Spanish Observatory on Drugs Julia Gonzalez Rosario Sendino Noelia Llorens Begoña Brime Aurora Ruiz Elena Alvarez (speaker) Prevalence and patterns of drug use among general population. GPS Indicator. Annual Expert Meeting 2013. 18-19 June 2013 - EMCDDA (Lisbon) Estimation of Problematic Drug Use in Spain Estimation of Problematic Drug Use in Spain - - Examples of estimation based in surveys Examples of estimation based in surveys - - Data and thought…
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Spanish Observatory on Drugs
Julia GonzalezRosario Sendino
Noelia LlorensBegoña Brime
Aurora RuizElena Alvarez (speaker)
Prevalence and patterns of drug use among general population. GPS
Indicator. Annual Expert Meeting 2013.
18-19 June 2013 - EMCDDA (Lisbon)
Estimation of Problematic Drug Use in SpainEstimation of Problematic Drug Use in Spain
-- Examples of estimation based in surveysExamples of estimation based in surveys--
Data and thought…
� INTRODUCTION � Concept and aspects to take into account � Source of information and methods, in Spain
� EXAMPLES � Cocaine PDU estimation based in surveys (frequency & age/vulnerability)
Objective. Methods. Results.
� Cannabis PDU base in surveys (scales). Objective. Methods. Results.
� DISCUSSION� Utility of surveys to estimate PDU, combination of different methods…
Until 2012: “problem drug use is injecting drug use or regular and/or long-term use of opiates, cocaine and/or amphetamines”
2013: focuses on “high-risk drug use. Drug use that is causing actual harm (negative consequences) to the person (including dependence but also other health, psychological or social problem) or is placing the person at a high probability/risk of suffering such harms”
Approach of problematic users...
The drug use is causing, the
users (or others), negative
physical, psychological or social
consequences or hight risk of
having them.
Approach of problematic users... Approach of problematic users...
The drug use is causing, the The drug use is causing, the
General population survey 2011(15-64 y.o)Student survey 2010. (14-18 y.o)
1) Frequency based
How many times in a period of time (month/year) do a person consume?.
Person (15-64 y.o.) who used cocaine 30 days or more within the last 12 months ORwho used cocaine 10 days or more within the last 30 days
2) Frequency & age (vulnerability)
20 years old ?? Phisic/psycic/social vulnerability. Implement prevention in early ages.
Persons (15-20 y.o) who used cocaine 10 d or more within the last 12 month AND who used cocaine from 1 to 3 d within in the last 30 days PLUS persons (21 to 64 y.o.) who used cocaine 30 days or more within the last 12 months ORwho used cocaine 10 d or more within the last 30 days .(More than 20 y.o)
Criteria
No clear consensus,
no evidence based criteria
General population survey 2011.
15-64 y.o. National coverage. Face to face questionnaire. 22, 128 questionnaires.
Source of information
Estimation of cocaine problematic drug users in Spain, using general population survey, based in frequency and age (vulnerability)
CAST- Cannabis Abuse Screening Test. 6 items. Measure social & health consequences for user and others. SDS-Severity of Dependence Scale. 5 items. Measure dependence. DSM-IV-American Psychiatric Association. 5 items for abuse and 13 for dependence. DSM-IV criteria. M-CIDI- Munich Composite International Diagnostic Interview.
Some thought based in our experience… different scenarios ���� dif. answers ���� dif. methods.
�Conceptual definition depend of situation, drug, user characteristic, pattern of use….
�Look for a complete picture using multiples sources and different indicators. Available information. Triangulation of the information. Problematic use!!
�Look for right sources & methods.
Are survey a good methods for estimate problematic use?Surveys can't answer “everything” but… yes “many things”Part of the puzzle to understand drug use? First step to oriented specific studies? .
� Methods : - General population/specific population. - Scales (AUDIT, CAST, DSM-V…). - Frequency of use, age, others. - Surveys + other indicator.
� Some limitation: classics surveys limitations. Drug with low prevalence. Surveywith small sample. High risk-social stigma. Out of sampling frame…
� Surveys are a possible toolSurveys are a possible tool: - Available (more cost effective than create new indicator). - Robust (quality and trends). - Flexible (periodic modules, adapt to needs).