Heritage: from DMD to NDTMS

The National Drug Treatment Information System (NDTMS) was devised in 2003, following a major review of information requirements around drug misuse treatment carried out for the Department of Health by Donmall, Hickman and Glavas (2000). The name NDTMS was coined by these authors.

The system built upon an earlier system, the first of its’ kind in Europe, that was called the Drug Misuse Database (DMD). This was originated as part of research at the University of Manchester in the late 1980s (Strang and Donmall, 1985), rolled out nationally and published by Donmall (1990) following a commission by the Department of Health.

This paper-based system was run by the University of Manchester team for more than a decade. The National Drug Evidence Centre (NDEC) and its’ predecessor Drug Misuse Research Unit (DMRU) developed the information system, trained staff nationally and implemented DMD in all Regional Health Authorities across the country, also receiving, processing, analysing and delivering the national data reports for England.

During this time the system became adopted also by Northern Ireland, Wales and Scotland, with the Manchester team leading and supporting these developments.

Concurrently, the system was brought together with initiatives in the Netherlands, Spain, and Germany, to form the first Treatment Demand Indicator (TDI), Simon, Donmall, Hartnoll, Kokkevi, Ouwehand, Stauffacher, Vicente (1999), Montanari, Guarita, Noor, Wiessing, Gomes, Hedrich, Pirona Simon, Vicente, Donmall, Best, Taylor, Maffli (2012). This is one of 5 Key Epidemiological Indicators that has been adopted across the whole European Community and is managed by the European Monitoring Centre on Drugs and Drug Addiction in Lisbon. In 2006 the United Nations commissioned a Global Toolkit to measure drug treatment demand, based on this work.

Since 2003 the development of NDTMS in England has been steered first by the National Treatment Agency and then 2013 by Public Health England. The system has been modified greatly to take on new information requirements at a local and national level, and contains many more fields and indicators than originally, even though the basic methodology, many of the codes, and the method of classifying drug types, still follows the original DMD.

Since 2003, complex analysis and communication of results via a web portal has been carried out by the National Drug Evidence Centre at the University of Manchester. Data are published monthly and many analyses have the status of National Statistics. This is both a public facing and restricted access site. Data are utilised daily by service providers, commissioners and national policy makers. Over the years the data have been extensively used for research: eg National Cocaine Treatment Study, Outcome of Waiting Lists, Drug Treatment Outcomes Research Study, Payment by Results Pilot Evaluation and Alcohol Capacity Project – see below example outputs.

Key DMD/ NDTMS/ TDI References:

Donmall M (1990) The Drug Misuse Database: Local Monitoring of Presenting Problem Drug Use. London, Department of Health, HMSO, ISBN 1 85197 541 1

Donmall M (1999) UK Monitoring of Problem Drug Users: the Drug Misuse Database - A System Based on Regional Centres. European Addiction Research, 5: 185-190

Donmall M, Hickman M, Glavas R (2000) New DMD: Specification for the new National Drug Treatment Monitoring System Parts 1 & 2: A review consultancy. London, Department of Health Donmall M (2006) Guidance for the measurement of drug treatment demand. Global Assessment Programme on Drug Abuse, Toolkit Module 8. (Translated into 6 languages). New York, United Nations Office on Drugs and Crime

Montanari L, Guarita B, Noor A, Wiessing L, Gomes F, Hedrich D, Pirona A, Simon R, Vicente J, Donmall M, Best D, Taylor C, Maffli E (2012) Treatment Demand Indicator: Standard Protocol 3.0: Guidelines for reporting data on people entering drug treatment in European countries. Luxembourg: Publications Office of the European Union, 2012. ISBN 978-92-9168-507-3

Simon R, Donmall M, Hartnoll R, Kokkevi A, Ouwehand AW, Stauffacher M, Vicente J (1999) The EMCDDA/Pompidou Group Treatment Demand Indicator. A European Core Item Set for Treatment Monitoring and Reporting. European Addiction Research, 5, 4: 197-207

Strang J, Donmall M (1985) Drug Addiction: A New Notification Form. Manchester Medicine, 1, 16

Simon R, Pfeiffer T, Hartnoll R, Vicente J, Luckett C, Stauffacher M, Donmall M, Kokkevi A, Ouwerhand A (1999) EMCDDA Scientific Report: Treatment Demand Indicator Standard Protocol 2.0. European Monitoring Centre for Drugs and Drug Addiction.

