04. a. cadet-tairou - trend scheme · rennes metz trend cities lyon nantes ? areas with sintes...

Agnès Cadet-Taïrou

Head of TREND Unit

French monitoring Centre for Drugs and Drug Addiction

TREND scheme

Emerging Trends and New DrugsThe French National Monitoring System on patterns of drug use and

local drug market

EMCDDA- 20 years of monitoring event, Lisbon, September 2015

Thread

� TREND Unit within the French Focal point

� TREND scheme (… and TREND network)

� Benefits, limitations and challenges

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TREND Unit, role

� Providing early information

– To limit time between the emergence of a new phenomenon and its consideration by decision makers

� To identify and analyze phenomena undetectable by classical quantitative indicators or before they seen by these indicators

� Providing clues for understanding

– Collection of qualitative data from the field– Cross–checking of a large range of data

� The French Focal point of the European EWS on drugs

– part of the French vigilance system on drugs

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Fields

� Drug users: profile, pattern of use, representation

� Substances: name, price, chemical composition

� Contexts: contexts of use, evolution in environments, local market and trafic

� Consequences

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TREND Unit, tools

� TREND scheme = a “User and Context” approach

– A network + local data collection tools + data synthesis

– A one year period + occasional rapid information requests

� SINTES Scheme = a substances approach

– A network for rapid sharing of information : vigilance on new substances / dangerous substances (EWS)

– A network for collecting and analysing substances from DUs

� I-Trend project (Internet tools for research in Europe on new drugs)

� Quantitative surveys

– Ena-CAARUD : National survey on low threshold facilities for DUs– Quanti-festif : on techno party environments

� Cross-checking of partners data

– Toxico/addicto-vigilance, law enforcement indicators, DRD, General population surveys…

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Main principle: triangulation

� Confrontation of independent sources of information

� Qualitative data analysed in the light of quantitati ve data

� Several levels of understanding– local– national– international context

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� TREND network : 7 cities (+ 2 entering soon ) + partners (Forensic, Toxicovigilance, Treatments, Harm reduction…)

� A common strategy to collect and analyse data

� Each Trend regional coordinator isalso a SINTES coordinator

The TREND network

Lille

Paris

MarseilleToulouse

Bordeaux

Rennes

Metz

TREND cities

Lyon

Nantes ?

Areas with SINTES coordination

� Gradually implemented in France since 1999

• 13 sites TREND in 2002 (3 oversea),

• 7 since 2005• 8 in 2016…9 ?

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8

TREND

Focus groups

(forensic, health)

Local media screening

Interviews

Key

Informants

Addicto-vigilance

toxico-vigilance

Forensic

SINTES

Vigilance on substances

French EMCDDA data

Ad hoc investigations

Price Barometer

Quanti surveys

(mainly lowthresholdfacilities

French CDC Ethnographicobservation

Qualitative questionnaires

(low threshold

facilities / specialised care

centres)

Local tools

Internal

tools

External

tools

Ideal aim: independant sources

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TREND, main qualitative observation areas

« Urban » settings « Techno » partyscenes

Squats

Streets

Private environment

Professional environment

Disadvantagedsuburbs

Alternative party scene

Conventionalparty sceneeg clubbing

Rural areas and

semi-rural suburbs

Gay partyscene

Low threshold/ harm reduction facilities

Specialised care setting

Law enforcement services

Virtual space

Internet

MonitoredPromptly observed

Unattainable


Ethnography

� 1 coordinator (sometimes co-coordination)

– 2 heads of ethnographic observation• 1 "festive"• 1 "urban"

– Each coordinator recruits at least 3 KI (Key-informants)• Anonymous (pseudonym), described by an identification sheets• privileged access to a / population (s) and context (s) consumption• "Independent" one from another• Issue of financial contribution for KI

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Checklist for observation Notes (3/Y)

« regular» meetings (1/ month)

oral reporting

Indirect

observation

Observation checklistKey-informants

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TREND network data flow

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city 1 city 2

Local network

Local tools

Analysis

(triangulation)

Synthesis

OFDT

(french focal point)

Software : NVivo

National analysis and synthesis

Trend national report

City n

National network

Annual local report

and database containing all ethnographic material

Other partners and

indicators

Treatment

Forensic

Toxicovigilance

Other outputs of the network�Quali surveys�Quanti surveys�Ad hoc investigtations

Health data

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What does the system provide?

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New significant trends

Emerging TrendNeed to keep an eye on it

Steady in-depth (structural) trends

« Flop »

Identification

Description

Follow up

Understanding

Emerging phenomenon


Benefits of TREND scheme

� Improvement on state of knowledge

� Better understanding of contexts and phenomena

– A dynamic view

– A spatial view on the French territory

– A population approach

� Perception of quantitative scales … with real limita tions !

� Reactivity in the French vigilance system on drugs

– Ability to quickly understand the issue raised by a signal

– Opportunity of rapid information recovery when necessary

� Allow implementation of less expensive multi-centri c studies

� Development of an expertise in rapid investigations spread by the coordinators

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- visible

+ wealthy

+ visible

Specialised Care

Centers

Harm reduction/

Low thresholds

Centers

Party

scenes

Streets, squats,

deals and use areas…

GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

TREND scheme in the global information system

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15w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care

CentersHarm reduction

Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

« Old » profile of opiates

users, taking OST

Hidden Drug users

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16w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care


Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)Hidden Drug users

Precarious

users

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17w w w . o f d t . f r

Hidden Drug users

Socially integrated

or “half

integrated” users

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18w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care


Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)Hidden Drug users

Very well socially

integrated” users

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19w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care


Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

General pop surveys

Quanti

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20w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care

Centers

Harm reduction

Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

General pop surveys

Clients surveys

Quanti

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21w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care


Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

General pop surveys

Party scene quanti

surveyClients surveys

Quanti

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22w w w . o f d t . f r

- visible

+ wealthy

+ visible

Specialised Care


Centers

Party

scenes

Streets, squats,


GPs

Private

environment

« Select »

party scene

+precarious

Work

environment

alternative

conventional

(clubbing, pubs…)

Cross chechking quali and quanti data

General pop surveys

Party scene quanti

surveyClients surveys

TREND “urban area”TREND “urban area”

TREND “party area”TREND “party area”

Quali

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Limitations and challenges (1)

� "Blind" or “blurred” areas in spite of adaptation of TREND scope

– Teenagers out of festive events

– Users scattered in general population

– Large or scattered areas (eg. country-side) or “closed” population (eg. some disadvantage suburbs)

� Too common phenomena

– Alcohol, cannabis use

– No ”quanti” perception: cocaine

� Blunting of interest on some points

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� Cost of the city network : around € 325 000 in 2015 (for OFDT)

– A lot for OFDT

– Too restrictive for coordinators

� For « TREND unit » staff

How to reach a balance between• worktime left for TREND scheme (coordination and scientific

production) (< 1 full-time equivalent)

And• Need for sustaining and improving quality of collected data• Sustaining in-depth analysis• Dissemination of results

Limitations and challenges (2)in a context of cuts in public expenditure

WWW.OFDT.fr

Thank you for your attention

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[email protected]

04. a. cadet-tairou - trend scheme · rennes metz trend cities lyon nantes ? areas with sintes...

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