Upload
hoangque
View
212
Download
0
Embed Size (px)
Citation preview
28.9.2015 1
Increase of opioid use in Finland —when is there enough
key indicator data to state a trend?Martta Forsell, Finnish Focal Point
Esityksen nimi / Tekijä
Martta Forsell
• Master of Social Sciences
• Senior officer in the statistical department ofInstitute of Health and Welfare
• Partly working for the Finnish Focal Point for six years
• No conflict of interest
28.9.2015 Esityksen nimi / Tekijä 2
When is there enough key indicator data to state a trend?
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Trends of opioids use in Europe
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
• Increasing in Finland when decreasing everywhere?
Trends of opioids use in Europe
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
• Or is Finland 40 y or 20 years late?
• Increasing in Finland when decreasing everywhere?
Some heroin consumption in Finland only in the late 90s.
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Opioid use in Finland is iv -use of buprenorphine together with other medicinal products.
Trends of opioids use in Europe
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
• Or is Finland 40 y or 20 years late?
• Or 10 years ahead?
• Increasing in Finland when decreasing everywhere?
General population surveys (GPS) –substances used in the lifetime
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
1998 2002 2006 2010 2014
Heroin ormorphine
Heroin ormorphine
Heroin Heroin Heroin
Other opioids(as Subutex)
Buprenorphine Buprenorphine
Methadone Methadone
Other opioids(as tramadol, fentanyl, codein,oxicodone, morphine)
Other opioids(as tramadol, fentanyl, codein,oxicodone, morphine)
• Pekka Hakkarainen• Leena Metso • Karoliina Karjalainen
Lifetime prevalance for any opioid misuse15-64 year olds
0.30.5 0.6
1.4
1.9
0
0.5
1
1.5
2
2.5
3
1998 2002 2006 2010 2014
28.9.2015 Esityksen nimi / Tekijä 15
%
General population surveys are not supposedto detect problem drug use trends …
28.9.2015 Esityksen nimi / Tekijä 16
Problem drug use (PDU)
• Päivi Partanen (Capture-recapture)
• Jukka Ollgren (Capture-recapture)
+ Lots of experts give and explain the source data
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Capture-recapture
• 2-4 sources, all independent from the KI data – Hospital discharge registry– Police registies– New Hepatits C cases
• 2012 data with Baynesian averaging
Opiod users 2012: • (Min) 12 700 - 15 100 (max)
• (Min) 0,38 % - 0,45 % (max) opiod problem users
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Lifetime prevalance for any opioid misuse15-64 year olds
0.30.5 0.6
1.4
1.9
0
0.5
1
1.5
2
2.5
3
1998 2002 2006 2010 2014
28.9.2015 Esityksen nimi / Tekijä 19
%
2012 PDU
0,4%
Problem opioid users, capture-recapture
28.9.2015 20
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
1996 1998 2000 2002 2004 2006 2008 2010 2012 2014
opioidit min
opioidit max
Max Opioidit
Min OpioiditX
%
Lähde: Ollgren ym 2014; Partanen ym. 2007.
Problem opioid users, capture-recapture
28.9.2015 21
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
1996 1998 2000 2002 2004 2006 2008 2010 2012 2014
opioidit min
opioidit max
Poly. (opioidit min)
Poly. (opioidit max)
Max Opioidit
Min OpioiditX
Lähde: Ollgren ym 2014; Partanen ym. 2007.
%
Problem opioid users, capture-recapture
28.9.2015 24
0
0.05
0.1
0.15
0.2
0.25
0.3
0.35
0.4
0.45
0.5
1996 1998 2000 2002 2004 2006 2008 2010 2012 2014
opioidit min
opioidit max
Poly. (opioidit min)
Poly. (opioidit max)
Max Opioidit
Min OpioiditX
Lähde: Ollgren ym 2014; Partanen ym. 2007.
%
Trend analyse on problem drug use studies is doubious …
28.9.2015 Esityksen nimi / Tekijä 25
Treatment demand data is collected every year
Treatment demand indicator (TDI)
• Airi Partanen
• Martta Forsell
• Voluntary data collection, coverage is not known
• Includes also continuous clients
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Drug clients reporting opioids use, share (%) from all reported drug clients (incl. continuous clients)
40
45
50
55
60
65
70
75
80
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
%
Huumehoidon tiedonkeruun kattavuutta ei tiedetä, lomakkeiden määrä vähenee
28.9.2015 Esityksen nimi / Tekijä 28
166
79
66
5 793
2 688
2 089
0
20
40
60
80
100
120
140
160
180
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
YksiköitäAsiakkaita
Yksiköitä
Asiakkaita
Paljon hoitoa (matalat indikaatiot), kiinnostava aihe
Huumehoidon tiedonkeruun kattavuutta ei tiedetä, lomakkeiden määrä vähenee
28.9.2015 Esityksen nimi / Tekijä 29
166
79
66
5 793
2 688
2 089
0
20
40
60
80
100
120
140
160
180
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
YksiköitäAsiakkaita
Yksiköitä
Asiakkaita
Hoito ja tiedon tuotanto keskittyy ’F11’ ympärille
Paljon hoitoa (matalat indikaatiot), kiinnostava aihe
Drug clients reporting opioids use, share (%) from all reported drug clients (incl. continuous clients)
40
45
50
55
60
65
70
75
80
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
%
In facilities specializing drugtreatment (and provide the data)
less and less treatment is givento non-opioid clients
TDI data is only on those in treatment…
28.9.2015 Esityksen nimi / Tekijä 31
Are there any absolutenumbers ?
Drug related deaths (DRD)
General mortality register – Statistics Finland
Special registry• Erkki Vuori • Ilkka Ojanperä • Pirkko Kriikku
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
Drug findings in post-mortem toxicogy, regardless the cause of death
- nationally- high rate
Opioid (heroin + buprenorphine+ methadone) findings in post-mortem toxicogy
0
20
40
60
80
100
120
140
160
180
200
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
opioid use is increasing in Finland
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
This study may indicate that
and further monitoring is needed.
GPS prevalence
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
HRDU problem opioid users
TDI treatment DRD deaths
opioid use is increasing in Finland
Huumehoidon Pompidou-tiedonkeruu / Martta Forsell
This study may indicate that
and further monitoring is needed.
Why? How to stop this trend?