Substance Use Disorders (SUDs) in Australia: What the data and evidence says regarding access to treatment and cost.

Brief overview of SUDs in Australia.

Substance use (SU) is a preventable cause of morbidity and mortality in Australia, with widespread economic, social and health impacts (Australian Institute of Health and Welfare [AIHW], 2025a). According to available data, more than 10 million people in Australia have used illicit substances in their lifetime (AIHW, 2025b), with over 600 000 people meeting the criteria for a substance use disorder (AIHW, 2025c). This highlights the importance of the necessity for timely access to treatment.

Unmet treatment needs in New South Wales (NSW).

In New South Wales (NSW), the Drug Policy Modelling Program (DPMP) used available datasets from the AIHW and Global Burden of Disease (GBD) study (2021) to estimate the unmet treatment need for people with SUDs in NSW. The results showed that more than 100 000 (mid-range estimate) people missed out on SU treatment in 2022 (O'Reilly & Ritter, 2024). The breakdown of relevant substances included:

1. Alcohol: 50 000 people

2. Methamphetamine: 20 000 people

3. Opioids:17 000 people

4. Cannabis:12 000 people

Figure 1.1: A representation of unmet treatment needs by substance in NSW (O'Reilly & Ritter, 2024).

These SUDs can be treated in an ambulatory setting, and this is often preferred by people seeking treatment as in has less of an impact on other activities of daily living (Rubenis et al., 2024). This further informs the need for more community treatment options for people with SUDs.

Lengthy waitlists and complex intake processes: Key barriers to accessing treatment.

There are several social and individual barriers for people accessing treatment for SUDs, including stigma, social isolation and comorbidities such as mental health disorders, which are often not managed well in SU treatment settings (Farhoudian et al., 2022; Wolfe et al., 2023). Most notably, however, structural barriers, mainly lengthy waitlists and complex intake processes are cited as the major barriers in treatment access for SUDs (Farhoudian et al., 2022; Francia et al., 2022; Neale et al., 2024; Rubenis et al., 2024; Wolfe et al., 2023).

Waiting for treatment and complicated assessment processes can have significant impacts, markedly poor engagement and health outcomes, secondary to ongoing SU and altered readiness to change perceptions while waiting (Searby et al., 2024).

Conversely, evidence suggests that rapid access to treatment for SUDs (within three days) improves retention in treatment and better outcomes for patients overall (Jhoom Roy et al., 2020; Sander et al., 2020).

SUDs: The Cost.

The cost of addiction in Australia is costly, from a financial, societal and human perspective. The below infographic highlights the main costs in the Australian context.

Figure 1.2: Infographic on the cost of addiciton in Australia.

Given the estimated large unmet treatment need in NSW, noted structural barriers to accessing treatment for SUDs and the cost to society, innovative pathways to access care are essential for this population.