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Pilot medical dispensing of smokable cocaine
The use of basecoke (smokable cocaine) has increased in recent years and has become quite visible in public spaces across the Netherlands. The question arises whether existing facilities for people who use drugs have adapted sufficiently to a changing drug scene. Within this pilot, Mainline is investigating whether the medical provision of smokable cocaine – for people who are already heavily dependent on this drug – can supplement existing harm reduction services.
Substitution
Unlike people dependent on opiates such as heroin, there is no legal substitute available for people dependent on (smokable) cocaine. Patterns of use are also different for stimulants (uppers) than for more sedative drugs (downers).
Still, many of the benefits that apply to, say, methadone or heroin assisted treatment could also apply to legal cocaine dispensing. Especially for people who use smokable cocaine frequently and problematically.
Advantages of legal provision
Some reasoning behind medical dispending of cocaine:
- Providing pharmaceutically produced cocaine gives people access to a product of consistent and verifiable quality
- In doing so, they no longer have to worry about scoring their drugs and can use that time to focus on other life goals
- Through dispending units, people can be linked to psychosocial support and care. People’s health can be monitored and support can be offered when people overdose (over-amp) or show other risk behaviours
- Provision potentially reduces petty crime (shoplifting, pickpocketing)
- Exploitation of often vulnerable users for criminal activities or as fall guy or money mule can be stopped
- Legal provision undermines the position of street dealers.
Practical preconditions: many questions
The idea behind legal, medical dispensing of cocaine is clear. But the preconditions for making such a facility possible raises many questions. For example, do people who use smokable cocaine see sufficient benefit in this? And if so, under what conditions? Where do health care professionals stand in this discussion? And how can you legally provide a drug that is now illegal? Who produces the drug and how and from where can it then be prescribed?
On investigation
It is exactly these questions we are trying to answer in this pilot project. We are gathering the perspectives and ideas of consumers of smokable cocaine and healthcare professionals. And we are looking at how smokable cocaine can have a place among other drugs that are dispensed for medical reasons.
Partners
For this project, Maineline works together with:
- MDHG
- Het Parnassia Addiction Research Centre (PARC)
- Amsterdam UMC
- GGD Amsterdam
Financial support
