ADDICTION to drink and drugs is a complex problem that can have a number of contributing factors according to healthcare professionals dealing with substance misuse in Cork.

Coordinator of Drug and Alcohol Services for Cork and Kerry, David Lane, who has been working in drug and alcohol treatment for the past 18 years said it is rare to have someone seek help for a single addiction to a particular substance.

“It is usually, poly addiction, cross addiction, using more than one substance at a time, but alcohol is often the gateway. It is often the first substance a person will have used and it will be the primary addiction.”

Mr Lane said within the drug and alcohol services offered by the HSE, they often work with people at the point where their drink and drug use is out of control and they are physically or psychologically dependent on a substance.

The drug and alcohol healthcare professional said the HSE offers their service to anyone who may need it. All age groups are treated, from under 18 to people in their 50s and 60s.

Speaking about the motivation to get clean, Mr Lane said it can come from varied sources.

“People come at different times in relation to their addiction. It could be family involvement in encouraging them to get help. Falling into homelessness or ending up in hospitals and other services that exist across the region here, and it is at that point that we pick up people.”

Mr Lane said the important thing was that people had a genuine desire to improve their lives.

“Another hugely important thing is people have to be wanting to change and want to recover and have a better quality of life for themselves.” Mr Lane stressed that addiction does not discriminate in terms of who falls foul of alcohol or substance abuse.

“It is not just a problem for the poorer parts of the city. It can happen anyone at any time. People come to us from all walks of life. It doesn’t discriminate in terms of social class, gender, age.

“We see such a massive variety of people coming to us for a selection of problems that they face. Sometimes it is not very straightforward.

Some people might be abusing a variety of substances legal and illegal and might have a mental health issue on top of that then again. So we can be dealing with very complex problems at times and it is not easy in terms of resolving the complexities of problems people have in their lives. We do our best, in terms of tackling as many things as we can.”

Clinical Director of Tabor Lodge Mick Devine said there is a strong connection between mental health and addiction.

In a recent report issued by the treatment centre Tabor Lodge, it showed that from a database of 50 clients, 40% reported four or more Adverse Childhood Experiences (ACEs) and over 50% showed a diagnosis of mental health.

Mr Devine said ACEs are extremely complex and can take a lot of working through.

“An ACE can be a parent addicted to drugs or alcohol, a parent in prison or who had mental health challenges, a parent or someone else who sexually abused you or being a witness of domestic violence.

“The ACEs has the impact on the person of not being able to deal with an experience as it is happening. A lot of ACEs may have stopped people developing healthy coping mechanisms.” Mr Devine said the services work collaboratively to help people with complex needs.

“The people who are succeeding don’t have complex needs, they have simple needs.

“They have an addiction problem, but they still have families intact, they still have accommodation, support, they are trained, educated and employed. It is straightforward to deal with this addiction because all the other supports are in place.

“When the needs are complex when the ACES are high, accommodation is precarious and the education system has not been a favourable experience for the person, so they are disadvantaged, they are starting from further back.”

Tabor Lodge’s clinical director said that there is a very eclectic mix of people who arrive at their door and in many cases they are referred from other services.

“TUSLA might refer a mother here because they feel the child might be in danger from the mother’s addiction.

“The probation services might refer someone as an alternative to sending someone to prison for drug related crime.

“A workplace might refer someone, because the alternative is to terminate the employee or a doctor might refer someone or hospitals. There is a whole cluster of people sensitive to when someone needs to come to Tabor Lodge.” In terms of recovery, Mick Devine said all addictions are not created equal. “I think heroin addiction is very difficult to recover from. The dependency is very strong and the level of social unacceptability is very high.

“We are more amenable to alcohol addicted people. Probably because we all probably know an alcoholic, we have a kind of a tolerance or familiarity with it We have a very ambiguous relationship with alcohol, one day we hate it and the next it is very endearing and it is a good way to celebrate.” “We tend to go the extra mile for a alcohol addict, but for a heroin addict, the family member might not have the same patience or tolerance.” Mr Devine said another problem with opiates is they are very addictive, very quickly whereas it can take a while to build up an alcohol addiction.

Discussing alcohol Mr Lane said even when consumption doesn’t reach the level of addiction, you can be doing a lot of harm to yourself.

“The general population is who we need to target around the harmful effects of alcohol. It’s about the impact that it can have at a physical level. It is a carcinogen that we consume regularly.

“The link between consumption of alcohol and cancer is one the industry is trying to reject for some time. We take for granted the health messages on cigarette packets for instance and how in your face those can be in terms of the link between cancers and cigarettes. People accept there is a very clear link between smoking and cancer. There is a very clear link, supported by research, between alcohol and cancer and we can’t continue to ignore it.

“While it might not get us into trouble with addiction or a need like that, people still need to know there are risks associated with drinking alcohol regularly.”

Mr Lane said that alcohol is normalised and even glamorised in society and we need to look beyond the marketing campaigns and look at the consequences of consuming large amounts of alcohol.

“All you need to do is look at what the drinks industry spends on advertising and you would be horrified. You would be horrified with how much is being spent getting people to drink more. Hundreds of millions of euro are spent on advertising in this country. The alcohol problem is stitched into our society” For more information on drug and alcohol misuse or to see the supports that are available in your locality, check out the Cork Local Drug and Alcohol task force website on www.corkdrugandalcohol.ie or speak to your GP.