Some Research References:

Mason T, Sutton M, Whittaker W, McSweeney T, Millar T, Donmall M, Pierce M, Jones A (2015) The impact of paying service providers for outcomes: difference-in-differences analysis of ‘payment by results for drugs recovery’ pilot. Addiction, 110(7): 1120-8

Gilchrist, G, Singleton, N, Donmall M, Jones A (2015) Prevalence and factors associated with sex trading in the year prior to entering treatment for drug misuse in England. Drug and Alcohol Dependence, 152: 116-122

Hayhurst KP, Leitner M, Davies L, Flentje R, Millar, T, Jones A, King C, Donmall M, Farrell M, Fazel S, Harris R, Hickman M, Lennox C, Mayet C, Senior J, Shaw J (2015) The effectiveness and cost effectiveness of diversion and aftercare programmes for offenders using Class A drugs: a systematic review and economic evaluation. Health Technology Assessment, 19: 6 ISSN 1366-5278

Millar T, Hayhurst KP, Jones A, Davies L, Weston S, Dunn G, Donmall M (2014) Factors associated with receipt of residential rehabilitation by opiate users indicate that these clients are more amenable to drug treatment. Drugs: education, prevention and policy, 21(2): 165–172

Donmall M, Jones A, Weston S, Davies L, Hayhurst K, Millar T (2012) The Drug Treatment Outcomes Research Study (DTORS): research design and baseline data. Open Addiction Journal, 5, 1-11

Hagel A, Aldridge J, Meier P, Millar T, Symonds J, Donmall M (2012) Trends in adolescent substance use, their implications for understanding trends in mental health. In: Changing Adolescence: Social trends and mental health. Ed. Ann Hagel. The Policy Press, Bristol

Donmall M, Millar T (2009) The effect of waiting for treatment. In: Responding to Drug Misuse: Research and Policy Priorities in Health and Social Care. Ed. Susanne MacGregor, Routledge Jones A, Donmall M, Millar T, Moody A, Weston S, Anderson T, Gittins M, Abeywardana V, D’Souza J (2009) The Drug Treatment Study Outcomes Research Study (DTORS): Final Outcomes Report. London, Home Office ISBN 978 1 84987 123 5

Donmall M, Watson A, Millar T, Dunn G (2005) Outcome of Waiting Lists (OWL) Study. Drugs: education, prevention and policy, 12, Supp 1, 62-68

Meier P, Barrowclough C, Donmall M (2005) The role of the therapeutic alliance in the treatment of drug misuse: a critical review of the literature. Addiction, 100(3), 304-316

Meier P, Donmall M, Barrowclough C, McElduff P, Heller R (2005) Predicting the early therapeutic alliance in the treatment of drug misuse. Addiction, 100(4), 500-511

Millar T, Donmall M, Jones A (2004) Treatment Effectiveness: demonstration analysis of treatment surveillance data about treatment completion and retention. NHS Briefings Paper, December 2004. London, National Treatment Agency for Substance Misuse

Millar T, Gemmell I, Hay G, Donmall M (2004) The dynamics of drug misuse: assessing changes in prevalence. Home Office Report 35/04. London, Home Office

Advisory Council on the Misuse of Drugs. (2003) Chapter 1: Estimates of the Scale of the Problem Donmall M, Meier PS, McKeganey N and Hay G (2003). In: Hidden Harm – Responding to the needs of children of problem drug users. ACMD London, Home Office. ISBN 1-84473 035 2