1. NACD and NDST 8 th March 2007 A Joint Report by the National Drugs Strategy Team (NDST) and the National Advisory Committee on Drugs (NACD)

2. NACD and NDST 8 th 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

3. NACD and NDST 8 th 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

4. NACD and NDST 8 th 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 3 rd level college students used ‘last year’; males 9%; females 4%. Gender gap narrowing

5. NACD and NDST 8 th March 2007 Large increase in cocaine related offences Source: An Garda Síochána Annual Reports from 1999-2005

6. NACD and NDST 8 th March 2007 Large increases in seizures made by An Garda Síochána Source: An Garda Síochána Annual Reports; 1999-2005; Personal Communication 2006

7. NACD and NDST 8 th March 2007 Increase in number of seizures Customs & Excise Source: Annual Reports of the Revenue Commissioner 2000-2005

8. NACD and NDST 8 th March 2007 Increase in levels seeking treatment for cocaine Source: National Drug Treatment Reporting System

9. NACD and NDST 8 th March 2007 Increase in levels seeking treatment for cocaine Source: National Drug Treatment Reporting System

10. NACD and NDST 8 th 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

11. NACD and NDST 8 th 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

12. NACD and NDST 8 th March 2007 Testing positive for Cocaine Source: Drug Treatment Centre Board

13. NACD and NDST 8 th March 2007 Why should we be concerned? Health Community

14. NACD and NDST 8 th March 2007 Health Risks: Occurrence of adulterants in cocaine % of cases in which adulterants detected YearTotal no. cocaine cases PhenacetinLignocaineBenzocaineProcaineCaffeine 200486040%34%4%<1%11% 2005110360% 4%3%15% 200696959% 8%3%19% Source: Forensic Science Laboratory Fluctuating purity range 3%-83% in 2005

15. NACD and NDST 8 th 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

16. NACD and NDST 8 th 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).

17. NACD and NDST 8 th 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)

18. NACD and NDST 8 th 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

19. NACD and NDST 8 th 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

20. NACD and NDST 8 th 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

21. NACD and NDST 8 th March 2007 Thank you to all our collaborators and to the NDST

22. NACD and NDST 8 th March 2007