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Technical Appendix

Drug Use Monitoring in Australia program glossary

Most serious offence (MSO) — The Australian Bureau of Statistics’ Australian and New Zealand Standard Offence Classification (ANZSOC) (ABS 2011) scheme is used to assign charges to eight categories—violent offences, property, drug, DUI (driving under the influence of alcohol and/or drugs), traffic, disorder, breach and other lesser offences. DUMA detainees are assigned to a most serious offence (MSO) category based on the charges recorded against them for their current detention by police. The charge nominated as the most serious is based on the following hierarchy, from most serious to least serious offence category:

  • violent;
  • property;
  • drug;
  • DUI;
  • traffic;
  • disorder;
  • breach; and
  • other lesser offences.

According to this classification, if a detainee has been charged with both a violent offence and a property offence, the detainee’s MSO is categorised as violent.

Any drug — Detainees described as testing positive to any drug tested positive via urinalysis to any of the following: amphetamines (methamphetamine, MDMA and/or other amphetamines), benzodiazepines, cannabis, cocaine or opiates (heroin, methadone, buprenorphine and/or other opiates).

Multiple drugs — Detainees described as testing positive to multiple drugs tested positive via urinalysis to two or more of the following: amphetamines (methamphetamine, MDMA and/or other amphetamines), benzodiazepines, cannabis, cocaine or opiates (heroin, methadone, buprenorphine and/or other opiates). A detainee who tested positive to more than one amphetamine (or opiate) type will not be recorded as a multiple drug user unless they also tested positive to another drug.

Overview of the Drug Use Monitoring in Australia program review

In January 2013, the AIC Executive temporarily suspended DUMA data collection to allow a review of the program’s relevance as a criminological and public health data collection system. This review meant data collection was not undertaken in the first and second quarter of 2013. Data collection was recommenced in the third quarter of 2013, using a rationalised number of collection sites. The DUMA questionnaire was also substantially revised during the review period. Direct comparisons with earlier annual reports should take into consideration the following changes:

  • in 2011–12, DUMA operated at nine sites. During the 2013–14 data collection period, DUMA operated at six sites—Adelaide, Bankstown, Brisbane, East Perth, Kings Cross and Surry Hills (see Tables A3 & A4);
  • in 2013–14, data collection at Bankstown and Kings Cross alternated each quarter (see Tables A3 & A4). Kings Cross operated during the first and third quarters of the 2013–14 data collection period and Bankstown operated during the second and fourth quarters. Surry Hills operated during the fourth quarter of 2013 and the first quarter of 2014;
  • prior to 2013, a detainee had to be in custody for less than 48 hours to be eligible for interview. Since the third quarter of 2013, detainees are eligible for interview if they have been in custody for less than 96 hours;
  • from 2012, urine samples have been collected in alternate quarters (see Table A3 & A4). For the 2013–14 data collection period, urine was collected in the third and fourth quarter of 2013 and the first and third quarter of 2014 at the Adelaide, Brisbane and East Perth sites. In New South Wales, urine was collected at Kings Cross in the third quarter of 2013 and the first and third quarters of 2014, urine was collected at Surry Hills in the fourth quarter of 2013 and the first quarter of 2014, and urine was collected at Bankstown in the fourth quarter of 2013; and
  • the MSO category of drink driving has been relabelled as DUI—driving under the influence of alcohol and/or illicit drugs—to more accurately reflect the inclusion of detainees who have been charged with drink and drug driving offences.

Drug Use Monitoring in Australia program data collection method

Participant eligibility

Interviewer access to detainees is facilitated by the police officer in charge of the watch house or police station, or their delegate. The police officer in charge determines a detainee’s eligibility for participation. This assessment of eligibility reflects the level of risk a detainee may pose to the interviewer. Detainees are not interviewed if they:

  • are deemed unfit for interview due to alcohol/drug/medication consumption;
  • are mentally unfit;
  • are children or juveniles (except for juveniles in New South Wales);
  • require an interpreter;
  • are considered to be potentially violent;
  • have been held in custody for longer than 96 hours; or
  • are deemed ineligible for other reasons at the discretion of the custody manager.

