Posted on Tuesday, 15 December 2020
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Drug and Alcohol Trends Monitoring System (DATMS) 2020: Year 5
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Research objectives & method

In 2015 we developed our DATMS in Dublin 15. The objective was to establish an evidence base for drug use in Dublin 15 and use this data to inform local service provision. To always have current information and to monitor changes over time the study is repeated annually. This report documents the fifth year of our DATMS. Year 1 reporting period began June 2014, Year 2 began June 2015, Year 3 relates to 2017, Year 4 to 2018 and Year 5 to 2019. The DATMS employs a mixed-method design comprised of primary and secondary data sources.
 

Trend analysis

As we now have five years of data, it is evident that there are three recurring themes emerging from different data sources over these years. These themes provide us with a deeper understanding of the nature and consequences of drug and alcohol use in Dublin 15. As these themes have been produced by a range of data sources, the validity of the research findings has been strengthened.

Theme 1: Drug use in Dublin 15 is a community wide issue that crosses all socio-economic boundaries

This theme profiles drug use in Dublin 15 as a community wide issue that crosses all socio-economic boundaries. It has been identified by the following data sources: treatment demand, untreated drug use, factors contributing to drug use, consequences of drug and alcohol use, and drug-related litter. The evidence is as follows:

  1. Mapping treatment demand for treated drug users and family members affected by drug and alcohol use has identified that clients were from every community in Dublin 15, from the affluent to the socio-economically deprived; mapping drug litter has identified a large geographical spread of drug litter throughout Dublin 15.
  2. Year 1 to 5 reported treated drug users aged under 18 attended secondary schools with and without DEIS status. Since Year 3, the evidence reports that these schools were a mixture of affluent and socio-economically deprived.
  3. All five years of the DATMS reported untreated drug use among all socioeconomic groups, ethnicities and in all areas of Dublin 15.
  4. Since Year 1 drug dealing was reported in local secondary schools. From Year 3 there has been an increase in the number of secondary schools with evidence of drug dealing, with Year 5 reporting drug dealing in all local secondary schools. Since Year 2, the evidence reports that these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status.
  5. All five years of the DATMS reported drug use before and during school time in local secondary schools. Since Year 2, the evidence reports that these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status. Year 5 was the first year participants reported drug use in all local secondary schools.
  6. Year 1 to 5 reported that some secondary school student’s education was compromised due to drug use before and during school time. Since Year 2, participants reported that these schools were a mixture of affluent and socioeconomically deprived and included those with and without DEIS status.
  7. From Year 2 to 5, there was an increase in the number of hidden sites used for smoking drugs and drinking alcohol, and a decrease in the number of sites for injecting drug use in Dublin 15; these sites were located in both affluent and socio-economically deprived communities.

Theme 2: Normalisation of drug and alcohol use in Dublin 15

In all five years of the DATMS the normalisation of drug use has featured prominently. The common perception was that alcohol and drugs were widely used, risk free and socially acceptable. This theme has been identified by the following data sources: treatment demand, untreated drug use, factors contributing to drug use and gaps in service provision. Alcohol was the most normalised drug in Dublin 15, followed by cannabis, cocaine powder, benzodiazepines and z drugs. Service providers and drug users reported the following consequences of normalisation:

  1. Since Year 3, the normalisation of drug use was reported as a factor contributing to the increase in drug use in Dublin 15.
  2. The normalisation of drug use may be a factor contributing to the reduction in the age of drug users in Dublin 15. Since Year 3, it has been reported that untreated drug users were getting younger.
  3. Since Year 3, data concerning gaps in service provision has reported the need to improve treatment programmes for under 18s and young people aged 18 to 25 years. Research participants reported that these programmes need to pro-actively attract the most vulnerable and hard-to-reach as most young drug users do not perceive the need for treatment. The normalisation of drug and alcohol use may be a factor that hinders help-seeking.
  4. Since Year 2, an increase in the number of under 18s dealing drugs has been reported. Year 5 reported that drug runners were getting younger. The normalisation of drug use may influence a young person’s decision to become involved in the drug market as they may not identify the negative consequences of such behaviour.
  5. All five years of the DATMS reported the family context as a risk factor for the normalisation of drug and alcohol use and the development of intergenerational drug and alcohol dependence. Since Year 3, the majority of treated drug users who participated in the DATMS reported having family members who also had issues with drugs and/or alcohol.
  6. Treatment demand data reports the main drugs used were those which were normalised, with the exception of heroin:
    • Treated drug users aged under 18: From Year 1 to 5, cannabis herb was the most commonly used drug followed by alcohol; since Year 2, an increase in the use of cannabis herb, cocaine powder and alcohol was reported
    • Treated adult drug users: From 2016 to 2019, the NDTRS reports the four main problem drugs were cocaine, alcohol, heroin and cannabis; over the reporting period, an increase in the number of cases treated for cocaine, alcohol and cannabis was reported, with cocaine becoming the most common main problem drug in 2019

Theme 3: Increase in drug and alcohol use in Dublin 15

Since Year 2, an increase in the use of drugs and alcohol has been reported by treated and untreated drug users. The data identifies how an increase in the availability of drugs and alcohol, and the normalisation of drugs and alcohol contributes to this trend. The increase in drug and alcohol use has been identified by the following data sources: treated drug use, untreated drug use, factors contributing to drug use and drug-related litter.

