Drug use Prevalence among Former SSI DA&A Recipients

This paper examines illegal drug use prevalence among former recipients of Supplemental Security Income (SSI) disability benefits for drug addiction and alcoholism (DA&A) in Chicago, Los Angeles, and Seattle, based on urinalysis and self-report data. It presents estimates of current prevalence (past three days) for four categories of illegal drugs–-opiates, cocaine, marijuana, or any use–-at 12 and 24 months after termination of the DA&A program. Data were obtained as part of a longitudinal study of 1,764 former SSI DA&A recipients in nine sites. Analyses indicate that a substantial number of former DA&A recipients, probably 45%–55%, were engaged in active drug use after termination of the program. Among users, cocaine and opiate use were extensive. Although there were high rates of underreporting by self-reported non-users, underreporting was not systematically associated with age, gender, ethnicity, criminal justice involvement, recent substance abuse treatment, or SSI benefit status.

Validating estimates of problematic drug use in England

Background

UK Government expenditure on combatting drug abuse is based on estimates of illicit drug users, yet the validity of these estimates is unknown. This study aims to assess the face validity of problematic drug use (PDU) and injecting drug use (IDU) estimates for all English Drug Action Teams (DATs) in 2001. The estimates were derived from a statistical model using the Multiple Indicator Method (MIM).

Methods

Questionnaire study, in which the 149 English Drug Action Teams were asked to evaluate the MIM estimates for their DAT.

Results

The response rate was 60% and there were no indications of selection bias. Of responding DATs, 64% thought the PDU estimates were about right or did not dispute them, while 27% had estimates that were too low and 9% were too high. The figures for the IDU estimates were 52% (about right), 44% (too low) and 3% (too high).

Conclusion

This is the first UK study to determine the validity estimates of problematic and injecting drug misuse. The results of this paper highlight the need to consider criterion and face validity when evaluating estimates of the number of drug users.

An enumeration method of determining the prevalence of users and operatives of cocaine and heroin in Central Harlem

INTRODUCTION

The investigators estimated the number and characteristics of crack, powder cocaine and heroin users and distributors ("operatives") in Central Harlem.

METHODS

Central Harlem was divided into 45 primary sampling units (PSUs) with 2 years of drug allegation data from the New York Police Department (NYPD) organized in three strata, those having high, middle or low levels of allegations. In nine randomly selected PSUs, interviewers employed chain referral sampling procedures that were steered by using a nomination technique.

RESULTS

Within sampled PSUs, 657 respondents nominated 5756 others for a total of 6413. Seven indicators identified 1007 unique individuals among 2835 nominated by two or more respondents, totaling to 4585 unique persons. These drug users and operatives were divided by the total number of persons in these PSUs according to the 1990 census to estimate the number of drug users and distributors in the 36 PSUs not sampled and for all 98,725 residents of Central Harlem. Approximately 13.4% of Central Harlem residents were estimated to be users of crack, powder cocaine and/or heroin with no roles in drug distribution. Approximately 6.7% of Central Harlem residents were estimated to be operatives of these drugs, some of whom may also have been users.

CONCLUSIONS

Enumeration techniques can be a basis for projecting prevalence estimates for crack, powder cocaine and heroin users and operatives in a large urban geographic area.