Home > Travellers accessing addiction services in Ireland.

Carew, Anne Marie (2014) Travellers accessing addiction services in Ireland. Drugnet Ireland , Issue 48, Winter 2013 , pp. 9-10.

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A recently published paper based on data from the National Drug Treatment Reporting System (NDTRS) for the years 2007–2010 describes individuals from the Traveller community who were assessed or treated for problem drug or alcohol use.1 This study provides an insight into the needs of Travellers with problem substance use and will be useful in informing and developing policies and strategies to tackle barriers and issues faced by the Traveller community. 

Since 2007 the NDTRS has recorded ethnic identifiers comparable with those used by the Central Statistics Office in the Census. The inclusion of an ethnic identifier question in routine data collection allows the recording of useful information on ethnicity for planning health services.  
 
Key findings
 
Numbers seeking treatment
In the period 2007–2010, 68,748 cases sought treatment for problem substance use and were reported to the NDTRS. Ethnicity was recorded for 68,329 cases (99.4%), of whom 1,098 (1.6%) identified themselves as Irish Travellers. The number of such cases increased by 163% in the four-year period, from 162 in 2007 to 427 in 2010. However, the authors note that the number of Traveller cases recorded in the routine national drug treatment data is likely to be underestimated.
 
The incidence of treated problem substance use among the Traveller community was three times that among the general population in 2010 (523 per hundred versus 173 per 100,000). 
 
Main problem substance
·         Alcohol was the most common problem substance for which cases both from the Traveller community (42.3%) and from the general population (52.7%) sought treatment.
·         The number of Travellers seeking treatment for opiates (heroin, methadone and other types) increased by 291% (from 43 cases in 2007 to 168 in 2010), comprising 36.0% of Traveller cases in the four-year period, compared to 28.7% of cases from the general population.  
·         Although the numbers were small, there was a sharp increase in cases of Travellers reporting their main problem substance as benzodiazepines (a 240% increase, from 5 in 2007 to 17 in 2010) and cannabis (a 200% increase, from 16 in 2007 to 48 in 2010). A similar upward trend, if less pronounced, was observed in cases from the general population: benzodiazepines (a 147% increase, from 177 to 435 cases) and cannabis (a 118% increase, from 1,065 to 2,326 cases).
·         Opiates (heroin and other types) were the most commonly reported problem substance among Traveller women, while alcohol was the most commonly reported among women from the general population.
·         Albeit small in number, the proportion of Traveller women treated for benzodiazepines as a main problem substance (9, 4.0%) was higher than that in women from the general population (328, 1.9%).
 
Additional problem substances
·         The proportion reporting problem use of more than one substance (polysubstance use) was higher among Traveller cases (523, 53.2%) than among cases from the general population (24,826, 42.1%).  The proportion reporting problem use of more than one substance was higher amongTraveller men (425, 56.1%) than Traveller women (98, 43.4%).
·         Cannabis was the most commonly reported additional problem substance among both Traveller cases and cases from the general population. Alcohol, cocaine, and benzodiazepines were the next most frequently reported additional problem substances for both groups.  
Age first used drugs
·         Traveller men who had used drugs commenced their drug use at a younger age (median, 14 years) than either Traveller women (median, 16 years) or their male counterparts from the general population (median, 16 years).
·         Traveller women who had used drugs commenced their drug use at an older age (median, 16 years) than women from the general population (median, 15 years). The median period of time between commencing alcohol or drug use and seeking treatment was shorter for Traveller women compared with women in the general population.
Injecting risk
A slightly lower proportion of Travellers reported ever injecting drugs compared to the general population, (15.3% versus 18.1%), and injecting status differed for men and women.
 
The proportions of Traveller men who reported ever injecting or ever having shared injecting equipment were lower than those in the general population. Traveller men reported starting to inject at an older median age than men in the general population (22 versus 19 years).
 
A higher proprotion of Traveller women reported ever having injected compared with women from the general population (24.3% versus 16.3%), and also started injecting at a younger median age than women from the general population (19 versus 20 years). The proportions of Traveller women who were injecting at the time of entry to treatment and who reported having shared injecting equipment were greater than those among women from the general population.
 
Gender differences
Traveller women reported high rates of problem opiate use and injecting behaviours, contrary to the perception that problem substance use in the Traveller community is a predominantly male issue. The findings present a major cultural issue and challenge to Traveller health services and given the high level of sharing this has implications for the delivery of needle exchange services.
 
The paper highlights that problem drug and alcohol use remains a serious issue, presenting ‘complex and multiple challenges for health services providing treatment’ and the specific needs and vulnerabilities of Travellers need to be considered in order to provide targeted, appropriate and effective addiction services.  
 
1.     Carew AM, Cafferty S, Long J, Bellerose D and Lyons S (2013) Travellers accessing addiction services in Ireland (2007 to 2010): analysis of routine surveillance data. Journal of Ethnicity in Substance Abuse, 12(4): 339–355. www.drugsandalcohol.ie/20892
Item Type:Article
Issue Title:Issue 48, Winter 2013
Date:January 2014
Page Range:pp. 9-10
Publisher:Health Research Board
Volume:Issue 48, Winter 2013
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:MA-ML Social science, culture and community > Sociocultural discrimination concepts > Minority group (racial group, immigrant, Traveller)
VA Geographic area > Europe > Ireland
J Health care, prevention and rehabilitation > Treatment and maintenance > Treatment factors

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