The Midlands Regional Task Force commissioned Niall McElwee and Grainne Monaghan to examine heroin misuse in Athlone and Portlaoise.1 Athlone is on the main route from Dublin to Galway; Portlaoise is situated on the main Dublin to Cork/Limerick road. The researchers employed a ‘relational child and youth care model’ to uncover and present the views and experiences of heroin users and service providers in the two towns.  They collected the data through interviews with heroin users and service providers. Their findings were triangulated using quantitative and qualitative information from a variety of stakeholders. 

According to the authors’ findings:

• In the urban area of Athlone in 1996, two-fifths of the population had no second-level qualifications.  In February 2000, 1,391 persons were unemployed.  At the time of the study, one local authority housing estate in west Athlone had an identifiable substance-use problem. The authors noted the difficulty in quantifying the numbers using heroin because figures varied between sources. In 2004, the local media reported that there were approximately 100 heroin users living in the town and, at the same time, service providers estimated that there were between 60 and 500 users.  In 2003, 39 cases were receiving treatment for problem opiate misuse through the Athlone Addiction Counselling Services.  Service providers believed that poverty and disadvantage were strongly linked to heroin use in the town. Many service providers reported that the location of a treatment centre in Athlone, with a transient clientele from Dublin, had contributed considerably to heroin use. There was an increase in heroin use among women in Athlone, with many of them introduced to heroin use by their partners.  One focus group reported that the majority of their clients started smoking heroin but then progressed to injecting.  According to the service providers, a large proportion of their clients were hepatitis C positive. The service providers stated that their clients’ heroin habits were funded through criminal activity and prostitution (both male and female). Users spent anything from €50 to €1,000 per week to feed their habits.  

• The population living in the urban area of Portlaoise was 3,842 in 2002.  In 2002, 19 per cent of the urban population had not completed primary level education and 20 per cent of those aged over 15 years were unemployed.  There are a number of high-density local authority housing estates in urban Portlaoise.  In 2002, Garda sources reported that there were approximately 50 persons using heroin in Portlaoise. According to the service providers, the figures varied from 70 to 250 persons misusing heroin. In 2003, 30 cases received treatment for problem opiate use from the Portlaoise Addiction Counselling Services. The service providers reported that most of the heroin was brought down from Dublin.  The treatment providers in the town stated that 50 per cent of their clients were female and that very few heroin users injected. It was found that criminal activity to fund heroin was a recent phenomenon and, to date, prostitution was not a serious problem in Portlaoise. There was only one pharmacy dispensing methadone in Portlaoise at the time of the study and the lack of such pharmacies was seen as a critical issue. 

Following focus groups and pilot interviews, a refined questionnaire was developed and data were collected between October and November 2004. In the two towns, the study participants were selected using personal contact, key informants, media appeals or a snowballing technique.  Of the 143 questionnaires distributed, only 16 (11%) were returned to the researchers.  According to the authors, the response rate was much lower than expected and many potential respondents failed to keep appointments for interviews. 

The key survey findings were:

• Over half (8/15) of respondents were female.
• Ten of the 16 respondents were under 30 years old.
• Twelve of the 15 respondents lived in Athlone, while only two lived in Portlaoise.
• Only one of the 16 respondents was brought up in Dublin.
• Seven of the fourteen respondents left school before their sixteenth birthday.
• Four of the 16 respondents were currently employed.
• Of the 16 respondents, nine drank alcohol; seven drank for two or more successive days.
• Of the respondents who answered the question, six were currently using heroin, five were currently using other drugs, 15 had ever used cannabis, 14 had used heroin and 10 had used cocaine. 
• Just over half of the respondents had used heroin by their 18th birthday;
• Of the 16 respondents, six injected heroin;
• The main reasons for taking heroin were to boost feelings of well-being and to overcome problems;
• Of the 16 respondents, nine said that they received treatment.  

The majority of problem heroin use is concentrated in specific local authority areas.  According to the authors, the Midland’s addiction service requires a client-centred approach to treatment, needle exchange outlets, an inpatient detoxification unit, stabilisation facilities and rehabilitation interventions.  There is a need for a dedicated addiction service response for those aged under18 who are misusing drugs.  

1. McElwee N and Monaghan G Darkness on the edge of town: an exploratory study of heroin misuse in Athlone and Portlaoise. Athlone Institute of Technology and Midlands Regional Drugs Task Force.