Transcript Problem, Intensive Drug Use And Polydrug Use

“Problem, intensive drug use and
polydrug use”
Introduction
Danica Klempova, Scientific Committee meeting, Lisbon, 17 November
The traditional Problem drug use key indicator
• To look at the most harmful, heavy forms of drug use
• Traditionally using indirect statistical methods (multipiers, CRC,
MIM) to estimate the sizes of these – largely hidden –
populations
• To assess needs and coverage of interventions
• Defined by (umbrella definition)
• drug-type (opioids, cocaine and amphetamines)
• and a broadly described behavioural pattern (injecting and/or longterm and/or regular)
• NOT BY PROBLEMS!
Changes in the drug situation and reaction to
them
• Changing patterns of drug use in the past 15 years
(stimulants, cannabis TDI)
• 2004 focused small expert meeting in Sintra
• Reporting by drug (POU, PSU) and IDU - overlapping
categories
• Applying instruments within general population
surveys (cannabis abuse and dependence)
Discussions about concepts…
• Traditional PDU – trends uninterrupted
• Intensive, frequent, long-term, dependent, harmful,
abuse…(by drug and pattern of use)
• Polydrug use yes, but what kind (+question of
alcohol)
• Substitution medication – distinguished
…have to be closely related to data sources
• Traditional data sources for the indirect estimates; improvement
of data quality
• Novel data sources for indirect estimates (e.g. emergency room
data, …)
• Out-of-treatment populations – focused studies in different
settings (street, LTS, ..) – e.g. RDS
• General population surveys for cannabis intensive/longterm/dependent use (other substances with high prevalence and
lower stigmatisation of use)
Starting from
concepts
Starting from
data sources
PDU
Injecting drug users
Problem
opioid users
Problem cocaine
users
Problem amphetamine users
“Problem, intensive and polydrug use”
Injecting drug users
e.g. Intensive, long-term or otherwise
harmful cocaine users (ILH)
Problem
opioid users
Problem cocaine
users
Heavy/long-term
cannabis users
Problem amphetamine users
And, and, and…
“Problem, intensive and polydrug use”
Injecting drug users
e.g. Intensive, long-term or otherwise
harmful cocaine users (ILH)
Problem
opioid users
Problem cocaine
users
Heavy/long-term
cannabis users
Problem amphetamine users
And, and, and…