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TDI meeting Lisbon 23rd and 24th of June 2003 1 Stichting Informatievoorziening Zorg - Randhoeve 231 - Postbus 504 - 3990 GH Houten.

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Presentation on theme: "TDI meeting Lisbon 23rd and 24th of June 2003 1 Stichting Informatievoorziening Zorg - Randhoeve 231 - Postbus 504 - 3990 GH Houten."— Presentation transcript:

1 TDI meeting Lisbon 23rd and 24th of June Stichting Informatievoorziening Zorg - Randhoeve Postbus GH Houten

2 Treatment Demand Indicator Working group on Cannabisprofile

3 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Purpose of the working group: Propose some recommendations to the National Focal Points and the treatment demand experts. Identify perspectives of work for the short period on analysis with treatment demand data, starting from cannabis. Develop a model for a profile analyses.

4 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Some facts in the EU on cannabis: There is a relevant group of clients asking treatment for cannabis as primary drug in the European countries Characteristics of this group seem to be quite similar across countries; this is different from other substances used The cannabis clients are reported to be very young

5 TDI meeting Lisbon 23rd and 24th of June Some facts in the EU on cannabis: Gender differences seem to be much lower for the cannabis clients than other groups A substantial part of the clients reports to use cannabis intensively The most reported combinations are with alcohol and/or stimulants. Treatment Demand Indicator

6 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Recommendations to the National Focal Points for the 2003 National Report, selected issue on problematic cannabis use: Select the population of clients using cannabis as primary drug. Select among this group of cannabis users people aged below 20 and people 20 years old and above.

7 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Variables to start with: Gender Source of referral Living status Labour status Educational level New/all Frequency of use Age at first use Secondary drugs used in combination with cannabis

8 TDI meeting Lisbon 23rd and 24th of June These data can be extracted TDI database New/Alla Frequency of usea Age at first usea Secondary drugs in combination cannabisa Treatment Demand Indicator

9 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Variables to use and availability in Treatment Demand Indicator-data`base but not possible to produce by EMCDDA: Genderb Source of referralb Living statusb Labour statusb Educational levelb

10 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Give an interpretation providing: context (i.e. legislation/policy) organisation of treatment system cultural background other information that could be useful to better interpret data

11 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Two examples of a profile: An example of a dummy profile of cannabis clients based on available Treatment Demand Indicator data An example of a filled in extended profile based on Dutch data

12 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Profile example based on Treatment Demand Indicator data only

13 TDI meeting Lisbon 23rd and 24th of June TDI: example of profile

14 TDI meeting Lisbon 23rd and 24th of June TDI: example of profile (cont.)

15 TDI meeting Lisbon 23rd and 24th of June Treatment Demand Indicator Example of a profile based on Treatment Demand Indicator data and some additional national data

16 TDI meeting Lisbon 23rd and 24th of June Treatment demand of cannabis users in The Netherlands: Which clients? Trends in treatment demand Crossectional comparison of different subgroups Longitudinal patterns in treatment demand.

17 TDI meeting Lisbon 23rd and 24th of June Selection: different types of clients In LADIS primary, secondary and tertiary drugs is registered. In our profile we developed an additional classification: single and multiple cannabis client. Single = only cannabis is registered and no other drug or behaviour (i.e. gambling). Multiple = cannabisproblem (be it primary or secondary) in combination with other drug / behaviour is registered (i.e. alcohol or opiates).

18 TDI meeting Lisbon 23rd and 24th of June Cannabis: outpatient treatment demand

19 TDI meeting Lisbon 23rd and 24th of June Single cannabis users (1994 = 100) year single cannabis user (1994=100) single cannabis user young (< 20 yrs.) (1994=100) single cannabis user old (>= 20 yrs.) (1994=100)

20 TDI meeting Lisbon 23rd and 24th of June Multiple cannabis users (1994 = 100) years % multiple cannabis user multiple cannabis user (+alcohol) multiple cannabis user (+opiates)

21 TDI meeting Lisbon 23rd and 24th of June % of cannabis clients of the total # of outpatient clients in LADIS % 10% 20% 30% 40% 50% 60% year % % cannabisclients % young cannabisclients(<20 yrs.)

