The advantages and challenges of developing a national earlier warning system - Transforming Bergen Earlier Warning System (BEWS) into Norwegian National Earlier Warning System (NNEWS).

Background

The early identification of new and emerging drug trends underpins the development of targeted and evidence-informed policy choices and interventions. The Bergen Earlier Warning System (BEWS) has been monitoring drug trends in the city of Bergen, Norway since 2002. The system monitors changes in patterns of drug consumption and availability, new substances, changes in modes of administration and changes in user groups. BEWS collects and analyses around fifty drug-related indicators and reports bi-annually on new trends and developments in the city. From 2018 the Norwegian Directorate of Health funded the extension of the BEWS model in to a national multi-city network for monitoring drugs and alcohol trends. The resulting National Norwegian Earlier Warning System (NNEWS), incorporates results from two additional cities, Oslo and Trondheim, alongside those from Bergen.

Methods

NNEWS is a multi-source and multi-method national drug trend monitor based on analysis of results from three sentinel cities. NNEWS triangulates and cross-references a wide range of datasets (seizures, alcohol and medicines sales, treatment data, key informant surveys etc.), collected every six months, and analyzed for identifiable national and local patterns and trends.

Results

Results from the initial two waves of NNEWS will be presented focusing on alcohol, cannabis, stimulants, opioids, misused medicines and new psychoactive substances, with comparisons made between the three Norwegian cities. The advantages and challenges of developing a national earlier warning system will be discussed, alongside consideration of how the results may apply to and interact with policy and practice. In particular, the utility of the three city NNEWS model to provide sufficient indicators for national drug trend monitoring will be addressed. Based on the seventeen years of BEWS experience, the presentation will also discuss the steps in the development of a common methodological framework for monitoring emerging trends, and how to expand and transform a local system into a national framework, highlighting both key success factors and barriers.

Conclusions

City level drug and alcohol monitors have an important role to play both in understanding and informing policy makers of new threats and developments. Multi-city networks of monitors may in addition have a central role in providing a national early warning function and rapid reporting of new trends in drug use, related harms and markets.