An increase in people experiencing psychiatric problems directly linked to cocaine abuse has been registered in the last year, according to the government’s top psychiatrist.

Anton Grech, clinical chairman of Mental Health Services, said the rise was “very clear”.

The issue of cocaine abuse has come into sharp focus after a car driven by a cocaine-fuelled driver rammed into a pedestrian on Wednesday in Gżira, killing her on the spot.

Jeremie Camilleri has since been charged with the murder of Pelin Kaya.

A few hours after the crash was reported, the Malta Hotels and Restaurants Association said it was “seriously concerned about what seems to be an increase in violence and accidents related to drug abuse in our community”. The association called for a national discussion on the subject.

Statistics for drug-linked violence and accidents were not immediately available but Grech indicated the problem is impacting the mental health of the nation.

“Over the past year, it is very clear that we have seen an increase in psychiatric problems resulting directly from cocaine use. These include diagnoses such as psychosis, depression and behavioural problems,” said Grech.

Can cocaine use result in violent behaviour?

Speaking in generic terms, Grech said that, like all drugs, cocaine does not have the same effect on everyone – genetics and the type of cocaine used are among the factors that impact the outcome.

Whereas people abusing cocaine generally feel euphoric, in some cases the drug results in them becoming hyper.

“They become too fast and lose control over their thoughts and actions. In some cases, it even makes them psychotic resulting in delusions or hallucinations,” Grech said.

Clinical practice shows that individuals who have psychiatric problems due to drug abuse face issues of addiction and, in some cases, this results in dual diagnosis, which means they become psychotic due to the drug use.

Grech elaborated that cocaine has become more available and affordable globally – “it is no longer the drug of the rich”.

While most cocaine users are in their 20s and 30s, he said, he was seeing more people in their 50s and 60s using cocaine. As with all drugs, most users are men, he said.

Cocaine use increasing in Malta

Malta is seeing an increase in cocaine use due to the increase in supply, Grech suggested, and the data appears to back up his claim.

Cocaine is the second most consumed illicit drug in the EU after cannabis. Malta is no exception. Last year, figures collected by the main NGOs providing drug rehabilitation services revealed that, in 2020, almost a third of all people in treatment reported cocaine as the drug which creates the most problems for them, up from 15 per cent in 2015.

Additionally, the proportion of people receiving treatment for using cocaine for the first time increased from 36 per cent in 2015 to 52 per cent in 2020.

According to a 2022 report released by the EU drugs agency (EMCDDA) and Europol, Malta was among 12 EU countries where large quantities of cocaine were seized in 2020.

Just last week, Customs Malta intercepted 40kg of cocaine at the Malta Freeport in a reefer container, transporting medical products, en route from Puerto Rico to Cairo. 

Customs said it has been registering successes in the fight against cocaine trafficking, year on year, with 2019 recording a total of 750kg (in 13 separate seizures), 2020: 612kg (in one seizure), in 2021 a total of 740kg (in one seizure) and in 2022: 800kg and 1494kg in two separate seizures.

Behavioural repercussions

While not all people who abuse cocaine are violent, experts working with drug users paint a picture of repercussions that may fly under the radar.

In an interview with Times of Malta in November, chief executive of the Foundation for Social Welfare Services, Alfred Grixti, said the foundation had received reports of people taking cocaine at baptisms and funerals. 

The service provided to cocaine users has tripled, he said.

There may also be repercussions in terms of people’s behaviour on the road.

Adrian Galea, director general from the Malta Insurance Association, described the problem as “Pandora’s box”, as no one could determine how drug use was translating into behaviour.

“Locally, we lack the equipment for roadside drug testing that is equivalent to the breathalyser test for alcohol use,” he said, adding that such equipment was used in other countries such as Ireland, Germany, Austria, Spain, Belgium and Cyprus.

Galea noted that this lack of enforcement and checks on the road meant drug users felt at ease when they got behind the wheel.

The agency Sedqa, which advises national policy on drug and alcohol abuse,  said more needs to be done regarding drug driving awareness especially when there is a mix of substances used.

It also suggested creating spaces where people can be admitted for short stays “as a time out period to settle down after a binge or when living rough and chaotically”.

All these factors, said Andrew Agius Muscat, CEO at Malta Hotels and Restaurants Association, resulted in bad publicity for Malta. Drug use, he said, was having a devastating impact on society as well as Malta’s reputation.

“Imagine you’re a parent. Would you allow your child to come and study English in Malta after hearing such news?” he said.