Crack cocaine in the Dublin region - Health Research Board

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cases of intravenous cocaine use, the user is a current or former heroin user. In thein-depth interviews, three of the services consulted reported that intravenous cocaineuse was a precursor to the client’s crack cocaine use:Like I saw between January and June I would have seen about 50 people. Now, not all ofthem would be, there would I would say be about 30 of them who would have been injectingcocaine. And I would say probably 20 of them now have gone on to use crack. Because theyhave just realised you know it is a waste trying to inject cocaine now. Their veins are that badand their abscesses and ulcers and they are that bad. And they are getting the same effectfrom smoking crack as they would from mainlining cocaine.Dublin 12, drug-treatment service (October 2007)Five of the ten users interviewed as part of the study had been using cocaineintravenously before they made a transition to crack cocaine:See a lot around the area started using the coke, injecting, and they were running out of veinsand things were happening, they were getting blood clots like myself and they either stoppedor they still wanted the same rush. So, then they turned to the crack for the same rush.north-east Dublin, current crack user (October 2007)So I ended up coming home and the usual I was strung out on coke for a long time, injectingcoke and my veins started going and I was finding it harder and harder and I wouldn’t usemy groin… So I started hearing then that it was very easy to get crack, either freebase whichlike would be just powder form, and you’d rock it up yourself like.north-east Dublin, former crack user (October 2007)The evidence suggests that the typical crack user profile in Dublin is that of an opiatedependentpolydrug user. This finding is consistent with the international literature.However, some caution should be exercised in relation to this finding. Many crackusers are known to treatment services because they are on methadone treatmentprogrammes for their opiate use. It is important to bear in mind that a population ofnon-opiate-dependent crack users may exist outside the knowledge of services thatprimarily cater for the needs of opiate users.5.6 Routes of administrationEvidence from a variety of sources suggests that crack cocaine is predominantlysmoked but that a small minority use it intravenously. The pilot study of the NationalDrug Trend Monitoring System found that of the participating trend monitors whoconfirmed the use of crack in their locality, 69% (36) of service providers reportedthat the main method of administration was by smoking, 12% (6) of service providersreported the main method as injecting, and 6% (3) reported that their clients used bothmodes of administration (NACD 2007).Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy63
Evidence from the in-depth interviews and focus groups and the NDTRS suggests thatthe majority of users smoke crack. The NDTRS confirms that 27 (77%) of new casesreported smoking crack cocaine and 3 (8.6%) reported using it intravenously (Table 5.4).Table 5.4Route of administration of crack cocaine reported by new cases in the month priorto treatment, 2004 to 2006Route of administration Number %Smoking 27 77.1Injecting 3 8.6Not known 5 14.3Total 35 100.0The most common equipment used for smoking crack included plastic bottles andcans pierced with makeshift tubes, such as the barrel of a plastic pen. Old inhalers,previously employed to treat respiratory problems such as asthma, may also be used tosmoke it.You get a plastic bottle, you put a little bit of tinfoil around the top, put little holes in the topof it, put a bit of ash on it, crack on the top of it and you stick the barrel of a pen in it andthat’s just, you know you set fire to the top, you just suck the smoke out of the bottle, becausethat’s all you need is the smoke … and they could use in any lane and do that, they don’tneed to be in a house, it only takes two minutes to do.north-east Dublin, current crack user (October 2007)Four services reported having clients who injected crack intravenously. Two servicesdid not know that it was possible to inject crack. Only one crack user in the studysample had injected it intravenously. However, former intravenous users of powdercocaine progressed to crack use because they could no longer use needles due to theabscesses they had developed. Therefore, intravenous injection of crack was not aviable route of administration for many users.5.7 Frequency of useEight of the 35 new cases reported to the NDTRS used crack cocaine on a dailybasis; an additional 5 cases used it between two and six times a week (Table 5.5). Asignificant minority of treated crack users had not used the drug in the month prior totheir treatment.64 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
Page 14 and 15: AbbreviationsADRUGNDUHRBISCCSGLDTFN
Page 16 and 17: Glossary of termsBenzos: The street
Page 18 and 19: Executive summaryBackground and stu
Page 20 and 21: phone and buyers are directed to sp
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 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
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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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