  1. Treatment demand data reported an increase in the number of cases treated for drug and/or alcohol use, this may be associated with an increase in drug use:
    • Treated cases aged under 18 increased by 129% from 51 in Year 1 to 117 in Year 5
    • NDTRS data reports treated adult cases increased by 70% from 292 in 2016 to 497 in 2019
  2. Over the reporting period, treated and untreated drug users reported an increase in the use of the following drugs:
    Drug type Treated drug users Untreated drug users
    Young Adult Young Adult
    Alcohol
    Cannabis herb
    Cocaine powder
    Benzodiazepines, z drugs
    Cannabis concentrates (oil, wax)
    Ketamine  
    MDMA  
    Amphetamines    
    Anabolic steroids    
    Pregabalin (Lyrica)      
    Crack cocaine      
    Prescribed opiates      
    OTC codeine      
    Nitrous oxide (laughing gas)      
    Lean (syrup)*      

    *Cough medicine mixed with carbonated drinks and sweets

  3. Each year the DATMS has reported an increase in the availability of drugs in Dublin 15. This increase is associated with an increase in drug and alcohol use. It identifies how demand influences the local drug market. This increase in demand has also resulted in an increase in the number of drug distributors. All drugs that have increased in availability are the most commonly used, except for crack cocaine and cannabis wax:
    • Since Year 1, an increase in the availability of benzodiazepines and z drugs has been reported; since Year 4, synthetic (NPS) benzodiazepines and z drugs were reported to be more commonly available than authentic tablets
    • Since Year 1, with the exception of Year 4, an increase in the availability of alcohol, including low cost alcohol, has been reported
    • Since Year 3, an increase in the availability of cannabis herb, powder and crack cocaine has been reported
    • Year 5 reported an increase in the availability of cannabis wax
  4. The increase in drug use is also associated with an increase in the types of drugs available, which identifies new trends in drug use. The chart below reports the new drugs that have entered the local market and the year they were first reported to the DATMS. These drugs are not commonly used though some are increasing in popularity.
    DATMS Year New drug
    Year 1 Lean (syrup)
    Year 2 GHB/GBL
    Year 3 Cannabis concentrate (oil)
    Year 4 Cannabis concentrate (wax)
    Nitrous oxide (laughing gas)
    Year 5 Cannabis edibles (sweets, chocolates)
    Cannabis drinks
    • In addition, with the use of cannabis cakes, the re-emergence of an old trend was reported by treated and untreated drug users in Year 5
    • The use of alcohol-free drinks by untreated drug users was first reported to the DATMS in Year 5, and this was also the first year that alcohol-free litter was found in Dublin 15
  5. Analysis of drug-related litter reported that from Year 2 to 5, there was an 82% increase in the amount of drug-related litter found in Dublin 15, which may identify an increase in drug and alcohol use.
  6. As reported above, since Year 3, the normalisation of drug use was reported as a factor contributing to the increase in drug use in Dublin 15.

Treated drug & alcohol use

Treated drug users aged under 18

  • Treated cases aged under 18 increased by 129% from 51 in Year 1 to 117 in Year 5
  • From Year 1 to 5, the majority of cases were male, white Irish and aged from 15 years, and cannabis herb was the most commonly used drug followed by alcohol
  • Changes in the profile of treated cases:
    • From Year 1 to 4, the majority of cases were polydrug users, in Year 5 the majority were non-polydrug users
    • From Year 3 to 5, the majority of cases were in education, though since Year 4 an increase in the number of cases not in education or employment has been reported
    • From Year 1 to 5, there has been an increase in the number of secondary schools and training centres attended by treated cases aged under 18; in Year 5, almost all secondary schools and training centres in Dublin 15 have students with drug and/or alcohol problems
    • Other changes are reported above in the trend analysis section

Treated drug users aged 18 and over

  • NDTRS data reports treated cases increased by 70% from 292 in 2016 to 497 in 2019. From 2016 to 2019:
    • The majority of treated cases were Irish, male and aged 35 to 44 years
    • A third of cases were in treatment for the first time
    • The four main problem drugs were cocaine, alcohol, heroin and cannabis
    • From 2016 to 2018, the majority of cases were treated for polydrug use, and in 2019, the majority were treated for non-polydrug use
    • Other changes are reported above in the trend analysis section
  • In Year 5, a number of data sources reported a decrease in injecting drug use

