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Lynn, Ena (2005) Joint Oireachtas Committee report on cocaine addiction. Drugnet Ireland , Issue 15, Autumn 2005 , p. 19.

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On 6July 2005, the Joint Oireachtas Committee on Arts, Sport, Tourism, Community, Rural and Gaeltacht Affairs launched its seventh report entitled The treatment of cocaine addiction, with particular reference to the Irish experience.1

Cecilia Keaveney, TD and chair of the Joint Committee, welcomed the audience to the launch and thanked the authors of the report, Dr Siobhán Barry, clinical director, and Ms Elizabeth Lawlor, senior clinical psychologist, both of the Cluain Mhuire Service.

The report includes information on the consequences of cocaine use, the usage of cocaine in Ireland and the Irish experience of managing cocaine addiction, and gives recommendations for preventative strategies and evidence-based treatment. According to the authors, lifestyles associated with cocaine use include poor nutrition, polysubstance use and criminality. The effects of cocaine on the body are cumulative and may result in fatal cardiovascular events. The report states that suicide is the cause of death in up to 10 per cent of cocaine-related deaths.

 

Irish patterns of cocaine use indicate:

·         Cocaine is used predominantly during early adult life.

·         More males than females use cocaine.

·         There is increased availability and use of cocaine.

·         Cocaine use is not confined to the Dublin region.

·         Data from the National Drug Treatment Reporting System indicate that cocaine is mainly reported as a second, third or fourth problem drug for clients seeking treatment for drug misuse.

A snapshot of the Irish experience of managing cocaine addiction indicates:

·         Although the number of clients seeking treatment who report cocaine as their main problem drug has increased, the total number is small. Clients do not seek treatment for one of two reasons: either they do not perceive themselves as requiring treatment or they think existing treatment services are inappropriate to their needs. This highlights the challenge for the drug treatment services to change what has historically been a predominantly opiate-focused treatment system into one that meets the needs of cocaine and polydrug users.

·         Many service providers are attempting to provide some level of service for cocaine users, which is increasing the pressure on existing services.

·         Training on evidence-based treatment for service providers is needed immediately.

In relation to treatment options, the authors highlight the need for a holistic approach based on the needs of the individual client. This involves dealing with medical, psychological and social problems and includes complementary therapies.

Recommendations of the report include:

1.       Preventative strategies, which embrace health promotion, provide basic factual information and offer specific psycho-education to expose the misconceptions about cocaine.

2.       A qualitative study of cocaine use identifying and exploring the distinct needs of people who use recreational cocaine and people who are polysubstance users.

3.       Resources to facilitate assessment for clients presenting for treatment for problem cocaine use which include:

·         basic physical assessment, including cardiovascular screening

·         formal substance misuse assessment

·         psychological assessment, for example, motivational interviewing

·         psychiatric assessment.

4.       A pyramid of interventions comprising:

·         drug-free outpatient care for clients who have a relatively small cocaine use problem, at the base 

·         a logical and sequential programme of detoxification for clients addicted to a wide range of substances, which includes psychological care, social intervention, practical education or occupational opportunities and complementary therapies, as the second tier

·         residential after-care programmes of significant duration which offer a wide range of intervention to assist clients who are at particular risk of relapse, at the apex.

5.       An outpatient-based, relapse-prevention programme to which self-referral for those who relapse would be encouraged.

Social reintegration was outside the scope of this report. As chair of the Joint Committee, Cecilia Keaveney outlined the committee’s present role as that of seeking the allocation of resources to implement the recommendations of this report. 

1. Joint Committee on Arts, Sport, Tourism, Community, Rural and Gaeltacht Affairs (2005) The treatment of cocaine addiction, with particular reference to the Irish experience. Dublin: Stationery Office.

 This publication can be purchased directly from Government Publications Sale Office, Sun Alliance House, Molesworth Street, Dublin 2, or by mail order from Government Publications, Postal Trade Section, 51 St Stephen’s Green, Dublin 2, Tel 01-476834/35/36/37.

   

Item Type
Article
Issue Title
Issue 15, Autumn 2005
Date
July 2005
Page Range
p. 19
Publisher
Health Research Board
Volume
Issue 15, Autumn 2005
EndNote
Accession Number
HRB (Available)

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