NACD and NDST 8 th March 2007 A Joint Report by the National Drugs Strategy Team (NDST) and the...
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Transcript of NACD and NDST 8 th March 2007 A Joint Report by the National Drugs Strategy Team (NDST) and the...
NACD and NDST 8th March 2007
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
• 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
• 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
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
0
200
400
600
800
1000
1200
1400
1999 2000 2001 2002 2003 2004 2005
Number ofcocainerelatedoffences
Source: An Garda Síochána Annual Reports from 1999-2005
NACD and NDST 8th March 2007
Large increases in seizures made by An Garda Síochána
0100
200300400500600
700800900
1000
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Number ofseizures
Source: An Garda Síochána Annual Reports; 1999-2005; Personal Communication 2006
NACD and NDST 8th March 2007
Increase in number of seizures Customs & Excise
0
10
20
30
40
50
60
70
2000 2001 2002 2003 2004
Number ofseizures
Source: Annual Reports of the Revenue Commissioner 2000-2005
NACD and NDST 8th March 2007
Increase in levels seeking treatment for cocaine
0
50
100
150
200
250
300
350
1998 1999 2000 2001 2002 2003
No. cases cocaine asmain problem drug
Source: National Drug Treatment Reporting System
NACD and NDST 8th March 2007
Increase in levels seeking treatment for cocaine
0
500
1000
1500
2000
2500
1998 1999 2000 2001 2002 2003
No. casestreated, cocaineadditionalproblem drug
Source: National Drug Treatment Reporting System
NACD and NDST 8th March 2007
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?
• 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
0
10
20
30
40
50
60
7080
90
100
Meth Opia Benzo Cann Alco Amph
Drugs used bycocaine positiveclients
Source: Drug Treatment Centre Board
NACD and NDST 8th March 2007
Why should we be concerned?
• Health
• Community
NACD and NDST 8th March 2007
Health Risks: Occurrence of adulterants in cocaine
% of cases in which adulterants detected
Year Total no. cocaine cases
Phenacetin Lignocaine Benzocaine Procaine Caffeine
2004 860 40% 34% 4% <1% 11%
2005 1103 60% 60% 4% 3% 15%
2006 969 59% 59% 8% 3% 19%
Source: Forensic Science Laboratory
Fluctuating purity range 3%-83% in 2005
NACD and NDST 8th March 2007
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
• “… 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
• 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
• 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
• 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
• 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
Thank you
to all our collaborators
and to the NDST
NACD and NDST 8th March 2007