Developing a sentinel network for illicit substance use monitoring in Spain: a qualitative approach to key...

Sentinel surveillance networks have been developed in different countries to monitor changes in patterns of addiction. The aim of this study was to ascertain fundamental aspects required for the design and implementation of a sentinel network for the surveillance of illicit drugs use in Spain.

Internationally, sentinel networks vary in organization, collaboration, and informants. Some rely on hospital emergency departments, such as Euro-DEN Plus and SISVEA; others include community pharmacists (Addictovigilance, Catalan Sentinel Pharmacies) or drug users themselves (IDRS, EDRS). Networks like N-DEWS and CCENDU combine real-time community data with epidemiological analysis. The challenges identified in the literature include the inclusion of drug users as informants due to reliability concerns, inconsistencies in data collection across health services, and professional fatigue. While focused on Spain, these findings may also be relevant for other countries with comparable public health challenges.

This qualitative study, based on focus groups with key informants, offers recommendations for the creation of a multidisciplinary, flexible sentinel network adapted to the Spanish context. Integration of professionals from diverse sectors, training in toxicology and digital tools, and mechanisms for feedback and motivation are critical. These insights can support clinical early detection, improve alert dissemination, and serve as a foundation for future research on surveillance systems for substance use.