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The Information System on Treatment D emand in EU EMCDDA

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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  1. The Information Systemon Treatment Demand in EUEMCDDA Linda Montanari, Buenos Aires, 22-24 October 2003 CICAD/OAS, Demand Reduction Experts Group Meeting

  2. 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/

  3. Tasks Areas Collecting and analysing existing data Improving data-comparison methods Disseminating data and information Situation Responses Impact

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

  5. Situation analysis: Working methods • Key indicators • Core data and developing areas • Expert groups • Reporting guidelines • Analytical project groups

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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 

  11. 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?

  12. 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

  13. 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

  14. 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)

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

  16. 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

  17. Percent of new clients by main drug Source: REITOX National Reports - Standard Table 3 –2001 data (*) 2000 data – All centre types

  18. % 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

  19. 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

  20. 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) Denmark 27.8 31.1 Germany 24.0 26.8 Greece 26.6 27.8 Spain 29.3 31.5 Italy 29.0 32.3 Luxembourg 21.8 30.7 The Netherlands 30.7 32.8 Finland 22.9 25.5 Sweden 31.0 31.8 United Kingdom n.a. 28.3 Source: REITOX National Reports - Standard Table 3 – 2001 data All centre types

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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)

  27. 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

  28. 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

  29. 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

  30. Further information on the 2003 EU drug situation: • http://annualreport.emcdda.eu.int/

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