National Research and Development Centre for Welfare and Health Knowledge for welfare and health1 Finnish Drug Treatment Information System Kristiina Kuussaari, Stakes

National Research and Development Centre for Welfare and Health Knowledge for welfare and health2 STAKES Information Division The division maintains national statistics and registers, and functions as a centre of excellence for information and communication technology in the field of social welfare and healthcare. An official status as a statistical authority. Our main clients are national and international decision-makers and actors.

National Research and Development Centre for Welfare and Health Knowledge for welfare and health3 Groups at STAKES Information Health Statistics and Indicators Alcohol and Drug Statistics and Reproduction Statistics Social Care and Personnel Statistics STAKES Unit for eHealth and eWelfare Statistical Information Systems

National Research and Development Centre for Welfare and Health Knowledge for welfare and health4 Contents of the presentation Background of Drug Treatment Information System Principles of data collection Description of data 2006 Results Future challenges

National Research and Development Centre for Welfare and Health Knowledge for welfare and health5 Background of the Drug Treatment Information System (1/2) Managed by Ms. Kristiina Kuussaari at Stakes, within the Finnish Focal Point of Reitox network Based on the EMCDDA protocol (Treatment Demand Indicator) Data collection was piloted in Finland in 1996 Round-the-year data collection since 2000

National Research and Development Centre for Welfare and Health Knowledge for welfare and health6 Background of the information system (2/2) Voluntary for the participating units Anonymous (national identity number, name or place of domicile are not requested). Overlapping case identification code is used. The data is reported annually both nationally and internationally (EMCDDA, UN)

National Research and Development Centre for Welfare and Health Knowledge for welfare and health7 Data collection process Data is collected either on paper questionnaires or electronically At the moment about 60 percent of the data is received electronically Training on data collection and use of electronic tool is provided for the staff of participating units twice per year Client data is collected when the client is in the specific treatment for the first time that year (incl. clients who continue treatment from the previous year on 1st of January) Data is based on self-reporting

National Research and Development Centre for Welfare and Health Knowledge for welfare and health8

National Research and Development Centre for Welfare and Health Knowledge for welfare and health9 Data collected on every client: Type of current treatment, history in treatment, route of referral to treatment, medication used in treatment Sociodemografic background History of substance abuse (drugs, route of administration, age of first use etc.) Risk behaviour (injecting, sharing of needles, testing and test results of infectious diseases) Additional national part on Subsitution Treatment

National Research and Development Centre for Welfare and Health Knowledge for welfare and health Data 133 units submitted data (no full coverage) Data on 5730 clients Analysis consists of data on 4865 clients (after cleansing of the overlapping cases)

National Research and Development Centre for Welfare and Health Knowledge for welfare and health11 Where is the data coming from? Most of the data (39 % in 2006) originates from general outpatient services for substance abusers (A-Clinics, youth clinics etc.) One fourth of the data is from inpatient units for substance users and another fourth from outpatient services scecialised in drug abuse Some data from health councelling centres (NSPs) and substance abuse treatment units in prisons.

National Research and Development Centre for Welfare and Health Knowledge for welfare and health Sociodemographic background and substance abuse history All clients (N=570) First time in treatment of all clients (N=990) All clients (N=5499) First time in treatment of all clients (N=884) All clients (N=4865 ) First time in treatment of all clients (N=655) Males (%) Mean age (yrs) 27,323,627,624,22825 Proportion of clients first time in treatment (%) Singles (%) Comprehensive school only (%) (compulsory education) Unemployed (%) Homeless (%) Mean age by the time of starting using alcohol (yrs) 12,71312,813,312,813,4 Mean age by the time of starting drug use (yrs) 15,816,415,61615,615,8 Injecting drug use, lifetime prevalence (%) Injecting drug use, last month prevalence (%) Mean age by the time of starting injecting (yrs) 19,119,61919,718,919,6

National Research and Development Centre for Welfare and Health Knowledge for welfare and health13 Age groups of clients in 2006 (%)

National Research and Development Centre for Welfare and Health Knowledge for welfare and health14 Drug group 1st drug2nd drug3rd drug4th drug5th drug Subgroup(N=4865) Opioids Heroin Buprenorphine Other opioids Stimulants Amfetamines Ecstasy Cocaine Other stimulants Hypnotics and sedatives Benzodiapines Other sedatives Hallucinogens Volatile inhalants Cannabis Alcohol + drug (polydrug use) Other drug No information All100

National Research and Development Centre for Welfare and Health Knowledge for welfare and health15 Primary drug among clients,

National Research and Development Centre for Welfare and Health Knowledge for welfare and health16 Polydrug use in 2006 (%) Primary drugSecondary and tertiary drug used along with the primary drug (%) Clients%OpioidsStimulantsCannabis Hypnotics and sedatives Alcohol Opioids heroin buprenorphine Stimulants Cannabis Pharmaceuticals Alcohol <1

National Research and Development Centre for Welfare and Health Knowledge for welfare and health17 Injecting behaviour by primary drug

National Research and Development Centre for Welfare and Health Knowledge for welfare and health18 Testing and test results of hepatitis C according to years of drug abuse in 2006 (%)

National Research and Development Centre for Welfare and Health Knowledge for welfare and health19 Future challenges 1.Improve the data quality -> broader and more systematic data cleansing with the help of software application 2.Improve the coverage 3.Increase the proportion of units submitting data electronically