Around five years ago Merchants Quay Ireland started providing crack cocaine pipes in its needle-exchange rooms alongside needles. “We have a crack epidemic,” says Amy Carroll, harm reduction service co-ordinator at the charity, which supports people affected by homelessness and addiction. “During and after Covid, it surged.
“I think this country goes through epidemics ... ... in the 1980s with heroin, everybody was dying from HIV ... There was the Celtic Tiger and there was powder cocaine. And then we had a couple of years where we had major issues with snow-blow [a synthetic stimulant] and major psychosis from that. Now we have a crack epidemic.”
“I’m surprised you weren’t offered anything on the way in here,” says Ryan Connolly, harm reduction lead project worker. “Crack is very available ... A lot of the older heroin users here would know where to get heroin. But if you’re 20 years of age in Dublin now you’re not seeing heroin – and if you are, it’s probably not great ... The trend is that they’re going towards crack.”
Some crack users, Carroll says, pride themselves on not being heroin users. “‘I don’t need needles, I only want a pipe.’ Heroin is seen as a dirty drug.”
Is there any other reason people gravitate towards crack? “It’s around and available,” says Connolly. “When heroin was available, people got addicted to that. So now it’s crack. And people’s situations aren’t getting easier.”
A young woman comes into the needle-exchange room out of breath. “I want to talk to you. I’m trying to get on the good side. I was in jail for four months and I did very well.”
“You’re going to start linking in, are you?” says Connolly.
She nods. “There’s also this group starting,” he says. He points to a poster that says, “What’s the Craic?” It advertises an ‘Informal social support group for people struggling for crack cocaine’.
She looks at it and nods. “I’ll come again, I promise you. What’s your name?”
“Ryan.”
“I’ll come again and explain it all, Ryan,” she says and laughs.
A middle-aged man comes in looking for a “straight shooter” (one of the more popular types of crack pipe).
“What’s the story?” says Connolly.
“I’m going to start a detox and the GP is going to take me on. He’ll test my urine and if there’s only benzos in it, he said he’ll start me. I haven’t taken heroin. Tomorrow it will be three weeks.”
He asks about being referred to a counsellor. Connolly sets it up. He also says he’ll get in touch with the detox service.
“You’re no longer injecting or anything are you?” says Connolly.
“Nah, only a few smokes and taking tablets. I live on my own. I don’t want to die on the floor. All the family work and have their own homes. Some days I’m in the gaff all day on my own. Most of the time they call in to see if I’m all right. I don’t want to collapse and OD and die when they haven’t called in.”
“Have you ever OD’d?”
“No never. Touch wood.” He taps the table. So does Connolly. The man says he always uses clean stuff, “barrels and spikes” from places like Merchants Quay. “I think that’s why I never had any abscesses.”
He’s sometimes tempted to do crack when he sees people he knows doing it on the street. It’s everywhere, he says. “Twice coming up it was offered to me on the bus.”
[ Huge increase in cocaine use, particularly among women, research showsOpens in new window ]
He first encountered it when he came out of prison in 2020. “I was hearing about crack and did it and got a rush, but then you get paranoia. There was six or seven of us in a laneway doing pipes. And they were all my mates I grew up with but I just thought, ‘I have to get out of here. I have to get out of here.’”
“Why is it so popular?” I ask.
“I don’t know. You get a rush. You come down. And then you have to go again.”
The reality is most drug users have jobs and go to college. The majority of people that use drugs are functional addicts
— 'Colin'
Andy O’Hara is a co-ordinator with Uisce, the national advocacy service for people who use drugs. He explains the market logic of the crack trend. In the past, drug dealers didn’t have the expertise required to “wash” cocaine into crack – but that changed over the past decade, he says.
“There’s a huge market for cocaine in this country. If I’m a dealer or a mid-level dealer, it’s much easier for me to get a nine bar [nine ounces] of coke than a nine bar of heroin. The heroin market is a niche market. Europe is being flooded [with cocaine]. Cocaine is available across all classes. More people can get it to sell.
“And it’s a very easy drug to sell. A dealer can get a consignment of cocaine and keep some to sell to the weekend warriors and some can be washed up into crack. So essentially, the dealer can sell to a few different kind of customer bases.”
