Demand for drug treatment in Europe: the Treatment Demand indicator (TDI)

Introduction

The TDI is one of the five key epidemiological indicators (KI), which consist of methodological guidelines for data collection, analysis and reporting in five domains that address key aspects of the prevalence and consequences of drug use. This poster is part of a set of five posters on the five EMCDDA key epidemiological indicators. As part of the TDI network, experts from 30 countries are responsible for data collection and analysis at national level. The expert network is fundamental for the indicator implementation.

Objective

The primary purpose of the TDI is to gain insight into the socio-demographic profile and patterns of illicit drug use of people entering drug treatment and to help estimate trends in number and patterns of high risk drug use (see PDU indicator). TDI data also help with planning and evaluating services for drug users and assessing the needs for treatment resources and treatment organisation.

Methods

Information on 24 items is collected in all European Union Member States, Norway and Turkey through a common Protocol, namely the protocol TDI version 3.0. Definitions and methodological specifications are described in detail in the guidelines. The TDI Standard protocol ver. 3.0 has been published in 2012 and is available in 12 languages. A system to assess the data quality of the indicators has been established in agreement with the national experts, following common criteria for the evaluation of the scientific data quality and of the implementation process at national level.

Results

The most recent TDI data from the year 2017 concern around 510 000 drug clients from about 6500 specialised treatment centres in 30 countries. Data show that after opioid users, cannabis and cocaine users are the second and third largest groups entering drug treatment. The proportion of people entering treatment for heroin dependence for the first time in life has decreased from around 36% in 2007 to around 12% of new treatment entrants in 2017, while that for cannabis has considerably increased. However, new increases in opioid clients have been recently reported. In addition users of substances recently appeared on the market, such as NPS, or opioids other than heroin start to enter treatment. Drug injection is on the decline in many EU countries since the decrease in heroin epidemic. Country differences in drug use patterns and trends exist and should be considered. Methodological limitations should however be considered when interpreting the data, as they may be affected by changes over time and country differences in national reporting systems.

Conclusions

The TDI is a reporting tool to monitor the socio-demographic characteristics of people entering specialised drug treatment services in the European countries and to document changing patterns and trends of drug use over time. The indicator contributes to improve the understanding of the drug situation at national level and in Europe, and can answer to the information needs of policy makers and professionals. The TDI has become one of the largest drug-related datasets in Europe and is increasingly used in analyses of the drug situation and trends. Its potential utility and analytical capacity is enhanced by combining its information with data from other epidemiological indicators and indicators from other domains.