Drug Misuse Monitoring

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Drug Misuse Monitoring Identifying
Trends Predicting Future Demands Responding
to Public Health Needs
J McVeigh, MA Bellis R Thomson
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Drug Misuse Monitoring

• Why do we need a robust drug misuse intelligence
  system?
• Who contributes to the system?
• What are the applications of the system?

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Reasons for a robust drug misuse intelligence
system

• Monitor progress of the National Drug Strategy
• Assess the needs of specific geographical areas
• Identify effectiveness of interventions
• Inform effective commissioning of services
• Identify trends in substance misuse
• Predict changes in drug service demand
• Identify and respond to public health issues
• Support original research

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Contributors to the system
Pseudoanonymised data from

• Health
• Specialist drug services
• Agency based syringe exchange services
• Pharmacy based syringe exchange services

• Criminal Justice
• Arrest referral schemes
• Probation
• Police arrest data
• Youth offending teams

• Additional providers
• Social services
• Housing
• Young people's services

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Applications of the drug misuse intelligence
system

• Independent database outputs
• Multiple database outputs
• Retrospective analyses
• Responding to public health needs

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Independent database outputs Merseyside
Cheshire specialist drug service contacts (2000/1)
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Independent database outputs specialist drug
services outcomes (2000/1)
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Multiple database outputs Merseyside multiple
agency contacts 1/10/2000 - 31/3/2001
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Multiple database outputs Estimate of
hidden/total populations of problematic drug
users in Liverpool (1998)
Data sources used to estimate total number of
problematic drug usersEstimated Total 7121
(aged 15-44)
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A higher percentage of females and those aged
25-44 accessing treatment services
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Retrospective data analyses
Problematic drug use reported by Merseyside
Cheshire SDA
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Retrospective data analyses
Main drug of use - new clients presenting to
agency based syringe exchange schemes in
Merseyside Cheshire
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Responding to public health needs
Unexplained deaths among injecting drug users in
NW England A case control study using Regional
Drug Misuse Database

• April June 2000 14 cases in North West (12
  fatalities)
• Need to
• Understand the outbreak
• Identify characteristics of those most at risk
• Provide harm reduction information and advice
• Prevent re-occurrence of the outbreak
• Develop appropriate advice and information in
  event of re-occurrence
• 12/14 cases located on DMD 10 controls per case

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Responding to public health needs
Unexplained deaths among injecting drug users in
NW England A case control study using Regional
Drug Misuse Database

• Results
• Cases were significantly more likely to be
• Female
• Older
• Longer users of heroin
• Injected benzodiazepines

Application Development of risk
profile Targeting of prevention activities
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Developments of the drug misuse intelligence
system

• Expansion of data providers to the Inter Agency
  Drug Misuse Database
• Extended outcome monitoring
• Establishing links with other sources of
  intelligence
• Web based dissemination of drug misuse
  intelligence

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Conclusions
Monitor and predict changes in size/characteristic
s of drug misuse problems and drug service demand
Facilitate the planning and evaluation of
health and criminal justice interventions with
drug misusers Enable a rapid response to public
health investigations
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For additional information contact
Rod Thomson Public Health Department South Sefton
PCT Burlington House Crosby Road
North Waterloo L22 0QB Rod.Thomson_at_southsefton-pct
.nhs.uk
Jim McVeigh / Mark Bellis Centre for Public
Health Liverpool John Moores University 70 Great
Crosshall Street Liverpool L3 2AB heajmcve_at_livjm.a
c.uk
Web www.phslive.com www.nwpho.org.uk