Ireland

"26.4% of Irish adults aged 15 years or older report using an illegal drug in their lifetime, 7.5% in the past 12 months and 4.0% in the past month.
"• Lifetime usage of cannabis (24.0%) is considerably higher than any other form of drug. The second most commonly used drug is ecstasy (7.8%) with lifetime usage of cocaine (including crack) and cocaine powder at 6.6% and 6.4% respectively.
"• Almost a fifth (19.9%) of Irish adults have used other opiates in the past month, with 43.4% doing so in the past 12 months and 61.5% having done so at some stage during their life. Results for other opiates are not comparable to previous waves of the survey due to wording and showcard changes (see showcard 138 in the technical report for a list of drugs included in the other opiates category).
"• Over 6 in 10 (62.1%) Irish adults have consumed alcohol in the past month, with past year and lifetime usage at 77.0% and 82.8% respectively.
"• Just over a quarter (25.1%) have smoked a tobacco product in the past month, with twice as many (50.9%) having done so at some stage during their life."

"The Irish data show a fall of 3 percentage points in the rate of lifetime use of any illicit drug between 2007 (22%) and 2011 (19%) (Table 2.3.1). Boys (23%) were more likely than girls (15%) to have used illicit drugs at some point in their life. As the majority of 15–16-year-olds who have tried any illicit drug have used cannabis (marijuana or hashish), the decrease in illicit drug use may be explained by the fall in the number of students who have tried cannabis at some point in their lives, from 20% in 2007 to 18% in 2011 (just above the European average of 17%). Boys (22%) were more likely than girls (15%) to use cannabis at some point in their life. Fourteen per cent of respondents had used cannabis in the year prior to the survey (higher than the European average of 12%). Only two per cent had used ecstasy at some point in their life and the proportion was the same in the year prior to the survey, indicating recent introduction to the use of this drug. In the case of cocaine powder, 3% had used it in their lifetime, just above the European average of 2%. Nine per cent of respondents reported that they had taken prescribed tranquillisers or sedatives at some point in their lives, and a further three per cent had taken them without a prescription. One in twenty had taken alcohol with pills ‘in order to get high’. Lifetime use of solvents/inhalants decreased considerably, from 15% in 2007 to 9% in 2011, and the rate is now the same as the European average (9%)."

"Four-fifths of the students (80% boys and 81% girls) reported that they had consumed alcohol at some point in their life, and 73% (72% boys and 73% girls) had drunk alcohol in the year prior to the survey. Half (48% boys and 52% girls) had drunk alcohol in the 30 days prior to the survey, a decrease of six percentage points since the 2007 survey (56%). Two-fifths (40%) reported having had five or more drinks on a single occasion in the month prior to the survey. Almost one-quarter (23%) reported that they had had one or more episodes of drunkenness in the 30 days prior to the survey, a decrease of three percentage points since the 2007 survey (26%). Nine per cent of the girls and 13% of the boys had had their first episode of drunkenness at or before the age of 13 years. The 2011 European average for alcohol consumption in the last 30 days was 57% (7 percentage points higher than Ireland), while the European average for drunkenness in the last 30 days was 17% (6 percentage points lower than Ireland)."

"Over two-fifths (43%) of the students (42% boys and 45% girls) reported that they had smoked cigarettes at some point in their life, and 21% (19% boys and 23% girls) had smoked cigarettes in the 30 days prior to the survey. Over one-fifth had had their first cigarette at or before the age of 13 years. Five per cent were smoking daily at or before the age of 13 years. The 2011 European average for smoking cigarettes in the last 30 days was 28% (7 percentage points higher than Ireland), while the European average for smoking cigarettes daily at age 13 or under was 6% (one percentage point higher than Ireland). Three-quarters reported that cigarettes were easy or fairly easy to acquire in Ireland. Over one-fifth thought that people who smoked cigarettes occasionally were at great risk of harming themselves; 67% thought that smoking one or more packs a day constituted a great risk.
"The reduction in cigarette use is larger than the reduction in alcohol use, and alcohol is easier to acquire than cigarettes. The rate of lifetime use of cigarettes decreased by 31 percentage points, from 74% in 1995 to 43% in 2011, and use in the month prior to the survey decreased by 20 percentage points, from 41% in 1995 to 21% in 2011. The proportion who reported smoking cigarettes on a daily basis by age 13 years decreased by 13 percentage points, from 18% in 1995 to 5% in 2011."

