Crack cocaine in the Dublin region - Health Research Board

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9.7 Key findings• Internationally, the most successful approaches to reducing or ceasing crackuse are the psychosocial interventions (such as cognitive behavioural therapy);however, these interventions can only be successful if the user is attracted toand retained in treatment. In order to attract people into a treatment programme,the service provider needs to deal with the immediate needs of the user (such aspractical health, social and family issues); in the medium term the provider mustbe able to deliver services to increase the user’s well-being.• Current treatment responses to crack use, which include complimentary therapies,counselling and cognitive behavioural therapy, evolved from responses to theincrease in problematic powder cocaine use. Of the 31 drug-treatment and socialservices participating in interviews and focus groups for this study, five reported alack of knowledge about treating clients for crack use.• The HSE reports that 38 staff members have been trained as cognitive behaviouraltherapists, and Merchants Quay Ireland has trained 53 frontline staff and 76 keyworkers in cocaine-related responses.• Some service providers and crack users argue in favour of separate facilities toaddress cocaine use. There is a widespread perception that the addiction servicesin Dublin are methadone-prescribing or -dispensing services only.• Since most crack users are polydrug users, the establishment of stimulant-specificservices requires careful consideration. Ireland may need to consider placingoutreach and psychosocial treatment at the centre of its addiction services, withthe addition of medical interventions as a specialist support for detoxification(from opiates, alcohol and benzodiazepines), methadone maintenance andpsychiatric treatment.• Some crack cocaine users have lifestyles that are too chaotic to facilitate theirattendance at treatment on a regular basis, and treatment services need to beable to make allowances for these people when they are in the initial stages oftreatment.• Some opiate users in treatment did not report their crack use to service providersin case they received sanctions as part of the methadone protocol, or lost accessto their children. Other clients who had reported their crack use to serviceproviders, had not been provided with any treatment.• The Department of Community, Rural and Gaeltacht Affairs has funded a numberof cocaine-treatment initiatives.Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy99
10 Policing crack markets10.0 OverviewThis section reviews law-enforcement activities in relation to drug supply. The overallobjective of such activities is considered. Using data from a focus group with membersof the Garda National Drugs Unit, a description of street-based interventions by AnGarda Síochána is provided. This includes Operation Plaza which was establishedin response to the emergence of crack cocaine in Dublin. The role of the gardaíin diverting drug users into treatment and some of the challenges faced by lawenforcement in this area are also considered.10.1 Introduction: responding to drug supplyIt is important to consider what policing interventions in illicit drug markets are seekingto achieve and how specific market structures and forms of organisation can impacton interventions. Policing initiatives, be they in terms of street patrols or intelligenceledoperations of a more covert nature, strive to disrupt markets and thus reduce orcontrol supply. On the other hand, demand-reduction strategies attempt to target usersand divert them into drug treatment, by means of arrest referral schemes, for example.It is assumed that by reducing supply and demand the market will ultimately shrink anddrug-related crime will decrease accordingly.A number of writers in this area have shown, however, that law-enforcement initiativescan have unintended consequences (Wilson and Stevens 2008). This is partly due to alimited evidence base in relation to supply-control activities. As May and Hough (2001:141) point out: ‘The relationships between the supply of illicit drugs, the demand forthem and enforcement activities are poorly conceptualised, under-researched and littleunderstood.’Applying basic market logic, it might be assumed that successful attempts to stiflesupply would lead to higher prices, and that this in turn would reduce consumption. Inreality, however, most estimates of prices throughout Europe show them to be eitherstable or falling (EMCDDA 2006). There are a number of possible reasons for this. First,it is estimated that law-enforcement activity leads to the seizure of only 10%–20% ofthe drugs in circulation; the amount that remains undetected is such that the longtermimpact of successful enforcement is likely to be minimal (Connolly 2006a; UNODC2005). Second, drug distribution systems adapt quickly, so that where drug suppliershave been arrested, they will quickly be replaced (Reuter et al. 1990). Third, demand isoften inelastic for problematic drug users, relative to moderate or recreational users,and increased prices may simply lead them to engage in greater levels of crime in orderto pay the higher prices (Wagstaff and Maynard 1988).100 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy
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HRB Research Series6Crack cocaine i
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This publication should be cited as
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HRB Research Series publicationsto
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ContentsList of tables and figures
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7 Social consequences of crack use
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List of tables and figuresTablesTab
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AbbreviationsADRUGNDUHRBISCCSGLDTFN
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Glossary of termsBenzos: The street
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Executive summaryBackground and stu
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phone and buyers are directed to sp
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Part 1IntroductionCrack cocaine in
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In the light of these concerns, it
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extensive reporting in the US about
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Ten interviews were conducted with
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also offers potential to trace supp
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Part 2Crack cocaine in the Dublin r
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2.2 Criminal justice data - cocaine
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Prevalence of crack use among homel
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Local survey dataA survey in 2006 o
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Respondent 1: I’d say it’s stil
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3 Dublin crack cocaine market3.0 Ov
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sold on the street for as little as
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Like, I was down on M… Street in
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3.4 Marketing crackFour interviewee
Page 50 and 51: While crack was generally bought al
Page 52 and 53: • Although a number of dealers, o
Page 54 and 55: 4.2 Crack use and genderAccording t
Page 56 and 57: From about 16 to 21 I would say - t
Page 58 and 59: Table 4.4Number of new cases who li
Page 60 and 61: 5.2 Crack and other drugsMany of th
Page 62 and 63: Whether treated cases reported crac
Page 64 and 65: cases of intravenous cocaine use, t
Page 66 and 67: Table 5.5Number (%) of new cases wh
Page 68 and 69: Part 3Consequences of crack useCrac
Page 70 and 71: etween heroin, cocaine and crime. T
Page 72 and 73: So, they would talk about the kind
Page 74 and 75: Crack and prostitutionNine services
Page 76 and 77: On the other hand, reports from two
Page 78 and 79: often with a prevalence of opiate d
Page 80 and 81: The data provided by the NDTRS in S
Page 82 and 83: But you know it would be about kind
Page 84 and 85: So, debt is another significant iss
Page 86 and 87: 7.6 Key findings• A significant p
Page 88 and 89: There are considerable long-term ps
Page 90: 8.3 Psychological consequences of c
Page 93 and 94: 9 Treating crack use9.0 OverviewIn
Page 95 and 96: Some services were in a position to
Page 97 and 98: Both opiate-dependent and non-opiat
Page 99: • more outreach work to identify
Page 103 and 104: local communities. There is growing
Page 105 and 106: He’d know me, I’d know him, you
Page 107 and 108: Table 10.1 Number of new cases who
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Page 111 and 112: 11 Discussion and research implicat
Page 113 and 114: 11.2 Responding to crack markets an
Page 115 and 116: 11.3 Reducing the harm that crack c
Page 117 and 118: Shoplifting, burglary and robbery w
Page 119 and 120: Bourgois P (2003b) Crack and the po
Page 121 and 122: Furey M and Browne C (2004) Opiate
Page 123 and 124: Loughran H and McCann ME (2006) A c
Page 125 and 126: San Diego Police Department (1998)
Page 127 and 128: Appendix A:An evidence base for tre
Page 129 and 130: note that providing information on
Page 131 and 132: MedicationsA number of studies have
Page 133 and 134: interpersonal psychotherapy. Americ
Page 135 and 136: Jurisdiction Intervention/Descripti
Page 137 and 138: Jurisdiction Intervention/Descripti
Page 139 and 140: Appendix C:Recent HRB series public
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