Crack cocaine in the Dublin region - Health Research Board

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phone and buyers are directed to specific meeting points outside the inner city for anexchange. Although some dealers, or clients themselves, possessed the skills to preparecrack from cocaine powder, many users believed that dealers who were primarily ofWest African origin prepared higher quality crack. The price of crack is relatively stableand uniform. According to six users and six drug-treatment services, prepared crackcocaine is being sold in €50 or €100 quantities or ‘rocks’. Dealers use a number ofmethods to market crack, including selling it in combination with other drugs, targetingdrug users outside methadone clinics, and offering heroin users crack instead of heroin.Crack users participating in the study described crack houses as locations where crackcould be used, and in some cases prepared in exchange for free crack. Crack houseswere not reported as major venues for crack dealing or as sites for sex work.Crack-related crimeShoplifting, burglary and robbery were reported as common means for users to sustaintheir crack cocaine habit. Service providers reported an increase in the numbers ofwomen returning to or beginning sex work to fund their crack use. There were noreports of new street-based sex markets; the data indicate that apartments are usedfor sex work. Crack users rarely reported dealing the drug themselves, but claimedthat there were numerous young people involved in using and selling crack. However,service providers said that they had no evidence of young people selling crack. Elevenparticipants, including both treatment staff and users, reported a rise in the numberof aggressive and violent incidents in their localities, involving assaults, ganglandviolence and fatal shootings. However, it is not clear whether such incidents are relatedto crack cocaine or to other substances such as powder cocaine or heroin.Treating crack useCurrent treatment responses to crack use, which include complimentary therapies,counselling and cognitive behavioural therapy, evolved from responses to the increasein problematic powder cocaine use. The Health Service Executive reports that 38 staffmembers have been trained as cognitive behavioural therapists, and Merchants QuayIreland have trained 53 frontline staff and 76 key workers in cocaine-related responses.The Department of Community, Rural and Gaeltacht Affairs has funded a number ofcocaine-treatment initiatives. Internationally, the most successful approaches to reducingor ceasing crack use are psychosocial interventions (such as cognitive behaviouraltherapy); 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, theservice provider needs to deal with the immediate needs of the user (such as practicalhealth, social and family issues); in the medium term, the provider must be able todeliver services to increase the user’s well-being (such as complementary therapies andCrack cocaine in the Dublin region: an evidence base for a crack cocaine strategy19
personal development programmes). Some service providers and crack users argue infavour of separate facilities to address cocaine use. Since most crack users are polydrugusers, the establishment of stimulant-specific services requires careful consideration.Ireland may need to consider placing outreach and psychosocial treatment at the centreof its addiction services, with the addition of medical interventions such as a specialistsupport for detoxification (from opiates, alcohol and benzodiazepines), methadonemaintenance and psychiatric treatment. There is a widespread perception that theaddiction services in Dublin are methadone services only.Policing crack marketsThe evidence indicates that drug-distribution systems adapt quickly, so that a drugsupplier who is arrested will quickly be replaced. For example, Operation Clean Streetwas regarded as a success from a law-enforcement point of view. However, the successof Operation Clean Street raised the issue of the so-called ‘Water Bed Effect’ wherebydrug activity was displaced to other locations around the city. 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. Law enforcement authorities canconcentrate their resources in specific locations at particular times and, consequently,are uniquely placed to prevent or disrupt emerging drug markets. Limited sources ofcrack supply in Dublin may have contributed to the stable high price of crack relativeto other drugs. Price increases, where they occur, do not necessarily deter use but maysimply lead problematic users to engage in greater levels of crime in order to pay thehigher prices. However, this study found some evidence that the high price of crackdoes deter use among individuals who are not willing to engage in criminal activity.ConclusionMany studies of emerging issues face a considerable time gap between data collectionand the date of publication of a final report, which may limit the usefulness of thefindings in terms of developing a proactive response. The analysis presented in thisreport was constrained by the limited amount and quality of data available through thecriminal justice system and the quality of the data available through the health system.In addition, the researchers were unable to interview young crack users because suchusers did not attend any health or social services. Despite these limitations, this studyprovides an adequate analysis of an issue of public concern, within a reasonabletimeframe. Furthermore, the main findings of this research are in line with thosereported in other countries.20 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy
Page 1 and 2: HRB Research Series6Crack cocaine i
Page 3 and 4: This publication should be cited as
Page 5 and 6: HRB Research Series publicationsto
Page 8 and 9: ContentsList of tables and figures
Page 10 and 11: 7 Social consequences of crack use
Page 12 and 13: List of tables and figuresTablesTab
Page 14 and 15: AbbreviationsADRUGNDUHRBISCCSGLDTFN
Page 16 and 17: Glossary of termsBenzos: The street
Page 18 and 19: Executive summaryBackground and stu
Page 22 and 23: Part 1IntroductionCrack cocaine in
Page 24 and 25: In the light of these concerns, it
Page 26 and 27: extensive reporting in the US about
Page 28 and 29: Ten interviews were conducted with
Page 30 and 31: also offers potential to trace supp
Page 32 and 33: Part 2Crack cocaine in the Dublin r
Page 34 and 35: 2.2 Criminal justice data - cocaine
Page 36 and 37: Prevalence of crack use among homel
Page 38 and 39: Local survey dataA survey in 2006 o
Page 40 and 41: Respondent 1: I’d say it’s stil
Page 42 and 43: 3 Dublin crack cocaine market3.0 Ov
Page 44 and 45: sold on the street for as little as
Page 46 and 47: Like, I was down on M… Street in
Page 48 and 49: 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
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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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But you know it would be about kind
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So, debt is another significant iss
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7.6 Key findings• A significant p
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There are considerable long-term ps
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8.3 Psychological consequences of c
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9 Treating crack use9.0 OverviewIn
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Some services were in a position to
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Both opiate-dependent and non-opiat
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• more outreach work to identify
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10 Policing crack markets10.0 Overv
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local communities. There is growing
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He’d know me, I’d know him, you
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Table 10.1 Number of new cases who
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108 Crack cocaine in the Dublin reg
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11 Discussion and research implicat
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11.2 Responding to crack markets an
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11.3 Reducing the harm that crack c
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Shoplifting, burglary and robbery w
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Bourgois P (2003b) Crack and the po
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Furey M and Browne C (2004) Opiate
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Loughran H and McCann ME (2006) A c
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San Diego Police Department (1998)
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Appendix A:An evidence base for tre
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note that providing information on
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MedicationsA number of studies have
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interpersonal psychotherapy. Americ
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Jurisdiction Intervention/Descripti
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Jurisdiction Intervention/Descripti
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Appendix C:Recent HRB series public
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140 Crack cocaine in the Dublin reg
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