A comparison of trends in problematic drug misuse from two reporting systems

BACKGROUND: Regional Drug Misuse Databases (RDMDs) are considered the main source of intelligence on problem drug takers in England. Originally intended to provide trend data on visible drug use, a recent strategic review concluded that their purpose should be to monitor treatment targets for the Government's latest 10 year strategy to tackle drug misuse. The aim of this analysis was to explore whether the General Practice Research Database (GPRD) could supplement RDMDs. METHODS: A retrospective analysis was carried out using the GPRD and the RDMD in the West Midlands from 1993 to 1997. RESULTS: Extrapolation of GPRD data indicates 6,574 drug misusing or dependent diagnosed patients in primary care in 1997 compared with 3,643 clients reported by all agencies including general practitioners (GPs) to the RDMD. From 1993 to 1997, the RDMD notification rate fluctuated whereas the GPRD rate has increased steadily since 1995. Half of all drug misusing or dependent patients recorded on the GPRD had psychiatric co-morbidity and 10 per cent had been referred to hospital for a drug overdose. CONCLUSIONS: As the GPRD has been unaffected by the demise of statutory notification of drug dependence in 1997, interpretation of trends may be more reliable than on the RDMD. There is also considerable potential for analysis of prescribing patterns, co-morbidity and drug-related hospitalization. As the Department of Health's Strategic Review of RDMDs recommends GPs as 'core reporters' for providing data to the national system, there is a need for a strategy to ensure valid and comprehensive reporting from GPs.