Sara Cassidy, Aiséirí Rehabilitation Clinics’ head of clinical services, has no doubt about the biggest emerging Irish trend in relation to drugs.

“It is the fact that cocaine and drug use is no longer an urban issue. It is a national issue. We’re talking every crossroads, down rural lanes, it is accessible everywhere,” she says.

It is this accessibility that is driving the increase in substance abuse and the addiction following it, she believes.

Sara has worked with Aiséirí for 17 years and has watched the situation worsen over time.

“17 years ago, cocaine wasn’t on the radar. It was once in a blue moon, very expensive and almost like a cheeseboard-type element at the end of middle class parties. Now, cocaine is everywhere. That’s a big concern.”

Young people, urban and rural, are accessing it via social media platforms, she states.

“Someone on a remote farm anywhere in Ireland can access it within a few miles’ radius because there is a network to deliver it. The other issue is that it’s 24/7. It’s not like an off-licence that closes so accessibility has gone through the roof,” she says.

While it is usually young people in their early 20s who present for treatment at Aiséirí centres, they have had many farmers in their 30s, 40s and 50s also come in for help.

“The emphasis has now switched from alcohol to cocaine,” she says.

Dealers see farms as ATMS

Aiséirí counsellors are finding that the young farmer in the family, aged 18-30, is most often impacted.

“The carnage that can follow is horrendous - from animal neglect to selling of cattle to pay debts, to very risky behaviour driving machinery and, ultimately, family farms being put in major jeopardy by drug debts [because users are given credit by dealers]. Dealers see the farming community as an ATM, basically. They think there is money where the farms are. We know of farm families paying back massive drug debts of €30,000.”

She believes this debt and stress is seriously impacting some farm families.

“Because of past stigma and stereotypes, the farming community would be worried about bringing it out into the light and saying what they are going through,” she says, “so they may be trying to deal with a lot of it themselves for a long time before they come looking for help or services.

“We’re finding that a crisis will often spur them to come and look for services. It’s often suicidality and suicide attempts. Those addicted can feel trapped with dealers who would be quite cruel around these individuals, forcing them to move drugs.

“They then end up with a legal charge for possession or selling where they’d never been in an ounce of trouble all the way up their teenage years.”

Best friend to greatest enemy

The problem also escalates over time, unfortunately, she states.

“What might start out as occasional cocaine use gets worse over time, often for individuals who might be struggling with any kind of past trauma or issue. Addiction really feeds on any vulnerabilities that people might have and they feel as though it’s their best friend for that short period of time, but then it turns into their greatest enemy quite quickly.”

She speaks of what parents go through at this time.

“Your heart would break for many of the parents we see because they are just tortured on so many levels. There is the threat of the financial debts, the threat of losing the farm, but this is surpassed by the possibility of losing their child to their own hand or to the hand of somebody else.”

She speaks of families being threatened, farms being burned, windows broken.

“These are intimidation tactics that are often going unseen because people are afraid to say it within their farming community,” she says. “They don’t want people thinking badly of their young person, their son or daughter.”

Weed to cocaine

Sara’s experience of the pattern of addiction is that young people often start with cannabis and then move onto cocaine.

“I looked back on our recent admissions from the farming community and they were all aged around 24 to 26 and all started the drug use at age 18. They hadn’t been in any trouble up to that point, but then they were with us at age 24-26. The damage in those very short years was very extreme.”

Addiction has to be fed, she points out, and the minute it’s fed that it gets worse.

“It’s like a major snowball going down a mountain, it gets bigger and bigger and bigger. It’s cruel.”

Combining alcohol and cocaine brings extra issues too, she states.

“Young men may be quite a bit more aggressive and it has a sexualised effect on them as well. It’s something to do with the chemistry between alcohol and cocaine when it’s mixed in the body so people can behave in a way they have never behaved before.”

Addiction, she believes, is “destroying this country.”

As head of clinical services at Aiséirí, she is hoping that the farming community will become aware of where they can get support and help.

“Families can ring for guidance. It is totally confidential,” she says.

Her biggest worry for the farming community is the isolation or the lack of conversation going on around drug addiction.

“We ask any family affected to talk about what they’re going through. Word of mouth is a massive thing. If people we work with would then start talking about their experience that would be a great help for other families.”

Recovery ahead. \iStock


For the person going in for residential treatment, admission is scheduled quickly after assessment.

“It’s very client centred, somebody might work well with CBT or they need trauma-type therapy. We would look at all those and work through a programme to do the 12 Steps as well. It educates people on where the support is and how they can live going forward. It’s a programme designed for living.”

