There are no harm-reduction programmes in place for drug users outside the greater Dublin area despite the fact the incidence of drug injection has tripled outside the capital, it emerged yesterday. Conor Lally reports.
A study on trends in drug treatment, published yesterday by the Health Research Board, revealed the rate of new cases being treated each year by health boards across the country increased almost three-fold between 1998 and 2002, from an average of 25 cases per 100,000 to 70 cases per 100,000.
The report identifies a shortage of drug treatment places all over the State, and a lack of harm-reduction programmes, such as needle exchanges, methadone programmes and outreach workers.
"No matter what happens people are going to take drugs and we must work to reduce harm. We have a duty of care," said Dr Jean Long, senior researcher with the Health Research Board's drugs misuse research division.
The study reveals there was a seven-fold increase per 100,000 - from six to 42 - in the number presenting for treatment for cocaine abuse in the same period.
Cannabis was the main problem drug throughout the State. The number of cases treated rose from 392 to 1,328.
The second most frequently reported drug for new cases was ecstasy, up from 84 to 156, and, for previously treated cases, opiates, up from 116 to 439. Opiates include heroin, methadone and morphine-based substances.
The research board said while the numbers involved in some categories were small, the rates of increase indicated early stages of high usage in some health board areas. None of the figures includes the ERHA area. These will be available at the beginning of next year.
Dr Long said between 75 and 80 per cent of those who presented for treatment between 1998 and 2000 used more than one drug. "We are finding that some people are using heroin to come down off ecstasy or amphetamines. It would also be common for people to use cannabis during the week and cocaine at weekends."
She said treatment of these so-called polydrug users was often not as successful as for those who used just one drug.
She also pointed to the difficulties involved in setting up treatment centres. "Very often a lot of dialogue has to take place in a community before a treatment centre can be located there. People don't want it on their doorstep. But users are entitled to treatment.
"We also need drug treatment approaches that are flexible and can adapt to new trends. It is cocaine today but we don't know what it's going to be next year."
The Southern Health Board region has emerged as the worst- hit area outside the ERHA.
Between 1998 and 2002 an average of 70.9 people per 100,000 population and per year presented for treatment there for the first time.
Not all of those included in that figure were treated in the health board area, however. The figures were calculated for each health board on the basis of where users live rather than where they are treated.
This will allow for the most accurate planning of services in areas with the highest concentration of drug users.