Home > Evaluation of projects to treat cocaine users.

Long, Jean (2007) Evaluation of projects to treat cocaine users. Drugnet Ireland , Issue 22, Summer 2007 , pp. 13-14.

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In 2004, the Department of Community, Rural and Gaeltacht Affairs requested the National Drugs Strategy Team (NDST) to identify projects that would tackle the growing problem of cocaine misuse in Ireland. In response, the NDST established the Cocaine Sub-Group to recommend pilot interventions aimed at different types of cocaine users. 

The three pilot treatment interventions selected were:

  • A community-based project involving St Dominic’s Community Response Project and Killinarden’s Community Addiction Response Programme, Tallaght, for problematic intranasal cocaine users.1 The interventions planned were advertising service availability, project meetings, relationship building, individual care plans, individual counselling, and holistic therapies.
  • Three inter-disciplinary, evidence-based interventions at Castle Street Clinic in the HSE South Western Area for polydrug users.2 The planned interventions employed a combination of individual and group counselling and cognitive behavioural therapy approaches.
  • A peer-support training project in the Women’s Health Project, Baggot Street and in Chrysalis, Benburb Street, for women using cocaine and working in the sex industry.3 It was envisaged that the project would train participants to provide accurate information on sexual health and drug use to their peers.

 A fourth project, selected and implemented by Merchants Quay Ireland,4 involved the provision of Tier 1 and Tier 2 training for health and social care staff working with cocaine users. The results of the training evaluation are not presented in this article. 

Goodbody Economic Consultants were appointed as external evaluators for the pilot treatment projects. In addition, the management committee for the Women’s Health Project decided to conduct an internal evaluation. The objectives of the external evaluation were to analyse what was achieved by the projects and report the lessons learned. In order to do this, the evaluators were to examine the structures, effectiveness, efficiency and value for money components of the projects. 

The project based in Tallaght was implemented in line with its original design. It commenced in February 2005 and ended in April 2006. The project employed six staff members on a part-time basis. The service was provided through two evening sessions and one afternoon session. The cocaine treatment service was promoted through a media campaign and proactive outreach work. The project communicated with cocaine users and concerned persons by telephone and received an average of 20 calls per week. Ninety-nine cocaine users attended the project, of whom 60 (61%) returned more than once. The uptake of complementary treatments, such as acupuncture and Indian head massage, was high. A further 60 people were assisted by the outreach worker. Seven clients were interviewed at the end of the project, of whom four were abstinent from all drugs and two said that their suicidal thoughts had ceased. According to the evaluators, the project was effective and very good value for money. 

At the implementation stage, the intervention for the project based in Castle Street was modified to provide participants with a group counselling programme consisting of a 90-minute session each week for 12 weeks. The topics for the counselling sessions were: understanding addiction, process of recovery, managing cravings, healthy relationships, self-help groups, support systems, managing feelings and coping with guilt and shame. It was envisaged that three groups of 12 cocaine users would complete the programme.  The project was implemented in 2005 and used existing staff resources. Two group counselling programmes were completed during the pilot period. Twenty-six polydrug users were referred to the project, of whom 14 were considered suitable to attend. Of the attendees, six completed the programme and five completed the post-intervention assessment. Of the five attendees assessed, one was abstinent from all drugs, two had reduced their cocaine and alcohol use, and two had reduced their cocaine use but not their alcohol use. The evaluators identified a number of weaknesses in the project design and implementation. The selection and referral process had serious flaws in that a high number of those referred were not suitable for the programme. The gap between counselling sessions was too long. Active drug users and those who were abstinent attended the same programme and this caused conflict. After-care was provided only to those who attended the second group and uptake was low.  The programme design did not take account of the participants’ other commitments (such as child care, training and employment) and this reduced attendance. There was no leadership or administrative support provided for the programme and the monetary resources allocated were not used. The evaluators recommended that this approach to cocaine treatment had merit but that the weaknesses identified must be addressed in any future programmes. 

The project based in both Baggot Street and Benburb Street changed its original objective from one of encouraging peer support to that of identifying participants who would invite other women (peers) to information and/or complementary therapy sessions. The topics for the information sessions were: harm reduction, working in a safe environment, general and sexual health, hepatitis C, effects of cocaine use and effects of complementary therapy. The complementary therapies were acupuncture, Indian head massage, Reiki, stress balls and upper body massage. The project management committee employed an experienced outreach worker on a part-time basis and introduced a complex system of payments for those attending the project. The project commenced in October 2005. Twenty-two women were contacted through the project, of whom 18 (7 participants and 11 peers) attended at least one project activity. Attendance at complementary services was better than that at information sessions, which did not hold the interest of the women; according to the external evaluators, this may have been linked to rates of payment. During the course of the project, it was observed that many of the women had complex social and medical problems and the project activities were not broad enough to address such issues. The outreach worker did address some of these problems through referrals to and negotiations with other services. The external evaluators reported that they could not form a judgement as to whether this project was effective or not without knowing the results of the internal evaluation.

 

1. Goodbody Economic Consultants (2006) Evaluation of the pilot cocaine project in Tallaght. Dublin: Department of Community, Rural and Gaeltacht Affairs. https://www.drugsandalcohol.ie/11702/

2. Goodbody Economic Consultants (2006) Evaluation of the pilot cocaine project in Castle Street Clinic. Dublin: Department of Community, Rural and Gaeltacht Affairs. https://www.drugsandalcohol.ie/11703/

3. Goodbody Economic Consultants (2006) Evaluation of the pilot cocaine Women’s Health Project. Dublin: Department of Community, Rural and Gaeltacht Affairs. https://www.drugsandalcohol.ie/11704/

4. Crampton W (2005) An evaluation of a cocaine training programme. Dublin: Merchants Quay Ireland. https://www.drugsandalcohol.ie/6345/

 

Item Type:Article
Issue Title:Issue 22, Summer 2007
Date:April 2007
Page Range:pp. 13-14
Publisher:Health Research Board
Volume:Issue 22, Summer 2007
EndNote:View
Accession Number:HRB (Available)
Subjects:B Substances > Cocaine
HJ Treatment method > Substance disorder treatment method

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