Blanchardstown Local Drug and Alcohol Task Force Drug and Alcohol Trends Monitoring System (DATMS) 2020: Year 5
NORMALISATION
MENTAL HEALTH
DRUGS
ALCOHOL
INTIMIDATION NORMALISATION
MENTAL HEALTH
DRUGS
ALCOHOL
INTIMIDATION Janet Robinson and Jim Doherty Researchers DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
CONTENTS
ACKNOWLEDGEMENTS 6
INTRODUCTION 7
1. EXECUTIVE SUMMARY 8
2. DATMS RESEARCH OBJECTIVES & METHOD 17 Research objectives 17 Research model 17 • Research participants 18 Methodological limitations & gaps in evidence base 20
3. SOCIO-DEMOGRAPHIC PROFILE OF DUBLIN 15 23
4. TREATED DRUG & ALCOHOL USE 27 Mapping treatment demand 27 Treated drug & alcohol users aged under 18 39 • Socio-demographic profile 40 • Profile of drug & alcohol use 43 Adult treated drug & alcohol users 45 • Treatment demand 45 • Profile of drug & alcohol use 49 • High-risk drug use 52 Changes in treated drug & alcohol use 55
5. UNTREATED DRUG & ALCOHOL USE 59 Untreated drug & alcohol use by young people 59 Untreated drug & alcohol use by adults 60 Untreated polydrug use 61 Pattern of untreated drug & alcohol use 61 Changes in untreated drug & alcohol use 61 Prevalence rates of drug & alcohol use in Dublin 15 65 Dublin 15 at-risk youth population 66
3 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
6. FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE 68 Accessibility of drugs and alcohol 68 • Methods for obtaining drugs 68 • Changes in drug availability 69 • New emerging trends in drug use 70 • Reasons for increase in drug and alcohol availability 70 • Under 18 drug runners and dealers 71 • Drug dealing in local secondary schools 72 • Drugs manufactured in Dublin 15 73 • Drugs sourced from outside Dublin 15 73 Normalisation of drug & alcohol use 75 Family context 76 • Prevalence of children affected by parental substance misuse 77 Mental health 78 • Youth mental health treatment demand 78 • Adult mental health treatment demand 80
7. CONSEQUENCES OF DRUG & ALCOHOL USE 82 Physical & mental health consequences of drug and alcohol use 82 • Hospital In-Patient Enquiry Scheme (HIPE) 83 • National Drug-Related Deaths Index (NDRDI) 85 Social consequences of drug and alcohol use 90 • Family 90 • Family support services and peer-led groups 90 • Treatment demand 91 • Mapping treatment demand 96 • Treatment demand for alcohol and drug users and family members 103 • Financial 107 • Employment 108 • Housing 108 • Education 109 • Drug use in Dublin 15 secondary schools 110 • Profile of school-based drug users 111 Drug & alcohol-related crime 113 • Drug debt intimidation 117
4 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
8. DRUG-RELATED LITTER 118 Visible and hidden drug litter sites 123 Analysis of drug-related litter by type 129
9. SCHOOL ATTENDANCE SUPPORTS 133
10. SERVICE PROVISION 134 Strengths of addiction services in Dublin 15 134 Gaps in service provision in Dublin 15 134 • Education & Prevention 134 • Treatment 135 • Rehabilitation 136
REFERENCES 137
5 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ACKNOWLEDGEMENTS
We want to thank the research participants for their participation in this research study. We want to acknowledge local service providers for providing data and for facilitating the recruitment of research participants. We also want to thank the Health Research Board and the Healthcare Pricing Office of the Economic and Social Research Institute for providing data. We want to thank the National Advisory Committee on Drugs and Alcohol for permission to use their drug trend monitoring system questionnaire. Thanks are also due to BLDATF staff, Linda Silvester, Ann Losty and Sarah-Jane Leonard for their support.
6 INTRODUCTION
INTRODUCTION
The Blanchardstown Local Drug and Alcohol Task Force (BLDATF) is one of fourteen Local Drug and Alcohol Task Forces established in 1997 in response to high levels of drug misuse within communities. We are responsible for implementing the National Substance Misuse Strategy and facilitating a more co-ordinated response in tackling drug and alcohol use and misuse in Dublin 15.
Since 1997, Blanchardstown has greatly developed and grown as an area. Many different services and interventions have been developed by the BLDATF to help the people living in Dublin 15 over that time. Unfortunately, the problems caused by drugs and alcohol have also grown and changed in many ways. Therefore, the interventions that are put in place to ameliorate these problems must also be capable of adapting to this change. A prerequisite for being able to adapt and change services is a thorough, comprehensive and deep knowledge of the problems of the area. We started the Drug & Alcohol Trend Monitoring System (DATMS) in 2015 to provide us with such an analysis. It is our intention to produce a new report every year to ensure that we will always have a strong, local evidence base for everything that we do.
For the purpose of this study we chose to categorise drug and alcohol use as treated and untreated drug use rather than as problem and recreational drug use. This is because the question of whether or not drug use is a problem for an individual is a subjective question which can only be properly answered by the individual, their family or close contacts; whereas, the question of whether drug use is treated or untreated is an objective measurement. The term ‘recreational’ drug use tends to de-emphasise the seriousness of the behaviour. It should be noted that individuals often underestimate the harm to themselves and rarely perceive the harm to the community which results from such behaviours.
7 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
1. EXECUTIVE SUMMARY
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 socio- economic 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
8 EXECUTIVE SUMMARY
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 socio- economically 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.
9 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
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 inter- generational 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
10 EXECUTIVE SUMMARY
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.
11 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
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
12 EXECUTIVE SUMMARY
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
13 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
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 inter- generational 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
14 EXECUTIVE SUMMARY
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
15 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
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
16 DATMS RESEARCH OBJECTIVES & METHOD
2. DATMS RESEARCH OBJECTIVES & METHOD
RESEARCH OBJECTIVES Establish evidence • Profile drug use in Dublin 15 base for drug use in • Identify gaps in service provision Dublin 15 to inform local service provision Repeat annually • Always have current information • Monitor changes in drug use over time
RESEARCH MODEL The DATMS model employs a mixed-method design comprised of the following primary and secondary data sources: PRIMARY QUANTITATIVE DATA: DATMS YEAR 5 (2019)
Drug treatment data • Profile drug users treated in Dublin 15* • Treated drug users area of residence visually represented on Dublin 15 map^ • Changes in drug use and drug related issues~ Untreated drug use~ • Profile of untreated drug use • Changes in drug use and drug related issues • Factors contributing to drug use Family members • Profile of family members attending local affected by drug use~ family support services and peer-led groups • Family members area of residence visually represented on Dublin 15 map∞ • Impact of drug use on families Drug use indicator • Drug litter survey of Dublin 15 • Drug litter data visually represented on Dublin 15 map꙳
* For the profile of treated cases aged under 18, Year 1 to 5 collected treatment demand data from local services. For the profile of treated adult cases, this method was used for Year 1 and 2. From Year 3, treatment demand data has been provided by the National Drug Treatment Reporting System (NDTRS; see Secondary Data Sources). The reasons for this change included:
• The new NDTRS LINK System (online web-based reporting system) reduced
17 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
data reporting times: prior to this, NDTRS data was time lagged and DATMS data was used to produce current data • To increase the quality of the data: DATMS data has no unique identifiers and treated drug users are counted more than once if they attend more than one local service; while the NDTRS data has no unique identifiers, the system has the capacity to remove duplicate cases thus providing more robust data • To end duplication in data reporting i.e. local services reporting to the BLDATF and NDTRS
^ Since Year 2 we have mapped treatment demand data in Dublin 15 for two reasons. Firstly, to identify the area of residence for treated drug users. Secondly, to find out the extent of the drug and alcohol dependence throughout Dublin 15. We repeat this mapping each year to identify any changes in the extent of drug and alcohol dependence throughout Dublin 15. For mapping purposes, the map of Dublin 15 was divided into quadrants that were 0.45 kilometres square. This unit of measurement was chosen as it is small enough to allow accurate mapping but large enough to protect client anonymity.
~ Year 1 and 2 used qualitative methods to collect data concerning treated and untreated drug use and the impact of drug use on families. This method is more resource hungry than quantitative methodologies. Due to limited resources, from Year 3, quantitative methods have been used to collect and analyse this data. A questionnaire was devised to collect data and descriptive statistics were used to analyse it.
∞ In 2018 we developed the BLDATF Family Support Service and mapped treatment demand for these family members. In Year 5 we included treatment demand data from local family support services and peer-led groups.
꙳ Since the first DATMS we have focused on drug-related litter as a way of evaluating the real levels of drug use within Dublin 15. In Year 1 we examined the visibility of drug use in six local communities. We did this by walking throughout these neighbourhoods and photographing what we found. Each photo was geo-tagged. In Year 2 and 5, we mapped this litter and extended the survey to the whole of Dublin 15.
RESEARCH PARTICIPANTS The number and type of participants that participated in Year 5 is reported in the table below; participant numbers for Year 4 have been included for comparison purposes (Table 2.1).
18 DATMS RESEARCH OBJECTIVES & METHOD
Table 2.1: Number and type of participants, DATMS Year 4 and 5 (2018 & 2019) Participant type Number of participants Year 4 Year 5 Service providers 36 26 Treated drug users*~ 27 31 Untreated drug users*~ 19 13 Young people*~ 8 0꙳ Family members affected by drug use~ 22 14 Community member 0 1 Total 112 85 * Includes participants aged 16+ years ~ Includes participants from the following ethnic backgrounds: White Irish, Irish Traveller, Irish African, Irish Eastern European ꙳ While no young people took part in Year 5, 22 treated and untreated drug users aged from 16 to 24 years provided data concerning drug use by young people in Dublin 15
Year 5 data collection began in January 2020 and due to covid-19 ended prematurely on 13 March 2020. This explains the reduction in participant numbers from Year 4 to 5. Data saturation was reached for the majority of the data presented in this report. Data saturation was not reached for the following data:
• Year 5 produced no data concerning chemsex in Dublin 15. Chemsex is a form of drug use that involves the use of specific drugs to facilitate or enhance sex. The most commonly used drugs are methamphetamine, mephedrone and GHB/GBL, with one or more of these drugs used during a session. Chemsex can be a high-risk activity involving overdose, injecting drug use, unsafe sexual practices, sexual assault and drug dependence. Chemsex usually refers to sex by men who have sex with men. Since Year 2, data has suggested that chemsex was hidden and/or not prevalent in Dublin 15. Year 2 and 3 reported that people engaged in this behaviour were male treated drug users who were homosexual. In Year 4, the profile of people engaged in this behaviour expanded to include male and female untreated drug users who were heterosexual which suggested that the prevalence of chemsex had increased. • The profile of untreated adult drug users may be incomplete: Year 1 to 4 reported the use of crack cocaine by untreated adult drug users, but Year 5 did not report the use of this drug by these drug users
19 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
SECONDARY DATA SOURCES: DATMS YEAR 5 (2019)
Drug prevalence • All-Ireland Drug Prevalence Survey (National indicator Advisory Committee on Drugs and Alcohol): prevalence of drug use among general population aged 15+ years Drug treatment • National Drug Treatment Reporting System indicator (Health Research Board): treated drug and alcohol use in Ireland Other drug-related • Hospital In-Patient Enquiry Scheme indicators (Healthcare Pricing Office): drug and alcohol related morbidity from in-patient discharges from national acute hospitals • National Drug-Related Deaths Index (Health Research Board): census of drug-related deaths in Ireland Mental health • Profile of under 18 and adult treatment demand for mental health services
See Year 1 for more detailed information concerning the rationale for the development of the DATMS, its methodology and ethical considerations.
METHODOLOGICAL LIMITATIONS & GAPS IN EVIDENCE BASE Each year we strive to improve the quality of the data produced for our DATMS. It is a continuous challenge to ensure that the primary and secondary data sources are complete.
In relation to the primary data sources, local services and community members work hard to assist us with the recruitment of research participants. In all five years of the DATMS, the recruitment of some target groups has been difficult. The table below identifies the target groups that are under-represented and those that have increased or decreased in representation (Table 2.2).
20 DATMS RESEARCH OBJECTIVES & METHOD
Table 2.2: Representation of participant target groups, DATMS Year 1 to 5 Target Group Year 1 Year 2 Year 3 Year 4 Year 5 Untreated drug Aged 25 years & over * * * * * users Females * * * * ↑ Ethnic diversity * * ↑ ↑ ↑ Treated drug users Aged 18 to 24 years * * * ↑ * Females * * * * ↑ Ethnic diversity * * * * ↓ Family members Males * * * * * affected by drug use Ethnic diversity * * * * * * Target group under-represented ↑ Increase in representation of target group ↓ Decrease in representation of target group
PARTICIPANT TARGET GROUPS: ETHNIC DIVERSITY While Year 5 has made progress in relation to the representation of all ethnic backgrounds among some target groups, it is evident that it remains a challenge to ensure all participating target groups are ethnically diverse.
Year 5 has produced a more comprehensive profile of untreated drug use by people from all ethnic backgrounds in Dublin 15. The Year 1 and 2 profile of untreated young drug users predominately reported drug use by the White Irish community, with limited data concerning Irish Traveller, Irish African and Eastern European communities. Since Year 3, there has been an increase in data concerning untreated drug use by these communities. Year 3 was the first time data was provided about untreated drug use among young people from an Irish Asian background; Year 5 produced a more comprehensive profile of drug use by this ethnicity. From Year 1 to 3, untreated drug users aged 25 years and over were under-represented in the DATMS. This resulted in the production of limited data concerning drug use among Irish and Irish Traveller ethnicities. Since Year 4, this issue has been addressed with more comprehensive data provided for all ethnicities except Irish Asians.
In Year 5 there was a decrease in the ethnic diversity of treated drug users participating in the DATMS. Year 4 participants included people from the White Irish, Irish African, Irish Eastern European and Irish Traveller communities. Year 5 included treated drug users from all of these ethnic backgrounds excluding the Irish Traveller community. Treated drug users from the Irish Asian community have not participated in any DATMS reports.
21 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Since Year 1, family members participating in the DATMS were from White Irish community. Family members from all other ethnicities have not participated in the DATMS.
GAPS IN EVIDENCE BASES In relation to the secondary data sources, the table below identifies gaps in evidence bases and the need to improve the quality of data (Table 2.3).
Table 2.3: Gaps in local evidence base, DATMS Year 5 (2019) Data type
Treated drug use To create a more robust profile of treated drug use the quality of data returns to the NDTRS needs to be improved.
Since 2017, data from the Central Treatment List has not been available. This data quantifies the number of people in receipt of methadone maintenance treatment.
At-risk youth Two services were approached to provide a profile of Dublin 15 at- population risk youth population. These services were the Blanchardstown Youth Service and Tusla Education Welfare Service. Unfortunately, these services were unable or unwilling to comply.
Mental health Several mental health services were contacted to provide a profile of treatment demand for children, youth and adult mental health and addiction services. These services were the Genesis Psychotherapy & Family Therapy Service, Jigsaw Dublin 15, HSE Substance Abuse Service Specific to Youth (SASSY), HSE Addiction Psychiatry Service and HSE Addiction Counselling Service. Unfortunately, not all of these services were able or willing to comply, resulting in the production of an incomplete dataset. Section 4 in the chapter ‘Factors contributing to drug & alcohol use’ and section 1 in the chapter ‘Consequences of drug & alcohol use’ report the data provided.
22 SOCIO-DEMOGRAPHIC PROFILE OF DUBLIN 15
3. SOCIO-DEMOGRAPHIC3. SOCIO-DEMOGRAPHIC PROFILE PROFILE OF DUBLIN OF DUBLIN15, 2006-2016 15, 3. SOCIO-DEMOGRAPHIC PROFILE OF DUBLIN 15, 2006-2016 2006-2016 Year 3 provided a trend analysis of the socio-economic profile of the Dublin 15 population Year 3 provided a trend analysis of the socio-economic profile of the Dublin 15 population from 2006 to 2016 (Central Statistics Office (CSO), 2006, 2011, 2016). A summary of this data Yearfrom 20063 provided to 2016 a(Central trend Statisticsanalysis Office of the (CSO), socio-economic 2006, 2011, 2016). profile A summary of the ofDublin this data 15 populationhas been provided from 2006below; to see 2016 Year (Central 3 for the Statistics full analysis. Office (CSO), 2006, 2011, 2016). Ahas summary been provided of this below; data seehas Year been 3 for provided the full analysis. below; see Year 3 for the full analysis.
• Dublin 15 population increased by 20% from 90,974 in 2006 to 109,895 in 2016 • Dublin• Dublin 15 15 population population increased by by 20% 20% from from 90,974 90,974 in 2006 in to 2006 109,895 to in109,895 2016 in • Population has become younger and more ethnically diverse 2016• Population has become younger and more ethnically diverse • Population• Stabilisation has of become unemployment younger levels and after more an increaseethnically during diverse the economic downturn • Stabilisation of unemployment levels after an increase during the economic downturn • Stabilisation of unemployment levels after an increase during the economic • Increase in educational attainment of population downturn• Increase in educational attainment of population • Increase in privately rented housing and decrease in owner occupied housing • Increase• Increase in ineducational privately rented attainment housing ofand population decrease in owner occupied housing • Increase• Dublin in 15 privately remain srented categorised housing as and marginally decrease above in owner average occupied and the housing socio- • • Dublin Dublin 15 15remains remain categoriseds categorised as asmarginally marginally above above average average andand thethe socio- socio- economically deprived population decreased from 31% in 2006 to 24% in 2016 economicallyeconomically deprived deprived populationpopulation decreased decreased from from 31% in31% 200 6in to 200624% in to 2016 24% in
2016 The following charts report the socio-demographic profile of the Dublin 15 population from The following charts report the socio-demographic profile of the Dublin 15 population from The2006 tofollowing 2016 (Charts charts 3.1 toreport 3.5). the socio-demographic profile of the Dublin 15 2006 to 2016 (Charts 3.1 to 3.5). population from 2006 to 2016 (Charts 3.1 to 3.5).
Chart 3.1: Dublin 15 population, CSO 2006 to 2016 Chart 3.1: DublinDublin 1515 population,population, CSO CSO 20062006 toto 2016 2016 150,000 109,895 150,000 101,032 109,895 125,000 101,032 (↑9%) 125,000 (↑11%) (↑9%) 100,000 90,974 (↑11%) 100,000 90,974 75,000 75,000 50,000 50,000 25,000 25,000 0 0 2006 2011 2016 2006 2011 2016
Chart 3.2: DublinDublin 1515 populationpopulation by by age age range, range, CSO CSO 20062006 toto 20162016 Chart 3.2: Dublin 15 population by age range, CSO 2006 to 2016 2006 2011 2016 2006 2011 2016 70,000 70,00060,000 60,00050,000 50,000
40,000 29,292 (27%) 23,423 (21%) 23,222 (23%) 22,688 (25%) 22,537 (22%) 21,282 (19%) 21,333 (21%) 40,00030,000 29,292 (27%) 18,596 (21%) 18,286 (17%) 18,304 (20%) 17,913 (18%) 23,423 (21%) 23,222 (23%) 22,688 (25%) 22,537 (22%) 13,944 (15%) 21,333 (21%) 21,282 (19%)
30,000 10,724 (12%) 18,596 (21%) 18,304 (20%) 18,286 (17%) 17,913 (18%) 9,294 (8%)
20,000 8,869 (9%) 8,318 (8%) 7,158 (7%) 6,718 (7%) 13,944 (15%) 10,724 (12%) 9,294 (8%)
20,000 8,869 (9%) 8,318 (8%)
10,000 7,158 (7%) 6,718 (7%) 10,0000 0 45+years 0-11 years 12-17 years 18-24 years 25-34 years 35-44 years 45+years 0-11 years
12-17 years 18-24 years 25-34 years 35-44 years
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23 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ChartChart 3.3:3.3: DublinDublin 15 population byby ethnicity, CSO CSO 20062006 toto 20162016
2006 2011 2016 200,000 150,000 68,237 (63%) 66,973 (67%) 68,237 (63%) 65,383 (73%) 66,973 (67%) 100,000 65,383 (73%) 68,237 (63%) 66,973 (67%) 100,000 65,383 (73%) 19,018 (17%) 19,018 (17%) 16,049 (16%) 50,000 16,049 (16%)
50,000 10,046 (11%) 10,046 (11%) 6,857 (6%) 6,967 (7%) 6,184 (6%) 5,481 (6%) 5,638 (6%) 6,967 (7%) 6,857 (6%) 6,184 (6%) 5,481 (6%) 5,638 (6%) 3,371 (4%) 3,263 (3%) 19,018 (17%) 2,253 (3%) 1,791 (2%) 3,371 (4%) 3,263 (3%) 658 (1%) 644 (1%) 558 (1%) 2,253 (3%) 16,049 (16%) 1,791 (2%) 50,000 644 (1%) 658 (1%) 558 (1%) 10,046 (11%) 6,967 (7%) 6,857 (6%) 6,184 (6%) 5,481 (6%) 5,638 (6%) 3,371 (4%) 3,263 (3%) 2,253 (3%) 1,791 (2%) 644 (1%) 658 (1%) 558 (1%) 0 mixed Irish mixed Irish Irish Traveller Irish Traveller mixed Irish White Irish Irish Traveller White Irish Other incl Other White Irish Other incl Other White Irish White Irish background background Other incl Other White Irish background background Other White Other Other White Other background background Other White Other Black or BlackorBlack Black or BlackorBlack Asian or Asian Asian or Asian Black or BlackorBlack Asian or Asian CategoryCategory totals totals less less than than population population totals totals as ascategory category 'unknown' 'unknown' not notinclude includedd
ChartChart 3.4:3.4: EducationalEducational attainmentattainment of Dublin 15 population agedaged 1515 yearsyears and over, CSOCSO 20062006 to 2016 to 2016
2006 2011 2016
100000 80000 60000 34,769 (54%) 60000 34,769 (54%) 30,885 (52%) 30,885 (52%) 27,232 (48%) 34,769 (54%) 27,232 (48%)
40000 30,885 (52%) 40000 27,232 (48%) 12,231 (21%) 11,823 (19%) 11,366 (20%) 12,231 (21%) 11,823 (19%) 11,366 (20%) 9,006 (16%) 9,006 (16%) 7,676 (13%) 7,192 (11%) 7,676 (13%) 7,192 (11%) 5,417 (10%) 5,238 (9%) 4,964 (8%) 5,417 (10%) 5,238 (9%) 4,964 (8%) 12,231 (21%) 11,823 (19%) 11,366 (20%)
20000 9,006 (16%)
20000 7,676 (13%) 7,192 (11%) 5,417 (10%) 5,238 (9%) 20000 4,964 (8%) 0 Lower Upper Lower Upper Lower Upper secondary secondary secondary secondary Third level Third level secondary secondary no formalno no formalno education) education) Third level no formalno education) Primary (incl. Primary Primary (incl. Primary Primary (incl. Primary CategoryCategory totals totals less less than than population population totals totals as ascategory category 'unknown' 'unknown' not notincluded included
ChartChart 3.5:3.5: EconomicEconomic status status of of Dublin Dublin 1515 populationpopulation aged 1515 years andand over,over, CSO 20062006 toto 2016
2006 2011 2016
120,000 100,000 80,000 49,607 (61%) 49,607 (61%) 45,917 (66%) 45,917 (66%) 43,535 (58%) 43,535 (58%) 60,000 49,607 (61%) 45,917 (66%) 60,000 43,535 (58%) 40,000 9,790 (13%) 9,106 (11%) 9,790 (13%) 9,106 (11%) 7,885 (11%) 6,893 (8%) 7,118 (10%) 7,885 (11%) 6,553 (10%) 6,784 (8%) 6,236 (8%) 6,129 (8%) 6,893 (8%) 7,118 (10%) 6,553 (10%) 6,784 (8%) 6,236 (8%) 6,129 (8%) 4,929 (7%) 4,788 (6%) 4,929 (7%) 4,788 (6%) 3,066 (4%) 2,848 (4%) 2,487 (4%) 3,066 (4%) 2,848 (4%) 1,827 (3%) 2,487 (4%) 9,790 (13%) 1,827 (3%) 20,000 9,106 (11%)
20,000 7,885 (11%) 6,893 (8%) 7,118 (10%) 6,784 (8%) 6,553 (10%) 6,236 (8%) 6,129 (8%) 4,788 (6%) 4,929 (7%) 2,848 (4%) 3,066 (4%) 2,487 (4%) 20,000 1,827 (3%) 0 Retired Retired Student Student Retired Student Employed Employed Unable to Unable to Employed workforce workforce work/Not in work/Not Unable to work/Not in work/Not workforce Unemployed Unemployed home/family home/family Looking after Looking Looking after Looking work/Not in work/Not Unemployed home/family Looking after Looking
The Pobal HP Deprivation Index identifies the geographical distribution of affluence and deprivation in Ireland (Central Statistics Office, 2006, 2011, 2016). The Small Area Population
25
24 SOCIO-DEMOGRAPHIC PROFILE OF DUBLIN 15
StatisticsThe Pobal (SAPS) HP Deprivationanalysis has been Index used identifies to calculate the thegeographical population ofdistribution Dublin 15 livingof affluence within Statistics (SAPS) analysis has been used to calculate the population of Dublin 15 living within differentand deprivation levels of affluencein Ireland and (Central deprivation. Statistics The majorityOffice, of2006, the population2011, 2016). is classified The Small as differentArea Population levels of affluenceStatistics and (SAPS) deprivation. analysis The has majority been used of the to population calculate theis classified population as marginally above the average (Chart 3.6). marginallyof Dublin above15 living the averagewithin different (Chart 3.6). levels of affluence and deprivation. The majority of the population is classified as marginally above the average (Chart 3.6).
Chart 3.6: Dublin 15 population by Deprivation Index Scores, 2006 to 2016 ChartChart 3.6:3.6: DublinDublin 1515 populationpopulation byby DeprivationDeprivation Index Scores,Scores, 2006 2006 toto 20162016 160,000 160,000 120,000 120,000 80,000 80,000 55,197 (50%) 41,516 (41%) 55,197 (50%) 35,905 (39%) 26,525 (29%) 26,073 (24%) 25,260 (25%) 40,000 41,516 (41%) 19,783 (20%) 35,905 (39%) 17,098 (19%) 15,832 (15%) 26,525 (29%) 26,073 (24%) 9,550 (9%) 25,260 (25%) 8,860 (8%) 7,199 (8%)
40,000 4,119 (4%) 19,783 (20%) 3,220 (4%) 2,961 (3%) 1,023 (1%) 972 (1%) 17,098 (19%) 804 (1%) 5 (0.01%) 0 (0%) 0 (0%) 15,832 (15%) 9,550 (9%) 8,860 (8%) 7,199 (8%) 4,119 (4%) 3,220 (4%) 2,961 (3%) 972 (1%) 1,023 (1%) 804 (1%) 0 (0%) 0 5 (0.01%) 0 (0%) 0 30) -20) 30) (over30) -20) 20 to-30) (over30) average (0 10)to average (0 Marginally above Marginally below average (0 to-10) 20 to-30) Affluent(10 to 20) Extremely affluent Extremely average (0 10)to average (0 Marginally above Marginally below Very affluent (20 to (20 affluent Very average (0 to-10) Affluent(10 to 20) Extremely affluent Extremely Very affluent (20 to (20 affluent Very Very disadvantaged (- disadvantaged Very Disadvantaged (-10 Disadvantaged to (-10 Very disadvantaged (- disadvantaged Very Disadvantaged (-10 Disadvantaged to (-10 2006 2011 2016 2006 2011 2016
From 2006 to 2016, there was a 7% decrease in the proportion of Dublin 15 population FromFrom 2006 2006 to to 2016, 2016, there there was was a 7% a decrease 7% decrease in the proportion in the proportion of Dublin 15of populationDublin 15 classified as socio-economically deprived (Charts 3.7 and 3.8). classifiedpopulation as socio classified-economically as socio-economically deprived (Charts 3.7 anddeprived 3.8). (Charts 3.7 and 3.8).
ChartChart 3.7:3.7: DublinDublin 1515 sociosocio-economically-economically depriveddeprived population,population, Deprivation IndexIndex 2006 toto 20162016 Chart 3.7: Dublin 15 socio-economically deprived population, Deprivation Index 2006 to 2016 40,000 40,000 30,137 35,000 27,517 30,137 35,000 27,517 (30%) 25,664 (31%) (30%) 25,664 30,000 (31%) (24%) 30,000 (24%) 25,000 25,000 20,000 20,000 15,000 10,000 5,000 0 20062006 20112011 20162016
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25 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Chart 3.8: Dublin 15 socio-economically deprived youth population, Deprivation Index 2006 to 2016 ChartChart 3.8:3.8: Dublin 1515 socio-economicallysocio-economically depriveddeprived youth youth population, population, Deprivation Deprivation Index Index 2006 2006 to Under 18 18-24 years to2016 2016 12,000 8,909 Under 18 18-24 years 10,000 7,757 (30%) 7,852 (31%) (24%) 12,0008,000 8,909 7,757 7,852 10,0006,000 3,324 (30%) (31%) 2,611 (24%) 8,000 (31%) 1,996 4,000 (30%) (24%) 6,000 3,324 2,000 2,611 4,000 (31%) 1,996 0 (30%) (24%) 2,000 2006 2011 2016
0 2006 2011 2016 The following chart describes the socio-demographic and economic characteristics associated
with different levels of deprivation and affluence (Chart 3.9). It identifies that the most TheThe following following chart chart describes describes the thesocio socio-demographic-demographic and economic and economic characteristics characteristics associated disadvantagedassociated with have different the lowest levels levels of of deprivation educational and attainment affluence and (Chartthe highest 3.9). rates It identifies of lone with different levels of deprivation and affluence (Chart 3.9). It identifies that the most parents,that the unemployment most disadvantaged and local have authority the lowest housing; levels as affluence of educational increases attainment the converse and is disadvantagedthe highest rates have theof lone lowest parents, levels of unemployment educational attainment and local and theauthority highest housing; rates of lone as reported. parents,affluence unemployment increases the and converse local authority is reported. housing; as affluence increases the converse is
reported. ChartChart 3.9:3.9: SocioSocio-demographic-demographic anandd economiceconomic characteristicscharacteristics ofof fourfour SmallSmall AreaArea deprivationdeprivation andand affluenceaffluence categories categories in in Dublin Dublin 15,15, DeprivationDeprivation Index 20162016 Chart 3.9: Socio-demographic and economic characteristics of four Small Area deprivation Very disadvantaged Marginally below average Marginally above average Very affluent and affluence categories in Dublin 15, Deprivation Index 2016
100% 94% Very disadvantaged Marginally below average Marginally above average Very affluent
90% 83%
100%80% 94% 66%
70%90% 83% 60%80% 50% 49% 50%70% 66% 38% 37% 33% 40%60% 33% 50% 49%
30%50% 22% 22% 38% 37% 16% 16% 14%
20%40% 33% 33% 8% 6% 5% 4% 4% 3% 10% 3% 3%
30% 22% 22% 0% 0% 16% 16% 20%0% 14% 8% 6% 5%
Lone parents4% Primary No third level Local authority Unemployment Unemployment4% 10% 3% 3% 3% ratio education only education rented0% 0% rate male rate female 0% Lone parents Primary No third level Local authority Unemployment Unemployment ratio education only education rented rate male rate female
27
27
26 TREATED DRUG AND ALCOHOL USE
4. TREATED DRUG AND ALCOHOL USE
Treatment demand data contains no unique identifiers and treated drug users may be counted more than once if they attend more than one service. Thus, the Year 5 profile of treated drug use reports the number of treatment episodes (cases) rather than the number of people treated.
