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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
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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)
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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)
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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…..
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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!)
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
The Midlands Problem?
Considerable differences even within the
provincial towns
Urban/Provincial divide
Service provision
Service access
Confidentiality
Funding allocations
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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.
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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”
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
What Good Has Come?
Task Force has funding for:
Follow up care programmes
Peer led initiatives
4 regional drop in points
Interagency capacity Development
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives
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
Dr. Niall McElwee, Dissertation Doctor's
Clinic/Research from the Archives