Easy access to crack cocaine is fuelling addiction and leading to a cycle of hardship, mental health issues and homelessness in deprived communities, particularly in the North of England, a new study suggests.
Researchers from the University of York and Birkbeck, University of London interviewed people with crack, opioid and alcohol dependency in two towns; one in the North and one in the South of England. All of the participants had been out of treatment for a year or more and the research, funded by the National Institute for Health and Care Research (NIHR), explored their experiences and reasons for avoiding treatment.
Many in the North reported that the ready availability of crack made them feel their addiction was "unavoidable", acting as a key factor in starting to use the drug and not being able to stop.
Emerging gateway effect
Some participants reported transitioning from powder cocaine directly to crack, suggesting an emerging gateway effect. This highlights the need for early intervention and prevention strategies to address the root causes of addiction, the researchers say.
While almost half (49%) of untreated participants in the Northern town used crack exclusively, only 4% of those in treatment services in the towns were crack users, suggesting a sizable gap in access to support.
Among the crack users outside treatment, 85% experienced disabling mental ill health, and 74% were in urgent need of housing, painting a picture of extreme marginalisation. Many said they used the drug for temporary relief from psychological and physical pain.
Short supply
Lead author of the study, Professor Charlie Lloyd from the School for Business and Society, at the University of York, said: "Violence, poor physical and mental health, severed relationships, bereavement and homelessness were common among the participants we interviewed in both locations. Crack and opioid use were part of their extreme marginalisation and formal drug treatment meant little in this context, when the fundamentals of safety and warmth were in such short supply.
"The majority of people in England who use opiates and/or crack cocaine, or are dependent on alcohol, are not in treatment representing what many have described as 'unmet treatment need'. Our study suggests a large proportion of crack users in particular are not accessing any form of support."
Complex needs
Most of the crack users in the present study described compulsive use, limited only by having the money to buy the drug. Crack users reported daily expenditure of £100-500 on the drug, with benefits, begging and shoplifting the main sources of income.
The researchers also surveyed treatment providers across England who confirmed high numbers of untreated crack and opiate users in their areas and acknowledged the complex needs these people face. They highlighted the 'unmet treatment need' and the challenges of providing effective support in the face of the widespread availability of drugs and alcohol.
Urgent
Dr Bina Bhardwa from the Institute for Crime & Justice Policy Research at Birkbeck, University of London, said: "Our empirical research across the two study sites has highlighted that those who are dependent on crack, opioids and alcohol face a myriad of complex and multifaceted needs: substance use being one unmet need among many others. This has led us to question - both conceptually and practically – ultimately, how we understand and respond to those with unmet needs in this area".
Professor Lloyd added: "Our study highlights the urgent need for targeted interventions and increased support for crack cocaine users, particularly in the North of England. We are calling for a comprehensive approach that addresses not only addiction, but also the underlying social and economic factors contributing to this crisis. This includes increased access to mental health services, housing support, and effective prevention strategies."
Further information:
Read the full report via: https://www.york.ac.uk/business-society/research/social-policy/substance-misuse-treatment/
