Crack cocaine in the Dublin region - Health Research Board

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• Females involved in the sex trade are a particularly problematic group. There isevidence of an increase in the number of women entering prostitution for thefirst time as a consequence of their crack use. Female users appear to developthe most chaotic crack addiction and are thus a particularly vulnerable group.The need for an urgent outreach response is heightened by the possible childcareissues associated with such users.• The goal of law enforcement could be more broadly conceived, with, forexample, greater emphasis placed on the importance of diverting into treatmentthose offenders whose offence is connected with drug use. There is a need toimprove our understanding of both the numbers of people in this category andthe numbers of people who are diverted into treatment from all sections of thecriminal justice system: gardaí, probation, prosecution, courts and the prisonservice. The involvement of young people in crack dealing and crack use is anissue which requires further attention.• With regard to the impact of crack use on the broader family and community, oneimportant issue which has been identified in this study is how the high cost ofcrack can lead to the diversion of finances from childcare to crack use, and howit can also lead to engagement in prostitution, homelessness, and the intimidationof crack users and their family members by crack dealers over debt collection.The issue of how debt affects users, parents and other family members is acomplex one, and needs to be addressed.• There is an apparent association between crack use and increased aggression.What remains unclear however is the association between crack use and violence– be it individual violence by users or violence associated with the illicit market.• Crack users appear to be dealing in prescribed substances which are beingobtained from pharmacies and/or general practitioners.It must also be stated that any attempt to develop a sustainable response to crackrelatedcrime must acknowledge the complexity of the relationship between drug use,crime and the underlying social factors which contribute to both. Irish research hasconsistently revealed that underlying social factors – such as educational disadvantage,poverty and inequality – contribute both to problematic drug use and to criminalbehaviour. The findings of this study suggest that the typical crack user is opiate ormethadone dependent with a problematic history of drug misuse, and is likely to sharemany of these social characteristics. This poses a significant challenge to policy makersas it suggests that drug-related crime strategies must move beyond the individual andaddress the environmental context in which both drug use and crime occur in order tobe more effective.Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy113
11.3 Reducing the harm that crack cocaine causes both toindividuals and communitiesThe importance of attracting crack users into treatment, and retaining them intreatment, is highlighted in this study. Service providers need to make allowances forthe chaotic lifestyles of typical crack users when they are managing clients who arein the initial stages of treatment. The issue of under-reporting of crack use (due tousers’ fear of sanctions or fears that they may lose access to their children) needs tobe addressed. The absence of treatment provision in some services was highlightedin the study. The perception among crack users that services are concerned onlywith dispensing methadone to heroin users needs to be addressed. There needsto be further debate about the nature of service provision and whether it shouldencompass polydrug treatment or whether it should be more tailored to specific drugtypetreatment only. Since most crack users are polydrug users, the establishment ofstimulant-specific services requires careful consideration. Other issues highlighted inthis study include the following:• Attracting crack users into treatment is an important objective. Users who areundertaking education or training programmes, which require a stable lifestyle,may fear that disclosing their crack use will lead to expulsion from theseprogrammes. This appears to be a counterproductive outcome of policy in thisarea.• Services could take further steps to offer support/therapies/information to theirclients around the issue of crack use.• There appears to be a perception among some young people that smoking crackis relatively harmless. Addressing this perception would be an important goal ofany education/prevention campaign.• Another vulnerable group highlighted in this study is homeless crack users.Outreach services should be developed to address the needs of homeless peopleusing crack.• Despite the introduction of a number of training programmes, it appears thatthere is a need for further information to be provided to service providers inrelation to the potential harms associated with crack use, particularly in relationto the routes of administration (i.e. whether crack is smoked or injected). Harmreductioninitiatives need to be informed by evidence as to the methods of crackadministration.114 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
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While crack was generally bought al
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• Although a number of dealers, o
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4.2 Crack use and genderAccording t
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From about 16 to 21 I would say - t
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Table 4.4Number of new cases who li
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5.2 Crack and other drugsMany of th
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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 and 100: • more outreach work to identify
Page 101 and 102: 10 Policing crack markets10.0 Overv
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
Page 109 and 110: 108 Crack cocaine in the Dublin reg
Page 111 and 112: 11 Discussion and research implicat
Page 113: 11.2 Responding to crack markets an
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
Page 141 and 142: 140 Crack cocaine in the Dublin reg
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