Collecting and interpreting data on the outcome/impact in the UK Anna Richardson Crime Drugs and Alcohol Research Home Office June 2010

Overview  Context - UK election 6 May -Coalition government -What next?  Measurement of the previous Drug Strategy  Evaluating the Drug Strategy through performance monitoring  Evaluating the Drug Strategy through the research framework

Drug Strategy 2002 Reduce drug-related crime Increase the number of problematic drug users retained in / completing treatment Prevent more young people from becoming problematic drug users Reduce the supply of Class A drugs  4 Strands:

Measuring the 2002 Drug Strategy  PSA 4: Reduce the harm caused by illegal drugs (as measured by the Drug Harm Index encompassing measures of the availability of Class A drugs and drug related crime) including substantially increasing the number of drug misusing offenders entering treatment through the Criminal Justice System.

Rationale for a drug harm index  Overall aim of Drug Strategy: “Reduce the harm that drugs cause to society - communities, individuals and their families”  Measures for individual strands of the strategy might not capture reductions in all harms and might move in different directions  The Drug Harm Index aims to capture in one simple measure the various harms that society suffers as a consequence of problematic drug use…  …and therefore provides a measure of progress against the overarching aim of the Strategy

Does a data series already exist (to provide 1998 baseline)? Are the data timely/reliable/frequent? Overview of the Drug Harm Index  Captures a substantial basket of harms  all harm caused by illegal drugs (e.g. productivity impact) Indicator list Conceptual model  Key Inclusion Criteria- Is it something the Drug Strategy can impact upon? Are all dimensions of the Strategy reflected? May show this  Social and economic costs used to convert diverse indicators into a common “currency” and show relative importance/provide basis for index – May show this

Conceptual Model INTERVENTIONS OUTPUTSOUTCOMES DIP YP PREVENTION SUPPLY REDUCTION Drug Trafficking Fear of Drug-Crime New HIV Acquisitive Crime New Hepatitis B Drug Deaths Mental Health Overdose  #s in treatment Fewer future PDUs  Availability Less crime/safer communities Fewer health problems DRUG HARMS

Choice of indicators  Criteria Harms must be drug-related Expected to be influenced by policy Cover all strands of policy Robust national indicators Available at least annually Time series back to 1998

List of harms included in the DHI  Drug-related acquisitive crime Burglary (domestic & commercial) Theft of vehicle (domestic & commercial) Theft from vehicle (domestic & commercial) Bike theft Other theft Robbery Shoplifting  Community harms Community perceptions of drug use/dealing Drug dealing offences  Health impacts New HIV cases due to intravenous drug use (IDU), including those infected through heterosexual sex with someone who contracted the disease through IDU New Hepatitis B cases due to intravenous drug use New Hepatitis C cases due to intravenous drug use Drug-related deaths Drug-related mental health and behavioural problems Drug overdoses Drug-related neonatal problems

How do we combine data series with different units/orders of magnitude into a single index value? Total harm# ‘95# ‘96# ‘97# ‘98# ‘99# ‘00# ‘01# ‘02

Creating the Index  The variables could be statistically ‘normalised’ and added together, but this would not reflect the relative importance that society places on different harms  We need an objective means of weighting the drug harms  We chose to use the estimates of the economic and social costs of class A drug use  Each harm can be valued in terms of the total costs incurred by society, and these costs are used to weight the individual harms within the overall index.

Constructing the index The index combines two types of data: Unit social & economic costs for each harm Volume series for each harm (baseline 1998) Steps: 1) Determine total costs (harm) for each year = sum over j [volume of harm j * unit cost of harm j] 2) Use total cost to construct a weight for each harm in each year = (total cost for harm j in year i) / (total cost in year i) 3) Determine the annual growth in each harm = Ln(volume of harm year i) - Ln(volume of harm year i-1) 4) Determine the weighted growth in each harm in each year = sum over j [weight (j) * volume growth series (j)] 5) Construct final index (year 1 = 100) = Antilog growth series and make relative to base year

