This report on Needle Exchange Provision in Ireland is aimed at improving needle exchange coverage and enhancing service delivery as a way of reducing rates of new HCV and HIV infection and charts a way forward in identifying potential care pathways for drug and alcohol services in this country.
This policy brief examines the expansion of drug markets on the Dark Net or ‘hidden web’
and the challenges they pose for both law enforcement agencies and the international
legal framework within which those agencies ultimately operate. The Dark Net drug markets
are one manifestation of an increasingly complex, transnationalised and lucrative trade
that the extant United Nations drug control system, and the treaties upon which it is based,
is poorly positioned to address.
Silk Road is located on the Deep Web and provides an anonymous transacting infrastructure for the retail of drugs and pharmaceuticals. Members are attracted to the site due to protection of identity by screen pseudonyms, variety and quality of product listings, selection of vendors based on reviews, reduced personal risks, stealth of product delivery, development of personal connections with vendors in stealth modes and forum activity. The study aimed to explore vendor accounts of Silk Road as retail infrastructure.
The online drug marketplace called ‘Silk Road’ has operated anonymously on the ‘Deep Web’ since 2011. It is accessible through computer encrypting software (Tor) and is supported by online transactions using peer to peer anonymous and untraceable crypto-currency (Bit Coins). The study aimed to describe user motives and realities of accessing, navigating and purchasing on the ‘Silk Road’ marketplace.
The online promotion of ‘drug shopping’ and user information networks is of increasing public health and law enforcement concern. An online drug marketplace called ‘Silk Road’ has been operating on the ‘Deep Web’ since February 2011 and was designed to revolutionise contemporary drug consumerism.
The research was undertaken at a time of increasing public concerns for drug- and alcohol-related public nuisance in the city center of Dublin, Ireland. Rapid Assessment Research was conducted involving qualitative interviewing with drug service users; business, transport, community, voluntary, and statutory stakeholders (n = 61); and an environmental mapping exercise. The interplay between homelessness, loitering, an influx of drug users via city metro systems, transient open drug scenes, street drinking, drug injecting, intimidation, knife crime, and prescribed medication abuse was evident. Potential strategies to address drug and alcohol related public nuisance are advised to include the relocation of treatment services, targeted harm reduction initiatives, urban regeneration, improved community rehabilitation pathways, and heightened policing intensity.
Mephedrone injecting has recently been reported in Romania, Slovenia, Guernsey and Ireland. The research reported here aimed to describe the experiences of a group of Irish injecting drug users, who were injecting mephedrone based headshop products prior to the introduction of legislative controls in Ireland, with particular focus on pre- and post-legislative use, effects of injecting mephedrone, settings and contexts for injecting, polydrug use and serial drug injecting, risk perceptions and harm reduction practises.
According to the European Monitoring Centre for Drugs and Drug Addiction, there are between 1.2 and 1.5 million opiate dependent individuals in the European Union (EMCDDA, 2010) with an estimated 18,136 and 23,576 opiate users resident in Ireland (Kelly et al., 2009). Approximately 11,807 opiate users in Ireland are known to services and are predominantly aged between 25 and 34 years, male, early school leavers, unemployed (Kelly et al., 2009; Carew et al., 2009). In terms of treatment data, records show an increase in both prevalence and incidence rates among 15 to 64 year olds, with 11,538 cases treated in 2007 (Carew et al.2009). One quarter of treatment cases in 2007 had stabilised prior to treatment entry and were on methadone maintenance (Long and Lyons, 2009). However, the chronic relapsing nature of opiate dependency remains evident with more than half of these cases needing more than one treatment intervention (Carew et al., 2009).
The researchers utilised a mixed method approach using focus groups with the Client forum representatives of the Special Community Employment schemes, and a series of in- depth interviews with individuals attending the Special Community Employment schemes in the Dublin North East Drug Task Force area.
The research and ultimate strategic recommendations are focused on the area between Christchurch and the Irish Financial Services Centre and from Parnell Square to St Stephen’s Green (the focus area). On behalf of the SRG I would like to thank the authors, Dr Marie Claire Van Hout and Tim Bingham for completing the research within the extremely limited time frame made available. I would also like to thank the Garda Síochána Analysis Service for providing the data presented in Chapter 4 which was derived from the Garda Síochána PULSE system. We also wish to thank the services users, members of the business community and transport representatives for their participation in the research. As this research shows, substance-related anti-social behaviour is an elusive issue to define. It can involve a range of actual activities such as harassment and intimidation and also behaviour such as congregation in groups or shouting that is not intended to offend but can do so. At the same time, the right of people to use and enjoy the civic space must be tempered by the responsibility to use it in a way that does not unduly impinge on the rights and entitlements of others.
The Research highlights the presence of individual strategies and attempts to achieve abstinence, which include self-detoxification attempts without formal medical assistance and/or with the help of drugs and/or alcohol. Detoxification and the achievement of abstinence is possible without formal treatment and is often preferred with community based supports from local General Practitioners, family and other users. The need for an increase in community and residential detoxification services in Ireland has been articulated at national and local level. Several Community Detox protocols and initiatives have been developed in Ireland.
Methadone maintenance treatment [MMT] is recognized as an effective treatment for opiate dependence. It is provided in Ireland in addiction clinics and for stabilized patients in primary care. The aim of the study was to explore doctor’s experiences of methadone prescribing, therapeutic alliance and methadone treatment pathways. Semi structured interviews were conducted with a convenience sample of prescribing doctors (n = 16). Thematic analysis of narratives was undertaken. Observations around MMT were positive in reducing harm associated with injecting drug use and opiate dependence, and represented an important turning point for patients. Doctor efforts to assist their patients were grounded in positive, empathic relationships. Some concerns were relayed with regard to prescribing restrictions. Participants commented on the need for policy makers to consider the expansion of MMT provision to include alternative pharmacological approaches, improved interagency, psychosocial and detoxification supports, community based nurse prescribing and adjunct treatment for poly drug and alcohol use
Detoxification from alcohol and/or drugs and the achievement of abstinence without formal treatment is often preferred using community-based supports from local GPs and family. Family members are often involved in the sourcing of information on detoxification and treatment options, user advocacy and provision of remedial supports while detoxifying within the family home. The aim of the research was to describe and explore family experiences of self-detoxification processes from the perspectives of mothers in the Mid West of Ireland. A convenience sample of adult mothers who had experienced their child detoxifying in the home (n=9) were interviewed. The findings illustrated varied personal definitions of detoxification. Addiction stigma and costly experiences of treatment and after care pathways facilitated home detoxification attempts. A lack of GP advice, support and information around safe home detoxification was observed to contribute to information and support seeking from friends, family and community members with home detoxification experience. Self-medication of both licit and illicit substances while detoxifying, and relapse cycles were common. The research highlights the need for inclusive health and social supports provided by GPs, community nurses, RGNs and district nurses for families and individuals detoxifying in the home setting.