Mr. Shane Hamilton:

I thank Ms Quigley and Ms Hill for opening up this discussion on this important issue, specifically for front-line services impacted by crack cocaine. As Ms Hill alluded to, until 2018, heroin was the primary drug of choice among individuals accessing services in JADD and services were developed primarily to respond to the problems associated with heroin use. However, since 2018, crack cocaine has emerged and become the primary problematic drug in Jobstown and the surrounding areas, including Killinarden and throughout west Tallaght.

Crack cocaine is no longer an emerging drug. Its availability and use are widespread throughout Tallaght and highly problematic. Crack cocaine use is a permanent feature in most addiction services in Tallaght and will be for the foreseeable future. Crack cocaine is a completely different drug to heroin. There is no substitute pharmacological treatment or silver bullet to address this issue.

With regard to the prevalence of crack cocaine use in JADD’s methadone service, we have just over 60 patients who attend daily, 70% of whom report crack cocaine use. This high prevalence of crack cocaine use among opioid users is in line with European data, with those European figures stating that 40% of those seeking treatment for crack cocaine use report heroin as their secondary drug of choice.

The majority of these patients in JADD would have previously had long periods of stability on methadone treatment. They would have completed education courses, returned to the workforce and managed successful and healthy family homes. However, the majority are now back attending the clinic on a daily basis, such is the extent of their respective crack cocaine use. Crack cocaine use is destabilising the recovery of a significant number of individuals on methadone treatment.

As outlined in the research, there is a considerable proportion of women using crack cocaine. This is in line with international data which states one third of all people seeking treatment for crack cocaine related problems are women. One study, in line with the figures locally, found that 90% of women reporting, reported involvement in the sex trade as a means to fund their addiction to crack cocaine. JADD is concerned about this and its impact on women and children, in particular.

Since 2018, JADD has supported 20 women whose children have been removed from their care because of their crack cocaine use and whose use is a barrier to those children returning to the family home. Among these 20 women, there are 45 children in care, with a sizeable number having previously attended JADD’s childcare service. It is unlikely that these children will return to these homes any time soon, because of this crack cocaine use, as research has found that women involved in sex work who are single mothers have been found to develop the most chaotic crack cocaine dependency. Therefore, it is critically important that any response to this issue must include a broader, early intervention response to families affected by crack cocaine use.

We welcomed Kitty Holland from The Irish Times to come out with us in early November to meet some of these individuals and she was invited into the homes of some of these women impacted by crack cocaine. One of the examples Ms Holland was able to confirm and write about was:

Robyn (45) has been on drugs most of her life. “But crack cocaine has destroyed me in less than five years. I have lost my four beautiful children to [this drug].”

Ms Holland also reported that:

Theresa (43), almost lost the apartment she rents from an approved housing body due to her addiction. It is dark and cold. Her daughter’s toys are everywhere, though she has not seen her for two years ... Aisling is trying to use less as she is hoping to get access visits with her children, who now live with her sister. She had a “total psychotic breakdown” about four months ago. “I couldn’t come down. I got paranoid by a hundred, climbing out the windows, thought everyone was against me. It was very frightening.” [Aisling] spent 19 nights in a psychiatric ward, but discharged herself. Thwarting her efforts to reduce are dealers “bombarding” her with text messages, offering “two-for-one” deals; saying “We drive to you, 24/7”.

The role of a front-line crack cocaine service has evolved to provide extensive and intensive support services towards the most damaging and complex areas in a service user's life.

Over the last few months for example, JADD has had to dedicate significant resources into a partnership with a task force with South Dublin County Council specifically for tenancy sustainment for crack cocaine users. Drug use is a restrictive factor in many areas of an individual's life but it is exacerbated completely by crack cocaine use regarding accessing appropriate residential treatments or domestic violence accommodation, or engaging successfully with multiple agencies. This has to be the role of any future agency.

In response to the extent of crack cocaine use, and wanting to understand the issue further, JADD self-funded an assertive outreach service from September 2021, as Ms Hill mentioned. This was to target the most vulnerable and isolated crack cocaine users including rough sleepers, those couch surfing, and those whose using in houses was permitted. This service has allowed JADD to scope the prevalence further and unfortunately we have identified many more service users within the immediate area, many in very unsafe environments, which is concerning from a public health perspective. These assertive outreach services are identifying many more individuals and situations with multiple users present, sharing drug using paraphernalia.

There is also an unintended consequence of stigmatising these houses as crack houses, which has been an issue for Tallaght to try and resolve. I would like to note to the committee that many of these homeowners are vulnerable women, whose homes are often controlled by others through violence, intimidation and so forth. Resolving these issues requires a compassionate and considered approach. Not all of these instances are of an antisocial nature.

These individuals, families and communities I have spoken about need members on their side. They need the support of this committee. As we all know, drugs are available in most communities, but they do not impact all communities in the same way. Crack cocaine is destroying the sense of community in parts of Tallaght, specifically in west Tallaght. I urge members to support our call for funding to keep individuals safe, to keep families in their homes, to keep children with their families, to minimise the public health risks and to increase treatment supports to individuals and families affected by crack cocaine use. The community response to this can be successful. It just has not been given the opportunity to be.