The novel use of endemic corridors for addictive behavior surveillance in Spain

To describe the pattern of contacts with the healthcare system associated with drug use in Spain in the years 2022 and 2023. For the period 2016-23, data derived from a registry of activity in specialized care, included in the clinical-administrative database of Spanish hospitals (Registro de Atención Especializada-Conjunto Mínimo Básico de Datos), were extracted. Contacts with the healthcare system associated with alcohol, cannabis, cocaine, morphine derivatives, and sedative-hypnotics use were analyzed. The methodology of endemic corridors was applied for each drug category based on data from 2016-21. The series of contacts in 2022 and 2023 were then represented in the corridors to compare their expected and observed pattern. A total of 193 433 contacts associated with the use of alcohol (90 735), cannabis (39 730), cocaine (23 485), morphine derivatives (4888), and sedative-hypnotics (34 595) were analyzed for the period 2016-23. Of the contacts, 70.3% corresponded to men and 23.4% corresponded to people aged 45-54. The number of contacts increased for all categories of drugs in 2022 and 2023. This increase was reflected in the corridors, where contacts were mainly located in alert zones, and sometimes in epidemic zones. The results of this study show that endemic corridors allow the surveillance of the pattern of contacts with the healthcare system associated with drug use and, indirectly, of drug use itself. This methodology should be further studied as a complement in epidemiological surveillance of addictive behaviors at a population level.