Home > HRB reports latest trends in treated opiate and cocaine use across Ireland.

Health Research Board. Alcohol and Drug Research Unit. [Health Research Board] HRB reports latest trends in treated opiate and cocaine use across Ireland. (03 Sep 2009)

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The number of people presenting for treatment for opiate (mainly heroin) and cocaine use is continuing to rise. Opiate cases* increased from 8,804 in 2002 to 11,538 in 2007, and cocaine cases* rose from 954 in 2002 to 2,643 in 2007. The Health Research Board (HRB) analysed trends in treatment for these drugs between 2002 and 2007 and has reported the key findings to help inform service planning.

*One case does not necessarily represent one person. A number of people presented for treatment on more than one occasion during the period under review.

According to Dr Jean Long, Head of Alcohol and Drug Research at the HRB,

‘The number of cases presenting for treatment is increasing – and this number is only an indication of the level of problem substance use in the wider community. The rise in opiate and cocaine cases is the result of a combination of factors: an increase in the number of treatment places, an increase in reporting to the National Drug Treatment Reporting System as well as an increased use of these drugs. These reports provide an indication of trends in treatment demand, as well as highlighting the types of service and intervention that are required.’

Opiates

According to the latest treatment figures:

Three in every five cases treated for problem drug use between 2002 and 2007 reported an opiate, mainly heroin, as their main problem substance.
In 2007, 11,538 cases were treated for problem opiate use. This is a 31% increase (2,734 cases) since 2002 and an increase of just over 7% (783 cases) since 2006.
Two-thirds (7,643 cases) of problem opiate users were continuing in care, that is, they were already in methadone treatment on 31 December 2006 and continued to receive that treatment on 1 January 2007.
Just over one-fifth (2,598 cases) had received treatment before and re-entered treatment again in 2007. This reflects the fact that problem opiate use is a recurring problem and requires repeated treatment over time.
Ten per cent (1,151 cases) were new cases presenting for treatment for the first time.
A small number of cases (146, 1.3%) were not clearly identified as either new or return cases.
Of the previously treated and new cases who entered treatment in 2007 and who reported opiates as their main problem substance, more than half used it daily, 10% used it on two to six days per week and 6% used it once a week or less. One-quarter had not used it in the month prior to treatment; this reflects the transfer of stable clients to alternative treatment centres.
Between 2002 and 2007, 5,304 cases entered treatment for the first time. The number of new cases aged 15–64 increased by 22%, from 28 per 100,000 in 2002 to 35 in 2007. The overall number of opiate cases was high in Dublin; however, the number of new cases was lower in 2007 than in 2002. Over the same period there was a significant increase in new cases elsewhere in the country, with a steady increase in the midland, south eastern and north eastern counties. The number of new cases is an indirect indicator of recent trends in problem substance use.
There was a 54% (2,680) increase in the number of methadone treatment places between 2001 and 2007. This reflects one of the benefits of the proactive approach of the National Drugs Strategy. It is important to note that methadone substitution is a long-term treatment that can take a number of years to show results.
Of the 3,575 cases who entered treatment and reported opiates as their main problem substance in 2007, 52% smoked it, 40% injected it and 5% consumed it orally. From 2003 to 2007, decreasing proportions of cases reported injecting as their primary route of administration, while correspondingly increasing proportions reported smoking as their primary route.

‘It is encouraging that people taking drugs are presenting for treatment, and studies show some promising progress among those who seek treatment,’ says Dr Long. ‘For example, in its report on the ROSIE study, the National Advisory Committee on Drugs highlighted the fall in both drug use and crime among opiate users at the end of their first year in treatment. In addition, people who have been treated for up to three years are seeing progress in relation to housing, training and employment opportunities.’

‘Another promising trend is the fact that fewer users are injecting opiates, which reduces their chances of transmitting or getting blood-borne viral infections,’ adds Dr Long.

Cocaine

According to the latest treatment figures:

One in every five cases treated for problem substance use between 2002 and 2007 reported cocaine as a problem drug. Cocaine is most often cited as an additional drug, most commonly used alongside opiates, alcohol or cannabis.
The total number who reported cocaine as their main problem substance remained relatively low, but there was a significant increase over the six years, from 128 in 2002 to 770 in 2007.
The prevalence of 15–64-year-old cases treated for cocaine as a main problem substance increased from nine per 100,000 in 2002 to 25 per 100,000 in 2007. This is an indication that cocaine use is a recurring addiction that requires repeated treatment over time.
The number of new cases who reported cocaine as their main problem substance increased from five per 100,000 in 2002 to 15 per 100,000 in 2007, which is an indication of recent trends in problem cocaine use.
The average annual number of new cases treated for cocaine as a main problem substance was highest in the south east and lowest in the west and north west of the country. Numbers in Dublin were lower than expected; however, this is attributed to the fact that many problem cocaine users in Dublin also use opiates and, in such cases, the opiate is recorded as the main problem substance.
The majority who reported cocaine as their main problem substance used it on two to six days per week, which would indicate that cocaine may be used as a weekend drug or as part of a binge.
It is evident that there are two distinct profiles of cocaine user: the social user who uses cocaine in conjunction with alcohol, ecstasy or cannabis, and the user from a more deprived background who uses cocaine in conjunction with opiates. Of note, 61% of 223 crack cocaine users treated in 2007 also used opiates.

Treated cocaine users were from a mix of social backgrounds, while treated opiate users tended to be from more deprived backgrounds. For example, the proportion of treated cocaine cases in employment was higher than that of treated opiate cases, 35% compared to 13%, and the proportion of treated cocaine cases who left school early was lower than that of treated opiate cases, 15% compared to 25%.

Dr Long concludes: ‘Since 2008, we are collecting and collating further information about the outcomes of individual treatment interventions. Our system will record all treatment interventions received by a client during a treatment episode, along with the outcome of their treatment when they are discharged or transferred to another service. This information, which will be available in late 2010, will enable us to assess the immediate value of treatment interventions for particular problem substances, which will be a source of more comprehensive guidance for the provision of services around the country.’

The data presented in this press release are taken from:
HRB Trends Series 6: Trends in treated problem cocaine use in Ireland, 2002 to 2007.
HRB Trends Series 7: Trends in treated problem opiate use in Ireland, 2002 to 2007.

For a hard copy of the report, contact
Mairea Nelson,
Database Administrator
t +353 1 2345127
e adru(at)hrb.ie

Item Type

News

Source

Health Research Board

Date

3 September 2009

Corporate Creators

Health Research Board. Alcohol and Drug Research Unit

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