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In brief
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In brief
The nature of the drug phenomenon is changing rapidly, and recent years have seen a marked increase
in the use of stimulants and dissociative substances. Geopolitical changes, the emergence of new
trafficking routes, and other supply-related factors add further complexity. The dangers posed by
polydrug use and the emergence of new synthetic drugs means that we will need to develop more timely
sources of information, linked to risk communication systems, and more responsive harm reduction
strategies, particularly in recreational settings. While we need to continue to respond effectively
to the current situation, much of our focus must be on developing preparedness and anticipatory
capacity in this constantly evolving field.

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Cover story
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Deaths among people who were homeless at time of death in Ireland, 2019
by Erica Keegan
The retrospective review by Lynn et al.1 sought to investigate mortality in homeless individuals in
Ireland during 2019. This was a feasibility study aimed at developing a greater understanding of
premature mortality among the homeless using the National Drug-Related Death Index (NDRDI), an
epidemiological database. The study was commissioned by the Department of Health and sought to
provide more complete and accurate data to help inform policy. It is the first Irish study to
examine the number and causes of homeless deaths nationally.

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Policy and legislation
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Launch of new drug prevention and education funding scheme
by Lucy Dillon
Five projects are to receive funding over the next 3 years under the Department of Health’s National
Drug Prevention and Education Funding Programme. The fund aims to increase the delivery in Ireland
of prevention programmes that are supported by evidence and adhere to international prevention
standards.1,2 The five funded organisations and their projects are outlined in Box 1.


They will be delivered in school, third-level, youth work, and community-based settings. To mark the
start of the funding programme, representatives of the five projects met with statutory and
non-statutory stakeholders working in the field of prevention at an event hosted by the Department
of Health on 6 June 2023.

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E-SHIELD: Enabling Students and Higher Education Institutions to Lead the response on Drugs
by Seán Millar
The MyUSE Research Group in University College Cork (UCC) is to receive funding over the next 3
years under the Department of Health’s National Drug Prevention and Education Funding Programme. The
funding programme aims to increase the delivery in Ireland of prevention programmes that are
supported by evidence and adhere to international prevention standards.1,2

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Public Health (Alcohol) (Labelling) Regulations 2023 signed into law
by Anne Doyle
Background


In May 2023, the Minister for Health, Stephen Donnelly TD, signed Section 12 of the Public Health
(Alcohol) Act 2018 into law, aligning alcohol products with other food and beverage products that
already contain health information and, where appropriate, health warnings.1,2 Ireland now leads the
world in the introduction of health labelling on alcohol products; no other country in the world has
such comprehensive labelling.

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Young people’s consultation for the Citizens’ Assembly on Drugs Use
by Lucy Dillon
To include the voices of young people at the Citizens’ Assembly on Drugs Use, youth consultations
were carried out on behalf of the Department of Health.1 A report on these consultations was
published in May 2023 in advance of the second meeting of the Citizens’ Assembly.2


Aims and methodology


The consultations aimed to give young people a voice at the Citizens’ Assembly. To meet this aim,
the views of young people on the impact of drug use on their lives, families, and communities were
explored, as well as their suggestions for appropriate responses to address the harms caused by drug
use. There were two strands to this work – a group consultation and a survey – which intended to
capture the views of young people with differing levels of exposure to drug use.

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New strategic action plan for national drugs strategy
by Lucy Dillon
A new strategic action plan for the delivery of the national drugs strategy, Reducing Harm,
Supporting Recovery, for 2023 through 2024, was published in June 2023.1,2


Context of action plan


The action plan represents the latest phase in the lifetime of the strategy, which at the time of
its publication in 2017 was accompanied by a shorter-term action plan (2017–2020).1 A midterm review
of the strategy was undertaken in 2021 and its findings informed the development of six new
strategic priorities for the remainder of the strategy.3 Six Strategic Implementation Groups (SIGs)
were established to drive delivery of these priorities. The new action plan represents the output of
their work in agreeing a set of actions for the six groups and associated deliverables for five of
them. (SIG 4 did not list any deliverables.) Overall, the new action plan represents a continuation
of earlier commitments and outputs from the national drugs strategy.

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Recent research
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Evaluation of Planet Youth in Western Regional Drug and Alcohol Task Force
by Lucy Dillon
A process evaluation of Planet Youth in the Western Regional Drug and Alcohol Task Force (WRDATF)
area was published in July 2023.1 The evaluation documents the outputs from the project to date and
explores the views of stakeholders on the project’s implementation and structures. This article
presents the international and national contexts to Planet Youth and the Icelandic model, as well as
an overview of some of the evaluation’s findings and a reflection on the implications for Planet
Youth in the WRDATF and elsewhere in Ireland. As with the evaluation, it considers the role of
Planet Youth in the WRDATF moving forward – whether it continues to focus on generating and
promoting data or to shift the focus of its resources to deliver on a broader range of its
objectives.2

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Trends in Irish public attitudes to permitting cannabis for recreational use since 2002
by Deirdre Mongan
Background


There has been much debate around the liberalisation of cannabis laws both in Ireland and
internationally. The recreational use of cannabis has been legalised in 23 states in the United
States (US), in Canada, and in Uruguay.


