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Cover story
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Alcohol: availability, affordability, related harm, and policy in Ireland
by Anne Doyle
Background


The Health Research Board (HRB) published its fifth alcohol overview in April 2024.1 Using data from
published Irish and international literature and information systems and surveys, the report
examines how much people drink in Ireland, trends over time, and the consequences of their alcohol
use. This report also examined alcohol availability and affordability, two key drivers of alcohol
use.


Alcohol use in Ireland

In 2023, per capita alcohol use per person aged 15 years and over in Ireland was 9.9 litres of pure
alcohol, a decrease since 2022 (10.2 litres).





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Policy and legislation
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Civil society involvement in the field of drug policy
by Lucy Dillon
The Correlation Network (Correlation–European Harm Reduction Network (C-EHRN)) published a report in
2023 entitled Critical partners: level and quality of civil society involvement in the field of drug
policy.1 It explores the experiences of decision-makers and civil society from working together in
the field of drug policy. Case studies were carried out in four countries – Finland, Greece,
Hungary, and Ireland. This article focuses on the findings as they relate to the Irish context.
Overall, they suggest a situation in which the mechanisms and structures are in place for meaningful
partnership, but it does not always follow through to implementation.



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The Harm Done: Community and Drugs in Dublin
by Lucy Dillon
The Harm Done: Community and Drugs in Dublin is a memoir by Dr Barry Cullen that is grounded in his
career since the early 1980s in community work, social services (as a qualified social worker), and
as a lecturer and researcher in third-level settings.1 In his introduction, Cullen says that this
‘personal narrative’ (p. 15) is aimed at those whose lives have been impacted by drugs and those who
study, work, and write about drug issues, community work, and related policy areas. The book
culminates in a call for major reforms to Ireland’s drug policies and for community development as
an essential element of the country’s response to the drugs issue.





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A spatial examination of alcohol availability and the level of disadvantage of schools in Ireland
by Anne Doyle
Background


Among schoolchildren and young adults aged 10–24 years, alcohol use was the second leading risk
factor attributable to deaths and disability-adjusted life years (DALYs) globally in 2019. Alcohol
use is common among adolescents in Ireland. By 17 years of age, four in five adolescents have
consumed alcohol, and Irish adolescent girls are ranked third highest (boys fourth highest) for
rates of heavy episodic drinking (HED) in a Lancet study examining 195 countries. The Public Health
(Alcohol) Act 2018 has children at its core, as not only does it aim to reduce population-level
alcohol use and related harms, but it also specifically aims to prevent and delay alcohol use among
children. This is why Section 14 of the Act prohibits alcohol advertising within 200 metres of the
perimeter of schools, playgrounds, and child service locations. However, not included in the
legislation is signage or sponsored awnings, partitions, umbrellas, etc. with logos of alcohol
products on premises selling alcohol (e.g. shops and pubs, etc.).

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New Minister for National Drugs Strategy
In April 2024, Colm Burke TD was appointed as the new Minister of State at the Department of Health
with responsibility for Public Health, Wellbeing and the National Drugs Strategy.1 Minister Burke
has been a TD serving Cork North-Central since 2020. Prior to that he was a Senator (2011-2020), a
member of the European Parliament for the Ireland South constituency (2007-2009), and a member of
Cork City Council (1999-2007). Among his first tasks as Minister will be to coordinate a response to
the 36 recommendations of the Citizens’ Assembly on Drugs Use, which will be the subject of a
forthcoming Oireachtas Joint Committee on Drugs Use.2





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Recent research
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Trends in gabapentinoid prescribing, law enforcement, drug seizures, and postmortem toxicology in
Ireland, 2010–2020
by Suzi Lyons
Gabapentin and pregabalin are collectively known as gabapentinoids.1 They are licensed as an
anti-epileptic, for neuropathic pain and generalised anxiety disorder.2 Since their market
introduction (gabapentin 1993; pregabalin 2004) they have risen to become one of the most commonly
prescribed medications in a number of countries. One of the theories for the rise in prescribing is
the increase in off-label prescribing, i.e. being prescribed for conditions other than that licensed
for, such as other pain disorders.


Of concern is that when gabapentinoids are used alongside opioids, there may be an increased risk of
respiratory depression, overdose, and death. When first released onto the market, these medications
were thought to have a low risk of misuse or dependence; however, ever since there has been a
growing recognition of those associated risks. There has been an increased reporting of misuse or
dependence to various agencies, and an increase in the number of overdose deaths where they are
implicated often in combination with opioids, specifically heroin and methadone. In 2019, the United
Kingdom (UK) authorities reclassified gabapentinoids as Schedule 3 (Class C) controlled drugs.



