Cocaine second only to alcohol in drug referrals

The rise in cocaine abuse is now being reflected in the number of drug-related fatalities - while efforts are underway locally to formally record instances of drug debt intimidation and put supports in place for those threatened.

The developments were reported by the head of Cavan and Monaghan Drug & Alcohol Service, Zoe Wells, ahead of several planned events across the two counties for International Overdose Awareness Day (IOAD) on August 31. This is the world’s largest annual campaign to end overdose and also to remember, without stigma, those who’ve died.

Ms Wells has been at the helm of the regional service since Merchants Quay Ireland’s took over CDA in 2021.

If anything, Ms Wells admits the issues that prevailed then have only exacerbated further, with greater demand for drug or alcohol addiction supports locally.

There are approximately 80 service users engaging with MQI Cavan-Monaghan on a regular basis but this figure can “fluctuate”, reports Ms Wells.

“It depends on case loads, what’s going on with clients,” she explained.

The highest number of people engaging with the service are “self referrals”, a trend Ms Wells finds “positive”. This is followed by referrals from the alcohol addiction nurses at Cavan General Hospital and Our Lady of Lourdes in Drogheda, and lastly GPs.

Not everyone referred to the service is directly emerging from a crisis situation, such as surviving overdose, emphasises Ms Wells.

“Crisis point is different for everyone. Specifically for overdose, some people disclose that, others don’t. There could have been a hospitalisation or not. We won’t really know until maybe further into the assessment process,” she explained.

In recognition of IOAD, Cavan County Council has committed to lighting up the local courthouse purple; while MQI plans to host a number of workshop events at their Farnham Road centre.

“Most of the time drug-related deaths, people could be using opiate substitute treatment, using opiates on top of that, or using benzodiazepines, those would be the major risks for overdose,” explains Zoe, who adds that “alcohol” remains high on the list of factors in Cavan and Monaghan in particular. “That would correspond with the [Health Research Board] data as well.”

According to the latest assessments carried out by the HRB, cocaine is the second most commonly used illicit drug in Europe, after cannabis.

Shift

In Ireland the most recent National Drug and Alcohol Survey (NDAS) 2019-20 shows that 4.7 per cent of 15–34 year olds used cocaine in that 12-month period, and in 2021, for the first time, there were more cases of treatment for cocaine as a main problem drug (3,248 or 30%) than heroin (3,168).

“We are seeing a slight increase in cocaine referrals, yes definitely, in comparison to other years. What we have seen in the past, in terms of Cavan specifically, we’d have seen alcohol, followed by cannabis, heroin and then cocaine as the top four. We’re starting to see a shift in that, with alcohol, cocaine, then heroin after that.

“We’re seeing men, particularly between the ages of 18 and 25, even a little bit older. The demographics have changed as well. It’s people who are employed who are referring to us, not just people from more marginalised groups. [Cocaine addiction] is definitely more prevalent, and we’re now beginning to see more drug-related deaths.”

Drug intimidation

The service is hearing anecdotally about an increase in drug-related intimidation, where a criminal or criminals allege a drug debt and put pressure on a vulnerable individual or their frightened and sometimes unsuspecting family.

It has led to the development of a new data-driven intervention model to respond effectively to drug-related intimidation and violence in communities across Ireland titled DRIVE (Drug Related Intimidation and Violence Engagement).

Launched in 2021, independent research was commissioned to examine drug-related intimidation, and what resources, systems and structures exist currently, or could be developed in the future to tackle the problem.

Ms Wells is hopeful the outcome will yield “positive” results in terms of providing more supports at local level.

“For Cavan and Monaghan, a tender has gone out for a DRIVE lead in the North East. So that’s out at the moment to provide a dedicated person for this region,” she said.

Challenging

As has been identified in the past, Ms Wells role carries the mantle of advocating for more services at local level, and a greater link-up between those that currently exist.

That however remains “challenging” she says, adding: “It’s difficult because in Cavan or Monaghan there is no dedicated homeless service, we’ve two beds available through Cavan County Council at Dundalk Simon. Monaghan has challenges around homelessness, we’re starting to see an increase around that. Domestic Violence as well, there is no actual refuge in Cavan and Monaghan, though I’m aware that is changing.”

The nearest residential treatment services for alcohol and gambling, meanwhile, are in Galway or Donegal, or for substance misuse it’s Dublin.

“It can be quite difficult for individuals [accessing treatment], especially if they have to pay for the treatment themselves. There are limitations on what we call social inclusion beds at Tier 4.”

Ms Wells further welcomed moves by Croke Park and the GAA to implement and roll-out a prevention and education programme, developed in tandem with the North East Drug Taskforce.

Since taking over from CDA, MQI Cavan-Monaghan has received additional funding and put in place an additional project worker post. The service has also attained funding under Community Enhancement, and is exploring the prospect of running a dedicated women’s health drop-in group similar to that which already exists with MQI elsewhere in the country.

“We’re trying to encourage more women to access the service because there are challenges for women through child protection or domestic violence. In MQI they run a women specific service called Jane’s Place, and we try to replicate that on a smaller scale here in Cavan. Funding is always challenging, but we’re always looking at alternatives to increase capacity, while meeting the needs of existing clients as well.”