Vacc<strong>in</strong>eHall and Carter (2004) state that ‘a <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e is a promis<strong>in</strong>g immuno<strong>the</strong>rapeuticapproach to treat<strong>in</strong>g <strong>coca<strong>in</strong>e</strong> dependence which <strong>in</strong>duces <strong>the</strong> immune system toform antibodies that prevent <strong>coca<strong>in</strong>e</strong> from cross<strong>in</strong>g <strong>the</strong> blood bra<strong>in</strong> barrier to act onreceptor sites <strong>in</strong> <strong>the</strong> bra<strong>in</strong>. The most promis<strong>in</strong>g application of a <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e isto prevent relapse to dependence <strong>in</strong> abst<strong>in</strong>ent users who voluntarily enter treatment’.Two published studies exam<strong>in</strong>ed <strong>the</strong> use of <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e among human populations(Martell et al. 2005; Kosten et al. 2002). Both studies showed some promis<strong>in</strong>g results;however, general availability of a <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e is not imm<strong>in</strong>ent. This <strong>in</strong>terventionwill only be useful for relapse prevention.1234567Greenhalgh T (1997) How to read a paper: Papers that summarise o<strong>the</strong>r papers(systematic reviews and meta-analyses) British Medical Journal, 315: 672–675.Lima MS, Reisser Lima AAP, Soares BGO and Farrell M (2003) Antidepressantsfor <strong>coca<strong>in</strong>e</strong> dependence. Cochrane Database of Systematic Reviews, Issue 2. Art.No.: CD002950. DOI: 10.1002/14651858.CD002950.Soares BGO, Lima MS, Lima Reisser A and Farrell M (2003) Dopam<strong>in</strong>e agonistsfor <strong>coca<strong>in</strong>e</strong> dependence. Cochrane Database of Systematic Reviews, Issue 2. Art.No.: CD003352. DOI: 10.1002/14651858.CD003352.Lima Reisser A, Lima MS, Soares BGO and Farrell M (2002) Carbamazep<strong>in</strong>e for<strong>coca<strong>in</strong>e</strong> dependence. Cochrane Database of Systematic Reviews, Issue 2. Art. No.:CD002023. DOI: 10.1002/14651858.CD002023.Silva de Lima M, de Oliveira Soares BG, Pereira Reisser AA and Farrell M(2002) Pharmacological treatment of <strong>coca<strong>in</strong>e</strong> dependence: a systematic review.Addiction, 97(8): 931–949.Gates S, Smith LA and Foxcroft DR (2006) Auricular acupuncture for <strong>coca<strong>in</strong>e</strong>dependence. Cochrane Database of Systematic Reviews, Issue 1. Art. No.:CD005192. DOI: 10.1002/14651858.CD005192.pub2.Smith LA, Gates S and Foxcroft D (2006) Therapeutic communities for substancerelated disorder. Cochrane Database of Systematic Reviews, Issue 1. Art. No.:CD005338. DOI: 10.1002/14651858.CD005338.pub2.8 Crits-Christoph P, Siqueland L, Bla<strong>in</strong>e J, Frank A, Luborsky L, Onken LS et al.(1999) Psychosocial treatments for <strong>coca<strong>in</strong>e</strong> dependence: National Instituteon Drug Abuse Collaborative Coca<strong>in</strong>e Treatment Study. Archives of GeneralPsychiatry, 56(6): 493–502.9Carroll KM, Rounsaville BJ and Gaw<strong>in</strong> FH (1991) A comparative trial ofpsycho<strong>the</strong>rapies for ambulatory <strong>coca<strong>in</strong>e</strong> abusers: relapse prevention and<strong>Crack</strong> <strong>coca<strong>in</strong>e</strong> <strong>in</strong> <strong>the</strong> Dubl<strong>in</strong> <strong>region</strong>: an evidence base for a crack <strong>coca<strong>in</strong>e</strong> strategy131
<strong>in</strong>terpersonal psycho<strong>the</strong>rapy. American Journal of Drug & Alcohol Abuse, 17(3):229–247.101112131415Higg<strong>in</strong>s ST, Budney AJ, Bickel WK, Foerg FE, Donham R and Badger GJ (1994)Incentives improve outcome <strong>in</strong> outpatient behavioral treatment of <strong>coca<strong>in</strong>e</strong>dependence. Archives of General Psychiatry, 51(7): 568–576.Crits-Christoph P, Siqueland L, McCalmont E, Weiss RD, Gastfriend DR, FrankA et al. (2001) Impact of psychosocial treatments on associated problems of<strong>coca<strong>in</strong>e</strong>-dependent patients. Journal of Consult<strong>in</strong>g and Cl<strong>in</strong>ical Psychology, 69(5):825–830.Bernste<strong>in</strong> J, Bernste<strong>in</strong> E, Tassiopoulos K, Heeren T, Levenson S, H<strong>in</strong>gson R (2005)Brief motivational <strong>in</strong>tervention at a cl<strong>in</strong>ic visit reduces <strong>coca<strong>in</strong>e</strong> and hero<strong>in</strong> use.Drug and Alcohol Dependence, 77(1): 49–59.Hall W and Carter L. (2004) Ethical issues <strong>in</strong> us<strong>in</strong>g a <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e to treat andprevent <strong>coca<strong>in</strong>e</strong> abuse and dependence. Journal of Medical Ethics, 30(4): 337–340.Martell BA, Mitchell E, Pol<strong>in</strong>g J, Gonsai K and Kosten TR (2005) Vacc<strong>in</strong>epharmaco<strong>the</strong>rapy for <strong>the</strong> treatment of <strong>coca<strong>in</strong>e</strong> dependence. Biological Psychiatry,58(2):158–64.Kosten TR, Rosen M. Bond J, Settles M, Roberts JS, Shields J, Jack L and Fox B(2002) Human <strong>the</strong>rapeutic <strong>coca<strong>in</strong>e</strong> vacc<strong>in</strong>e: safety and immunogenicity. Vacc<strong>in</strong>e,20(7–8):1196–1204.132 <strong>Crack</strong> <strong>coca<strong>in</strong>e</strong> <strong>in</strong> <strong>the</strong> Dubl<strong>in</strong> <strong>region</strong>: an evidence base for a crack <strong>coca<strong>in</strong>e</strong> 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
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Table 5.5Number (%) of new cases wh
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Part 3Consequences of crack useCrac
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etween heroin, cocaine and crime. T
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So, they would talk about the kind
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Crack and prostitutionNine services
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On the other hand, reports from two
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often with a prevalence of opiate d
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The data provided by the NDTRS in S
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