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Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland

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Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland Executive Report November 2004 Issued January 2005 Gordon Hay, Maria Gannon, Neil McKeganey, Sharon Hutchinson & David Goldberg Centre for Drug Misuse Research, University of Glasgow Scottish Centre for Infection and Environmental Health Summary In this report we outline the results of the second national study funded by the Scottish Executive to provide estimates of the prevalence of problem drug misuse in Scotland. The estimates refer to the calendar year 2003. The study used the capture-recapture method and focussed on those aged 15-54 years old. Estimates of the prevalence of opiate and / or benzodiazepine misuse have been provided for every Council area, Drug and Alcohol Action Team (DAAT) area, NHS Board area and Police Force area within Scotland. Estimates of the prevalence of drug injecting are also given at the Council and NHS Board area level. These estimates are compared with the results of a previous study relating to 2000. In addition, this study has also provided estimates of the prevalence of opiate and / or benzodiazepine misuse at the Local Health Care Co- operative (LHCC) level. This study has also provided an estimate of the number of crack cocaine users in the Aberdeen City Council area; however there were too few data to provide estimates in any other Council area for crack cocaine use. Moreover, it was not possible to provide estimates of psychostimulant use more generally. In terms of the national prevalence of problem drug misuse we estimate that there were 51,582 individuals misusing opiates and / or benzodiazepines in the year 2003. This corresponds to 1.84% of the population aged between 15 and 54. The 95% confidence interval (CI) attached to the national estimate ranges from 51,456 to 56,379 (1,84- 2.01%). The proportion estimated to be female is 31% and male 69%. The age breakdown among males was 30% aged between 15 and 24, 45% between 25 and 34 and 25% aged between 35-54. In terms of the local estimates we have identified problem drug misuse in every Council area in Scotland. Aside from the comparatively low prevalence rates found in island Council areas, the prevalence of problem drug misuse by Council area has ranged from 0.66% (95% CI 0.39-3.48%) in Moray and 0.69% (95% CI 0.51-1.50%) in East Dunbartonshire through to 3.31% (95% CI 3.16-3.49) in Glasgow City. The highest prevalence of problem drug misuse within a DAAT area is to be found in the Dundee City DAAT area, with a prevalence rate of 2.80% of those aged 15 to 54 (95% CI 2.51-3.22%), followed by Greater Glasgow with a prevalence of 2.64% of the 15 to 54 age range (95% CI 2.55-2.87%). With that prevalence rate, Greater Glasgow is also the NHS Board with the highest prevalence. Finally, the highest prevalence rates in terms of Police Force areas were found in Tayside and Dumfries & Galloway, although over half of the problem drug users in Scotland reside in the Strathclyde Police Force area. In terms of drug injecting we estimate that 18,737 people were injecting opiates and/or benzodiazepines in 2003 (95% CI 17,731 to 20,289). The highest drug injecting prevalence rates were identified in the Argyll & Clyde, Greater Glasgow and Grampian NHS Board areas; in each of these areas it is estimated that just under 1% of the population inject drugs. The LHCC analyses found that there were variations in the levels of opiate / benzodiazepine use within DAAT areas, with comparatively high levels of problem drug use being found in LHCC areas within the Greater Glasgow, Ayrshire & Arran and Argyll & Clyde DAAT areas. There were only sufficient data to provide an estimate of the prevalence of crack cocaine use in Aberdeen City where there are an estimated 1,070 people using that drug (95% CI 736 to 1,672). That estimate corresponds to 0.72% of the population aged 15 to 54 (95% CI 0.53-1.20%) or alternatively 38% of those estimated to use opiates and / or benzodiazepines in the city. Overall the prevalence of problem drug use has decreased in Scotland from 55,800 (95% CI 1.92 to 2.09) in 2000 to 51,582 (95% CI 1.84 to 2.01) in 2003. This decrease is statistically significant at the 90% level and is thus indicative of a true decline in problem drug use prevalence. Significant decreases at the 95% level in prevalence were found in the Aberdeen, Glasgow City and North Lanarkshire areas. In contrast, significant increases were seen in Dumfries and Galloway and South Ayrshire. There was also a decrease in injecting prevalence nationally. As an injecting estimate for Ayrshire and Arran was not obtained in 2000, in order to compare 2000 and 2003, the estimates for Ayrshire and Arran for 2003 were deducted from the overall figure of 18,737. Thus, for mainland Scotland, the prevalence decreased from 22,805 in 2000 to 17,022 in 2003 (not including Ayrshire & Arran), although such a decrease is not statistically significant. There was, however, a statistically significant decrease in the Greater Glasgow NHS Board area. There have been increases (though not statistically significant) in some other areas, particularly Dumfries & Galloway. This study has demonstrated that it is possible to undertake a repeated comparable analysis to provide successive prevalence estimates over time. Contents Page No Summary 1 Introduction.............................................................. 