Data collection shifts are scheduled for times of the day and days of the week when the number of detainees is expected to be at a maximum, within a set four week collection period. During data collection shifts all eligible detainees are asked to participate in the study.

In 2013–14, 635 detainees were deemed by police to be unfit for interview—this represents 13 percent of the potential sample. The percentage deemed unfit for interview varied by site, ranging from a high of 30 percent of detainees in Adelaide, followed by Kings Cross (14%), Bankstown (11%), East Perth (7%), Brisbane (4%) and Surry Hills (1%). As a consequence, the DUMA sample is not a random sample of all persons detained by the police.

DUMA interviewers do not have access to persons processed by police away from the watch house or police station. In all jurisdictions, alleged offenders can be processed off-site through methods such as diversion programs, notices to attend court (or the equivalent) and cautions. Normally, police would give notices or cautions for minor offences. Diversion programs may be used for drug possession cases and cases involving juvenile offenders.

State legislation governs the length of detention, reason for detention and procedures for detention. This may influence the potential for detainees to be interviewed; sites with longer holding periods provide greater opportunities for participation.

Given the high rate of recidivism in the detainee population, it is likely that a small group of detainees will appear twice or more across quarterly collection periods. As participation is anonymous and detainee names are not recorded, individuals cannot be tracked across interview periods. Strictly speaking, the sample is one of ‘episodes of detention’ rather than ‘individual detainees’. Detainees are asked at the end of the interview if they recall participating in the study on a previous occasion. In 2013–14, 418 detainees—representing 12 percent of the sample—confirmed they had previously participated in the DUMA study; a further 25 detainees could not recall whether they had previously participated.

It is important to note that although the DUMA sites are referred to by the name of the area in which they are located, the catchment area may not necessarily reflect the suburb or city boundaries. Because of this, the estimated size of the catchment area varies between the six DUMA sites.

Consent

If eligible, a detainee is approached by a police officer or interviewer and asked if they are willing to participate in the DUMA study. Detainees are informed that the researcher is independent of the police and that anything they say will be treated in strict confidence.

If the detainee declines to be interviewed, the reason for their refusal is recorded on a separate interview form known as a refusal form. Their decision not to participate has no impact on their criminal case or subsequent processing by the police.

If the detainee agrees to be interviewed, informed consent procedures are undertaken. The interviewer advises the detainee that the research project is Commonwealth Government-funded and that participation is confidential and voluntary. The detainee is provided with a plain language information statement describing the aims of the project. The detainee is informed that they may end the interview at any time and that they can choose not to answer individual questions. Detainees are informed that they can make a complaint to watch house staff or the AIC ethics secretariat if they feel they have been treated unfairly or unethically. The detainee is then asked to consent to a structured interview and provide a urine sample (during relevant collection periods). Detainees’ interview responses are included in the DUMA study regardless of whether they provide a urine sample.

At several points during the interview—before questions relating to drug use and prior offending—detainees are reminded of the confidential nature of the research. The detainee’s name is never recorded on the survey or urine sample.

In New South Wales, juveniles are interviewed if both they and their primary caregiver give consent.

Provision of a urine sample

During relevant collection periods, detainees are asked to provide a urine sample at the end of the interview.

Eligibility for urine collection depends on the length of time in custody. Only detainees who have been in a custodial setting for less than 48 hours are deemed eligible to provide a urine sample.

Detainees who refuse to provide a urine sample are read the following statement:

Your participation is completely voluntary, but I would like to remind you that no names will appear on the specimen and the results will not be given to the police or affect the outcome of your case. An independent laboratory will perform the analysis, and the sample will be destroyed as soon as the tests have been done. There is no way that the results can be tied back to you. The urine sample cannot and will not be used for DNA extraction. Would you agree to provide a sample?

If a detainee declines to provide a urine sample after the second prompt, they are thanked for their participation and escorted back to their cell.

