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The Information System on Treatment D emand in EU EMCDDA. Linda Montanari, Buenos Aires, 22-24 October 2003 CICAD/OAS, Demand Reduction Experts Group Meeting. Mission of the EMCDDA.

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The Information System on Treatment D emand in EU EMCDDA

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The Information Systemon Treatment Demand in EUEMCDDA

Linda Montanari, Buenos Aires, 22-24 October 2003

CICAD/OAS, Demand Reduction Experts Group Meeting


Mission of the EMCDDA

  • To provide the Community and the EU Member States with objective, reliable and comparable information concerning drugs and drug addiction and their consequences 

  • Further information: http://www.emcdda.eu.int/


Tasks

Areas

Collecting and analysing existing data Improving data-comparison methods Disseminating data and information

Situation

Responses

Impact


Map of EU Member States, Norway, acceding and candidate countries


Situation analysis: Working methods

  • Key indicators

  • Core data and developing areas

  • Expert groups

  • Reporting guidelines

  • Analytical project groups


Key indicatorsA common language for describing the drug situation

  • Extent and patterns of drug use in the general population

  • Prevalence of problem drug use

  • Drug-related deaths and mortality among drug users

  • Treatment demand

  • Drug-related infectious diseases


Core data and developing areas

  • Crime

    • Arrest Data

    • Drug Related Crime

  • Drug Markets & Availability

    • Perceived availability

    • Seizures

    • Price & Purity

  • Social Exclusion

  • Youth and vulnerability

  • New Trends


Treatment Demand IndicatorTDI

  • One of the 5 key Indicators at the EMCDDA

  • Provide information on the people demanding treatment in the specialised drug services in Europe

  • Further information:

  • http://www.emcdda.eu.int/situation/themes/demand_treatment.shtml


What is the objective?

  • To provide comparable, reliable and anonymous information on:

    • Number of people treated for their drug use

    • Characteristicsand Profile of clients

    • Patterns of use

    • Trends over time


What is the purpose?

  • Indirect indicator of trends in problem drug use

  • Identification of patterns of drug use

  • Basis for other methodologies on problemdrug useprevalence estimation

  • Identify patterns of use of services and plan and

    evaluation of services 


Information in TDI: 20 items

Which questions the TDI answer to?

What drug treatment?

  • Treatment contact details

    • centre type, time of treatment, source of referral

  • Socio-demographic information

    • gender, age, living and labour status, education, nationality

  • Drug related information

    • primary and secondary drug, substitution treatment, route of administration, frequency of use, age at first use

What characteristics of clients?

Which substances /

Patterns of use?


Guidelines

  • A joint EMCDDA/Pompidou Group protocol (TDI protocol), with definitions and guidelines for data collection

    TDI Protocol

    http://www.emcdda.org/multimedia/project_reports/situation/treatment_indicator_report.pdf


How data are collected?

  • 23 excel sheets (cross tabulations) inserted in a central EMCDDA database (EISDD)

  • By centre type: outpatient, inpatient, low threshold, GPs, prison, others

  • By each country (29):

    15 Member States

    + Norway

    + 10 acceding countries

    + 3 candidate countries


What are the main resources?

  • Network: one expert identified in each country by the NFP

  • Working group in most of the countries involving professionals from the treatment centres at national level

  • European annual expert meeting: the state of progress and future perspectives

  • Small thematic working group (e.g. data coverage and cannabis data in 2003)


Some ResultsClients admitted to drug treatment in 2001:trends and patterns of use


Percent of new clients admitted to treatmentby main drug in 2001

Source: 2002 Reitox National Reports; Standard Table 3; 2001 data

All Centre Types; N.cases: 34 768 (new clients)

Countries included: Dk, Ge, Gr, Sp, IR (2000 data), Nl, FI, Sw

Weighted average on the total numbers of new clients by country


Percent of new clients by main drug

Source: REITOX National Reports - Standard Table 3 –2001 data

(*) 2000 data – All centre types


% of new clients admitted to treatment for opiates, cocaine, cannnabis in some EU countries- 1996 to 2001 -

Source: Reitox National Reports; Standard Table 4; All Centre Types

Countries included: Dk, Ge, Gr, Sp, Nl, Sw

Average weighted on the number of clients by country


Percent of new outpatient clients in some country by source of referral

(n. 689)

(n. 488)

(n. 4700)

*

(n. 1258)

(n. 831)

(n. 5970)

Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres –

Valid per cent, n = 13 936 cases, new clients - * Ireland: 2000 data


  • Opiates and Cocaine between 20-29 and 30-39

  • Stimulants and cannabis between 15-19 and 20-29

Mean age of clients in treatment in 2001

New clientsAll clients

(n = 83571)(n.337842)

Denmark27.831.1

Germany24.026.8

Greece26.627.8

Spain29.331.5

Italy29.032.3

Luxembourg21.830.7

The Netherlands30.732.8

Finland22.925.5

Sweden31.031.8

United Kingdomn.a.28.3

Source: REITOX National Reports - Standard Table 3 – 2001 data

All centre types


Gender distribution among new clientsin 2001

  • Mainly males: 79.2 males / 20.8 females

  • Differences between drugs:

    • Opiates:81.2 males / 18.8 females

    • Cocaine:85.0 males / 15.0 females

    • Stimulants:67.5 males / 32.5 females

    • Cannabis: 85.8 males / 14.2 females

  • Highest proportion of males in Spain (84.9), lowest in Sweden (69.1)

Source: Reitox National Reports -Outpatient Treatment Centres

N. Cases: n. 29 133

Countries: Dk, Ge, Gr, Sp, Nl, Fi, Sw


Percent of new outpatient clients by level of education in 2001

Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres

Valid per cent, n = 29 493 cases, new clients

Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw


Percent of new outpatient clients by labour status among in 2001

8.2% in general population

Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres

Valid per cent, n = 29 596 cases, new clients

Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw


Age at first use of main drug among new clients in some countries

Source: 2002 Reitox National Reports – Outpatient Treatment Centres

Year covered: 2001

Countries covered: Dk, Ge, Gr, Sp, Fin, Sw


Frequency of use of main drug:% new clients in 2001 (last 30 days before starting treatment)

%

Source: 2002 Reitox National Reports – TDI data – Outpatient Treatment Centres

Year covered: 2001

Countries covered: 2001: Dk, Ge, Gr, Nl, Fin, Sw


Route of administration among all and new clients in some country in 2001

Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres

Countries: Dk, Ge, Gr, Ir (2000 data), Nl, Sp, Fin, Sw, Uk (all clients)


Most used secondary drugs among new clients in 2001 in some countries

85.1% use more than one drug

%

Source: Reitox National Reports 2002 – TDI data -Outpatient Treatment Centres

Valid per cent, n. 25 824 using a secondar drug (n =30 344 total new clients)

Countries: Dk, Ge, Gr, Nl, Sp, Fin, Sw


Conclusions (1)

  • Opiates main substance, followed by cannabis and cocaine

  • Decrease of opiates users, increase cannabis and cocaine

  • Clients are males in their 20s or 30s

  • Clients demand treatment spontaneously or through family

  • Social conditions are worsening than general population

  • Clients start to use in the adolescence: earlier for cannabis


Conclusions (2)

  • Polarization of frequency of use for opiates and cocaine graduation for stimulants and especially cannabis

  • Clients tend to inject opiates, sniff cocaine, eat stimulants: less injection among new clients

  • Polydrug use is apparent, with cannabis as main secondary drug, followed by cocaine

  • Relevant differences between countries


Further information on the 2003 EU drug situation:

  • http://annualreport.emcdda.eu.int/


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