Crack cocaine in the Dublin region - Health Research Board

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Part 4Responding to crack cocaine:towards a crack cocaine strategyCrack cocaine in the Dublin region: an evidence base for a crack cocaine strategy91
9 Treating crack use9.0 OverviewIn this section current treatment responses to crack cocaine misuse in Dublinare reviewed. Difficulties attracting users into treatment and retaining such usersin treatment are considered. The views of treatment practitioners with regard toimproving treatment services are then presented.9.1 IntroductionInternationally, the most successful approaches to reducing or ceasing cocaine use(including crack) are the 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 treatment, the service providermust be able to deal with the immediate needs of the user (such as acute medicalproblems or accommodation); in the medium term they must be able to provideservices to increase the user’s well-being (such as complementary therapies andpersonal-development opportunities). In Appendix A, Long and Keenan (2007) presentthe effectiveness of various types of psychosocial and medical treatment for problemcocaine use.9.2 Current treatment responses to crack misuse in DublinFindings from in-depth interviews and focus groups, in addition to informationreceived from the Health Service Executive (HSE), indicate that many current treatmentresponses to crack addiction evolved from responses to the increase in problematicpowder cocaine use. 20Eight services reported receiving crack-specific training and information either fromexperienced practitioners from the UK, or during the course of workshops which theyhad attended in Merchants Quay Ireland. Just 5 of the 31 drug-treatment and socialservices consulted reported a lack of knowledge about treating clients for crack cocaineuse. The most common responses reported included alternative or complementarytherapies such as acupuncture and massage (16 services), one-to-one counselling (8services) and cognitive behavioural therapy (5 services).20 Not all drug-treatment services consulted could provide specific therapies. A portion acted as drop-incentres and linked clients into therapeutic services in accordance with their needs.92 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
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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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Prevalence of crack use among homel
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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
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 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
Page 115 and 116: 11.3 Reducing the harm that crack c
Page 117 and 118: Shoplifting, burglary and robbery w
Page 119 and 120: Bourgois P (2003b) Crack and the po
Page 121 and 122: Furey M and Browne C (2004) Opiate
Page 123 and 124: Loughran H and McCann ME (2006) A c
Page 125 and 126: San Diego Police Department (1998)
Page 127 and 128: Appendix A:An evidence base for tre
Page 129 and 130: note that providing information on
Page 131 and 132: MedicationsA number of studies have
Page 133 and 134: interpersonal psychotherapy. Americ
Page 135 and 136: Jurisdiction Intervention/Descripti
Page 137 and 138: Jurisdiction Intervention/Descripti
Page 139 and 140: Appendix C:Recent HRB series public
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140 Crack cocaine in the Dublin reg
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