Finnish Drug Treatment Information System

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Finnish Drug Treatment Information System

• Kristiina Kuussaari, Stakes
• kristiina.kuussaari_at_stakes.fi

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STAKES Information Division

• The division maintains national statistics and
  registers, and functions as a centre of
  excellence for information and communication
  technology in the field of social welfare and
  healthcare.
• An official status as a statistical authority.
• Our main clients are national and international
  decision-makers and actors.

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• Groups at STAKES Information
• Health Statistics and Indicators
• Alcohol and Drug Statistics and Reproduction
  Statistics
• Social Care and Personnel Statistics
• STAKES Unit for eHealth and eWelfare
• Statistical Information Systems

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Contents of the presentation

• Background of Drug Treatment Information System
• Principles of data collection
• Description of data
• 2006 Results
• Future challenges

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Background of the Drug Treatment Information
System (1/2)

• Managed by Ms. Kristiina Kuussaari
  (kristiina.kuussaari_at_stakes.fi) at Stakes, within
  the Finnish Focal Point of Reitox network
• Based on the EMCDDA protocol (Treatment Demand
  Indicator)
• Data collection was piloted in Finland in 1996
• Round-the-year data collection since 2000

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Background of the information system (2/2)

• Voluntary for the participating units
• Anonymous (national identity number, name or
  place of domicile are not requested). Overlapping
  case identification code is used.
• The data is reported annually both nationally
  and internationally (EMCDDA, UN)

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Data collection process

• Data is collected either on paper questionnaires
  or electronically
• At the moment about 60 percent of the data is
  received electronically
• Training on data collection and use of
  electronic tool is provided for the staff of
  participating units twice per year
• Client data is collected when the client is in
  the specific treatment for the first time that
  year (incl. clients who continue treatment from
  the previous year on 1st of January)
• Data is based on self-reporting

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(No Transcript)
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Data collected on every client

• Type of current treatment, history in treatment,
  route of referral to treatment, medication used
  in treatment
• Sociodemografic background
• History of substance abuse (drugs, route of
  administration, age of first use etc.)
• Risk behaviour (injecting, sharing of needles,
  testing and test results of infectious diseases)
• Additional national part on Subsitution Treatment

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2006 Data

• 133 units submitted data (no full coverage)
• Data on 5730 clients
• Analysis consists of data on 4865 clients (after
  cleansing of the overlapping cases)

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Where is the data coming from?

• Most of the data (39 in 2006) originates from
  general outpatient services for substance abusers
  (A-Clinics, youth clinics etc.)
• One fourth of the data is from inpatient units
  for substance users and another fourth from
  outpatient services scecialised in drug abuse
• Some data from health councelling centres (NSPs)
  and substance abuse treatment units in prisons.

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  2004 2004 2005 2005 2006 2006
Sociodemographic background and substance abuse history All clients (N570) First time in treatment of all clients (N990) All clients (N5499) First time in treatment of all clients (N884) All clients (N4865) First time in treatment of all clients (N655)
  First time in treatment of all clients (N990) First time in treatment of all clients (N884) First time in treatment of all clients (N655)
Males () 72 68 70 68 69 66
Mean age (yrs) 27,3 23,6 27,6 24,2 28 25
Proportion of clients first time in treatment () 18   17   14  
Singles () 67 78 66 73 64 74
Comprehensive school only () (compulsory education) 67 65 67 64 68 63
Unemployed () 62 43 62 48 62 45
Homeless () 11 8 12 8 11 5
Mean age by the time of starting using alcohol (yrs) 12,7 13 12,8 13,3 12,8 13,4
Mean age by the time of starting drug use (yrs) 15,8 16,4 15,6 16 15,6 15,8
Injecting drug use, lifetime prevalence () 74 43 77 47 78 49
Injecting drug use, last month prevalence () 43 26 43 29 43 30
Mean age by the time of starting injecting (yrs) 19,1 19,6 19 19,7 18,9 19,6
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Age groups of clients in 2006 ()
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Drug group 1st drug 2nd drug 3rd drug 4th drug 5th drug
Subgroup (N4865) (N4865) (N4865) (N4865) (N4865)
Opioids 41 12 7 5 4
Heroin 2 2 1 1 1
Buprenorphine 31 6 4 2 2
Other opioids 8 4 2 2 1
Stimulants 21 17 13 8 4
Amfetamines 21 16 11 6 2
Ecstasy 0 1 2 2 2
Cocaine 0 0 0 0 0
Other stimulants 0 0 0 0 0
Hypnotics and sedatives 7 23 15 8 3
Benzodiapines 7 23 15 8 3
Other sedatives 0 0 0 0 0
Hallucinogens 0 0 0 0 0
Volatile inhalants 0 0 0 0 0
Cannabis 14 23 17 7 3
Alcohol drug (polydrug use) 1 12 9 6 4
Other drug 0 1 0 0 0
No information 0 11 37 63 79
All 100 100 100 100 100
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Primary drug among clients, 2000-2006
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Polydrug use in 2006 ()
Primary drug Primary drug Primary drug Secondary and tertiary drug used along with the primary drug () Secondary and tertiary drug used along with the primary drug () Secondary and tertiary drug used along with the primary drug () Secondary and tertiary drug used along with the primary drug () Secondary and tertiary drug used along with the primary drug ()
  Clients Opioids Stimulants Cannabis Hypnotics and sedatives Alcohol
Opioids 1994 41 14 38 37 48 12
- heroin 104 2 42 43 31 30 7
- buprenorphine 1495 31 11 39 37 54 11
Stimulants 1031 21 26 9 54 31 28
Cannabis 655 13 15 38 2 16 48
Pharmaceuticals 327 7 23 22 27 16 47
Alcohol 812 17 12 39 62 39 lt1
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Injecting behaviour by primary drug
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Testing and test results of hepatitis C according
to years of drug abuse in 2006 ()
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Future challenges

1. Improve the data quality -gt broader and more
   systematic data cleansing with the help of
   software application
2. Improve the coverage
3. Increase the proportion of units submitting data
   electronically