Scottish Drug Misuse, 1996-
- Scottish Drug Misuse, 1996-
- Principal investigator(s):
- Information Services Division - NHS National Services Scotland
- Data collector(s):
- Information Services Division - NHS National Services Scotland
- Health services and medical care - Health
Abstract copyright ADRN.
The Scottish Drug Misuse Database (SDMD) offers a profile of the misuse of drugs, based on information about drug clients seen at a broad range of services across Scotland. Services contributing to the database consist mainly of specialist drug services, general practitioners and prison drug services. The system has been in operation in Scotland since August 1990 and data is available for access from 1996 onwards.
The dataset is part of a wide range of health related administrative data collected by the Information Services Division (ISD), on behalf of the NHS National Services Scotland (part of NHS Scotland). ISD has been the authoritative source of Scottish national healthcare statistics for over 50 years. The data is used to enhance decisions about Scottish health care to improve the health of the people of Scotland. ISD is part of the SHIP (ScottisH Informatics Programme), a Scotland wide research platform for the collation, management, dissemination and analysis of Electronic Patient Records. As part of SHIP, ISD delivers Electronic Data Research and Innovation Service (eDRIS), a one stop shop for health research designed to provide a single point of contact and to assist researchers in study design, approvals and data (non-patient or patient identifiable) access in a secure environment (the NSS National Safe Haven).
The SDMD holds a wide variety of information on the characteristics of clients coming to the attention of medical services (general practice, hospital etc.) and specialist drug services (statutory and non-statutory). This includes client demographics, social profile, dependants, prescription profile and injecting / sharing information.
More recently the database has been adapted to collect both initial and follow up information. SMR25A dataset collects the initial data and the follow up dataset is collected in SMR25B. More specifically, Follow-Up Data is supplied by services for active clients at specific time points (12-weeks and annually from the start date of an episode) and on an ad-hoc basis. Annual extracts are analysed by the Health Improvement Team (formerly the Substance Misuse team) each year. Typically the data is finalised for the previous financial year in September of each year.
As specified previously, the Scottish Drug Misuse Database has evolved over time and data within the database is referred to by SMR number dependant on the time period.
The initial SMR22 dataset was in use from 1990 onwards, collecting a limited amount of data and with initially sporadic returns. SMR24 was introduced in April 2001 and provided profiles of clients coming into care for treatment of their drugs misuse problem. In addition, more information was collected about the client’s social circumstances and drug using habits than was collected previously.
In April 2006, SMR25a (covering new assessments) were introduced to reflect the need for more in depth and focussed information from clients. Key changes to the dataset included the addition of Blood Borne Virus and Dependent children data. A summary of the main changes are highlighted below:
- More detailed ethnic categories
- More detailed referral categories
- Waiting times information added
- Information added about contact with other services
- New section on blood borne viruses added
- Alcohol profile added
- Expanded information on social profile
- New section on dependent children
Note that for the SMR25a collection, the definition of a new client varies from that used in SMR24. Previously, an SMR24 form was completed for clients who were either new to a treatment service, or clients who had not attended that treatment service for at least six months. SMR25a is designed to collect information on clients from the beginning of an episode of care so the six month rule no longer applies.
In 2008, a decision was made to collect information from clients throughout their care period and not just at assessment stage in order to help measure their capacity, access and outcomes. The periods for collection cover the following:
- Initial assessment
- 12 week follow up
- Annual follow up
- Discharge from Service
- Transfer from Service
This follow up collection is known as SMR25b and provides more detailed information for research purposes about the length of time people spend in treatment, the interventions they receive and the changes that can occur in their drug use and social situations whilst they are in contact with treatment services.
SMR 24 and 25 are separate datasets. However, it is possible for the two datasets to be linked together. There are slight differences between the way SMR22/SMR24 and SMR25 are collected and so figures are not directly comparable between the two.
