Cannabis use fell during the Covid-19 pandemic but there was an increase in the use of cocaine, alcohol and street-sourced prescription medication, according to a new report.
The survey by Queen’s University and Ulster University researchers for the Northern Ireland Alcohol and Drug Alliance (NIADA) found that the physical and mental health of those using drugs deteriorated during the pandemic.
“While there was some disruption to street-based retail markets during the initial stages of the pandemic, European research suggested that drug markets remained relatively resilient,” the report stated.
“(They) adapted through increased use of encrypted messaging services and social media applications, postal and home delivery services. This development was also identified in Northern Ireland by the PSNI.”
It found that a disruption in the cannabis market with “reductions in supply, quality and higher prices” corresponded with an “increase in the accessibility and purity of cocaine and decreasing price.
“There was also evidence of some clients’ supplementing and/or substituting preferred drugs with stimulants, synthetic cannabinoids and online or street-sourced benzodiazepines.
“A marked change in the operation of drug markets was a move to more online purchasing using encrypted messaging services, social media applications and other online services. This adaption had been a growing trend which was accelerated by the pandemic,” it said.
Providers of statutory support services for drug users expressed concern about the suspension of some statutory substance use services and the more limited access to statutory mental health services for young people and adults.
This in turn increased pressure on the community and voluntary sector, according to the report.
Drug use was more visible to families due to lockdown restrictions and this, combined with changing drug use patterns, led to increased tension and conflict, the authors said.
Services providers noted that the income of people in the homeless and injecting drug use communities was affected.
“Their main source of money was begging in city-centre streets which was substantially affected by lockdown restrictions. Consequently, alternative sources of money, such as sex work, clients borrowing from each other and criminality, were sought,” the report said.
“Some practitioners working in day/drop-in centres and hostels stated that decreased overdose rates were observed during the first lockdown which they attributed to reduced movement due to pandemic restrictions. However, overdoses increased during subsequent lockdowns.
“Other community-based organisations experienced elevated rates throughout the pandemic which they linked to social isolation, lengthier waiting times to access statutory substance use services, clients using different drugs and polydrug use. There was also a feeling that some clients acquired a more ambivalent attitude to risk, perhaps most evident among younger people.”
The report found that there was an increase in “injecting-related harms” for some clients.
There was “increased injecting frequency due to cocaine . . especially by a younger, less experienced cohort of clients” and “more groin injecting and injecting-related injuries”, and more sharing of needles and syringes which led to more Hepatitis C and HIV diagnosis.
Among its numerous recommendations, the report called for a “long-term, strategic, coordinated, cross-departmental, cross-sectoral strategy” to tackle alcohol and other drug-related deaths.
“Clear objectives and strategies to reduce these unnecessary deaths need to be established. Evidence-based approaches, including the implementation of overdose prevention sites, should be implemented,” it said.
It urged the Department of Health to provide more secure funding and contracts for voluntary and community sector service providers.
The report also called for a “single point of referral system for all clients throughout the HSCTs (health and social care trusts) areas experience problematic substance abuse.
“There is an urgent need to review accessibility and provision of residential detox and rehabilitation treatment given unequal access and increased demands for these services,” it added.