Results

Results

Understanding changes in the DHI Example: - The DHI changed by -5.9% ( ) Main contributors (growth rate * weight)

The Drug Harm Index … Can  Monitor change over time  Show which harms are changing the most  Provide an overall national picture Cannot  Measure total harms  Indicate which interventions have had an impact  Predict changes in harms  Provide a local picture

Issues / Limitations  Can only include harms for which there are robust indicators  Drug-related crime has a large weighting within the DHI, but data for this element must be estimated  Some of the indicators are only available with long time lags and may be subject to change  How quickly can an impact be expected? e.g. prevention interventions aiming to reduce harm in the future  A black box - any change is a combination of many small changes and can relate to change in either.

Further information can be found at:  MacDonald, Z. et al (2005) Measuring the harm from illegal drugs using the Drug Harm Index Home Office OLR 24/05 (  MacDonald, Z. et al (2006) Measuring the harm from illegal drugs using the Drug Harm Index – an Update Home Office OLR 08/06 (  Godfrey, C. et al (2002) The economic and social cost of Class A drug use in England and Wales Home Office Research Study 249 (  Gordon, L. et al (2006) The economic and social costs of Class A drug use in England and Wales, 2003/04 in Singleton, N et al (eds) Measuring different aspects of problem drug use: methodological developments Home Office OLR 16/06 (  Crime and Drugs Analysis and Research (2009) Measuring the harm from illegal drugs: a summary of the Drug Harm Index 2006 Home Office Research Report

Drug Strategy 2008 Delivering new approaches to drug treatment and social re-integration Public information campaigns, communications and community engagement Protecting communities through robust enforcement to tackle drug supply, drug-related crime and anti-social behaviour Preventing harm to children, young people and families affected by drug misuse  4 strands:

Measuring the 2008 Drug Strategy  Strand 1: Protecting communities through robust enforcement to tackle drug supply, drug-related crime and anti-social behaviour.  PSA 25 indicator 3: The rate of drug-related offending % of public who perceive drug use/ dealing to be a problem in their area  National Indicators NI16 – serious acquisitive crime rate; NI17 – perceptions of asb; NI18 – adult re-offending rates for those under probation supervision; NI21 – dealing with local concerns about asb and crime by local council and police; NI30 – re-offending rate of PPOs; NI38 – drug-related (Class A) offending rate

Strand 2: Preventing harm to children, young people and families affected by drug misuse.  PSA 14 indicator 3: the proportion of young people frequently using illicit drugs, alcohol or volatile substances;  PSA 25 indicator 1: the number of drug users in effective treatment  National Indicators NI110 – young people’s participation in positive activities; NI111 – first-time entrants to the YJS aged 10–17; NI114 – rate of permanent exclusions from school; NI115 – substance misuse by young people; and NI117 – 16–18-year-olds who are not in education, training or employment.

Strand 3: Delivering new approaches to drug treatment and social re-integration.  PSA 25 indicator 1: The number of drug users in effective treatment  National indicators: NI40 – drug users in effective treatment; NI120 – all-age all-cause mortality rate; NI141 – number of vulnerable people achieving independent living; NI143, 145, 147, 149 – socially excluded adults living in settled and suitable accommodation; NI144, 146, 148, 150 – socially excluded adults in employment, education or training; and NI152 – working-age people on out-of-work benefits.

Strand 4: Public information campaigns, communications and community engagement.  PSA 14 indicator 3: the proportion of young people frequently using illicit drugs, alcohol or volatile substances; And,  PSA 25 indicator 1: the number of drug users in effective treatment

Further information can be found at:  Home Office 2010 Drug-misusing offenders: results from the 2008 cohort for England and Wales, Home Office

Research framework to support evaluation – The CGRPD  Established following DS commitment to improve drugs evidence  Overall objective to: Provide a research strategy that will provide the foundations, direction and guidance for collaboration within government, and between government and other stakeholders, in the short and long term.  Sub-aims – to develop: a shared vision across government of the future direction of drugs research; An overview of existing and planned government research into drugs; A list of prioritised drug research needs for short and longer term; A delivery plan for future drugs research