Crack cocaine in the Dublin region - Health Research Board

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11.4 ConclusionThe purpose of this report is to help the ISCCSG and other decision makers andstakeholders to develop an evidence-base for a crack cocaine strategy. This researchwas conducted using a rapid situation assessment technique recommended by theWorld Health Organization. The aim of rapid situation assessments is to gatherinformation from multiple data sources within a defined timeframe, using a numberof data-collection techniques. The rapid situation assessment has proven particularlysuitable in the current context.The analysis was constrained by the limited amount and quality of data availablethrough the criminal justice system and the quality of the data available through thehealth system. In addition, the researchers were unable to interview young crack usersbecause such users did not attend any health or social services. Despite the data issuesexperienced, the main findings of this study are in line with those reported in othercountries.Crack cocaine is a serious and increasing problem for a small number of marginaliseddrug users in Dublin, many of whom are former opiate users. A high proportionof crack cocaine users are male, homeless, unemployed and do not have formaleducational qualifications. The vast majority of cases used more than one drug; opiates(mainly heroin) were the most common drugs used alongside crack. Smoking was thepredominant mode of administration of crack. Frequency of use varied from a dailyhabit to a weekly habit. The most common physical side effects of crack use werebreathing problems, heart problems and rapid weight loss and the most commonpsychological consequences were paranoia, aggressiveness and depression.Despite targeted Garda operations in 2005/2006, the north-inner city remains theprimary crack market in Dublin. According to the data available, crack has beenavailable since late 2006 in other areas of Dublin. Findings indicate that the crackmarkets currently operating in Dublin are closed markets, that is, dealers do not selldrugs to strangers, exchanges are normally arranged using a mobile phone, and usersare directed to specific meeting points outside the inner city for an exchange. Usersreported that dealers of West African origin prepared higher quality crack. The priceof crack is relatively stable and uniform at €50 for a thumbnail size ‘rock’. Dealers usea number of methods to market crack, including selling it in combination with otherdrugs, targeting drug users outside methadone clinics, and offering heroin users crackinstead of heroin.Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy115
Shoplifting, burglary and robbery were reported as common means for users to sustaintheir crack cocaine habit. Among women, an increase in the numbers returning toor beginning sex work was observed by service providers. A small number of usersreported dealing prescription drugs. A number of service providers and users reporteda rise in the number of aggressive and violent incidents in their localities involvingassaults, gangland violence and fatal shootings.Internationally, the most successful approaches to reducing or ceasing crack use arepsychosocial interventions; however, these interventions can only be successful ifthe user is attracted to and retained in treatment. In order to attract people into atreatment programme, the service provider needs to deal with the immediate needs ofthe user; in the medium term the provider must be able to deliver services to increasethe user’s well-being. Some service providers and crack users argue in favour ofseparate facilities to address cocaine use. Since most crack users are polydrug users,the establishment of stimulant-specific services require careful consideration. Irelandmay need to consider placing outreach and psychosocial treatment at the centre of itsaddiction services, with the addition of medical interventions as a specialist support fordetoxification (from opiates, alcohol and benzodiazepines), methadone maintenanceand psychiatric treatment.The evidence indicates that drug-distribution systems adapt quickly, so that a drugsupplier who has been arrested will be quickly replaced. International evidenceindicates that effective intervention strategies are those which combine attempts todisrupt local markets, thus rendering them less predictable to both buyers and sellers,with attempts to divert drug offenders into treatment services. There is growingevidence that partnership working between all stakeholders offers the most sustainablemethod of responding to street-level drug markets. If law enforcement authoritiesconcentrated their resources in specific locations at particular times, emerging drugmarkets could be disrupted or prevented. Limited sources of crack supply in Dublinmay have contributed to the stable high price of crack relative to other drugs. Priceincreases, where they occur, do not necessarily deter problematic users from usingdrugs but may encourage an increase in crime in order to pay the higher prices.However, this study found some evidence that the high price of crack does deter useamong individuals who are not willing to engage in criminal activity.116 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
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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 and 114: 11.2 Responding to crack markets an
Page 115: 11.3 Reducing the harm that crack c
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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Crack cocaine in the Dublin region - Health Research Board

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