In March 2004 CityWide published the results of a survey on the extent to which 27 community-based drug projects were dealing with the problems of cocaine use.1 The results illustrated that cocaine was a growing problem.

CityWideconducted a follow-up survey on cocaine in local communities in 2006.2 Twenty-eight projects responded to this survey, 13 of which had participated in the 2004 survey. The results show that local community drug projects have experienced a major increase since 2004 in people presenting with cocaine as their primary drug.

In 2004, four projects (15%) reported seeing clients with what they then described as problematic cocaine use. Two years later, 62% of projects reported treating clients presenting with cocaine as their primary drug. Figure 1 shows that a majority of projects reported an increase in cocaine use among clients since 2004.

The follow-up survey reports a deterioration in the general health of clients with problematic cocaine use, with 39% of the projects surveyed reporting a rise in the number of clients experiencing abscesses and wounds due to poor injecting habits. Twenty-two per cent of projects reported an increase in mental health problems, including depression, anxiety, stress, psychotic episodes and attempted suicide.

Projects also reported increases in weight loss, sexually transmitted infections (STIs), heart conditions, amputations, opiate users stabilised on methadone destabilising with cocaine use, and risk taking among clients using cocaine. One project reported being aware of one heroin-related death in the 10 years up to 2005, in comparison with knowledge of four cocaine-related deaths in 2006.

All projects expressed concern about clients who got into financial debt, resulting in their living in fear of violent reprisal for debts unpaid, and engaging in increased criminal activity to feed their addiction. The majority of projects surveyed reported an increase in violent and gun-related crime since 2004.

The projects reported a strain on resources due to cocaine use. This was due to the chaotic lifestyle and behaviours that can be associated with cocaine use and the reported problem of opiate-using clients destabilising through cocaine use.

Since 2004, in response to the growing problem of cocaine use, three cocaine-specific pilot projects have been set up and 93% of the projects surveyed in 2006 had key workers who had undertaken cocaine-related training.

1.  Citywide (2004) Cocaine in local communities: Survey of community drug projects. Dublin: CityWide Drugs Crisis Campaign. www.citywide.ie

2.  CityWide (2006) Cocaine in local communities: CityWide follow-up survey. Dublin: CityWide Drugs Crisis Campaign. www.citywide.ie