If a detainee agrees to provide a urine sample, they are given a urine collection bottle and escorted to an appropriate location to provide the sample. The sample is then returned to the interviewer and the detainee is escorted back to their cell.

Urine samples are given a unique barcode, refrigerated and sent to an authorised testing laboratory in New South Wales.

Charge and demographic information

At the completion of each interview and for each detainee for whom a refusal form is completed, interviewers collect charge and demographic information (year of birth, gender and adult/juvenile status) from police charge records. A maximum of 10 charges can be recorded. All charges recorded must relate to the detainee’s current period of police custody. Protocols for collecting charge information vary between jurisdictions. Gender is recorded based on the gender assigned on police charge records.

Completed interview forms are locked in a secure cabinet until the end of the four-week collection period, at which time they are couriered to the AIC via safe handling or registered mail.

Drug testing

Research has documented the shortcomings of relying solely on self-report data when reporting on drug use (see Makkai 1999). Some of the issues affecting self-report data include the respondent’s ability to accurately recall events (especially drug use over defined periods of time) and their willingness to share information of a sensitive nature with interviewers. These shortcomings are likely to result in the under-reporting of particular behaviours, including drug use and participation in illegal activities. In order to enhance the veracity of self-report information obtained from police detainees, and as a cross-validation measure, the DUMA program conducts urinalysis on the urine samples voluntarily provided by police detainees. Urine testing is the most cost-effective means of objectively measuring the presence of illicit drugs. It is also a scientifically valid measure of drug use within the known limits of the test.

Urinalysis

Urinalysis screening is conducted for five drug classes—amphetamines, benzodiazepine, cannabis, cocaine and opiates—and secondary screening tests are conducted for the opiate pharmacotherapy substances methadone and buprenorphine. A positive result is recorded when the drug or its metabolites are detected at or above the cut-off levels set in accordance with Australian Standards (prescribed at AS/NZS 4308). If a positive result is obtained for opiates or amphetamines, a further set of tests using confirmatory gas chromatography-mass spectrometry (GC/MS) is performed to ascertain which specific drugs are present in the urine. Opiates are then classified as either heroin or other opiates (including prescription opiates). Amphetamines are classified as methamphetamine, MDMA, or other amphetamines (including prescription amphetamines). Urinalysis results indicate whether the drug was consumed shortly before detention, with the exception of cannabis and benzodiazepines. A positive test indicates prior use within up to 30 days for cannabis and 14 days for benzodiazepines. Table A1 indicates the average detection times and the cut-off levels for a positive screen.

There are five important points to note about urinalysis:

  • the screen detects the class of drug, not the specific metabolite;
  • false positives and false negatives can occur, although cut-off levels are designed to minimise their frequency;
  • detection times can vary depending on the individual person and specific rates of metabolism and excretion;
  • a positive result does not necessarily imply illicit use; and
  • the presence of the drug does not necessarily mean the person was intoxicated or impaired.

In 2006, further testing was carried out on buprenorphine results as a cross-checking mechanism. Results from these tests indicated a high level of reliability (over 80%). For more information see Mouzos et al (2007).

All drug testing for the program is conducted at one laboratory, NSW Forensic & Analytical Science Service, Drug Toxicology Unit a business unit of the Northern Sydney Area Health Service. The laboratory is accredited to Australian Standard AS/NZS 4308: 2008. The laboratory provides urinalysis test results to the AIC in electronic form. At no point are police or local data collectors informed of individual test results. All urine samples are destroyed once the AIC receives and validates the results.

Table A2 shows the percentage of detainees who tested positive for heroin, methamphetamine or cocaine use by self-reported drug use in the previous 48 hours and previous 30 days. There is a higher level of under-reporting for recent use (past 48 hours) than for use in the past 30 days. Less than half of those who tested positive to heroin, methamphetamine and cocaine reported that they had used the substance in the previous 48 hours. For the previous 30 days, self-reporting increased to almost two-thirds of those who tested positive for heroin, methamphetamine and cocaine. From 2013 to 2014, the level of discrepancy between reported use and urine results has remained relatively consistent for heroin and methamphetamine, while the level of discrepancy for cocaine decreased by 15 percentage points. However, this difference may be a result of the small number of detainees who tested positive to cocaine in 2013 and 2014.

