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Thematic analysis with ATLAS.ti, guided by SRQR-adherent triangulation, identified four design categories and 13 subcategories. Results support a multidisciplinary, flexible sentinel network integrated into existing surveillance systems to enable sustainable early 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are sentinel networks important for drug use surveillance?","Question",{"text":62,"@type":63},"They can address the time lag between conventional reporting systems and population-level perception, enabling earlier detection of emerging consumption patterns and new psychoactive substances.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How was the qualitative study conducted?",{"text":67,"@type":63},"From February to May 2025, the study used three focus groups and four in-depth interviews with 13 experts, and analyzed data thematically using ATLAS.ti with triangulation guided by SRQR guidelines.",{"name":69,"@type":60,"acceptedAnswer":70},"What key categories and subcategories were identified for the sentinel network design?",{"text":71,"@type":63},"The study identified four categories with 13 subcategories, covering alert activation criteria, selection of key informants, management and temporality of alerts, and enabling factors for 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Florida  \nBrown University School of Public Health  \nUniversity of Santiago de Compostela  \nUniversity of Santiago de Compostela  \ndrug use, sentinel surveillance, qualitative research, public health  December 15th, 2025  \n [https://doi.org/10.21203/rs.3.rs-8165107/v1](https://doi.org/10.21203/rs.3.rs-8165107/v1)  \n 􀁱 􀅏 This work is licensed under a Creative Commons Attribution 4.0 International License.  \nRead Full License  \n No competing interests reported.  \nAn effective surveillance program of drugs and addiction requires timely detection of emerging consumption patterns and new psychoactive substances. The time lag between conventional reporting systems and population-level perception creates a gap that can be more effectively addressed through sentinel networks.  \nA qualitative study was conducted between February and May 2025. A total of 13 regional, national and international experts in public health, drug policy, prevention, epidemiology, and digital technologies participated in three focus groups and four in-depth interviews. Data were analyzed thematically using ATLAS.ti, with triangulation of researcher data with adherence to SRQR guidelines to ensure rigor.  \nFour categories and 13 subcategories were identi«ed for the design of a sentinel network on drug use:  \n( 1) De« nition and criteria for activating sentinel alerts; (2) Selection of key informants;(3) Management and temporality of alerts; and (4) Enabling factors for sustainability.  \nA sentinel network for drug use should be multidisciplinary, ¬exible, and integrated into existing surveillance structures. Incorporating diverse perspectives and information, ensuring adequate professional support, and establishing mechanisms for motivation and sustainability are essential. This system could enhance early detection and serve as a model for substance use surveillance incomparable contexts.  \nSurveillance of drug use and the determinants of use remains a constant challenge for public health systems. Despite advances in surveillance methods, there is a time lag between changes in consumption patterns occurring in community settings and their detection by surveillance systems. This delay often leads to late detection of emerging phenomena, such as the use of new psychoactive substances (NPS), shifts in patterns of use or changes in the pro«le of consumers (1) .  \nAn international review of drug surveillance systems showed that they commonly rely on consolidated data and are structured for the monitoring of de«ned indicators ( 1) . However, these systems are not  \ndesigned to capture signals from more informal settings such as social networks or local nongovernmental agencies (NGOs), highlighting the need for complementary approaches with greater contextual sensitivity (2) .  \nTo strengthen their surveillance systems, some countries have adopted a sentinel approach based on the collection of signals from the active participation of professionals or strategic sites that serve as\"key informants\". The National Drug Early Warning System (NDEWS) in the United States is an outstanding example of an integrated approach to drug surveillance. This early warning system employs multiple forms of surveillance, in which key informants from diverse «elds act as a sentinel site director, referring signals to the coordinating center. Through this approach, the system enables a comprehensive characterization of substance use and facilitates the early identi«cation of emerging drugs and their availability (3) . At the European level, the European Union Drug Agency (EUDA) has also promoted sentinel surveillance through the Euro-DEN Plus program. This initiative collects information from hospital emergency departments across several European countries and integrates it with information from other indirect toxicological sources. Each country participating in this network contributes its own data,","cbCaingX174ORtYw","https://ap.wps.com/l/cbCaingX174ORtYw","pdf",872413,18,"English","# Background and rationale\n## Why sentinel surveillance is needed\n## Limits of conventional and indicator-based systems\n# Study design and methods\n## Qualitative approach and reporting standards\n## Participants and sampling\n## Data analysis strategy\n# Design considerations for sentinel alerts\n## Definition and criteria for activating alerts\n## Selection of key informants\n## Management and temporality of alerts\n## Sustainability enabling factors\n# Implications for practice","[{\"question\":\"Why are sentinel networks important for drug use surveillance?\",\"answer\":\"They can address the time lag between conventional reporting systems and population-level perception, enabling earlier detection of emerging consumption patterns and new psychoactive substances.\"},{\"question\":\"How was the qualitative study conducted?\",\"answer\":\"From February to May 2025, the study used three focus groups and four in-depth interviews with 13 experts, and analyzed data thematically using ATLAS.ti with triangulation guided by SRQR guidelines.\"},{\"question\":\"What key categories and subcategories were identified for the sentinel network design?\",\"answer\":\"The study identified four categories with 13 subcategories, covering alert activation criteria, selection of key informants, management and temporality of alerts, and enabling factors for sustainability.\"}]","Key Considerations in the Design of a Sentinel Network for Drug Use - Qualitative Findings | PDF",1790741162,45]