Expert meeting on the epidemiological indicator Problem drug Use (PDU)

Consolidate, integrate, innovate

The Problem drug use (PDU) indicator is one of the five key epidemiological indicators of the EMCDDA. The five key indicators are used by the EMCDDA to report trends and developments of the EU drug situation. The overall objectives of the PDU expert meeting were to share latest developments on problematic drug use in Europe and beyond, and to identify as a network the steps to improve the production of public health-oriented information at the European level. The specific objectives were to propose activities to consolidate national core estimates (people who inject drugs, high-risk opioid use), to illustrate the useful integration between the PDU indicator and the other four key indicators and to explore complementary alternative data sources to strengthen the PDU indicator.

The network

The meeting brought together national experts nominated by the national focal points from the European Union Member States, Norway, Turkey, six candidate and potential candidate countries (Albania, Bosnia and Herzegovina, former Yugoslav Republic of Macedonia, Kosovo*, Montenegro, Serbia), expert guests from France (Observatoire Français des Drogues et des Toxicomanies), Norway (Bergen Clinics Foundation), the United States (Centres for Disease Control and Prevention) and Australia (National Drug and Alcohol Research Centre) and EMCDDA staff. National experts come from ministries of health, home affairs, justice, public health institutes, drugs agencies, universities and hospitals. This unique network provides action-oriented information in the field of problematic drug use for EU institutions, Member States and professionals.

One of the core tasks of the PDU network is to share national estimates on problematic drug use, as defined by ‘recurrent drug use that is causing actual harms to the person or is placing the person at a high risk of suffering such harms’. Definitions of estimates that are included under the PDU key indicator umbrella are defined in the PDU revision summary (link). Among these estimates, those of people who inject drugs and high-risk opioid use are among the most important for public health policymakers. By measuring the prevalence of actual or potentially harmful drug use, the PDU indicator is also closely linked to the other key indicators (Drug-related deaths and mortality among drug users (DRD), Drug-related infectious diseases (DRID), the Treatment demand indicator (TDI) and General population surveys (GPS)).

* This designation is without prejudice to positions on status, and is in line with UNSCR 1244 and the ICJ Opinion on the Kosovo declaration of independence.

Key Documents

Meeting topics

Consolidate: National experts from the United Kingdom, Hungary, Estonia and Serbia provided an overview of injecting drug use in their countries. National experts from the United States, Italy, the Czech Republic and the EMCDDA presented recent trends on high-risk opioid use. Experts from Norway and the United Kingdom presented successful examples of national and local PDU estimates produced by indirect methods. Working in small groups, the network identified training needs and proposed capacity building activities in order to increase the completeness of reported injecting and high-risk opioid drug use estimates.

Integrate: The importance and challenges of integrating the PDU indicator with other indicators for public health purposes was outlined by presentations on the drug-related infectious disease risk assessment at EU level, the opioid substitution treatment coverage in Finland and integrated approaches used by the Netherlands and Spain. The bridges between the PDU and GPS indicators were illustrated by surveys (including the CAST scale for high-risk cannabis use) and integrated monitoring tools implemented in the United States, Australia, Norway, Spain, France, Romania and Germany to monitor problem drug use.

Innovate: Experts from Norway and France presented methods and results from city-level monitoring for problem drug use (Bergen in Norway and eight cities in France). Data on drug-related hospital emergency visits from a European sentinel network of hospitals (Euro-DEN project) were discussed. They are used to describe drug-related morbidity in the participating hospitals. An on-going pilot study on the correlation between city-level wastewater analysis and drug-related emergency room visits was presented.