Alcohol and drug treatment population profile: a comparison of 1998 and 2004 data in New Zealand.

AIMS To describe the profile of clients attending dedicated alcohol and other drug (AOD) treatment services in New Zealand, and to compare this profile with data from a 1998 survey. METHODS 288 randomly selected AOD treatment workers in New Zealand were interviewed by telephone regarding their most recent assessment and follow-up clients, yielding a randomly selected sample of 383 clients. Workers were asked to identify the age, gender, ethnicity, main substance use problem, and geographical location of clients. RESULTS 65% of clients were male; 32% were Maori. The mean age was 34 years and the largest group of clients were seen for alcohol-related issues (47%), followed by cannabis (24%) and opioids (15%). Amphetamines had risen as the main substance used--from near zero (in 1998) to 10% of the sample (in 2004). In 2004, surveyed clients were older and less likely to be Caucasian (European ethnicity), and were more likely to be seen in district health board (DHB) and non-residential settings. Compared to clients attending assessment appointments, those attending for follow-up were older, less likely to be female or Maori, and more likely to use opioids. Overall, Maori clients were younger, used cannabis more, and were less likely to live in a large city. Amphetamine users were younger and almost exclusively living in the North Island. CONCLUSIONS Several substantial changes have occurred in the profile of AOD clients over the 6 years (1998-2004). Although the traditional substances of alcohol, cannabis, and opioids continue to predominate, the rise in amphetamine use in the community is reflected in a corresponding rise in amphetamine presentations to AOD services, particularly amongst younger clients and those in the North Island. While other observed changes might have been predicted from broader demographic trends and service reconfiguration, the emergence of a substantial disparity in treatment follow-up rates between Maori and non-Maori is not so easily explained.