I sit in on a meeting of Uisce clients who are working on an anti-stigma project with academics from the University of West London at Uisce’s offices. They’re all either in recovery or have stabilised their lives significantly. This is partly through the sense of encouragement, dignity and purpose they get from being part of this group. They feed into policy documents, do outreach with drug users and train people how to use the opiate overdose reversal drug, Naloxone.
“Since I came here, I’ve been helping others,” says Paul (not his real name). “But also, it’s given me the platform to look at myself. Nothing is being asked of me here.”
I don’t ask about the specifics of their addictions, but they have a better understanding than most about what’s happening with drugs on our streets. “Crack is the trend at the moment,” says ‘Bill’. “When that goes, there’s going to be something else to replace it.”
The first safe, medically supervised injection facility is to open in Merchant Quay’s premises in December. The Uisce volunteers I speak to feel it should be changed to a “consumption room” to include people who smoke crack or who smoke heroin (Merchants Quay informs me that smoking any sort of drug doesn’t fall under the scope of the Misuse of Drugs Act 2017 that facilitates injection rooms). “The epidemic is not heroin now, it’s crack,” says Bill.
Crack is hugely psychologically addictive, says ‘Colin’. “After the first [hit], your brain and your endorphins are so spiked that when you start going down ...”
“You want more, more, more,” says Bill, finishing his sentence.
Crack users exhibit very different behaviour from people on opiates. “People become hyped up,” says Colin.
“They don’t realise what they’re doing half the time,” says Bill.
But not all people react the same way. They stress that stereotypes about any drug are simplifications. “The reality is most drug users have jobs and go to college,” says Colin. “The majority of people that use drugs are functional addicts.”
Getting entirely clean of any drug is a struggle. There’s a huge shortage of detox beds in the country and there are waiting lists and hurdles to jump for addicts trying to access them. And there’s very little aftercare.
They believe one of the big reasons for the rise in crack is that it’s simply a more profitable drug to sell. The high from crack doesn’t last long. “When you come down you need one more [hit] to keep it at that level,” says Colin.
“So you have to buy a lot more,” says Bill.
Many young men in deprived neighbourhoods, says Colin, “see it as an opportunity. That’s why you see 17-year-olds and 18-year-olds selling”.
Also, the quality of heroin in Ireland is inconsistent. One person tells me: “You could be buying cooking chocolate.”
Paul says he thinks that heroin in Dublin “was deliberately f**ked up because there was more money in crack”.
What are the health problems associated with crack? “Respiratory issues,” says Carroll. “A lot of recovering drug addicts would suffer from chronic obstructive pulmonary disease (COPD).”
“There’s a thing called ‘crack lung’, an acute pulmonary syndrome,” says Connolly. “Respiratory illnesses, mini heart attacks. Six years ago [crack] came here and now you’re starting to see real health issues with it.”
This is one of the places I feel most safe. I don’t know what that says about me. We save lives in here
— Ryan Connolly, Merchants Quay
Last week Connolly helped with a client who was having a heart attack. The staff here are all trained in CPR and how to administer Naloxone to reverse opiate overdoses.
“A lot of our clients would have hepatitis from cuts on their lips and hands and sharing pipes to smoke crack,” says Carroll. “It can bring on drug-induced psychosis.”
One common phenomenon is crack users hallucinating crack rocks on the footpath. “It’s a psychological effect,” says Connolly. “You imagine it’s there. The mind playing tricks. It’s very intense. Anything you’re feeling is magnified. Your body is going through a lot of stress.”
All they can do is be there for people. “Some will want to come in and talk to the staff for half an hour,” says Carroll. “Others won’t even sit down, they’re so agitated.”
“We’re here to talk to people,” says Connolly. “What runners have you? Did you watch the football?”
“Have you eaten today?” says Carroll.
People’s drug use often escalates coming up to Christmas due to family estrangement and loneliness. For rough sleepers it’s also harder to smoke in colder weather, so lots of them move to injecting. For Connolly and Carroll it’s really important that the clients feel listened to and respected.
Do staff ever feel unsafe here? “This is one of the places I feel most safe,” says Connolly. “I don’t know what that says about me. We save lives in here.”
A young man comes into the needle-exchange room in a ripped jacket, looking a bit frantic. “I took 15 of the new Tranax,” he says.
