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annex3

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									Knowledge for welfare and health                                                           1




                                   Finnish Drug Treatment
                                     Information System

                                       Kristiina Kuussaari, Stakes
                                            kristiina.kuussaari@stakes.fi



                         National Research and Development Centre for Welfare and Health
Knowledge for welfare and health                                                           2




                         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 health                                                           3




               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 health                                                           4




                         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
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                         Background of the Drug Treatment
                         Information System (1/2)
                         Managed by Ms. Kristiina Kuussaari
                        (kristiina.kuussaari@stakes.fi) 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



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                         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
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                         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
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                         National Research and Development Centre for Welfare and Health
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                        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
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                         2006 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
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                         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                                                                                                 12



                                                      2004                        2005                        2006
   Sociodemographic background                All       First time in   All clients   First time      All       First time in
   and substance abuse history              clients     treatment of    (N=5499)           in       clients   treatment of all
                                           (N=570)        all clients                 treatment    (N=4865         clients
                                                          (N=990)                        of all        )          (N=655)
                                                                                        clients
                                                                                       (N=884)

   Males (%)                                  72             68             70           68          69              66
   Mean age (yrs)                            27,3            23,6          27,6          24,2        28              25
   Proportion of clients first time in        18                            17                       14
   treatment (%)
   Singles (%)                                67             78             66           73          64              74
   Comprehensive school only (%)              67             65             67           64          68              63
   (compulsory education)
   Unemployed (%)                             62             43             62           48          62              45
   Homeless (%)                               11              8             12            8           11              5
   Mean age by the time of starting          12,7            13            12,8          13,3        12,8            13,4
   using alcohol (yrs)
   Mean age by the time of starting          15,8            16,4          15,6          16          15,6            15,8
   drug use (yrs)
   Injecting drug use, lifetime               74             43             77           47          78              49
   prevalence (%)
   Injecting drug use, last month             43             26             43           29          43              30
   prevalence (%)
   Mean age by the time of starting          19,1            19,6           19           19,7        18,9            19,6
   injecting (yrs)
                         National Research and Development Centre for Welfare and Health
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                                          Age groups of clients in 2006 (%)

                                     35


                                     30                  29
                                                                 26
                                     25
                        Prosenttia




                                     20

                                                                           15
                                     15

                                                 10
                                     10                                             8
                                                                                                        6
                                                                                                 5
                                     5

                                           0
                                     0
                                          <15   15-19   20-24   25-29     30-34   35-39        40-44   >=45

                                                                   Ikäryhmät



                             National Research and Development Centre for Welfare and Health
Knowledge for welfare and health                                                                                        14



          Drug group                                      1st drug        2nd drug     3rd drug   4th drug   5th drug

           Subgroup                                      (N=4865)        (N=4865)     (N=4865)    (N=4865)   (N=4865)
          Opioids
                                                            41              12            7          5          4
           Heroin                                            2               2            1          1          1
           Buprenorphine                                    31               6            4          2          2
           Other opioids                                     8               4            2          2          1
          Stimulants                                        21              17           13          8          4
            Amfetamines                                     21              16           11          6          2
            Ecstasy                                          0               1            2          2          2
            Cocaine                                          0               0            0          0          0
            Other stimulants                                 0               0            0          0          0
          Hypnotics and sedatives                            7              23           15          8          3
           Benzodiapines                                     7              23           15          8          3
           Other sedatives                                   0               0            0          0          0
          Hallucinogens                                      0               0            0          0          0
          Volatile inhalants                                 0               0            0          0          0
          Cannabis                                          14              23           17          7          3
          Alcohol + drug (polydrug use)                      1              12            9          6          4
          Other drug                                         0               1            0          0          0
          No information                                     0              11           37         63         79
          All                                              100              100          100        100        100




                           National Research and Development Centre for Welfare and Health
Knowledge for welfare and health                                                                                              15




                    Primary drug among clients, 2000-2006

                                    45

                                    40

                                    35
                                                                                                                            2000
                                    30
                                                                                                                            2001
                       Prosenttia




                                    25                                                                                      2002
                                                                                                                            2003
                                    20                                                                                      2004
                                                                                                                            2005
                                    15
                                                                                                                            2006
                                    10

                                    5

                                    0
                                         Opioids       Stimulants       Cannabis     Alcohol (and illegal   Hypnotics and
                                                                                          drugs)              sedatives

                             National Research and Development Centre for Welfare and Health
Knowledge for welfare and health                                                                                      16




                                     Polydrug use in 2006 (%)

  Primary drug                                 Secondary and tertiary drug used along with the primary drug (%)
                                                                                           Hypnotics and
                               Clients    %     Opioids      Stimulants      Cannabis        sedatives      Alcohol

  Opioids                          1994   41       14            38             37              48            12

  - heroin                         104    2        42            43             31              30                7

  - buprenorphine                  1495   31       11            39             37              54            11

  Stimulants                       1031   21       26             9             54              31            28

  Cannabis                         655    13       15            38              2              16            48

  Pharmaceuticals                  327    7        23            22             27              16            47

  Alcohol                          812    17       12            39             62              39            <1

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


                  100 %
                   90 %
                   80 %
                   70 %
                   60 %
                   50 %
                   40 %
                   30 %
                   20 %
                   10 %
                    0%
                                    Opiates       Stilmulants    Hypnotics and        Cannabis     Alcohol + illegal
                                   (N=1840)        (N=946)         sedatives          (N=544)       drug (N=693)
                                                                    (N=270)

                                      Currently injecting   Ever injected, but not currently   Never injected

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


                 90
                 80
                 70
                 60
                 50
                 40
                 30
                 20
                 10
                  0
                         Less than 3         3-4 years       5-7 years        8-10 years         More than 10
                        years (N=332)        (N=335)         (N=619)           (N=554)          years (N=981)

                              Tested, positive result                Tested, negative reslult
                              Tested, no information about results   Never tested



                         National Research and Development Centre for Welfare and Health
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                         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




                         National Research and Development Centre for Welfare and Health

								
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