Crack cocaine in the Dublin region - Health Research Board

5 Patterns of crack use and routes of administration5.0 OverviewThis section outlines common patterns of crack cocaine use as well as routes ofadministration that have been reported in international studies. It also presents findingsfrom NDTRS data and from the in-depth interviews and focus groups with users andservice providers in relation to the use of crack with other substances, the frequency ofuse and how crack is administered by users in Dublin.5.1 IntroductionResearch evidence from the UK indicates that the majority of crack users in Britainare polydrug users, and dependent users of heroin in particular (Home Office 2002). Astudy by Gossop et al. (2002) found that some heroin users who were not using crackprior to treatment switched to crack on completion of, or during, their treatment.People receiving methadone treatment for heroin addiction may begin using crackto give them a high while failing to recognise that their use of crack is problematic(Turning Point 2005). Alternatively, crack cocaine users may start to use heroin in orderto manage the adverse effects of crack and reduce their withdrawal symptoms (TurningPoint 2005). It has been estimated that a substantial part of the growth of crack cocaineuse in London was due to its adoption by opiate users, coupled with a growth in opiateuse (GLADA 2004a). Heavy alcohol consumption has also been linked to crack use,and UK reports document how street drinkers have begun to use crack (Strange andMcGauley 2004). Similarly, US studies have highlighted heroin addiction as a likelypath to crack cocaine abuse and Sterk’s (1999) ethnographic study of 149 crack-usingmothers found that intravenous cocaine use was often a precursor to their crack habit;these women had abandoned intravenous use because their veins were damaged.Crack is usually smoked using a pipe, glass tube, plastic bottle or piece of tinfoil(GLADAa). It can also be used intravenously by preparing the solid rocks of crackcocaine with a transforming agent such as lemon juice or vinegar, and by applyingheat to the mixture. It has been suggested that injecting crack cocaine has remaineda relatively hidden practice because many drug-treatment service providers do notspecifically question crack users on their modes of administering the drug (Lankenau etal. 2004).58 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy