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High uptake of sterile crack pipes in response to surge in use of drug in Dublin

There has been an increase in use of the drug since the start of last year.

crack1 Source: Shutterstock

DRUG OUTREACH AND needle exchange services in Dublin say there’s been a strong uptake of clean crack pipes by service users in response to a surge in availability and consumption of the drug in recent months.

Similar to the approach taken to needle exchange, which has been available in the city for decades, sterile crack pipes are distributed as part of a harm reduction approach to problem drug use.

Merchants Quay Ireland, which opened the country’s first needle exchange back in 1991 and now offers a range of services for people who are homeless and experiencing addiction issues, began providing clean crack pipes from its centre on the south quays on 13 July and gave out 69 in the scheme’s first week of operation.

Anna Liffey Drug Project, which runs an outreach needle and syringe programme based out of Middle Abbey Street, began handing out its reusable crack pipes in April 2017.

Head of Services with ALDP Dawn Russell said 287 of the items have now been handed out – both in Dublin and in the Mid West of the country, where the service also operates.

Of those, almost half – 128 – have been handed out between March and July of this year (the majority in Dublin).

While most users smoke the drug, Russell said staff were also engaging with a very small cohort of people who are neck-injecting the drug, which she described as a “very risky activity”. Around 3 to 5 people are regularly taking the drug this way, she said.

ALDP outreach staff first began noticing makeshift crack pipes, usually constructed from plastic soft drink or water bottles, around a year-and-a-half ago.

crackpipe The sterile crack pipes distributed by ALDP include a gauze to smoke the substance through and a stick to help push the crack into the pipe. Source: Ana Liffey Drug Project

A smokeable form of cocaine made by chemically altering cocaine powder to form crystals or rocks, crack-cocaine produces a short but intense high with effects much stronger than the powdered version of the drug.

The rise in availability of cocaine in the capital has also led to an increase in the amount of crack being manufactured, drug services say.

Addiction experts say use of cocaine has now returned to Celtic Tiger levels, and earlier this week the HSE launched a new harm reduction campaign in conjunction with ALDP to provide information and advice to users about both cocaine and crack-cocaine.

Tony Geoghegan, CEO of Merchants Quay Ireland, said he had seen service users go “downhill rapidly” after beginning to take cocaine.

“The cohort we deal with here are primarily street drug users, rough sleepers, people who are homeless. That wouldn’t be your kind of archetypal cocaine user, it is much more spread across society. But it is important nonetheless [to address it] because cocaine and crack have the propensity for more harm very quickly.

Cocaine itself is an amphetamine so in very basic terms people don’t eat as much and don’t feel like they have to eat as much because it is an appetite suppressant. If someone already is nutritionally compromised then the impacts of that are more severe.

Similarly you don’t sleep when you’re on cocaine, whatever about heroin and alcohol and drugs like that, people can drink a certain amount or take a certain amount of heroin and then they pass out or fall asleep. People with cocaine will just keep going and go on binges where they stay up for two days.

Geoghegan said the “wear and tear” on the body can be significant and it can also impact on a person’s decision-making and general mental stability, particularly if they have had mental health issues in the past.

Our experience of cocaine here is you see people starting to use cocaine and going downhill rapidly – much more rapidly than they would on any other drugs.

crack An example of a makeshift crack pipe in Dublin. Source: Ana Liffey Drug Project

The effects of crack cocaine wear off very quickly, prompting users to repeat the dose in a binge pattern. It has a more intense and immediate effect than powder cocaine.

The total number of people who availed of Merchant’s Quay Ireland’s Open Access service so far this year is 1,556. So far there have been 12,789 needle exchange interventions in the period and 1,127 safer injecting workshops.

Of the clients who attended, 499 were using power and/or crack cocaine. Some 345 of the people who use crack cocaine also use other drugs.

Geoghegan said the increased availability of cocaine and crack in Dublin has driven the price down.

“You can see people now smoking crack through bottles sometimes or with little hash pipes.

“Before last year or the year before the type of drug use you’d see on the street aside from people smoking cannabis was injecting, whereas now, in terms of the discarded litter you see as well, it’s bottles, tinfoil, homemade crack pipes.”

Smoking crack in homemade pipes can increase its toxicity as users inhale the plastics from bottles and other items used when they are heated up. This is why services have started providing users with clean pipes made of material that will not add to the harm.

cocaine The HSE published two factsheets on Tuesday with information for users to help reduce the harm to their health. Source: Michelle Hennessy/TheJournal.ie

Geoghegan said harm reduction campaigns like the one launched by the HSE are important, but it is also vital to encourage people to seek treatment.

It is hoped that the factsheets and the accompanying social media campaign will reach people who use cocaine on a regular basis socially, but who may not know the real danger or recognise their dependence on it.

“The biggest thing is that attitude – people wouldn’t identify themselves as drug users and then are reticent to ask for help. That’s why signposting is important. It’s about talking to people… they do engage at some point, [but] often it’s when things go wrong,” he said.

“Often it’s work, missing days or their performance is dropping because of drugs and they are struggling to keep it together.

“A little bit of support can go a long way, it does not require major intervention because it is not physically addictive, it’s more of a psychological compulsion and that does diminish over time.”

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About the author:

Michelle Hennessy and Daragh Brophy

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