Keeping on target – Keeping on target – the need for more the need for more rapid and policy rapid and policy

relevant reportingrelevant reporting

Jane MounteneyJane Mounteney

Bergen Clinics Foundation/ Bergen Clinics Foundation/

University of BergenUniversity of Bergen

Early identification and rapid reporting of new drug

developments allows for early intervention

Rapid reporting – the ’speed’ problem

• Slow reporting systems

• Levels of bureaucracy

• Lengthy research processes

• New codes

• Collation/ communication gap

Possible solutions to the ’speed’ problem

• City/ local level systems – less levels of bureaucracy

• Pragmatic use of existing data (not new studies)

• Validity attained through triangulation of sources & methods (multi-indicator, mixed methods)

• Inclusion of sensitive sources – informants, media etc.

Research paradigms for rapid/relevant trend monitoring

ALTERNATIVE RESEARCH PARADIGMS

PostpositivismDeterminationReductionismEmpirical observation & measurement Theory verification

ConstructivismUnderstandingMultiple participant meaningsSocial and historical constructionTheory generation

Advocacy/ParticipatoryPoliticalEmpowerment-issue orientedCollaborativeChange-oriented

PragmatismConsequences of actionProblem-centredPluralisticReal-world practice oriented

Creswell (2003)

Model - rapid identification and response to emerging drug trends

SBK

City level drug monitoring system – early identification

Rapid assessment & response capability – early intervention

Combination of two methods

Monitoring & rapid assessment:

• Identification of emerging drug trends

• In-depth investigation of worrying findings

• Multi-agency action planning

SCHOOL PANEL

RAPID ASSESSMENT STUDIES

ROUTINE DATA

MEDIA MONITORING

SBK

KEY INFORMANT PANEL

SCHOOL SURVEY

Bergen Earlier Warning System (BEWS) model

Heroin trends in Bergen 2002-2009: use, market & interest indicator scores

-30

-20

-10

0

10

20

30

40

50

60

1 2 3 4 5 6 7 8 9 10 11 12 13

2002-2009

Ag

gr.

sco

re Aggr. Use

Aggr. Market

Aggr. Interest

RAPID ASSESSMENT & RESPONSE

Problem

Initial consultationSteering/ reference

group

Project planning

Assessproblem

Assesscurrent responses

Gap analysis

Final consultation

RAR report & action plan

RAR PROCESS

RAR report – young people linked to opiate milieu

•Increase in number of young opiate users (16-22)

•Majority of young opiate users debut with synthetic opiates (Subutex/ Temgesic)

•Injection debut likely to be with amphetamine

•Many placements in childcare institutions….

RAR action plan

• Multi-agency response

• Concrete action plan

• Focus on youth service provision

• Improving staff competence etc

• ’Unplanned’ response…

Media & political response

• Overdose death & RAR report• 3 weeks of media reporting• Regional childcare director called in to answer to

situation• National govt – all staff to be trained in drug

issues• Political parties take up theme – call for

ministers resignation• Resignation of regional director• Promise for national assessment re institutions

and drugs

Rapid & policy relevant reporting

• Pragmatic approach - multi-indicator, mixed-method

• Rapid identification plus in-depth investigative option

• Bridging the gap from monitoring to action• Involvement of policy makers – choosing

focus, choosing interventions• Integrated action planning, offering

solutions.

SBKSBKSBK

NATIONAL DRUG TRENDS NETWORK

CITY CITY CITY

EPOD/ EMCDDA

NATIONAL PLAN