While no national government in Europe supports legalisation of cannabis sale for recreational use,
a new coalition government in Germany agreed in late 2021 to regulate the sale of cannabis to adults
for recreational purposes, while Luxembourg has also announced that it will legalise the production,
sale, and consumption of cannabis.

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Impact of changes to opioid agonist treatment during the Covid-19 pandemic
by Erica Keegan
A 2023 article by Durand et al.1 examined the impact of changes introduced to the delivery of opioid
agonist treatment (OAT) on the number of people accessing treatment and treatment dropout during the
Covid-19 pandemic. This is an important Irish study, as it directly examines OAT coverage and access
during the pandemic.

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Association between increased levels of hope and slower rates of relapse in opioid use disorder
by Erica Keegan
A 2023 study by Reddon and Ivers evaluated the association between levels of hope and rates of
relapse following discharge from opioid agonist treatment (OAT) and/or detoxification programmes
among those with opioid use disorder (OUD).1 This study adds to the body of evidence on hope levels
and recovery, indicating that strategies that cultivate hope and empowerment may be an effective
strategy to increase personal recovery capital and decrease relapse rates.



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A thematic analysis of alcohol use and culture among elite GAA players
by Anne Doyle
Background


In Ireland, Gaelic football and hurling are the most popular field sports in the country, with in
excess of 1.5 million spectators viewing the Championship finals every year. The Gaelic Athletic
Association (GAA) manages and promotes all Gaelic games, while the Gaelic Players Association
represents almost 4,000 male and female players. A study published in 2022 highlighted that
hazardous alcohol use, including binge drinking, and alcohol-related harms are prevalent among elite
Gaelic footballers and hurlers.1 The online survey used in the 2022 study included an optional free
text section for the players to make any comments in relation to alcohol; these comments were then
examined in a 2023 study.2

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Alcohol, drug use and experiences of sexual violence victimisation among first-year college students
in Ireland
by Anne Doyle
Background


Emerging adulthood along with starting third-level education is a period of considerable change for
young people. Newly independent, it is also a key time for them to experiment with drugs, alcohol,
and sexual intimacy, which when combined increases the risk of sexual violence.

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Self-harm in Irish prisons, 2017–2019
by Seán Millar
The Self-Harm Assessment and Data Analysis (SADA) Project was set up in Ireland in 2016 to provide
robust information relating to the incidence and profile of self-harm within prison settings as well
as individual-specific and context-specific risk factors relating to self-harm.


In addition, it examines patterns of repeat self-harm (non-fatal and fatal). Both the Health Service
Executive’s National Office for Suicide Prevention and the National Suicide Research Foundation
assist the Irish Prison Service with data management, data analysis, and reporting.

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Health needs assessment in Irish prisons, 2022
by Seán Millar
The Irish Prison Service (IPS) operates according to a multi-year strategic plan that provides
guidance and direction to the activities and ambitions of the organisation.


In particular, the IPS strategic plan provides a narrative for the improvement and further
development of all facets of healthcare during the prisoner experience. Key areas of focus are
prisoner support for improving healthcare, enhancing psychological wellbeing, increasing
rehabilitation support, and resettlement and integration.

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Prevalence/current situation
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Drug treatment demand in Ireland, 2022
by Derek O’Neill
Published in June 2023, the latest report from the National Drug Treatment Reporting System (NDTRS)
presents data on treated problem drug use (excluding alcohol) for the year 2022, followed by trends
for the seven-year period from 2016 to 2022.1


Key findings, 2022


In 2022, some 12,009 cases were treated for problem drug use.2 This is the highest annual number of
cases recorded by the NDTRS to date. Almost 4 in 10 (37.1%) of those cases were never treated
before, while almost 7 in 10 (68.9%) cases were treated in outpatient facilities.

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Progress in the Penal System: drug treatment
by Seán Millar
A report from the Irish Penal Reform Trust (IPRT), entitled Progress in the Penal System (PIPS): a
framework for penal reform (2022), was published in 2023.1 PIPS aimed to set out a clear vision for
the future of the Irish penal system, taking as its starting point that Ireland, as a small wealthy
country, should work towards becoming a leading model of international best penal practice. In
total, 28 standards were assessed in 2022, including drug and alcohol treatment.