1 2 Aims and Objectives ............................................... 2 3 Methods.................................................................... 3 4 Data......................................................................... 10 4.1 Scottish Drug Misuse Database .............................. 10 4.2 Hospital Admissions ................................................ 11 4.3 Social Enquiry Reports ............................................ 11 4.4 Police....................................................................... 12 4.5 Hepatitis C Virus...................................................... 12 4.6 Summary ................................................................. 12 5 Results ................................................................... 15 5.1 Opiates and Benzodiazepine Use ........................... 15 5.1.1 National Prevalence ................................................ 15 5.1.2 Council Areas .......................................................... 15 5.1.3 DAAT Areas ............................................................ 26 5.1.4 NHS Board Areas.................................................... 29 5.1.5 Police Force Areas .................................................. 32 5.1.6 LHCC Areas ............................................................ 35 5.2 Drug Injecting .......................................................... 36 5.3 Psychostimulants..................................................... 41 6 Comparison between 2000 and 2003 ................... 43 7 Discussion and Conclusions................................ 46 References ............................................................. 50 Acknowledgements............................................... 51 Index of Tables 1 Summary of data on problem drug use by Council area (age 15 to 54) 2 Summary of data on drug injecting by NHS Board area (age 15 to 54) 3 Estimates of the number of problem drug users by Council area (age 15 to 54) 4 Estimates of the prevalence of female problem drug use (age 15 to 54) 5 Estimates of the prevalence of male problem drug use (age 15 to 54) 6 Estimates of the percentage of problem drug users who are female (age 15 to 54) 7 Estimates of the prevalence of male problem drug use by age group 8 Prevalence rates of male problem drug use by age group 9 Estimates of the number of problem drug users by DAAT area (age 15 to 54) 10 Estimates of the number of problem drug users by NHS Board area (age 15 to 54) 11 Estimates of the number of problem drug users by Police Force area (age 15 to 54) 12 Estimates of the number of drug injectors by NHS Board area (mainland Scotland, age 15 to 54) 13 Estimates of the number of drug injectors by Council area (mainland Scotland, age 15 to 54) 14 Crack cocaine users identified from Scottish Drug Misuse Database (SDMD) and Social Enquiry Report (SER) data sources (age 15 to 54) 15 Comparison between 2000 and 2003 problem drug use prevalence estimates by Council area (mainland Scotland, age 15 to 54). Index of Figures 1 Estimated prevalence of problem drug use by Council area (age 15 to 54) 2 Estimated prevalence of problem drug use by Council area (non rural areas, age 15 to 54) 3 Estimated prevalence of problem drug use by Council area (rural areas, age 15 to 54) 4 Estimated prevalence of problem drug use by DAAT area (age 15 to 54) 5 Estimated prevalence of problem drug use by DAAT area (age 15 to 54) 6 Estimated prevalence of problem drug use by NHS Board area (age 15 to 54) 7 Estimated prevalence of problem drug use by NHS Board area (age 15 to 54) 8 Estimated prevalence of problem drug use by Police Force area (age 15 to 54) 9 Estimated prevalence of problem drug use by Police Force area (age 15 to 54) 10 Estimated prevalence of problem drug use by LHCC area (age 15 to 54) 11 Estimated prevalence of drug injecting by NHS Board area (age 15 to 54) 12 Estimated prevalence of drug injecting by NHS Board area (age 15 to 54) 1 Introduction In this report we outline the results of research funded by the Substance Misuse Division of the Scottish Executive and carried out jointly by the Centre for Drug Misuse Research at the University of Glasgow and the Scottish Centre for Infection and Environmental Health to provide national and local estimates of the prevalence of problem drug misuse within Scotland for the year 2003. Previously estimates of the prevalence of problem drug use and drug injecting were obtained for 2000 (Hay, McKeganey and Hutchinson, 2001). This study sought to replicate those analyses to provide comparable estimates, and in addition has endeavoured to respond to the needs of Drug and Alcohol Action Teams (DAATs) by providing prevalence estimates at a smaller geographical area than in 2000. This study also attempts to provide information on the extent of psychostimulant use in Scotland.
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