Crack cocaine in the Dublin region - Health Research Board

Both opiate-dependent and non-opiate-dependent crack users may not believe thatexisting drug-treatment services, which are geared towards the demands of heroinaddiction, can help them, given that there is no pharmacological substitute such asmethadone:I suppose there’s not a lot to offer them either you know. Like methadone is a great carrot todraw people into a service, because you know with treatment, but there isn’t the equivalentthere for cocaine users…north-inner city, drug-treatment service (August 2007)Yeah, some are looking at the point of going into treatment. But mainly again that’s becausewhat’s the reinforcement for them going into treatment? You know that that’s the specialist inopiate addiction and the clients know that, you know. So, we know when a client comes inand maybe has an opiate problem and maybe would identify straight away what programmethey want to go to, we can give them the information. Again put it back to coke and crack,where is the specialist residential programme there?Clondalkin, drug-treatment service (October 2007)9.4 Retaining crack users in treatmentEncouraging clients to attend regular appointments and therapy sessions can beproblematic. Users seeking treatment often look for an immediate response, such asa residential programme or counselling, which a service may not be in a position toprovide. Seven services reported the difficulties involved when clients seek treatment ina chaotic state, and services may find it hard to assess these clients and communicatewith them in a meaningful way. This is especially problematic given the risk that theuser may not seek help again for a long period of time:But those on crack or cocaine usually, it’s very fleeting that you’d see them, very ... do youknow do you find like they’d be hectic, a lot more hectic they’d be in and out and you mightsee him for once this week and then in a couple of weeks’ time. So, it’s very hit and miss asto how often you’d see them, you wouldn’t be able to say ‘oh that person is going to be inthis day’, there would be no pattern with them like.north-inner city, drug-treatment service (September/October 2007)Since crack has come in, that has kind of shifted. And a lot of crisis coming to the centre, alot of panic. You know and it’s quite hard to manage that from a service point of view … wetry to accommodate, we try to be there when needed. It might take over the whole centre.So, your structured appointments have to kind of take a back seat which you know it’s hardgetting that balancing act … you need to be able to get to see them then and there. If youdon’t, you lose them.Clondalkin, drug-treatment service (October 2007)96 Crack cocaine in the Dublin region: an evidence base for a crack cocaine strategy