Regional Drug Misuse Databases Research Articles

Dental Management of Patients Taking Methadone

Methadone is a synthetic opiate used in the treatment of opiate addiction. Various side-effects have been associated with the use of methadone. These include xerostomia, which can contribute to a high caries rate. The UK Regional Drug Misuse Database reported that around 118,500 drug users were receiving treatment from drug misuse agencies and GPs. The vast majority (87%) were receiving treatment from community specialist services. As many drug abusers have poor oral health, general dental practitioners are likely to encounter such individuals. It is essential therefore that dentists are aware of the potential difficulties that may be encountered when treating subjects receiving methadone. These problems may relate to previous drug abuse and to the effects of methadone therapy.

Continuing the epidemiological function of the addicts index—evidence from matching the home office addicts index with the National Drug Treatment Monitoring System

Aims: We discuss the Addicts Index (AI) and examine whether the epidemiological trends of the AI can be continued by the regional drug misuse databases (DMDs, now known as National Drug Treatment Monitoring System (NDTMS). Methods: (i) Matching individuals recorded as addicted to opiates and/or cocaine in the AI with those reported to the North Thames Drug Misuse Database (NT-DMD) 1992–1996; (ii) comparison of trends over time. Findings: Of 26,120 notifications to the AI from North Thames 73% were also reported to drug misuse database. There were no significant differences in the proportion of notifications reported over time or by sex. At least 80% of reports from specialist drug agencies were matched compared to approximately 60% of reports from GPs (χ2 p < 0.001). Compared to specialist drug agencies the adjusted odds ratio of being reported to NT-DMD was 0.45 (95% CI 0.40 to 0.49) for GPs. Nationally time trends in notifications to AI and reports to DMDs were highly correlated (Pearson correlation coefficients of 0.98). Conclusions: The epidemiological function of the AI can be continued. However, new strategies are urgently required to improve reporting from GPs.

Artefact or reality? Increases in persons notified to the Regional Drug Misuse Database in the South West of England, 1996-2001.

The incidence of new persons and repeat attenders presenting for treatment for problem drug misuse in the South West of England more than doubled from 1996-1997 to 2000-2001. During this time there was an increase in the number and severity of chronic cases, both in terms of the prevalence of heroin and crack-cocaine use and in the frequency of injecting and sharing injecting equipment. Growth in the availability of treatment, changes in notification practice and sub-regional variation make it difficult to be confident about real rates of increase, or age, gender and substance misuse changes, but the size of these changes mean they are unlikely to be purely artefactal.

Estimating the prevalence of problem drug use in inner London: a discussion of three capture-recapture studies.

To provide an evidence base of estimates of the prevalence of problem drug use in inner London. Re-analysis of three capture-recapture studies using subjects aged 15-49 years, that aim to estimate the hidden population from analysing the overlaps between three data sources. Newham (1995) Camden and Islington (C&I) (1993/4) and Lambeth, Southwark and Lewisham (LSL) (1992). Each study collected data from three sources of problem drug users including: the Regional Drug Misuse Database, specialist drug agencies, HIV tests, social services, police arrests and court records. In LSL opiate users were analysed separately. The studies identified 1832 individuals in LSL, 543 in Newham, and 1321 in C&I. Poisson models were fitted to the data testing different interactions between the data sources representing potential dependencies. The simplest model was selected on the basis of its AIC score and log-likelihood ratio tests. The number of hidden problem drug users were estimated to be 12,500 (95% CI 9600-16,100) in LSL with 4400 (3200-6100) opiate users; 7000 (5000-10,000) in C&I and 3800 (2000-7200) in Newham. The prevalence of problem drug use in those aged 15-49 was estimated to be 3.1% (2.5-3.9%) in LSL with 1.3% (1.0-1.6%) opiate users; and 3.6% (2.7-4.9%) and 3.3% (1.9-5.7%) in C&I and Newham, respectively. Despite the inherent problems with capture-recapture methods, our three studies establish an evidence base for estimates of problem drug use in London. It is important that a larger study is carried out in London.

Surveillance of problem drug use in the UK: a review of a Regional Drug Misuse Database.

We report detailed findings of the first systematic validation of a Regional Drug Misuse Database (RDMD); such databases constitute the main investment in routine drug statistics in the UK by the Department of Health. A retrospective case-finding study in a stratified random sample of one in three specialist drug agencies was carried out. Agency records of clients attending during 1994 were matched with reports (episodes) to the North Thames RDMD to assess the level of under-reporting, and the relationship between RDMD reports (episodes) and the number of problem drug users in contact with agencies. Under-ascertainment of cases was estimated using two-sample capture-recapture. Under-reporting was associated with agency records missing full date of birth or initials (attributers), and agency type. Compared with drug dependency units (DDU) the odds of under-reporting were 3-18 times higher by the other specialist drug agencies. Even after excluding episodes with missing attributers the odds ratio (OR) of not being reported was significantly higher among needle exchanges (OR 2.7), non-statutory community based drug teams (OR 3.2), statutory community based drug teams (OR 4.9) and residential rehabilitation units (OR 8.7) compared with DDUs. Overall database episodes represented 60 per cent of the number of clients attending specialist agencies as a result of a mixture of under-reporting and the proportion of clients retained in treatment, which also varied by agency type. A total of 727 individuals (16 per cent) had never been reported. Surveillance of drug misuse through RDMDs does not yet fulfil its objectives. It is essential that a system of following up reports is introduced to improve their utility, and to contribute to the monitoring of the UK Government's new drugs strategy, and wider European surveillance.

Validation of the University of Manchester Drug Misuse Database.

OBJECTIVE: The study was conducted to assess the validity and quality of data held by one of the UK regional drug misuse databases (DMD). DESIGN: The research was multi-centred and...

Validation of a regional drug misuse database: implications for policy and surveillance of problem drug use in the uk

The eight regional drug misuse databases constitute the largest investment (about £100 000 each annually) in drugs surveillance in England. Along with databases in Scotland and Wales, they provide the...

The optimal size of attributor for use with the University of Manchester Drug Misuse Database

This paper describes the anonymous, attributable code which is applied to different individuals when they are reported to the regional drug misuse databases using the University of Manchester system. It then reports on the effect of removing selected data items included in the attributor on the system's ability to distinguish between different drug users reported to the database. All of the attributable codes that did not use the full set of data items were found to reduce the system's ability to distinguish between the reporting of new drug users and new episodes of drug use for users previously reported to the database.