“We would schedule admission pretty quickly in case people change their minds,” she says. “There isn’t a medical detox for cocaine but there certainly is a symptomatic or psychological detox. People would need a few days to come back around to themselves and begin to sleep and eat properly again and then the 28-day programme would start.”

Treatment in Aiséirí is abstinence-focused and based on the 12 Steps of AA (Alcoholics Anonymous).

“It’s not just about stopping the chemical. Mental health, work, housing, spirituality, trauma, medical issues - the whole lot is looked at and done in a safe way.”

Therapy suited to the person is then prescribed. “It’s very client centred, somebody might work well with CBT or they need trauma-type therapy. We would look at all those and work through a programme to do the 12 Steps as well. It educates people on where the support is and how they can live going forward. It’s a programme designed for living.”

As people recover it’s like a whole new world opens up to people, she says.

“They learn how to live in recovery and they have figured out by that point how they got to where they were and what were the core issues that were encouraging them to use the cocaine. All of those are addressed and family therapy is an important part of treatment too.”

It is a very intense 28-day programme, but people do come back to life, she says.

“Often coming in the door, coming into detox, you’re looking at a half dead person walking, as their whole personality and temperament has been affected.

“Over time, though, you see the person brightening up and actually smiling by the time they leave; feeling freedom and peace of mind. It’s just incredible to see the change in people.”

The whole family is affected when one member is addicted to cocaine, she states. “Mother, father, siblings, uncles, grannies, grandads – they all need a lot of support even to understand what’s happened. Realising that they are not on their own anymore is probably the biggest comfort for them.”

As well as receiving counselling therapy during the addicted person’s treatment, the family are also given follow up support afterwards.

“It can involve weekly continuous care meetings for the families. Our new strategy, launched in September, is also putting more focus on family support,” she says.

Drug debt

But how is the drug debt sorted out while the person is in treatment?

“Drug debt is a massive stress for the family and there is no easy answer to that because, even for the Gardaí, it is a very difficult one. In the end the family has to weigh up the risks [around whether to pay or not pay] as the essential threat is to them and their property. It’s a very scary thing. Dealers are criminals and they will shift the goalposts, which makes it very difficult. The debt might be €10,000, then when something’s not paid, it’s €15,000. It’s very hard for someone in recovery to move forward when that’s hanging over them as well. We’ve had many families pay large debts in the past too, but the person hasn’t had treatment and then the debt blows up again.”

Huge hope

Her overall message is positive, however. “It is a very difficult situation but people do get better. There is huge hope and we have many examples of people who have moved into recovery and families who are at peace again, which is amazing. People need that peace of mind and not to be living in fear anymore.”

Next week we focus on non-residential treatment programmes.

About Aiséirí

Aiséirí has four recovery centres in Ireland – in Tipperary, Kilkenny, Wexford and Waterford. It has been treating addiction for 40 years.

There are many other residential treatment centres in Ireland and you can find details of those in your area on or by telephoning the HSE Drugs Helpline 1800 459 459.

Prices for private residential treatment programmes are around €11,500 for a 28-day programme. Addiction services that are provided by the HSE are public services and out-patient services are free of charge. There may be a charge for some residential programmes. A medical card may cover stays in selected drug treatment centres.

If you have health insurance, contact your insurer to find out if treatment costs are covered.

Note: Addiction can be treated in a residential or non-residential setting, depending on your assessed needs. Most people are treated in the community in non-residential settings.


Cocaine numbers

Irish people are the joint-fourth highest consumers of cocaine globally, according to a new United Nations report. Only Australia, the Netherlands and Spain consume more.

The HSE predicts that the number of people seeking treatment for cocaine use in Ireland will rise by 55% by 2026.

Report: Drug Treatment in Ireland: Key Patterns and Trends: 2014-2021.

What is cocaine?

Cocaine is a stimulant drug made from the leaves of the coca plant, native to South America. It is also called snow, C, charlie, coke, rock, dust and white. It is an expensive, strong, but short acting drug and is usually divided into lines and snorted. Effects start quickly but only last for up to 30 minutes.

Short-term effects include feeling more alert, energetic, exhilarated and confident, along with heart and pulse rate speeding up suddenly, hyperactivity, loss of appetite and increased sex drive.

Longer term physical effects can include tightness in the chest, insomnia, exhaustion, mood swings, aggression, depression and digestive disorders. It is very dangerous if pregnant as it reduces oxygen supply to a baby. Cocaine is very addictive psychologically. Tolerance increases over time so more is required to get the same effect as before.