Statistics from the Scottish Drug Misuse Database are produced to high professional standards. The data regularly undergoes quality assurance reviews and cleaning processes. Because of the importance of accuracy in the statistics and information, members of the SDMD also contact services asking for clarification on the data sent to the SDMD. The SDMD web-system contains also a level of built in validation ensuring that the mandatory fields within the dataset are completed, and that the data passes a number of quality validation checks. Note that many fields in the SDMD are non-mandatory so may not be well answered and clients who wish to remain anonymous are not recorded by the system
Recently, with the introduction of the SDMD web-system, the collection of the “follow-up” SMR25b data has begun, but a number of issues have impacted on the level and completeness of the SMR25b records submitted to ISD. In the years since introducing the SMR25b dataset, the number of submissions has steadily increased as more areas begin submitting data, but significant issues still remain with the submissions. Any request for information should bear in mind the potential for SMR25b records to be incomplete. It is hoped moving forward that the outstanding issues with follow-up submissions will be resolved.
Information in the SDMD is considered sensitive and therefore is guarded to the highest level of ISD’s disclosure rules. Limited personal information was collected on individuals recorded in the SDMD prior to the introduction of the web based system (only first initial of forename and first and fourth initial of surname). Full names and CHI numbers are now asked for in the online system but it still only asks for partial postcode or the town in which the client lives.
Research Usage and Linkage
The data collected in the Scottish Drug Misuse Database feeds into the Scottish Government’s national drug strategy – the Road to Recovery. The strategy emphasises ‘a new approach to tackling problem drug use based firmly on the concept of recovery.
The Scottish Drug Misuse Database contains limited personal data, and therefore identifiers such as the client’s full postcode are not sent to ISD by recording local medical services. Since the roll out of the web based data entry full names have been collected, prior to this however, only the first name initial, surname initial with fourth character was collected.
SMR24 and SMR25 are separate datasets. It is possible to link these datasets together using the ISD Medical Record Linkage Service subject to Privacy Advisory Committee (PAC) approval being granted.
Previous linkages have been done between the SDMD database and a Blood Borne Viruses database held by Health Protection Scotland.
Coverage, universe, methodology
- Time period:
- 1996 -
- Observation units:
Events and processes
- Kind of data:
Individual (micro) level
Clients coming to the attention of medical services (general practice, hospital etc.) and specialist drug services (statutory and non-statutory) for drug misuse in Scotland, since 1996.
- Time dimensions:
Repeated cross-sectional study
Follow-up to cross-sectional study
- Sampling procedures:
No sampling (total universe)
- Number of units:
- Approximately 12,000 new assessments and more than 13,000 follow up assessments per year
- Method of data collection:
Compilation or synthesis of existing material
Continuous process through web submissions, where electronic uploads of batch files of data are collected from local systems (formerly collected on paper forms).
- Frequency of release:
- Data Updated:
Administrative and access information
- Crown copyright
- Access conditions:
- Contact the Network
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By principal investigator(s):
- Scottish Health Informatics Programme (2012) A Blueprint for Health Records Research in Scotland, Scottish Health Informatics Programme.
- Hecht, G., Barnsdale, L., McAuley, A. (2014) The National Drug Related Deaths Database (Scotland) Report 2012, The Information Services Division and National Health Service.
Resulting from secondary analysis:
- Scottish Government (2008) The Road to Recovery., Edinburgh, UK: Scottish Government.
- Hay, G., Gannon, M., Casey, J., McKeganey , N. (2009) Estimating the National and Local Prevalence of Problem Drug Misuse in Scotland, Glasgow, UK: University of Glasgow.
- Mc Donald, S.A., Hutchinson, S.J., Bird, S.M., Robertson, C., Mills, P.R., Dillon, J.F., Goldberg, D.J. (2011) 'Hospitalisation for an alcohol-related cause among injecting drug users in Scotland:', International Journal of Drug Policy, 22(1), pp. 63-69. 10.1016/j.drugpo.2010.04.003
- Williamson, A.E. (2011) Patients repeatedly removed from GP lists:, PhD thesis, University of Glasgow.
- Merrall, E.L.C., Bird, S.M., Hutchinson, S.J. (2012) 'Mortality of those who attended drug services in Scotland 1996-2006:', International Journal of Drug Policy, 23(1), pp. 24-32. 10.1016/j.drugpo.2011.05.010
- Norah, E. P., Ramsay, C. N., Browning, L., Goldberg, D. J., Hutchinson, S. J. (2012) 'Anthrax Infection Among Heroin Users in Scotland During 2009-2010:', Clinical Infectious Diseases, 55(5), pp. 706-710. http://dx.doi.org/10.1093/cid/cis511