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Suicide risk following hospital attendance with self-harm: a national cohort study in Ireland
by Erica Keegan
An Irish study by Griffin et al.1 assessed suicide risk following hospital attendance with
self-harm. This is an important Irish study as it calculated the risk of suicide among those with a
history of hospital-presenting self-harm using national-level data.


Background


Self-harm can be defined as intentional self-injury or poisoning, irrespective of motive.1 There are
many ways people can intentionally harm themselves, including poisoning with tablets or toxic
chemicals, misusing alcohol or drugs, or cutting or burning their skin.

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Prevalence/current situation
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Adolescent Addiction Service report, 2024
by Seán Millar
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
2024, the AAS published a report detailing referrals for 2023.1

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National Self-Harm Registry Ireland annual report, 2021
by Seán Millar
The 2021 annual report from National Self-Harm Registry Ireland was published in February 2024.1 The
report contains information relating to every recorded presentation of deliberate self-harm to acute
hospital emergency departments in Ireland in 2021 and complete national coverage of cases treated.
All individuals who were alive on admission to hospital following deliberate self-harm were
included, along with the methods of deliberate self-harm that were used. Accidental overdoses of
medication, street drugs, or alcohol were not included.

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Merchants Quay Ireland annual review, 2022
by Seán Millar
Merchants Quay Ireland (MQI) is a national voluntary agency providing services for homeless people
and those that use drugs. There are 27 MQI locations in 14 counties in the Republic of Ireland (see
Figure 1). MQI aims to offer accessible, high-quality, and effective services to people dealing with
homelessness and addiction to meet their complex needs in a non-judgemental and compassionate way.
This article highlights services provided by MQI to people who use drugs in Ireland in 2022.1




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Irish Prison Service drugs strategy, 2023–2026
by Seán Millar
A new strategy document published by the Irish Prison Service (IPS), entitled Irish Prison Service
drugs strategy 2023–2026, proposes to tackle the use of illicit drugs in Irish prisons by focusing
on education, detection, reduction, support, and treatment.1 The purpose of the IPS strategy is
primarily to update the commitments of the IPS in its previous strategy, Keeping drugs out of
prison,2 and to set out clear measures to be taken by the IPS to tackle the problem of substance
abuse in prisons over the next three years.


There are 12 institutions in the IPS, comprising 10 traditional ‘closed’ institutions and two open
centres that operate with minimal internal and perimeter security. The majority of female prisoners
are accommodated in the purpose-built Dóchas Centre adjacent to Mountjoy Prison in Dublin, while the
remainder are located in a separate wing of Limerick Prison. Despite a lack of published data,
interviews conducted with prisoners indicate that there is a readily available supply of drugs in
some Irish prisons. Reports suggest that visits by friends and family and the throwing of drugs over
perimeter walls are among the supply routes used in Irish prisons.3

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Responses
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Alcohol Liaison Service at Beaumont Hospital, Dublin
by Anne Doyle
Background


In 2022, there were 17,512 discharges from Irish hospitals for wholly alcohol-related diagnoses,
according to the Hospital In-Patient Enquiry (HIPE) scheme, indicating that alcohol is a common
reason for hospital admission.1 The mean length of stay for alcohol-related hospitalisations
nationally is 9.9 days, increasing from 6.1 days in 2001, and almost double that of
non-alcohol-related conditions (5.7 days), and representing 5.2% of all inpatient bed days.2 This
does not include emergency department (ED) presentations as they are not routinely collected in
Ireland. However, a study carried out in Beaumont Hospital in Dublin found that 19.4% of ED
presentations were alcohol-related.3



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Seeing in the years – alcohol attitudes and behaviours in Ballymun, 2011–2023
by Anne Doyle
Background


The Ballymun Community Alcohol Strategy, part of the Ballymun Local Drugs and Alcohol Task Force
(LDATF), aims to use a public health approach to reduce alcohol-related risk to the community’s
health, safety, and well-being. One of the objectives of the strategy is to monitor alcohol use,
behaviours, and attitudes through surveys. The most recent survey was conducted by IPSOS B&A in 2023
and updates those carried out in 2011, 2015, and 2019, and examines what, if anything, has changed.1


Methods


A representative sample of the adult population (aged 15 years or greater) of Ballymun in Dublin was
surveyed in August–September 2023 to examine alcohol use trends, relevant community issues, and the
policy context.

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Updates
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Recent publications
Responses


Advancing early detection of suicide? A national study examining socio-demographic factors,
antecedent stressors and long-term history of self-harm
McMahon EM, Cully G, Corcoran P, Arensman E and Griffin E (2024) J Affect Disord, 350: 372–378.
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Prevalence/current situation


Male patient attendances at Sexual Assault Treatment Units in Ireland: an analysis of 381 cases and
a comparison with female patients
Kane D, Kennedy KM, Flood K and Eogan M (2024)
J Forensic Leg Med, 102: 102643.
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