ADOM: A decade of measuring alcohol and drug outcomes

The alcohol and drug outcome measure (ADOM) has been collected into our national mental health data collection (the Programme for the Integration of Mental Health Data, also known as PRIMHD) for 10 years.

With 2025 almost over, it is important to acknowledge and celebrate this milestone.

ADOM is a simple 20-item outcome measure with three sections. Section one records the amount and frequency of use of various substances, section two the effect those substances have on people's lifestyle and wellbeing, and section three the person's satisfaction with their recovery and goals. It is meant to be collected at admission, six weekly, 12 weekly and at treatment end (discharge). Additionally, it is mandated to be offered to tāngata whai ora and should be completed collaboratively between the tangata whai ora and the practitioner.

If ADOM was a person, it can be seen as having had four distinct phases in its life so far: conception, birth, early life and present day. This approach is as good a way as any for seeing the progress the sector has made in collecting outcomes in community addiction services using ADOM.

Conception

The addiction sector was keen to see an outcome measure focused on addiction. Back in 2009, when discussions were being had initially about this possibility, some people supported the idea of simply using an overseas measure, but others wanted the sector to develop its own here in Aotearoa. It was this view which ultimately won out. With support from Waitemata DHB (as it then was) and the University of Otago, a New Zealand-based outcome measure was developed for use in community addiction services.

Read more about the research which gave rise to ADOM.

Birth

It was an easy birth. The sector wanted it and were expectantly waiting for it. In 2014, Te Pou did some trial training to get the sector ready and decided to use a train-the-trainer model where Te Pou provided national training for trainees who went back to their own services to provide training to their clinicians. The model has worked well, and the sector is still using it.

In 2015, there was a voluntary roll out of ADOM, which saw an impressive take up of the measure.

Early Life

The early life of ADOM had Te Whatu Ora services collecting ADOM the most, with fewer collections from non-governmental organisations (NGOs).

During the early period from 2016 to 2020, there was an emphasis on developing the training, resources and occasional reports for ADOM.

The ADOM Guide for Practitioners was developed, and can be downloaded from the Te Pou website.

The primary uses for ADOM are at the individual tangata whai ora level. At the individual level, ADOM can be used to set goals, develop personal plans, assist in developing a therapeutic relationship and with motivational interviewing.

Te Pou also published a number of national reports which can be viewed here.

Present day

In the past few years, NGO service providers have started to use ADOM to great effect, with collections being greater than for Te Whatu Ora services for treatment starts.

Over the past year, Te Pou have developed an ADOM dashboard which is interactive and enables teams and services to compare themselves against each other. Te Whatu Ora and NGO clinicians are eligible to access the dashboard.

Check out ADOM dashboard on the Te Pou website.

What’s next

In summary, the ADOM has come of age. Collection numbers have been building well, and services are using ADOM in many different ways. Most importantly, tāngata whai ora are using ADOM to help with their own recovery.

As we look forward to ADOM’s future, there will be a need to ensure it continues to be a valuable and meaningful addition to the addiction landscape.

• For more information about ADOM, please contact Mark Smith, programme lead outcomes and information at Te Pou: mark.smith@tepou.co.nz