MAPPING TREATMENT DEMAND Mapping data was provided by the following local services: D15 CAT, the Health Service Executive’s Substance Abuse Service Specific to Youth (SASSY), Blanchardstown Youth Service Drug Education Prevention programme, Mulhuddart/Corduff Community Drug and Alcohol Team, Tolka River Project, Coolmine Therapeutic Community (Coolmine Lodge and Ashleigh House) and Genesis Psychotherapy & Family Therapy Service.
Mapping treatment demand in Year 5 identified the following:
• In 2019, treated cases were from Dublin 15, outside Dublin 15 and homeless (see maps overleaf) • The majority of treated cases were from Dublin 15: • Treated drug users were from every community in Dublin 15, though most lived in socio-economically deprived areas • Drug and alcohol dependence is a community wide issue crossing all socio-economic boundaries • Year 2 to 4 mapping data reported similar findings
27 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 2 Treatment demand in Dublin 15 Adults & Under 18s
28 TREATED DRUG AND ALCOHOL USE
YEAR 3 Treatment demand in Dublin 15 Adults & Under 18s
29 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 4 Treatment demand in Dublin 15 Adults & Under 18s
30 TREATED DRUG AND ALCOHOL USE
YEAR 5 Treatment demand in Dublin 15 Adults & Under 18s
31 DRUG AND ALCOHOLThis page TRENDS has been left blank intentionally MONITORING SYSTEM YEAR 5
YEAR 5 (2019) TREATMENT DEMAND IN DUBLIN 15 ADULTS & UNDER 18s
32 TREATED DRUG AND ALCOHOL USE
YEAR 2 Treatment demand in Dublin 15 Under 18s
33 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 3 Treatment demand in Dublin 15 Under 18s
34 TREATED DRUG AND ALCOHOL USE
YEAR 4 Treatment demand in Dublin 15 Under 18s
35 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 5 Treatment demand in Dublin 15 Under 18s
36 YEAR 5 (2019) TREATMENT DEMAND IN DUBLIN 15 UNDER 18s
37 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
38 TREATED DRUG AND ALCOHOL USE
TREATED DRUG & ALCOHOL USERS AGED UNDER 18 TheTREATED profile of treated DRUG drug use& reportsALCOHOL five years USERSof data. Year AGED 1 reporting UNDER period began 18 June 2014,The profile Year 2 began of treated June 2015, drug Yearuse 3reports to 5 relates five to years2017 toof 2019. data. Data Year was 1 reporting provided by period the began June 2014, Year 2 began June 2015, Year 3 to 5 relates to 2017 to 2019. Data Blanchardstown Youth Service Drug Education Prevention programme and SASSY. Overall, was provided by the Blanchardstown Youth Service Drug Education Prevention theprogramme number of and treated SASSY. cases agedOverall, under the 18 number increased of by treated 129% from cases 51 inaged Year 1under to 117 18 in Yearincreased 5, though by fluctuations129% from in 51 this in upward Year 1 trend to 117 were in reportedYear 5, though during this fluctuations period (Chart in 4.1). this Thisupward increase trend may were be related reported to an during increase this in period drug use (Chart in Du blin4.1). 15, This though increase it could may also be be related to an increase in drug use in Dublin 15, though it could also be related to relatedan increase to an increasein data inreturns. data returns.
ChartChart 4.1:4.1: Treated casescases aged under 18, DATMS Year 11 toto 55
124 150 117 (↑85%) 97 (↑21%) (↓22%) 100 67 (↑31%) 51 50
0 Year 1 Year 2 Year 3 Year 4 Year 5
From Year 1 to 5, an estimate of 1% of the Dublin 15 population aged 12 to From17 years Year 1has to 5,attended an estimate treatment of 1% of for the drug Dublin and/or 15 population alcohol ageduse 12(Table to 17 4.1). years It has is attendedprobable treatment that this is for an drug underestimate and/or alcohol of usetreatment (Table 4.1).demand It is as probable it does that not this include is an underestimateyoung people of treated treatment outside demand Dublin as it does15, privatelynot include or young those people not accessing treated outside any services. As CSO data relates to individuals and treatment demand data relates Dublinto cases, 15, privately this estimate or those is not not accessing without any its services. flaws. As CSOHowever, data relates it has to beenindividuals included and treatmentservice planning demand purposes.data relates to cases, this estimate is not without its flaws. However, it has been included service planning purposes. Table 4.1: Percentage of Dublin 15 population aged 12 to 17 years treated in local community and statutory services, DATMS Year 1 to 5 TableDATMS 4.1: Percentage of DublinD15 15 population population aged 12 to 17 years% treatedof D15 populationin local community andYear statutory services, DATMSaged Year 12 to 1 t17o 5(CSO) aged 12 to 17 in treatment DATMSYear 1 D15 population aged7,158* 12 to 17 (CSO) % of D15 population1% aged 12 to 17 in YearYear 2 7,158* treatment1% Year 1 7,158* 1% Year 3 9,294^ 1% Year 2 7,158* 1% YearYear 34 9,294^9,294^ 1%1% YearYear 45 9,294^9,294^ 1%1% * YearCSO 52011 9,294^ 1% *^ CSOCSO 2011 2016 ^ CSO 2016
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39 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
SOCIO-DEMOGRAPHIC PROFILE SOCIO-DEMOGRAPHIC PROFILE OverSOCIO-DEMOGRAPHIC the reporting period, the majority PROFILE of treated cases aged under 18 were male and white Over the reporting period, the majority of treated cases aged under 18 were male and white IrishOver (Charts the reporting 4.2 and 4.3). period, the majority of treated cases aged under 18 were male Irishand (Charts white Irish4.2 and (Charts 4.3). 4.2 and 4.3).
Chart 4.2: Treated cases aged under 18 by gender, DATMS Year 1 to 5 ChartChart 4.2: 4.2: TreatedTreated cases aged aged under under 18 18 by by gender, gender, DATMSDATMS YearYear 11 toto 55 Male Female Male Female 140 140 101 103 101 103 120 (81%) 85 (88%) 120 (81%) 85 (88%) 100 (88%) 100 (88%) 80 80 40 43 60 40 43 60 (78%) (64%) 24 23 (78%) (64%) 24 23 14 40 11 (36%) (19%) 12 14 40 11 (36%) (19%) 12 20 (22%) (12%) (12%) 20 (22%) (12%) (12%) 0 0 Year 1 Year 2 Year 3 Year 4 Year 5 Year 1 Year 2 Year 3 Year 4 Year 5
Chart 4.3: Treated cases aged under 18 by ethnicity, DATMS Year 1 to 5 ChartChart 4.3: 4.3: TreatedTreated cases aged aged under under 18 18 by by ethnicity, ethnicity, DATMSDATMS YearYear 11 toto 5 Year 1 Year 2 Year 3 Year 4 Year 5 Year 1 Year 2 Year 3 Year 4 Year 5 160 160 140 (78%) (70%) (82%) 140 (78%) 120 (70%) (82%) 91 (90%) 120 87 79
100 91 (92%) (90%) 87
100 79 60 80 (92%) (19%) 47 80 60
60 (19%) 47 (8%) 24 (8%) (7%)
60 (6%) (0%) (0%) (0%) 40 (0%) (8%) 24 (8%) (7%) 9 8 8 (6%) * 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ (0%) (0%) (0%) (0%) 0 0 0 2040 0 9 8 8 * 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 200 0 0 0 0 0 White IrishWhite White IrishWhite Irish Traveller Irish Asian/Chinese background^ background^ Irish Traveller Irish Any otherAny black Asian/Chinese background^ Any otherAny white background^ Any otherAny black Any otherAny white ~~ Number Number of of cases cases too too small small to tobe bereported reported (5 or(5 less)or less) ~ Number of cases too small to be reported (5 or less) * Number of cases greater than 5 not reported to ensure cases with 5 or less are not disclosed ** NumberNumber ofof cases cases greater greater than than 5 not5 not reported reported to toensure ensure cases cases with with 5 or 5 less or lessare notare disclosednot disclosed ^ Ethnic category ‘Any other black background’ includes African Irish and the category ‘Any other ^^ EthnicEthnic category category ‘Any ‘Any other other blackblack background’ background’ includes includes African African Irish Irish and and the the category category ‘Any ‘Any other other white background’ includes Eastern European Irish white background’ includes Eastern European Irish white background’ includes Eastern European Irish
From Year 3, the quality of the data increased producing a more comprehensive profile of FromFrom Year Year 3, 3,the the quality quality of theof thedata data increased increased producing producing a more acomprehensive more comprehensive profile of treated drug users in Dublin 15. Thus, for some of the following profile there was limited data treatedprofile drug of treated users in Dublindrug users15. Thus, in forDublin some 15. of theThus, following for some profile of there the followingwas limited profiledata availablethere was for limitedYear 1 and data 2. Favailablerom Year 3for to Year 5, the 1 majority and 2. Fromof treated Year cases 3 to were5, the aged majority from 15 of available for Year 1 and 2. From Year 3 to 5, the majority of treated cases were aged from 15 treated cases were aged from 15 years (Chart 4.4). years (Chart 4.4). years (Chart 4.4).
31 31
40 TREATED DRUG AND ALCOHOL USE Chart 4.4: Treated cases by age, DATMS Year 3 to 5 (2017-2019)
Year 3 Year 4 Year 5 ChartChart 4.4: 4.4: TreatedTreated cases byby age,age, DATMS DATMS YearYear 33 toto 55 (2017(2017-2019)-2019) 80 (49%) 57
Year 3 Year 4 (33%) Year 5 (33%) 60 (38%) (36%) 41 41 37 (20%) (19%) 35 (17%) (49%) 8040 (19%) 24 23 20 57 18 (8%) (33%) (33%) (6%)
60 (38%) * (36%)
20 9 7 ~ ~ ~ 41 41 (0%) (0%) (0%) 37 (20%) (19%) 35 (17%) 400 (19%) 24 23 20 18 (8%) (6%) *
20 9 7 ~ ~ ~ (0%) (0%) (0%)
0 12 years 13 years 14 years 15 years 16 years 17 years
~ Number of cases too small to be reported (5 or less) * Number of cases greater than 5 not reported to ensure cases with 5 or less are not disclosed 12 years 13 years 14 years 15 years 16 years 17 years ~~ Number Number of of cases cases too too small small to tobe be reported reported (5 or(5 less)or less) There are ten mainstream secondary schools and three training centres in Dublin 151. From ** NumberNumber ofof cases cases greater greater than than 5 5not not reported reported to to ensure ensure cases cases with with 5 or 5 lessor less are arenot notdisclosed disclosed Year 1 to 5, there has been an increase in the number of secondary schools and training TherecentresThere are are attended ten ten mainstream mainstream by treated secondary secondary cases agedschools schools under and three 18 and (Chart training three 4.5). training centres Since incentresYear Dublin 4, almostin15 1Dublin. From all 151. From Year 1 to 5, there has been an increase in the number of secondary secondaryYear 1 to 5,schools there andhas trainingbeen an centres increase in inDublin the number15 have ofstudents secondary with schoolsdrug and/or and trainingalcohol schools and training centres attended by treated cases aged under 18 (Chart problems.centres4.5). Since attended This Year indicates by4, almost treated that drug all ca sessecondary use aged is a community under schools 18 (Chartwide and issue training 4.5). cross Since centresing Yearall socio in 4, Dublin- almosteconomic 15 all boundaries.secondaryhave students schools with and drugtraining and/or centres alcohol in Dublin problems. 15 have studentsThis indicates with drug that and/or drug alcoholuse is a community wide issue crossing all socio-economic boundaries. problems. This indicates that drug use is a community wide issue crossing all socio-economic Chboundaries.Chartart 4.5: 4.5: Secondary Secondary schools/training schools/training centres centres in in Dublin Dublin 15 15 attend attendeded by by treated treated cases cases aged aged under 18, DATMS Year 1 to 5 under 18, DATMS Year 1 to 5 16 11 Ch14art 4.5: Secondary13 schools/training centres in Dublin 15 attended by treated cases10 aged (85%) under12 18, DATMS Year 1 to7 5 (77%) 10 6 6 (54%) 168 (46%) (46%) 11 14 13 10 6 (85%) 124 7 (77%) 10 6 6 2 (54%) 80 (46%) (46%) 6 Dublin 15 Year 1 Year 2 Year 3 Year 4 Year 5 4 2 secondary 0 schools/training Dublincentres 15 Year 1 Year 2 Year 3 Year 4 Year 5
secondary schools/training From Yearcentres 3 to 5, there was a change in the education and employment profile
of treated drug users aged under 18. While the majority of treated cases were in education, since Year 4 an increase in the number not in education or employment has been reported (Chart 4.6). 1 Training centres include Blanchardstown Community Training Centre, Blanchardstown Youthreach, Blanchardstown Youth Service Early School Leavers Programme
1 Training centres include Blanchardstown Community32 Training Centre, Blanchardstown Youthreach, Blanchardstown Youth Service Early School Leavers Programme 1Training centres include Blanchardstown Community Training Centre, Blanchardstown Youthreach, Blanchardstown Youth Service Early School Leavers Programme 32
41 From Year 3 to 5, there was a change in the education and employment profile of treated drug users aged under 18. While the majority of treated cases were in education, since Year From Year 3 to 5, there was a change in the education and employment profile of treated 4 an increase in the number not in education or employment has been reported (Chart 4.6). DRUGdrug usersAND aged ALCOHOL under 18. While TRENDS the majority of treated cases were in education, since Year MONITORING SYSTEM YEAR 5 4 an increase in the number not in education or employment has been reported (Chart 4.6). Chart 4.6: Treated cases aged under 18 by education and employment status, DATMS Year 3
to 5 (2017-2019) ChartChart 4.6:4.6: TreatedTreated cases agedaged underunder 18 by education andand employmentemployment status, status, DATMS DATMS Year Year 3 3 Year 3 Year 4 Year 5 toto 55 (2017(2017-2019)-2019) 123 150 Year 3 Year 4 Year 5 (99%) 90 123 74 (77%) 100150 (76%) (99%) 90 74 50 (77%) 7 16 100 (76%) 0 (17%) * (0%) (7%) ~ ~ 500 7 16 0 (17%) * In education Employed/Apprenticeship(0%) (7%) ~ Not~ in education or 0 employment
~ Number of casInes educationtoo small to be reportedEmployed/Apprenticeship (5 or less) Not in education or employment * Number of cases greater than 5 not reported to ensure cases with 5 or less are not disclosed ~ Number of cases too small to be reported (5 or less) ~ Number of cases too small to be reported (5 or less) ** NumberNumber ofof casescases greater greater than than 5 5 not not reported reported to to ensure ensure cases cases with with 5 or5 or less less are are not not disclosed disclosed From Year 3 to 5, the majority of treated cases aged under 18 were in mainstream education
(ChartFrom 4.7).Year 3 to 5, the majority of treated cases aged under 18 were in mainstream From Year 3 to 5, the majority of treated cases aged under 18 were in mainstream education education (Chart 4.7).
(Chart 4.7). ChartChart 4.7:4.7: TrTreatedeated casescases aged under 18 byby educationeducation status, status, DATMS DATMS Year Year 3 3 to to 5 5(2017-2019) (2017-2019)
Year 3 Year 4 Year 5 Chart 4.7: Treated cases aged under 18 by education status, DATMS Year 3 to 5 (2017-2019) 99 120 (80%) Year 3 Year 4 Year 5 100 99 12080 55 (80%) 41 (61%) 10060 (56%) 21 22 8040 55 16 12 13 41 (28%) (25%) 8 (61%) (13%) (16%) (14%) 6020 (56%) (7%) 16 21 22 400 8 12 13 (13%) (28%) (25%) 20 Mainstream education In education (type unknown) Non-mainstream(7%) (16%) education(14%)
0 In Year 3,Mainstream treated educationcases agedIn under education 18 (type were unknown) from allNon-mainstream socio-economic education groups In Year 3, treated cases aged under 18 were from all socio-economic groups though the though the majority attended local secondary schools with DEIS status. This majorityidentified attended the relationship local secondary between schools social with deprivationDEIS status. Thisand identifieddrug use. the In relationshYear 4, theip In Year 3, treated cases aged under 18 were from all socio-economic groups though the betweenopposite social was deprivationreported, with and drugthe majority use. In Year of treated 4, the oppositecases in was non-DEIS reported schools., with the majorityYear 5 attendedreports anlocal almost secondary equal schools distribution with DEIS of status. treated This casesidentified from the allrelationsh socio-ip majority of treated cases in non-DEIS schools. Year 5 reports an almost equal distribution of betweeneconomic social groups deprivation (Chart 4.8). and drug use. In Year 4, the opposite was reported, with the treated cases from all socio-economic groups (Chart 4.8). majority of treated cases in non-DEIS schools. Year 5 reports an almost equal distribution of treated cases from all socio-economic groups33 (Chart 4.8).
33
42 TREATED DRUG AND ALCOHOL USE
Chart 4.8: Treated cases aged under 18 by DEIS status of mainstream education, DATMS Year 3ChartChart to 5 4.8:(20174.8: TrTreated-eated2019) cases cases aged under 18 byby DEISDEIS status of mainstream education,education, DATMS DATMS Year Year 33 ttoo 55 (2017(2017-2019)-2019) Year 3 Year 4 Year 5 84 Year 3 Year 4 Year 5 100 (85%)84 10080 (85%) 6080 27 24 28 60 17 15 40 (49%)27 (59%)24 (51%)28 (41%)17 (15%) 2040 (49%) 15 (59%) (51%) (41%) (15%) 200 0 DEIS status Non-DEIS status DEIS status Non-DEIS status
PROFILEPROFILE OF DRUGOF DRUG & ALCOHOL & ALCOHOL USE USE PROFILE OF DRUG & ALCOHOL USE TheThe main main problem problem drugs drugs used used by treated by treated cases agedcases under aged 18 under were similar18 were for allsimilar reporting for Theall reportingmain problem periods, drugs withused cannabisby treated herbcases theaged most under commonly 18 were similar used, for followed all reporting by periods, with cannabis herb the most commonly used, followed by alcohol (Chart 4.9). periods,alcohol with(Chart cannabis 4.9). herb the most commonly used, followed by alcohol (Chart 4.9).
Chart Chart 4.9:4.9: Treated casescases aged under 18 byby mainmain problemproblem drug, drug, DATMS DATMS Year Year 1 1to to 5 5 Chart 4.9: Treated cases aged under 18 by main problem drug, DATMS Year 1 to 5 Year 1 Year 2 Year 3 Year 4 Year 5 Year 1 Year 2 Year 3 Year 4 Year 5 200 (97%) (90%) 160200 (67%) (97%) (90%) 120 (67%) 112 (84%) 120160 110 120 (82%) 81 112 (84%) 110 120 (90%) 55 (82%)
80 (34%) 81 46 (90%) (11%) 55 23
80 (34%) * (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%)
40 46 11 (11%) ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 * 40 (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) 11
0 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 LSD LSD MDMA Alcohol Solvents Cannabis Ketamine MDMA Alcohol Solvents Cannabis drugs Ketamine drugs Cocaine powder Cocaine Benzodiazepines/z- Cocaine powder Cocaine
~ Number of cases too small to be reported (5Benzodiazepines/z- or less) ~ Number of cases too small to be reported (5 or less) *~* Number ofof casescases greaterto greatero small than than to be 5 5 not reportednot reported reported (5 or to to less) ensure ensure cases cases with with 5 or5 or less less are are not not disclosed disclosed * Number of cases greater than 5 not reported to ensure cases with 5 or less are not disclosed
FromFrom Year Year 3 3 to to 5, 5, a achange change in thein the profile profile of drug of drug use amonguse among treated treated cases casesaged under aged 18under was From18 was Year reported. 3 to 5, a changeIn Year in3 theand profile 4, the ofmajority drug use of among treated treated cases cases were aged polydrug under users, 18 was reportedand in Year. In Year 5 the 3 and majority 4, the weremajority non-polydrug of treated cases users were (Chart polydrug 4.10). users, Over and the in reporting Year 5 the reported. In Year 3 and 4, the majority of treated cases were polydrug users, and in Year 5 the majorityperiod, cannabis were non and-polydrug alcohol users were (Chart the most 4.10). common Over the form reporting of polydrug period, use. cannabis and majority were non-polydrug users (Chart 4.10). Over the reporting period, cannabis and alcohol were the most common form of polydrug use. alcohol were the most common form of polydrug use.
34 34
43 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ChartChart 4.10:4.10: Treated cases cases agedaged underunder 18 18 by by polydrug polydrug use, use, DATMS DATMS Year Year 3 3to to 5 5(2017-2019) (2017-2019)
Year 3 Year 4 Year 5 150 115 (93%) 78 74 100 (67%) (76%) 39 23 9 (33%) 50 (24%) (7%) 0 Non-polydrug users Polydrug users
TheThe use use of of synthetic synthetic drugs drugs (New (New Psychoactive Psychoactive Substances/NPS) Substances/NPS) was not was reported not reported by treated by treated young drug users. Synthetic drug types include cannabinoids, opioids, youngbenzodiazepines, drug users. Synthetic and stimulants drug types including include cannabinoids, cocaine and opioids, MDMA. benzodiazepines, As drugs are and stimulantsgenerally includingused without cocaine completing and MDMA. an As analysis drugs are of generally their composition used without it iscompleting probable an 2 analysisthat synthetic of their types composition are used it iswithout probable users’ that knowledgesynthetic types. The are EMCDDA used without reported users’ that new psychoactive substances have become a more persistent problem 2 knowledgein Europe .(EMCDDA, The EMCDDA 2020). reported At thatthe endnew psychoactiveof 2019, the substances EMCDDA have was become monitoring a more persistentaround 790 problem new psychoactive in Europe (E MCDDA,substances, 2020). 53 At of thewhich end were of 2019, reported the EMCDDAfor the first was time in 2019. These substances are not controlled by international drug laws. monitoring around 790 new psychoactive substances, 53 of which were reported for the first time in 2019. These substances are not controlled by international drug laws.
2 The use of NPS also applies to treated adult drug users and untreated drug users 2 The use of NPS also applies to treated adult drug users and untreated drug users 35
44 TREATED DRUG AND ALCOHOL USE ADULT TREATED DRUG & ALCOHOL USERS The National Drug Treatment Reporting System (NDTRS) is an epidemiological database on ADULT TREATED DRUG & ALCOHOL USERS treated drug and alcohol misuse in Ireland. Analysis of NDTRS data from 2016 to 2019 The National Drug Treatment Reporting System (NDTRS) is an epidemiological provides the profile of adult treated drug use for Year 5. This data will report a profile of all database on treated drug and alcohol misuse in Ireland. Analysis of NDTRS data casesfrom living2016 in to the 2019 BLDATF provides area whothe accessedprofile ofcommunity adult treated and statutory drug use servic for esYear inside 5. Thisand outsidedata will the report BLDATF a area. profile As this of dataall casesis based living on the in BLDATFthe BLDATF area it doesarea notwho include accessed cases community and statutory services inside and outside the BLDATF area. As this from Tyrrelstown, Carpenterstown and Castleknock. Our mapping data (reported above) data is based on the BLDATF area it does not include cases from Tyrrelstown, identifiedCarpenterstown treated cases and fromCastleknock. these areas Our were mapping accessing data the lo (reportedcal community above) services. identified treated cases from these areas were accessing the local community services.
TREATMENT DEMAND TREATMENT DEMAND FromFrom 2016 2016 to to201 2019,9, there there has been has abeen 70% increasea 70% inincrease the number in theof cases number assessed of casesand/or treatedassessed (Chart and/or 4.11). treated This increase (Chart may4.11). be This related increase to an increasemay be inrelated drug use to anin Dublinincrease 15, thoughin drug it usecould in also Dublin be related 15, though to an increase it could in dataalso returns be related to the to NDTRS. an increase in data returns to the NDTRS.
ChartChart 4.11:4.11: All cases livingliving inin BLDBLDATFATF area, area, NDTRSNDTRS 2016 2016 to to 20120199 600 497 (↑43%) 500 348 400 (↑41%) 292 247 300 (↓15%) 200
100
0 2016 2017 2018 2019
FromFrom Year Year 1 to1 to5, an5, estimatean estimate of less of than less 1% than of the 1% Dublin of the 15 Dublinpopulation 15 agedpopulation 18 to 64 aged years 18 to 64 years has attended treatment for drug and/or alcohol use (Table 4.2). It is has attended treatment for drug and/or alcohol use (Table 4.2). It is probable that this is an probable that this is an underestimate of treatment demand as it does not include underestimateadults treated of privately treatment or demand those not as it accessing does not include any services. adults treated As CSO privately data orelatesr those notto individualsaccessing any and services. treatment As CSO demand data relates data torelates individuals to cases, and treatment this estimate demand is datanot without its flaws. However, it has been completed for service planning purposes. relates to cases, this estimate is not without its flaws. However, it has been completed for service planning purposes.
36
45 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
TableTable 4.2: Percentage of Dublin 15 popopulationpulation aged 18 to 64 years treatedtreated in local community andand statutorystatutory services, DATMS Year 1 to 5 DATMSDATMS Year D15 populationD15 population aged 18 to 64 % of D15 %population of D15 population aged 18 to 64 in aged 18 to 64 (CSO) aged 18 to 64 in treatment Year (CSO) treatment YearYear 1 66,480*66,480* 0.5%~0.5%~ YearYear 2 66,480*66,480* 0.4%0.4% YearYear 3 69,807^69,807^ 0.4%0.4% Year 4 69,807^ 0.5% Year 4 69,807^ 0.5% Year 5 69,807^ 0.7% * YearCSO 20115 69,807^ 0.7% ^* CSOCSO2016 2011 ~ Based on 315 treated cases, NDTRS 2015 ^ CSO 2016 ~ Based on 315 treated cases, NDTRS 2015 The NDTRS data identified that cases who lived in the BLDATF area were assessed and/or The NDTRS data identified that cases who lived in the BLDATF area were assessed treated in services within and outside the BLDATF area (Chart 4.12). and/or treated in services within and outside the BLDATF area (Chart 4.12).
ChartChart 4.12:4.12: AllAll cases cases living living in inBLDATF BLDATF area, area, assessed assessed and/or and/or treated treated in or in outside or outside BLDATF BLDATF area, NDTRSarea, NDTRS 2016 to 2016 201 to9 2019
2016 2017 2018 2019 700 600
500 (63%) (57%) (37%) 400 315 (55%) (43%) (54%) (45%) 300 (46%) 197 182 161 151 133 131
200 114 100 0 area BLDATF area
Outside BLDATF
The data reported that the majority of cases were in treatment for more than one The data reported that the majority of cases were in treatment for more than one year and year and about a third were new to treatment (Chart 4.13). about a third were new to treatment (Chart 4.13).
37
46 TREATED DRUG AND ALCOHOL USE Chart 4.13: All cases living in BLDATF area by treatment status, NDTRS 2016 to 2019
2016 2017 2018 2019 ChartChart 4.13:4.13: All cases livingliving inin BLDATFBLDATF area area by by treatment treatment status, NDTRS 20162016 toto 20120199 400 350 2016 2017 2018 2019 (40%)
300 (50%) (28%) (46%)
250 (50%) 194 (31%)
400 (35%) 200 169 (17%) (32%) 137 350 135 121 (40%) (15%) 107 103 (17%) 150 (13%) (50%)
300 84 78 (28%) (46%) 100 52 (50%) 42 250 39 194 (31%) (35%) 20050 169 (17%) (32%) 137 135 121 (15%)
0 107 103 (17%) 150 (13%) 84 78
100 52 42 50 39 0 New to Treated treatment Previously
Assessedonly New to Treated treatment Annual totals less than 100% as unknown cases removed Previously
Assessedonly
Annual totals less than 100% as unknown cases removed AAnnual demographic totals less profile than 100% of all as cases unknown reports cases that removed the majority of cases were Irish, male and aged
35A demographicto 44 years (Charts profile 4.14 toof 4.16). all cases reports that the majority of cases were Irish, A demographic profile of all cases reports that the majority of cases were Irish, male and aged male and aged 35 to 44 years (Charts 4.14 to 4.16). 35 to 44 years (Charts 4.14 to 4.16). ChartChart 4.14:4.14: All cases livingliving inin BLDATFBLDATF area area by by ethnicity, ethnicity, NDTRS 2016 2016 toto 20120199
2016 2017 2018 2019 Chart 4.14: All cases living in BLDATF area by ethnicity, NDTRS 2016 to 2019 700
600 (86%) 2016 2017 2018 2019 (90%) 500 429 700 (80%)
400 (84%) 313 600 (86%)
300 233 207 (90%) 500 429 (6%)
200 (80%) (5%) (5%) (5%) (6%) 400 (84%) 313 (3%) (2%) (2%) (1%) (0%) (0%) (0%) (0%) (0%) (0%) 31 16 16
100 14 15 9 9 6 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 300 233 0 207
200 (6%) (5%) (5%) (5%) (6%) (3%) (2%) (2%) (1%) (0%) (0%) (0%) (0%) (0%) (0%) 31 Irish 16 16
100 14 15 9 9 6 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 0 Roma Irish Black African Black Irish Traveller background background background Roma Any other other black Any Any other other Asian Any Any other other white Any background Black African Black Irish Traveller background background background Other, including mixed Any other other black Any Any other other Asian Any Any other other white Any ~~ Number Number of of cases cases too too small small to tobe be reported reported (5 (5or orless) less) background
Other, including mixed
~ Number of cases too small to be reported (5 or less)
38
38
47 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ChartChart 4.15: 4.15: AllAll casescases living living in in BLDATF BLDATF area area by by gender, gender, NDTRS NDTRS 2016 2016 to to 201 20199
2016 2017 2018 2019 600 (68%) 500 (68%) (70%) 338 400 (70%) 400 338 (62%) (68%) (62%) (32%) (68%) (32%) 300 242 242 300 (36%) (30%) (30%) (36%) 181 167 181 (32%) 159 167 159 200 (32%) 107
200 106 107 106 80 100 80 0 Male Male Female Female 20162016 total total less less than than 100% 100% as asunknown unknown cases cases removed removed
ChartChart 4.16: 4.16: AllAll casescases living living in in BLDATF BLDATF area area by by age, age, NDTRS NDTRS 2016 2016 to to 201 20199
2016 2017 2018 2019 300 (35%) 250 (35%) (28%) (28%) (36%) (43%) 175 (36%) (43%) 175 200 (32%)
200 (32%) (41%) (41%) 137 (33%) 137 (33%) 125 124 (17%) 125 (31%) 150 124 (17%) 111 (14%) 150 (31%) 111 100 (14%) 97 100 97 (14%) (19%) 84 (14%) (19%) 77 (11%) 84 (11%) (11%) 69 77 100 (11%) (11%) (9%) (11%) 100 69 (9%) 49 48 49 48 38 33 31 38 33 22 50 31 50 22 0 18-24 years 25-34 years 35-44 years 18-24 years 25-34 years 35-44 years 45 years orover 45 years 45 years orover 45 years 20182018 & & 2019 2019 total totalss less less than than 100% 100% as unknownas unknown cases cases removed removed
The remaining NDTRS analysis relates to cases living in the BLDATF area who The remaining NDTRS analysis relates to cases living in the BLDATF area who were treated in were treated in services in and outside Dublin 15. From 2016 to 2019, the majority services in and outside Dublin 15. From 2016 to 2019, the majority of treated cases were male servicesof treated in and cases outside were Dublin male 15. and From aged 2016 35 to 2019,to 44 theyears majority (Charts of treated 4.17 and cases 4.18). were male and aged 35 to 44 years (Charts 4.17 and 4.18).
