How well do trends in incidence of heroin use reflect hypothesised trends in prevalence of problem drug use in the North West of England?

Abstract

This study investigates whether hypotheses about trends in the prevalence of problem drug use (PDU), prompted by capture-recapture based age-specific prevalence estimates, are corroborated by estimates of trends in incidence. Lag correction techniques were used to provide incidence estimates adjusted for the time-lag between onset of drug use and its first recorded treatment for heroin users seeking treatment in three areas of North West England between 1986 and 2000 (n ¼ 4142). The incidence trends indicated geographical variation in the progress of heroin 'epidemics' in the areas studied and corroborated previously estimated prevalence rates that suggested PDU has passed its peak and is declining in some areas, but continues to increase in others. The lag correction method is capable of producing estimates that will improve our understanding of changes in the size and composition of the population targeted for drug misuse treatment and may provide a basis on which to forecast the direction of future trends.

Opiate and crack cocaine use: A new understanding of prevalence

“…As this paper has shown, a large proportion of problem drug users in the North East are from the younger age range. Previous research suggests this age distribution is characteristic of a recent increase in incidence whereby young people have joined the using population, and an increase in prevalence is an expected outcome (Millar, Gemmell, Hay, Heller, & Donmall, 2006). It is acknowledged that insufficient time has lapsed between the two study periods to report confidently on trends, and any significant changes should be interpreted as a possible change in prevalence rather than evidence of a definite change.…”

Estimating Prevalence of Injecting Drug Users and Associated Heroin-Related Death Rates in England by Using Regional Data and Incorporating Prior Information

“…However, it is an encouraging sign for London and the North West (with high prevalence rates) that their injector age group ratios (15–34 to 35–64 years) are relatively low compared with England as a whole (posterior mean 1.59 for males and 2.24 for females; and see Millar et al . () for further detailed discussion of problem drug use in the North West up to 2001). Regions with high injector ratios by age group may have experienced later diffusion with younger injectors predominating.…”

Assessing UK drug policy from a crime control perspective

“…For example, De Angelis et al (2004) find that though there is a moderate downturn in incidence between 1980 and 1985, prevalence of heroin addiction in the UK grew from 1968 to 2000, with especially large increases in the 1990s. Research from the north-west of England suggests that, during the 1990s, initiation into heroin use may have started to fall in areas which had seen big increases in the 1980s (Millar et al, 2006), even if it continued to increase in other areas.…”

“…Few health indicators have shown such rapid deterioration over such a long period. I t a l y P o r t u g a l S p a i n A u s t r i a I r e l a n d F i n l a n d S w e d e n F r a n c e N e t h e r l a n d s G e r m a n y P o l a n d (Millar et al, 2006), even if it continued to increase in other areas.…”