| Summary: | © 2015 Elsevier B.V. Background: This study aimed to explore the association between substance use, social disadvantage and past year alcohol and other drug (AOD) treatment among clients entering publically funded AOD services in Victoria and Western Australia, to inform system development. Methods: Participants (n = 781) completed a structured interview on substance use, social circumstances, and past year service use. Results: Most participants were severely AOD dependent and a high proportion were recently homeless, receiving welfare benefits, and with criminal justice issues. Previous AOD treatment was common. Logistic regression analysis showed that past year AOD treatment was more frequent among those receiving welfare benefits, with opioids as their primary drug of concern, and using multiple substances. Conclusion: While AOD dependence characterised this treatment group, social disadvantage independently predicted higher rates of prior AOD service use. Specialist AOD treatment systems need capacity to provide or at least work alongside services designed to address social disadvantage.
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