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Alcohol and drug use among Irish farmers
by Seán Millar
Farming is a high-pressure occupation that carries numerous risks for farmers, many of which are
beyond their control.1 In Ireland, this pressure is borne by a shrinking population of farmers, most
of them older men, working on a declining number of farms.2 As a result of these pressures, some
farming populations have a higher prevalence of mental health issues,3 while some populations of
farmers are known to drink heavily.4

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Problem gambling in Ireland: Irish health data, 2008–2022
by Cathy Kelleher and Tiiana Lynch
Background


Problem gambling is a considerable burden on society as well as on persons who gamble and those
around them. In Ireland, about one-half of the population (49%) gambles in some form, while 0.3% (or
12,000 people) engage in problem gambling and tens of thousands more are deemed at risk.1


In 2022, legislation was introduced in Ireland to provide for the establishment of a new regulatory
body – the Gambling Regulatory Authority of Ireland (GRAI) – with a focus on public safety and
wellbeing and including an addiction specialist within its members.2
Coinciding with the establishment of the GRAI, the Economic and Social Research Institute (ESRI) was
commissioned to review relevant policy issues.3

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Responses
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Evaluation report on Youth Diversion Projects
by Ciara H Guiney
The Evaluation report on Youth Diversion Projects (YDPs) was launched on 13 June 2023 by Minister of
State James Browne TD.1,2 This was the first evaluation report on YDPs1 and was carried out by
Research Matters Ltd between December 2021 and November 2022. The central aim was to create
policy-relevant information relating to the structure, conduct, and impact of YDPs.


Context of report


YDPs target young people aged 12 to 17 years who are part of communities with a detected need or
where youths are at risk of continuing to be involved with the criminal justice system.

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Progress on Youth Justice Strategy implementation statement, 2021
On 16 December 2022, the Department of Justice provided an update on the progress made in addressing
the objectives and key actions identified in the Youth Justice Strategy 2021–2027 (YJS).1,2,3 The
YJS is centred on a developmental framework that aims to target ongoing and emerging challenges in
youth justice in Ireland.2 A key strength of this strategy is that its development was informed by
an expert steering group representing key stakeholders across Ireland. The implementation statement
focuses on several strategic objectives identified in Appendix 3 of the strategy.2

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Launch of What Works Ireland Evidence Hub
As part of the What Works: Sharing Knowledge, Improving Children’s Futures initiative of the
Department of Children, Equality, Disability, Integration and Youth (DCEDIY), Minister Roderic
O’Gorman TD launched the What Works Ireland Evidence Hub on 31 May 2023.1



What Works Ireland Evidence Hub


The What Works Ireland Evidence Hub is an online tool that enables users to search for prevention
and early intervention (PEI) programmes that have been evaluated and found to improve one or more of
a set of specified outcomes in children and young people.
The target audience for the hub includes service commissioners, policymakers, practitioners, and
evaluators.

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Model of Care for Dual Diagnosis launched: mental health disorder and substance use disorder
by Vivion McGuire
The Model of Care for Dual Diagnosis, approved by the Health Service Executive (HSE) Chief Clinical
Officer Forum and endorsed by the College of Psychiatrists of Ireland, was formally launched on 23
May 2023 by Mary Butler TD, Minister of State for Mental Health and Older People, and Hildegarde
Naughton TD, Minister of State for Public Health, Wellbeing and the National Drugs Strategy.1


The term ‘dual diagnosis’ is used to describe a person who presents with a simultaneous mental
health disorder and a substance use disorder (SUD). However, dual diagnosis can often be defined in
different terms internationally. While dual diagnosis is not unusual, research suggests that up to
one-half of those attending HSE Community Mental Health Teams also have a comorbid SUD.

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Updates
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Recent publications
Prevalence/current situation


Trends in public attitudes to permitting cannabis for recreational use: analysis of Irish survey
data since 2002
Mongan D, Millar SR, O’Dwyer C, et al. (2023) European Journal of Public Health,
33(4): 627–632.
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An occupation-based lifestyle lecture intervention as part of inpatient addiction recovery
treatment: exploring occupational performance, balance and personal recovery
Ryan D, Naughton M, de Faoite M, et al. (2023) Substance Abuse: Research and Treatment, 17:
11782218231165123.
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John Bennett – an appreciation
We were deeply saddened to learn of the sudden death of John Bennett, Coordinator of the Finglas
Cabra Local Drug and Alcohol Task Force (LDATF). John was a good friend to the HRB. In 2014, he
presented the findings of the first two reports in the HRB’s Drug and Alcohol Review series and was
involved in several other research and knowledge transfer projects. John was very respectful of the
scientific aspect of drug response work but brought an extraordinarily broad frame of learning to
his understanding of the topic. He was intellectually voracious and was as likely to refer to a work
of literature, art or music as a journal article or report. He was serious, determined and committed
to the interests of those who needed the services he managed. He also was very good fun, great
company, and a curious and cultured man.



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Upcoming events
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National Drugs Forum 2023


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