Quality control processes

Before each data collection period, interviewers undergo training in the questionnaire and operational procedures specific to their site.

During data collection, site coordinators audit each questionnaire and report any errors back to interviewers.

At the completion of the data collection quarter, the AIC audits all questionnaires. Error reports are compiled by the AIC and distributed to each site manager prior to the next quarter. Errors that frequently occur are:

  • nil responses to particular questions, where an interviewer fails to record a response to a mandatory question;
  • non-recognition of internal skip patterns, where an interviewer incorrectly follows a specified skip pattern, leaving some mandatory questions unanswered; and
  • incorrect coding.

The AIC also monitors the level of urine provision compliance at both the site and interviewer level. This internal monitoring allows for the identification of emerging issues and provides an opportunity to address individual or site-based problems if and when they arise.

Teleconferences are held at regular intervals with members of the AIC’s DUMA team and site coordinators and managers. The teleconference is a forum in which issues related to the administration of the questionnaire or addendum can be discussed.

Data entry

The questionnaire results are entered into a database by an external data entry contractor, and the dataset is returned to the AIC for cleaning and analysis. Questionnaire responses and urinalysis data are matched by the AIC using barcode numbers.

Response rates

As at December 2014, 5,278 detainees had refused to be interviewed, 51,748 had agreed to be interviewed and 37,398 had provided a urine sample; of those who agreed to answer the questionnaire, 7,382 refused to provide a urine sample and 4,719 did not provide a urine sample for other reasons such as being unable to produce a specimen or not being eligible for urine collection, or because urine samples were not being collected during that quarter.

Tables A3 and A4 provide information on the fieldwork dates for the 2013–14 quarterly data collections. This includes information on the periods during which fieldwork was undertaken, the number of hours interviewers were in the police station or watch house, the number of detainees approached and interviewed and the number of urine samples collected at each site. As noted earlier, the AIC Executive temporarily suspended data collection in order to review the program; this meant DUMA data collection was not undertaken during the first and second quarter of 2013.

In 2013–14, a total of 3,497 detainees were interviewed, of whom 3,456 were adults aged 18 years and over; thirty-five were 17 years of age from Brisbane; and six were juvenile detainees from the three NSW sites. In 2013–14, of those who agreed to be interviewed in a urine collection quarter and who were eligible to provide a urine sample, 71 percent provided a urine sample. The rate of urine provision compliance in 2014 (74%) was six percentage points higher than in 2013 (68%). The collection rate achieved in 2013–14 is consistent with that recorded in previous years.

Table A5 sets out the response rates for adult detainees who agreed to an interview. The data show there are no substantial differences by gender and response rates are generally consistent across sites—with the exception of Adelaide, where male detainees were eight percentage points more likely than females to agree to be interviewed (58% cf 50%).

There were a number of differences between sites in the provision of urine samples. At the Adelaide, Bankstown, Kings Cross and Surry Hills sites, female detainees were more likely than males to provide a urine sample, whereas at East Perth female detainees were less likely than males to provide a urine sample. In Brisbane, male and female detainees were equally as likely to agree to the provision of a urine sample. Given the small sample size of females across the NSW sites, these differences should be interpreted with caution.

The response rates obtained by the DUMA program are higher than those normally achieved in social science research in Australia; for example, the response rate for interview (69%) is higher than that achieved by the Australian National Drug Strategy Household Survey (49%; AIHW 2014). Response rates for DUMA are calculated by dividing the number of those who agreed to be interviewed by the potential sample—that is, it includes detainees who were deemed ineligible (eg those who were mentally unfit or potentially violent) or were unavailable (eg due to watch house constraints or being taken to court). If the response rate is calculated by dividing the number of those who agreed to be interviewed by the number of detainees who were eligible but who refused to be interviewed only (ie those who declined to police or the DUMA interviewer), the response rate increases to 87 percent.

