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A Joint Report by the National Drugs Strategy Team (NDST) and the National Advisory Committee on Drugs (NACD). Background to the report. Late 2005 Minister asked NDST and NACD to prepare joint briefing on cocaine Data from a wide range of sources

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A Joint Report by the National Drugs Strategy Team (NDST) and the National Advisory Committee on Drugs (NACD)

NACD and NDST 8th March 2007

background to the report
Background to the report
  • Late 2005 Minister asked NDST and NACD to prepare joint briefing on cocaine
  • Data from a wide range of sources
    • Population Survey, NDTRS, FSL, AnGS, C&E, ROSIE, HIPE, other research, literature
  • Report compiled by Justine Horgan PhD researcher at the NACD

NACD and NDST 8th March 2007

methodological issues
Methodological issues
  • Some data focus on ‘problem drug use’
  • Routine statistics generated for a specific purpose
  • Hard-to-reach and problem drug users may be excluded from household surveys
  • Cocaine user focus group - MQI

NACD and NDST 8th March 2007

indicators show upward trend
Indicators show upward trend

Prevalence in Ireland

  • Adult population
    • NACD/DAIRU 2002/2003: ‘last year’ use at 1%
    • SLÁN 1998-2002 ‘last year’ cocaine use up and
      • 1998: males 1.8% vs females 0.6%
      • 2002: males 3.0% vs females 1.9%
  • Young people
    • ESPAD 1999 at 2%; 2003 at 3% lifetime use
    • CLAN 2005: 6% of 3rd level college students used ‘last year’; males 9%; females 4%.
  • Gender gap narrowing

NACD and NDST 8th March 2007

large increase in cocaine related offences
Large increase in cocaine related offences

Source: An Garda Síochána Annual Reports from 1999-2005

NACD and NDST 8th March 2007

large increases in seizures made by an garda s och na
Large increases in seizures made by An Garda Síochána

Source: An Garda Síochána Annual Reports; 1999-2005; Personal Communication 2006

NACD and NDST 8th March 2007

increase in number of seizures customs excise
Increase in number of seizures Customs & Excise

Source: Annual Reports of the Revenue Commissioner 2000-2005

NACD and NDST 8th March 2007

increase in levels seeking treatment for cocaine
Increase in levels seeking treatment for cocaine

Source: National Drug Treatment Reporting System

NACD and NDST 8th March 2007

increase in levels seeking treatment for cocaine1
Increase in levels seeking treatment for cocaine

Source: National Drug Treatment Reporting System

NACD and NDST 8th March 2007

other indicators
Other indicators
  • Medical Bureau of Road Safety
    • 2002: 9 cases
    • 2005 86 cases
  • Hospital In-Patient Enquiry
    • 1999 52 cases
    • 2004 222 cases

NACD and NDST 8th March 2007

who is using cocaine
Who is using cocaine?
  • Cocaine is across all social strata
    • NACD Bulletin 4: cocaine use evenly distributed across SEGs
  • Polydrug use cases seeking treatment
  • Methadone maintained
    • 45% of ROSIE cocaine users on entry to treatment were in the Methadone Modality

NACD and NDST 8th March 2007

testing positive for cocaine
Testing positive for Cocaine

Source: Drug Treatment Centre Board

NACD and NDST 8th March 2007

why should we be concerned
Why should we be concerned?
  • Health
  • Community

NACD and NDST 8th March 2007

health risks occurrence of adulterants in cocaine
Health Risks: Occurrence of adulterants in cocaine

Fluctuating purity range 3%-83% in 2005

Source: Forensic Science Laboratory

NACD and NDST 8th March 2007

health risks
Health Risks
  • Physical health problems affecting heart, lungs, brain kidney and nose. IV-use can lead to abscesses, clots, HIV & Hep B/C infections
  • Mental health problems: depression, anxiety, agitation, compulsive behaviour, paranoia, aggression
  • Combined with alcohol – more toxic effects
  • Binge use leading to problematic behaviour
  • Crash
  • Problem of quick dependence: economic & social harm, public nuisance, violence crime

NACD and NDST 8th March 2007

problem drugs use nds
Problem drugs use - NDS
  • “… drug misuse or problem drug use refers to drug use which causes “social, psychological, physical or legal difficulties as a result of an excessive compulsion to continue taking drugs”.”

National Drugs Strategy 2001-2008 Building on Experience (p. 24).

NACD and NDST 8th March 2007

reports from the community
Reports from the Community
  • National Drug Trend Monitoring System
    • 90% report cocaine availability in community
    • 81% report their contacts use cocaine
    • 71% report cocaine as most frequently used drug
    • 50% report cocaine as drug which has seen greatest increase in community
  • CityWide Cocaine Survey 2004/2006 Follow-up
    • Increased use in community (irregular heroin supply)
    • Drugs transaction less visible but intimidation increased
    • Concerns re physical & mental health deterioration
    • Alcohol & cocaine combined leading to increased aggression and violence in the community (NACD Community Drugs Study)

NACD and NDST 8th March 2007

key issues
Key Issues
  • Reorientation of addiction services from being opiate focussed to all encompassing
  • Specific interventions in acute problem areas
  • Harm reduction services need to adapt to added burden
  • Training and development of staff to enhance competencies & capacity to address cocaine
  • Optimum number of personnel in Garda Drug Units
  • Roll out local policing fora in LDTFs as per guidelines
  • Information of cocaine harms needs to be disseminated
  • Data collection by smallest area – DED
  • Understanding diffusion of cocaine and other drugs

NACD and NDST 8th March 2007

progress
Progress
  • Information presented to the IDG
  • HSE plan to make all drug treatment facilities accessible for all drug addiction
  • HSE considering 2 cocaine specific services
  • NDST are pursuing issue through implementation of cocaine specific initiatives
  • Other issues raised in the report are being pursued through ongoing work of the IDG

NACD and NDST 8th March 2007

treatment works
Treatment works
  • ROSIE study shows that even those treated for heroin dependence reduced their cocaine use
  • Whilst there is no drug of substitution psychosocial interventions such as CBT are shown to be effective
  • Other therapies play a role in recruitment and retention in treatment
  • The NDS is showing positive outcomes: Capture

Recapture Study; Community Study; ROSIE

NACD and NDST 8th March 2007

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