Crack cocaine in the Dublin region - Health Research Board

Six services reported that crack-using clients on heroin-recovery programmes may bereluctant to seek specific treatment for their crack addiction. Users may believe thatthey risk suffering punitive measures from methadone clinics should they disclose theircrack use or should it be detected in urine analysis. Such penalties could ultimatelylead to a loss of privileges regarding their methadone maintenance, for example theloss of ‘takeaways’ – a supply of methadone for a number of days at a time (losing‘takeaways’ means that a client has to attend a clinic every day for his/her daily doseof methadone). Such a routine restricts a client’s working or recreational options. Asa consequence, some users will not disclose their current drug-use patterns to serviceproviders, and will either avoid using crack when they are due to give a sample ofurine or submit a ‘bogey’ (another person’s urine which is clear of all illicit substances):Some try to hide it because the way of dealing with people with heroin nowadays is that if youhave a dirty urine you’re penalised. Penalty usually is that you’re put on dailies. Which meansyou can’t go on holidays, you can but it’s very, very difficult. You can’t get a job becauseyou’ve to go to the chemist every day. Unless you happen to have a time that’s very, verysuitable. So, there are lots of difficulties there for people. So, the whole climate of not sayingwhat you’re on is there. So, that makes it difficult alright? So, we would have a number ofpeople that are using crack yes.Tallaght, drug-treatment service (October 2007)Similarly, users on education or training programmes, which require a stable lifestyle,may fear that disclosing crack use will lead to their expulsion from these programmes:I’d say it’s a lot of fear about how people are going to approach them or maybe they’ll losetheir course, or their job. So, you know it’s community employment and it’s you know basictraining programmes, but it means a lot to them, and to lose that to them would be a greatfear and they probably wouldn’t … that’s why we’re saying that … well then a lot talk aboutit, and when I ask people you know what are you seeing in the area? They’ll tell me whatthey’re seeing and who’s taking it but not … but that they’re not.Ballyfermot, drug-treatment service (November 2007)They’re probably not saying they’re using it, yeah, see it’s difficult down here for us, like, alot of the people who come in here would be on a community employment programme andyou have to be fairly stable, like they’re not going to come in here and say, say they’re onmethadone and they’re on 80 mls of methadone, they can’t come in then and say the nextday – listen I’m after being out all night smoking crack. Because you’re not stable, know whatI mean? The criteria for our programme is you have to be fairly stable to remain on this, soit’s a bit of a catch, you know what I mean?south inner city, drug-treatment service (September 2007)Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy95