Tracking New Trends in Drug Use
Diemel, Steven, Blanken, Peter, Journal of Drug Issues
The Netherlands has developed a broad range of information systems and other data sources that focus on various aspects of illicit drug use. Researchers can put these to use for the early detection, tracking, and understanding of changes in drug consumption patterns it) various populations. This article first assesses the suitability of existing data sources for this purpose in a series of case studies including (1) the emergence of ecstasy; (2) changing routes of heroin administration; and (3) the introduction of crack cocaine. It then discusses how to develop an effective model for tracking new trends in drug use. In this model, the suitability of different data sources depends on the topic, the population, and the stage in the diffusion process of the trend. Because each data source has its own strengths and weaknesses, changes can only be detected, tracked, and understood by continuously comparing information from various sources.
Policy makers, researchers, and others who work in the drug field have experienced a growing need for a system that will enable them to swiftly detect, track, and understand the significance of new trends in drug use. Examples of such drug trends are the emergence of new substances, renewed interest in traditional substances, changes in typical routes of administration, and the consequences (such as health effects) of these changes in drug use patterns. In recent decades, researchers in the Netherlands have developed a wide range of information systems to estimate the prevalence of illicit drug use and map out consumption patterns. Some of these data sources seem sensitive enough to detect and track changes at a very early stage in their development.
The aim of our article is twofold. We first analyze the suitability of existing and potential data sources for the swift assessment of changing drug patterns in different populations. We propose and then discuss a model that may be effective in "tracking new trends"' in drug use from an epidemiological perspective. We begin by reviewing some data sources that may be used to monitor changing consumption patterns.
SUITABILITY OF DATA SOURCES
Two general types of data can be distinguished: routine statistics and nonroutine indicators. In addition to the most frequently used data sources, less common ones, such as news media and telephone help lines, may also yield useful information. Some of the key Dutch information systems and data sources on various aspects of illicit drug use are summarized in Table 1.
The first category is comprised of police and criminal justice statistics, drug treatment data, and ongoing assessments of drug users' health (Table 1). Although tracking new trends is not their primary objective, routine statistics can provide valuable information on many aspects of drug use. These data are collected continuously and are documented in annual reports and statistical yearbooks (for example CBS, 1996; de Zwart and Mensink, 1996; IVV 1997; Spruit, 1997b).
Data on drug seizures serve as indicators of the market availability of illicit drugs, although they may also reflect changes in policy or in enforcement priorities. In extrapolating these observations to drug consumption, one should bear in mind that figures on offenses against the Dutch Opium Act refer mostly to large-scale drug trafficking and production and not specifically to individual use. In addition, while some of the drugs confiscated in the Netherlands are meant for domestic consumption, others are intercepted while in transit to other places. Data from drug treatment systems are especially suitable for tracking those experiencing problems with their drug use who have sought assistance. In practice, the clientele of the Dutch treatment system is comprised largely of daily heroin users attending low-threshold methadone maintenance programs. Data on drug-related morbidity and mortality can serve as indirect indicators of changes in consumption patterns, notably in routes of administration within specific drugusing populations. …