39
48 TREATED DRUG AND ALCOHOL USE
Chart 4.17: Treated cases living in BLDATF area by gender, NDTRS 2016 to 2019
ChartChart 4.17: 4.17: TreatedTreated cases livingliving inin BLDATF2016BLDATF 2017area area byby2018 gender,gender,2019 NDTRSNDTRS 2016 2016 toto 20120199 450 2016 2017 2018 2019 (71%)
450 (71%)
350 292 (71%) (64%) (67%) 210 (29%) (71%)
250350 292 158 (35%) (29%) (64%) 136 (33%) (67%) 121 210 150250 (29%) 86 86 66 158 (35%) (29%) 136 (33%) 15050 121 86 86 66 -5050
-50 Male Female 2016 total less than 100% as unknownMale cases removed Female 2016 2016 total total less less than than 100% 100% as asunknown unknown cases cases removed removed
ChartChart 4.18: 4.18: TreatedTreated cases livingliving inin BLDATFBLDATF area area byby age,age, NDTRS NDTRS 2016 2016 to to 201 20199 Chart 4.18: Treated cases living in BLDATF2016 2017area by2018 age, NDTRS2019 2016 to 2019 200 2016 2017 2018 2019 180 (35%)
200 (29%) 160 143 (44%) (35%) (36%) 180 (34%)
140 120 (29%) 108 143
160 105 (44%) (33%) 101 (39%) 120 (36%) (34%) (33%) (16%)
140 120 (15%)
100 81 79 108 105 (33%) 66 101 (39%) 120 65 62 (19%) 80 (13%) (33%) (10%) (16%) (11%) (15%)
100 81 79
60 (9%) 38 38 (4%) 31 66 65 28 62 4080 (19%) (13%) 19 (10%) (11%) 10
60 (9%) 20 38 38 (4%) 31 40 28 0 19 20 10 0 18-24 years 25-34 years 35-44 years 45 years orover 45 years 18-24 years 25-34 years 35-44 years 20201818 & & 2019 2019 total totalss less less than than 100% 100% as asunknown unknown cases cases removed removed 45 years orover 45 years 20 18 & 2019 totals less than 100% as unknown cases removed
PROFILE OF DRUG & ALCOHOL USE PROFILE OF DRUG & ALCOHOL USE Over the reporting period, the four main problem drugs used by treated cases OverPROFILE the OFreporting DRUG &period, ALCOHOL the four USE main problem drugs used by treated cases were cocaine, were cocaine, alcohol, heroin and cannabis (Chart 4.19). From 2016 to 2019, alcoholOverthere the has, heroin reporting been and an period, cannabis increase the (Chart four in the main4.19). number problem From 2016 of drugs cases to used2019, treated by there treated forhas cocaine,casesbeen anwere increase with cocaine, this in thealcoholdrug number becoming, heroin of casesand the cannabis treated most common(Chartfor cocaine, 4.19). main withFrom problem this 2016 drug to drug 2019,becoming inthere 2019. the has Inmost bee 2017n common an andincrease 2018, main in the majority of cases were powder cocaine, with 5 or less treated for the use problemthe number drug of in cases 2019 treated. In 2017 for and cocaine, 2018, t withhe majority this drug of casesbecoming were the powder most cocaine,common with main 5 of crack cocaine. However, the NDTRS stated that nationally crack cocaine use orproblemwas less under-reported treated drug in for 2019 the. useIn or 2017 ofmis-reported. crack and cocaine2018, the. InHowever, majority2019, 98the of cases NDTR wereS werestated powder treated that nationallycocaine, for powder with crack 5 orcocainecocaine less treated use and was for12 under thecases -usereported forof crackcrack or cocainemis cocaine.-reported.. However, Over A breakdown the the reporting NDTR ofS stated2019 period, cocaine that therenationally cases has was crackalso not been an increase in the number of cases treated for alcohol and cannabis. From availablecocaine use. Over was the under reporting-reported period or mis, there-reported. has also A breakdown been an increase of 2019 in cocaine the number cases ofwas cases not 2018 to 2019, a decrease in the number of cases treated for heroin was reported. available. Over the reporting period, there has also been an increase in the number of cases 40
40
49 DRUGtreated AND for alcohol ALCOHOL and cannabis TRENDS. From 2018 to 2019, a decrease in the number of cases MONITORING SYSTEM YEAR 5 treated for heroin was reported.
ChartChart 4.19: 4.19: Treated Treated casescases living living inin BLDATFBLDATF area area by by main main problemproblem drug, NDTRS 20162016 toto 20120199
2016 2017 2018 2019 160 (27%) 140 (26%) 110 120 107 (29%) (33%) (38%) (26%) (18%)
100 85 82 (25%) 77 76 74 (13%) 80 (17%) (22%) 61 55 (12%) 51 (7%) (14%) 45 60 (11%) (10%) (9%) (9%) (7%) 35 (8%) (7%) (5%) (3%) 29 28 27 40 26 22 22 22 17 (1%) 15 15 14 * (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) (0%) 6 ~ ~ ~ ~ ~ ~ ~ ~ ~ 20 ~ 0 0 0 0 0 0 0 0 0 0 Heroin Ecstasy Alcohol Cocaine Cannabis Other opiates Other substances Benzodiazepines Other stimulants Other Volatile inhalants Volatile Novel psychoactive Novel
Other sedative/hypnotics Other ~~ Number Number of of cases cases too too small small to beto bereported reported (5 or(5 less)or less) ** Number Number of of cases cases greater greater than than 5 5and and suppressed suppressed to toensure ensure cases cases with with 5 or 5 lessor less are arenot not disclosed disclosed
NDTRSNDTRS cases cases treated treated for alcohol for alcohol are categorised are categorised by the extent by of the the extent problem, of from the hazardousproblem, from hazardous to harmful or dependent drinking. The Health Research Board's to harmful or dependent drinking. The Health Research Board's definition of these categories definition of these categories is as follows (Health Research Board, 2016): is as follows (Health Research Board, 2016): • Hazardous drinking increases the risk of harmful consequences for the user; it describes drinking over the recommended limits by a person who has no • Hazardous drinking increases the risk of harmful consequences for the user; it describes apparent alcohol-related health problems • Harmfuldrinking overdrinking the recommended is a pattern limits of useby a personthat results who has in no damage apparent to alcohol physical-related or mentalhealth health;problems some would also consider social consequences among the harms caused by alcohol • Harmful drinking is a pattern of use that results in damage to physical or mental health; • Dependent drinking: includes a strong desire to consume alcohol, impaired controlsome would over its also use, consider persistent social drinkingconsequences despite among harmful the harms consequences, caused by alcohol a higher • priorityDependent given drinking: to drinking includes than a strong to other desire activitiesto consume and alcohol, obligations, impaired controlincreased over alcohol tolerance; also, notably a physical withdrawal reaction when alcohol its use, persistent drinking despite harmful consequences, a higher priority given to use is discontinued drinking than to other activities and obligations, increased alcohol tolerance; also, Out ofnotably all cases a physical treated withdrawal for alcohol, reaction the extentwhen alcohol of the use problem is discontinued for the majority was categorised at the highest level as dependent drinking (Chart 4.20).
41
50 Out of all cases treated for alcohol, the extent ofTREATED the problem DRUG for the majorityAND ALCOHOL was categorised USE at the highest level as dependent drinking (Chart 4.20).
ChartChart 4.20:4.20: TreatedTreated cases livingliving inin BLDATFBLDATF area area byby extentextent ofof alcoholalcohol problem,problem, NDTRS 20162016 to 20120199
2016 2017 2018 2019 100 (45%) 90 (45%)
90 (67%) (67%) (52%) (52%) 70 80 70 (48%) (48%) 64 64
70 59 70 59 53 53
60 (23%) 60 (23%) (21%) (21%)
50 (23%) 50 (23%) 36 36 (18%) 32 (18%) (17%) 32 (15%) (17%) (15%)
40 (16%)
40 (16%) 26 (13%) 26 (13%) 20 20
30 18 17
30 18 17 15 15 12 20 12 10 0 Harmful drinker Harmful Harmful drinker Harmful Hazardous drinker Hazardous Hazardous drinker Hazardous Dependent drinker Dependent Dependent drinker Dependent AnnualAnnual totals totals less less than than 100% 100% as asunknown unknown cases cases removed removed IncludesIncludes all all cases cases treated treated for for alcohol alcohol use, use, those those treated treated for foralcohol alcohol as aas main a main problem problem drug drug and alsoand asalso an asadditional an additional problem problem drug drug
FromFrom 2016 2016 to to201 2018,8, the the majority majority of cases of cases were treatedwere treated for polydrug for polydrug use, and use,in 2019, and the in majority2019, the were majority treated were for non treated-polydrug for usenon-polydrug (Charts 4.21 anduse 4.22(Charts). 4.21 and 4.22).
ChartChart 4.21: 4.21: TreatedTreated cases livingliving inin BLDATFBLDATF area area byby polydrugpolydrug use,use, NDTRSNDTRS 2016 2016 to to 20 201919 2016 2017 2018 2019 400
350 (56%) 350 (56%) (44%) 300 (44%) 231 (52%) 231 (52%) (48%) (48%) (54%) 250 (54%) (46%) (46%) 182 (51%) 182 (51%) 154 200 (49%) 154 200 (49%) 142 142 134 134 114 114
150 103 99 150 103 99 100 50 0 users users Non-polydrug Non-polydrug Polydrug users Polydrug Polydrug users Polydrug
42
51 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ChartChart 4.22:4.22: Treated casescases living in BLDATF areaarea by number ofof problemproblem drugs, drugs, NDTRSNDTRS 2016 to 201to 20199
2016 2017 2018 2019 400 350 (56%) 300
250 231 (48%)
200 (46%) (49%) 142 (21%) (25%) 150 114 (15%) (24%) 99 (17%) (23%) (18%) 87 (8%) (16%) 75 (12%) (10%) (12%) 62 100 61 51 46 44 33 32 29 28 50 25 0 One Two Three
Four or five
Methadone maintenance treatment The Central Treatment List (CTL) reports the number of people in receipt of Methadone maintenance treatment methadone maintenance treatment for opiate dependence in Ireland. No current Thedata Central was available Treatment to Listquantify (CTL) the reports treatment the number demand of peoplefor this in service. receipt The of methadone following maintenancedata was reported treatment in Yearfor opiate 3. In dependence2015, the CTL in Ireland. reported No thatcurrent 270 data patients was available in Dublin to quantify15 were the prescribed treatment demandmethadone for this and service. 95% The were followi agedng dataover was 30. reported In 2016, in theYear CTL 3. In reported a slight increase in the number of patients prescribed this drug, though 2015,the actual the Central number Treatment was not List provided. (CTL) reported that 270 patients in Dublin 15 were prescribed methadone and 95% were aged over 30. In 2016, the CTL reported a slight increase in the number of patients prescribed this drug, though the actual number was not provided. HIGH-RISK DRUG USE
High-risk drug use includes injecting drug use, sharing injecting equipment and other drug paraphernalia. The profile of high-risk drug use in Dublin 15 is HIGHincomplete-RISK DRUG as the USE quality of the data returned to the NDTRS is poor. Despite this, HighNDTRS-risk drugdata usehas includes been presented injecting drug to provide use, sharing some injecting insight equipment into high andrisk otherdrug druguse in the community. From 2016 to 2018, a fifth of treated cases reported injecting paraphernalia.drugs in their The lifetime, profile this of high decreased-risk drug useto 13% in Dublin in 2019 15 is incomplete(Chart 4.23). as the quality of the data returned to the NDTRS is poor. Despite this, NDTRS has been presented to provide some insight into high risk drug use in the community. From 2016 to 2018, a fifth of treated cases reported injecting drugs in their lifetime, this decreased to 13% in 2019 (Chart 4.23).
43
52 TREATED DRUG AND ALCOHOL USE
Chart 4.23: Treated cases living in BLDATF area by lifetime injecting drug use, NDTRS 2016 to 201ChartChart9 4.23:4.23: TreatedTreated casescases living in BLDATF areaarea by lifetime injectinginjecting drug drug use, use, NDTRS NDTRS 20162016 to to 20120199 2016 2017 2018 2019
400 2016 2017 2018 2019 (78%) (78%) 400350 321 (74%)
350300 321 (71%) (74%) 219 300250 (73%) (71%) 177
200 219
250 (73%) 147
150 177 (19%) 200 (13%) (19%) 147 100 (20%) 57 150 55 46 (19%) 41 (13%) (19%) 10050 (20%) 57 55 46 500 41 No 0 Yes
No Annual totals less than 100% asYes unknown cases removed Annual Annual totals totals less less than than 100% 100% as as unknown unknown cases cases removed removed The extent of current injecting in the BLDATF area is unclear as the current injecting status of The extent of current injecting in the BLDATF area is unclear as the current theThe majorityextent of of current cases was injecting not reported in the BLDATF to the NDTRSarea is (Chartunclear 4.24). as the However, current injectingthe data statussuggests of injecting status of the majority of cases was not reported to the NDTRS (Chart the majority of cases was not reported to the NDTRS (Chart 4.24). However, the data suggests a4.24). decrease However, in injecting the drug data use, suggests and this ais validateddecrease by in other injecting DATMS drug data use, sources and3. this is 3 3 avalidated decrease inby injecting other DATMS drug use, data and sourcesthis is validated. by other DATMS data sources .
ChartChart 4.24:4.24: TreatedTreated casescases living in BLDATFBLDATF area by currentcurrent injectinginjecting status,status, NDTRS NDTRS 20162016 toto Chart20120199 4.24: Treated cases living in BLDATF area by current injecting status, NDTRS 2016 to 2019 2016 2017 2018 2019 30 2016 2017 2018 2019
2530 (35%) (36%) (44%) 20 20 (35%) (36%)
25 18
20 (44%) 20 20 (22%) (21%) 18 20 (22%)
15 12 12 (22%) (21%) 10 (17%) (22%)
15 12 12
10 7 10 ~ (17%)
105 7 ~ 05 No 0 Yes
No AnnualAnnual totals totals less less than than 100% 100% asYes as unknown unknown cases cases removed removed
Annual~~ Number Number totals of of cases lesscases than too too small100% small toas to beunknown be reported reported cases (5 (5or removed orless) less) ~ Number of cases too small to be reported (5 or less) From 2016 to 2018, the majority of treated cases began injecting aged 19 or less, From 2016 to 2018, the majority of treated cases began injecting aged 19 or less, in 2019 the in 2019 the majority were aged 20 to 24 years (Chart 4.25). majorityFrom 2016 were to 2018, aged 20the to majority 24 years of (Chart treated 4.25). cases began injecting aged 19 or less, in 2019 the majority were aged 20 to 24 years (Chart 4.25).
3 These data sources are reported in the following section ‘Changes in treated drug & alcohol use’ 3 These data sources are reported in the following section ‘Changes in treated drug & alcohol use’ 44 3 These data sources are reported in the following section ‘Changes44 in treated drug & alcohol use’
53 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
ChartChart 4.25: 4.25: TreatedTreated cases livingliving inin BLDATFBLDATF area area byby ageage first first injected, injected, NDTRS NDTRS 2016 2016 to to 201 20199 2016 2017 2018 2019
30 (37%)
25 (46%) 21 (37%) (31%) 19 17 20 17 (26%) (22%) (17%) 12 15 12 (17%) 10 (14%) (15%) 8 (15%) (15%) 8 10 8 6 6 5 0 19 or less 20-24 25-70
AnnualAnnual totals totals less less than than 100% 100% as asunknown unknown cases cases removed removed
NDTRS data reports the extent of harm reduction practices by injectors. NDTRSIn particular, data reports whether the extent cases of harm ever reduction shared practices injecting by injectoequipmentrs. In particular, or other whether drug casesparaphernalia. ever shared Itinjecting also reports equipment the historyor other of drug viral paraphernalia. screening for It also HIV reports and Hepatitis the history B and C. Incomplete NDTRS data returns has resulted in a lack of data concerning of viral screening for HIV and Hepatitis B and C. Incomplete NDTRS data returns has resulted these practices and services. in a lack of data concerning these practices and services. From Year 1 to 5, treated drug users and service providers reported the types of
drugs injected by treated adult drug users (Table 4.3). During this period, there Fromwere Year no reports1 to 5, treated of treated drug users young and drug service users providers injecting reported drugs. the types of drugs injected by treated adult drug users (Table 4.3). During this period, there were no reports of treated Table 4.3: Drugs injecting by treated adult drug users in Dublin 15, DATMS Year 1 to 5 youngDrug drugtype users injecting drugs.Year 1 Year 2 Year 3 Year 4 Year 5 2014/2015 2015/2016 2017 2018 2019 TableHeroin 4.3: Drugs injecting by treated√ adult drug users√ in Dublin√ 15, DATMS√ Year 1 to 5 √ DrugCocaine type powder Year√ 1 Year√ 2 Year√ 3 Year√ 4 Year√ 5 Crack cocaine 2014/2015√ 2015/2016√ 2017√ 2018√ 2019√ HeroinBenzodiazepines, Z drugs √ √ √√ √√ √ √√ CocaineAmphetamines~ powder √ √ √√ √√ √ √** CrackOpioid cocaine (Oxycodone) ^ √ √√ √√ √ √** Benzodiazepines,Opioid (Fentanyl) Z drugs * √ *√ *√ √ √** √Amphetamines~ Drugs injected √ √ √ √ ** ~Opioid Includes (Oxycodone) New Psychoactive Substances,^ Mephedrone√ and Methamphetamine√ √ ** **Opioid Injecting (Fentanyl) of drug not reported in Year* 5 * * √ ** √^ Drugs Injecting injected of drug first reported in Year 2 ~* IncludesInjecting New of drug Psychoactive first reported Substances, in Year Mephedrone4 and Methamphetamine ** Injecting of drug not reported in Year 5 ^From Injecting Year of drug 1 to first 5, reportedparticipants in Year reported2 that injecting of crack cocaine was not *common, Injecting of drugsmoking first reported was the in Year most 4 commonly used method for taking this drug. From Year 1 to 3, treated drug users reported injecting anabolic steroids and skin Fromtanning Year drugs. 1 to 5, In participants Year 4 and reported 5, there that was injecting little evidence of crack cocaineof the injection was not common,of these drugs by treated drug users4. smoking was the most commonly used method for taking this drug. From Year 1 to 3, treated 4 Further data concerning injecting use of non-psychoactive drugs by untreated drug users is reported in the chapter ‘Untreated drug & alcohol use’ 45
54 TREATED DRUG AND ALCOHOL USE
CHANGES IN TREATED DRUG & ALCOHOL USE Since Year 1, treated drug users and service providers have reported perceptions concerning changes in drug use.
TREATED YOUNG DRUG USERS (UNDER 18s) From Year 1 to 5, an increase in the use of cannabis herb, cocaine powder and alcohol were reported among treated young drug users. Year 5 also reported an increase in the use of other drugs (Table 4.4). The use of cannabis wax by treated young drug users was first reported in Year 5 (use of this drug by treated adult drug users first reported in Year 4). Identifying a new emerging trend, the use of cannabis edibles (sweets and chocolates) and drinks by treated young drug users were first reported in Year 5.
Table 4.4: Changes in drug use by treated young drug users in Dublin 15, DATMS Year 1 to 5 Drug type Year 2 Year 3 Year 4 Year 5 2015/2016 2017 2018 2019 Cannabis herb ↑ ↑ ↑ ↑ Cocaine powder ↑ ↑ ↑ ↑ Alcohol ↑ ↑ ↑ ↑ Benzodiazepines, Z drugs ↑ * ↑ ↑ Ketamine * * ↑ ↑ MDMA * * ↑ ↑ Cannabis oil ^ ^ ↑ ↑ Lean (syrup)~ * * ↑ * Nitrous oxide (laughing gas)" * * ↑ * Cannabis wax ꙳ ꙳ ꙳ ꙳ Cannabis edibles (sweets/chocolates) × × × × Cannabis drinks × × × × ↑ Increase in use of drug * No change in use of drug ^ Use of drug first reported in Year 3 ~ Cough medicine mixed with carbonated drink and sweets " Use of drug first reported in Year 4 ꙳ Use of drug first reported in Year 5 × Use of drug first reported in Year 5
55 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
TREATED ADULT DRUG USERS From Year 1 to 5, treated adult drug users reported an increase in the use of cannabis herb, alcohol, powder and crack cocaine, benzodiazepines and z drugs. Year 5 also reported an increase in the use of other drugs (Table 4.5). The new emerging trend identified by treated young drug users, the use of cannabis edibles and drinks, was also reported by treated adult drug users. In addition, with the use of cannabis cakes, the re-emergence of an old trend was reported by treated adult drug users.
Table 4.5: Changes in drug use by treated adult drug users in Dublin 15, DATMS Year 1 to 5 Drug type Year 2 Year 3 Year 4 Year 5 2015/2016 2017 2018 2019 Cannabis herb ↑ ↑ ↑ ↑ Alcohol ↑ ↑ ↑ ↑ Cocaine powder ↑ ↑ ↑ ↑ Crack cocaine ↑ ↑ ↑ ↑ Benzodiazepines, Z drugs ↑ ↑ ↑ ↑ Pregabalin (Lyrica) ↑ * ↑ ↑ Prescribed opiates~ ↑ ↑ * ↑ Cannabis oil ^ ^ ↑ ↑ OTC codeine** * * * ↑ Cannabis wax ꙳ ꙳ ꙳ ↑ Heroin * ↓ ↑ ↓ Methamphetamine * ↑ * ^^ Methadone * * * * Cannabis resin ↓ ↑ * * Amphetamines * * * * Cannabis edibles (cakes) × × × × Cannabis edibles (sweets/chocolates) × × × × Cannabis drink × × × × ↑ Increase in use of drug * No change in use of drug ~ Year 2 Oxycodone; Year 3 Oxycodone, Tramadol, Tylex, Kapake; Year 4 Oxycodone, Tramadol, Tylex; Year 5 Oxycodone, Tramadol, Tylex ^ Use of drug first reported in Year 3 ** Solpadine, Nurofen Plus ꙳ Use of drug first reported in Year 4 ↓ Decrease in use of drug ^^ Use of drug not reported in Year 5 × Use of drug first reported in Year 5
56 TREATED DRUG AND ALCOHOL USE
Cannabis Year 5 continues to report changes in the type of cannabis products available in Dublin 15. This change in the cannabis market is also occurring within the rest of Europe (EMCDDA, 2020).
Cannabis concentrates Cannabis concentrates include cannabis oil and wax5. Cannabis oil is available with and without THC (the psychoactive component), the former for intoxication, the latter for medicinal purposes. Treated drug users reported the following perceptions concerning these drugs:
• Cannabis oil was a healthier alternative to smoking cannabis herb • Cannabis wax was not prevalent as it is expensive and hard to access • Cannabis concentrates contain higher THC content compared with cannabis herb or resin
New emerging trend: cannabis edibles and drinks Treated drug users reported the following perceptions concerning cannabis edibles (cakes, sweets, chocolates) and drinks6:
• Cannabis edibles were a healthier alternative to smoking cannabis herb and were more prevalent among people who do not smoke • Cannabis sweets and chocolates were not prevalent as they were expensive and hard to access • Cannabis drinks were available but not commonly used • Cannabis cakes tended to have high THC content
Powder and crack cocaine Treated drug users reported an increase in the purity of powder and crack cocaine in Dublin 15. They associated this with an increase in demand and in the number of cocaine distributors which has created a competitive market for these drugs. Over the past decade, the purity of cocaine in Europe has been on an upward trend (EMCDDA, 2020).
Benzodiazepines and z drugs In Year 4, treated drug users reported that authentic benzodiazepines and z drugs were rare and counterfeit tablets had become more commonly available7.
5 Data concerning the use of cannabis concentrates by untreated drug users is reported in the chapter ‘Untreated drug and alcohol use’; data concerning the availability of these drugs is reported in the chapter ‘Factors contributing to drug and alcohol use’ 6 Data concerning the use of cannabis edibles and drinks by untreated drug users is reported in the chapter ‘Untreated drug and alcohol use’; data concerning the availability of these drugs is reported in the chapter ‘Factors contributing to drug and alcohol use’ 7 Further data concerning the accessibility of benzodiazepines and z drugs is reported in the chapter ‘Factors contributing to drug use’
57 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
This trend continues in Year 5. This is also reported at a European level, with the EMCDDA stating that over the last few years there has been an increase in the number, type and availability of NPSs belonging to the benzodiazepine class (EMCDDA, 2020).
Injecting drug use In relation to injecting drug use, in Year 5 there were a number of data sources that reported a reduction in this mode of drug administration:
• Data from the National Drug-Related Deaths Index reported poisoning deaths among people who were injecting at the time of death decreased from 67 (11%) in 2008 to 34 (4%) in 20178 • From Year 2 to 5, there was a decrease in the number of hidden sites used for injecting drug use, and a decrease in the amount of injecting-related litter in Dublin 159 • As reported above, treated adult drug users reported a decrease in the use of heroin; this may infer a reduction in injecting drug use • From 2018 to 2019, the NDTRS data reported a decrease in injecting drug use by treated drug users
8 Reported in the chapter ‘Consequences of drug & alcohol use’ 9 Reported in the chapter ‘Drug-related litter’
58 UNTREATED DRUG & ALCOHOL USE
5. UNTREATED DRUG & ALCOHOL USE
All five years of the DATMS reported untreated drug use among all socio-economic groups, ethnicities and in all areas of Dublin 15. From Year 1 to 5, similar profiles of untreated drug use by young people and adults were reported, whereby alcohol, cannabis herb, MDMA and cocaine powder were the main drugs used. This profile of drug use was also reported nationally (NACDA, 2016) and at a European and global level (EMCDDA, 2020; Winstock et al. 2019).
UNTREATED DRUG & ALCOHOL USE BY YOUNG PEOPLE The following reports the drugs used by untreated young drug users (aged up to 24 years) in Dublin 15 in 2019:
DRUGS USED BY UNTREATED YOUNG DRUG USERS (aged up to 24 years) Drug type White Irish Irish Irish Irish Irish Traveller African Eastern Asian European Most Alcohol √ √ √ √ common Cannabis herb √ √ √ √ √ MDMA (pills, powder) √ √ √ √ √ Cocaine powder √ √ √ √ Ketamine √ √ Benzodiazepines, Z drugs~ √ √ Least Alcohol √ common Cannabis resin √ √ Cannabis oil √ √ √ √ Lean (syrup)* √ √ √ √ Amphetamines √ √ √ √ √ Crack cocaine √ Magic mushrooms √ LSD √ Nitrous oxide (laughing gas) √ √ √ √ Cannabis wax √ √ √ √ √ Cannabis edibles^ √ √ √ √ √ Cannabis drinks √ √ Other Anabolic steroids √ √ drugs Injected skin tan √ √ used Slimming drugs √ √ ~ Includes New Psychoactive Substances * Cough medicine mixed with carbonated drink and sweets ^ Cannabis cakes, sweets, chocolates
59 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Year 5 has produced a more comprehensive profile of untreated drug use by young people from an Irish Asian background. Year 4 reported the use of cannabis herb by this ethnic group and Year 5 has reported the use of a range of other drugs. This change may be due to an increase in the quality of the data rather than an increase in drug use among Irish Asian young people.
UNTREATED DRUG & ALCOHOL USE BY ADULTS The following reports the drugs used by untreated adult drug users (aged 25 years and over) in Dublin 15 in 2019:
DRUGS USED BY UNTREATED ADULT DRUG USERS (aged 25 years and over) Drug type White Irish Irish Irish Irish Irish Traveller African Eastern Asian European Most Alcohol √ √ √ common Cannabis herb √ √ √ √ √ MDMA (pills, powder) √ √ Cocaine powder √ √ √ √ Benzodiazepines, Z drugs* √ √ Least Cannabis resin √ √ common Alcohol √ Cannabis oil √ √ Cocaine powder √ Ketamine √ √ MDMA √ √ Heroin √ GHB/GBL √ Khat √ Amphetamines √ Cannabis wax √ √ Cannabis edibles^ √ √ Other Anabolic steroids √ √ √ drugs Injected skin tan √ √ used Slimming drugs √ √ * Includes New Psychoactive Substances ^ Cannabis cakes, sweets, chocolates
From Year 1 to 3, untreated drug users aged 25 years and over were under- represented in the DATMS. This resulted in the production of limited data concerning drug use among white Irish and Irish Traveller ethnicities. Since Year
60 UNTREATED DRUG & ALCOHOL USE
4, this issue has been addressed with more comprehensive data provided for all ethnicities except Irish Asians.
