ARQ part II data management

Training pack 1:

Content and conceptual issues

Content

Prevalence of drug abuse among the general population

Prevalence of drug abuse among the school (youth) population

Injecting drug abuse Severe drug abuse

New developments in prevalence and patterns of drug use

Drug-related morbidity Drug-related mortality Drug treatment Data collection capacity Reports and additional

information

Structure

• Specification by drug

• Summary expert opinions

• Quantitative estimates

Specificationby drug (1)

• What information is required?

– Narcotic drugs and psychotropic substances listed in the UN conventions

– Drug classes and/or drug types relevant for each question are pre-coded

– Countries can add other classes and types of substance

– Some questions allow aggregate information for “any drug”

Specification by drug (2)

• Why specify by drug?

– Individual drugs show different patterns of use and risk behaviour

– Individual drugs are used by different subgroups

– Individual drugs have different health and social consequences

Specification by drug (3)

• How to obtain the information required:

– Make sure that all your experts and data collectors know the ARQ terminology and classification of drugs

– If reports do not specify ARQ categories, their source material might still be useful: check and ask for dedicated runs on source data

– If you cannot match the ARQ categories, add and specify your own

Summary expert opinions (1)

• Expert opinions should be gathered on:

– The occurrence of individual drugs– The rank order of individual drugs– New developments– Trends in the use of individual drugs

Example: occurrence questions

Q1 Have the drugs below been used in your country in the past year?

Q15 Has there been practice of injecting among drug users in the past year?

Q33 Have there been reports about prevalence of infections among drug injectors in the past year?

Q39 Have there been reports about drug-related deaths in the past year?

Q48 Have people received treatment for drug problems in the past year?

NO/YESper drug

NO/YESper drug+ “Any drug”

NO/YESper

infection

NO/YESper drug+“Any drug”

NO/YESper drug+ “Any drug”

Example: rank order questions

Q2 How are main drug classes ranked in order of prevalence?

Q40 How are drugs ranked in order of the primary cause in drug- related deaths?

Q49 How are drugs ranked in order of the primary cause of receiving treatment?

Q3 Within each drug class separately, how are drug types ranked in order of prevalence?

Rank in numerical order

Example: new developments

Q29 Have new drugs or new patterns of drug use been reported in the past year?

Q31 Have new groups of drug users been reported in the past year?

Q32 Which new groups of drug users have been reported and in relation to which types of drugs?

Q30 Which new drugs or new patterns of use have been reported?

Respond according to evidencein reports or the field experience

of informed experts

Example: trend questions

Q4 What has been the trend over the past year in prevalence of each drug class?

Q5 What has been the trend over the past year in prevalence of each drug type?

Q16 What has been the trend in injecting over the past year?

Q24 What has been the trend over the past year in “severe / problematic” drug use?

Q34 What has been the trend over the past year in prevalence of infections among drug injectors?

Q41 What has been the trend over the past year in drug-related deaths?

Q50 What has been the trend over the past year in the numbers of people receiving treatment?

Large increase

Some increase

No great change

Some decrease

Large decrease Mark according to

the perspective of your country

Summary expert opinions (2)

• Why include expert opinions?

– Because quantitative estimates are not available or not possible

– Because existing quantitative estimates might not be specific for individual drugs

– To include rare and new drugs– To qualify trends in relation to context

Example: rare and new drugs

– Rare drugs might not show up in survey results

– Rare drugs might not be specified separately in treatment or mortality data

– New drugs might not yet have been included in forms or questionnaires

Example: qualification of trends

– The qualification of any absolute change as “large” or “small” depends on the starting position or the size of the reference population

– An identical absolute change may be perceived as “large” for one drug but as “no great change” for another

Summary expert opinions (3)

• How to respond on the basis of expert opinions:

– Select relevant experts:• Start with existing advisory group(s) if

possible • Use the nomination method and purposive

selection– Consult the experts:

• Use the expert-survey or Delphi method– Respond to the ARQ according to consensus

or (weighted) average opinion

Example: assessment of expert opinions

colour = field of expertisesize = amount (weight) of expertise

AVAILABLE EXPERTISESOURCES OFINFORMATION

SOURCES OFINFORMATION

Research

Statistics

Media reports

Adm inistration

Conferencevisits

Contacts withdrug users

Example: selection of experts

• Start with the usual government advisers or advisory group

• Ask them to nominate experts in different fields relevant for responding to the ARQ

• Select on the basis of consensus and acknowledged expertise

Example: Delphi-method consultation

EXPERTS OPINIONS AVERAGE /CONSENSUS

OPINION

CONFRONTATION / DISCUSSION

Quantitative estimates (1)

• The ARQ asks for quantitative estimates on:

– Lifetime and last year prevalence among adult and school (youth) population

– Recent injecting and equipment “sharing”– “Problem” drug use– Drug-related infections– Drug-related deaths– Drug treatment

Quantitative estimates (2)

• Why choose these topics and report formats?

– Globally accepted core indicators for the description of:

• The extent of drug abuse prevalence, problem use

• Risk behaviour in drug abuse injecting, sharing

• The consequences of drug abuse infections, death, treatment demand

Example: coherence between indicators

Drugusers

Problem users

IDU

Treatment

IDU related infections

Drug-related deaths

Prevalence estimates

Quantitative estimates (3)

• Reports should consist of one of the following:

– Existing data and research at national level relating to the ARQ reporting year

– Purposive national estimates – Existing incomplete, fragmented, sub-

national quantitative data and research reports

Example: existing data

– Reports from national monitoring system– National reports to other international

organizations (WHO, EMCDDA, etc.)– Results from national studies– National statistics

If not related to reporting year:• Attempt trend extrapolation• Report most recent year available

Example: purposive estimates

– Purposive for completion of the ARQ– Not applicable for all indicators– Based on accepted scientific estimation

methods– Resources:

• Drug Abuse Rapid Situation Assessments

• GAP Toolkit Module 2: Estimating Prevalence

Example: fragmented data

– Try to construct a national estimate by an inductive approach:

• Start with an expert opinion about likely national figures

• Check against available dispersed qualitative and quantitative information

• Adapt expert opinion according to findings• Seek consensus among informed experts

– If not possible, report a partial estimate

Data collection capacity

• Rate your country’s capacity to meet ARQ reporting needs

• Responses enable UNODC to assess needs in capacity-building

End of presentation

References (1)

Web sites: www.incb.org/e/ind_conv.htmwww.unodc.org/pdf/publications/report_2003-09-01_1.pdf

Single Convention on

Narcotic Drugs .

1961

Convention on

Psychotropic Substances .

Single Convention on

Narcotic Drugs .

Convention on

Psychotropic Substances .

1971

References (2)

Web site: www.unodc.org

Example: differences in rank order

Eastern Europe Western Europe

Rank order

Crack 9 Crack

Opium 8 Inhalants

Cocaine 7 Opium

Hallucinogens 6 Heroin

Inhalants 5 Hallucinogens

Ecstasy 4 Amphetamines Amphetamines 3 Ecstasy

Heroin 2 Cocaine

Cannabis 1 Cannabis

Situation in the late 1990s