"The data available have limitations in respect to quality and coverage, however, the information available suggests that heroin was only present in the majority of overdose deaths in a relatively small number of EU countries. A significant share of overdose deaths was reported by Austria (67%), Italy (56%), Ireland (46% in 2017), Poland (44% in 2016) and Romania (43%). In 7 other European countries, heroin was found in approximately a quarter to a third of reported overdose deaths: Portugal (37%), Slovenia (33%), Denmark (36%), France (33% in 2020), Türkiye (32%), Spain (28% in 2020) and Norway (23%). In 2021, in the north of Europe, less than 1 in 6 overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin."

"Cigarette smoking has been shown in other studies to act as a 'gateway' to cannabis use and further risk taking behaviours. This study aims to establish the prevalence of cigarette smoking and cannabis use in Irish teenagers, to quantify the strength and significance of the association of cigarette smoking and cannabis use and other high risk behaviours and to examine whether the above associations are independent of social networking (O'Cathail, et al. 2011).
"Adolescent students across five urban, non-fee paying, schools were invited to complete an abridged European schools survey project on alcohol and other drugs (ESPAD) questionnaire. The abridged questionnaire was completed by 370 out of a possible 417 students, giving a response rate of 88.7%. Of these, 228 (61.6%) were girls and 349 (94.3%) were aged 15–16 years.
"The proportion who had smoked cigarettes at some point in their life was 48.4% and 18.1% had smoked in the 30 days prior to the survey. Just over 15.1% used cannabis at some stage in their life and 5.7% had used it in the 30 days prior to the survey. A higher proportion of cigarette smokers (29.6%) had used cannabis compared with 1.6% of non-smokers. After controlling for the influence of other factors, hard drug (heroin or cocaine) use was six times more likely among lifetime cigarette smokers compared to non-smokers (adjusted OR=6.0, p<0.01); soft drug use (cannabis) was almost five times more common among smokers (adjusted OR=4.6, p<0.01); high-risk sex practices were almost 11 times more common among cigarette smokers (adjusted OR=10.6, p<0.05); poor examination results were almost three times more common among smokers (adjusted OR=2.9, p<0.0001); and being absent from school owing to illness was almost twice as likely among smokers (adjusted OR=1.9, p<0.01)."

"Recent (or last-year) illicit drug use among the 15–64-year-old population stabilised or decreased marginally in most RDTF [Regional Drug Task Force] areas between 2006/7 and 2010/11, with no area showing a significant increase (Table 2.2.5). As expected, recent use is higher among men than women and higher among those aged 15–34 years than among their older counterparts.
"Cannabis was the most commonly reported illegal drug used in each of the RDTF areas, with rates of recent use ranging between 2.8% in the North West and 9.4% in North Dublin (Table 2.2.6 and Figure 2.2.1). Rates have stabilised or fallen in six RDTF areas (not statistically significantly) and increased significantly in one area, the Western RDTF area."

"Lifetime cannabis use increased over the four years since the 2006/7 survey, but last-year use remained stable (Table 2.2.2). The proportion of adults who reported using cannabis at some point in their life increased from 21.9% in 2006/7 to 25.3% in 2010/11. The proportion of young adults who reported using cannabis in their lifetime also increased, from 28.6% in 2006/7 to 33.4% in 2010/11. The lifetime prevalence rate in 2010/11 was higher for men (33.2%) than for women (17.5%).
"The proportion of adults who reported using cannabis in the last year did not decrease significantly in 2010/11 (6.0%) when compared to 2006/7 (6.3%). The proportion of young adults who reported using cannabis in the last year remained reasonably stable over the last two survey periods. The proportion of adults who reported using cannabis in the last month remained stable also, at 2.8%."

"Lifetime cocaine use increased in 2010/11 compared to 2006/7, but last-year use remained stable (Table 2.2.3). The proportion of adults who reported using cocaine (including crack) at some point in their lives increased from 5.3% in 2006/7 to 6.8% in 2010/11. The proportion of young adults who reported using cocaine in their lifetime also increased, from 8.2% in 2006/7 to 9.4% in 2010/11. As expected, more men (9.9%) reported using cocaine in their lifetime than women (3.8%).
"The proportion of adults who reported using cocaine in the last year remained reasonably stable at 1.7% in 2006/7 and 1.5% in 2010/11. The proportion of young adults who reported using cocaine in the last year did not vary significantly, being 3.1% in 2006/7 and 2.8% in 2010/11. The proportion of adults who reported using cocaine in the last month remained stable at 0.5%."

"Almost 11% of young adults surveyed in 2010/11 claimed to have tried ecstasy at least once in their lifetime (Table 2.2.4). More young men (15%) reported using ecstasy in their lifetime than young women (6%) as presented in Standard Table 1. The proportion of young adults who used ecstasy in the last year decreased significantly, from 2.4% in 2006/7 to 0.9% in 2010/11. The decrease in ecstasy use may be partly explained by the proportion (6.7%) of young people reporting use of new psychoactive substances sold in head shops and on line ((National Advisory Committee on Drugs and Public Health Information and Research Branch 2011): Table 1.3).
"As already noted in Section 2.1, the increase in the proportions using any illegal drug at some point in their lives between 2006/7 and 2011/12 was influenced by the fact that drug use in Ireland is a recent phenomenon and the population of lifetime and recent drug users is relatively young. Drug use is measured among adults aged 15–64, and those leaving this age group over the next five years are less likely to have been exposed to drug use than those entering the measurement cohort. The relative stability in last-year use of cannabis and cocaine indicates that the situation with respect to these drugs has stabilised."

Problem Drug Use

"A PDU is defined in Ireland as an ‘injecting drug user or long duration/regular user of opiates, cocaine and/or amphetamines’ (EMCDDA 2004).
"It is not possible to estimate the number of injecting drug users or PDUs, apart from opiate users, in Ireland as the National Drug Treatment Reporting System (NDTRS) does not use a unique identifier.
"A national 3-source capture-recapture (CRC) study, to provide statistically valid estimates of the prevalence of opiate drug use in the national population, was commissioned by the National Advisory Committee on Drugs (NACD) and undertaken in 2001 and 2006. The 2006 study (Kelly, Alan, et al. 2009) indicated that use had increased since the 2001 survey (Kelly, Alan, et al. 2003). There were 11,807 known opiate users in 2006. The major expansion of the national methadone treatment programme between 2001 and 2006 was the main reason for the inflation of the figures. There is some doubt over the estimate produced of a possible further 8,983 opiate users who had not come into contact with any of the drug treatment services, hospital in-patient services or the Gardaí.
"The following were among the trends (2001–2006) seen in the study results:
"? the rate of opiate use among females and males aged 15–24 decreased, indicating a significant reduction in the number of young people commencing opiate use,
"? an increase in opiate use outside of Dublin, and
"? a higher proportion of opiate users in treatment in Dublin than elsewhere, reflecting the more recent spread of opiate use outside Dublin and the later development of treatment services."

"Voluntary linked testing for antibodies to HIV has been available in Ireland since 1985. According to the most recent report of the HPSC, at the end of 2011 there were 6,287 diagnosed HIV cases in Ireland, of which 1,485 (24%) were probably infected through injecting drug use (O'Hora and O'Donnell 2011). Figure 6.2.1.1 presents the number of new cases of HIV among injecting drug users reported in Ireland, by year of diagnosis; data from 1982 to 1985 are excluded as these four years were combined in the source records. There was a fall in the number of HIV cases among injecting drug users between 1994 and 1998, with about 20 cases per year, compared to about 50 cases each year in the preceding years. There was a sharp increase in the number of cases in 1999 (69 new cases), which continued into 2000 (83 new cases). Between 2001 and 2010 there was an overall decline in the number of new injector cases when compared to 2000.
"Of the 16 new HIV cases reported in 2011, 13 were male and three were female, and the median age among intravenous drug users (IDUs) was 37 years (range 22–48 years). Eight cases (36.4%) were born in Ireland and another three (36.4%) in central and eastern Europe and two in Africa. Nine new cases were Irish, eight cases were not Irish and five cases had no country of origin recorded. At the time of HIV diagnosis in 2011, 85% of IDUs for whom CD4 count was reported were classified as diagnosed late (CD4 count <350 cells/mm3), three had AIDS and two had an acute HIV infection."