The use of synthetic drugs (New Psychoactive Substances/NPS) were not reported by untreated young or adult drug users. As drugs are generally used without completing an analysis of their composition it is probable that synthetic types are used without users’ knowledge.
UNTREATED POLYDRUG USE From Year 1 to 5, the profile of untreated drug use has been similar. Polydrug use was the norm and alcohol was an integral part of it. The most common forms of polydrug use were similar among untreated young and adult drug users.
MOST COMMON FORMS OF UNTREATED POLYDRUG USE
Untreated young & • 1st: Alcohol & cannabis herb adult drug users • 2nd: Alcohol & cocaine powder &/MDMA • 3rd: Cannabis herb, benzodiazepines, z drugs Untreated young • 4th: Alcohol & ketamine drug users
PATTERN OF UNTREATED DRUG & ALCOHOL USE From Year 1 to 5, the pattern of untreated drug use was the same. Alcohol and cannabis herb were used throughout the week, and other drugs were mainly used at the weekend. The frequency of drug use varied from daily, weekly to less regular use. For some young people drug use occurred before and during school time10. The frequency of drug use was age dependent, with those aged 18 and over reporting more regular use.
CHANGES IN UNTREATED DRUG & ALCOHOL USE DRUG TYPE BY AGE OF FIRST USE The following reports the age that people in Dublin 15 began using drugs. The norm is reported for all drug types and for some, the norm plus youngest age is reported. From Year 3 to 5, a change was reported whereby untreated drug users were getting younger (Chart 5.1).
10 The use of drugs during school time is discussed further in the chapter ‘Consequences of drug and alcohol use’
61 drug use occurred before and during school time10. The frequency of drug use was age dependent, with those aged 18 and over reporting more regular use.
CHANGES IN UNTREATED DRUG & ALCOHOL USE
DRUG TYPE BY AGE OF FIRST USE The following reports the age that people in Dublin 15 began using drugs. The norm is reported for all drug types and for some, the norm plus youngest age is reported. From Year DRUG AND ALCOHOL TRENDS 3 to 5, a change was reported whereby untreated drug users were getting younger (Chart MONITORING SYSTEM YEAR 5 5.1).
ChartChart 5.1: 5.1: MostMost commonlycommonly used drugs byby ageage ofof firstfirst use, use, DATMS DATMS Year Year 3 3to to 55 (2017(2017-2019)-2019)
2017 The norm 2017 Youngest age 2018 The norm 2018 Youngest age 2019 The norm 2019 Youngest age
18 16 16 15 15 15 15 15 15 16 14 14 14 14 14 14 14 14 14 14 13 13 13 13 13 13 13 13 13 14 12 12 12 12 12 12 11 11 12 10
10
8
6
4
2
0 Alcohol MDMA Ketamine Z Z drugs^ Cannabisherb Cocaine powder Benzodiazepines, ^Includes^ Includes New New Psychoactive Psychoactive Substances Substances
• •The The norm norm age age of of firstfirst use use of ofMDMA, MDMA, benzodiazepines benzodiazepines and z drugsand zare drugs getting are younger getting younger • •The The norm norm age age of of first first useuse of ofcocaine cocaine powder powder and ketamineand ketamine are getting are gettingolder older • •The The norm norm age age of of first first useuse of ofalcohol alcohol and and cannabis cannabis herb remainsherb remains stable stable
From Year 3 to 5, changes in the age of first use of other drugs were also reported (Charts 5.2 and 5.3).
10 The use of drugs during school time is discussed further in the chapter ‘Consequences of drug and alcohol use’
54
62 From Year 3 to 5, changes in the age of first use of other drugs were also reported (Charts 5.2 From Year 3 to 5, changes in the age of first use of other drugs were also reported (Charts 5.2 and 5.3). UNTREATED DRUG & ALCOHOL USE and 5.3).
Chart 5.2: Least commonly used drugs by age of first use, DATMS Year 3 to 5 (2017-2019) ChChartart 5.2:5.2: LeastLeast commonlycommonly usedused drugsdrugs byby ageage ofof firstfirst use, use, DATMS DATMS Year Year 3 3 toto 55 (2017(2017-2019)-2019) 2017 The norm 2018 The norm 2019 The norm 2017 The norm 2018 The norm 2019 The norm
35
35 30 30 30 30 30 30 30
30 25 25
25 23
25 23 20 20 20 19 20 20 20
20 18 18 18 19
20 18 18 18 16 16 16 16 16 16 16 16 15 15 15 15 15 15 15 16 16 16 16 16 16 16 16 14 14 14 14 15 15 15 15 15 15 15
15 13 13 13 14 14 14 14 12 12 13 13 15 13 12 12
10
10
5
5
0 0 LSD LSD Khat∞ Khat∞ Heroin Heroin oxide) oxide) Cannabis oil drinks^ Cannabis oil drinks^ Lean (Syrup)Lean Lean (Syrup)Lean Crack cocaine Crack Crack cocaine Crack (wax)* (wax)* Cannabisresin chocolates^ Cannabisresin chocolates^ Amphetamines Amphetamines Cannabis cakes^ Cannabis Cannabis cakes^ Cannabis Cannabisinfused Solvents(Nitrous Cannabis sweets, Cannabis Cannabisinfused Solvents(Nitrous Cannabis sweets, Cannabis Magicmushrooms Magicmushrooms Prescribed opiates~ Prescribed opiates~ Cannabisconcentrate Cannabisconcentrate ~~ Use Use of of drugdrug drug notnot not reported reported reported in in Yearin Year Year 5 5 5 ∞∞ UseUse of of drugdrug drug notnot not reported reported reported in in inYear Year Year 4 4 4 * Use of drug first reported in Year 4 ** UseUse of of drug drug first first reported reported in in Year Year 4 4 ^ Use of drugdrug firstfirst reported reported in in Year Year 5 5 ^ Use of drug first reported in Year 5
ChartChart 5.3: 5.3: Other OtherOther drugs drugs used usedused by byby age ageage of ofof first firstfirst use, use, use, DATMS DATMS DATMS Year Year Year 3 to3 3 to 5to (20175 5(2017 (2017-2019)-2019-2019) ) 2017 The norm 2018 The norm 2019 The norm 2017 The norm 2018 The norm 2019 The norm
18.5 18 18 18.5 18 18 18
18
17.5
17.5 17
17 16.5 16 16
16.5 16 16 16
16 15.5 15 15 15 15 15 15.515 15 15 15 15 15
14.515
14.514
13.5 14
13.5 Anabolic steroids Skin tanning injections Slimming drugs Anabolic steroids Skin tanning injections Slimming drugs
PREVALENCE OF UNTREATED DRUG & ALCOHOL USE PREVALENCE OF UNTREATED DRUG & ALCOHOL USE PREVALENCEFrom Year 1 OF to UNTREATED 5, untreated DRUG young & ALCOHOL and adult USE drug users have continued to report Froman increase Year 1 to in5, untreatedthe use of young alcohol, and adult cannabis drug users herb, have cocaine continued powder to report and an increaseketamine. From Year 1 to 5, untreated young and adult drug users have continued to report an increase inYear the 5us alsoe of alcohol, reported cannabis an increase herb, cocaine in the powderuse of andother ketamine. drugs. YearThe use5 also of reported alcohol-free an indrinks, the us ecannabis of alcohol, edibles cannabis and herb, drinks cocaine were powder first reported and ketamine. to the Year DATMS 5 also in reported Year 5. anAll changes in the prevalence of drug use55 are reported in the table below (Table 5.1). 55
63 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Table 5.1: Changes in prevalence of untreated drug use in Dublin 15, DATMS Year 1 to 5 Drug type Year 2 Year 3 Year 4 Year 5 2015/2016 2017 2018 2019 Alcohol ↑ ↑ ↑ ↑ Cannabis herb ↑ ↑ ↑ ↑ Cocaine powder ↑ ↑ ↑ ↑ Ketamine ↑ ↑ ↑ ↑ Benzodiazepines, z drugs * ↑ ↑ ↑ Cannabis oil ^ ^ ↑ ↑ Lean (syrup) * * ↑ ↑ MDMA * ↑ ↓ ↑ Nitrous oxide (laughing gas) ~ ~ ~ ↑ Amphetamines * ↓ * ↑ Cannabis wax ~ ~ ~ ↑ Anabolic steroids * ↑ * ↑ Crack cocaine * * ↑ * Cannabis resin ↑ ↓ ↓ * Prescribed opiates * ↓ ↓ ∞ OTC codeine꙳ * ↓ ↓ ∞ GHB/GBL ~ ~ ~ * Cannabis edibles** × × × × Cannabis drinks × × × × Alcohol-free drinks × × × × ↑ Increase in use of drug * No change in use of drug ^ Use of drug first reported in Year 3 ↓ Decrease in use of drug ~ Use of drug first reported in Year 4 ∞ Use of drug not reported in Year 5 ꙳ Solpadeine, nurofen plus ** Cannabis cakes, sweets, chocolates × Use of drug first reported in Year 5
Alcohol • The increase in the use of alcohol by untreated young and adult drug users was in part associated with an increase in use of spirits; the availability of low- price spirits in supermarkets contributed to this trend. • An increase in use of alcohol-free drinks was reported among White Irish and Irish Traveller communities11.
11 Further data concerning the use of alcohol-free drinks is reported in the chapter ‘Drug-related litter’
64 UNTREATED DRUG & ALCOHOL USE
Cannabis • Year 4 reported the availability of cannabis herb with higher amounts of THC. This trend continues in Year 5. The EMCDDA reported cannabis herb now contains on average about twice as much THC compared to a decade ago (EMCDDA, 2020). • Further data concerning new cannabis products such as cannabis edibles, drinks, oil and wax is reported in the chapters ‘Treated drug and alcohol use’ and ‘Factors contributing to drug and alcohol use’.
Solvents • The solvent nitrous oxide (laughing gas) is not a controlled substance. Young people reported that as it can be purchased in local shops, there is the perception that the use of this drug was not associated with any health risks.
Crack cocaine • In Year 5, the use of crack cocaine by untreated adult drug users was not reported; its use was previously reported by these drug users. This finding may be due to methodological limitations, see chapter ‘DATMS Research Objectives & Method’ for further information.
PREVALENCE RATES OF DRUG & ALCOHOL USE IN DUBLIN 15 Year 3 provided a trend analysis of the prevalence of drug use in the general Irish population from 2006/07 to 2014/15 (NACDA, 2016). No new data was available for Year 5, though to contextualise the prevalence of drug use in Dublin 15, a summary of this analysis has been provided. The findings suggest illegal drug use has increased and alcohol use has decreased. However, the proportion of the population using alcohol remains high and it remains the most commonly used drug12. 2014/15 prevalence rates of drug use and the 2016 CSO population statistics were used to estimate the number of drug users in Dublin 15 (Chart 5.4). The data identified that the most commonly used drug in Dublin 15 is alcohol.
12 Any illegal drug refers to cannabis, MDMA, cocaine powder, magic mushrooms, amphetamines, poppers, LSD, new psychoactive substances, mephedrone, solvents, crack cocaine, heroin
65 commonly used drug12. 2014/15 prevalence rates of drug use and the 2016 CSO population DRUG AND ALCOHOL TRENDS statistics were used to estimate the number of drug users in Dublin 15 (Chart 5.4). The data MONITORING SYSTEM YEAR 5 identified that the most commonly used drug in Dublin 15 is alcohol.
ChartChart 5.4: 5.4: Recent, Recent, last last y earyear and and lifetime lifetime prevalence prevalence rates rates of of drug drug use use among among Dublin Dublin 15 15 population,population, NACDA NACDA drug drug prevalence prevalence rates rates 2014/2015 2014/2015 and and CSO CSO 2016 2016
15-34 years 35 years & over 100,000 (87%) 80,000 (80%) (65%) (83%) (80%) 60,000 (65%) (26%) (37%) 43,979 40,440 32,873 (16%) (9%) (4%)
40,000 (2%) 25,547 24,630 20,015 13,143 20,000 11,389 4,926 2,771 2,022 1,011 0 use use Recent alcohol use Lifetime alcohol use Lifeltime illegal drug Last year Lastyear illegal drug Last year use Lastyear alcohol Recent illegal drug use
Lifetime prevalence rates of drug use in Dublin 15 and nationally are higher Lifetime prevalence rates of drug use in Dublin 15 and nationally are higher than lifetime than lifetime prevalence rates in Europe. The EMCDDA estimated 29% of prevalenceEuropean rates adults in Europe. aged The15 toEMCDD 64 yearsA estimated have used29% of illegal European drugs adults during aged their15 to lives64 years(EMCDDA, have used 2020). illegal drugs during their lives (EMCDDA, 2020).
DUBLIN 15 AT-RISK YOUTH POPULATION DUBLINIt is important 15 AT to-RISK quantify YOUTH socio-economically POPULATION deprived youth populations as they It haveis important higher to riskquantify factors socio -foreconomically drug use deprived compared youth withpopulations non-socio-economically as they have higher deprived youths. This data can then be used for service planning. Year 2 mapped risk factors for drug use compared with non-socio-economically deprived youths. This data at-risk under 18 year olds in Dublin 15 to identify where these young people lived. canThe then map be usedshowed for service that theplanning. highest Year concentration 2 mapped at-risk of under at-risk 18 youthsyear olds lived in Dublin in areas 15 totraditionally identify where associated these young with people disadvantage. lived. The map This showed data that was the not highest provided concen trationfor Year 3 to 513. Thus, the Deprivation Index has been used to quantify the at-risk youth population of Dublin 15 (Chart 5.5)14. The areas where these young people lived
12 wereAny illegal similar drug to refers the areasto cannabis, reported MDMA, in cocaineYear 2. powder, magic mushrooms, amphetamines, poppers, LSD, new psychoactive substances, mephedrone, solvents, crack cocaine, heroin
58
13 Further information reported in the chapter ‘DATMS research objectives & method’ 14 Previously reported in chapter ‘Socio-demographic profile of Dublin 15’
66 of at-risk youths lived in areas traditionally associated with disadvantage. This data was not provided for Year 3 to 513. Thus, the Deprivation Index has been used to quantify the at-risk youth population of Dublin 15 (Chart 5.5)14. TheUNTREATED areas where these DRUG young & ALCOHOLpeople lived wereUSE similar to the areas reported in Year 2.
ChartChart 5. 5.5:5: Dublin Dublin 15 15 sociosocio-economically-economically deprived deprived youthyouth population,population, CSO 20062006 toto 2016
Under 18 18-24 years 12,000 8,909 7,757 (30%) 7,852 (31%) (24%) 8,000 3,324 2,611 (31%) 1,996 4,000 (30%) (24%)
0 2006 2011 2016
13 Further information reported in the chapter ‘DATMS research objectives & method’ 14 Previously reported in chapter ‘Socio-demographic profile of Dublin 15’
59
67 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5 6. FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE
6. AFACTORS range of factors contributeCONTRIBUTING to drug and alcohol useTO in DublinDRUG 15. They & include ALCOHOL easy access toUSE drugs and alcohol, the normalisation of drug and alcohol use, the family context and mental ill-health. A range of factors contribute to drug and alcohol use in Dublin 15. They include easy access to drugs and alcohol, the normalisation of drug and alcohol use, the family context and mental ill-health. 1) ACCESSIBILITY OF DRUGS & ALCOHOL METHODS1) ACCESSIBILITY FOR OBTAINING DRUGS OF DRUGS & ALCOHOL FromMETHODS Year 1 to 5FOR, the mainOBTAINING method for DRUGSobtaining drugs was through local dealers. Year 1 and 2From reported Year the 1 to internet 5, the wasmain the method second for most obtaining commonly drugs used was method, through while local Year dealers. 3 to 5 reportedYear 1 and it was 2 reportedfriends. Chart the internet6.1 reports was the the methods second used most to obtain commonly drugs since used Year method, 3; all while Year 3 to 5 reported it was friends. Chart 6.1 reports the methods used to of these methods were also reported in Year 1 and 2. obtain drugs since Year 3; all of these methods were also reported in Year 1 and 2.
ChartChart 6.1: 6.1: MethodsMethods forfor obtainingobtaining drugs, DATMSDATMS YearYear 33 toto 5 (2017(2017-2019)-2019)
2017 2018 2019
140% (62) (60) (79)
120% (51) 100% 100% (86) (44) 97% (43) (43) 94% (55) (45) 92% (53) 90% 90% (63) 89% 89% (62) 100% (41) 80% 74% 74% (64) (29) 73% 73% (51) (27) (26) 69% 69% 69% (59) 67% 67% (26) 64% 80% 64% 62% 59% (19)
60% 45% 42% 42% 42% (36) 41% 41% 41% (35) 37%
40% 27% 20% 20% (14) 16% 16% (14)
20% ~ 0% Friend Family Dealer Darknet Internet Dial-a-drink^ Social media* Social Cannabis cultivation General practitioners General ** IncludesIncludes Facebook, Facebook, Snapchat, Snapchat, Instagram Instagram ^^ Includes Includes delivery delivery of of alcohol alcohol and and illegal illegal drugs drugs ~ Number too small to be reported (5 or less) ~ Number too small to be reported (5 or less)
TreatedTreated drug drug users users continue continue to report to reportthat some that General some Practitioners General Practitioners services were servicesmisused towere obtain misused access toto controlledobtain access drugs. However,to controlled since drugs.Year 4, However,they have alsosince reported Year 4, that they it have also reported that it has become more challenging to access benzodiazepines and z drugs using this method. Synthetic60 (NPS) benzodiazepines and z drugs have become more commonly available and authentic tablets were rare.
68 FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE
CHANGES IN DRUG AVAILABILITY From Year 1 to 5, participants reported changes in the availability of drugs (Table 6.1). All drugs that have increased in availability are the most commonly used except for crack cocaine and cannabis wax. Each year of the DATMS has reported an increase in the availability of benzodiazepines and z drugs.
Table 6.1: Changes in drug availability in Dublin 15, DATMS Year 1 to 5 Drug type Year 1 Year 2 Year 3 Year 4 Year 5 2014/2015 2015/2016 2017 2018 2019 Benzodiazepines, z drugs∞ ↑ ↑ ↑ ↑ ↑ Cannabis herb ↑ * ↑ ↑ ↑ Crack cocaine ↑ * ↑ ↑ ↑ Cocaine powder * * ↑ ↑ ↑ Alcohol ↑ ↑ ↑ * ↑ Cannabis wax × × × × ↑ Heroin * * ↑ ↑ * Cannabis oil ^ ^ ^ ↑ * Pregabalin (Lyrica) * ↑ ↑ * * MDMA * * ↑ * * Ketamine * * ↑ * * Cannabis resin ↓ ↑ ↓ ↓ * Steroids ↑ * * * * Opiate (oxycodone) * ↑ * * * Cannabis cakes ꙳ ꙳ ꙳ ꙳ ꙳ Cannabis sweets, chocolates ꙳ ꙳ ꙳ ꙳ ꙳ Cannabis infused drinks ꙳ ꙳ ꙳ ꙳ ꙳ ∞ Includes synthetic types (NPS) ↑ Increase in drug availability * No change in drug availability × Availability of drug first reported in Year 4 ^ Availability of drug first reported in Year 3 ↓ Decrease in drug availability ꙳ Availability of drug first reported in Year 5
While Year 5 reported an increase in the availability of cannabis wax, it also reported that the use of this drug was not prevalent as it is expensive and hard to access15.
15 Further data concerning the use of cannabis wax by drug users is reported in the chapters ‘Treated drug and alcohol use’ and ‘Untreated drug and alcohol use’
69 While Year 5 reported an increase in the availability of cannabis wax, it also reported that the use of this drug was not prevalent as it is expensive and hard to access15.
DRUG AND ALCOHOL TRENDS MONITORINGNew emerging trendsSYSTEM in drug YEAR use 5 Year 5 reported an increase in the type of drugs available in Dublin 15. The availability of cannabis edibles and drinks were first reported to the DATMS in Year 5, identifying new emergingNew emerging trends in trends drug use. in Ndrugew cannabis use products included cannabis sweets, chocolates Year 5 reported an increase in the type of drugs available in Dublin 15. The and drinks; with the availability of cannabis cakes the re-emergence of an old trend was also availability of cannabis edibles and drinks were first reported to the DATMS in Year reported5, identifying16. Drug new users emerging reported trends the usein drug of cannabis use. New sweets cannabis and chocolatesproducts included were not prevalentcannabis a ssweets, they are chocolates expensive and and hard drinks; to access. with theYear availability 5 reported ofcannabis cannabis cakes cakes were the re-emergence of an old trend was also reported16. Drug users reported the available for sale in local and neighbouring communities, with easy access facilitating use. use of cannabis sweets and chocolates were not prevalent as they are expensive and hard to access. Year 5 reported cannabis cakes were available for sale in local and neighbouring communities, with easy access facilitating use. Reasons for increase in drug and alcohol availability DrugReasons users reportedfor increase the main in drugreasons and for alcohol the increase availability in drug availability was an increase in drugDrug use users and thatreported they were the maineasily reasonsaccessed (Chartfor the 6.2). increase in drug availability was an increase in drug use and that they were easily accessed (Chart 6.2).
ChartChart 6.2:6.2: RationaleRationale for increase in drug availability, DATMS DATMS Year Year 3 3 to to 5 5 (2017-2019) (2017-2019)
2017 2018 2019 60% 49% 44% (42) 44% 42% 50% (31) (28) 37% (27) 40% (26) 21% 30% (18) 20% 10% 0% Increase in drug use Easy access to drugs
Since Year 2, treated and untreated drug users have reported an increase in the use of alcohol. The availability of low-price spirits in local supermarkets continues to contribute to this trend.
15 Further data concerning the use of cannabis wax by drug users is reported in the chapters ‘Treated drug and alcoholSince use’ Year and 3, ‘Untreated the normalisation drug and alcohol of use drug’ use was reported as a factor contributing 16 Further data concerning the use of cannabis edibles17 and drinks by drug users is reported in the chapters ‘Treatedto the drugincrease and alcohol in drug use’ and use ‘Untreated in Dublin drug 15 and alco. Inhol Year use’ 5, drug users reported that the increase in drug use identified how demand influences the local drug market. They reported that this increase resulted62 in an increase in the number of drug
distributors, as high demand means high profit for distributors. This resulted in the development of a competitive drug market, with dealers employing different tactics to increase market share. In relation to powder and crack cocaine, these tactics included a reduction in price and an increase in purity. An increase in the availability, use and purity of powder and crack cocaine has also been reported at a European level (EMCDDA, 2020). 16 Further data concerning the use of cannabis edibles and drinks by drug users is reported in the chapters ‘Treated drug and alcohol use’ and ‘Untreated drug and alcohol use’ 17 Further data concerning the normalisation of drug use is reported in the following section
70 Since Year 2, treated and untreated drug users have reported an increase in the use of alcohol. The availability of low-price spirits in local supermarkets continues to contribute to this trend. Since Year 3, the normalisation of drug use was reported as a factor contributing to the increase in drug use in Dublin 1517. In Year 5, drug users reported that the increase in drug use identified how demand influences the local drug market. They reported that this increase resulted in an increase in the number of drug distributors, as high demand means high profit for distributors. This resulted in the development of a competitive drug market, with dealers employing different tactics to increase market share. In relation to powder and crack cocaine, these tactics included a reduction in price and an increase in purity. An increase in the availability, use and purity of powder and crack cocaine has also been reported at a European level (EMCDDA, 2020). FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE
Since Year 3, the majority of participants reported that access to drugs in Dublin 15 was very Since Year 3, the majority of participants reported that access to drugs in Dublin easy (Chart 6.3). 15 was very easy (Chart 6.3).
ChartChart 6.3: 6.3: EaseEase of of access access to to drugs drugs in in Dublin Dublin 15, 15, DATMS DATMS Year Year 3 3 to to 5 5 (2017 (2017-2019)-2019)
Year 3 Year 4 Year 5 99% 94% 86% (85) (60) 100% (60)
50% 14% (10) ~ ~ 0% Very easy Fairly easy
~~ Number Number of of cases cases too too small small to tobe be reported reported (5 or(5 less)or less)
TheThe following following factors factors have have contrib contributeduted to the easeto the of accessease ofto drugsaccess in Dublinto drugs 15 (Table in Dublin 6.2). 15 (Table 6.2).
Table 6.2: Factors contributing to ease of access to drugs, DATMS Year 1 to 5 Factors contributing to ease Year 1 Year 2 Year 3 Year 4 Year 5 of access to drugs 2014/2015 2015/2016 2017 2018 2019 Increase in number of dealers √ √ √
Increase in number of under 18s dealing √ √ √ √ 17 Further data concerning the normalisation of drug use is reported in the following section Dealers making home
deliveries^ √ √ √ √ Obtaining drugs from the 63 internet √ √ √ Obtaining drugs from General Practitioners √ √ √
^ Includes Dial-A-Drink
Under 18 drug runners and dealers Since Year 2 of the DATMS, an increase in the number of under 18s dealing drugs has been reported. Year 3 to 5 reported the age of drug runners and dealers in Dublin 15 (Chart 6.4); the norm plus the youngest age has been reported. Year 5 has reported that drug runners were getting younger, while drug dealers were getting older.
71
Table 6.2: Factors contributing to ease of access to drugs, DATMS Year 1 to 5 Factors contributing to ease of access to Year 1 Year 2 Year 3 Year 4 Year 5 drugs 2014/2015 2015/2016 2017 2018 2019 Increase in number of dealers √ √ √ Increase in number of under 18s dealing √ √ √ √ Dealers making home deliveries^ √ √ √ √ Obtaining drugs from the internet √ √ √ Obtaining drugs from General Practitioners √ √ √ ^ Includes Dial-A-Drink
Under 18 drug runners and dealers Since Year 2 of the DATMS, an increase in the number of under 18s dealing drugs has been reported. Year 3 to 5 reported the age of drug runners and dealers in Dublin 15 (Chart 6.4); the norm plus the youngest age has been reported. Year 5 has reported that drug runners DRUG AND ALCOHOL TRENDS MONITORINGwere getting younger, SYSTEM while drugYEAR dealers 5 were getting older.
Chart 6.4: Drug runners and dealers in Dublin 15 aged under 18, DATMS Year 3 to 5 (2017- 2019Chart) 6.4: Drug runners and dealers in Dublin 15 aged under 18, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019 20 16 14 14 13 13
15 12 10 10 10 10 8 10 8 5 0 (norm age) (norm age) Drug dealer Drug runner Drug dealer Drug runner (youngest age) (youngest age)
SinceSince Year Year 3, 3, the the profile profile of underof under 18 18 drug drug runners runners and and dealers dealers was similar.was similar. They wereThey were predominately male, though females aged from 12 years also engaged in predominatelythese activities. male, though females aged from 12 years also engaged in these activities.
The reasons that children and young people become involved in this criminal activity The reasons that children and young people become involved in this criminal activity are are multi-faceted and incorporate personal, family and environmental factors. The multidesire-faceted to increase and incorporate social status personal, is an important family and driver environmental of drug dealing factors. behaviour The desire and to increaseto make social ‘easy statusmoney’. is anWithin important a family driver context, of drug participants dealing behaviour reported and that to older make family ‘easy members were drug dealers. Three environmental factors were reported. Firstly, since Year 2, participants reported that drug debt intimidation is increasing in Dublin 15. 64 It is likely that there is a link between the increasing levels of drug debt intimidation and under 18s drug running and dealing, whereby young people are forced to hold and sell drugs to pay off debts. Secondly, in all four years of the DATMS, the normalisation of drug use has featured prominently whereby drugs are perceived to be socially acceptable18. This normalisation may influence a young person’s decision to become involved in drug running and dealing as they may not identify the negative consequences of such behaviour. Thirdly, the use of minors for drug distribution has been a long-standing method used by older, larger scale dealers, as due to their age there are fewer criminal consequences. This also has the consequence of easy access to customers, whereby young people distribute drugs to their peers and friends.
Drug dealing in local secondary schools All five years of the DATMS reported that drug dealing occurred in local secondary schools. Since 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 (Chart 6.5). Since Year 3, these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status. This indicates that drug use is a community wide issue that crosses all socio-economic boundaries.
18 Further data concerning the normalisation of drug and alcohol use is reported in the following section
72 money’. Within a family context, participants reported that older family members were drug dealers. Three environmental factors were reported. Firstly, since Year 2, participants reported that drug debt intimidation is increasing in Dublin 15. It is likely that there is a link between the increasing levels of drug debt intimidation and under 18s drug running and dealing, whereby young people are forced to hold and sell drugs to pay off debts. Secondly, in all four years of the DATMS, the normalisation of drug use has featured prominently whereby drugs are perceived to be socially acceptable18. This normalisation may influence a young person’s decision to become involved in drug running and dealing as they may not identify the negative consequences of such behaviour. Thirdly, the use of minors for drug distribution has been a long-standing method used by older, larger scale dealers, as due to their age there are fewer criminal consequences. This also has the consequence of easy access to customers, whereby young people distribute drugs to their peers and friends.
Drug dealing in local secondary schools All five years of the DATMS reported that drug dealing occurred in local secondary schools. Since 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 (Chart 6.5). Since Year 3, these schools were a mixture of affluent and socio-economically deprived and included those with and without DEIS status. This indicates that drug use is a community wide FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE issue that crosses all socio-economic boundaries.
ChartChart 6.5:6.5: NumberNumber of secondary schools inin Dublin 15 with evidenceevidence ofof drugdrug dealing,dealing, DATMS DATMS YearYear 33 toto 55 (2017(2017-2019)-2019)
12 10 10 10 7 8 6 6 4 2 0 Number of secondary 2017 2018 2019 schools in Dublin 15
18 Further data concerning the normalisation of drug and alcohol use is reported in the following sectionDRUGS MANUFACTURED IN DUBLIN 15
Year 1 to 5 reported that drugs were manufactured65 in Dublin 15. Table 6.3 reports the types of drugs manufactured. In Year 3, 27% (19) of participants reported that drugs were manufactured in Dublin 15, this increased to 50% (32) in Year 5.
