Powder cocaine becoming most reported substance at Belfast needle exchanges

Powder cocaine is becoming the most reported substance being used at Belfast needle exchanges, according to a recent report.

The Public Health Agency has released it annual Needle Exchange report which highlights the usage of needle exchange facilities across Northern Ireland and the substances reported by users, with 2023 seeing the lowest number of transactions since 2017/18, with 31,851 taking place.

The report highlighted that the substance used most by needle exchange clients across Northern Ireland is anabolic steroids, followed by heroin/morphine and powder cocaine.

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In the Belfast Trust area Heroin is the most used substance with 9,749 reports followed by powder cocaine with 8,748 reports. However, in the last three months of 2023, powder cocaine use overtook that of heroin/morphine for the first time ever.

In all other trust areas anabolic steroids is the most reported substance, followed by heroin/morphine.

Belfast Independent councillor and homeless outreach worker Paul McCusker said that he has seen a noticeable increase in cocaine use within the City Centre within the past six to eight months and warned of the dangerous impact of intravenous drug use, saying that he has worked with people who have lost limbs as a result of it.

Speaking to Belfast Live, he said: "Our teams are definitely seeing an increase in cocaine use in the city centre, particularly those smoking or injecting it and it is coinciding with a reduction in overdoses from opioids and an increase in those from cocaine use. Drug trends do change over time and this is one that is becoming very noticeable.

"Our teams are being told that cocaine is proving to be cheaper and longer lasting for users, but can also lead to an increase in medical problems with it causing problems for the heart and damaging people's veins. We are working with people who have lost limbs as a result of drug use and have growing concerns regarding hepatitis and HIV.

"We work with around 50 to 60 people per night and are finding that people are having difficulty accessing accommodation alongside addiction and mental health issues and what is very concerning is that we are seeing an increase in young females engaging with our teams."

Kevin Bailey, Regional Lead for Drugs and Alcohol at the PHA, said: “Sharing or reusing injecting equipment can increase the risk of bloodborne viruses so needle exchanges have an important role to play in helping to protect not only those using the service, but also the wider community more generally by providing clean equipment for people who inject substances.

“NSES are based in areas where there is an existing pattern of people who inject, but the service benefits the entire community by helping to lower the risk of diseases such as HIV and Hepatitis B and C within the wider population.

“Providing services locally is vital, as people who inject substances are often vulnerable, may be in poor health, dealing with complex social issues and without local access to sterile equipment and advice. Needle exchanges are particularly valuable for engaging these people, because it may be the only service they are willing to use and provides opportunities to signpost them to additional support and information.”

Community pharmacies continue to complete most of the overall transactions of the NSES at 50.4% of the total in 2023, followed by the community-based providers completing 46% of the total transactions.

In 2022, the PHA fully implemented a new online database to record needle exchange activity alongside anonymous, non-identifiable client data. This database is called the Neo360 Harm Reduction Information System and became fully operational across all NSES sites on 1 December 2022.

Kevin Bailey continued: “With the introduction of the new online Neo360 Harm Reduction Information System, live data can be accessed, immediately, which in turn will allow for a timely and effective public health response to any trends we identify.

“For the first time, Neo360 provides the client the opportunity to report how they administer the substance used, which is additional information we can capture and respond to appropriately. For example, as part of our strategy to promote harm reduction, staff within needle exchange sites are encouraged to dispense foils which will support smoking, thus, reducing the added harm that is caused through injecting.”

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