"Hepatitis C is one the most common blood-borne viral infections among injecting drug users and is transmitted through contact with the blood of an infected person. The main routes of transmission are mother-to-baby, unsafe injections, transfusion of blood and blood products, and unsterile tattooing and skin piercing. There were 1,236 cases of hepatitis C reported to the HPSC in 2010 (Table 6.2.1.2), compared to 1,257 cases in 2011.
"The number of notifications of hepatitis C continued at a very high rate in 2011 (Table 6.2.1.2). Where risk factor data were available, 82% were injecting drug users (Table 6.2.1.3). Most cases occurred in middle-aged adults and males (Table 6.2.1.4). The majority of cases were notified in the eastern region of Ireland."

"In 2010, there were 164 deaths owing to poisoning recorded in Ireland by the NDRDI [National Drug-Related Deaths Index]. This represents a substantial drop compared to 2009, when 216 such deaths were recorded (Table 6.4.1.1; see also Standard Tables 5 and 6). It should be noted that annual data previously reported has been changed as the database has been updated as new information has become available.
"The number of deaths where cocaine was implicated (either alone or with another drug or substance) declined from 53 in 2009 to 20 in 2010. This reflects decreasing trends in relation to cocaine seen in other areas, with the exception of prevalence data. In 2010 there was a reduction in the number of seizures of cocaine reported (Irish Focal Point (Reitox) 2011) and a reduction in the number of cases treated for cocaine (see Section 5.3.2). However, data from the general population prevalence survey showed an increase in reported lifetime use, from 5.3% in 2006/07 to 6.8% in 2010/11 (National Advisory Committee on Drugs and Public Health Information and Research Branch 2011). Notwithstanding the increase in lifetime use, there was a small decrease in the prevalence of last-year use, from 1.7% in 2006/07 to 1.5% in 2010/11.
"The number of deaths where heroin was implicated (alone or with another drug or substance) also dropped, from 115 in 2009 to 70 in 2010. This is the first time since 2005 there has been a decrease in the number of deaths owing to poisoning where heroin was implicated. In 2010 there was a reduction in the number of heroin seizures reported, but it cannot be ascertained if this was due to a reduction in heroin use, a change in law enforcement activities or another factor as yet unknown (Irish Focal Point (Reitox) 2011)."

"Data extracted from the Hospital In-Patient Enquiry (HIPE) scheme were analysed to determine trends in non-fatal overdoses discharged from Irish hospitals in 2010. There were 4,562 overdose cases in that year, of which 40 died in hospital. The 4,522 discharged cases were included in this analysis. The number of overdose cases increased by 8% between 2009 and 2010, following a decrease of 13% between 2008 and 2009 (Figure 6.3.1.1)."

Treatment

"It is important to note that each record in the NDTRS [National Drug Treatment Reporting System] database relates to a treatment episode (a case), and not to a person. This means that the same person could be counted more than once in the same calendar year if he/she had more than one treatment episode in that year.
"The number of cases entering drug treatment each year and reported to the NDTRS increased by 52%, from 5,176 in 2005 to 7,878 in 2010. The increase in the total number of people requiring drug treatment services, including previously treated cases returning to treatment is a strong indication that problematic drug use remains a pressing issue, and presents complex and multiple challenges to those providing treatment. The clear spread and increase in treated drug use throughout the country reflect not only the extent of problem drug use but also an increase in treatment availability and compliance with the NDTRS.
"Figure 5.3.2.1 presents the rates for the incidence (new cases) and prevalence (all cases) of treated problem drug use for the years 2005–2010, expressed per 100,000 of the population aged 15–64 years, based on census figures for 2005 and 2006 and Central Statistics Office (CSO) estimated figures for 2007 to 2010.The incidence increased consistently each year, rising from 70 cases per 100,000 in 2005 to 106 cases in 2010. The number of new cases entering treatment is an indirect indicator of recent trends and points to an increase in drug use over the six-year period.
"The prevalence also increased consistently during the reporting period, rising from 423 cases per 100,000 in 2005 to 544 cases in 2010. This indicates that problem drug use is a chronic, recurring health condition that requires repeated episodes of treatment over time."

