Emerging Trends and New Drugs The French National Monitoring System on patterns of drug use and local drug market

Transcription

1 TREND scheme Emerging Trends and New Drugs The French National Monitoring System on patterns of drug use and local drug market Agnès Cadet-Taïrou Head of TREND Unit French monitoring Centre for Drugs and Drug Addiction EMCDDA- 20 years of monitoring event, Lisbon, September 2015

2 Thread TREND Unit within the French Focal point TREND scheme ( and TREND network) Benefits, limitations and challenges 2

3 TREND Unit, role Providing early information To limit time between the emergence of a new phenomenon and its consideration by decision makers To identify and analyze phenomena undetectable by classical quantitative indicators or before they seen by these indicators Providing clues for understanding Collection of qualitative data from the field Cross checking of a large range of data The French Focal point of the European EWS on drugs part of the French vigilance system on drugs 3

4 Fields Drug users: profile, pattern of use, representation Substances: name, price, chemical composition Contexts: contexts of use, evolution in s, local market and trafic Consequences 4

5 TREND Unit, tools TREND scheme = a User and Context approach A network + local data collection tools + data synthesis A one year period + occasional rapid information requests SINTES Scheme = a substances approach A network for rapid sharing of information : vigilance on new substances / dangerous substances (EWS) A network for collecting and analysing substances from DUs I-Trend project (Internet tools for research in Europe on new drugs) Quantitative surveys Ena-CAARUD : National survey on low threshold facilities for DUs Quanti-festif : on techno party s Cross-checking of partners data Toxico/addicto-vigilance, law enforcement indicators, DRD, General population surveys 5

6 Main principle: triangulation Confrontation of independent sources of information Qualitative data analysed in the light of quantitative data Several levels of understanding local national international context 6

7 The TREND network TREND cities Areas with SINTES coordination Lille Metz Paris Rennes Nantes? Lyon Bordeaux Toulouse Marseille TREND network : 7 cities (+ 2 entering soon) + partners (Forensic, Toxicovigilance, Treatments, Harm reduction ) A common strategy to collect and analyse data Each Trend regional coordinator is also a SINTES coordinator Gradually implemented in France since sites TREND in 2002 (3 oversea), 7 since in ? 7

8 Local tools Ideal aim: independant sources Internal tools French CDC French EMCDDA data Qualitative questionnaires (low threshold facilities/ specialisedcare centres) Quanti surveys (mainly low threshold facilities Ethnographic observation Price Barometer TREND Ad hoc investigations Focus groups (forensic, health) Local media screening SINTES Vigilance on substances Addictovigilance toxicovigilance Interview s Key Informants Forensic External tools 8

9 TREND, main qualitative observation areas Rural areas Unattainable and semi-rural «Urban» settings suburbs «Techno» party scenes Squats Monitored Promptly observed Streets Low threshold/ harm reduction facilities Alternative party scene Disadvantaged suburbs Specialised care setting Law enforcement services Conventional party scene eg clubbing Gay party scene Private Virtual space Internet Professional 99

10 Ethnography 1 coordinator (sometimes co-coordination) Checklist for observation Notes (3/Y) 2 heads of ethnographic observation 1 "festive" 1 "urban" Observation checklist Key-informants Each coordinator recruits at least 3 KI (Key-informants) Anonymous (pseudonym), described by an identification sheets privileged access to a / population (s) and context (s) consumption "Independent" one from another Issue of financial contribution for KI Indirect observation «regular» meetings (1/ month) oral reporting 10

11 TREND network data flow Local network Local tools Analysis city 1 (triangulation) city 2 Synthesis Software : NVivo City n Annual local report and database containing all ethnographic material National network Other partners and indicators Forensic Toxicovigilance Treatment Health data Other outputs of the network Quali surveys Quanti surveys Ad hoc investigtations OFDT (french focal point) National analysis and synthesis Trend national report 11 11

12 What does the system provide? Steady in-depth(structural) trends Identification Description Understanding Follow up New significant trends Emerging phenomenon Emerging Trend Needto keepan eyeon it «Flop» 12 12

13 Benefits of TREND scheme Improvement on state of knowledge Better understanding of contexts and phenomena A dynamic view A spatial view on the French territory A population approach Perception of quantitative scales with real limitations! Reactivity in the French vigilance system on drugs Ability to quickly understand the issue raised by a signal Opportunity of rapid information recovery when necessary Allow implementation of less expensive multi-centric studies Development of an expertise in rapid investigations spread by the coordinators 13

14 TREND scheme in the global information system Harm reduction/ Low thresholds + visible SpecialisedCare GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Work conventional (clubbing, pubs ) «Select» party scene Private -visible 14 14

15 TREND scheme in the global information system Harm reduction + visible SpecialisedCare «Old» profileof opiates users, taking OST GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Hidden Drug users Work conventional (clubbing, pubs ) «Select» party scene Private -visible 15 15

16 Precarious users Harm reduction + visible SpecialisedCare GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Hidden Drug users Work conventional (clubbing, pubs ) «Select» party scene Private -visible 16 16

17 TREND scheme in the global information system Socially integrated or half integrated users Hidden Drug users 17 17

18 TREND scheme in the global information system Harm reduction + visible SpecialisedCare GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Hidden Drug users conventional (clubbing, pubs ) «Select» party scene Work Private -visible Very well socially integrated users 18 18

19 TREND scheme in the global information system Harm reduction + visible SpecialisedCare GPs Quanti General pop surveys +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Work conventional (clubbing, pubs ) «Select» party scene Private -visible 19 19

20 TREND scheme in the global information system + visible Quanti Clients surveys Harm reduction SpecialisedCare GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Work conventional (clubbing, pubs ) «Select» party scene Private -visible General pop surveys 20 20

21 TREND scheme in the global information system Harm reduction + visible Clients surveys SpecialisedCare GPs Quanti Party scene quanti survey +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy Work conventional (clubbing, pubs ) «Select» party scene Private -visible General pop surveys 21 21

22 Cross chechking quali and quanti data Harm reduction + visible Clients surveys SpecialisedCare Quali Party scene quanti survey TREND urban area GPs +precarious Streets, squats, deals and use areas alternative Party scenes + wealthy TREND party area Work conventional (clubbing, pubs ) «Select» party scene Private -visible General pop surveys 22 22

23 Limitations and challenges (1) "Blind" or blurred areas in spite of adaptation of TREND scope Teenagers out of festive events Users scattered in general population Large or scattered areas (eg. country-side) or closed population (eg. some disadvantage suburbs) Too common phenomena Alcohol, cannabis use No quanti perception: cocaine Blunting of interest on some points 23

24 Limitations and challenges (2) in a context of cuts in public expenditure Cost of the city network : around in 2015 (for OFDT) A lot for OFDT Too restrictive for coordinators For «TREND unit» staff How to reach a balance between And worktime left for TREND scheme (coordination and scientific production) (< 1 full-time equivalent) Need for sustaining and improving quality of collected data Sustaining in-depth analysis Dissemination of results 24 24

25 Thank you for your attention 25