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Transcript of Suzi Lyons - Health Research Board
CELEBRATING ACHIEVEMENT NATIONAL COMMUNITY ACTION ON
ALCOHOL PILOT PROJECT 2015 CAAP©
MEASURING PROBLEM ALCOHOL USE USING
ROUTINE RESEARCH DATASUZI LYONS
HEALTH RESEARCH BOARD
Measuring problem alcohol use using routine surveillance data
Dr Suzi Lyons, 20th January 2016
Overview
• Drug treatment data from the National Drug Treatment Reporting System
• Alcohol Diary – interactive tables and on-line data
• Drug-related deaths from the National Drug-Related Deaths Index
Drug treatment data
National Drug Treatment Reporting System (NDTRS)
• Health information system/epidemiological database• 1990 started in Dublin; 1995 expanded nationally• 2004 alcohol included as a main problem drug• Co-ordinated by the Health Research Board• Purpose - to provide information on trends in treated
problem drug and alcohol use• 75% coverage although participation is not uniform
NDTRS - methodological points
• All new treatment episodes in a calendar year• As per EU reporting criteria• Annual data does not include those who are in continuous
treatment• Case based, not individual based - no unique health
identifier in Ireland
National trends treated problem alcohol and drug use, main problem, NDTRS 2008 to 2013
2008 2009 2010 2011 2012 20130.0
10.0
20.0
30.0
40.0
50.0
60.0
AlcoholOpiatesCannabisBenzodiazepinesCocaineOthersAmphetaminesEcstasyVolatile inhalants
Prop
ortio
n of
case
s
Data for 2012 & 2013 is unpublished but subset available on-line
Incidence and prevalence of treated problem alcohol use, NDTRS 2009 to 2013
Proportion of cases treated for problem alcohol use by type of treatment service, NDTRS 2009 to 2013
2009 2010 2011 2012 2013
Outpatient 56.9 53.1 53.9 54.1 55.9
Residential 40.7 41.0 39.3 39.7 37.2
Low-threshold 2.4 5.8 6.9 6.2 6.9
36% 64%
Median age in treatment 40 (19 to 64)
Median age first used alcohol
15 (12 to 22)
Characteristics of cases treated for problem alcohol use, NDTRS 2013
Employed Homeless Early school leavers
0
5
10
15
20
25
21.5
5.7
13.5
Prop
ortio
n
56.919.0
13.1
11.0
Problematic use
Dependant drinkerHarmful drinkerNot knownHazardous drinker
Treatment status by problematic use, NDTRS, 2013
Hazardous
drinkerHarmful drinker
Dependant drinker
Not known
Never treated 66.3% 61.5% 42.3% 34.0%Previously treated 31.8% 36.5% 56.9% 56.9%Not known 1.8% 2.0% 0.8% 9.2%
Treatment status by problematic use, NDTRS, 2013
Hazardous
drinkerHarmful drinker
Dependant drinker
Not known
Never treated 66.3% 61.5% 42.3% 34.0%Previously treated 31.8% 36.5% 56.9% 56.9%Not known 1.8% 2.0% 0.8% 9.2%
Source of referral by problematic use, NDTRS, 2013
Hazardous drinker Harmful drinker Dependant drinker0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
36.2%35.2%
37.7%
11.1%
8.1%9.8%
2.0% 2.2%
6.1%
8.3%
13.7%15.0%
10.8%
23.0%
17.7%18.6%
10.4% 9.7%10.4%
5.6%
2.6%1.2% 1.2%
0.7%
SelfFamily and friendsOther drug treatment centreGeneral practitionerHospital or other medical sourceSocial servicesCourt/probation/policeOther
Source of referral by problematic use, NDTRS, 2013
Hazardous drinker Harmful drinker Dependant drinker0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
36.2%35.2%
37.7%
11.1%
8.1%9.8%
2.0% 2.2%
6.1%
8.3%
13.7%15.0%
10.8%
23.0%
17.7%18.6%
10.4% 9.7%10.4%
5.6%
2.6%1.2% 1.2%
0.7%
SelfFamily and friendsOther drug treatment centreGeneral practitionerHospital or other medical sourceSocial servicesCourt/probation/policeOther
Source of referral by problematic use, NDTRS, 2013
Hazardous drinker Harmful drinker Dependant drinker0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
