Darkness on the Edge of Town: Exploring Heroin Misuse in Athlone & Portloaise

Heroin Misuse in

Athlone & Portlaoise

Dr Niall McElwee

Senior Editor,

Dissertation Doctor’s

Clinic

Dr. Niall McElwee, Dissertation Doctor's

Clinic/Research from the Archives



A Relational Research

Approach

We were not particularly interested in

numbers of people using heroin, but more

in how heroin misuse effects the

individual, the family and those trying to

provide services.



The Duty to do no Harm in Research

It is my belief that

social research into

‘marginalised

populations’ should,

as fully as possible,

involve those people

and should result in

some tangible benefits

to them (OPAC

Model of research)



Our Study

Took place over a nine month period in

2004 in two towns in the midlands –

Athlone and Portlaoise

36 Agencies

32 Service/Non Service Users

32 Questionnaires



We Knew Starting out…

In a general population survey conducted by Friel, Nic Gabhainn & Kelleher (1999) heroin was found to be the drug least used in the general population.



http://images.google.ie/imgres?imgurl=http://www.heroinaddiction.com/heroin.jpg&imgrefurl=http://www.heroinaddiction.com/heroin_methadone.html&h=162&w=215&sz=7&tbnid=SLKxeGTnewcJ:&tbnh=76&tbnw=101&hl=en&start=20&prev=/images%3Fq%3DHeroin%2BAddiction%26svnum%3D10%26hl%3Den%26lr%3D

Our Research Approach

Individual in-depth interviews were the

main research instrument used

We ‘hung out’ for hours, days and nights

in both towns in all sorts of areas, agencies

and homes (the relational research model)



Our Research Approach

Our colleague, Ferghal McHugh (Athlone

Institute of Technology) also analysed 32

in-depth questionnaires with over 70

questions seeing background information

and biographical/treatment details



These are Real People

I don’t want our interviewees to be reduced to mere statistics…

These are real people with real identities who are on a journey, who have stepped for a time off a known path. Please don’t lose sight of this. It could, one day, be your son, brother, sister, cousin, friend. That was, for sure, one of our main findings…..



Has the Study Proven Useful?

We believe we can say that our book did,

at least, contribute to a more extensive

consultation in the Midlands area of

Ireland which has been acknowledged by

the Health Services Executive.



What We Were Told…

In the town of Portlaoise, people living in the communities most affected by heroin reported things like, “nearly everyone uses heroin”

“I think that nearly everyone of them are drugged. There’s loads doing it”

Most commonly reported figures were between 70 and 250 persons.



Portlaoise Town

Perceived to be a ‘new’ phenomenon

Younger cohort of users

Smoking heroin is perceived as the main

method of using

Feeling that more needs to be done by

statutory services

Commonality of both towns is the strong

Dublin influence



What We were Told…

In Athlone, the most common figures from heroin users themselves was between 80 -300.

“I wouldn’t be able to put a figure on it. I’d say it’s in the hundreds, like they mightn’t be regular users, but regular users and dabblers”.



Athlone Town

Has experienced heroin use since the 1980’s

Injecting heroin and addiction problems are features for some of the landscape

More people in the older age bracket

(25+)

Some agencies feel that the situation has improved since 2001

“I think the last four years there has been a number of agencies trying to address the problem…that stopped it from becoming a bigger problem”



Some Comments on Media Reporting

In the main, the print

media tended to

sensationalise our

study & focus only on

negative aspects of

the study (and there

were some positives!)



The Midlands Problem?

Considerable differences even within the

provincial towns

Urban/Provincial divide

Service provision

Service access

Confidentiality

Funding allocations



The ‘Experts’ Give Varying Figures

All of the service providers gave us

different figures for heroin misuse in their

towns. This presented us with enormous

problems around triangulation



Everyone has a Different Journey

Drug users are often divided into three distinct categories – experimental users (curiosity and often under peer pressure), recreational users (taken regularly but at intervals) and problem drug users (dependent characteristics). We have met persons from all three categories in our study and this is a key point to understanding heroin use/misuse.



Stages of Development

People at different

stages of developing

problems with heroin

in both towns

“It wouldn’t surprise me

to discover that there’s

maybe 200 people out

there who are developing

problems around heroin”



http://images.google.ie/imgres?imgurl=http://news.bbc.co.uk/media/images/38355000/jpg/_38355249_heroin300.jpg&imgrefurl=http://news.bbc.co.uk/2/hi/england/2338623.stm&h=180&w=300&sz=8&tbnid=YUrSqP4m-34J:&tbnh=66&tbnw=111&hl=en&start=17&prev=/images%3Fq%3DHeroin%2BAddiction%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DG

http://images.google.ie/imgres?imgurl=http://news.bbc.co.uk/media/images/38355000/jpg/_38355249_heroin300.jpg&imgrefurl=http://news.bbc.co.uk/2/hi/england/2338623.stm&h=180&w=300&sz=8&tbnid=YUrSqP4m-34J:&tbnh=66&tbnw=111&hl=en&start=17&prev=/images%3Fq%3DHeroin%2BAddiction%26svnum%3D10%26hl%3Den%26lr%3D%26sa%3DG

Accessing Services

Confidentiality in assessing services is a

real issue for people and a major part of

why many do not seek support

“You go to the Chemist with a prescription

and everyone knows”



Heroin Misuse

Males are females are reported as using

heroin in both towns

“It would be 50/50, definitely, yeah. No, it

would be, probably a few more lads”

Unusual to have one partner in a

relationship using heroin.



Supply

On many occasions, interviewees in both towns joked

“Give me €25 and I’ll get you a bag of heroin right now”

“If I wanted heroin right now, there’s a fistful of people I could score from”



So, they suggested they use Heroin

to…

Escape

Pain in Life

To help cope

Experiment

Peer involvement

Family involvement

Feels good

Nothing else to do



Agencies were trying hard but…

Not an issue that can be effectively dealt

with by one agency but as a community we

need to listen courageously and

collectively to seek potential solutions

“We are all doing great work, but not tying

in”



What Good Has Come?

All of our recommendations have been subsumed into the Regional Action Plan

All the actions have been approved in principal

A full-time GP Co-ordinator is in position and is about to train Level 1 GP’s

Additional Nursing Staff have been appointed to the Clinics



What Good Has Come?

Outreach services to satellite clinics

outside of the main areas are to be

established

€100,000 has been approved for outreach

workers in the area of harm reduction &

needle exchange



What Good Has Come?

Task Force has funding for:

Follow up care programmes

Peer led initiatives

4 regional drop in points

Interagency capacity Development



Concluding Comments

Heroin misuse must be tackled from a multi-disciplinary perspective

Accurate figures will only emerge over time and through careful triangulation

Collaborative effort between the agencies is crucial

All individuals with individual stories

Not to act now in a preventative manner will create enormous issues later



Darkness on the Edge of Town: Exploring Heroin Misuse in Athlone & Portloaise

Education

dissertation doctors

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heroin misuse effects

relational research

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midlands athlone

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