

INTRODUCTION AND AIMS: To estimate the prevalence of non-medical use of pharmaceutical opioids and examine the socio-demographic, psychological, health and behavioural correlates and type of opioids used. DESIGN AND METHODS: Data from the Australian National Drug Strategy Household Survey 2016 was used. The sample consisted of. 23 448 participants aged over 14 years (54% female). The key measure was opioid use status in the past year. Based on participants' responses to questions about their substance use in the past 12 months, they were grouped into four opioid use status: (i) No illicit substance use (ISU) and no non-medical use of pharmaceutical opioids (NMUPO); (ii) ISU but no NMUPO; (iii) NMUPO but no ISU; and (iv) NMUPO and ISU. RESULTS: The prevalence non-medical pharmaceutical opioid use was 3.56%. Two-thirds of them engaged in NMUPO but no ISU; one-third engaged in NMUPO and ISU. Younger people were more likely to use pharmaceutical opioids in addition to other illicit drugs, while older people were more likely to only use pharmaceutical opioids. Alcohol risk and daily smoking were associated with using pharmaceutical opioids and other illicit drugs, but not with pharmaceutical opioids only. Those who reported only using pharmaceutical opioids were more likely to use over-the-counter codeine products. DISCUSSION AND CONCLUSIONS: Over 700 000 Australian used pharmaceutical opioids for non-medical purpose. Among users, two-thirds used only opioids and one-third used opioids in addition to other illicit drugs. Profile of these two types of users were substantially different. Future prevention efforts targeting different type of opioids users may need to be optimised based on their profiles.