Crack cocaine in the Dublin region - Health Research Board

Some services were in a position to provide complementary therapy such asacupuncture, reiki, art therapy or massage on a daily basis. Essentially, these therapiesoffer clients alternatives to using drugs, which may aid their efforts to break up theirpattern of drug use. A number of these services had trained existing staff membersto provide therapies; this enabled them to offer clients an immediate response, ratherthan giving them another appointment for a later date, which they might not attend.However, not all services have the staff or resources to provide such interventions.In 2005, the Department of Community, Rural and Gaeltacht Affairs funded andevaluated training courses for 53 frontline staff and 76 key workers (Crampton 2005).The courses were organised through Merchants Quay Ireland. In 2006 and 2007, theHSE in conjunction with the University of Leeds trained 38 counsellors in the statutoryand voluntary/community sector in the use of cognitive behaviour coping skills(CBCS). This training programme is recognised widely by clinicians and professionalsin the addiction field as the most appropriate method available to enhance the skill setsrequired by staff working with stimulant misuse issues. Further courses are due to beheld in 2008 (Joe Doyle, HSE, personal communication, June 2008).The Department of Community, Rural and Gaeltacht Affairs also funded and evaluateda number of projects that address cocaine use. A community-based project involvingSt Dominic’s Community Response Project and Killinarden’s Community AddictionResponse Programme in Tallaght was (according to the evaluators) effective and verygood value for money (Goodbody Economic Consultants 2006). The project caters forproblematic intranasal cocaine users mainly, but also treats a small number of crackusers. Interventions used at the project include the advertising of service availability;the holding of project meetings; a proactive outreach programme; the maintenance ofa helpline; the promotion of relationship building between service suppliers and clients;the use of individual care plans; the provision of individual counselling; and the use ofcomplimentary therapies. This example of good practice could be applied elsewhere.9.3 Attracting crack users into treatmentSixteen services reported that the biggest challenge is attracting crack users intotreatment and retaining them long enough to achieve long-lasting change. Reportedreasons for users’ reluctance to seek treatment include:1234Users’ scepticism of the benefits of treatment, given that there is no medicalsubstitute.Users’ fear of suffering penalties from their methadone or employment programmes.Users’ lifestyles being too chaotic to facilitate them attending treatment regularly.Users’ perception that crack use is stigmatised, thus discouraging disclosure.94 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy