Summary

The aim of this report is to examine potential data sources for early warning of changes in drug use in the community. The report is written for the consideration of the National
Drug Abuse Information Centre (NDAIC) in order to stimulate discussion on the topic of what indicators should be included in an early warning system. The aim of the system to be
discussed is to measure, in a timely fashion, changes in drug use so as to allow the administrators and planners of drug and alcohol programs to adapt their services to
meet the changing needs of their clients.

The content of the report is based largely on consultation with officials from the NSW Directorateofthe Drug Offensive. No attempt was made to assess the feasibility of the
potential indicators in other Australian jurisdictions. It is hoped that the list of indicators will stimulate other States/territories to consider the feasibility of collecting data on each indicator within their jurisdiction, and to identify other indicators which should be considered. The aim ofthe paper is therefore to present a discussion of the indicators from the point of view of the NSW situation as an initial stimulus for the development of a national early warning system.

Methodologically, the topic was approached by, ftrst, listing all possible indicators of changes in drug use. This list was generated simply by asking those in the field to name indicators they thought relevant. Then, consideration was given to what aspects of drug use the indicators would be expected to cover. That is, the "dimensions of drug use" relevant to early warning were identified.

Next, literature on early warning was consulted to determine what criteria should be considered for inclusion of an indicator in an early warning network. Five criteria were identified: timeliness, volume of data, complementarity with other indicators, validity of data, and cost.

Each indicator was then discussed with respect to the early warning criteria and dimensions of drug use issues. Finally, relationships between the indicators were considered. The result was a list of seven indicators which are seen from the point of view of NSW as able to form an early warning network.

A range of sources were considered, as well as two systematic reporting systems (National Drug Poisonings Case Reporting Systems-NDPCRS & National Forensic Case Reporting System-NFCRS). It was concluded that:

Law enforcement data are unreliable and lack consistency because they are open to various economic, social and political influences.
Drug purity as an indicator is not currently measured systematically, and the costs of setting up more comprehensive testing of seized drugs may be prohibitive.
A survey of those entering treatment facilities would be a useful indicator as it would provide information on the using trends in the established dependent population. Key informant studies could alternatively be used to gather similar information.
Data on calls to telephone counselling services may be used to gather information on abuse of licit substances; whereas data gathered in needle exchange centres provide information on illicit users who are not necessarily in contact with treatment centres or correctional services.
Notifications of AIDS and Hepatitis B and reports from private psychiatrists should not be considered partofan early warning network because the number of expected cases would be too small to reveal reliable changes in drug use.
A modified National Drug Poisonings Case Reporting System, as proposed in a previous paper (Pedic, 1989), should provide reliable and comprehensive early warning data on changes in drug use through reporting of drug poisonings presenting to hospital casualty units.
Information should be obtained from ambulance officers on those cases where patients refuse transport to casualty after being revived in order to supplement NDPCRS data.

It is therefore recommended that an early warning network consist of information gathered through the NDPCRS, the NFCRS, key informants, ambulance officer reports, telephone advice lines, patients in treatment, and needle exchange centres.