Emerging drug trends: monitoring, communicating and responding
Croke Park, Dublin, Thursday 14 November 2024

As patterns in drug use and markets change, so too do the techniques used for monitoring and responding to these patterns. Routine monitoring on levels of drug use, treatment demand, and harms is essential for observing trends and planning services, but the unpredictable nature of synthesised drugs requires more immediate responses and a capacity to interpret diffuse information from a wide variety of sources.

Health services and policy-makers have adapted the principles of early warning systems designed to mitigate the consequences of natural disasters, and drug early warning systems are well established in the European Union (EU), the United States of America (USA), and Australia. We have learned a lot from these large national and multinational systems, and EU member states successfully exchange information on the appearance of new drugs or unusual outbreaks. The outcomes from these initiatives are both practical and regulatory. The results is a well-coordinated system of communication and a robust mechanism with which to provide the European Commission with scientific advice on control decisions.

National early warning systems are not as well developed as the EU’s system, and there are obvious challenges, such as developing the new monitoring tools on which to build such a system.

There has been progress in this regard in the past 10 years Previously experimental techniques – such as wastewater analysis, drug checking and testing, analysis of syringe residues, and online surveys – are becoming far more common, and each EU member state has at least some of the monitoring elements on which an early warning system can be built. This will involve putting in place reporting tools with the sensitivity to detect early signals. We also need to develop the analytical capacity to determine the level of urgency these signals represent and to synthesise the information emerging from a very diverse range of information resources in the health, nightlife, and security settings.

There are also technical challenges, such as the availability of standards to confirm the chemical compositions of substances. Time pressure on those working as first responders, as key workers in low-threshold services, or in emergency departments means that the opportunity to collect data and gain valuable insights into new drug phenomena is limited. Awareness of the needs of these staff will help to harness the rich knowledge they hold and their skill in extracting information in difficult circumstances. These areas need work, but the main task facing our public health services in relation to drugs is administrative and relates to communication, the diffusion of knowledge, and the coordination of services. The main challenges are in health intelligence: how do we use the knowledge that is available to us in order to protect lives?

The National Drugs Forum 2024 will be an opportunity to learn about the disparate elements that comprise our developing emerging drug trends monitoring system. It is also a chance to think through how all stakeholders can contribute to this system in order to meet the challenge of a changing drug world with confidence and determination.