Home > Doing more: the health and social impacts of crack cocaine use in Limerick City.

Duopah, Yaa Asuaba and Elmusharaf, Khalifa and Moran, Lisa and Kelly, Dervla (2023) Doing more: the health and social impacts of crack cocaine use in Limerick City. Dublin: Ana Liffey Drug Project.

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The primary aim of this study is to explore the health and social impacts of crack cocaine use in Limerick City.

Research objectives:
• To report on the lived experience of people who use the drug in Limerick City area.
• To report on the health and social impacts of crack cocaine use.
• To consider what impact the COVID-19 pandemic has had on the use of crack cocaine in the Limerick City area.
• To report on the current service responses in the Limerick City area addressing the use of crack cocaine.
• To make recommendations, in line with good practice, to ensure that the needs of people who use crack cocaine are met 

Policy context: Laws on drug control in Ireland began when the country was still part of the United Kingdom. The first significant legislation on drug control in Ireland was the Dangerous Drug Act of 1934. It was not until 1991 that drug legislation was in the outline of a National Drug Strategy (National Coordinating Committee on Drug Abuse, 1991). The Misuse of Drugs Acts 1977 is the main policy which outline criminal offences related to illicit drug use (European Monitoring Centre for Drugs and Drug Addiction, 2013). Since then, diverse national drug strategies have been established based on internal and external influences. The latest national drug strategy being ‘Reducing Harm Supporting Recovery: A health-led response to drug and alcohol use in Ireland 2017-2025’ - which was published on 17th July 2017. Also, attempts to deal with illicit drug use and its consequences are evident in a wide range of national policies and initiatives such as the Mental Health Strategy, the National Sexual Health Strategy 2015-2020, the Homeless Strategy National Implementation plan, the Irish National Strategy to Reduce Suicide 2015-2020 and An Garda Siochana’s 2016 National, Regional and Divisional Policing plans (Department of Health, 2017). 

One significant development with regards to the policy development process was the introduction of harm reduction strategies and the increasing acknowledgment of the association between illicit drug use and social disadvantage (Butler, 1997). The acknowledgement of this link led to development of 12 local Drugs Task Forces in specified areas experiencing high incidence of illicit drug use accompanied with a range of socioeconomic issues. After this, Regional Drug and Alcohol Task Forces were established for areas facing related problems (O’Reilly & Cionnaith, 2019). The Mid-West Regional Drugs and Alcohol Forum is the main statutory body that oversees responses to the drug problem in Limerick City and County. This forum is one of the ten regional task forces that was established based on the recommendation of the National Drug Strategy 2001 – 2008. The forum is comprised of community, voluntary and statutory representation. The role of the task forum is to formulate and supervise the execution of action plans which coordinate significant drug projects in the region and deal with disparities in the delivery of services (Howley, 2009). It also identifies gaps in drug and alcohol problems in the mid-west and reviews emerging trends. Ireland’s current policy on illicit drug use, “Reducing Harm Supporting Recovery”, is the first approach which focuses on a unified public health approach to illicit drug and alcohol use rather than a criminal justice approach. Action plans that have recognized current and evolving disparities were used in implementing the strategy. These action plans are in supply reduction, prevention, treatment, rehabilitation and research (Department of Health, 2017). Under the mid-term review of “Reducing Harm Supporting Recovery” there are six strategic priorities to be implemented for the period 2021-2025 (Department of Health, 2021).

The six priorities are:
1. Strengthen the prevention of drug and alcohol use and the associated harms among children and young people.
2. Enhance access to and delivery of drug and alcohol services in the community.
3. Develop integrated care pathways, to achieve better health outcomes, for people who engage in high-risk drug use.
4. Address the social determinants and consequences of drug use in disadvantaged communities.
5. Promote alternatives to coercive sanctions for drug-related offences.
6. Strengthen evidence-informed and outcomes-focused practice, services, policies and strategy implementation.

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