Ethics

The AIC Human Research Ethics Committee (HREC) first approved the DUMA project in January 1999 as a three year pilot study. Continuation of the DUMA project was subsequently approved by the AIC HREC in December 2001, November 2003, November 2010 and July 2013. Addenda administered as part of the DUMA questionnaire are also approved by the AIC HREC.

Oversight committees

Each jurisdiction has a local steering or advisory committee, which is engaged as needed to discuss key issues around DUMA methodology and operation. The committee’s role is to support the local data collectors, monitor the local progress of the study, suggest ways of improving the project and ensure the dissemination of information at a local level to relevant agencies.

An important aspect of the DUMA program is the dissemination of questionnaire and urinalysis results to stakeholders as soon as practicable after their receipt by the AIC. Test positive rates for drugs and a list of detainee responses relating to new and re-emerging drugs are developed for each quarter in which data are collected in order to provide timely intelligence to inform local policy and strategic initiatives. The dissemination of questionnaire and urinalysis results ensures those in law enforcement who are tasked with tackling local crime issues are equipped with the most up-to-date DUMA data for their area.

Uses of DUMA data

The DUMA program continues to provide a unique source of data collected from people detained in police custody. DUMA is the only Australian survey of police detainees conducted on a routine basis, and there is no other regular source of data on drugs and offending among this population in Australia. The continuing aim of DUMA is to provide timely and accurate information about trends in alcohol and drug use among Australian detainees to support and inform policy, evaluations and strategic planning. Because data are collected, audited and documented under the same set of protocols for each site, greater confidence can be placed in their comparability, validity and reliability.

As well as the information published through monitoring reports, DUMA data are regularly used by law enforcement agencies, healthcare organisations, government policymakers and researchers. Quarterly addenda administered with the primary questionnaire provide the opportunity to examine data on a broad range of criminological topics of specific research interest. Addenda findings were used by the AIC in 2013–14 to inform several research papers exploring issues such as drink and drug driving, substitution patterns during periods of reduced illicit drug availability, the use of the Internet to obtain illicit drugs, and detainees’ intentions to seek help from informal and formal sources for drug misuse.

As of 2013, the AIC has made the DUMA addenda space available for purchase by other organisations and researchers. If you wish to purchase space in the DUMA addenda, please contact the AIC at duma@aic.gov.au.

Table A1 Cut-off levels and drug detection times
Drug class Cut off AS 4308 (ug/L) Average detection timea
Amphetamines 300 2–4 days
Benzodiazepines (hydrolysed) 100 2–14 days
Cannabis 50 Up to 30 days for heavy use; 2–10 days for casual use
Cocaine 300 24–36 hours
Methadone 300 2–4 days
Opiates 300 2–3 days
Buprenorphine 5 2–7 days

a: Depends on testing method and equipment, the presence of other drugs, level of drug present and frequency of use

Source: Makkai 2000

Table A2 Comparing and self-reported drug use (%)a,b
Self-reported use past 48 hours Self-reported use past 30 days Total (n)
Yes No Yes No
Heroin Positive urinalysis result 48 52 69 31 119
Negative urinalysis result 2 98 5 95 1,432
Methamphetamine Positive urinalysis result 55 45 81 19 530
Negative urinalysis result 2 98 18 82 1,021
Cocaine Positive urinalysis result 26 74 35 65 31
Negative urinalysis result 1 99 4 96 1,520

a: Results for 2013–14

b: The figures reflect adult detainees aged 18 years and over only

Source: AIC DUMA collection 2013–2014 [computer file]

