Home > New report on cocaine use in Ireland.

Kelly, Fionnola and Long, Jean (2004) New report on cocaine use in Ireland. Drugnet Ireland, Issue 10, March 2004, pp. 2-3.

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In December 2003, the National Advisory Committee on Drugs (NACD) published a report entitled An overview of cocaine use in Ireland. 1 This report provides baseline information on cocaine, its use and treatment options.

The authors provide background information on the origins of cocaine, which is derived from coca bushes that grow mainly in South America. As the authors state, in Ireland, it is illegal to produce, possess or supply the drug except on prescription. When taken, cocaine heightens sensations of sight, sound and smell, as well as making the user feel more energetic, talkative, alert and euphoric. Chronic use of cocaine can lead to the development of mental health problems (for example, paranoia, hallucinations, anxiety attacks and agitation). The authors point out that repeated snorting of cocaine damages the membranes that line the nose.  In addition, use of this drug can also lead to cardio-vascular complications. Furthermore, if cocaine is injected, then complications such as, abscesses and blood-borne viral infection may occur. 

The authors describe a small but increasing trend in cocaine use in Ireland. The first general population survey designed to calculate the prevalence of drug use in Ireland was carried out by the NACD in 2003.  It found that three per cent of the adult population (15 to 64 years) reported using cocaine (powder) in their lifetime. The highest lifetime prevalence rate (5%) of cocaine use reported was among young persons between 15 and 24 years.  SLAN carried out a population survey in 1998 and found that just under two per cent of males and 0.6 per cent of females aged 18-64 had used cocaine in the previous year. In 2002 the rate among males had increased to three per cent and among females had more than trebled to almost two per cent. Data from the National Drug Treatment Reporting System (NDTRS) also highlighted an increasing trend in cocaine use. The number of treatment contacts who reported cocaine as their main problem drug increased from 25 in 1996 to 76 in 2000. In addition, the number who reported cocaine as their second problem drug increased substantially, from 121 in 1996 to 504 in 2000.  In line with this, the number of cocaine-related offences increased substantially, from 11 in 1990 to 297 in 2001.  Although, as a proportion of all drug-related offences, cocaine related offences remain relatively low at three per cent in comparison to offences relating to cannabis (60% approximately) and ecstasy (27% approximately). 

It is difficult to ascertain the nature of cocaine use in Ireland as very few studies have explored this issue in depth. Paula Mayock’s  study for the Health Research Board in 2001 provided information on the nature of recreational cocaine use.  The vast majority of recreational users took cocaine orally or intranasally and consumed the drug at weekends.  It was of  note that  recreational users did not consider their drug consumption damaging or problematic.  Mayock reported that the nature and extent of cocaine use was likely to differ substantially between her study group and opiate users. However, the author stated, there was little understanding of the nature of cocaine use among opiate users. As Mayock argued, this information was essential in order to increase service providers’ knowledge and awareness of the health risks associated with this drug.

As part of the overview, the NACD commissioned two studies in two different settings so as to explore a wider spectrum of cocaine use in Dublin. The first study conducted by UISCE (Union for Improved Services, Communication and Education) used a purposive sampling technique in that interviewers used their networks and contacts to approach people they thought likely to be cocaine users.  Merchant’s Quay Ireland conducted the second study. They surveyed 100 clients who presented for treatment at their health promotion unit and who had used cocaine or crack in the previous year.  The respondents’ average age of first cocaine use was similar in the UISCE study and the Merchant’s Quay study, 21 and 22 years respectively. In both studies almost half of the respondents used cocaine on a weekly basis.  Twenty per cent of respondents in the Merchant’s Quay study reported using cocaine on a daily basis, while this figure doubled to 40 per cent in the UISCE study. The discrepancy in the two figures may be due to the fact that the majority of respondents in the Merchant’s Quay study (83%) reported using heroin in addition to cocaine, with almost three-fifths reporting heroin as their main problem drug.  In contrast, just over two-fifths of cocaine users in the UISCE study reported heroin use.  Participants in both studies reported high levels of polydrug use.  A lower proportion of respondents in the UISCE study reported injecting cocaine than their counterparts in the Merchant’s Quay study, 58 versus 82 per cent.  As Merchant’s Quay provides a needle exchange facility this finding was not surprising. 

In the study at Merchant’s Quay, the majority of injector respondents did not mix the cocaine with another drug, while 41 per cent mixed it with heroin (as a snowball). In addition, 30 per cent of crack users reported injecting crack. As the authors state, these high rates of injecting cocaine, crack and ‘speedball’ indicate the high risks taken by this group.  In this study, it was reported that 45 per cent of crack users and 23 per cent of cocaine users had not used the drug in the last month but three-quarters of the respondents reported binge use. The authors highlighted the high-risk practices associated with binge use and stress this is an important issue for harm minimisation interventions.  Many of the injecting cocaine users in the study reported a range of mental health problems, such as, depression and hallucinations. The authors stated that it was unclear whether the difficulties experienced by cocaine/crack users were due to intravenous heroin or cocaine use as 87 per cent of cocaine injectors were also using heroin.  These issues were not reported for the cocaine users that participated in the UISCE study. 

In the Merchant’s Quay study, only 44 per cent of respondents said that their cocaine use was problematic, and of these, only 16 per cent had sought treatment. In contrast, three fifths of respondents in the UISCE survey felt that their cocaine use was problematic as almost all (98%) had experienced changes in behaviour since they started using cocaine. Despite this, only a small proportion of these (less than one third) had sought treatment. According to the authors, low levels of treatment seeking were related to the belief among cocaine users across both studies that treatment for cocaine use was futile due to the lack of a pharmacological substitute.

The authors reviewed approaches to treatment and some important issues were highlighted. The authors emphasised the need to attract problem cocaine users into services and the need to empower them to make lasting change.  They found that the most effective method of achieving this was ensuring that there were no delays in starting treatment by providing early appointments.  According to the authors, assessments to classify the severity of the problem were essential in order to provide appropriate treatment.  For example, providing outpatient programmes for moderate problems and providing residential programmes for complex cases were more likely lead to a successful outcome.  The authors reported that the most effective methods of treating cocaine users were individual drug counselling, group therapy and counselling, self-help groups and peer leadership.  The authors stated that treatment services need to cater for the wider spectrum of illicit drugs used rather than problem opiate use per se.

Finally, the authors emphasised the need for drug treatment agencies to establish services orientated toward the needs of cocaine and polydrug users. The report described two distinct groups of cocaine users: cocaine users who never used heroin, and existing heroin users. The non-heroin users perceive the drug as clean and acceptable with minimal health implications. The perception of cocaine as a safe drug needs to be tackled given the risk behaviours associated with administering the drug, which increase when it is used in combination with alcohol and other drugs.

An overview of cocaine use in Ireland  is available on the National Advisory Committee on Drugs website at www.nacd.ie

1. National Advisory Committee on Drugs (2003) An Overview of Cocaine Use in Ireland. Dublin: NACD  

Item Type
Publication Type
Irish-related, Open Access, Article
Drug Type
Issue Title
Issue 10, March 2004
March 2004
Page Range
pp. 2-3
Health Research Board
Issue 10, March 2004
Accession Number
HRB (Available)

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