Table 6.3: Types of drugs manufactured in Dublin 15, DATMS Year 1 to 5 Drug type Year 1 Year 2 Year 3 Year 4 Year 5 2014/2015 2015/2016 2017 2018 2019 Cannabis herb √ √ √ √ √ Crack cocaine √ √ √ Cannabis oil √ √ √ Benzodiazepines √ √ √ Z drugs √ MDMA √ √ √ Cannabis edibles (cakes) √ Synthetic stimulants (NPS) √
DRUGS SOURCED FROM OUTSIDE DUBLIN 15 In Year 5, drug users continued to report that people travelled outside Dublin 15 to obtain drugs (Chart 6.6). Areas travelled to included Dublin City Centre, Finglas and Ballymun. However, drug users reported that this was not the norm as drugs were always available in the area. Drug users reported travelling outside Dublin 15 to get larger quantities, better quality and price. Other motivations included keeping drug use private and avoiding local dealers due to drug debts.
73 DRUGS MANUFACTURED IN DUBLIN 15 Year 1 to 5 reported that drugs were manufactured in Dublin 15. Table 6.3 reports the types of drugs manufactured. In Year 3, 27% (19) of participants reported that drugs were manufactured in Dublin 15, this increased to 50% (32) in Year 5.
Table 6.3: Types of drugs manufactured in Dublin 15, DATMS Year 1 to 5 Drug type Year 1 Year 2 Year 3 Year 4 Year 5 2014/2015 2015/2016 2017 2018 2019 Cannabis herb √ √ √ √ √ Crack cocaine √ √ √ Cannabis oil √ √ √ Benzodiazepines √ √ √ Z drugs √ MDMA √ √ √ Cannabis edibles (cakes) √ Synthetic stimulants (NPS) √
DRUGS SOURCED FROM OUTSIDE DUBLIN 15 In Year 5, drug users continued to report that people travelled outside Dublin 15 to obtain drugs (Chart 6.6). Areas travelled to included Dublin City Centre, Finglas and Ballymun. However, drug users reported that this was not the norm as drugs were always available in
DRUGthe a ANDrea. Drug ALCOHOL users reported TRENDS travelling outside Dublin 15 to get larger quantities, better MONITORINGquality and price. SYSTEM Other motivations YEAR included5 keeping drug use private and avoiding local dealers due to drug debts.
ChartChart 6.6:6.6: DDrugsrugs sourcedsourced fromfrom outside Dublin 15,15, DATMSDATMS YearYear 3 3 to to 5 5 (2017-2019) (2017-2019)
100% 75% 67% (48) 80% (47) 48% 60% (41) 40%
20%
0% 2017 2018 2019
66
74 FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE
2) NORMALISATION OF DRUG AND ALCOHOL USE In all five years of the DATMS the normalisation of drug use featured prominently as a factor contributing to drug use. The common perception was that alcohol and drugs were widely used, risk free and socially acceptable. This normalisation was reported among peer groups and family units.
The drugs normalised included alcohol, cannabis, cocaine powder, benzodiazepines and z drugs. Since Year 1, this normalisation has been identified by the following participant perceptions:
• When participants were asked to report the five most frequently used drugs, they had to be prompted to include alcohol in their answer; they did not view alcohol as a drug and drinking to excess was the norm; this identifies that alcohol was the most normalised of all drugs in Dublin 15 • The use of cannabis was perceived to be similar to the use of cigarettes • Benzodiazepines and z drugs are perceived to be risk free as they are prescribed drugs
Since Year 1, participants have reported that not all drugs were normalised, and the use of some drugs was associated with health risks including dependence, overdoses and death. These drugs included opiates, crack cocaine, synthetic benzodiazepines and z drugs.
Year 4 reported that the normalisation of drug use provided a deeper understanding of the nature and consequences of drug use. Over the lifetime of the DATMS the normalisation of alcohol and drug use has been associated with the following:
• Increase in drug use among young people • Untreated drug users getting younger • Hindering help-seeking for alcohol and drug use among young people • Increase in the number of under 18s dealing drugs, thus, contributing to the ease of access to drugs • Development of inter-generational drug and alcohol dependence • Main drugs used by treated drug users were those which were normalised19
19 Further data concerning the normalisation of drug and alcohol use is reported in the previous section ‘Accessibility of drugs’ and the next section ‘Family context’
75 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5 3) FAMILY CONTEXT All five years of the DATMS reported the negative impact of drug and alcohol dependence within3) FAMILY the family. CONTEXT The data reported the family context as a risk factor for the normalisation ofAll drug five and years alcohol of the use, DATMS and the reported development the negative of inter -impactgenerational of drug drug and and alcohol alcohol dependence within the family. The data reported the family context as a risk dependence20. Since Year 3, the majority of treated drug users who participated in the DATMS factor for the normalisation of drug and alcohol use, and the development of inter- reportegenerationald having drug family and members alcohol whodependence also had problems20. Since Yearwith 3,dru thegs and/ormajority alcohol of treated (Chart 6.drug7). users who participated in the DATMS reported having family members who also had problems with drugs and/or alcohol (Chart 6.7).
ChartChart 6. 6.7:7: Drug Drug and/orand/or alcohol issues amongamong treated drugdrug usersusers family members, members, DATMS DATMS Year Year 33 to to 5 5 (2017(2017-2019)-2019)
2017 2018 2019 30 24 20 (77%) 25 (66%) 17 20 (63%) 11 10 15 (34%) (37%) 7 10 (23%) 5 0 Yes No/unknown
InIn Year Year 3 and3 and 4, inter 4, -inter-generationalgenerational drug and drug alcohol and use alcohol spanning use up spanning to three generations up to three was generations was reported by 48% of treated drug users. In Year 5 this increased reported by 48% of treated drug users. In Year 5 this increased to 65% of treated drug users. to 65% of treated drug users. Chart 6.8 reports the type of treated drug users’ Chartfamily 6. 8members reports the with type drug of treatedand/or drugalcohol users’ issues. family members with drug and/or alcohol issues. ChartChart 6.6.8:8: Type ooff treated drug users family members withwith drug drug and/orand/or alcohol alcohol issues, issues, DATMSDATMS YearYear 3 to 5 (2017-2019)(2017-2019)
2017 2018 2019 18 20 (75%) 14 (58%) 15 10 10 10 10 10 (50%)(59%) 8 (59%)(42%) (59%) 10 (40%) 6 (30%) ~ ~ ~ ~ 5 0 0 (0%) (0%) 0 Parent Sibling Extended family* Child(ren) Partner
CategoryCategory totals totals exceed exceed total total number number of of participants participants as assome some treated treated drug drug users users had hadmore more than than one 20 drugone Further drugand/or dataand/or alcohol concerning alcohol dependent dependent the impact family familyof member drug member dependence within the family is reported in the chapter ‘Consequences~ Number of ca ofses drug too andsmall alcohol to be reported use’ (5 or less) *~ Grandparent,Number of cases uncle/aunt, too small cousin, to be niece/nephew reported (5 or less) * Grandparent, uncle/aunt, cousin, niece/nephew69
20 Further data concerning the impact of drug dependence within the family is reported in the chapter ‘Consequences of drug and alcohol use’ Prevalence of children affected by parental substance misuse A methodological framework for estimating the prevalence of children whose parents misuse 76 substances has been developed in the Irish context (Galligan & Comiskey, 2019). These estimates and the 2016 CSO population statistics21 have been used to estimate the number of children affected by parental drug and alcohol use in Dublin 15. Up to a quarter of children are affected by parental illicit drug use and up to 37% are affected by parental alcohol dependency (Chart 6.9). This research assists with quantifying the hidden harm associated with parental drug and alcohol misuse which is important for planning service provision.
Chart 6.9: Prevalence of children affected by parental illicit drug use and alcohol dependency in Dublin 15 by CSO 2016
40,000 32,717 30,000 4,580 to 12,105 20,000 4,907 to 7,852 (14%-37%) (15%-24%) 10,000 0 Children aged 0 to 17 in Children affected by Children affected by Dublin 15 parental illicit drug use parental alcohol dependency
21 Most recent CSO population census
70
Chart 6.8: Type of treated drug users family members with drug and/or alcohol issues, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019 18 20 (75%) 14 (58%) 15 10 10 10 10 10 (50%)(59%) 8 (59%)(42%) (59%) 10 (40%) 6 (30%) ~ ~ ~ ~ 5 0 0 (0%) (0%) 0 Parent Sibling Extended family* Child(ren) Partner
Category totals exceed total number of participants as some treated drug users had more than one drug and/or alcohol dependent family member ~ Number of cases too small to be reported (5 or less) * Grandparent, uncle/aunt, cousin, niece/nephew
FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE
Prevalence of children affected by parental substance misuse APREVALENCE methodological framework OF CHILDREN for estimating AFFECTED the prevalence BY PARENTAL of children whose SUBSTANCE parents misuse substancesMISUSE has been developed in the Irish context (Galligan & Comiskey, 2019). These A methodological framework for estimating the prevalence of children whose 21 estimatesparents misuse and the substances2016 CSO population has been statistics developed have inbeen the used Irish to context estimate (Galligan the number of& childrenComiskey, affected 2019). by parentalThese estimates drug and alcohol and the use 2016 in Dublin CSO 15. population Up to a quarter statistics of children21 have been used to estimate the number of children affected by parental drug and are affected by parental illicit drug use and up to 37% are affected by parental alcohol alcohol use in Dublin 15. Up to a quarter of children are affected by parental illicit dependencydrug use and (Chart up to 6.9) 37%. This are research affected assists by parental with quantifying alcohol dependency the hidden harm (Chart associated 6.9). withThis parentalresearch drug assists and alcohol with quantifying misuse which the is hiddenimportant harm for planningassociated service with provision. parental drug and alcohol misuse which is important for planning service provision.
ChartChart 6.9: Prevalence ofof children children affected affected by by parental parental illicit illicit drug drug use use and and alcohol alcohol dependency dependency inin Dublin 1515 byby CSOCSO 20162016
40,000 32,717 30,000 4,580 to 12,105 20,000 4,907 to 7,852 (14%-37%) (15%-24%) 10,000 0 Children aged 0 to 17 in Children affected by Children affected by Dublin 15 parental illicit drug use parental alcohol dependency
21 Most recent CSO population census
70
21 Most recent CSO population census
77 DRUG AND ALCOHOL TRENDS MONITORING4) MENTAL HEALTHSYSTEM YEAR 5 Poor mental health is a risk factor for drug and alcohol use which identifies the importance of early intervention. The following data reports youth and adult mental health treatment 4) MENTAL HEALTH demand in Dublin 15. Treatment demand for these services is higher than reported, as data Poor mental health is a risk factor for drug and alcohol use which identifies the from some statutory and private services is not included. importance of early intervention. The following data reports youth and adult mental health treatment demand in Dublin 15. Treatment demand for these services is higher Youththan reported, mental health as data treatm froment some demand statutory and private services is not included. Jigsaw Dublin 15, HSE Substance Abuse Service Specific to Youth (SASSY) and Genesis PsychotherapyYOUTH MENTAL and Family HEALTH Therapy TREATMENT Services (Genesis) DEMAND provided treatment demand statistics forJigsaw 2017 andDublin 2019 2215,. These HSE are Substance counselling Abuseservices Servicefor under Specific 18s and yo toung Youthadults, (SASSY)with one and Genesis Psychotherapy and Family Therapy Services (Genesis) provided also providing treatment for substance use. As there are no unique identifiers the number of treatment demand statistics for 2017 and 201922. These are counselling services casesfor under will be 18s reported and young rather thanadults, the withnumber one of also individuals providing treated; treatment thus, individuals for substance may be counteduse. As more there than are onceno unique if they identifiersattend more the than number one service of .cases From 2017will be to reported 2019, there rather was athan 70% increasethe number in the of number individuals of under treated; 18s and thus,young individualspeople treated may for bemental counted health moreissues than once if they attend more than one service. From 2017 to 2019, there was a (Chart70% 6.10).increase Over in the the reporting number period, of under the majority 18s and of youngcases were people female treated and aged for 12mental to 17 yearshealth (Chart issues 6.10). (Chart In 2017 6.10). and Over 2019, the some reporting cases were period, treated the formajority more thanof cases one mental were healthfemale issue and (Chart aged 6.11). 12 to 17 years (Chart 6.10). In 2017 and 2019, some cases were treated for more than one mental health issue (Chart 6.11).
ChartChart 6.10:6.10: Total cases,cases, gender and ageage rangerange ofof youngyoung people, people, SASSY, SASSY, JigsawJigsaw Dublin 15 andand GenesisGenesis,, 2017 2017 andand 20192019
2017 2019
900 746
800 (64%) 700 (56%) (44%) 480 600 (63%) (56%) 438 420 (42%)
500 (23%) 326 (27%)
400 274 244 (13%) 186 (8%)
300 171 120 200 95 100 36 0 Male Female Total casesTotal 12-17 years Under 12 12 years Under 18 years & over CategoryCategory totals totals less less tha thann total total number number of of cases cases as unas knownunknown cases cases not includednot included
22 Jigsaw Dublin 15 was the only service in 2018 to provide treatment demand data; due to the incomplete dataset, 2018 data has not been reported
71
22 Jigsaw Dublin 15 was the only service in 2018 to provide treatment demand data; due to the incomplete dataset, 2018 data has not been reported
78 FACTORS CONTRIBUTING TO DRUG & ALCOHOL USE Chart 6.11: Mental health issues among young people, SASSY, Jigsaw Dublin 15 and Genesis, 2017 and 2019
ChartChart 6.11:6.11: MentalMental healthhealth issues issues amongamong youngyoung2017 people,people,2019 SASSY, SASSY, Jigsaw DublinDublin 15 and Genesis,Genesis, 20172017 andand 20192019 400 (44%)
350 328 2017 2019
400300 (44%) (44%)
350250 328 (19%) 191 300200 (17%) (44%) 140 (13%) 128 (20%)
250150 (19%) (9%) (14%) (8%) (19%) 94 191 89 (10%) (17%) 81 (9%) (8%) (8%)
200100 69 61 58 (2%) (1%) 44 140 40 37 37 (13%) 128 (20%) (0%) (0%) (0%) 150 (19%)
50 13 10 (9%) ~ ~ ~ ~ ~ (14%) 0 0 0 (8%) 94 89 (10%) 81 (9%) (8%) (8%) 1000 69 61 58 (2%) (1%) 44 40 37 37 (0%) (0%) (0%)
50 13 10 ~ ~ ~ ~ ~ 0 0 0 Anger
0 Anxiety Self-harm Low Low mood issues Suicidal Bereavement Anger Trauma/abuse Anxiety Health problems Health Behaviour issues Behaviour Drug/alcohol Drug/alcohol use Self-harm Low Low mood ideation/attempts Family/relationship Learning disabilities Learning issues Suicidal Bereavement Trauma/abuse Health problems Health Behaviour issues Behaviour
~ Number of cases too small to be reported (5 or less) Drug/alcohol use ideation/attempts Family/relationship Category totals exceed total number of cases as some cases experienced more than one mentaldisabilities Learning health issue~~ Number Number of of cases cases too too small small to tobe be reported reported (5 or(5 less)or less) CategoryCategory totals totals exceed exceed total total number number of casesof cases as some as some cases cases experienced experienced more thanmore one than mental one mental health issue Inhealth 2018 issue and 2019, Jigsaw Dublin 15 operated youth mental health promotion workshops in
Dublin 15 (Chart 6.12). These workshops included Jigsaw’s One Good School™ framework. InIn 2018 2018 and and 2019, 2019, Jigsaw Jigsaw Dublin Dublin 15 operated 15 operated youth mental youth health mental promotion health workshops promotion in This is a comprehensive initiative which supports the mental health and wellbeing of young Dublinworkshops 15 (Chart in Dublin6.12). T h15ese (Chart workshops 6.12). included These Jigsawworkshops’s One Goodincluded School™ Jigsaw’s framework. One peopleGood School™ by developing framework. a shared This responsibility is a comprehensive for mental healthinitiative across which the supports whole school the This is a comprehensive initiative which supports the mental health and wellbeing of young community.mental health and wellbeing of young people by developing a shared responsibility peoplefor mental by developing health across a shared the whole responsibility school for community. mental health across the whole school community. ChartChart 6.12: 6.12: NumberNumber and type of people who attended youthyouth mental mental health health workshops, workshops, Jigsaw Jigsaw Dublin 15, 2018 and 2019 Dublin 15, 2018 and 2019 Chart 6.12: Number and type of people who attended youth mental health workshops, Jigsaw 2018 2019 Dublin 15, 2018 and 2019 1,500 1,418 2018 2019 1,060 1,418 1,5001,000 1,060 459 1,000500 238 88 459 45 500 0 238 Young people People working/volunteering 45 Parents88 0 with young people Young people People working/volunteering Parents with young people
From Year 1 to 5, service providers reported72 an increase in the incidence of mental health issues (anxiety and mood related issues) among children and young people. 72
79 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Service providers reported the following personal, familial and environmental factors that compromised youth mental health:
• Drug and/or alcohol use • Lack of mental health protective factors such as resilience skills • Parental mental health and/or drug and alcohol issues • Child neglect • Poverty • Homelessness
These factors affected children’s educational attendance and attainment. Service providers reported the need to increase access to youth mental health services23. The negative impact of inter-generational drug use and deprivation on young people’s mental health was apparent24.
ADULT MENTAL HEALTH TREATMENT DEMAND Genesis Psychotherapy and Family Therapy Services provided treatment demand statistics for adults attending their service in 2017 and 2019. Over the reporting period, there was a 5% decrease in the number of adults treated (Chart 6.13). The majority of cases were female, and some cases were treated for more than one mental health issue (Chart 6.13 & 6.14).
Chart 6.13: Total clients, gender and age range of adults, Genesis 2017 and 2019 Chart 6.13: Total clients, gender and age range of adults, Genesis 2017 and 2019
2017 2019
600 (76%) 458 (72%) 435 500 (63%) (52%) 349
400 312 (33%) 288 (27%) (28%) (24%)
300 225 (15%) (10%) 146 123 123
200 109 64 100 47 0 Male Female 45+years Total clientsTotal 18 to24 years 25 to44 years
Chart 6.14: Mental health issues among adults, Genesis 2017 and 2019
2017 2019
240 (38%) (38%)
200 173 164 (26%) 160 119 (20%) (19%) 23 The type of mental health services (19%) required are reported in the chapter ‘Service provision’
120 (15%) 87 85 84 24 (7%) Further 80data concerning the impact drug use64 has on education is reported in chapter ‘Consequences of drug use’ (4%) (4%) (3%) (3%) (3%) (3%) 34 (2%) (2%) (2%) 19 18 (0%) (0%) (0%) (0%) (0%) 15 13 12
40 11 9 9 8 ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 80 Anxiety concerns Suicidal Bereavement Trauma/abuse Physical health Financial issues issues/disorders Partner/family Family members drug/alcohol use drug/alcohol Drug/alcohol Drug/alcohol use ideation/attempts relationship issues relationship issues/disorders Mental health crisis Work related related issues Work Psychiatric diagnosis Psychiatric Mood issues/disorders Emotional/behavioural ~ Number of clients too small to be reported (5 or less) 2019 category total exceeds total number of clients as some clients experienced more than one mental health issue/disorder
74
Chart 6.13: Total clients, gender and age range of adults, Genesis 2017 and 2019
2017 2019 600 (76%) 458 (72%) 435 500 (63%) (52%) 349
400 312 (33%) 288 (28%) (27%) (24%)
300 225 (15%) (10%) 146 123 123
200 109 64 100 47 0 Male Female
FACTORS CONTRIBUTING TO DRUG & ALCOHOL45+years USE Total clientsTotal 18 to24 years 25 to44 years
ChartChart 6.14:6.14: MentalMental health issuesissues amongamong adults, Genesis 2017 and 2019
2017 2019
240 (38%) (38%)
200 173 164 (26%) 160 119 (20%) (19%) (19%)
120 (15%) 87 85 84 (7%) 80 64 (4%) (4%) (3%) (3%) (3%) (3%) 34 (2%) (2%) (2%) 19 (0%) 18 (0%) (0%) (0%) (0%) 15 13 40 12 11 9 9 8 ~ ~ ~ ~ ~ ~ 0 0 0 0 0 0 Anxiety concerns Suicidal Bereavement Trauma/abuse Physical health Financial issues issues/disorders Partner/family Family members drug/alcohol use drug/alcohol Drug/alcohol Drug/alcohol use ideation/attempts relationship issues relationship issues/disorders Mental health crisis Work related related issues Work Psychiatric diagnosis Psychiatric Mood issues/disorders Emotional/behavioural ~~ Number Number of of c lientclientss too too small small to to be be reported reported (5 (5or orless) less) 20192019 categorycategory totaltotal exceedsexceeds total total numbernumber ofof cclientslients as somesome cclientslients experiencedexperienced moremore thanthan oneone mental health issue/disorder mental health issue/disorder
74
81 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
7. CONSEQUENCES OF DRUG & ALCOHOL USE
1) PHYSICAL AND MENTAL HEALTH CONSEQUENCES OF DRUG USE There was limited data concerning the health-related consequences of drug use for Year 1 to 5. Table 7.1 reports the main physical and mental health issues reported by treated adult drug users in Year 5; similar issues were reported from Year 1 to 4.
Table 7.1: Main physical and mental health issues experienced by treated adult drug users, DATMS Year 5 (2019) Physical Respiratory issues/diseases associated with smoking drugs health Problems associated with injecting drug use (blood borne viruses, vein damage) Liver diseases due to injecting drug use and alcohol use Non-fatal overdoses and drug-related deaths Mental Mood issues/disorders (depression) health Anxiety issues/disorders Behavioural issues/disorders Psychotic symptoms (paranoia, psychosis) Self-harm Suicide ideation/attempt
Since Year 4, service providers have reported an increase in mental health issues among treated adult drug users.
The following data reports youth and adult treatment demand for substance use and mental health issues in Dublin 15. Treatment demand for these services is higher than reported, as limited data was provided to the DATMS. Table 7.2 reports the youth and adult services that provided data.
Table 7.2: Local mental health services by data returns, DATMS Year 3 to 5 (2017-2019) Community/statutory service Year 3 Year 4 Year 5 2017 2018 2019 Genesis Psychotherapy & Family Support Service (Genesis) √ X √ HSE Substance Abuse Service Specific to Youth (SASSY) √ √ √ HSE Addiction Psychiatry Service X X X HSE Addiction Counselling Service X X X √ Data provided X No data provided
82 CONSEQUENCES OF DRUG & ALCOHOL USE
In 2019, a total of 77 clients were treated for drug or alcohol use in local mental health In 2019, a total of 77 clients were treated for drug or alcohol use in local mental services (Chart 7.1)25. health services (Chart 7.1)25.
ChartChart 7.1:7.1: TreatedTreated clients byby gendergender andand age,age, SASSYSASSY and and Genesis, Genesis, 2017 2017 and and 2019 2019
2017 2019 90 80 77 70
60 (55%) (45%)
50 42 (36%) 35 32
40 (56%) (53%) 28 (21%) (44%) (17%) 30 (16%) 18 17 16 (10%) 14 (19%) (19%) 13 20 12 8 6 6 ~ 10 ~ 0 Male Female 18-24 years 25-34 years 34-44 years Total clientsTotal Under 18 18 years Under 45 years & over ~~ Number Number of of c lientclientss too too small small to tobe be reported reported (5 or(5 less)or less)
FromFrom January January 2020, 2020, addiction addiction services services can record can mental record health mental problems health as problemsan additional as probleman additional within problem the NDTRS. within This the has NDTRS. the potential This has to providethe potential more to meaningful provide more data meaningful data concerning treated drug users with mental health issues. concerning treated drug users with mental health issues.
HOSPITAL IN-PATIENT ENQUIRY SCHEME (HIPE) HOSPITALHIPE is a IN health-PATIENT information ENQUIRY SCHEME system (HIPE) that reports day and in-patient discharges from acute public hospitals. Each HIPE discharge record represents one episode HIPE is a health information system that reports day and in-patient discharges from acute of treatment rather than an individual patient; a patient may be admitted to hospital publicmore hospitals.than once Each in HIPE any discharge given time record period represents with onethe episodesame or of treatmentdifferent diagnoses.rather than anFrom individual 2012 patient; to 2019 a patientthere maywere be 2,198 admitted treatment to hospital episodes more than for once mental in any health given time and behavioural disorders26 associated with drug and alcohol use among Dublin 15 period with the same or different diagnoses. From 2012 to 2019 there were 2,198 treatment residents (Charts 7.2 to 7.4). episodes for mental health and behavioural disorders26 associated with drug and alcohol use among• Overall, Dublin from 15 residents 2012 to (Charts 2019, 7.the2 to number 7.4). of treatment episodes for mental health and behavioural disorders associated with drug and alcohol use increased by 99%; fluctuations in this upward trend were reported during this period
25• FurtherThe datadrugs concerning implicated the profile included of clients alcohol, treated foropioids, mental healthcannabis, issues/disorders benzodiazepines, is reported in thez chapterdrugs, ‘Factors cocaine, contributing other stimulants, to drug and alcoholhallucinogens, use’ solvents and polydrug use 26 The HIPE classification ‘mental health and behavioural disorders’ includes the following diagnostic 25 Furthercodes: data acuteconcerning intoxication; the profile physicalof clients treated health for consequencesmental health issues/disorders of drug use; is reported drug dependence; in the chapter ‘Factors drug contributingwithdrawal; to drug psychotic and alcohol disorder; use’ other mental and behavioural disorders. The number of treatment 26 The HIPE classification ‘mental health and behavioural disorders’ includes the following diagnostic codes: acute intoxication; physical health consequences of drug use; drug dependence;76 drug withdrawal; psychotic disorder; other mental and behavioural disorders. The number of treatment episodes for some of the diagnostic categories was too small to be reported and therefore the data has been presented together.
83 • Overall, from 2012 to 2019, the number of treatment episodes for mental health and • Overall, from 2012 to 2019, the number of treatment episodes for mental health and behavioural disorders associated with drug and alcohol use increased by 99%; behavioural disorders associated with drug and alcohol use increased by 99%; fluctuations in this upward trend were reported during this period fluctuations in this upward trend were reported during this period DRUG• ANDThe drugsALCOHOL implicated TRENDS included alcohol, opioids, cannabis, benzodiazepines, z drugs, • The drugs implicated included alcohol, opioids, cannabis, benzodiazepines, z drugs, MONITORINGcocaine, otherSYSTEM stimulants, YEAR hallucinogens, 5 solvents and polydrug use cocaine, other stimulants, hallucinogens, solvents and polydrug use • From 2012 to 2019, the majority of cases were male and aged over 30 years • From 2012 to 2019, the majority of cases were male and aged over 30 years • Over the reporting period, treatment episodes increased from 1% to 2% of national • •From Over 2012 the reportingto 2019, period,the majority treatment of cases episodes were increased male and from aged 1% toover 2% 30of nationalyears treatment episodes • Over the reporting period, treatment episodes increased from 1% to 2% of treatment episodes national treatment episodes Chart 7.2: Treatment episodes for mental health and behavioural disorders due to drug and alcoholChartChart 7.7.2: use2: TreatmenTreatment among Dublint episodes 15 residents, forfor mentalmental HIPE healthhealth 2012 andand to 2019behaviouralbehavioural disordersdisorders duedue toto drug drug and and alcohol use among Dublin 15 residents, HIPE 2012 to 2019 alcohol400 use among Dublin 15 residents, HIPE 2012 to 2019 400 333 337 350 316 304 337 350 286 333 300 272 316 304 286 250300 272 250 200 169 181 181 150200 169 100150 10050 500 0 2012 2013 2014 2015 2016 2017 2018 2019 2012 2013 2014 2015 2016 2017 2018 2019
Cha Chartrt 7.7.3:3: TreatmentTreatment episodes forfor mentalmental healthhealth andand behaviouralbehavioural disordersdisorders duedue toto drug drug and and alcoholChaalcoholrt 7. use3use: Treatment amongamong DublinDublin episodes 1515 residenresidents for mentalts by healthgender, and HIPE behavioural 2012 to 2019 disorders due to drug and alcohol use among Dublin 15 residents by gender, HIPE 2012 to 2019 Male Female Male Female
300 (70%) (65%) (68%) (65%)
300 (70%) 234 (67%) 250 (65%) (66%) 218 (68%) (65%) 206 205 234 250 (67%) 193 (66%) 218 179 206 200 205 193 (35%) (65%) (35%) 200 179 (35%) (65%) (30%) 150 (32%) (35%) (33%) (34%) 119 117 (51%) (49%) 111 99 98 (30%) 150 (32%) 93 93 (35%) (33%) (34%) 119 117 86 (51%) 83 100 (49%) 111 99 98 64 93 93 (35%) 86 100 83 50 64 50 0 0 2012 2013 2014 2015 2016 2017 2018 2019 2012 2013 2014 2015 2016 2017 2018 2019
ChartChart 7.7.4:4: TreatmentTreatment episodes forfor mentalmental healthhealth andand behaviouralbehavioural disordersdisorders duedue toto drug drug and and alcoholepisodesalcohol us usefore amongsomeamong of Dublin Dublinthe diagnostic 1515 residents categories by age, was HIPE too small 20122012 to toto be 2019 reported and therefore the data hasepisodes been forpresented some of together. the diagnostic categories was too small to be reported and therefore the data has been presented together. Under 30 Years Over 30 Years 500 77 (91%) (89%)
77 (90%) 400 (88%) (92%) (78%) 302 300 283 267
300 251 (86%) 224 (80%)
200 155 136 (22%) (12%) (11%) (20%) (10%) (9%) (14%) (8%) 100 62 37 37 33 33 31 26 21 0 2012 2013 2014 2015 2016 2017 2018 2019
From 2012 to 2019, there were 187 treatment episodes for drug-related poisonings (overdoses) among Dublin 15 residents (Chart 7.5). The poisonings may not have resulted in 84 death.