22 TDI meeting Lisbon 23rd and 24th of June % of cannabis clients of the total # of outpatient clients in LADIS according to type of use ( ) 0% 2% 4% 6% 8% 10% 12% 14% 16% year % % cannabisclients % single cannabisusers % multiple cannabisusers

23 TDI meeting Lisbon 23rd and 24th of June Mapping of geographical patterns in treatment demand of cannabis clients: relative growth (10,000 inh.) Clients per inhabitants > 4 clients (3) clients (39) < 2 clients (462) 1994 Clients per inhabitants > 4 clients (12) clients (90) < 2 clients (402) 2001

24 TDI meeting Lisbon 23rd and 24th of June Table 1 Characteristics of cannabisclients according to type of use Single tot. Single (< 20 yrs.) Single (>= 20 yrs.) Multiple tot. Multiple +alcohol Multiple + opiates % in treatment in 2001 (> 1 contact) 64%76%62%68%66%70% % female18% 15% mean age26,616,928,831,332,631,2 % > 40 years7%9%20%24%19% Size of municipality (%) < inhabitants2%3%1% 2% inhabitants7%13%6%7%9%6% inhabitants21%28%20%21% 20% inhabitants22%25%22%23%22%23% > inhabitants45%31%48%45% 46% ( source: LADIS data 2001)

25 TDI meeting Lisbon 23rd and 24th of June Table 1 (cont.) ( source: LADIS data 2001)

26 TDI meeting Lisbon 23rd and 24th of June Age in categories of single and multiple cannabis users (LADIS data 2001) 0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% yrs yrs yrs.40 yrs. or older age category % single cannabis user multiple cannabis user

27 TDI meeting Lisbon 23rd and 24th of June Social situation of cannabis clients (LADIS data 2001) 0% 10% 20% 30% 40% 50% 60% 70% 80% single cannabis usermultiple cannabis user single cannabis user young (< 20 yrs.) single cannabis user old (=> 20 yrs.) multiple cannabis user (+ alcohol) multiple cannabis user (+ opiates) type of client % alone with parents with children

28 TDI meeting Lisbon 23rd and 24th of June Ethnic background of three groups of cannabis clients (LADIS data 2001) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% single cannabis usermultiple cannabis user single cannabis user young (< 20 yrs.) single cannabis user old (=> 20 yrs.) multiple cannabis user (+ alcohol) multiple cannabis user (+ opiates) type of cannabis client % % dutch % western world % allochtoneus

29 TDI meeting Lisbon 23rd and 24th of June Type of professional help for various categories of cannabis clients (LADIS data 2001) 0% 10% 20% 30% 40% 50% 60% 70% single cannabis user multiple cannabis user single cannabis user young (< 20 yrs.) single cannabis user old (=> 20 yrs.) multiple cannabis user (+ alcohol) multiple cannabis user (+ opiates) type of cannabisclient % social worker psychologist psychiatrist medical doctor nurse psychiatric nurse other

30 TDI meeting Lisbon 23rd and 24th of June Time in treatment and mean # of contacts per month of different type of cannabis clients (LADIS data 2001) 0 0,5 1 1,5 2 2,5 single cannabis user multiple cannabis user single cannabis user young (< 20 yrs.) single cannabis user old (=> 20 yrs.) multiple cannabis user (+ alcohol) multiple cannabis user (+ opiates) type of cannabis client mean # of contacts mean # days in treatment mean # contacts / month mean # days in treatment

31 TDI meeting Lisbon 23rd and 24th of June Cumulative and annual returnrate of different types of cannabis clients discharged in % 10% 20% 30% 40% 50% 60% cumulative returnrate '95-01 % returned in 1995% returned in 1996% returned in 1997% returned in 1998% returned in 1999 % returned in 2000 % returned in 2001 % single + multiple users young single users multiple users

32 TDI meeting Lisbon 23rd and 24th of June Primary problem on readmission (in the period 94-03) of young single and multiple use cannabis clients discharged in % 5% 10% 15% 20% 25% 30% 35% 40% 45% 50% % alcohol% opiates% cocain% cannabis% other primary problem % young single users multiple users

33 TDI meeting Lisbon 23rd and 24th of June Conclusions If broken down according to age ( 20 yrs.) or/and multiple or single use meaningful data can be presented. The total treatment demand for cannabis is growing: about 44% in the period The multiple cannabis client is the growth factor; specifically the client co-using alcohol. Combined use of cannabis seems to be the prevalent type of use. The cannabis client is growing older as with other clients groups.

34 TDI meeting Lisbon 23rd and 24th of June Conclusions (cont.) The young single cannabis client (< 20 yrs.) is a relatively small group, but overrepresented under young clients (55%). Young single clients markedly differ on type of referral, living situation, care pattern (i.e. intensity) and returnrate. About 65% of the single young cannabis clients do not return to outpatient treatment. When young single users return, about half of them applies for help for cannabis; about 20% returns to apply for help for problems with cocain.

35 TDI meeting Lisbon 23rd and 24th of June LADIS clients profiles; current developments Evolving to a fixed format with information on: - trends - longitudinal patterns (for example readmission) - cross-sectional comparisons Additional surveys (quick scans) are done to gather contextual information about treatment programs. Every outpatient drug treatment centre receives a benchmark in which the data on the national profile is compared to the profile of the service itself.


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