Cocaine in Scotland

1

• Cocaine in Scotland -
• The big picture
• David Liddell
• Director

2

• The scale and nature of current use.
• Current response.
• Policy and Practice issues.

3
The Scale of use

• 1. Price
• 2. Recreational.
• 3. Cocaine as main drug problem.
• 4. Cocaine as secondary drug to primary problem
  with opiate/ benzos.

4
Price

• Cocaine
• Five years ago could cost
• 100 a gram
• Now as low as 35
• Heroin
• Currently 100-50

5
Conclusion

6
Conclusion

7
Recreational use Scotland Table C-1 Trends in
use of specific drugs, 1993-2004 16-59 age range
Source Scottish Crime and victimisation
survey significant at the 95 per cent confidence
interval significant at the 99 per cent
confidence interval
8
Recreational Use

• 1. Scottish Crime and Victimisation Survey 16-59
  
• year olds use in last year age profile
• Cocaine(overall 1.5)
• 20-24 year olds 3.5 30-34 year olds 2.8
• Crack(overall 0,2) 16-19 year olds
  (peak age) 0.9
• 45,000 used cocaine in last year?
• Under reporting in the 20-24 age range?

9
Recreational use Table C-1 Trends in use of
specific drugs, 1993-2004
significant at the 95 per cent confidence
interval significant at the 99 per cent
confidence interval
10
Cocaine as main drug problem

• Very limited data.
• Primarily from opiate focused/dominated treatment
  and care service.
• 2004/5 data available 2005/6 released in December

11
Primary problem with Cocaine/Crack Main illicit
drug year ending 31 March 2005NHS board area of
residenceNEW INDIVIDUAL PATIENTS/CLIENTS Source
ISD Scotland
12
All illicit drugs year ending 31 March
2005number of new individuals reporting using
each drug of misuse Source ISD Scotland
13
Secondary use of Cocaine/Crack among opiate
population

• All drug use All drug use primary
  users
• Cocaine 949 (6.6) 671 (4.7)
• Crack 348 (2.4) 300 (2.1)
• Other data such as DORIS and new attenders at the
  Glasgow Drug Crisis Centre show much higher
  levels of cocaine use 25-30 among opiate users
• Secondary use to Alcohol

14
Drug related deaths 2005 Source SDCEA
15
Current response

• 1. Recreational users
• - Few services. Crew 2000.
• 2. Special provision for Cocaine/Psycho
  stimulant
• as main drug problem
• ESUS Edinburgh, INCITE Aberdeen,
  Cocaine Anonymous
• 3. Specialist drug services responding
  primarily to secondary use
• Some training reach so far fairly limited
• Know the Score/website helpline

16
Key policy issues - Recreational users

• More coherent response to recreational
  users required
• CREW 2000 type services
• Better use of Helplines/websites
• Better targeting of information campaigns
• For example little information provided on risks
  of Blood Borne Virus transmission through sharing
  banknotes for snorting

17
Conclusion

18
Key policy issues - Provision for problem Psycho
stimulant users

• Do we need to develop existing services or
  create specialist Psycho stimulant services?
• The answer likely to be that we need to do both.
• Existing specialist services have been slow to
  react to a new population?
• Workload?
• Service rather than needs led?
• Need specialist provision in areas where major
  problems exist until mainstream provision has
  adapted?
• Mental Health and alcohol agencies role?
• Pillar to post scenario integrated services

19
Key policy issues - Response to use among
existing opiate population

• Cocaine impacting on stability of those on
  substitute programmes?
• E.g. increases in-
• benzo use?
• Alcohol?
• Aggression?
• Mental health?
• Under reporting of cocaine use to services
  why?
• Training for frontline staff

20
Conclusion

• Need to retain a perspective cocaine problems
  small compared to opiates
• But need to proactively respond in order that
  problems do not escalate
• Improved response to the three groups
  recreational primary problem users and opiate
  users using cocaine

21
Conclusion

• Recreational use
• More Crew 2000 type provision
• Cocaine as main drug problem
• Changes to existing services and retain and
  develop specialist provision
• Cocaine use among opiate population
• Improve service responses, more user led focus

22
Conclusion

• Resourcing
• Need some specific resources devoted to the
  problems of cocaine
• 66.5 million for direct responses to drugs per
  year(including 34 million for drug treatment and
  care)
• 2 of treatment monies would be 680,000
• Currently spending - 300,000 for 2 services