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HRB reports rise in cocaine and crack cocaine treatment

The latest figures from the Health Research Board (HRB) show continued growth in the number of cases* seeking treatment for problem cocaine use, including crack cocaine use, despite an overall drop in the numbers entering drug treatment**.

The report, National Drug Treatment Reporting System 2014 – 2020 Drug Treatment Data, describes drug treatment figures over a seven-year period from 2014 to 2020. It shows that opioids remain the most common drug among cases treated for problem drug use. However, the number of cocaine cases continues to increase with cocaine being the primary issue for 1-in-4 cases treated in 2020.

Commenting on the key findings of the report, Dr Anne Marie Carew, Research Officer at the HRB says:

“In 2020 cocaine was the only substance where we saw an increase in numbers entering treatment. This increase must be seen in the context of a 9% drop in the overall numbers entering drug treatment, as a result of temporary service closures and other measures introduced to comply with Covid-19 restrictions.”

“There has been a three-fold increase in the number of cases treated for problem cocaine use since 2014. In 2020, for the first time, cocaine was the most common drug among new cases entering treatment. And for the second year running, cocaine surpassed cannabis as the second most common drug reported among all cases treated for problem drug use.”

Cocaine trends

  • A total of 2,619 cases were treated for problem cocaine use in 2020, more than three times the number of cases reported in 2014 (853 cases).
  • While men continue to account for the majority (4-in-5) of cases with cocaine as the main problem drug, the proportion of women reporting cocaine has increased (from 17% in 2014 to 21% in 2020).
  • For the first time, cocaine was more common than alcohol and benzodiazepines as an additional problem drug among cases reporting polydrug use (problem use of more than one drug).

Crack cocaine trends 

There are different types of cocaine. The most common form of cocaine in Ireland is powder cocaine/cocaine hydrochloride (commonly known as ‘coke’). Crack cocaine, though far less common than powder cocaine, is the other main type that we see in Ireland. 

  • The number of cases treated forcrack cocaine as the main problem drug isalso increasing, accounting for 16% of all cocaine treatment last year.
  • The number of crack cocaine cases have increased year-on-year, from a relatively low number of 84 cases in 2014 to 414 in 2020, an increase of almost 400%.
  • Crack cocaine use was more common among women entering treatment for cocaine use (3-in-10) than among men (1-in-10).
  • Among women entering treatment for problem cocaine use, crack cocaine (3-in-10) was less common than powder cocaine (7-in-10).

Commenting on these figures, Dr Anne Marie Carew says:

“There are notable distinctions between cases reporting problem use of powdered cocaine and cases reporting problem use of crack cocaine. In general, those seeking treatment for powdered cocaine use are male, aged 30, in paid employment and most likely to use alcohol as an additional drug. Crack cocaine cases, however, are more likely to be unemployed and homeless. Monitoring these trends is critical for developing tailored approaches to drug treatment.”

“When we look at gender differences within cocaine treatment, the rate of male cases entering treatment for crack cocaine has remained stable year-on-year. However, the number of women reporting problem use of crack cocaine has increased by almost 80% since 2018.” 

Residing with children 

For the first time, data on parents in drug treatment are reported. In 2020:

  • Approximately 1-in-10 cases entering treatment for problem drug use had children aged 17 years or younger at home.
  • Approximately 1-in-4 cases had children aged 17 years or younger who did not reside with them.

According to Dr Carew:

“This is the first time we have reported data on parents in drug treatment. It is essential that we understand the wider context of the impact of drugs. By monitoring these emerging trends in drug use and treatment in Ireland, the Health Research Board has a pivotal role to inform evidence-based approaches that help reduce harm and support recovery among people seeking treatment for drug use and their families.”

More details on drug treatment figures from the National Drug Treatment Reporting System are shown below. The full report is available on the HRB website. An infographic that outlines key data is also available for download.

* It is important to note that each record in the NDTRS database relates to a treatment episode (a case), and not to a person. This means that the same person could be counted more than once in the same calendar year if they had more than one treatment episode in that year.

** In 2020 we saw an overall drop in the number of cases entering drug treatment for problem use of any drug, which is the result of temporary service closures and measures introduced to comply with Covid-19 restrictions. This does not necessarily indicate a real decline in demand for treatment. 

ENDS 

For further information, infographics or to organise interviews with experts, please contact:

Martha Connolly, Communications Officer, Health Research Board 

m +353 85 859 0250, e  mconnolly@hrb.ie

 

NOTE TO EDITORS 

This report describes trends in treated problem drug use in Ireland over the seven-year period 2014 to 2020, as recorded by the National Drug Treatment Reporting System (NDTRS). This information will assist policy makers, service planners and public health practitioners to develop appropriate responses to problem drug use in the future.

The Health Research Board (HRB) is Ireland’s lead funding agency supporting innovative health research and delivering data and evidence that improves people’s health and patient care. We are committed to putting people first, and ensuring data and evidence are used in policy and practice to overcome health challenges, advance health systems, and benefit society and economy.

Overall findings on drug treatment in 2020 

In 2020, a total of 9,702 cases were treated for problem drug use, a 9% decrease from 10,664 in 2019. 

Main problem drug (excluding alcohol)

  • Opioids (mainly heroin) were the most reported problem drug, accounting for 37% of cases treated in 2020, a decrease from 50% of cases in 2014.
  • Cocaine was the second most common problem drug reported, accounting for 27% of cases treated in 2020, an increase from 9% of cases in 2014.
  • Cannabis was the third most common main drug reported, accounting for 22% of cases treated in 2020, a decrease from 28% of cases in 2014.
  • Benzodiazepines were the fourth most common main problem drug, accounting for approximately 10% of cases each year from 2014, with a slight increase to 11.3% in 2020. 

Socio-demographic characteristics (all drugs) 

  • The median age of cases increased from 29 years in 2014 to 31 years in 2020.
  • Men accounted for approximately 3-in-4 drug treatment cases over the seven-year reporting period.
  • The number of cases under 18 years of age decreased from 822 cases in 2019 to 674 cases in 2020.
  • The majority of cases over the reporting period were unemployed. However, the overall rate of unemployment decreased over the seven-year reporting period, while the number of cases in paid employment doubled from 816 cases in 2014 to 1,574 cases in 2020.
  • The number of cases recorded as homeless decreased slightly from 2019 (1,173 cases) to 2020 (1,023 cases). However, there was a general upward trend in the number of homeless cases over the seven-year reporting period.
  • The number of cases who reported Irish Traveller as their ethnicity remained stable, accounting for approximately 3% of cases each year from 2014 to 2020.

Polydrug use (problem use of more than one drug)

  • There were fluctuations in the proportion of cases using more than one drug over the seven-year reporting period. However, treatment for polydrug use has been increasing over the past three years, from 53% in 2018 to 59% in 2020.
  • For the first time in the seven-year reporting period, cannabis surpassed alcohol as the most common additional drug reported by cases with polydrug use. This was followed by cocaine, benzodiazepines, and then alcohol.
  • MDMA (ecstasy) as the main problem drug accounted for a small number of cases (31 cases) in 2020. However, significantly more cases reported MDMA as an additional problem drug (424 cases).