Table A3 Fieldwork information, 2013
Quarter Site Period Hours in facility Detainees approached (n) Detainees interviewed (n) Specimens collected
3 Adelaide 20.07.13–16.08.13 300 201 126 68
Brisbane 01.07.13–30.07.13 390 215 202 177
East Perth 28.07.13–26.08.13 307 302 180 103
Kings Cross 10.07.13–04.08.13 320 63 48 32
4 Adelaide 05.10.13–01.11.13 307 186 115 53
Bankstown 02.11.13–03.11.13 320 77 53 36
Brisbane 07.10.13–03.11.13 360 224 213 194
East Perth 13.10.13–10.11.13 311 330 187 92
Surry Hills 01.11.13–30.11.13 176 33 33 20
Total All sites 2013 2,791 1,631 1,157 775

Source: AIC DUMA collection 2013–14 [computer file]

Table A4 Fieldwork information, 2014
Quarter Site Period Hours in facility Detainees approached (n) Detainees interviewed (n) Specimens collected
1 Adelaide 11.01.14–07.02.14 303 204 111 60
Brisbane 06.01.14–02.02.14 360 213 192 174
East Perth 19.02.14–16.01.14 365 342 221 158
Kings Cross 15.01.14–09.02.14 160 39 29 18
Surry Hills 15.01.14–09.02.14 160 37 30 23
2 Adelaide 29.04.14–26.05.14 304 205 119 NA
Bankstown 09.04.14–04.05.14 320 79 54 NA
Brisbane 07.04.14–04.05.14 210 221 209 NA
East Perth 06.04.14–04.05-14 288 363 229 NA
3 Adelaide 26.07.14–22.08.14 300 244 138 67
Brisbane 07.07.14–03.08.14 390 223 209 178
East Perth 06.07.14–03.08.14 288 284 157 104
Kings Cross 16.07.14–10.07.14 295 60 36 19
4 Adelaide 23.10.14–19.11.14 304 242 117 NA
Bankstown 15.10.14–14.11.14 320 100 62 NA
Brisbane 06.10.14–02.11.14 390 255 248 NA
East Perth 05.10.14–03.11.14 288 316 179 NA
Total All sites 2014 5,045 3,427 2,340 801

Source: AIC DUMA collection 2013–14 [computer file]

Table A5 Response rate by gender and adult status, 2013–14
Adelaide Bankstown Brisbane East Perth Kings Cross Surry Hills
Adult males
Approached (n) 1,064 198 1,070 1,538 114 53
Agreed to interview (n) 616 137 1,001 923 85 50
Agreed to interview (%) 58 69 94 60 75 94
Agreed to interviewa during urine collection quarters (n) 406 44 610 597 85 50
Provide urine specimen (n) 204 28 572 378 50 33
Provided urine (of those who agreed to interviewa during urine collection quarters; %)b 50 64 94 63 59 66
Adult females
Approached (n) 218 40 246 397 40 12
Agreed to interview (n) 110 29 237 230 27 11
Agreed to interview (%) 50 73 96 58 68 92
Agreed to interviewa during urine collection quarters (n) 79 7 137 133 27 11
Provide urine specimen (n) 44 6 129 79 19 9
Provided urine (of those who agreed to interviewa during urine collection quarters; %)b 56 86 94 59 70 82
Juveniles
Approached (n) 0 18 0 0 8 5
Agreed to interview (n) 0 3 0 0 1 2
Agreed to interview (%) 0 17 0 0 13 40
Agreed to interviewa during urine collection quarters (n) 0 2 0 0 1 2
Provide urine specimen (n) 0 2 0 0 0 1
Provided urine (of those who agreed to interviewa during urine collection quarters; %)b 0 100 0 0 0 50
Brisbane 17 year olds
Approached (n) 0 0 35 0 0 0
Agreed to interview (n) 0 0 35 0 0 0
Agreed to interview (%) 0 0 100 0 0 0
Agreed to interviewa during urine collection quarters (n) 0 0 24 0 0 0
Provide urine specimen (n) 0 0 22 0 0 0
Provided urine (of those who agreed to interviewa during urine collection quarters; %)b 0 0 92 0 0 0

a: Detainees who have been in custody for less than 48 hours

b: Percentage has been calculated for the quarters in which urine samples were requested, which in 2013 was both quarters and in 2014 was 2 out of 4 quarters