36.2%35.2%
37.7%
11.1%
8.1%9.8%
2.0% 2.2%
6.1%
8.3%
13.7%15.0%
10.8%
23.0%
17.7%18.6%
10.4% 9.7%10.4%
5.6%
2.6%1.2%1.2%
0.7%
SelfFamily and friendsOther drug treatment centreGeneral practitionerHospital or other medical sourceSocial servicesCourt/probation/policeOther
Problem alcohol use: poly drug use, NDTRS, 2013
41%
18%
16%
9%
8%4%4%
CannabisCocaineBenzodiazepinesOpiatesEcstasyOther drugsAmphetaminesVolatile inhalants
National Alcohol Diary Survey
Alcohol Diary
The main objective of the National Alcohol Diary Survey was to:• Estimate personal consumption of, and expenditure on, alcohol
among the general population aged 18–75 years living in private households in Ireland
• National survey with 5,991 randomly selected participants conducted between July and October 2013
• Weighted by age, gender and regional distribution• Household response rate of 67.2%
Key Irish data at http://www.drugsandalcohol.ie/key-info/
Heading to go here
Graph• Bullet points to go here bullet points to go here bullet points to go here bullet points to go here
Drug-related deaths
The National Drug-Related Deaths Index (NDRDI)
• Families, through the NFSN, advocated for accurate figures– Underestimation of number of drug-related deaths
• Action from the National Drug Strategy 02-08• Aim:
– Census of drug and alcohol-related deaths and deaths among drug users and those who are alcohol dependent in Ireland
– To allow the State to respond in a timely manner with accurate data on drug-related mortality
The National Drug-Related Deaths Index (NDRDI)
• Four sources: – Coroners: 48 districts with ~16,000 deaths reported annually– Hospital In-patient Enquiry Scheme (HIPE) : 61 hospitals– Central Treatment List (CTL) - Register of methadone treatment for opiate
dependence– General mortality register (GMR)
• Inclusion criteria: – Documented history of illicit drug use– Documented history of misuse of licit medication– Documented history of alcohol dependence– Where drugs or alcohol were implicated in the death by the coroner
Overview of all drug-related deaths, NDRDI, 2013
Poisoning deaths
All poisoning deaths, NDRDI, 2004 to 2013 (n=3,519)
2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
50
100
150
200
250
300
350
400
450
Num
ber
• 68% Male
• Median age of 41 years
Type of drugs implicated in poisoning deaths 2004 - 2013
Specific drugs implicated in poisoning deaths, NDRDI 2004 to 2013 (Multi-response)
2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
20
40
60
80
100
120
140
160
180
200
AlcoholDiazepamMethadoneHeroinZopicloneFlurazepamCocaineOlanzapineCitalopramMDMA
Num
ber
34
Alcohol-related poisoning deaths, NDRDI 2004 to 2013
2004 2005 2006 2007 2008 2009 2010 2011 2012 20130
5
10
15
20
25
30
35
40
45
50
All poisonings where alcohol was involved
Alcohol only poisoningsProp
ortio
n
Types of drugs implicated along with alcohol, NDRDI, 2013
Benzodiazepines Opiates Antidepressants Other prescription meds0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
83.3
48.746.2
37.2
Summary
• Alcohol is the drug most commonly treated in Ireland– Many of those who present for the first time are already alcohol
dependent, making it harder to have successful outcomes
• Alcohol is a major contributor to poisoning deaths– Implicated in 35% of all deaths in 2013– 15% of all poisonings were due to alcohol alone in 2013
CELEBRATING ACHIEVEMENT NATIONAL COMMUNITY ACTION ON
ALCOHOL PILOT PROJECT 2015 CAAP©
THE COMMUNITY ACTION ON ALCOHOL PROJECT WAS DESIGNED, DEVELOPED AND DELIVERED BY
ANNE TIMONY MEEHAN, ALCOHOL FORUM