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In brief
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National Drugs Forum 2024
Emerging drug trends: monitoring, communicating and responding
As patterns in drug use and markets change, so too do the techniques used for monitoring and
responding to these patterns. Routine monitoring on levels of drug use, treatment demand, and harms
is essential for observing trends and planning services, but the unpredictable nature of synthesised
drugs requires more immediate responses and a capacity to interpret diffuse information from a wide
variety of sources.





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Cover story
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Launch of new interactive map to locate Irish addiction treatment services
by Anne Marie Carew
A new interactive map has been launched to help people in Ireland quickly find addiction treatment
services in their area. Developed by the Health Research Board (HRB) in collaboration with the
Department of Health, the map provides a comprehensive overview of all publicly funded addiction
treatment and family support services across the country (see Figure 1).





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Policy and legislation
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Drug use and current alternatives to coercive sanctions in Ireland
by Ciara H Guiney and Lucy Dillon
In July 2024, the Centre for Justice and Innovation published a report, presented by Tony Duffin,
the chair of the National Drugs Strategy Strategic Implementation Group 5 (SIG-5), which aimed to
map existing alternatives to coercive sanctions (ACS) for individuals found in possession of
controlled drugs for personal use in Ireland.1 The authors explored how ACS are delivered in
Ireland, stakeholders’ views on how these could be improved, and the potential for the expansion of
ACS in the Irish context.

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Review of drugs and alcohol work sector of British–Irish Council, 2021–2024
by Lucy Dillon
A ministerial meeting of the drugs and alcohol work sector of the British–Irish Council (BIC) was
held in Dublin on 26 January 2024. The Irish Government is the lead administration for this strand
of work.



The meeting was chaired by Minister for Public Health, Well-being and the National Drugs Strategy,
Hildegarde Naughton TD. It was also attended by ministers from Scotland, Wales, the Isle of Man, and
Guernsey.1

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Oireachtas Joint Committee on Drugs Use
by Lucy Dillon
In March 2024, the Joint Committee on Drugs Use was established by the Irish Government to consider
the recommendations in the report of the Citizens’ Assembly on Drugs Use.1

Oireachtas Committees
In Ireland, there are mechanisms that Government can use to inform the policy-making process.
Oireachtas (Parliamentary) committees advise the Oireachtas on a range of specific areas, including
drug policy.

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Young Ireland: national policy framework for children and young people
by Lucy Dillon
In November 2023, Young Ireland: national policy framework for children and young people was
launched by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY).1 It
sets out the policy direction and key priorities in respect of children and young people (aged 0–24
years) in Ireland across all Government Departments and State agencies to the end of 2028.

Background
Young Ireland is the successor strategy to Better Outcomes, Brighter Futures: the national policy
framework for children & young people 2014–2020, which was Ireland’s first national policy framework
for children and young people.2 Overall, Young Ireland reflects a continuation in its aim, focus,
and approach when compared with its predecessor.



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Road Traffic Act 2024
by Ciara H Guiney
The Road Traffic Act 2024 was enacted on 17 April 2024.1 The purpose of the Act is to overcome
anomalies evident in the existing legislation. It provides for changes to the penalty points regime
(Part 2), speed limits (Part 3), and mandatory roadside testing of drivers involved in serious
collisions for intoxicants, which will now include drug testing (Part 4). This article will focus on
Part 4, which provides for several amendments to the Road Traffic Act 2010.



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Irish delegation report from 67th session of United Nations Commission on Narcotic Drugs, 2024
by Richie Stafford
An Irish delegation attended the 67th session of the United Nations Commission on Narcotic Drugs
(CND)1 in Vienna on 14–22 March 2024. The delegation consisted of:

Jim Walsh, Brian Dowling and Richie Stafford of the Department of Health
Lisa Fay of the Department of Justice
Detective Superintendent Sé McCormack of An Garda Síochána
Ambassador Eoin O’Leary and officials from the Irish Permanent Representation to the United Nations
(UN).
CND meets annually and adopts a range of decisions and resolutions.2 Intersessional meetings are
convened throughout the year. Towards the end of each year, CND meets at a reconvened session to
consider budgetary and administrative matters as the governing body of the UN drugs programme.

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Recent research
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Drug prevention training in Ireland
by Lucy Dillon
A feature of an effective drug prevention system is the training of stakeholders.1 Progress in this
area in Ireland can be seen through the implementation of the European Prevention Curriculum (EUPC)
training programme,
albeit to limited numbers to date.

What is the EUPC?
The EUPC is a training programme whose primary goal is ‘to reduce the health, social and economic
problems associated with substance use by building international prevention capacity through the
expansion of the European professional prevention workforce’ (p. 10).2



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Review of Prevention Systems (RePS)
by Lucy Dillon
Improving the quality of drug prevention interventions and systems internationally is a focus of the
United Nations Office on Drugs and Crime (UNODC). Building on its International Standards on Drug
Use Prevention, the UNODC has developed a tool for countries to assess their drug prevention systems
and interventions in line with the standards.1,2 The Review of national prevention systems based on
the UNODC/WHO International Standards on Drug Use Prevention: final report of the pilot in Norway
was published in September 2023 and a webinar on the project findings held on 19 April 2024.2,3

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Review on evidence on place-based responses to drug-related threats in communities
by Brian Galvin
In July 2024, the Health Research Board (HRB) published Integrative review on place-based and other
geographically defined responses to drug-related threats in communities,1 the ninth report in the
Drug and Alcohol Evidence Review series. On behalf of the Department of Health, the HRB commissioned
this report to systematically review and synthesise the international evidence on this topic.
Place-based initiatives emerged originally in the field of health, guided by new ideas relating to
the social determinants of health, the role of the socioecological context, implementation science,
and the importance of community empowerment.



Although there are considerable variations, it is possible to identify an underlying model which
focuses on providing universal, structural interventions that seek to improve health and well-being
by modifying the social context in which health-related behaviour occurs.

The key findings of the review are set out below under the five research questions.

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Recreational and sexualised drug use among men who have sex with men
by Seán Millar
Background and methods
The overall prevalence of recreational drug use (RDU) has risen in Ireland from 5.6% in 2002/2003 to
7.4% in 2019/2020; and males report a higher prevalence of RDU in comparison to females (12.3% and
5.7%, respectively).1 International evidence suggests that gay, bisexual, and other men who have sex
with men (gbMSM) have a higher prevalence of drug use versus age-comparable non-gbMSM.2 Previously
cited reasons for this drug use disparity may include ‘minority stress’, as well as the perceived
‘normalisation’ of drug use within the gbMSM community, including sexualised drug use (SDU).3,4,5
However, in Ireland, there is a paucity of literature regarding the prevalence of drug use and its
determinants among gbMSM.



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Prevalence/current situation
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Criminal Justice (Engagement of Children in Criminal Activity) Act 202
by Ciara H Guiney
The Criminal Justice (Engagement of Children in Criminal Activity) Act 2024 was enacted on 11 March
2024.1 The purpose of the Act is to provide for offences relating to the engagement of a child in
criminal activity. Section 2 of the Act addresses engagement of children in criminal activity, while
Section 3 makes amendments to the Schedule of the Bail Act, 1997.

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Drug treatment demand in Ireland, 2023
by Tiina Lynch
Published in June 2024, the latest report from the National Drug Treatment Reporting System (NDTRS)
presents data on treated problem drug use (excluding alcohol) for the year 2023, as well as trends
for the seven-year period from 2017 to 2023.1

Key findings, 2023
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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An exploration of organizational climate in community-based opiate prescribing services; a mixed
methods stud
by Anne Marie Carew
A recent study by Kelly et al.1 aimed to understand how different factors within community-based
opiate-prescribing services affect the overall work environment. The study examines how clear each
organisation’s goals are, how well the team works together, how much freedom staff have, and how
open each organisation is to change. The goal was to identify what makes a good work environment in
these services and how to improve it.

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Deaths among people who were homeless at time of death in Ireland, 2020
by Cathy Kelleher
The Health Research Board (HRB) has published its second report on deaths among people who were
homeless at the time of death.1 The report describes deaths that occurred in 2020 and contains
updated figures for deaths in 2019.2 The report follows on from research originally commissioned by
the Department of Health, which examined deaths in 2019 among people who were homeless.3

Background
The HRB collects data on all deaths among people who were homeless at the time of death in order to
better understand and prevent premature death among people who are homeless. The data are extracted
from closed coronial files nationwide using the methodology of the National Drug-Related Deaths
Index (NDRDI), even if the deaths do not meet the standard NDRDI inclusion criteria.4 The NDRDI
validates these data with the Dublin Regional Homeless Executive through its Pathway Accommodation
and Support System (PASS).

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Non-fatal drug-related hospital admissions in Ireland, 2023
by Seán Millar
The HIPE (Hospital In-Patient Enquiry) scheme is a computer-based health information system, managed
by the Economic and Social Research Institute (ESRI) in association with the Department of Health
and the Health Service Executive. It collects demographic, medical, and administrative data on all
admissions, discharges, and deaths from acute general hospitals in Ireland. Each HIPE discharge
record represents one episode of care; each discharge of a patient, whether from the same or a
different hospital, with the same or a different diagnosis, gives rise to a separate HIPE record.
The scheme therefore facilitates analysis of hospital activity rather than of the incidence of
disease. HIPE does not record information on individuals who attend emergency departments but are
not admitted as inpatients. Monitoring of drug-related acute emergencies in the Irish context refers
to all admissions for non-fatal overdoses to acute general hospitals in Ireland.

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Emergence of synthetic opioids on the Irish heroin market
by Seán Millar
On 9 November 2023, Ireland’s Health Service Executive (HSE) was made aware of an overdose cluster
in Dublin, with 24 cases notified throughout the day and another 10 cases the following morning.
This triggered an urgent review across a number of information sources to identify possible signals
of change on the Dublin drug market.1 Data were monitored by the HSE on 9–12 November, and a total
of 57 non-fatal overdoses were recorded during this period. Analysis by Forensic Science Ireland of
a sample obtained by An Garda Síochána on the evening of 10 November confirmed the emergence of
nitazenes in a light brown/sandy-coloured powder on the Dublin heroin market, which resulted in the
HSE issuing a Red Alert for the city. The nitazene was later confirmed as N-pyrrolidino
protonitazene (protonitazepyne), which was a first identification for Ireland and a substance under
intensive monitoring by the European Union Drugs Agency (EUDA). Samples were also found to contain
caffeine, paracetamol, benzoic acid, and mannitol.2

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Review of Pharmacy Needle Exchange Programme in Ireland
by Seán Millar
Pharmacy needle exchange in Republic of Ireland
The current national drugs strategy (2017–2025) aims to reduce harms arising from substance misuse
and to reduce the prevalence of blood-borne viruses among people who inject drugs (PWID) through the
expansion of needle exchange provision to include community pharmacy-based programmes. In October
2011, the HSE rolled out the national Pharmacy Needle Exchange Programme, which is a partnership
initiative between the Elton John AIDS Foundation, the Irish Pharmacy Union, and the HSE. Once
pharmacies have signed a service level agreement with the HSE, their contact details are passed on
to the relevant HSE services so they can promote access to sterile injecting equipment at the
participating pharmacies and accept referrals for investigation and treatment. There are pharmacies
providing needle exchange in each Regional Drugs and Alcohol Task Force (RDATF) area, apart from
those covering Counties Dublin, Kildare, and Wicklow, which are served by a mix of static and
outreach needle exchange programmes.

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‘K culture’ – the emergence of ketamine on the Irish drug scene
by Seán Millar
In January 2024, addiction services warned of a concerning increase in the use of ketamine in
Ireland. In 2023, Revenue seized 41.2 kg of ketamine, valued at €2.47m. The drug, known for its use
as a horse tranquiliser, has become popular among revellers at festivals and parties. In 2022,
Revenue seized 7.86 kg of ketamine, while in 2021 officers seized 25.19 kg of the drug.1 A letter to
the editor of the Irish Journal of Medical Science (IJMS) by the HSE National Social Inclusion
Office noted that ketamine has become a prominent feature of recreational drug repertories in
Ireland, often used in combination with other ‘club drugs’ for stimulant and euphoric effects when
socialising.2



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Injecting trends in Dublin and Midlands regions: results from Syringe Analysis Programme, 2021–2022
by Seán Millar
Background
In 2022, the HSE, in partnership with Merchants Quay Ireland, collected 165 used syringes from the
Dublin and Midlands regions during September and October. Residual drugs were extracted from these
syringes and the data obtained were used to compare drug trends from the two regions.



The Syringe Analysis Programme is the first of its kind in Ireland and enables the HSE to identify
temporal and geographical trends annually as part of its emerging drug trend monitoring. Analysis of
235 drugs and metabolites was performed using liquid chromatography–mass spectrometry.



These analyses spanned a wide range of substances, such as opiates (including new synthetic
opioids), benzodiazepines, amphetamines, cocaine, new psychoactive substances (NPS), Z-drugs,
gabapentinoids, ketamine, and various cutting agents. In 2023, the HSE published a report1 detailing
the findings from the 2022 analysis programme; it also compared 2022 programme results to findings
from a syringe analysis programme conducted in 2021. The main findings are discussed below.

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Responses
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Launch of study on human rights and equality issues in drug treatment services in Dublin’s
North-East Inner City
by Tiina Lynch
Background
Serious human rights and equality concerns emerged regarding the lived experience of service users
in Dublin’s North-East Inner City. In 2009, drug service users, their representatives, and community
activists formed a coalition after concerns were raised about the practice of and over-reliance on
urine testing and the lack of information and choice on pathways to health for each service user. A
study was conducted1 to identify issues experienced by service users of drug treatment projects and
to review the key monitoring points and changes arising from the Health Service Executive (HSE)
Action Plan. A great emphasis of this study was on peer-led processes, as the voice of the service
user is rarely heard.

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HSE Integrated Alcohol Service: A coordinated approach to alcohol treatment
by Anne Doyle
Background
The Health Service Executive (HSE) Integrated Alcohol Service (IAS) began operating on North Great
Clarence Street, Dublin 1 in 2022, following the growing recognition of and concern regarding
widespread problem alcohol use in the area, particularly during the COVID-19 pandemic. The IAS is
based on the recommendations outlined in the National Drugs Rehabilitation Framework Document, and
provides a coordinated response to address both prevention and the provision of services and support
to those who require it.1

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Updates
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Recent publications
Prevalence and current situation

An exploration of organizational climate in community-based opiate prescribing services; a mixed
methods study.

Kelly P, Searby A and Goodwin J (2024) Journal of Substance Use and Addiction Treatment, 162,
209362.
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Current management of neonatal abstinence syndrome: a survey of practice in the UK and Ireland.

Dempsey S and O’Grady MJ (2024) Archives of disease in childhood. Fetal and neonatal edition, 109,
(3), pp. 261-264.
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