Untreated drug & alcohol use

  • All five years of the DATMS reported similar profiles of untreated drug use by young people and adults:
    • Alcohol, cannabis herb, MDMA and cocaine powder were the main drugs used
    • Polydrug use was the norm and alcohol was an integral part of it
    • Changes in the profile of untreated drug use included:
      • Untreated drug users were getting younger
      • Year 4 reported the availability of cannabis herb with higher amounts of THC; this trend continues in Year 5
      • Other changes are reported above in the trend analysis section
    • Prevalence rates estimated 24,630 (80%) of Dublin 15 residents aged 15 to 34 years used alcohol in the last year and 40,440 (80%) aged from 35 years; and 4,926 (16%) of Dublin 15 residents aged 15 to 34 years used illegal drugs in the last year and 2,022 (4%) aged from 35 years

Factors contributing to drug use

Accessibility of drugs and alcohol

  • Factors contributing to the ease of access to drugs and alcohol included an increase in the number of people dealing drugs in Dublin 15, and the continued availability of low-price alcohol
  • Other changes are reported above in the trend analysis section

Normalisation of drug and alcohol use

  • As reported above in the trend analysis section

Family context

  • All five years of the DATMS reported the family context as a risk factor for the normalisation of drug and alcohol use and the development of intergenerational drug and alcohol dependence
  • Prevalence rates estimate up to 24% (7,852) of children were impacted by parental illicit drug use in Dublin 15, and up to 37% (12,105) were impacted by parental alcohol dependency in Dublin 15

Mental health

  • Poor mental health is a risk factor for drug use which identifies the importance of early intervention
  • From Year 1 to 5, service providers reported an increase in the incidence of mental health issues among children and young people
  • The negative impact of inter-generational drug use and deprivation on young people’s mental health was reported

Consequences of drug and alcohol use

Health consequences

  • HIPE data from 2012 to 2019 reported the following:
    • Overall, the number of treatment episodes for mental health and behavioural disorders associated with drug and alcohol use increased by 99%
    • Overall, the number of treatment episodes for poisonings increased by 100%
  • NDRDI data reports drug-related deaths due to poisoning (overdose) increased by 25% from 630 in 2008 to 786 in 2017
    • Benzodiazepines and z drugs were the main drug group associated with deaths, followed by opiates and alcohol
    • Polydrug poisonings increased from 50% (192) in 2008 to 58% (218) in 2017
    • Over the reporting period poisoning deaths among people who were injecting at the time of death decreased from 67 (11%) in 2008 to 34 (4%) in 2017

Social consequences

  • All five DATMS years reported the negative impact drug use has on family relationships, employment, finances, housing and education
  • From 2017 to 2019, an increase in the number of family members receiving support from services was reported:
    • Over the reporting period, there has been a significant increase in the number of family members who attended an evidence-based/informed programme

Drug-related crime

  • All five years of the DATMS reported the existence of drug-related crime in Dublin 15
  • Since Year 3, drug-debt intimidation was the most frequently occurring crime with an increase in its frequency also reported

Drug-related litter

  • Largest concentrations of litter found in hidden sites used for drug consumption; many of these sites used for drug use in Year 5, were found in Year 1 or 2; thus, evidence that these sites have been used repeatedly over a five-year period
  • Alcohol remains the most common type of drug-related litter
  • Increase in smoking-related litter associated with the use of heroin and crack cocaine
  • Benzodiazepines and z drugs were the most common prescribed drug-related litter

School attendance supports

  • One of the strongest protective factors for drug and alcohol misuse is school attendance
  • One of the strongest factors that militated against school attendance is educational disability or inability
  • As a long-term prevention intervention, the BLDATF facilitated access to psycho-educational and clinical assessments for the most socio-economically disadvantaged cohort of children in Dublin 15
  • In Year 5, 17 children received support for psychological issues; interventions included occupational therapy and cognitive behavioural therapy

Service provision strengths & gaps identified by research participants

Strengths of addiction services

  • The Dublin 15 addiction services offer a continuum of care from low threshold to stabilisation, to drug free and rehabilitation programmes for young people and adults
  • The service provision for family members affected by drug use has been improved with the development of BLDATF Family Support Service and D15 CAT
  • Family support groups provide supportive and non-judgemental environments for family members affected by drug use
  • The service provision of a methadone maintenance clinic has been improved with the ability to screen patients for cannabis use, and the use of suboxone for opiate dependence (codeine and heroin)
  • Availability of naloxone for opiate users on early discharge from Coolmine Lodge and Ashleigh House

Gaps in service provision

Education & prevention

  • Improve drug prevention programmes for under 18s
  • Increase knowledge of local service provision on a local and targeted basis
  • Training/apprenticeships required for early school leavers
  • Increase access to skills-based parenting courses

Treatment

  • Improve treatment programmes young people aged 18 to 25 years
  • Improve accessibility of treatment programmes
  • Improve access to naloxone, the antidote to an opioid overdose
  • Integrate counselling and rehabilitation services into methadone maintenance treatment
  • Improve access to detoxification programmes
  • Increase access to mental health services for children, young people and adults

Rehabilitation

  • Improve access to aftercare services
  • Increase access to training, employment and apprenticeships
  • Increase access to housing
     
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