Dr Tim Millar
Cluster Title: Nationally Integrated Quantitative Understanding of Addiction Harms (NIQUAD)
Area of interest
NIQUADs objective is to enable key public health questions about addiction to be addressed by:
- Improving, integrating, and harmonising the information base
- Assessing the quality, precision, validity and consistency of available information
- Making data accessible to a wider range of expertise
- Developing methods to better exploit existing and new information sources
This requires parallel work on developing micro (record linkage) and macro (evidence synthesis) integration of available information. The former strand will integrate administrative and research data at the individual case level to create statistically powerful virtual cohorts that track pathways in and out of treatment, criminal justice, and healthcare, sequencing key events. Evidence synthesis will develop models that link all the available evidence to link and test its consistency and to examine the relationships between parameters.
NIQUAD will develop work in the following areas:
- Methodology/data resources: for example - approaches to data integration; refining case linkage; accounting for bias
- Estimating scale of substance-specific misuse/harms: for example - prevalence estimation via Bayesian capture-recapture; evidence synthesis to test the consistency of prevalence estimates with other information, and to integrate information on intervention effects, economic costs and natural history; quantifying /monitoring incidence; estimating cocaine prevalence
- Natural history, intervention effects and impact in reducing or magnifying harm: for example - quantifying temporal, population and economic protective effects of interventions; quantifying desistence, relapse and recidivism; embedding injecting and BBV transmission models within surveillance, database linkage, and evidence synthesis
NIQUAD includes: key experts in surveillance and substance use epidemiology; non-addiction scientists with high-level skills in relevant statistical, mathematical modelling and health economic techniques; and health informatics experts to support the development of data resources to fuel the planned work.
Policy direction
Policy makers need information about the size of the addiction problem, the amount of harm that arises from addiction, and the impact that their policies have in modifying such harm. Without this information it is difficult to know whether their policies are effective. However, measuring the scale of addiction and associated harm is a highly complex task: not least because socially stigmatised, and in some cases illegal, behaviour is often hidden from conventional, survey-based, research methods.
The information that is available to inform policy is limited, rarely integrated, and is often imprecise and (statistically) biased. In respect of drug use, the recent report An Analysis of UK Drug Policy (UKDPC) concluded that policy makers have to operate partially blind when choosing effective measures to reduce the serious harms associated with the use of illicit drugs.
NIQUAD will, initially, focus on drug injecting and the use of opiates or crack cocaine, which are policy priorities. It will combine, and then compare, different sorts of information to develop more exact estimates of how many people are involved, how many get involved in crime, trends in the proportion that die, and how helpful treatment has been in reducing death and crime. Using advanced statistical techniques, it will examine all of the available sources of information about drug misuse and bring these together to test whether they are consistent, to find out why inconsistencies occur, and to adjust the estimates to allow for any inconsistencies that are found. Thus NIQUADs findings will provide policy makers with the information they need in order to make decisions about how to deal with the addiction problem and how to spend public money wisely.
Co-Investigators
Prof Tony Ades
Prof Sheila Bird
Dr Daniela De Angelis
Prof Christine Godfrey
Dr Gordon Hay
Dr Matthew Hickman
Collaborators
Current:
- Prof Iain Buchan
- Prof Linda Davies
- Dr Michael Donmall
- Prof Graham Dunn
- Dr Sharon Hutchinson
- Dr Ruth King
- Dr John Marsden
- Dr Toby Seddon
- Dr Nicky Welton
Prospective:
Prof Bianca de Stavola
Prof Hamid Ghodse
John Ainsworth
Dr Martin Frisher
Dr Viv Hope
Dr Judith Aldridge
Dr Diane Atkinson
Andrew Jones
Prof Karen Hassell
Prof Bill Deakin
Prof Mohammed Abou-Saleh
Prof Peter John
Prof Mark Bellis
Prof Christine Barrowclough
John Corkery
Prof David Goldberg
Dr Janine Lamb
Prof Shon Lewis
Janette Logan
Faye Macrory
Dr Elizabeth Merrall
Dr Simon Moore
Will Morton
Craig Moss
Dr Carlos Nordt
Prof Andrew Pickles
Dr Mary Ramsey
Prof Tim Rhodes
Dr Roy Robertson
Dr Shaun Seaman
Dr Louise Sell
Prof Jennifer Shaw
Prof Colin Sibley
Anthea Springbett
Michael Sweeting
Dr Brian Tom
Dr Arpana Verma
Dr Peter Vickerman