Harm Reduction

"MQI’s [Merchants Quay Ireland's] needle-exchange service recorded approximately 25,000 client visits in 2010, a 20% decrease on 2009 figures. The report highlighted a continuing high level of demand for homeless services, with 57,840 meals provided in 2010. The number of health care interventions provided increased by 15%, to 3,685 in 2010.
"In 2010 MQI successfully tendered to provide the national prison-based addiction counselling service to 13 prisons. In excess of 13,000 counselling hours were provided during 2010. This service was provided by 23 counsellors, each with an average caseload of 550 prisoners.
"MQI in association with the Midland Regional Drugs Task Force administers the Midlands Family Support and Community Harm Reduction Service, providing outreach and working with families of those actively using drugs in that task force region. The family support service provided services to 237 new clients across the region during 2010. The harm reduction service provided needle-exchange services to an average of 124 clients each month during 2010."

"On 7 February 2012 the report of the National Substance Misuse Strategy Steering Group was launched (Department of Health 2012a). In 2009, having decided to include alcohol in a national substance misuse strategy, the government established this steering group, chaired by the Department of Health, to advise on a new strategy. The steering group was drawn from relevant government departments and agencies, medical professional bodies, the community and voluntary sectors and the alcohol industry. Its terms of reference were to:
"? set out an evidence-based framework identifying effective policies and actions to tackle the harm caused to individuals and society by alcohol use and misuse;
"? decide on appropriate structures and frameworks for an effective and efficient implementation plan for the National Substance Misuse Strategy;
"? align, as far as possible, the proposed policies and actions with the existing pillars of the National Drugs Strategy; and
"? make proposals for an overall National Substance Misuse Strategy, incorporating the National Drugs Strategy 2009–2016.
"The steering group adopted a population-based approach. Its report contains 45 recommendations under the supply, prevention, treatment and rehabilitation, and research pillars ((Mongan 2012c), (Mongan 2012a))."

"Established in June 2011 by the new coalition government, the Joint Committee on Health and Children in the 31st Dáil decided that an early priority would be to consider the issues surrounding the misuse of alcohol and other drugs. In the course of its discussion on the misuse of drugs, committee members asked whether it was time to consider the drug policy options preferred by Portugal and the Netherlands, i.e. eliminate criminal sanctions for illicit drug users (Dowds 2011, 22 September), and whether it was time to consider allowing people with a complete physical and chemical dependence on heroin or morphine to get their heroin or morphine in well-supervised, clean, incorruptible circumstances, i.e. establish safe injecting facilities (Crown 2011, 15 September).
"In January 2012 the Joint Committee on Health and Children published its conclusions in a report on the misuse of alcohol and drugs (Joint Committee on Health Children 2012). The committee’s overarching aim was to highlight the prevalence of alcohol and other drugs in society and to emphasise the misuse of alcohol in particular. The report was based primarily on published research on the issue of alcohol and drug misuse, submissions made to the committee by stakeholders (including some 20 or so groups from the statutory and voluntary sectors), and transcripts of the committee’s discussions.
"The Joint Committee formed the opinion that no single measure will solve the problem of alcohol use and that a package of measures is needed to change attitudes, as well as behaviours, regarding the consumption of alcohol. With regard to the misuse of illicit drugs, the committee made recommendations with regard to the following aspects:
"• Supply reduction: In light of the spread of grow houses in Ireland, legislation is needed criminalising the importation of cannabis seeds. Stricter controls are needed in relation to the importation and prescription of benzodiazepines.
"• Prevention and education: The government should consider how a programme of new, preventative, educational initiatives, aimed at the general public, could be devised to highlight the implications and dangers of alcohol and drug misuse, and to influence prevailing cultural attitudes, particularly with regard to the use of alcohol.
"• Treatment and rehabilitation: There should be renewed emphasis on the implementation by the HSE of the four-tier model, and more resources should be allocated to drug rehabilitation services, to significantly increase the number of dedicated inpatient detoxification beds, and to reduce waiting times to access drug services across the country."