Crack cocaine in the Dublin region - Health Research Board

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