Crack cocaine in the Dublin region - Health Research Board

5.8 Key findings• Of the 135 cases treated for problem crack cocaine use between 20004 and 2006,18 reported crack cocaine as a main problem drug and 117 cases reported it as anadditional problem drug.• According to NDTRS data, of the 18 cases who reported crack cocaine as a mainproblem drug, 10 reported an opiate (mainly heroin) as an additional problemdrug. Of the 117 cases who reported crack cocaine as an additional problem drug,91% reported an opiate as the main problem drug.• Information obtained in the in-depth interviews suggests that crack use mayencourage the use or reuse of substances such as heroin, benzodiazepines orother tablets in order to manage the side effects of crack, such as anxiety ordepression.• Among recreational users of powder cocaine, crack was generally regarded ina negative manner. Recreational users of powder cocaine, who administer itintranasally (by sniffing), rarely made the transition to crack cocaine.• A proportion of intravenous powder cocaine users made a transition to smokingcrack cocaine because of the physical harms of injecting powder cocaine (such asabscesses and damaged veins).• Smoking was the predominant mode of administration of crack cocaine, butintravenous use is preferred by a small minority. A small number of services wereunaware that crack could be used intravenously.• Eight of the 35 new cases reported to the NDTRS used crack cocaine on a dailybasis, and an additional five cases used it between two and six times a week. Fiveof the ten users interviewed had been or were currently using crack on a dailybasis, and three were currently using it once or twice a week (usually when theyreceived their social welfare payment). These users admitted that they would usemore crack if they had greater financial resources available to them.• While some drug-treatment personnel reported the rapid onset of addiction incertain clients, they also pointed out that a number of clients used crack onlysporadically or opportunistically, rather than compulsively. Even among clientswith a history of problematic use of other drugs, not all were compulsiveusers of crack.66 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy