Estimating the size of crack cocaine users in France: Methods for an elusive population with high heterogeneity |
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| Institution: | 1. French Monitoring Centre on Drugs and Drug Addiction (Observatoire Français des Drogues et Toxicomanies – OFDT), 69 rue de Varenne, 75007 Paris, France;2. Department of Sociology, Ohio State University, 238 Townsend Ave, 1885 Neil Avenue Mall, Columbus, OH 43210, USA;1. Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N Michigan Ave, Chicago, IL 60611, United States;2. Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, B601 West Fee Hall, 909 Wilson Road, East Lansing, MI 48824-1030, United States;1. University of Queensland, Institute for Social Science Research, 80 Meiers Road, Indooroopilly, QLD 4068, Australia;2. Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia;3. University of New South Wales, National Drug and Alcohol Research Centre (NDARC), 22-32 King St, Randwick, NSW 2031, Australia;1. Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW, 22-32 King Street, Randwick, NSW 2031, Australia;2. Centre for Crime Policy and Research, Flinders University, SA, Australia;3. Monash Addiction Research Centre, Monash University, Peninsula Campus, McMahons Road, Frankston, VIC 3199, Australia;1. School of Population Health, University of Auckland, Auckland, New Zealand;2. School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand;3. Department of Psychiatry, University of Toronto, Toronto, Canada;4. Centre for Applied Research in Mental Health & Addiction, Simon Fraser University, Vancouver, Canada;5. Department of Psychiatry, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil;6. National Institute for Health Innovation, School of Population Health, University of Auckland, New Zealand;1. National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, 2052 New South Wales, Australia;2. School of Pyschology, The University of Queensland, Brisbane, 4072, Queensland, Australia;3. The Kirby Institute, UNSW Sydney, Sydney, 2052, New South Wales, Australia;4. Population Health Sciences, University of Bristol, BS8 1QU, Bristol, United Kingdom;5. National Institute of Health Research, Health Protection Research Unit in Evaluation of Interventions, Bristol Medical School, BS8 1QU, Bristol, United Kingdom |
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| Abstract: | BackgroundDespite several sources corroborating an expanding market and increased visibility and greater diversity in users’ profiles, very little is known about the number of crack cocaine users in France.MethodThe estimates rely on a single data source capture–recapture method. Annual data are extracted from treatment centres nationwide. To account for heterogeneity, we use an innovative zero-truncated geometric, regression-based estimator controlling for individual and centre characteristics. We use the well-known Zelterman estimator as a benchmark.ResultsThe number of crack cocaine users received in treatment centres increased dramatically, from 3388 in 2010 to 5143 in 2017 (+52%). The estimated number of crack cocaine users is believed to have tripled over the course of the same period (from 9775, 95% CI 8288–11530] to 28983 24876–33766], respectively), with prevalences below 1‰, similar to other European countries. The coverage rate (observed number/estimated number of users) decreased in a similar fashion, indicating lower utilization. In particular, females and younger users are underestimated by data from treatment centres.ConclusionThe prevalence of crack cocaine use is fairly low but steadily increasing. The diversity in users’ profiles is a challenge to prevention and public health policies that should expand their scope to a more inclusive perspective of what defines crack cocaine users. Our method overcomes several methodological issues (data sources, data linkage, heterogeneity) and can be easily applied to a wide range of settings. |
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