Connolly looks concerned. “There’s new Tranax going around? The yellow ones?”
“Nah. Different ones again. They’re white. They’re like the cheap version. I should have been all right but I took a seizure. I woke up in the hospital. They said I was very lucky. They said they had morphine in them.”
This is useful information for Connolly. He monitors drug trends and feeds the information to the HSE. Last Christmas there was a spate of overdoses because of the synthetic opiate nitazene. “Twenty-five in one day,” he says.
“My friend put me on my back,” says the young man. “He didn’t know about the recovery position. He said there was froth on my mouth and he could hear me choking on my tongue.” He points to his ripped jacket. “They had to cut me out of my clothes.”
Connolly starts asking him questions about his use. He wants to get into recovery he says but it’s too hard to get a bed.
Connolly is worried about him. “Do you have a phone number or anything?”
“Collecting a new phone tomorrow from the shop.”
Connolly asks if he wants to talk to a counsellor. He shakes his head. “Be very careful,” says Connolly, but he’s already out the door.
In harm reduction services there are a lot more categories than just “using” or “drug-free”. Sometimes a person might not be ready to completely quit but they get some structure in their lives. They stop being so chaotic. They might get a job. They might reunite with their family. Over the course of a morning in Merchants Quay, I meet all types of people.
Two of the people who come in are purely heroin users. Connolly explains to one man the safer parts of the body to inject (there are three types of needle distributed depending on where the person is injecting – long-term users have to change the injection sites). Most who visit are looking for crack pipes but many are polydrug users, often using one drug to counteract another, and they ask for needles as well.
As he talks to them, Connolly tries to establish the state of their health and their drug usage and checks out what services they are linked in with or want to be linked in with. People ask him about Community Employment schemes, seeing a counsellor or visiting the doctor.
What might be surprising to some readers is how warm and good-humoured it all is. One vulnerable young man comes in holding a $20 bill. “Which president is that?” he wonders genuinely. “It’s not Abraham Lincoln, Benjamin Franklin or George Washington. Is it Thomas Jefferson?”
Connolly talks to him about his drug use. As he’s leaving, he grabs a trolley filled with drug paraphernalia and pretends to casually pull it out of the door. He’s only messing. Connolly laughs. “A pleasure as always,” he says.
We have thousands more people living in hostels … Emergency accommodation can be stressful and traumatic. A lot of people’s drug use is escalating because of that
— Andy O'Hara, Uisce
An older man talks about his plans to uses his disability benefit to get some “new clobber” later that day and how nice it will make him feel. He and Connolly talk about how good Penneys can be before they ever get on to his need for drug paraphernalia.
A well-dressed, healthy-looking man, says, mischievously: “You showed me how to inject!” He means safely inject. But the man also credits Connolly with helping him to stop taking heroin. He’s on methadone now. He still uses crack but he aspires to stop that too.
Another man tells Connolly that he’s living in the same house as his child again. He still uses crack but less chaotically. “It’s good to see my child every day,” he says before leaving.
Andy O’Hara stresses that I shouldn’t write about crack in a way that stigmatises users further. He talks about how bad policy leads to trauma, which leads to addiction, which leads to people being punished and criminalised for that addiction.
“Why do we have cohorts of people who are willing to take the riskiest drugs?” he says. “The streets that people are walking around on are a reflection of how we treat people. Because the worse we treat people, and the worse we shame people, and the more we criminalise people, the worse things get.
“Right now, there are far more people in the city than ever who have loads of underlying problems, and that’s to do with our housing policy. We literally have thousands and thousands more people living in hostels ... Emergency accommodation can be quite stressful and quite traumatic. A lot of people’s drug use is escalating because of the trauma of that.”
The crack epidemic is just the newest symptom, he says, of deprivation and inequality. “We’ve created this ground zero here for any one with underlying conditions.”
Before I leave Merchants Quay an employee named Mary Enright asks if I noticed how friendly and upbeat the centre is. “They’re all someone’s child,” she says. “They have enough stigma and survival out on the streets. And they know we’re not here to make a laugh at anybody. That’s why they come back – because we love them and they love us.”
What is fuelling Ireland’s cocaine epidemic?
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