Involuntary treatment for substance use disorders in Victoria – An audit of people treated under the Severe Substance Dependence Treatment Act from 2011 to 2023

Abstract

Objective:

Characteristics and outcomes of all patients treated involuntarily under Victoria’s Severe Substance Dependence Treatment Act 2010 between 2011 and 2023 were described. Predictors of outcomes 6 months after the end of the Severe Substance Dependence Treatment Act 2010 treatment period were examined.

Method:

All admissions under the Severe Substance Dependence Treatment Act 2010 from when the programme began in January 2011 to December 2023 were audited. Data were analysed using descriptive statistics and univariate logistic regression.

Results:

There were 70 admissions for 60 patients. 58% were male, and 5% were Aboriginal and Torres Strait Islander people. Alcohol was a substance of concern for 91%, 43% had liver disease and 78% had additional psychiatric diagnoses. Six months after the end of treatment, 15% were deceased and 48% of patients had returned to their previous level of substance use. 27.6% were either using less or abstinent at 6 months which was predicted by reduced use or abstinence at 1 month (OR = 70, 95% CI = [11.5, 424.8], p < 0.001).

Conclusion:

This study suggests that brief involuntary treatment is associated with meaningful improvements in substance use outcomes for a minority of patients. If reduced substance use is achieved early following involuntary admission, it is likely to be sustained. No other clear predictor of outcome emerged in this cohort. In the absence of a control group, it is not possible to attribute these results to treatment under the Severe Substance Dependence Treatment Act 2010. Larger cohorts are required to determine variables that can be used to predict outcomes and enable judicious use of involuntary treatment for substance use disorders.