COCAINE, THE so-called glamour drug, has rarely been out of the headlines in the last six months. Much of the focus has been on the use of the drug by young upwardly mobile professionals. But cocaine, once the preserve of celebrities and the uber-rich, is being used across the State and by a range of ages and social groups.
Although only a certain proportion of cocaine users will experience the severe health problems we have come to associate with the drug, the doomsday scenario of lives spiralling out of control thanks to addiction is becomingfamiliar: road traffic crashes, broken relationships, accidental deaths and mounting debts - forcing users to leave their homes and families.
One addiction professional based in Blanchardstown says that anecdotal evidence points to children as young as 12 trying cocaine. Another addiction specialist insists that such is the prolific use of cocaine as a weekend party drug that a random drug screening next Monday morning in all public, private and government organisations would cause a lot of red faces in corporate Ireland.
A study by the National Advisory Committee on Drugs (NACD) published recently revealed that the percentage of Irish and Northern Irish people who have used cocaine at some stage in their lives has risen from 3 per cent in 2002 to just over 5 per cent in 2007. The number of young adults aged 15 to 34 who used cocaine at some stage in their life has risen dramatically from 4.5 per cent to almost 8 per cent in this period.
One major concern among all professionals is the high level of alcohol consumption among cocaine users. Research published by the NACD last year revealed that cocaine is usually mixed with alcohol, resulting in aggressive behaviour. As a stimulant, cocaine sustains the individual's capacity to drink alcohol, resulting in longer binges. The dangers are compounded by the fact that, when the two are mixed, they combine to form cocaethylene, a substance more toxic than either in isolation.
When alcohol is consumed with cocaine and other substances, it is extremely dangerous.
"You have no idea where it will end up," explains one clinical addiction specialist (who asked not to be named in this article), who has been working in the area for over 15 years.
"Cocaine use," he says, "goes right across the social spectrum, from road sweeper to high court judge."
He describes drugs and alcohol as the "great remover".
"Money, cars, relationships, children, sex and money will all be traded for them. The downward spiral is much quicker with cocaine and the endgame is reached sooner," he says.
If someone has a propensity for addiction, they could spiral out of control within two years, he says. Dedicated cocaine services in Ireland are patchy and under-resourced,particularly outside Dublin, and those who can afford it go to private detox centres.
One such centre is the Forest Addiction Centre in Co Wicklow (forest.ie), where clients pay €17,000 for a three-week residential course. Given that it is a private service, the majority of cocaine users that Forest treats are middle-class professionals.
According to Declan Murphy from Forest, most come looking for help when their debts get out of control. Cocaine users typically reach breaking point when they owe one-and-a-half to two times their salaries, he says, which usually takes two years. For some, this can involve running their own business into the ground. Others will have destroyed relationships, jeopardised careers and caused permanent damage to their bodies.
"It's not unusual to encounter users who spend more than €2,000 a month on cocaine while others have seemingly limitless amounts of money to spend on their habit," he says.
"They may start off as weekend users but will eventually end up taking cocaine first thing in the morning and using it throughout their working day."
The great difficulty is that cocaine gives users the illusion that everything will work out and encourages them to abandon the normal checks and balances, according to Murphy.
Meanwhile, cocaine is taking root in communities where heroin was traditionally the drug of choice. Merchant's Quay Ireland (mqi.ie), an organisation that provides services to opiate users, has seen the number of heroin addicts using cocaine as a secondary drug increase radically over the last two years.
The impact of cocaine on heroin users is huge, according to Tony Geoghegan from Merchant's Quay drug treatment centre. "Only so much heroin can be used before a person falls asleep, but cocaine is a stimulant and users can stay up and take much much more," he explains. Clients undergoing heroin treatment who begin to use cocaine can get into difficulty very quickly, according to Geoghegan.
"Typically they go on a two-week binge, get into debt, their treatment is undermined and relationships break down. This downward spiral can take as little as a week or two," he says. Frequently clients have racked up such debt that they have had to leave the country, he adds.
Many addiction professionals agree that one of the biggest challenges in Ireland today is getting cocaine users to admit that they are addicted.
"Often cocaine users don't see themselves as drug users. The reasoning is: 'I'm not injecting heroin so I'm not a drug user',"explains Geoghegan.
Phillip Keegan, chairman of Blanchardstown Local Drug Task Force, agrees. He says that cocaine use is now widely accepted and most people who use it regard it as a clean, safe drug. This makes rehabilitation all the more difficult.
The National Drug Awareness Campaign, launched earlier this month, aims to dispel the myth that cocaine is a recreational and social drug, which is clean and somehow less harmful to users then opiates.
Drug treatment services in Ireland were initially developed to deal with opiate users but with the rise of polydrug use (the consumption of more than one drug to get a combined, and usually heightened, effect) and the increasing use of cocaine, new approaches are needed.
The Health Service Executive's (HSE) current policy seems to be to adapt existing services (primarily opiate-orientated services) to the needs of cocaine and other drug users.
The HSE has undertaken a training programme for workers in the statutory, voluntary and community sector in the use of cognitive behaviour coping skills (CBCS) for the treatment of cocaine and polydrug users. A new programme will bring to about 60 the number of people who are specifically trained in CBCS, according to a spokesperson for the HSE.
The problem is that cocaine users are notoriously hard to target. As a group they are unlikely to identify their need for help, they're usually reluctant to attend known drug treatment centres and have higher than average drop-out rates.
A dedicated cocaine drop-in centre was established in Galway last year. While the results of a review undertaken last month have yet to be published, the HSE admits that, despite the fact that the service was widely publicised, uptake has been less than initially anticipated. Plans for three dedicated stimulant intervention clinics in north Dublin are in the pipeline, according to the HSE.
Many of those working at grassroots level don't think that this is enough. Bearing in mind that a number of cocaine users do better in in-patient scenarios, there is criticism of the under-provision of residential drug services.
A health service working group recently reported that there was a deficit of 350 detox and rehabilitation residential beds in Ireland.
According to Geoghegan, a more flexible approach to cocaine services is needed. He says that cocaine users presenting with panic attacks and drug-induced injuries should be targeted at accident and emergency departments and GP clinics.