7.6 Key f<strong>in</strong>d<strong>in</strong>gs• A significant proportion of crack users <strong>in</strong> treatment are homeless or live <strong>in</strong>unstable accommodation such as prisons, halfway houses, homeless hostels, orbed and breakfasts. <strong>Crack</strong> users reported hav<strong>in</strong>g become homeless because ofnon-payment of rent, <strong>the</strong>ft, or violence and anti-social behaviour <strong>in</strong>flicted onfamily members.• The lifestyles of such users appear to be too chaotic to susta<strong>in</strong> a legitimate sourceof <strong>in</strong>come. Only 6% of new crack cases enter<strong>in</strong>g treatment were employed.• <strong>Crack</strong> users who were <strong>in</strong> employment reported that <strong>the</strong>y funded <strong>the</strong>ir use from<strong>the</strong>ir wages, and used crack only on days when <strong>the</strong>y were not at work.• <strong>Crack</strong> use may prevent entry <strong>in</strong>to employment schemes. Individuals <strong>in</strong> recoveryfrom hero<strong>in</strong> addiction who are receiv<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g to provide <strong>the</strong>m with skills tore-enter <strong>the</strong> job market risk expulsion if <strong>the</strong>ir crack use is detected or if use isprompt<strong>in</strong>g disruptive behaviour dur<strong>in</strong>g tra<strong>in</strong><strong>in</strong>g.• Compulsive crack users reported neglect<strong>in</strong>g <strong>the</strong>ir children, often divert<strong>in</strong>g <strong>the</strong>irf<strong>in</strong>ancial resources towards buy<strong>in</strong>g crack.• Given <strong>the</strong> high cost of crack, users often acquired debts very quickly which, whenleft unpaid, led to <strong>in</strong>timidation from crack dealers. This <strong>in</strong>timidation was oftendirected not only at <strong>the</strong> users <strong>the</strong>mselves but also at <strong>the</strong>ir parents or o<strong>the</strong>r familymembers.• Few drug-treatment services reported that members of <strong>the</strong>ir local communitieswere concerned about crack <strong>coca<strong>in</strong>e</strong> use <strong>in</strong> <strong>the</strong> area. There were no reportsof crack-specific discarded drug paraphernalia, such as pipes, litter<strong>in</strong>g localpublic spaces.<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> strategy85
8 <strong>Health</strong> consequences of crack use8.0 OverviewThis section considers f<strong>in</strong>d<strong>in</strong>gs from <strong>in</strong>ternational research with regard to <strong>the</strong> healthcomplications associated with crack use. Data from previous studies and <strong>in</strong>-depth<strong>in</strong>terviews and focus groups with service providers are <strong>the</strong>n exam<strong>in</strong>ed to describe <strong>the</strong>ma<strong>in</strong> physical and psychological health consequences associated with crack use <strong>in</strong> <strong>the</strong>Dubl<strong>in</strong> <strong>region</strong>.8.1 Introduction: health consequences of crack useLong-term use of crack is associated with a range of physical and mental healthproblems (GLADA 2004a). The physical effects of crack use on people <strong>in</strong>clude narrowedblood vessels, dilated pupils, <strong>in</strong>creased temperature, faster heart rate, and high bloodpressure. These medical symptoms can lead to chest pa<strong>in</strong>, disturbances <strong>in</strong> heartrhythm, lack of oxygen to <strong>the</strong> heart muscle, respiratory failure, strokes, seizures andheadaches (NIDA 2004). Because crack has a tendency to decrease appetite, manychronic users can become malnourished. Fur<strong>the</strong>r potential risks <strong>in</strong>clude ammoniapoison<strong>in</strong>g from protracted use of poorly manufactured crack and <strong>the</strong> use of acetone(used to reclaim <strong>coca<strong>in</strong>e</strong> from crack pipes) may cause kidney, liver and nerve damage(NACD 2007b).In terms of maternal crack use, it is important to dispel erroneous myths such as thatof <strong>the</strong> <strong>in</strong>cidence of ‘crack babies’ portrayed <strong>in</strong> <strong>the</strong> US media <strong>in</strong> <strong>the</strong> 1980s (NIDA 2004).The specific effect(s) of crack on <strong>the</strong> foetus rema<strong>in</strong>s unknown. However, <strong>the</strong> effects ofmaternal crack <strong>coca<strong>in</strong>e</strong> use may <strong>in</strong>clude premature birth, low birth weight and smallerhead circumference (NIDA 2004), although <strong>the</strong>se symptoms may be caused by o<strong>the</strong>rconcomitant factors such as alcohol use, tobacco use and/or poor diet.As is <strong>the</strong> case with users of o<strong>the</strong>r illicit drugs, crack users may be at risk of contract<strong>in</strong>gHIV, hepatitis B and hepatitis C through shar<strong>in</strong>g <strong>in</strong>ject<strong>in</strong>g equipment, shar<strong>in</strong>g crackpipes, and engag<strong>in</strong>g <strong>in</strong> risky sexual behaviour. <strong>Research</strong> has underl<strong>in</strong>ed that drug use,<strong>in</strong>clud<strong>in</strong>g crack use, can ‘<strong>in</strong>terfere with judgement about risk-tak<strong>in</strong>g behaviour, andcan potentially lead to reduced precautions regard<strong>in</strong>g sexual behaviours, <strong>the</strong> shar<strong>in</strong>g ofneedles and <strong>in</strong>jection paraphernalia, and <strong>the</strong> trad<strong>in</strong>g of sex for drugs, by both men andwomen’ (NIDA 2004: 6). Recent research <strong>in</strong> Canada has demonstrated <strong>the</strong> l<strong>in</strong>k betweencrack smokers who share makeshift glass or alum<strong>in</strong>ium pipes, which may cut <strong>the</strong>ir lips,and <strong>the</strong>reby facilitate <strong>the</strong> transmission of hepatitis C (CARBC 2007).86 <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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- Page 38 and 39: Local survey dataA survey in 2006 o
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- Page 44 and 45: sold on the street for as little as
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- Page 48 and 49: 3.4 Marketing crackFour interviewee
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- Page 66 and 67: Table 5.5Number (%) of new cases wh
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- Page 103 and 104: local communities. There is growing
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- Page 125 and 126: San Diego Police Department (1998)
- Page 127 and 128: Appendix A:An evidence base for tre
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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