Unusually for books on the topic, Drug Policy includes a chapter on the democratic process and the role played by the public in drug policy formation.1 Author Alison Ritter explores how the public might participate in the decision-making process and identifies several obstacles to participation in contemporary liberal democracies. Justifications for government decisions are based on the strength of the arguments supporting them and on the consent which the electorate gives through the electoral process. Because of the complexity of governing, the technical tasks of policy are left to experts, with input from the bulk of the population largely limited to infrequent elections.

The Programme for Government, which was launched in June 2020, committed to holding a Citizens’ Assembly on Drugs Use.1 In February 2023, the Government gave its approval for the assembly to be established. The assembly’s work will run from April to December 2023. The establishment of the assembly has been overwhelmingly welcomed by stakeholders across the sector and the political spectrum

In December 2022, the Joint Committee on Justice published Report on an examination of the present approach to sanctions for possession of certain amounts of drugs for personal use.1 The report makes a set of wide-reaching recommendations on how the committee thinks Ireland’s approach to people who use drugs should change. It includes a recommendation for the decriminalisation of the possession of drugs for personal use.

Joint Committee on Justice

The Joint Committee on Justice is described as shadowing the Department of Justice and considers policy ‘in the fields of justice, security and the rule of law to ensure that Irish society is safe, secure, just, open-minded and impartial’.2 The committee comprises Dáil Deputies and Senators of the Oireachtas from across all political parties and independents. It is chaired by James Lawless TD of Fianna Fáil and its members include Labour Party TD Aodhán Ó Ríordáin and Independent Senator Lynn Ruane, both of whom are long-standing contributors to the national discussion on drug issues. The aim of the committee is to have meaningful input into key legislation and policy areas. It should be noted that the committee’s findings and recommendations do not necessarily reflect those of the Minister for Justice or the Department of Justice.

Alcohol use is a leading risk factor for death and disability and there is a need for evidence-based policy measures to tackle excess alcohol consumption and related harms. A 2023 study, led by University College Cork (UCC), examined attitudes towards alcohol control measures among the general public in Ireland in the context of significant reforms undertaken in the Irish alcohol policymaking landscape.1

In this research, conducted by Dr Susan Calnan and Dr Seán Millar of the UCC School of Public Health and Dr Deirdre Mongan of the Health Research Board, a representative household survey was undertaken in three regions of Cork and Kerry. A total of 1,069 participants took part. Descriptive and univariate analyses were used to examine factors associated with support for alcohol control policy measures.

A 2023 report grounded in women’s lived experiences of substance use in Ireland was launched by the then Minister for Justice Simon Harris TD on 30 March entitled, ‘You can’t fix this in six months’: Understanding the intersectionality of women’s substance use in the Irish context.1 The report highlights the complex nature of women’s substance use and the issues they face. It argues for female-only services that support motherhood and recognise the exploitation, trauma, and abuse many women who use substances experience (p. 19).1 The research, funded by the Irish Research Council New Foundations scheme, was carried out by a team from University College Dublin led by Dr Sarah Morton in partnership with Merchants Quay Ireland.

Background

Breast cancer is the most common cancer among women in Ireland and alcohol use is estimated to be attributable to approximately 7% of breast cancer cases.1,2 Almost one-half of women in Ireland drink alcohol on a weekly basis (48%) and approximately one in five women report binge drinking on a typical drinking occasion (19%). However, despite alcohol being classified as a Group 1 carcinogen (cancer-causing) since 1988, many people appear unaware of this fact.3,4

Background

Minimum unit pricing (MUP) of £0.50 sterling per unit (10 ml or 8 g) was introduced in Scotland in 2018 in response to health harms from alcohol being disproportionately higher in Scotland compared with the rest of the United Kingdom, especially so in areas of deprivation. MUP is a measure recommended by the World Health Organization as a ‘best buy’ to reduce alcohol-related harms. As it targets those who buy the cheapest alcohol who are typically the heaviest drinkers, it has the potential to reduce inequalities of alcohol-related harms.1,2 Three years after implementation, MUP resulted in a 3% reduction in alcohol sales in Scotland, most evident in households that before MUP had purchased the most alcohol.1 A 2023 study to examine the impact of MUP on alcohol-related deaths and hospitalisations wholly attributable to alcohol use compared time periods before and after the introduction of MUP.3

Background

A systematic review of the literature was undertaken to examine the impact of minimum unit pricing (MUP) on alcohol-related hospitalisations.1 The review also sought to determine if MUP had an effect on length of hospital stay for alcohol-related conditions, on hospital mortality, and for alcohol-related liver disease. Given that the costs of alcohol-related hospitalisations on the Irish healthcare system are estimated at €1.5 billion (in 2012) and the high levels of alcohol use in Ireland, legislation to reduce alcohol use and related harms were introduced in 2018.2–4 A component of this legislation, the Public Health (Alcohol) Act 2018, is MUP, set at €1.00 per standard drink or per 10 g of alcohol. Ireland is one of the few countries globally to introduce such a measure, as well as certain provinces in Canada; Northern Territory, Australia; Scotland; Wales; Jersey; Armenia; Belarus; Kyrgyzstan; Moldova; Russia; Ukraine; and Uzbekistan.5

Background

Methadone maintenance treatment (MMT) is considered a common treatment for opiate- dependent people across Europe and especially in Ireland. As MMT services cater for vulnerable populations, a human-rights-focused approach can assist in shaping and framing processes to provide more equality and access to services. A 2022 qualitative study1 looked at how to better understand the human-rights perspective in relation to people accessing MMT services in Ireland.

The Adolescent Addiction Service (AAS) of the Health Service Executive (HSE) provides support and treatment in relation to alcohol and drug use for young people and families from the Dublin suburbs of Ballyfermot, Clondalkin, Palmerstown, Lucan, and Inchicore. Services provided include advice, assessment, counselling, family therapy, professional consultations, and medications if required. In 2023, AAS published a report detailing referrals for 2022.1

The annual report published by the Mental Health Information Systems Unit of the Health Research Board, Activities of Irish psychiatric units and hospitals 2021,1 shows that the rate of new admissions to inpatient care for alcohol disorders has decreased.

In 2021, some 758 cases were admitted to psychiatric facilities with an alcohol disorder, of whom 311 were treated for the first time. Figure 1 presents the rates of first admission between 2001 and 2021 for cases with a diagnosis of an alcohol disorder. The admission rate in 2021 was lower than the previous year and trends over time indicate an overall decline in first admissions. Just over one-third (35.2%) of cases hospitalised for an alcohol disorder in 2021 stayed under 1 week, while 29.8% of cases were hospitalised for between 1 and 3 months, similar to previous years.

Strategy Statement 2022–2024

An Garda Síochána Strategy Statement 2022–2024 was published on 9 June 2022.1 The mission of An Garda Síochána (AGS) for the duration of the strategy is simply ‘Keeping people safe’ (p. 6). While the strategy is set against the backdrop of living in a post-pandemic world, with global political and economic uncertainty, AGS is committed to evolving and meeting policing demands that are continually changing. The five pillars that the strategy focuses on are:

• Community
• Tackling crime and preventative policing
• Victims and the vulnerable
• Protecting the security of the Irish State
• Sustainable change and innovation.

The 2021 annual report of the Courts Service was published on 28 July 2022. While the report presented data for all criminal cases arising within the Irish justice system between January and December 2021, this article only discusses the statistics of prosecutions for drug offences.1 The data provided are for overall drug law offences. The Courts Service in Ireland does not distinguish between the different supply offences and possession/use offences (Courts Service, personal communication, 2017).

The 2021 annual report of the Department of Justice was published on 18 January 2023.1 The report outlines the progress made by the Department to fulfil goals and objectives identified in its Statement of Strategy 2021–2023.2

The Ana Liffey Drug Project (ALDP) is a ‘low-threshold, harm reduction’ project working with people who are actively using drugs and experiencing associated problems. ALDP has been offering harm reduction services to people in the north inner-city area of Dublin since 1982, from premises at Middle Abbey Street. ALDP offers a wide variety of low-threshold, harm reduction services that provide pathways for people who use drugs out of their current circumstance, including addiction and homelessness.

The services offered in Dublin include:

• Open access
• Assertive outreach
• Needle and syringe programme
• Medical services
• Stabilisation group
• Detox group
• Harm reduction group
• Treatment options group
• Assessment for residential treatment
• Key working and case management
• Prison in-reach.

The Danger of Viral Exposure (DOVE) Service in the Rotunda Hospital, Dublin was established to meet the specific needs of pregnant women who have or are at risk of blood-borne or sexually transmitted bacterial or viral infections in pregnancy. Exposure may also occur through substance use. Figures from the service for 2021 were published in the hospital’s annual report in 2022.1

Clinical activity

Figure 1 shows the number of women who booked into the DOVE Service for antenatal care each year during the period 2011–2021. It also shows the diagnosis of viral disease for these women. During 2021, some 166 women booked into the DOVE Service for antenatal care. 

Prevalence and current situation

Denormalising alcohol industry activities in schools
van Schalkwyk MCI, Petticrew M, Maani N and Hawkins BR (2023) Lancet, 8(2): e90–e91.
https://www.drugsandalcohol.ie/38019/ 

‘The area I’m from is very rough’: drug users’ views on the role of social and economic factors in their experiences of drug-related harm
O’Mahony S (2023) Journal of Ethnicity in Substance Abuse, Early online. https://www.drugsandalcohol.ie/38331/ 

Illicit drug use in university students in the UK and Ireland: a PRISMA-guided scoping review
Boden M and Day E (2023) Substance Abuse Treatment, Prevention, and Policy, 18: 18.
https://www.drugsandalcohol.ie/38384/ 

Drugnet Ireland is the quarterly newsletter of Ireland’s focal point for the EMCDDA and is produced in collaboration with the HRB National Drugs Library. Drugnet Ireland is published by the Health Research Board.

Managing editor: Brian Galvin
Copyediting: O’Hanlon Media

© Health Research Board, 2023