Research objectives and 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 sixth year of our DATMS, and it deviates from the trend reports previously produced. A longitudinal qualitative study has been completed to increase understanding of the subjective experience of clients attending local services, and the impact of drug and alcohol use on the individual and their families. The impact local service provision has in supporting people was also explored. Since March 2020, Covid-19 has influenced programme participation and implementation. Thus, the impact of Covid-19 on local community services has also been explored. Drug-related litter has been included to record any changes in the amount of litter found during the pandemic with the amount found previously. Treatment demand data has been presented to ensure the continuity of the trend monitoring system.
The impact of Covid-19 on service provision
In 2020 and 2021, the implementation of Covid-19 health and safety policies led to fluctuations in demand for services. A decrease in demand was associated with staff redeployment. An increase in demand was associated with an increase in drug consumption as a coping strategy for the social isolation connected with Covid-19 health and safety policies.
The implementation of Covid-19 health and safety policies led to changes to service delivery, with some services changing from face-to-face to online or phone contact. Service providers reported challenges associated with online and phone contact, including a lack of privacy and technology to engage with services. For some, online service provision resulted in a reduction in client engagement. The importance of face-to-face meetings for the development of interpersonal relationships between clients and service providers was highlighted. In response to the impact of the pandemic and the needs of the client, some programmes could not be operated, and others were developed.
Losing and regaining control: The cyclical nature of addiction & recovery
Four people shared their experiences of attending local treatment and rehabilitation services. The themes of control and change are central to their experiences of addiction and recovery. They reported that when they started treatment their lives were chaotic and their drug use was out of control. The factors that contributed to their alcohol and drug dependence included mental health, trauma, relationships, and Covid-19 health and safety policies. As these people progressed through treatment, they became empowered to change and gain control of their addiction. They reported the positive impact of identifying and implementing protective factors to reach and maintain their drug free status. Each person reported the integral role treatment services played in their recovery. Once again, the importance of the interpersonal relationship between client and service provider for client engagement was highlighted. The people reported that the shared experience of peer support improved their wellbeing. By completion of the research process, each person was drug free. They had regained control over their lives and begun the process of reintegration into their families and society. This analysis identifies how engagement with treatment and rehabilitation programmes can empower people to gain control of their addiction. The analysis highlights the value of and need for evidence-led community-based treatment and rehabilitation services.
Losing and regaining control: The nature of addiction within the family
Five people affected by drug and/or alcohol use shared their experiences of attending local family support services. They reported the negative impact of drug use on their mental health and family relationships. Through implementation of the evidence-based 5-Step Method parenting programme, these people were encouraged to reflect on their situation. Through this self-reflection, they developed new levels of understanding and awareness which empowered them to improve their coping strategies. These changes positively impacted their wellbeing. Once again, the importance of the interpersonal relationship between client and service provider for client engagement was highlighted. Like the people in treatment, these people reported that the shared experience of peer support improves wellbeing. They also reported that the themes of change and control were central to their experiences. When the people first presented to services, they reported feelings of helplessness and a lack of control over their situation. As they progressed through the programme, they were empowered to change, to prioritise their wellbeing and regain control over their lives. The effectiveness of the 5-Step Method for supporting positive progression is evident. The data highlights the value of and need for evidence-led community-based family support services.
In addition, a person shared their experience of completing the evidence-based Parents Plus programme. This case study highlights how learning and implementing this programme can have a positive impact on parent-child communication and relationships. Just like the other people who participated in the research, the themes of control and change are evident throughout this data. When the person first attended the service, they reported feeling a lack of control over their situation, including their parenting ability. By completion of the programme, it was clear that the person had regained control and confidence in their abilities.
- Large geographical spread of drug litter throughout Dublin 15, identifying drug and alcohol use is a community wide issue crossing all socio-economic boundaries.
- From DATMS Year 2 to 6, there was a 123% increase in the amount of drug-related litter found in Dublin 15. This may be associated with the Covid-19 health and safety policies, whereby the closure of alcohol-related establishments may have increased outdoor consumption of alcohol.
- Largest concentrations of litter found in hidden sites used for drug consumption. Many of these sites used for drug use in Year 6, were found in Year 1 or 2. Thus, evidence that these sites have been used repeatedly over a six-year period.
- Alcohol remains the most common type of drug-related litter.
- Increase in smoking-related litter associated with the use of heroin, crack cocaine and cannabis.
- Benzodiazepines and z drugs were the most common prescribed drugrelated litter; an increase in the amount of this litter was reported