Harm to Others from Substance Use and Abuse: The Underused Potential in Nationwide Registers

This article considers the potential in using nationwide registers to study harm to others from substance use and abuse. The advantages of using registry data include the opportunity to include the data on the entire population nationwide and continuously updated longitudinal datasets; they allow for studying small subpopulations and have little missing data. Personal identification numbers and family numbers enable linkage of data from different registers. Such datasets can include extensive information on individual and family levels. In this article, we provide an introduction to nationwide registers and explain how they can be applied to investigate two types of third-party harms: harm to children and harm to partners/spouses from substance use and abuse in parents and partners/spouses. Finally, we discuss challenges, benefits, and ethical considerations regarding the use of such data.

Substance use and abuse contribute not only to harm to the user but also to third parties. Current estimates of the prevalence and extent of harm to others from substance use and abuse may be unreliable partly because persons with substance use problems are less likely to respond to surveys.¹ Nationwide registers provide a unique opportunity to study harm to others from substance use and abuse that can contribute to more reliable estimates of the prevalence and extent of such harms. Registry data enable studying the entire populations for long periods of time; they often include large samples and are therefore well suited to study small patient groups and rare outcomes. Despite these advantages, registry data are rarely used to study harm to others from substance use and abuse. We aim to provide information that make more researchers aware of the possibilities with registry data, alone or in combination with survey data, to answer research questions on this topic in both clinical and general populations. We describe relevant registers and how they can be applied to investigate two types of third-party harm: (1) harm to children from in utero exposure to substances^2,3 and from growing up with parents who use or abuse legal and/or illegal substances^4,5 and (2) harm to spouses/partners. We also discuss challenges, benefits, and ethical considerations regarding the use of such data. It is beyond the scope of this article to cover how all registers available across countries can be used to study harm to others from substance use and abuse. Instead, we use the Norwegian setting as an example of how nationwide registers can be applied to address such research questions. However, we also refer to examples from other countries….

Full article at:  http://goo.gl/CTwAKp

By:  Lund IO1, Bukten A2.

• 1The Norwegian Institute of Alcohol and Drug Research (SIRUS), Oslo, Norway.
• 2Norwegian Centre for Addiction Research, Oslo, Norway. 

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