The National Advisory Committee on Drugs (NACD) launched the report An overview of cocaine use in Ireland: II 1on 8 March 2007.  Prepared jointly by the NACD and the National Drugs Strategy Team (NDST), the report looks at the prevalence, prevention and treatment, and consequences of cocaine use in Ireland.

This report updates the baseline information presented in the NACD’s 2003 cocaine report.2  Dr Des Corrigan, chairman of the NACD, stated at the launch that all indicators show a continued increase in cocaine use that crosses all social strata.

Examining data from the NACD/DAIRU (Drug and Alcohol Information and Research Unit, Northern Ireland) Drug Prevalence Survey 2002/2003,3 the authors conclude that cocaine use is highest among the 15–34 age group, is predominantly an urban phenomenon and is more common among males than females.  The last point is consistent with findings from the College Lifestyle and Attitudinal National (CLAN) survey in 2005.4 

Comparisons between data collected in the 1998 and the 2002 National Health and Lifestyle Surveys (SLAN)5 indicate that cocaine use has increased.  In 1998 1.8% of males and 0.6% of females surveyed had used cocaine in the last year.  In the 2002 survey, levels of cocaine use in the last year had increased to 3% among males and 1.9% among females. Data from the Human Toxicology Section of the State Laboratory, which carries out analysis for coroners and criminal cases, and the Medical Bureau of Road Safety, based on road safety tests, indicate an increase in cocaine-positive tests between 2002 and 2005.

Using Garda data on offences under the Misuse of Drugs Act 1977, the report reveals an increase in the number of cocaine-related offences from 180 in 2000 to 1,224 in 2005. Forty-seven per cent of the cocaine-related offences recorded in 2005 were in the Dublin Metropolitan Region.  The report shows that both Garda and Customs seizure data indicate a growing supply of cocaine in Ireland.  In 2005 cocaine was the second most commonly seized drug after cannabis resin. 

Data from the National Drug Treatment Reporting System (NDTRS) presented in the report are representative of people who attend for treatment for problem cocaine use, rather than of the general population using cocaine. Analysis of this data indicates a sustained increase between 1998 and 2003 in the number of treated cases reporting cocaine as a problem drug.  The number of treated cases reporting cocaine as a main problem drug increased by 262%, from 86 in 1998 to 311 in 2003.  The number of cases reporting cocaine as an additional problem drug increased by 394%, from 454 in 1998 to 2,244 in 2003.  The majority (92%) of cases reporting cocaine as their main problem drug in 2003 used one or more additional drugs.  Cannabis, alcohol and ecstasy were the most common additional drugs reported among these cases.  Cocaine was reported as an additional drug in cases where opiates, cannabis or ecstasy were reported as the main problem drug.  Data presented from the Hospital In-Patient Enquiry System (HIPE) also indicate an increase in the number of cases treated for cocaine-related problems in the years up to 2004.  In relation to the method of administration reported by people attending treatment for cocaine use, 70% reported snorting, 17% reported injecting and 11% reported smoking cocaine.

According to the authors, evidence from the data collected in the Research Outcome Study in Ireland (ROSIE), for which the study sample consists of problem opiate users in treatment, suggests that current treatment services have contributed to reducing both opiate use and cocaine use.  The authors report that, although no pharmacological substitution treatment is available for cocaine use, existing evidence indicates that many approaches currently being practised in treatment services, such as cognitive behavioural therapy, brief interventions, group therapy/counselling, contingency management, and peer leadership, work well with cocaine users.  However, the authors state that current treatment services require a more cocaine-specific focus in order to encourage cocaine users to avail of such services.

At the launch of this report, Dr Corrigan highlighted the impact cocaine is having in the community, in terms of sharp increases in public disturbance, noise, intimidation and violence, while individuals are experiencing disrupted personal relationships, reduced productivity, loss of employment and income as well as physical and/or mental ill-health.  Physical problems, including heart conditions, strokes, nasal damage and breathing problems, are associated with cocaine use.  Intravenous cocaine use can lead to abscesses, blood clots and a range of systemic infections, including HIV and hepatitis B and C.  Mental health problems include depression, agitation, anxiety, compulsive behaviour, aggression and paranoia.  The authors report that levels of alcohol use among cocaine users are high. Alcohol and cocaine, when used together, combine to form a more toxic substance called cocaethylene.

The report makes 13 recommendations, focusing mainly on treatment but also covering supply, prevention and research. Those relating to treatment include:

• Establish stimulant-specific interventions in areas where cocaine problems are acute.
• Re-orient drug treatment services from drug-specific interventions to treatment tailored towards the individual regardless of the drug(s) they use.
• Dispel the myth that there is no effective treatment for cocaine use.
• Launch needle-exchange and related harm-reduction strategies.
• Identify and meet training needs of frontline staff.
• Improve working relationships between GPs, A&E staff and the drug services.
• Include cocaine among the problem drugs addressed by prison drug treatment services and drug awareness programmes. 

1. National Advisory Committee on Drugs and the National Drugs Strategy Team (2007) An overview of cocaine use in Ireland: II. Dublin: Stationery Office. www.nacd.ie

2. National Advisory Committee on Drugs (2003) An overview of cocaine use in Ireland. Dublin: Stationery Office. https://www.drugsandalcohol.ie/5655/

3. National Advisory Committee on Drugs and Drug and Alcohol Information Research Unit (2006) Drug use in Ireland and Northern Ireland. 2002/2003 drug prevalence survey: cocaine results. Bulletin 4. Dublin: National Advisory Committee on Drugs.

4. Health Promotion Unit (2005) The health of Irish students. Dublin: Department of Health and Children.

5. Centre for Health Promotion Studies, NUI Galway (2003) Survey of lifestyle, attitudes and nutrition (SLAN) and the Irish health behaviour in school-aged children (HBSC) survey. Dublin: Department of Health and Children.