International Alcohol and Drug Monitoring Systems

Abstract

Proper documentation of alcohol and drug use and associated harms can be used to better understand epidemiological issues related to usage, policy development and evaluation. Comprehensive monitoring systems can be used to track changes over time and between geographic jurisdictions, contribute to evaluations of major policy changes, determine higher priority areas for interventions, and better understand correlates of heavier using populations.Different types of data collection systems exist worldwide. In many countries, randomized surveys of the general population are conducted to assess consumption patterns and related harms. Such surveys can be associated with considerable error and in the case of alcohol, can greatly underestimate overall consumption. For other drugs, the degree of error is unknown, but likely is as large or even larger given the difficulty of reaching illicit drug users by population survey methods. Population-based monitoring systems or enforcement systems, treatment systems for substance users, hospital separations, sales of alcohol, and substance related mortality all provide valuable indicators on the extent of substance related problems - though each of these datasets contains its own biases.Establishment of monitoring systems may seem like a fairly straightforward task; however, the design, development, and operation of such systems can be fraught with difficulties. Data collection systems across and between countries are often established independently, with consequent inconsistent data collection methods and different types of data collected, making comparisons among jurisdictions problematic. Even with methods and data that appear consistent, interpretation of results can be misleading, attributable more due to sociocultural differences in the diagnoses of problems or differential discretionary practices by police for the example of enforcement data. In this special issue, alcohol and drug monitoring systems around the world are discussed. The articles address both the challenges in establishing systems and the progress made toward their implementation in various countries and globally.This special edition includes articles that were first presented at a special thematic international symposium of the Kettil Bruun Society in Victoria, 2007. The edition opens with an article by Rush and colleagues that carefully documents factors crucial to the implementation of a treatment monitoring system. Dr. Rush has spent close to 30 years refining data collection and procedures for substance use treatment systems and their clients in Ontario and this reading provides valuable insights into factors relevant to successful monitoring of individuals in treatment and treatment systems. Next is an article by Rehm and Room who provide an overview of alcohol systems currently in place or planned for monitoring alcohol use and related harm from a global perspective, and make recommendations concerning optimal indicators. …