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Methods and definitions

Information on the number of people seeking treatment for a drug problem provides insight into general trends in problem drug use and also offers a perspective on the organisation and uptake of treatment facilities. Treatment demand data come from each country with varying degrees of national coverage, principally from outpatient clinics' treatment records.

The objective of the TDI project is to extend the detailed data collection to a full coverage on all the treatment centres in order to have a better picture of the European clients demanding treatment for their drug use. The collection system classifies clients by primary and secondary drugs used: primary drug is the drug reported as most important for the client and the main reason for asking for treatment; the secondary drugs are the drugs taken in addition to the primary drug;

Data are collected in two forms: summary data on all types of treatment centres (Sources: Standard Table 3 and Standard Table 4, see below) and detailed data by centre type (outpatient treatment centres, inpatient treatment centres, low threshold agencies, general practitioners, treatment units in prison, and any other types of centres) (Sources: TDI detailed data collection by centre type, see below).

Information on socio-demographic characteristics of clients and patterns of drug use (route of administration, frequency of use, age at first use) are based on detailed data and mainly concern outpatient treatment centres where the coverage is more extensive.

Most information is collected on clients starting a treatment for drug use for the first time in their life (new clients) and also for clients starting treatment for the first time in the reporting year, but who may have been treated in previous year(s) (all clients). Currently no data are collected on clients continuing a treatment from the year(s) before the reporting year.

The EU Member States, the candidate countries and Norway collect the data on people starting a treatment for their drug use according to an established European protocol (theTDI protocol): the Joint Pompidou Group-EMCDDA Treatment Demand Indicator Protocol version 2.0, along with a more detailed Technical Annex. This protocol is the result of the developmental work undertaken by the Pompidou Group, the study of the national experiences, in particular in Germany, The Netherlands, Spain and United Kingdom and specific projects run by the EMCDDA.

The EMCDDA’s treatment demand indicator (TDI) provides a uniform structure for reporting on the number and the characteristics of clients referred to drug treatment facilities. The TDI Protocol is based on 20 items concerning the type of treatment provided and the characteristics of clients: socio-demographic data and drugs information.

The item list of 20 variables which should be collected by EU countries is reported below. For further details see the TDI Protocol at the web page (http://www.emcdda.eu.int/?nnodeid=1420).

The protocol describes a routine system for collecting standard data (20 variables) from each client starting treatment. Each country's definition of what constitutes a treatment case or episode is, if not the same, at least acceptably compatible with the TDI definition. The protocol provides a classification of treatment centres, defines which clients they should notify, and gives guidelines on methods of data collection, analysis and reporting. The TDI protocol states that it is essential to identify clearly the types of treatment centres involved in order to increase the comparability of treatment data among countries. The protocol includes procedures for minimising double-counting whilst respecting confidentiality, and for internal consistency checks to improve reliability. The items do not necessarily have to be collected in exactly the same form and using exactly the same categories as specified in the TDI Protocol, but each country should be able to draw these data from its national sources.

There are some problems and deficiencies in the way many of the national focal points report treatment data to the EMCDDA. It is difficult to know exactly how double-counting is affecting the data since the level of control of double-counting is not the same in all Member States. The number of missing cases for each data item is another limitation, and is for many variables sometimes unknown.

The results presented in the tables reflect that treatment information is not available from all the Member States. Differences in coverage among Member States affect data comparability. Some countries lack information on treatment units and the definitions used are not always 100 % compatible with the TDI protocol. Most countries have different kinds of treatment facilities and, moreover, the differences in the availability and use of drug treatment services could bias the results. The network of drug treatment centers has changed in the last decade; for example, methadone programs have expanded. These changes in treatment services could have influenced treatment figures over time. A last problem concerns the network of treatment centers and whether it is extensive enough to meet all treatment demands.

The quantity and type of treatment services offered provide important background information, but it is essential that treatment-related data be interpreted in the context in which they are collected.

An extensive report For more information on data quality and data collection concerning the years 2000-2001 is published at the web page at the following address: Quality assessment of TDI data 2000-2001.

Specific analysis based on treatment demand data are also reported in the web page, according to clients profile by:

The last statistics published in the web page concerns:

The item list

Treatment centre type

Date of treatment month

Date of treatment year

Ever previously treated

Source of referral

Gender

Age/ year of birth

Living status (with whom)

Living status (where)

Nationality

Labour status

Highest educational level completed

Primary drug

Already receiving substitution treatment

Usual route of administration

Frequency of use (primary drug)

Age at first use of primary drug

Other (=secondary) drugs currently used

(See list of primary drug + alcohol)

Ever/currently (last 30 days) injected