• Overall, from 2012 to 2019, the number of treatment episodes for poisonings increased by 100%; fluctuations in this upward trend were reported during this period • From 2012 to 2017, the number of treatment episodes for poisonings associated with opioids, cocaine and other drugs increased from 2% to 3% of national treatment episodes, decreasing to 2% for 2018 and 2019 • From 2012 to 2019, the number of treatment episodes for poisonings associated with anti-epileptic and sedative-hypnotic drugs increased from 1% to 2% of national treatment episodes
Chart 7.5: Treatment episodes for drug-related poisonings by drug type among Dublin 15 residents, HIPE 2012 to 2019
Poisoning by Heroin, other Opioids (including Codeine, Methadone), Cocaine & other unspecified drugs Poisoning by Anti- Epileptic, Sedative-Hypnotic drugs 25 22 20 19 20 16 15 13 13 15 11 12 11 10 9 10 7 5 ~ ~ ~ 0 2012 2013 2014 2015 2016 2017 2018 2019
~ Number of poisonings too small to be reported (5 or less)
78
Chart 7.4: Treatment episodes for mental health and behavioural disorders due to drug and alcohol use among Dublin 15 residents by age, HIPE 2012 to 2019
Under 30 Years Over 30 Years 500 (91%) (89%) (90%)
400 (88%) (92%) (78%) 302 300 283 267
300 251 (86%) 224 (80%)
200 155 136 (22%) (12%) (11%) (20%) (10%) (9%) (14%) (8%) 100 62 37 37 33 33 31 26 21 0 2012 2013 2014 2015 2016 2017 2018 2019
CONSEQUENCES OF DRUG & ALCOHOL USE From 2012 to 2019, there were 187 treatment episodes for drug-related poisonings (overdoses) among Dublin 15 residents (Chart 7.5). The poisonings may not have resulted in death.From 2012 to 2019, there were 187 treatment episodes for drug-related poisonings (overdoses) among Dublin 15 residents (Chart 7.5). The poisonings may not have resulted• Overal in death.l, from 2012 to 2019, the number of treatment episodes for poisonings increased by 100%; fluctuations in this upward trend were reported during this period • Overall, from 2012 to 2019, the number of treatment episodes for poisonings •increased From 2012 by to100%; 2017, fluctuationsthe number of in treatment this upward episodes trend for poisoningswere reported associated during with this periodopioids, cocaine and other drugs increased from 2% to 3% of national treatment • From 2012 to 2017, the number of treatment episodes for poisonings episodes, decreasing to 2% for 2018 and 2019 associated with opioids, cocaine and other drugs increased from 2% to 3% of •national From 2012treatment to 2019, episodes, the number decreasing of treatment to episodes2% for 2018for poisonings and 2019 associated with • Fromanti 2012-epileptic to 2019, and the sedative number-hypnotic of treatment drugs increased episodes fromfor poisonings 1% to 2% associated of national with anti-epileptic and sedative-hypnotic drugs increased from 1% to 2% of treatment episodes national treatment episodes
ChartChart 7.7.5:5: TreatmentTreatment episodesepisodes for drug-relateddrug-related poisoningspoisonings by drug type among Dublin 15 residents,residents, HIPEHIPE 2012 2012 toto 20192019
Poisoning by Heroin, other Opioids (including Codeine, Methadone), Cocaine & other unspecified drugs Poisoning by Anti- Epileptic, Sedative-Hypnotic drugs 25 22 20 19 20 16 15 13 13 15 11 12 11 10 9 10 7 5 ~ ~ ~ 0 2012 2013 2014 2015 2016 2017 2018 2019
~~ Number Number of of poisonings poisonings too too small small to tobe be reported reported (5 (5or orless) less)
78
NATIONAL DRUG-RELATED DEATHS INDEX (NDRDI) The NDRDI provides a census of drug-related deaths in Ireland. From 2008 to 2017, there were 6,933 drug-related deaths (Health Research Board, 2019):
• 3,715 (54%) were due to poisoning (overdose) • 3,218 (46%) were due to non-poisoning (trauma or medical causes) • Drug-related deaths increased by 25% from 630 in 2008 to 786 in 2017 • From 2008 to 2017, the majority of people who died were male
Key findings poisoning deaths • From 2008 to 2017, poisoning deaths fluctuated on an annual basis (Chart 7.6) • Over the reporting period, the number of people who died and were living in the BLDATF area decreased from five to less than five (Chart 7.7)
85 NATIONAL DRUG-RELATED DEATHS INDEX (NDRDI) The NDRDI provides a census of drug-related deaths in Ireland. From 2008 to 2017, there were 6,933 drug-related deaths (Health Research Board, 2019):
• 3,715 (54%) were due to poisoning (overdose) • 3,218 (46%) were due to non-poisoning (trauma or medical causes) • Drug-related deaths increased by 25% from 630 in 2008 to 786 in 2017 • From 2008 to 2017, the majority of people who died were male
Key findings poisoning deaths • From 2008 to 2017, poisoning deaths fluctuated on an annual basis (Chart 7.6) DRUG AND ALCOHOL TRENDS MONITORING• Over the SYSTEM reporting period, YEAR the 5 number of people who died and were living in the BLDATF area decreased from five to less than five (Chart 7.7)
CharChartt 7. 7.6:6: PPoisoningoisoning deathsdeaths byby year, year, NDRDINDRDI 20082008 toto 2017 410 401 400 387 390 377 376 380 371 370 370 368 370 356 360 350 339 340 330 320 310 300 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
ChartChart 7.7.7:7: Poisoning deaths by Regional && Local DrugDrug && Alcohol Task Force areas, NDRDI 20082008 andand 20172017 2008 2017 45 41
40 40 35
35 33 30 30 30 29
26 24 23 23 25 23 21 20 20 20 19
20 17 16 16 15 14 14
13 13 13 12 15 12 12 11 11 11 11 9 9 8 8
10 7 7 7
6 6 5 ~ ~ 5 ~ ~ ~ ~ 5 0 79
Bray LDTF Cork LDTF Cork Tallaght LDTFTallaght Ballymun LDTF Ballymun Western RDTF Western Dublin 12 LDTF Southern RDTF Southern Midlands RDTF Midlands Clondalkin LDTF Clondalkin Mid West RDTF Other/unknown South East RDTFEast South East Coast RDTF Ballyfermot LDTF North West North RDTF West Finglas-Cabra Finglas-Cabra LDTF North Eastern RDTF North Eastern South Western RDTF Western South North Inner City LDTF Blanchardstown LDTF Blanchardstown Dublin North East LDTF East North Dublin Canal Communities LDTF Communities Canal Dublin South Inner City LDTF City Inner South Dublin Dun Laoghaire-Rathdown LDTF Dun Laoghaire-Rathdown
North Dublin City and County RDTF County and City Dublin North ~~ LessLess than than 5 5deaths deaths
• Benzodiazepines• Benzodiazepines and and z drugsz drugs were thethe main main drug drug group group associated associated with deaths, with deaths, followed by opiates and alcohol (Charts 7.8 and 7.9) followed by opiates and alcohol (Charts 7.8 and 7.9) • Polydrug poisonings increased from 50% (192) in 2008 to 58% (218) in 2017 • In 2008,• Polydrug 3% (12) poisonings of all poisoning increased deathsfrom 50% had (192) four in 2008or more to 58% drugs (218) involved, in 2017 this increased• In 2008, to 18% 3% (12)(67) ofin all2017 poisoning deaths had four or more drugs involved, this • Over the reporting period, poisoning deaths among people who were increased to 18% (67) in 2017 injecting at the time of death decreased from 67 (11%) in 2008 to 34 (4%) in • 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 (Chart 86 7.10)27 • Almost 1 in 10 of 2017 poisoning deaths were among people who were injecting at the time of death
27 Further data reporting a reduction in injecting drug use is reported is the chapter ‘Treated drug & alcohol use’
80
CONSEQUENCES OF DRUG & ALCOHOL USE
2017 (Chart 7.10)27 • Almost 1 in 10 of 2017 poisoning deaths were among people who were injecting at the time of death
ChartChart 7.7.8:8: PoisoningPoisoning deathsdeaths byby drugdrug group,group, NDRDINDRDI 20020088 andand 20120177
2008 2017 234 250 234 179 179 171 200 171 157 157 125 150 125 99 99 61 100 61 57 57 53 53 41 41 18 18 14 50 14 7 7 ~ ~ 0 MDMA MDMA Alcohol Alcohol Opiate§ Cocaine Opiate§ Cocaine Z drug* Z Z drug* Z Anti-psychotic" Anti-psychotic" Benzodiazepine/ Benzodiazepine/ Anti-depressant^ Anti-depressant^ CategoryCategory totals totals exceed exceed total total number number of of poisoning poisoning deaths, deaths, as individualas individual cases cases may may have have more more than than one drugone drugimplicated implicated in their in deaththeir death ** IncludesIncludes diazepam, diazepam, alprazalam, alprazalam, zopiclone, zopiclone, flurazepam, flurazepam, etizolam etizolam §§ Includes Includes methadone, methadone, heroin heroin and and fentanyl fentanyl "“ Includes Includes pregaba pregabalin,lin, quetiapine quetiapine ~~ Less Less than than 5 5deaths deaths ^ Includes amitriptyline, citalopram ^ Includes amitriptyline, citalopram
ChartChart 7.7.9:9: PoisoningPoisoning deathsdeaths byby specificspecific drug, drug, NDRDI NDRDI 2008 2008 and and 2017 2017
2008 2017 157 180 157 150 125 125 120 95 95 91 91 90 90 80 80 77 90 77 65 65 63 63 61 61 53 53 45 45 42 60 42 34 34 21 21 20 20 20 20 14 14 12 12 10 10 9 9 9 9 7 7 30 7 7 ~ ~ 5 ~ ~ 5 0 0 0 0 0 0 0 MDMA MDMA Alcohol Alcohol Cocaine Cocaine Heroin§ Heroin§ Etizolam* Etizolam* Fentanyl§ Fentanyl§ Zopiclone* Zopiclone* Diazepam* Diazepam* Pregabalin" Pregabalin" Quetiapine" Quetiapine" Citalopram^ Citalopram^ Alprazalam* Alprazalam* Flurazepam* Flurazepam* Methadone§ Methadone§ Amitriptyline^ Amitriptyline^ CategoryCategory totals totals exceed exceed total total number number of of poisoning poisoning deat deaths,hs, as individualas individual cases cases may may have have more more than than one drugone drugimplicated implicated in their in deaththeir death §§ Opiate Opiate ** Benzodiazepine/ZBenzodiazepine/Z drug drug "“ Anti Anti-psychotic-psychotic ^^ Anti Anti-depressant-depressant ~~ Less Less than than 5 5deaths deaths
27 Further data reporting a reduction in injecting drug use is reported is the chapter ‘Treated drug & alcohol use’
87 81
DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5 Chart 7.10: Poisoning deaths among people who were injecting at time of death (% of all poisoning deaths), NDRDI 2008 to 2017 90 ChartChart 7.7.10:10: PoisoningPoisoning69 deathsdeaths amongamong peoplepeople whowho werewere injectinginjecting atat timetime of death (% ofof allall poisoning67 deaths), NDRDI 2008 to 2017 poisoning(11%) deaths),(11%) NDRDI 2008 to 2017 70 57 56 90 50 47 49 (8%) (8%) 67 69 (8%) (7%) 38 (7%) 50 (11%) (11%) 35 34 70 (6%) 57 56 50 47 49 (8%) (8%) (5%) (4%) 30 (8%) (7%) 38 (7%) 50 35 34 (6%) (5%) (4%) 10 30
-10 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 10
-10 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
Key findings non-poisoning deaths Key• findingsThe number non-poisoning of non-poisoning deaths deaths increased by 69% from 243 in 2008 to 410 in Key findings non-poisoning deaths • The201 number7 (Chart of 7.1 non-poisoning1) deaths increased by 69% from 243 in 2008 to •410 The in 2017number (Chart of non 7.11)-poisoning deaths increased by 69% from 243 in 2008 to 410 in • The number of people who died and were living in the BLDATF area remains low • The201 number7 (Chart of 7.1 people1) who died and were living in the BLDATF area remains lowco comparedmpared with with other other Task Task Force Force areas areas(Chart (Chart7.12) 7.12) • The number of people who died and were living in the BLDATF area remains low • In 2017, 196 (48%) deaths were due to trauma; 114 (28%) of these deaths • In 2017, 196 (48%) deaths were due to trauma; 114 (28%) of these deaths were due wereco mpareddue to withhanging, other andTask 63%Force ofareas these (Chart people 7.12) had a history of mental health to hanging, and 63% of these people had a history of mental health issues •issues In 2017, 196 (48%) deaths were due to trauma; 114 (28%) of these deaths were due • •In 2017,In 2017, 214 214 (52%) (52%) werewere due to to medical medical causes, causes, with with 56 (14%) 56 (14%) due to due cardiac to cardiac events to hanging, and 63% of these people had a history of mental health issues events
• In 2017, 214 (52%) were due to medical causes, with 56 (14%) due to cardiac events ChartChart 7.7.11:11: NNon-poisoningon-poisoning deaths by year, NDRDINDRDI 20082008 toto 2017 2017
450 404 410 Chart400 7.11: Non-poisoning deaths by year, NDRDI 2008 to 2017357 371 450350 305 308 284 404 410 300 268 268 371 400 243 357 350250 305 308 284 300200 268 268 243 250150 200100 15050 1000 50 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
0 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
82
82
88 CONSEQUENCES OF DRUG & ALCOHOL USE
ChartChart 7.17.12:2: NonNon-poisoning-poisoning deaths by Regional & LocalLocal Drug & AlcoholAlcohol TaskTask ForceForce areas,areas, NDRDINDRDI 20082008 and 2017
2008 2017
40 36 35 34
30 27 26 24 25 23 21 21 20 20 20 20 18
20 17 17 16 16 16 16 15 15 14 14 13
15 12 11 11 11 10 10 10 9 8 8 8 7 10 7 6 6 5 5 ~ ~ 5 ~ 5 ~ ~ ~ ~ 5 0 Bray LDTF Cork LDTF Cork Tallaght LDTFTallaght Ballymun LDTF Ballymun Western RDTF Western Dublin 12 LDTF Southern RDTF Southern Midlands RDTF Midlands Clondalkin LDTF Clondalkin Mid West RDTF Other/unknown South East RDTFEast South East Coast RDTF Ballyfermot LDTF North West North RDTF West Finglas-Cabra Finglas-Cabra LDTF North Eastern RDTF North Eastern South Western RDTF Western South North Inner City LDTF Blanchardstown LDTF Blanchardstown Dublin North East LDTF East North Dublin Canal Communities LDTF Communities Canal Dublin South Inner City LDTF City Inner South Dublin Dun Laoghaire-Rathdown LDTF Dun Laoghaire-Rathdown North Dublin City and County RDTF County and City Dublin North
~~ Less Less than than 5 5deaths deaths
83
89 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
2) SOCIAL CONSEQUENCES OF DRUG AND ALCOHOL USE The2) SOCIAL social consequences CONSEQUENCES of drug and alcohol OF use DRUG were reported AND ALCOHOL to be a barrier to rehabilitationUSE for treated drug users. They include issues with family, employment, finances, housingThe social and consequences education. These of consequencesdrug and alcohol have use bee weren reported reported in allto fivebe a years barrier of tothe rehabilitation for treated drug users. They include issues with family, employment, DATMS, with many treated drug users and their families experiencing more than one, as they finances, housing and education. These consequences have been reported in all five areyears inextricably of the DATMS, linked. Year with 5 manyreported treated that fractured drug users family and relationships their families and experiencing financial issues weremore the than most one, common as they (Chart are inextricably 7.13). linked. Year 5 reported that fractured family relationships and financial issues were the most common (Chart 7.13).
ChartChart 7.7.13:13: Social issuesissues experiencedexperienced by treated drugdrug users,users, DATMSDATMS Year Year 3 3 to to 5 5 (2017-2019) (2017-2019)
2017 2018 2019 92% 92% 85% 88% 100% (80) (80) 83% 78% (40) (56) 72% (53) 73% 72% (37) 64% 63% 80% (34) 60% 60% (47) (46) 57% (56) (40) (28) (52) 45% (50) 60% (21) 40% 20% 0% Family Financial Housing/ Employment Education homelessness
FAMILY FAMILYAll five years of the DATMS reported the negative impact of drug and alcohol Alldependence five years of within the DATMS the family. reported Family the membersnegative impact reported of drug that and addiction alcohol dependencewithin the family caused conflict, turmoil and led to the breakdown of relationships and within the family. Family members reported that addiction within the family caused conflict, family units28. Family members reported having to deal with the fear, violence and turmoilfinancial and implications led to the breakdownassociated ofwith relationships drug debt andintimidation. family units As28 . a Familyconsequence, members reportedtheir physical having toand deal mental with the health fear, violence was compromised. and financial implications Family members associated reported with drug attending family support services, counselling services and peer-led groups. They debt intimidation. As a consequence, their physical and mental health was compromised. stated that these services and groups provided supportive and non-judgemental Familyenvironments members that reported helped attending them deal family with support their familyservices, circumstances. counselling services and peer-
FAMILY SUPPORT SERVICES & PEER-LED GROUPS
Local community services provide family support through one-to-one and group 28 Data concerning the family context as a risk factor for the normalisation of drug use and the developmentinterventions of interfor children,-generational young drug peopledependence and is adults. reported Table in the 7.3 chapter reports ‘Factors the contributingservices toand drug peer-led use’ groups that provided data; 2019 is the first year that all support services and peer-led groups provided data.
28 Data concerning the family context as a risk factor for the normalisation84 of drug use and the development of inter-generational drug dependence is reported in the chapter ‘Factors contributing to drug use’
90 CONSEQUENCES OF DRUG & ALCOHOL USE
Table 7.3: Local family support services and peer-led groups by data returns, DATMS Year 3 to 5 (2017-2019) Local Community Service/Peer-Led Group 2017 2018 2019 BLDATF Family Support Service (BLDATF) ~ √ √ Blakestown Mountview Youth Initiative (BMYI) √ √ √ Mulhuddart/Corduff Community Drug & Alcohol Team (M/C CDAT) √ √ √ Genesis Psychotherapy & Family Support Service (Genesis) √ X √ Neighbourhood Youth Project (NYP) √ √ √ D15 CAT * √ √ Blanchardstown Youth Service, Working to Enhance X √ √ Blanchardstown (WEB) Peer-Led Groups (P2P, Craft, Cri Croiga 1 & 2, Dove) X √ √ ~ Service opened in January 2018 √ Data provided X No data provided * Service opened in October 2018
Treatment demand The following data reports a profile of family members who received support from local community services and peer-led groups from 2017 to 2019. Treatment demand data contains no unique identifiers and clients are counted more than once if they attend more than one service or peer-led group. Thus, this profile reports the number of cases rather than the number of clients. A total of 149 cases received family support services in 2017 and this increased to 622 in 2019 members receiving support was higher due to some services and peer-led groups not (Chart 7.14). For 2017 and 2018, the actual number of family members receiving providingsupport data.was higher due to some services and peer-led groups not providing data.
ChartChart 7.147.14:: Family support cases, cases, Local FamilyFamily SupportSupport CommunityCommunity Services & Peer-Led Peer-Led Groups, DATMS Year 3 to 5 (2017-2019) Groups, DATMS Year 3 to 5 (2017-2019) 700 622 600 500 424 400 300 200 149 100 0 2017 2018 2019
OverOver the the reporting reporting period, period, the themajority majority of cases of caseswere female were (Chartfemale 7.15 (Chart). 7.15).
Chart 7.15: Family support cases by gender, Local Family Support Community Services & Peer- Led Groups, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019 600 447 500 (72%) 91 288 400 (68%) 175 300 136 99 (28%) (32%) 200 (66%) 50 100 (34%) 0 Female Male
Chart 7.16 reports the age range of cases that attended services that provide family support services to young people and adults. Chart 7.17 reports the age range of cases that attended services that provide family support services to with adults only.
86
members receiving support was higher due to some services and peer-led groups not providing data.
Chart 7.14: Family support cases, Local Family Support Community Services & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019) 700 622 600 500 424 400 300 200 149 100 0 2017 2018 2019 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5 Over the reporting period, the majority of cases were female (Chart 7.15).
ChartChart 7.15 7.15:: Family Family support support cases cases by bygender gender,, Local Local Family Family Support Support Communi Communityty Services Services & Peer &- LedPeer-Led Groups, Groups, DATMS DATMS Year 3 Year to 5 3(2017 to 5 (2017-2019)-2019)
2017 2018 2019 600 447 500 (72%) 288 400 (68%) 175 300 136 99 (28%) (32%) 200 (66%) 50 100 (34%) 0 Female Male
ChartChart 7.16 7.16 report reportss the the age age range range of cofase casess that thatattended attended services services that provide that provide family family support services to young people and adults. Chart 7.17 reports the age supportrange of services cases to that young attended people servicesand adults. that Chart provide 7.17 reports family thesupport age range services of case tos thatadults attended only. services that provide family support services to with adults only.
ChartChart 7.167.16:: Family support casescases by agage,e, BMYI,BMYI, NYPNYP & & WEBWEB,, DATMSDATMS YearYear 33 toto 5 (2017(2017-2019)-2019)
2017 2018 2019
500 441
400 (59%) 332 (53%) 260 300 (35%) 175 (27%)
153
200 (62%) 115 (31%) 90 (5%) (3%) 71
100 36 * 16 10 ~ ~ ~ 0 86
Total Under 18 Under 45+years 18-24 years 25-44 years ~~ NumberNumber of of cases cases too too small small to to be be reported reported (5 (5or or less) less) ** Number of cases greater greater than than 5 5 and and suppressed suppressed to to ensure ensure cases cases with with 5 or5 orless less are are not not disclosed disclosed TTotalsotals lessless than than 100% 100% as as unknown unknown cases cases removed removed
Chart 7.17: Family support cases by age, BLDATF, M/C CDAT, Genesis, D15 CAT & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019
200 181
150 (58%) 104 (38%) 100 92 (45%) 69 (59%) 41 34
50 (4%) 20 * 8 ~ ~ 0 0 Total 45+years 18-24 years 25-44 years ~ Number of cases too small to be reported (592 or less) * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed Totals less than 100% as unknown cases removed
In 2017, 71 cases experienced active or chaotic drug use by another family member, and this increased to 350 in 2019 (Chart 7.18).
87
Chart 7.16: Family support cases by age, BMYI, NYP & WEB, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019
500 441
400 (59%) 332 (53%) 260 300 (35%) 175 (27%) 153
200 (62%) 115 (31%) 90 (5%) (3%) 71
100 36 * 16 10 ~ ~ ~ 0 Total Under 18 Under 45+years 18-24 years 25-44 years ~ Number of cases too small to be reported (5 or less) * Number of cases greater than 5 and suppressedCONSEQUENCES to ensure cases OF with DRUG 5 or less & areALCOHOL not disclosed USE Totals less than 100% as unknown cases removed
ChartChart 7.177.17:: Family supportsupport casescases by age,age, BLDATF, M/C CDAT,CDAT, Genesis,Genesis, D15D15 CATCAT && Peer-Led Peer-Led Groups,Groups, DATMS Year 3 to 5 (2017-2019)(2017-2019)
2017 2018 2019
200 181
150 (58%) 104 (38%) 100 92 (45%) 69 (59%) 41 34
50 (4%) 20 * 8 ~ ~ 0 0 Total 45+years 18-24 years 25-44 years ~~ NumberNumber of of cases cases too too small small to to be be reported reported (5 (5or or less) less) ** Number of cases greater greater than than 5 5 and and suppressed suppressed to to ensure ensure cases cases with with 5 or5 orless less are are not not disclosed disclosed Totals less than 100% as unknown cases removed Totals less than 100% as unknown cases removed
InIn 2017,2017, 71 71 cases cases experienced experienced active or active chaotic or drug chaotic use by druganother use family by member,another andfamily this increasedmember, toand 350 this in 2019 increased (Chart 7.1to 8350). in 2019 (Chart 7.18).
Char Chartt 7.17.18:8: Family support cases experiencingexperiencing active/chaoticactive/chaotic drug use by aa familyfamily membermember,, Local Local Family Family Support Support Commu Communitynity ServicesServices & & PeerPeer-Led-Led Groups,Groups, DATMSDATMS YearYear 33 toto 5 (2017(2017-2019)-2019)
2017 2018 2019 450 350 (56%) 272 350 252 (59%) (44%) 250 172 (41%) 87 78 150 71 (48%) (52%) 50
-50 Active/chaotic drug/alcohol use Not active/chaotic drug/alcohol use
TheThe services services received received by byfamily family members members is reported is reported in the in char thet chartbelow below (Chart (Chart7.19). 7.19).
Chart 7.19: Family support cases by service type, Local Family Support Community Services & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019
600 (63%) (58%)
500 (65%) 393 (37%) 358
400 (41%) 277 (32%) (21%)
300 228 (53%) 173 (12%) (11%) (30%) 136 (23%) 130 (7%) (7%) (13%) (13%)
200 (7%) 79 74 46 44 34 29 23 20 20
100 10 ~ 0
93 support awareness Education/ programme Parent/family Counselling Peer-led group Peer-led Pro-social activities Respite Category totals exceed total number of cases, as some cases received more than one intervention ~Number of cases too small to be reported (5 or less)
Over the reporting period, there has been a significant increase in the number of family members who attended an evidence-based/informed programme (Chart 7.20). This increase is predominantly associated with the development of the BLDATF Family Support Service in 2018.
88
Chart 7.18: Family support cases experiencing active/chaotic drug use by a family member, Local Family Support Community Services & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019
450 350 (56%) 350 252 272 (59%) (44%) 250 172 (41%) 78 150 71 (48%) (52%) 50
-50 Active/chaotic drug/alcohol use Not active/chaotic drug/alcohol use
DRUG AND ALCOHOL TRENDS MONITORINGThe services received SYSTEM by family YEAR members 5 is reported in the chart below (Chart 7.19).
ChartChart 7.17.19:9: FamilyFamily supportsupport casescases by by service service type type,, Local Local Family Family Support Support Community Community Services Services & Peer& Peer-Led-Led Groups, Groups, DATMS DATMS Year Year 3 to3 to5 (20175 (2017-2019)-2019) 2017 2018 2019
600 (63%) (58%)
500 (65%) 393 (37%) 358
400 (41%) 277 (32%) (21%)
300 228 (53%) 173 (12%) (11%) (30%) 136 (23%) 130 (7%) (7%) (13%) (13%)
200 (7%) 79 74 46 44 34 29 23 20 20
100 10 ~ 0 support awareness Education/ programme Parent/family Counselling Peer-led group Peer-led Pro-social activities Respite CategoryCategory totals totals exceed exceed total total number number of of cases, cases, as as some some cases cases received received more more than than one one intervention intervention ~Number~ Number of of c asecasess too too small small to tobe bereported reported (5 or(5 less)or less)
OverOver thethe reportingreporting period, period, there there has has been been a significant a significant increase increase in the in number the number of family of family members who attended an evidence-based/informed programme (Chart members who attended an evidence-based/informed programme (Chart 7.20). This increase 7.20). This increase is predominantly associated with the development of the isBLDATF predominantly Family associated Support Servicewith the indevelopment 2018. of the BLDATF Family Support Service in 2018. ChartChart 7.7.20:20: FamilyFamily supportsupport casescases whowho attendedattended anan evidenceevidence-based/informed-based/informed programmeprogramme,, Local Local Family Family Support Support Community Community Services Services & & Peer Peer-Led-Led Groups, Groups, DATMS DATMS Year Year 3 3 to to 5 5 (2017 (2017-2019)-2019) 200 144 (23%) 150 88 100
26 50 (6%) ~ 0 2017 2018 2019
~Number~ Number of of case casess too too small small to beto bereported reported (5 or (5 less)or less)
TheThe most most commonly commonly used used evidence evidence-based-based programme programmess were the were 5 Step the Method5 Step Method and the and the Triple P Programme (Chart 7.21). Triple P Programme (Chart 7.21).
Chart 7.21: Family support cases by evidence-based/informed programme, Local Family Support Community Services & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019)
2017 2018 2019 120 (13%) 100 83
80 (9%) 60 57 (4%) (3%) (4%) 40 (3%) 94 23 20 (1%) 15 13 9 20 (0%) (0%) (0%) (0%) (0%) (0%) ~ ~ 0 0 0 0 0 0 0 Triple P Triple Families Resistance Programme Non-Violent Parents Plus Parents Programme Strengthening 5 Step Method ~Number of cases too small to be reported (5 or less) 2019 total exceeds total number of cases, as some cases received more than one intervention
Over the reporting period, the majority of cases attended local family support services for less than a year (Chart 7.22).
89
Chart 7.20: Family support cases who attended an evidence-based/informed programme, Local Family Support Community Services & Peer-Led Groups, DATMS Year 3 to 5 (2017-2019) 200 144 (23%) 150
100 26 50 (6%) ~ 0 2017 2018 2019
~Number of cases too small to be reported (5 or less)
The most commonly used evidence-based programmes were the 5 Step Method and the CONSEQUENCES OF DRUG & ALCOHOL USE Triple P Programme (Chart 7.21).
ChartChart 7.27.21:1: FamilyFamily supportsupport cases byby evidenceevidence-based/informed-based/informed programme, programme, Local Local Family Family SupportSupport CommunityCommunity ServicServiceses && PeerPeer-Led-Led Groups,Groups, DATMSDATMS YearYear 3 to 5 (2017-2019)(2017-2019)
2017 2018 2019 120 (13%) 100 83
80 (9%) 60 57 (4%) (3%) (4%)
40 (3%) 23 20 (1%) 15 13 9 20 (0%) (0%) (0%) (0%) (0%) (0%) ~ ~ 0 0 0 0 0 0 0 Triple P Triple Families Resistance Programme Non-Violent Parents Plus Parents Programme Strengthening 5 Step Method ~Number~ Number of of case casess too too small small to beto bereported reported (5 or(5 less)or less) 20192019 total total exceed exceedss total total number number of of cases, cases, as assome some cases cases received received more more than than one oneintervention intervention
OverOver the the reporting reporting period, period, the majority the majority of cases of attend casesed localattended family supportlocal family services support for less services for less than a year (Chart 7.22). than a year (Chart 7.22). Chart Chart 7.27.22:2: FamilyFamily supportsupport casescases byby length length ofof timetime inin attendanceattendance at Local FamilyFamily SupportSupport CommunityCommunity Services,Services, DATMS DATMS Year Year 3 3 to to 55 (2017(2017-2019)-2019)
2017 2018 2019
500 389 (66%) 400 236 300 (60%) 185 89154 (31%) 200 83 (39%) 43 (66%) 18 100 (34%) 0 (0%) ~ (3%) 0 Less than 1 year 1-3 years 4-10 years
~~ Number Number of of cases cases too too small small to tobe bereported reported (5 or(5 less)or less)
DueDue to to the the small small numbers numbers attending attending peer- peer-ledled groups, groups, it is not itpossible is not possibleto quantify to the quantify length ofthe time length in attendance. of time in However, attendance. the majorityHowever, of thecases majority attended of these cases groups attended for over these 10 groups for over 10 years. This identifies the chronic nature of drug and alcohol years. This identifies the chronic nature of drug and alcohol use and the need for enduring use and the need for enduring support for families. support for families.
MAPPING TREATMENT DEMAND Mapping treatment demand data for family support services and peer-led groups reports where family members affected by drug or alcohol use live. Year 4 collected mapping data 95 from the BLDATF Family Support Service. Year 5 collected mapping data from all local family support services and peer-led groups. Thus, Year 5 has produced two maps. The first maps the BLDATF Family Support Service and the second maps all family support services (including the BLDATF Family Support Service) and peer-led groups in Dublin 15.
Year 4 and 5 mapping data for the BLDATF Family Support Service identifies the following:
• Clients attending the service were from Dublin 15 and outside Dublin 15 • The majority of clients were from Dublin 15:
o The data identifies that clients were from every community in Dublin 15, from the affluent to the socio-economically deprived
90
DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
MAPPING TREATMENT DEMAND Mapping treatment demand data for family support services and peer-led groups reports where family members affected by drug or alcohol use live. Year 4 collected mapping data from the BLDATF Family Support Service. Year 5 collected mapping data from all local family support services and peer-led groups. Thus, Year 5 has produced two maps. The first maps the BLDATF Family Support Service and the second maps all family support services (including the BLDATF Family Support Service) and peer-led groups in Dublin 15.
Year 4 and 5 mapping data for the BLDATF Family Support Service identifies the following:
• Clients attending the service were from Dublin 15 and outside Dublin 15 • The majority of clients were from Dublin 15: • The data identifies that clients were from every community in Dublin 15, from the affluent to the socio-economically deprived • Drug and alcohol dependence is a community wide issue crossing all socio-economic boundaries
Similar conclusions were drawn from the Year 5 mapping data for all family support services (including the BLDATF Family Support Service) and peer-led groups in Dublin 15. The only difference was larger concentrations of clients lived in socio- economically deprived areas.
96 CONSEQUENCES OF DRUG & ALCOHOL USE
YEAR 4 BLDATF Family Support Service 2018
97 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 5 BLDATF Family Support Service 2019
98 YEAR 5 (2019) BLDATF FAMILY SUPPORT SERVICE
99 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
100 CONSEQUENCES OF DRUG & ALCOHOL USE
YEAR 5 All Family Support Services in Dublin 15 2019
101 DRUG AND ALCOHOLThis page TRENDS has been left blank intentionally MONITORING SYSTEM YEAR 5
YEAR 5 (2019) ALL FAMILY SUPPORT SERVICES IN DUBLIN 15
102 CONSEQUENCES OF DRUG & ALCOHOL USE
Treatment demand for alcohol and drug users and family members Year 5 is the first time that we mapped treatment demand for alcohol and drug users, and family members together. This has identified that while drug and alcohol use affects people from every community, it impacts people from socio-economically deprived communities more significantly. This was highlighted in the maps ‘YEAR 5 All Family Support Services in Dublin 15’ and ‘YEAR 5 Treatment demand in Dublin 15 Adults & Under 18s’. When this data is amalgamated the concentration of clients from socio-economically deprived communities is more pronounced.
103 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 5 Treatment Demand in Dublin 15 Treated Drug Users & Family Members affected by Drug & Alcohol Use 2019
104 YEAR 5 (2019) TREATMENT DEMAND IN DUBLIN 15 TREATED DRUG USERS & FAMILY MEMBERS AFFECTED BY DRUG & ALCOHOL USE
105 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
106 CONSEQUENCES OF DRUG & ALCOHOL USE
NDTRS data reports the accommodation status of assessed and treated cases. It identifies thatNDTRS from data2016 reportsto 2019 thethe majorityaccommodation of cases were status living of wit assessedh family (Charts and treated 7.23 and cases. 7.24). ThIt iidentifiess data identif thaties thefrom need 2016 for familyto 2019 support the services.majority of cases were living with family (Charts 7.23 and 7.24). This data identifies the need for family support services.
ChartChart 7.7.23:23: All cases livingliving inin BLDABLDATFTF area area by by accommodation accommodation status,status, NDTRSNDTRS 2016 2016 to to 201 20199
2016 2017 2018 2019 (40%) (40%) 250
250 (47%) (47%) 198 198 (40%) 200 (40%) 162 162 (40%) (40%)
150 116
150 116 (15%) (15%) 98 (12%) 98 (12%) (22%) (18%) (22%) (11%) (18%) (11%) (15%) (15%) (13%) (13%) (9%) (9%) (8%) (8%) 75 75 (13%) (13%)
100 (10%) (10%)
100 (10%) (10%) (9%) (9%) (7%) 60 (7%) 60 (7%) (5%) (8%) 55 (7%) 54 (5%) (7%) (8%) (5%) 55 53 54 (7%) (5%) 51 53 51 46 44 46 44 42 42 33 33 (4%) (2%) (4%) (2%) 29 (3%) 28 (2%) 29 (3%) 28 26 (2%) 26 24 24 20 19 19 20 18 18 19 19 18 50 18 9 9 9 9 7 6 7 ~ 6 ~ 0 Alone Alone Other* Other* Friends Friends Parents/family Parents/family Partner (alone) Partner Partner (alone) Partner Partner & child(ren) & Partner Partner & child(ren) & Partner Alone with child(ren) with Alone Alone with child(ren) with Alone AnnualAnnual totalstotals less less than than 100% 100% as asunknown unknown cases cases removed removed ** Includes cases cases living living in in institutions, institutions, residential residential care, care, halfway halfway houses houses or prisonsor prisons ~ Number of cases too small to be reported (5 or less) ~ Number of cases too small to be reported (5 or less)
ChartChart 7.27.24:4: All cases livingliving inin BLDATFBLDATF area area with with family,family, NDTRS 20162016 to 20120199
Living with family, partner, children 400 359 (72%)
300 251 (72%) 218 (75%) 190 (77%) 200
100
0 2016 2017 2018 2019
FINANCIAL FINANCIAL From Year 1 to 5, service providers and treated drug users reported high levels From Year 1 to 5, service providers and treated drug users reported high levels of drug-related of drug-related poverty. Drug use was prioritised over living expenses and some poverty.reported Drugusing use moneylenders. was prioritised Increasing over living housing expenses costs, andunemployment some reported and drug using debts added further to levels of poverty.
92
107 moneylenders. Increasing housing costs, unemployment and drug debts added further to levels of poverty.
DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5 EMPLOYMENT From Year 1 to 5, treated drug users reported difficulties maintaining employment due to EMPLOYMENT drug use, with many unemployed. They also reported leaving employment to enter From Year 1 to 5, treated drug users reported difficulties maintaining employment treatment.due to drug For use, those with in recovery, many unemployed. getting back into They the also workforce reported after leaving being out employment for a length ofto time enter proved treatment. challenging. For NDTRSthose datain recovery, reports that getting the majority back into of treated the workforce cases from after2016 tobeing 2019 outwere for unemployed a length of(Chart time 7.2 proved5). challenging. NDTRS data reports that the majority of treated cases from 2016 to 2019 were unemployed (Chart 7.25).
ChartChart 7.27.25:5: All cases livingliving inin BLDATFBLDATF area area by by employment employment status,status, NDTRSNDTRS 2016 2016 toto 22019019
2016 2017 2018 2019
400 (54%)
350 (62%) 300 270 (53%) (56%) 250 216 (20%) 200 155 139 (20%) (19%) (15%)
150 99 (11%) (5%) (4%) (6%) (6%) 68 47
100 44 32 27 22 21 15 * * ~ ~ ~ ~ 50 ~ 0 Student time) Unemployed disability) work (including work (including (including part- Retired/unable to Retired/unable In paid employment paid In Housewife/husband AnnualAnnual totals totals less less than than 100% 100% as asunkno unknownwn cases cases removed removed ~ Number of cases too small to be reported (5 or less) ~ Number of cases too small to be reported (5 or less) * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed
HOUSINGHOUSING InIn allall fivefive years years of ofthe the DATMS, DATMS, participants participants reported reported that thathousing housing was compro was compromisedmised due to drugdue useto anddrug anti use-social and behaviour, anti-social including behaviour, drug dealing including and drug drug debt dealing intimidation. and Thesedrug debt intimidation. These anti-social behaviours also impacted negatively on anti-social behaviours also impacted negatively on drug users’ families and communities. The drug users’ families and communities. The financial difficulties reported above finanfurthercial compromised difficulties reported housing. above The further consequences compromised for housing. treated Thedrug consequences users included for treatedexclusion drug from users theincluded family exclusion home fromand thehomelessness. family home and Despite homelessness. this, NDTRS Despite data this, from 2016 to 2019 reports the majority of cases assessed or treated were in stable accommodation (Chart 7.26). 93
108 NDTRS data from 2016 to 2019 reports the majority of cases assessed or treated were in CONSEQUENCES OF DRUG & ALCOHOL USE stable accommodation (Chart 7.26).
ChartChart 7.2 7.26:6: AllAll casescases living living in in BLDATF BLDATF area area by by accommodation accommodation status, status, NDTRS NDTRS 2016 2016 to to 201 20199
2016 2017 2018 2019
600 (87%)
500 433 (89%) 400 (74%) 310 (79%) 300 217 194 200 (4%) (4%) (4%) (3%) (2%) (4%) (3%) (2%) (2%) (2%) (3%) 100 (0%) 19 18 11 11 11 * 9 7 7 6 6 ~ ~ ~ ~ 0 0 Prison Homeless house) Stable Institution (residential care/halfway accomodation Other unstable Other accommodation AnnualAnnual totals totals less less than than 100% 100% as asunknown unknown cases cases removed removed ~ Number of cases too small to be reported (5 or less) ~ Number of cases too small to be reported (5 or less) * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed
EDUCATIONEDUCATION From Year 1 to 5, service providers reported that drug use by parents and young Frompeople Year affected 1 to 5, serviceschool providers attendance, reported performance that drug use and by educational parents and youngattainment, people affectedand in some school cases attendance, resulted performance in early school and educational leaving or attainment, expulsions. and in some cases resulted in early school leaving or expulsions. Under performance in education was also reported by the NDTRS data. Charts 7.27 and 7.28 report cases assessed and treated by highest level of education Undercompleted, performance and the in education age cases was left also school reported from by the2016 NDTRS to 2019. data. ChartsThese 7.2cases7 and have 7.28 reportlower caseseducational assessed andattainment treated by when highest compared level of education with the completed, general and population the age cases of Dublin 1529. left school from 2016 to 2019. These cases have lower educational attainment when compared with the general population of Dublin 1529.
29 Educational attainment of Dublin 15 population reported in chapter ‘Socio-demographic profile of Dublin 15, 2006-2016’
94
29 Educational attainment of Dublin 15 population reported in chapter ‘Socio-demographic profile of Dublin 15’
109 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Chart 7.27: All cases living in BLDATF area by highest level of education completed, NDTRS ChartChart 7.27.27:7: All cases livingliving inin BLDATF areaarea byby highesthighest level of education completed,completed, NDTRSNDTRS 20162016 toto 20120199 2016 2017 2018 2019 2016 2017 2018 2019 240 240
200 (27%) (25%) 200 (27%) (25%) (30%) (35%) 135 (30%)
160 (35%) 123 160 135 (35%) (24%) 123 103 (35%) (24%) 101 120 (14%) (21%) 103 101 (14%) 85 84 (18%) (21%)
120 (14%) (21%) (9%) 85 84 (18%) (21%) (15%) 68 (14%) (9%) 60 (11%) (15%) 68 53 80 52 (7%) 48 60 46 (11%) 53 52
80 38 (7%) 48 46 28 38 19 (0%) (0%) (0%) (0%) 40 28 * * 19 ~ ~ ~ (0%) (0%) (0%) (0%)
40 0 0 0 0 * * ~ ~ ~ 0 0 0 0 0 0 school Third level Junior cert school Third level Junior cert Leaving cert incomplete Primary level Primary level Leaving cert incomplete Never went to went Never Primary level Primary level Never went to went Never AnnualAnnual totals totals less less than than 100% 100% as asunknown unknown cases cases removed removed ~ Number of cases too small to be reported (5 or less) ~~ Number Number of of cases cases too too sm smallall to tobe be reported reported (5 (5or orless) less) * Number of cases greater than 5 and suppressed to ensure cases with 5 or less are not disclosed ** Number of cases greater greater than than 5 5 and and suppressed suppressed to to ensure ensure cases cases with with 5 or 5 lessor less are are not not disclosed disclosed
ChartChart 7.27.28:8: All cases livingliving inin BLDATFBLDATF area area by by age age left left school, school, NDTRS NDTRS 2016 2016 to to 201 20199 2016 2017 2018 2019 2016 2017 2018 2019 500
500 (61%) 400 (61%) 400 301 (56%) (62%) 301 (67%) (56%) (62%)
300 (67%) 300 195 181 195 165 181 (15%) 165
200 (17%) (17%) (15%) (16%)
200 (17%) (17%) (16%) 77 59 49 77 (0%) (0%) (0%) (0%) (0%) 100 40 59 49 (0%) (0%) (0%) (0%) (0%) 40 ~ ~ ~ 0 0
100 0 0 0 ~ ~ ~ 0 0 0 0 0 0 0 school school Still inschool Still Never went to went Never Still inschool Still years or over Never went to went Never years or over years or younger Left school age 14 Left school age 15 years or younger Left school age 14 Left school age 15 Annual totals less than 100% as unknown cases removed Annual totals less than 100% as unknown cases removed ~ Number of cases too small to be reported (5 or less) ~ Number of cases too small to be reported (5 or less)
Drug use in Dublin 15 secondary schools DrugYear use 1 toin Dublin5 reported 15 secondary that some schools secondary school student’s education was compromised due to drug use before and during school time. Year 5 participants Year 1 to 5 reported that some secondary school student's education was compromised due reported evidence of drug use in all local secondary schools (Chart 7.29). Since to drug use before and during school time. Year 5 participants reported evidence of drug use toYear drug 2, use participants before and duringreported school that time. these Year schools 5 participa werents reported a mixture evidence of affluent of drug useand insocio-economically all of these schools (Chart deprived 7.29). Sinceand includedYear 2, participants those with reported and withoutthat these DEIS schools status. were This indicates that drug use is a community wide issue that crosses all socio- a mixture of affluent and socio-economically deprived and included those with and without economic boundaries. 95
110 DEIS status. This indicates that drugCONSEQUENCES use is a community OFwide DRUG issue that & ALCOHOL crosses all socioUSE- economic boundaries.
ChartChart 7.27.29:9: NumberNumber of Dublin 15 secondarysecondary schools with evidence of drug use before andand duringduring schoolschool time,time, DATMS Year 1 to 5 14 10 9 12 10 (100%) 8 (90%) 10 (80%) 8 6 ~ ~ 4 2 0 Number of Year 1 Year 2 Year 3 Year 4 Year 5 secondary schools in Dublin 15
~Number~ Number of of schools schools too too small small to beto bereported reported (5 or(5 less)or less)
Profile of school-based drug users ProfileFrom ofYear school 1 to-based 5, changes drug users in the profile of school-based drug users have been Fromreported Year 1(Table to 5, changes 7.4). These in the changes profile of scincludehool-based the following:drug users have been reported (Table 7.4). These changes include the following: • Year 1 to 4 reported drug users were getting younger, with the norm age decreasing from 14 to 13 years; Year 5 continues to report the use of drugs •by Year13 year 1 to olds,4 reported though drug also users reports were gettingan increase younger, in thewith age the normof drug age users decreasing with most drugs users aged 14 or 15 years old from 14 to 13 years; Year 5 continues to report the use of drugs by 13 year olds, though • Year 1 and 2 reported school-based drug users were White Irish, from Year 3 thesealso drug reports users an increase were reported in the age to of be drug from users all withethnic most groups drugs users aged 14 or 15 • Yearyears 3 to old 4 reported an increase in the types of drugs used during school time and this increase continues in Year 5 • Year 1 and 2 reported school-based drug users were White Irish, from Year 3 these drug users were reported to be from all ethnic groups • Year 3 to 4 reported an increase in the types of drugs used during school time and this increase continues in Year 5
96
111 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Table 7.4: Profile of school-based drug users, DATMS Year 1 to 5 Year Drug Norm Young- Gender White Irish Irish Irish Irish type age est age Irish Traveller African Eastern Asian European 1 14 12 M & F* √ 2 14 12 M & F* √ Cannabis 3 14 12 M & F* √ √ √ √ herb 4 13 12 M & F* √ √ √ √ √ 5 15 12 M & F* √ √ √ √ √ 1 ^ ^ ^ ^ ^ ^ ^ ^ 2 ^ ^ ^ ^ ^ ^ ^ ^ Cocaine 3 14 14 M & F* √ powder 4 15 14 M & F* √ 5 15 15 M & F* √ √ √ √ 1 ^ ^ ^ ^ ^ ^ ^ ^ 2 ^ ^ ^ ^ ^ ^ ^ ^ MDMA 3 14 14 M & F* √ (pills) 4 14 14 M & F* √ 5 14 14 M & F* √ 1 ~ ~ ~ ~ ~ ~ ~ ~
2 Benzodi- ~ ~ ~ ~ ~ ~ ~ ~ 3 azepines ~ ~ ~ ~ ~ ~ ~ ~ Z drugs 4 13 13 M & F* √ 5 13 13 M & F* √ 1 × × × × × × × × 2 × × × × × × × × Cannabis 3 × × × × × × × × oil 4 × × × × × × × × 5 14 12 M & F* √ √ √ √ √ 1 × × × × × × × × 2 × × × × × × × × 3 Alcohol × × × × × × × × 4 × × × × × × × × 5 14 14 Males √ √ * Male & female, though predominately males ^ Use of drug during school time first reported in Year 3 ~ Use of drug during school time first reported in Year 4 × Use of drug during school time first reported in Year 5
112 CONSEQUENCES OF DRUG & ALCOHOL USE
3) DRUG AND ALCOHOL-RELATED CRIME All3) five DRUG years of ANDthe DATMS ALCOHOL-RELATED reported the existence of drug CRIME-related crime in Dublin 15. From 2017All five to 2019, years participants of the DATMS reported reported perceptions the existence concerning of the drug-related frequency with crime which in drugDublin- related15. From crime 2017 occurred to 2019, (Charts participants 7.30 to 7. reported33). Since perceptions Year 3, drug concerning debt intimidation the frequency has been with which drug-related crime occurred (Charts 7.30 to 7.33). Since Year 3, drug the most frequently reported drug-related crime. debt intimidation has been the most frequently reported drug-related crime.
Chart 7.30: Frequency of drug-related crime in Dublin 15, DATMS Year 3 to 5 (2017-2019) Chart 7.30: Frequency of drug-related crime in Dublin 15, DATMS Year 3 to 5 (2017-2019)
Frequently 2017 Frequently 2018 Frequently 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019
120% (40) (39) (70) 120% (40) (39) (50) (70) (49) (48) (48) (34) (50) (49) (48) (48) (32) (34)
100% (32) 86% 84% 100% (52) (51) 82% 86% 84% (52) (51) 78% 82% 77% 75% 75% 74% 78% 77% 75% 75% 70% 74% 80% (39) 70% 80% (39) 61% 60% 61% 60% 60% (20) (20) 60% 46% (20) (20) 46% (11) (9) (9) (9) (12) (13) (6) (11) (9) (9) (12) (9) 40% (13) (6)
40% 24% 24% 24% 24% 17% 14% 14% 14% 14% 13% 13% 17% 14% 14% 14% 14% 20% 13% 13% ~ 20% ~ ~ ~ ~ ~ 0% Drug debt Visible drug use Shoplifting Handling stolen goods intimidation
~Number~ Number too too small small to tobe be reported reported (5 (5or orless) less) Category totals less than 100% as category 'unknown' removed CategoryCategory totals totals less less than than 100% 100% as categoryas category 'unknown' ‘unknown’ removed removed
ChartChart 7. 7.31:31: FrequencyFrequency ofof drugdrug-related-related crime in Dublin 15,15, DATMSDATMS YearYear 3 3 to to 5 5 (2017-2019) (2017-2019)
Frequently 2017 Frequently 2018 Frequently 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019 100%
100% (46) (44) (46) (58) (44) (58) (39) (27) (39) (36) 72% (47) (27)
80% (25) (36) 69% (24) 72% (47) 68%
80% (25) 69% (24) 68% (41) (21) (41) 61% (37) (21) 58% 61% (37) 56% 55% 58% 54% 56% 52% 55% (16)
60% 54% 52% (16) 60% 48% 46% (18) 48% 44% (17) 46% (18) 44% (17) (10) (19) (17) (13) (16) (19) (10) 35% (13) (17) (16) 35% 40% (7) (14) (7) (14) (7) (7) 28% 40% (7) 27% 28% (7) 27% 22% 22% 20% 20% 19% 22% 22% 20% 20% 19% 15% 15% 15% 15% 15% 15%
20% 11%
20% 11%
0% Drug driving Anti-social behaviour Visible drug dealing Burgulary/ robbery
Category totals less than100% as category 'unknown' removed CategoryCategory totals totals less less than100 than 100%% as category as category 'unknown' ‘unknown’ removed removed
98
113 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Chart 7.32: Frequency of drug-related crime in Dublin 15, DATMS Year 3 to 5 (2017-2019) ChartChart 7.7.32:32: Frequency of drug-relateddrug-related crimecrime in in Dublin Dublin 15, 15, DATMS DATMS Year Year 3 3 to to 5 5(2017-2019) (2017-2019) Frequently 2017 Frequently 2018 Frequently 2019 Frequently 2017 Frequently 2018 Frequently 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019 100% 100% (34) (34) (28) 74%
80% (28) (35) (35) (46) 80% 74% (35) (35) (32) (46) (22) (41) 61% (32) (29) (41) (22) (26) 61% (29) 55% 55% 54% (26) 60% (23) (16) 55% 55% 50% 54% (28) 48% 48% (27) 60% (23) (16) (19) 50% 45% (25) (28) 48% 48% (27) (17) (23) (22) (12) (19) 41% (21) 45% (25) (17) (23) (10) (22) (12) 41% 36% (21) 35% 33% (10) (8) 32% 40% 36% (7) 35% 30% 29% 33% (8) 32% 40% 27% 27% (7) 26% 26% 30% 25% 29% 27% 27% 22% 26% 26% 25% 22% 17% 15%
20% 17% 20% 15% 0% 0% Visible alcohol use Firearm offences Violent offences Drink driving Visible alcohol use Firearm offences Violent offences Drink driving Category totals less than100% as category 'unknown' removed CategoryCategory totals totals less less than100% than 100% as categoryas category 'unknown' ‘unknown’ removed removed
ChartChart 7.7.33:33: Frequency of drug-relateddrug-related crimecrime in in Dublin Dublin 15, 15, DATMS DATMS Year Year 3 3 to to 5 5(2017-2019) (2017-2019) Chart 7.33: Frequency of drug-related crime in Dublin 15, DATMS Year 3 to 5 (2017-2019) Frequently 2017 Frequently 2018 Frequently 2019 Frequently 2017 Frequently 2018 Frequently 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019 Sometimes 2017 Sometimes 2018 Sometimes 2019 70%
70% (30) (30) (27)
60% (26) (33) (18) (27)
60% (26) (17) (18) (33) (16) 47% (22) (17) (15) (16) 47% (26) (26) 50% (20) (22) 42% (15) 41%
50% (26) (26) (20) 39% 39% 42% 41% (21) 37% 37% (17) 39% 39% (15) 35% 34% (21) 37% 37% (17)
40% 33% (15) 35% 31% 31% 31% 34%
40% 33% 31% 31% 31% (6) (8) 25% (10)
30% 23% (6) (8) 25% (10)
30% 23% (7) (7) (7) (7) 13% 20% 13% 12%
20% 13% 13% 12% 8% 8% ~ ~ ~ ~ 10% 8% 8% ~ 10% ~ ~ ~ 0% 0% Domestic violence Domestic violence Sex work Cannabis cultivation Domestic violence Domestic violence Sex work Cannabis cultivation among partners child on parent among partners child on parent ~Number~ Number too too small small to to be be reported reported (5 (5or or less) less) ~Number too small to be reported (5 or less) Category totals less than 100% as category 'unknown' removed CategoryCategory totals totals less less than than 100% 100% as ascategory category 'unknown' ‘unknown’ removed removed
Participants reported perceived changes in the frequency of drug-related crime from ParticipantsParticipants reported reported perceived perceived changes changes inin the frequencyfrequency of of drug drug-related-related crime crime from from YearYear 3 3 toto 55 (Charts(Charts 7.3 7.344 and and 7.3 7.37).7). Since Since Year Year 3, an 3, increase an increase in the in frequency the frequency of drug of drugYear debt 3 tointimidation 5 (Charts 7.3 has4 and been 7.3 7reported.). Since Year Year 3, 5an reported increase anin the increase frequency in firearm of drug debt intimidation has been reported. Year 5 reported an increase in firearm offences offencesdebt due intimidation to feuding has between been reported. local drug Year 5gangs. reported an increase in firearm offences due to feuding between local drug gangs. due to feuding between local drug gangs.
99 99
114 CONSEQUENCES OF DRUG & ALCOHOL USE
Chart 7.34: Changes in frequency of drug-related crimes in Dublin 15, DATMS Year 3 to 5 (2017Chart- 7.34:2019) Changes in frequency of drug-related crimes in Dublin 15, DATMS Year 3 to 5 (2017- (20172019)-2019) Increase 2017 Increase 2018 Increase 2019 Increase 2017 Increase 2018 Increase 2019 Decrease 2017 Decrease 2018 Decrease 2019 140% Decrease 2017 Decrease 2018 Decrease 2019 140% No change 2017 No change 2018 No change 2019 No change 2017 No change 2018 No change 2019 120% 120% (56) (56) 100% 88%
100% (45) 88% (56) (45) (30) (54) (56) (30) (54) 80% (49) (49) 70% (32) (32)
80% 66% 70% 65% (22) 64% (32) (32) (38) 66% 65% (22) 64% 58% (19) (38) 58% (19)
60% (22) 50% 50% (15) (15) 48% (19) 60% (22) 50% 50% (15) (15) 45% 48% (19) 41% (11) 45% 41% (11) (12) 34% (8) 33% 33% (14) (12)
40% (12) 30% (6) 34% (8) 33% 33% (14) (9)
40% (12) 30% (6) 24% (9) (7) 24% 19% 17% (7) 16% 19% 14% 13% 17% 16% 20% 11% 14% 13% 8%
20% 11% ~ ~ ~ ~ ~ 8% ~ ~ ~ ~ ~ 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Firearm offences Drug debt Visible drug use Anti-social behaviour Firearm offences Drug debt Visible drug use Anti-social behaviour intimidation intimidation ~Number too small to be reported (5 or less) ~Number~ Number too too small small to tobe bereported reported (5 or(5 less)or less) Category totals less than 100% as category 'unknown' removed CategoryCategory totals totals less less than than 100% 100% as category as category 'unknown' ‘unknown’ removed removed
Chart 7.35: Changes in frequency of drug-related crimes in Dublin 15, DATMS Year 3 to 5 (2017- Chart 7.35: Changes in frequency of drug-related crimes in Dublin 15, DATMS Year 3 to 5 (20172019)-2019) (2017-2019) Increase 2017 Increase 2018 Increase 2019 Increase 2017 Increase 2018 Increase 2019 Decrease 2017 Decrease 2018 Decrease 2019 Decrease 2017 Decrease 2018 Decrease 2019 No change 2017 No change 2018 No change 2019
(52) No change 2017 No change 2018 No change 2019 70% (52) 70% 61% 61% (30) 60% (40) (30) (40) (28) (28)
60% (27) (28) (28) (27) (33) 47% 47% (33) (23) (16)
50% 47% 47% 44% 44% (22) (23) (21) (15) (16) 50% 42% 44% 44% (22) (20) (15) (21) (14) 42% 39% (20) (13) (24) (14) 39% 36% (12) (12) (12) (24) (13) 40% 35% 34% (20) 36% (12) (12) (12) 33% 33% 40% 35% 34% (20) 31% 33% 33% 30% (16) 31% 28% 28% 30% (8) (16) 26% 26% 26% (14) 30% 28% 28% (8) 24% 26% 26% 26% 30% (14) 24% (9) 19% (9) 17% 19% 16%
20% 17% 20% 16% 11% 11%
10% ~ ~ ~ ~ ~ ~
10% ~ ~ ~ ~ ~ ~ 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Visible drug dealing Drug driving Handling stolen goods Burgulary/robbery Visible drug dealing Drug driving Handling stolen goods Burgulary/robbery ~Number too small to be reported (5 or less) ~Number~ Number too too small small to tobe bereporte reportedd (5 or(5 less)or less) Category totals less than 100% as category 'unknown' removed CategoryCategory totals totals less less than than 100% 100% as category as category 'unknown' ‘unknown’ removed removed
100 100
115 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Chart 7.36: Changes in frequency of drug-related crimes in Dublin 15, DATMS Year 3 to 5 (2017ChartChart -7.3 2019)7.36:6: Changes in frequencyfrequency ofof drug-related drug-related crimes crimes in inDublin Dublin 15, 15, DATMS DATMS Year Year 3 to 35 to(2017- 5 (20172019)-2019) Increase 2017 Increase 2018 Increase 2019 Increase 2017 Increase 2018 Increase 2019 Decrease 2017 Decrease 2018 Decrease 2019 Decrease 2017 Decrease 2018 Decrease 2019 No change 2017 No change 2018 No change 2019 No change 2017 No change 2018 No change 2019 80% 80% (44)
70% (22) (44) (21) (29)
70% (22) (21) (26) (29) (18) (25) (25)
60% (24) 52% (24) (26) 48% (25) (25) (18) (29) (24) (24) 60% 52% (21) 46% (26) 45% 48% (29) (21)
50% (18) (13) 46% 41% 45% (26) 39% 39% 39% 38% (11) 38% (11) (18) 50% (13) 41% (10) 39% 39% 39% 34% (17) 38% 38% (11) (11) 40% (16) 33% (10) 31% (8) 30% 30% (14) 34% (17) (13) (13) (13) (16) 33% 40% 28% 28% 31% (8) 30% 30% (14) (13) (13) (13) 24% 24% 28% 28%
30% 22% 20% 24% 24% 19%
30% 22% (6) 17% 20% 15% 15% 15% 19% (6) 20% 17% 15% 15% 20% 15% 7% ~ ~ ~ ~ ~
10% 7% ~ ~ ~ ~ ~ 10% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Shoplifting Domestic violence Violent offences Domestic violence Shoplifting Domestic violence Violent offences Domestic violence child on parent among partners child on parent among partners ~Number too small to be reported (5 or less) ~Number~ Number too too small small to beto bereported reported (5 or (5 less) or less) Category totals less than 100% as category 'unknown' removed CategoryCategory totals totals less less than than 100% 100% as category as category 'unknown' ‘unknown’ removed removed
ChartChart 7.3 7.37:7:: ChangesChanges inin frequencyfrequencyfrequency of ofof drug-related drugdrug--relatedrelated crimes crimescrimes in inDublinin Dublin Dublin 15, 15, DATMS15, DATMS DATMS Year Year Year3 to 3 5 3 to(2017- to 5 5 (20172019)-2019) IncreaseIncrease 20172017 IncreaseIncrease 2018 2018 IncreaseIncrease 2019 2019 DecreaseDecrease 20172017 DecreaseDecrease 2018 2018 DecreaseDecrease 2019 2019 NoNo changechange 20172017 NoNo change change 2018 2018 NoNo change change 2019 2019 (28) 80% (28) 70%
70% 61% (39) 61% (39) 60% (16) (22) (16) 46% (22) (26) (20) 46% (19) (26) (20)
50% (19)
50% (17) (12) (17) (12) (19) 35% (18) (19) 34% 35% (18)
40% 34% 31% 31%
40% (11) 30% 31% 31% (11) (13) 30% (9) (13) 27% (8) (6) (9) 26% 27% (6) (8) (9) (7) (7) 26% 30% (7) (9) (7) 22%
30% 21% 22% 21% (7) (7) (6) (6) 17% (7) (7) (6) (6) 17% 15% 14% 15% 13% 13% 20% 14% 13% 13% 11% 11% 20% 11% 11% 11% 11% 8% 8% 7% 7% 8% 8% 7% 7% ~ ~ ~ ~ ~ ~ ~ ~ 10% ~ ~ ~ ~ ~ ~ ~ ~ 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% 0% Visible alcoholalcohol useuse DrinkDrink driving driving SexSex work work CannabisCannabis cultivation cultivation ~ Number too small to be reported (5 or less) ~Number too small toto bebe reportedreported (5(5 oror less) less) CategoryCategory totals totals less less thanthan than 100%100% 100% asas category categoryas category 'unknown' 'unknown' ‘unknown’ removed removed removed
101101
116 CONSEQUENCES OF DRUG & ALCOHOL USE
Drug debt intimidation SimilarDrug todebt previous intimidation DATMS reports, drug debt intimidation takes many forms including forcing Similar to previous DATMS reports, drug debt intimidation takes many forms victimsincluding to hold forcing or deal victims drugs toor hold firearms or deal todrugs pay off or debts.hold firearmsThis could topartly pay explain off debts. the perceivedThis could increase partly in explain the number the perceivedof people dealing increase drugs in si thence numberYear 230. Gardaiof people intervention dealing 30 wasdrugs rarely since sought Year (Chart 2 7.3. Gardai8), with interventionvictims and families was payingrarely debtssought to protect (Chart their 7.38), families. with victims and families paying debts to protect their families.
