The Inchicore Bluebell Community Addiction Team (IBCAT) recently published its 2014 annual review.1 IBCAT was formed in 2011 with the merger of Inchicore Community Drugs Team and Bluebell Addiction Service. The service underwent a change of leadership in 2014, with Stuart Fraser succeeding Celine Martin, who was director for 15 years.

Services

IBCAT recognises that many of its users struggle with issues such as homelessness, poverty and mental health problems, and aims to offer a holistic approach to addiction treatment. In 2014 the service provided 25,311 interventions to problem drug users, their children and families. This was a slight increase on 2013, achieved despite funding cutbacks. Services provided include:

• key working,
• counselling,
• a drop-in service,
• a children’s project,
• family support,
• outreach (including prison visits), and
• aftercare.

IBCAT operates several groups for specific target populations. The women’s and men’s groups offer a safe environment for discussion and support around gender-specific issues. The family support group offers a safe space and peer supports for local people living with addiction. The cannabis group offers a peer support model to help service users make more informed choices and to reduce their usage. Progression of clients in the cannabis group is tracked every three months by evaluating how cannabis use is affecting the client financially, physically, emotionally and socially.

Let It Shine programme

The main focus of IBCAT’s 2014 annual review is the pilot polysubstance misuse group. The ‘Let It Shine’ group was created in response to a perceived trend of service users misusing more than one drug. This trend had also been reported in a 2010 ethnographic study of drug use in the Canal Communities area.2

Ten IBCAT clients took part in the pilot – five women and five men, all of whom were also on the methadone programme. The average age of the participants was 38, and the average number of different drugs being used weekly before attending the group was five. The programme lasted 12 weeks and the aim was ‘To give those attending factual, relevant information so that they could be more aware of their drug use and make more informed choices…Peer support is to be encouraged at all times’. (p. 19)

A contingency management method of treatment was used, whereby each participant was given a loyalty card and received incentives for regular attendance. The facilitators monitored the behaviours they were trying to change, including attendance and abiding by group rules. Positive reinforcement was in the form of credits, which could be exchanged for phone credit, food vouchers and so on. When the participant did not attend or the group rules were broken, positive reinforcement was withheld. The three aims of a contingency management approach are to reduce alcohol and drug use, retain problem drug users in treatment programmes, and promote positive contributions to society.

The programme was evaluated using two metrics: (1) drug spend before and after the programme, and (2) a ‘happiness scale’ to test for changes in happiness, again before and after the programme. Table 1 tracks the changes in drug use and drug-related spending over the course of the 12-week programme. Although the number of participants is very small (n=10), the reductions in drug use are notable. Of particular interest are the 74% decrease in average weekly spend on heroin, and the 89% decrease in the average weekly spend on crack cocaine. The number of clients using heroin reduced from eight before the programme to three after the programme.

Increases in happiness were reported across the nine areas of their lives about which participants were asked, ranging from a 13% increase in happiness about their ‘personal life’ and a 14% increase in happiness in relation to their ‘drug use’ up to a 37% increase in ‘job or educational prospects’ and a 38% increase in relation to their ‘social life’. Overall, participants reported a 39% increase in ‘general happiness’. The happiness scores for individual participants were not reported.

1 Inchicore Bluebell Community Addiction Team (2015) Inchicore Bluebell Community annual review 2014. Dublin: Inchicore Bluebell Community Addiction Team. https://www.drugsandalcohol.ie/24226/ For further information on IBCAT, visit www.icdt.eu

2 Saris A J and O'Reilly F (2010) A dizzying array of substances: an ethnographic study of drug use in the Canal Communities area. Canal Communities. Dublin: Local Drugs Task Force. https://www.drugsandalcohol.ie/13503/