19% of total sample currently injecting drugs

1
Injecting Drug Use

• 19 of total sample currently injecting drugs
• (27 of Dublin sample)
• 74 of current heroin users were injecting
• (16 of total sample were injecting heroin
  users)
• 63 of current cocaine users were injecting
• (10 of total sample were injecting cocaine
  users)

2
Risk Behaviour
3
Changes in Drug Use

• Changes in Drug Use
• Changes noted in primary drug/routes of
  administration and increased frequency/quantity
• Changes in Injecting Behaviour
• Changes noted in different types of drugs,
  greater quantities of drugs, using more
  frequently and less safely

4
HIV
5
Hepatitis C
6
Psychiatric Issues
7
Gaps in Drug Service Provision the Provider
Perspective (1)

• no drug service interviewed had a policy on
  homeless drug users
• Difficulties meeting multiple needs
• Quality of services

8
Gaps in Drug Service Provisionthe Provider
Perspective (2)

• Needle Exchanges lack of needle exchanges
  outside Dublin absence of needle exchanges in
  the evenings and at weekends in Dublin
• Methadone Maintenance area-based treatment
  provision waiting lists keeping appointments
  harsh sanctioning for failing urinalysis
  problems having to attend methadone clinics daily
• Drug Treatment not enough detox and residential
  beds delay between assessment and drug
  treatment routine and structure lack of
  aftercare

9
Gaps in Homeless Service Provision the Provider
Perspective

• Few services with official policy on drug use,
  possession and dealing
• Lack of knowledge and training around drug users
• Difficulties addressing multiple needs
• Safety issues
• Tackling traditional view of homelessness
• Limited range of low threshold services
• Poor quality of some accommodation services
• Lack of move-on options

10
Developing Drug Services

• range of harm reduction services
• methadone maintenance and drug treatment
  flexible, less structured, take a holistic
  approach, access accommodation
• respite care
• more aftercare

11
Developing Homeless Services

• promoting multi-disciplinary work
• specialist service provision
• remaining flexible
• increase in resources and funding
• develop range of accommodation options

12
Policy Implications

• increased co-ordination and joint working
  relationships between sectors
• implementation of a continuum of care model
• development of organisational policies to
  positively include homeless drug users
• development of homeless services to accommodate
  homeless drug users
• increase the availability, capacity and
  effectiveness of drug treatment and harm
  reduction services

13

• Thank You