ChartChart 7.37.38:8: ReportingReporting ofof drugdrug debtdebt intimidationintimidation toto Gardai,Gardai, DATMSDATMS YearYear 33 to to 5 5 (2017-2019) (2017-2019)
2017 2018 2019 80% 65% 66% (55) (42) 60% 46% (21) 28% 40% 26% 23% (13) 16% (12) 19% 11% (15) (14) (16) 20% (7)
0% Yes No Unknown
FromFrom Year Year 3 to 3 5, to participants 5, participants reported reported that drug thatdebt drugintimidation debt intimidationwas rarely reported was torarely the Gardaireported because: to the Gardai because:
• Victims were fearful the intimidation would escalate • •Victims Victims were were fearful fearful of the highlighting intimidation theirwould criminal escalate activity • •Perception Victims were that fearful Gardai of hdidighlighting not have their the criminal capacity activity to eradicate the intimidation • Gardai Perception data for Year that Gardai1 and 2did stated not have that the the capacity number to oferadic familiesate the reporting intimidation drug debt intimidation to Gardai were too small to be reported (to protect anonymity). In Year Gardai3 and 4, data An forGarda Year Síochána 1 and 2 reported stated that that the drug number debt ofintimidation families reporting remains drug an issue debt in Dublin 15, though due to the confidentiality of the Drug Related Intimidation intimidation to Gardai were too small to be reported (to protect anonymity). In Year 3 and 4, Reporting Programme no data concerning these drug-related offences could be Anprovided. Garda Síochána Year 5 reported reported that an drug increase debt intimidation in the number remains of an drugissue indebt Dub linintimidation 15, though duecases to thereported confidentiality to the of Drug the Drug Related Related Intimidation Intimidation Reporting Programme Programme. no data An Garda Síochána reported that this increase was more likely due to an increase concerning these drug-related offences could be provided. Year 5 reported an increase in the in awareness about the service rather than an increase in the incidence of this numbercrime. Whileof drug it debt is difficult intimidation to quantify cases reported the extent to the of Drug drug Related debt intimidationIntimidation Reporting in Dublin Programme.15, as reported An Garda above, Síochána since reported Year 3 thatparticipants this increase continue was more to likely report due an to increase an increase in the incidence of this drug-related crime.
30 Reported in the chapter ‘Factors contributing to drug use’
102
30 Reported in the chapter ‘Factors contributing to drug use’
117 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
8. DRUG-RELATED LITTER
Since the first DATMS we have focused on drug-related litter as a way of evaluating the real levels of drug use within Dublin 15. Drug-related litter is defined as drug paraphernalia that has been improperly discarded. It provides a way to add to existing information sources about local drug use. Drug-related litter is tangible, incontrovertible proof of drug use in the area in which it is found. It is a current indicator of the type of drugs being consumed and the methods of use.
In Year 1 we examined the visibility of drug use in six local communities. We did this by walking throughout these neighbourhoods and photographing what we found. Each photo was geo-tagged. In Year 2 and 5, we mapped this litter and extended the survey to the whole of Dublin 15. In Year 2 we reached some conclusions that were also evident in Year 5:
• Year 2 and 5 identified a large geographical spread of drug litter throughout Dublin 15, identifying drug and alcohol use is a community wide issue crossing all socio-economic boundaries • In Year 2, the largest concentrations of drug litter were found outside areas more traditionally associated with drug use; in Year 5, the largest concentrations of drug litter were found throughout Dublin 15, in areas associated with both affluence and socio-economic deprivation • Concentrations of drug litter did not always correlate with the distribution of existing service users indicating the presence of drug user who have not engaged with services • Concentrations of drug litter in close proximity to schools
118 DRUG-RELATED LITTER
YEAR 2 Drug Litter in Dublin 15
119 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
YEAR 5 Drug Litter in Dublin 15
120 YEAR 5 (2019) DRUG LITTER IN DUBLIN 15
121 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
122 The following analysis involves a comparison of drug-related litterDRUG-RELATED found in Year 2 and LITTER 5. From Year 2 to 5, there was an 82% increase in the amount of drug-related litter found in Dublin 15 The following analysis involves a comparison of drug-related litter found in Year 2 and 5. From (Chart 8.1). This may be due to an increase in the use of alcohol and drugs within the YearThe 2following to 5, there analysis was an 82% involves increase a comparison in the amount of of drug-related drug-related litterlitter found found in in Dublin Year 152 community. In several areas throughout Dublin 15, residents and community groups remove (Chartand 5. 8.1).From This Year may 2 to be 5, due there to was an increase an 82% in increase the use in of the alco amounthol and of drugs drug-related within the druglitter- relatedfound litterin Dublin on a regular15 (Chart basis. 8.1). It isThis interesting may be to due note to that an increaseif this activity in the was use not of in community. In several areas throughout Dublin 15, residents and community groups remove placealcohol more and drug drugs-related within litter the would community. have been Inreported several in Yeareasar 2 andthroughout 5. Dublin 15, drugresidents-related and litter community on a regular groups basis. Itremove is interesting drug-related to note thatlitter i fon th isa activityregular w basis.as not Itin placeis interesting more drug to-related note thatlitter ifwould this activityhave be enwas reported not in in place Year 2more and 5. drug-related litter Chartwould 8.1: have Amount been of reported drug-related in Year litter, 2 DATMSand 5. Year 2 and 5 (2016 & 2019)
Year 2 Year 5 ChartChart 8.1:8.1: Amount ofof drug-relateddrug-related litter, litter, DATMS DATMS Year Year 2 2and and 5 5(2016 (201 &64687 2019)& 2019) 6000 (↑ 82%) Year 2 Year 5 4000 4687 6000 2580 (↑ 82%) 2000 4000 2580 0 2000 Year 2 Year 5
0
Year 2 Year 5
VISIBLE AND HIDDEN DRUG LITTER SITES
DrugVISIBLE-related AND litter HIDDENwas found DRUGin visible LITTER and hidden SITES locations throughout Dublin 15. Hidden VISIBLE AND HIDDEN DRUG LITTER SITES sitesDrug-related included are litteras where was found the environment in visible and provided hidden privacy locations for the throughoutuse of drugs. DublinThese areas 15. DrugHidden-related sites litter included was found areas in wherevisible andthe hiddenenvironment locations provided throughout privacy Dublin for 15. the Hidden use are places that are covered by trees, in parks, behind walls or in derelict buildings. Visible sites of drugs. These areas are places that are covered by trees, in parks, behind walls sites included areas where the environment provided privacy for the use of drugs. These areas includedor in derelict a range buildings. of locations Visible such sites as housing included estates, a range on roads, of locations at shops such or in as parks. housing From are places that are covered by trees, in parks, behind walls or in derelict buildings. Visible sites Yearestates, 2 to Yearon roads, 5, drug -atrelated shops litter or inhas parks. become From less visibleYear 2 in to Dublin Year 155, (Chartdrug-related 8.2). litter includedhas become a range less of visiblelocations in suchDublin as housing15 (Chart estates, 8.2). on roads, at shops or in parks. From
Year 2 to Year 5, drug-related litter has become less visible in Dublin 15 (Chart 8.2). ChartChart 8.8.2:2: Number ofof drugdrug litterlitter sites sites by by type, type, DATMS DATMS Year Year 2 2 and and 5 5 (2016 (201 6& &2019) 2019)
Year 2 Year 5 Chart 8.2: Number of drug litter sites by type, DATMS Year 2 and 5 (2016 & 2019) 250 194 Year 2 Year 5 166 (100%) 200 139 (100%) 103 (72%) 150250 194 (62%) 63 166 (100%) 200 55 139 100 (38%) (100%) 103 (28%) (72%) 15050 (62%) 55 63 100 0 (28%) (38%) 50 Visible sites Hidden sites Total sites
0 Visible sites Hidden105 sites Total sites • In Year 2 and 5, the highest concentrations of drug-related litter were at the hidden sites, suggesting these sites were used for drug consumption 105 • From Year 2 to 5, there was an increase in the number of hidden sites used
123 • In Year 2 and 5, the highest concentrations of drug-related litter were at the hidden sites, suggesting these sites were used for drug consumption DRUG AND ALCOHOL TRENDS • MONITORING From Year SYSTEM 2 to 5, there YEAR was an increase5 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 (Chart 8.3); these sites were located in both affluent and socio-economically fordeprived smoking communities drugs and 31drinking alcohol, and a decrease in the number of sites for injecting drug use (Chart 8.3); these sites were located in both affluent and • 63 (45%) of the hidden sites used for alcohol and/or drug consumption in Year 5, were socio-economically deprived communities31 • 63 found(45%) in of Year the 1 hidden or 2; thus, sites evidence used for that alcohol these sites and/or have drug been consumption used repeatedly in overYear a 5, werefive-year found period in Year 1 or 2; thus, evidence that these sites have been used repeatedly over a five-year period
ChartChart 8. 8.3:3: NumberNumber of hidden drugdrug litterlitter sites sites by by type, type, DATMS DATMS Year Year 2 2and and 5 5(2016 (201 &6 2019)& 2019)
Year 2 Year 5
150 (71%) 99 100 (76%) (17%) (24%) 48 (16%) (1%) 50 23 15 10 2 0 Hidden Hidden Hidden alcohol sites smoking sites injecting injecting sites The following photos show a number of hidden sites found in Dublin 15. Some Theof thesefollowing sites pho weretos show found a number in Year of1 hiddenor 2 and sites continue found in to Dublin be used 15. Some for alcohol of these and sites drug consumption. These sites highlight how the environment supports the use were found in Year 1 or 2 and continue to be used for alcohol and drug consumption. These of alcohol and drugs. sites highlight how the environment supports the use of alcohol and drugs. This first hidden site was well prepared, and the evidence suggested it was frequently used (Photos 1 to 2). This was a hidden site found in Year 1 that continues This first hidden site was well prepared, and the evidence suggested it was frequently used to be used for alcohol and drug consumption. The site is set within the ruins of (Photosa building; 1 to 2).a Thischair was provides a hidden some site found comfort in Year while 1 that using continues drugs, to andbe used a makeshift for alcohol andtray drug has consumption. been fashioned The siteto facilitateis set within the the preparation ruins of a building; of drugs a chairfor smoking provides someand injecting. Smoking and injecting equipment included homemade pipes, tin foil comfort while using drugs, and a makeshift tray has been fashioned to facilitate the with traces of heroin, used stericups and an empty cigarette related to smoking preparationcannabis. Evidenceof drugs for of smokingthe use andof alcohol injecting. and Smoking prescribed and injecting medication equipment (empty included bottle homemadeof methadone pipes, and tin foilpacket with tracesof benzodiazepines) of heroin, used stericups was also and found an empty at this cigarette site. related
31 Further data concerning injecting drug use is reported is the chapter ‘Treated drug & alcohol use’
106
31 Further data concerning injecting drug use is reported is the chapter ‘Treated drug & alcohol use’
124 DRUG-RELATED LITTER
Photo 1
Photo 2
Photo 3 shows a hidden site in a forest. It highlights how the environment provides seclusion for the use of alcohol and drugs. This hidden site was found in Year 2 and three years later it continues to be used for alcohol consumption.
125 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Photo 3
Photo 4 shows another hidden site in a forest. This hidden site was found in Year 2 and it continues to be used for smoking drugs and alcohol consumption. The equipment for smoking cannabis was hidden under a plastic box suggesting the site was used repeatedly. The smoking equipment included a grinder for preparing cannabis herb. Other drug-related litter included empty bottles of alcohol and empty drug bags and containers.
Photo 4
126 DRUG-RELATED LITTER
Photo 5 shows a hidden site used for the consumption of alcohol and cannabis. This hidden site was found in Year 5. The equipment for smoking cannabis includes cigarette papers and empty drug bags. Other drug-related litter included empty bottles of alcohol.
Photo 5
127 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
Photo 6 shows a hidden site in a park used for the consumption of heroin and crack cocaine. This hidden site was found in Year 5. The equipment for smoking crack cocaine included homemade pipes. The equipment for smoking heroin included tin foil with traces of heroin.
Photo 6
128 DRUG-RELATED LITTER
Photo 7 shows a hidden site in a forest used for alcohol and drug consumption including injecting drug use. This hidden site was found in Year 1. The equipment for injecting drugs included a syringe. Evidence of the use of alcohol and prescribed medication (empty methadone bottles and packet of zopiclone) was also found at this site.
Photo 7
ANALYSIS OF DRUG-RELATED LITTER BY TYPE Analysis of drug-related litter found throughout Dublin 15 in Year 2 and 5 reports the following:
• Increase in amount of litter associated with legal drugs (Chart 8.4) • Alcohol remains the most common type of drug-related litter (Chart 8.5) • Alcohol-free-related litter was first reported in Year 532 (Chart 8.6) • Increase in smoking-related litter associated with the use of heroin and crack cocaine (Chart 8.7) • Decrease in the amount of injecting-related litter (Chart 8.8)33 • Benzodiazepines and z drugs were the most common prescribed drug-related litter (Chart 8.9)
32 Further data concerning the use of alcohol-free drinks is reported in the chapter ‘Untreated drug and alcohol use’ 33 Further data reporting a reduction in injecting drug use is reported is the chapter ‘Treated drug & alcohol use’
129 32 • Alcohol-free-related litter was first reported in Year 532 (Chart 8.6) • Increase in smoking-related litter associated with the use of heroin and crack cocaine (Chart 8.7) 33 • Decrease in the amount of injecting-related litter (Chart 8.8)33 DRUG• ANDBenzodiazepines ALCOHOL and TRENDS z drugs were the most common prescribed drug-related litter MONITORING SYSTEM YEAR 5 (Chart 8.9)
ChartChart 8.4:8.4: DrugDrug-related-related litterlitter by by legal legal status, status, DATMS DATMS Year Year 2 2 and and 5 5(2016 (201 6& &2019) 2019)
Year 2 Year 5
5000 4484 (96%) 4000 3000 3000 2300 (89%) 2000
1000 280 (11%) 280 (11%) 203 (4%) 0 Legal drugs^ Illegal drugs*
^^ Alcohol, Alcohol, prescribed prescribed & & over over-the-counter-the-counter drugs, drugs, aerosols aerosols * Drug bags/containers, smoking and injecting equipment ** Drug bags/containers,bags/containers, smoking smoking and and injecting injecting equipment equipment
ChartChart 8.5:8.5: DrugDrug-related-related litterlitter by by type, type, DATMS DATMS Year Year 2 2and and 5 5(2016 (201 6& &2019) 2019)
Year 2 Year 5
7000 (95%) 7000 (95%) 6000 4448
5000 4448 5000 (86%) (86%) 4000
3000 2231
3000 2231 (5%) (2%)
2000 (5%) (2%) (4%) (2%) (2%) (2%) (2%) (0.7%) 2000 (0.7%) (4%) (2%) (2%) (2%) (2%) (0.7%) (0.7%) (0.3%) (0.2%) (0%) (0.04%) (0.2%) (0%) (0.3%) (0.04%) 127 1000 117 91 78 62 50 34 18 8 1 0 2
1000 127 117 78 91 62 50 34 8 18 0 1 2 0 Alcohol Alcohol Inhalants Smoking Injecting Inhalants OTC drugs Drug Smoking Injecting equipment equipment OTC drugs Drug equipment equipment bags/containers Prescribed drugs bags/containers Prescribed drugs ChartChart 8.6: 8.6: AlcoholAlcohol-related-related litter byby type,type, DATMSDATMS YearYear 2 2 and and 5 5 (2016 (2016 & & 2019) 2019) 32 32 Further data concerning the use of alcohol-free drinks is reported in the chapter ‘Untreated drug Further data concerning the use of alcoholYear-free 2 drinksYear 5is reported in the chapter ‘Untreated drug and alcohol use’ 33 338000 Further data reporting a reduction in injecting drug use is reported is the chapter ‘Treated drug & Further data reporting(98%) a reduction in injecting drug use is reported is the chapter ‘Treated drug & alcohol use’ alcohol6000 use’ (98%) 4366 4000 112
2187 (1%) (1.7%) (0.5%) 2000 (0.3%) (0%) (0.2%) (0.1%) (0%) 46 38 22 0 14 5 1 0 0 Spirits Alcopop Wine/sparkling Beer/cider/stout Alcohol free beer Alcohol free
Chart 8.7: Smoking-related litter by type, DATMS Year 2 and 5 (2016 & 2019)
Year 2 Year 5 130
80 (54%)
70 63 60 50 (30%) 40 (21%) (22%) 27 (13%) 25 (14%) 30 (13%) 20 15 (10%) (7%) 13 12
20 (6%) (4%) 9 8 (2%) (2%) (1%) (1%) (0%) (0%) (0%) (0%) (0%) 5 5 2 2
10 1 1 0 0 0 0 0 0 Bong/pipe papers Heroin tutor cigarette Empty cigarettes Cannabis Cannabis grinder Pack of cigarette of Pack material) (roach Tinfoil roll/sheets Torn cigarette box Roach forRoach cannabis Foil crack pipe head Foil with traces Foil heroin
113
Chart 8.6: Alcohol-related litter by type, DATMS Year 2 and 5 (2016 & 2019)
Year 2 Year 5 8000 (98%) 6000 (98%) 4366 4000 2187 (1%) (1.7%) (0.5%) 2000 (0.3%) (0%) (0.2%) (0.1%) (0%) 46 38 22 0 14 5 1 0 0 Spirits Alcopop
DRUG-RELATEDWine/sparkling LITTER Beer/cider/stout Alcohol free beer Alcohol free
ChartChart 8.7:8.7: SmokingSmoking-related-related litter byby type,type, DATMSDATMS YearYear 2 2 and and 5 5 (2016 (2016 & & 2019) 2019)
Year 2 Year 5
80 (54%)
70 63 60 50 (30%) 40 (21%) (22%) 27 (13%) 25 (14%) 30 (13%) 20 (10%) 15 (7%) 13 12 (6%) 20 (4%) 9 (2%) (2%) 8 (1%) (1%) (0%) (0%) (0%) (0%) (0%) 5 5 2 2 1 10 1 0 0 0 0 0 0 Bong/pipe papers Heroin tutor cigarette Empty cigarettes Cannabis Cannabis grinder Pack of cigarette of Pack (roach material) (roach Tinfoil roll/sheets Torn cigarette box Roach forRoach cannabis Foil crack pipe head Foil with traces Foil heroin
ChartChart 8.8:8.8: InjectingInjecting-related-related litterlitter by by type, type, DATMS DATMS Year Year 2 2and and 5 (20165 (201 &6 2019)& 2019)
Year 2 Year 5
30
25 (29%)
20 (22%) 18 (16%) 14
15 (14%)
10 9 (74%) 10 (10%) 6 6 (5%) (13%) (13%) (2%) (2%)
3 (0%) (0%) (0%) (0%) 5 (0%) 1 1 1 1 0 0 0 0 0 0
113 Citric acid wrappers Sharps bin Sharps Syringes & Tourniquet wrappers Sterile water Sterile Alcohol Alcohol swab Stericups Stericups and Needles, needle Needles, caps & capswrappers
Chart 8.9: Prescribed and OTC drug-related litter by type, DATMS Year 2 and 5 (2016 & 2019)
Year 2 Year 5 40 (44%)
35 (79%) 30
30 27 25 (27%) 20 18 15 (10%) (21%) (7%) (6%) 10 7 7 (3%) (3%) 5 4 (0%) (0%) (0%) (0%) (0%) 5 2 2 0 0 0 0 0 0
Opiate 131 drug OTC codeine Anti-epileptic Anti-psychotic Anti-depressant Benzodiazepine/z Anti-inflammatory
114
Chart 8.8: Injecting-related litter by type, DATMS Year 2 and 5 (2016 & 2019)
Year 2 Year 5 30
25 (29%)
20 (22%) 18 (16%) 14
15 (14%) 10 9 10 (74%) (10%) 6 6 (5%) (13%) (2%) (2%) (13%) 3 5 (0%) (0%) (0%) (0%) (0%) 1 1 1 1 0 0 0 0 0 0 Citric acid wrappers Sharps bin Sharps Syringes & Tourniquet wrappers Sterile water Sterile Alcohol Alcohol swab DRUG AND ALCOHOL TRENDS Stericups and Needles, needle Needles, MONITORING SYSTEM& capswrappers YEAR 5
Chart 8.9: Prescribed and OTC drug-related litter by type, DATMS Year 2 and 5 (2016 & 2019Chart) 8.9: Prescribed and OTC drug-related litter by type, DATMS Year 2 and 5 (2016 & 2019)
Year 2 Year 5 40 (44%)
35 (79%) 30
30 27 25 (27%) 20 18 15 (10%) (21%) (7%) (6%) 7 10 7 (3%) (3%) 5 4 (0%) (0%) (0%) (0%) (0%) 5 2 2 0 0 0 0 0 0 Opiate drug OTC codeine Anti-epileptic Anti-psychotic Anti-depressant Benzodiazepine/z Anti-inflammatory
114
132 SCHOOL ATTENDANCE SUPPORTS
9. SCHOOL ATTENDANCE SUPPORTS
In 2017, the BLDATF determined, using research on risk factors for drug and alcohol misuse, that one of the strongest protective factors for children was school attendance. We then set about looking at factors that militated against school attendance.
One of the strongest factors is educational disability or inability. Children who need specialist services to allow them to fully participate in education face long waiting lists for such services and cannot access special educational assistance without psycho-educational and clinical assessments. As a long-term prevention intervention, the BLDATF intervened to facilitate this access for the most socio- economically disadvantaged cohort of children in the Dublin 15 area. Each year, we work in close partnership with schools to identify children in need, who are then funded to access educational and clinical assessments and concomitant therapies in a timely manner. These services are provided by a multi-disciplinary team. These services are funded by the BLDATF with support from Tusla, Child and Family Agency.
In Year 5, 17 children received support for psychological issues. This support took the form of intake psychology consultations, psychological assessments and interventions. Intake psychology consultations occurred between a parent and clinical psychologist. The aim was to establish any concerns in relation to the child’s development and behaviour and assess whether the child required psychological assessment. Psychological assessments included speech and language, educational and cognitive, and teacher interviews. Teacher interviews reported an educational perspective concerning the child’s progress and participation in class, and an emotional and behavioural perspective with their peers. Psychological interventions included occupational therapy and cognitive behavioural therapy. A breakdown of support received is reported in the chart below (Chart 9.1).
ChartChart 9.1:9.1: Psychological serviceservice provision,provision, DATMS YeaYearr 5 (2019) 20 17 14 15 12 10
5
0 Intake Psychology Consultation Assessments Interventions
133
116
DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
10. SERVICE PROVISION
This section reports strengths and gaps in local service provision identified by research participants in Year 5.
STRENGTHS OF ADDICTION SERVICES IN DUBLIN 15 Strengths underlined were also reported in previous DATMS reports. • 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 operation of BLDATF Family Support Service and D15 CAT • Family support groups (both peer and facilitated) 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 due to high risk of overdose
GAPS IN SERVICE PROVISION IN DUBLIN 15 Gaps underlined were also reported in previous DATMS reports. Barriers to accessing treatment and to social rehabilitation are highlighted in italics.
EDUCATION & PREVENTION • Improve drug prevention programmes for under 18s; service provision to include: • Information about drug use, mental health and reducing the stigma associated with seeking help for drug or mental health issues • Drug education prevention training for secondary school guidance counsellors • Increase knowledge of local service provision on a local and targeted basis; service provision to include: • Public awareness of service provision • Encourage help seeking behaviours and highlight confidentiality of service provision • Training/apprenticeships required for early school leavers • Increase access to skills-based parenting courses; service provision to include one-to-one support in the home setting
134 SERVICE PROVISION
TREATMENT • Improve treatment programmes young people aged 18 to 25 years; service provision to include: • Work experience/apprenticeships • Service provision to pro-actively attract the most vulnerable and hard-to- reach as most young drug users do not perceive the need for treatment • Improve accessibility of treatment programmes; service provision to include: • Part-time day programmes for women who have children • Improve access to childcare • Develop a stabilisation programme for non-opioid polydrug users; service provision to be provided on a one-to-one capacity in preparation for group work • Increase one-to-one keyworking capacity in D15 CAT; group programmes were reported to be a barrier to accessing treatment for alcohol and cannabis use • Improve access to D15 CAT cannabis programme; the service supports young people aged up to 25 years, there is the need for this service for people aged 25 years and over • Out-of-hours treatment service including weekends • Drop-in service provision for drug users and family members; service provision to include homeless service providing food, showers, referrals to housing supports • Increase access to harm reduction services; service provision to include pipes for smoking crack cocaine • Improve access to naloxone, the antidote to an opioid overdose • Integrate counselling and rehabilitation services into methadone maintenance treatment • Improve access to benzodiazepine and heroin detoxification programmes including community-based services • Increase access to counselling, mental health clinical assessments and treatment services for children, young people and adults; service provision to include: • Out-of-hours services • A comprehensive dual diagnosis service for the treatment of all drug types involving partnerships with community, voluntary and statutory mental health and addiction services • In-school counsellors in both primary and secondary schools that are free of charge
135 DRUG AND ALCOHOL TRENDS MONITORING SYSTEM YEAR 5
REHABILITATION • Improve access to aftercare services; service provision to include: • Drug-free social club • Facilitated support services • Increase access to training, employment and apprenticeships • Increase access to housing
136 REFERENCES
REFERENCES
Central Statistics Office (2006, 2011, 2016) Electoral Division and Small Area Analysis Pobal Maps CSO Population Census 2006, 2011, 2016. Downloaded from www.census.cso.ie
European Monitoring Centre for Drugs and Drug Addiction (2020) European Drug Report 2020: Trends and Developments. Publications Office of the European Union, Luxembourg.
Galligan K & Comiskey C (2019) Hidden harms and the number of children whose parents misuse substances: A stepwise methodological framework for estimating prevalence, substance use and misuse. Substance Use & Misuse, Early online.
Health Research Board (2019) National Drug-Related Deaths Index 2008 to 2017 data. Available at: http:/www.drugsandalcohol.ie/31275 and at www.hrb.ie/publications
National Advisory Committee on Drugs and Alcohol (2016) Prevalence of drug use and gambling in Ireland and drug use in Northern Ireland. Bulletin 1. Dublin: National Advisory Committee on Drugs and Public Health Information and Research Branch, Dublin.
Winstock AR, Barratt MJ, Maier LJ, Aldridge A, Zhuparris A, Davies E, Hughes C, Johnson M, Kowalski M and Ferris JA (2019) Global Drug Survey (GDS) 2019 Key Findings Report. Available at: https://issuu.com/globaldrugsurvey/docs/gds2019_key_findings_report_may_16_
137 NORMALISATION
MENTAL HEALTH
DRUGS
ALCOHOL
INTIMIDATION NORMALISATION
MENTAL HEALTH
DRUGS
ALCOHOL
INTIMIDATION
Blanchardstown LDATF 37a Coolmine Industrial Estate, Blanchardstown, Dublin 15, D15 X6XD T: 01 824 9590 W: www.bldtf.ie