All the bodies involved in the 'Tackling Drugs Together' initiative collect data on drug abuse. They all produce reports at a regular frequency on the statistics of drug and alcohol matters within the County from the perspective of their own organisation. Assimilating data from the various sources is not easy when the requirement of maintaining client confidentiality is considered. Without names, addresses and full postcodes there is a danger of double-counting within the data from any one organisation and especially between data from several organisations. For this reason the question stated above cannot be answered by simply by combining the data directly into one big database.
Similarly reproducing all of these reports by one central organisation such as the DAT is a pointless exercise. Instead, indirect approaches have to be considered that present different viewpoints of the problem, rather than trying to get the whole picture in one go (which can never be a true picture of substance abuse anyway). There are several ways that the DAT propose to carry out this research. This is not a definitive list, it is limited to the information available at this time.
Develop
a GIS system to map data
Using
drug consumption data to estimate disease prevalence
1) Develop a GIS system to map data
GIS (Geographical Information System) is a good way of looking at data from a geographic point of view i.e. categorised in terms of location rather than other factors. This will provide a unique picture of the county. Mapping the police data will highlight the areas where for example the drug dealing activities are prevalent. Mapping the Health Authority data on top of this will show us where the effects of this drug abuse are felt. The two sets of data may not correlate because people from the rural areas may be coming into the big towns to buy the drugs and the effects are felt back in the small villages and farms. Manipulation of the data in such a way will allow us to target our resources better, because we can see where the problems lie within the county relative to the service providers. We can use the map to plan an itinerary for visits by the outreach vehicle or mobile needle-exchange service to communities with such problems that are too far from conventional services.
Mapping data over a period of time will illustrate the trends in migration of the drugs trade within the county e.g. police crackdowns within one town may shift the problem to another local town that does not have an adequate amount of support services for the users.
Several 'layers' of information can be mapped on top of each other. In this way we can use demographic data from other sources such as the County Council to look at for example the levels of deprivation, population structure, leisure facilities etc. in comparison with the health and police data.
The most vital piece of information that such a system requires to work is the postcode. This is an emotive issue because postcodes are thought of as being able to track down the location and subsequent identity of the individuals concerned, therefore many organisations may feel that the confidentiality of their clients may be compromised. This is true if the whole postcode is used but not if using the partial code. For example for the postcode WR16 5EB using all but the last two characters does not allow identification of an individual address but only gets down to sector level, which may be made up of a hundred houses. However, the full postcode would be the ideal. The potential benefits of such a system to the 'Tackling Drugs Together' initiative are tremendous.
2) Using drug consumption data to estimate disease prevalence
Prevalence is commonly obtained from a field survey, namely cross-sectional studies to find subjects with the disease of interest (substance abuse in this case) in a random sample of the population. Within the 'shady' world of substance abuse this may not seem the best approach. There are specific medications used to treat addictions to various substances and looking at prescriptions of these may provide an indirect way of estimating prevalence.
The Pharmaceutical Advisor to the Health Authority (Duncan Jenkins), receives quarterly returns from dispensaries regarding prescriptions. This only covers GP prescriptions and not those made by other sources, such as the hospital pharmacies which have to be contacted directly. These data will tell us how many people are receiving treatment at any particular time as well as the number of people on potential drugs of abuse such as tranquillisers. These data only cover the past 18 months, but once the formulations we are interested in are 'tagged' on the database it can be a source of regular information thereby providing trends in prescriptions. The system can also be used to calculate the overall cost of such treatment. It is important to look at legal pharmaceuticals because they can be obtained easily and relatively cheaply (or free) and yet still have the potential for abuse. Many such drugs find their way into the hands of dealers who sell them on the streets for a quick and easy profit. This scenario applies mainly to tranquillisers.
This age group is very important in the drugs field. The age of first experimentation with drugs is lower each year. A survey of this kind will provide some information on the actual scale of use, but more importantly, it will give an insight into perceptions of drug use, attitudes to drugs, drug-related knowledge and especially where to turn to for help and advice. This survey will gauge the effectiveness of the masses of health promotion targeted at this age group to determine if the message is getting across. It is currently being carried out in conjunction with Worcester College and representatives from Health Promotion, Education and the Youth Service.
The survey is expected to take about a year from start to finish (final report by March 1998). The main target will be school children, attendees of FE and HE colleges and those not in education. The expected sample size will be between 8,000 and 10,000 young people. This will cover urban, suburban and rural populations throughout the county. The questionnaire was developed over a period of several months after extensive research of surveys carried out previously in this country and abroad. It was agreed that the highest percentage of returns could only be achieved using a direct method of administration rather than a postal survey. Involvement of the schools was kept to a minimum so that there will be less reluctance, on behalf of the children, to open up and give true responses.
The questionnaire consists of both tick boxes and short answers, with space at the end for general comments on the drug problem within the county. The main gist of the questions are to determine where young people go for drugs information, what they are looking for and how much credence do they place in the information. Tapping into their drugs knowledge will give us an idea of the amount of misinformation there is in these circles.
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Last updated January 2001
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