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Cover story
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Healthy Ireland Survey 2024 – Alcohol findings
by Anne Doyle
Background


The Healthy Ireland Survey is an annual survey designed to increase knowledge of the population’s
health and health behaviours.1 It is commissioned by the Department of Health, carried out by Ipsos
B&A, and conducted with a representative sample of the general population aged 15 years and over.
For the 2024 Survey, telephone interviews took place between October 2023 and April 2024 with 7,398
respondents. Questions about alcohol use are routinely asked in each wave of the survey. In addition
to these questions, the survey explores general health, tobacco use, mental health, use of general
practitioner (GP) and other health services, COVID-19 and long COVID, physical activity, weight
management, caring responsibilities, and sleep.



Figure 1: Percentage of respondents who consumed alcohol in the previous 12 months, by sex and age



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Policy and legislation
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An Garda Síochána Strategy Statement 2022–2024 and 2024 Policing Plan Strategy Statement 2022–2024
by Ciara H Guiney
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.

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New Programme for Government and Minister for the National Drugs Strategy
by Lucy Dillon
A new Programme for Government was agreed in January 2025 by the Fianna Fáil and Fine Gael parties,
and a group of Independent TDs.1 While lacking in much detail, it indicates an ongoing commitment to
the health-led strategic direction of the current national drugs strategy. The Government commits
to:

Assess the outcomes of the national drugs strategy, Reducing Harm, Supporting Recovery 2017–2025,
and publish a successor strategy. No date is given for when this strategy will be published.
Divert those found in possession of drugs for personal use to health services. This reflects an
ongoing commitment to implement the Health Diversion Approach, which was originally announced by the
government of the day in 2019.


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Joint Committee on Drugs Use Interim Report
by Lucy Dillon
The Joint Committee on Drugs Use was established by the Government to consider the Report of the
Citizens’ Assembly on Drugs Use and to make a reasoned response to each of its 36 recommendations.1
On 22 October 2024, the Committee published its Interim Report.2


Context


The Committee included members from across the spectrum of political parties (not just Government
parties).3 The Joint Committee on Drugs Use Interim Report is based on the Committee’s seven
meetings held between June and September 2024.

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Recent research
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Alcohol Statistics Dashboard
by Anne Doyle
HRB National Drugs Library


Background


Alcohol use is responsible for four deaths every day in Ireland and causes many conditions, such as
alcohol dependence and alcohol-related liver disease, as well as common health conditions, including
cardiovascular disease and cancer.1


The Health Research Board (HRB) periodically publishes alcohol overviews to collate information
about alcohol use as well as related harms; the most recent of these was published in April 2024.1

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Alcohol-related brain injury hospitalisations, 2015–2023
by Anne Doyle
Background


Alcohol-related brain injury (ARBI) is a term that encompasses various conditions associated with
heavy and prolonged alcohol use.1-3 Wernicke encephalopathy and Korsakoff syndrome are the two most
commonly known conditions, and develop as a result of thiamine deficiency (vitamin B1).4 Most at
risk are those with alcohol dependency who may substitute food with alcohol. Their poor diet, and
particularly the lack of vitamin B1, as well as alcohol interfering with the absorption and
metabolism of vitamin B1, increase the risk of developing thiamine deficiency, and consequently
ARBI.


Symptoms of ARBI include a cognitive impairment and behavioural changes, including short-term memory
loss, an inability of the brain to shift focus from one task or idea to another, limited attention
span or ability to focus, difficulty regulating self-control (both behaviourally and emotionally),
difficulty with decision-making, and diminished social interaction.

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Psychotic illness triggered by widely available semi-synthetic cannabinoid
by Seán Millar
Cannabis has been shown to be linked to the development of psychotic illness. Although it has been
legalised in many jurisdictions over the last 20 years, its apparent detrimental effects on mental
health has slowed its legalisation on a widespread basis in Europe. However, a possible consequence
of continuing illegality is that users in an unregulated environment are consuming high-potency or
synthetic cannabinoids, which may also lead to adverse effects, including psychosis.1

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Prevalence/current situation
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The burden of alcohol and other drugs on the District Court
by Anne Doyle
Introduction


The burden of alcohol and other drugs on the criminal justice system is complex to quantify. Data
availability, the difficulty in classifying offences according to the role alcohol and/or other
drugs may have played, and the uncertainty of a cause-and-effect relationship all complicate the
narrative. However, an extensive body of evidence has consistently shown significant and definite
associations between alcohol and other drug use and rates of criminal offences.


Global evidence estimates that over 50% of perpetrators had been drinking prior to the offence
committed.1 A systematic review and meta-analysis found that drug users were 3–4 times more likely
to commit a criminal offence than those who do not use drugs.2 Irish data from the Probation Service
found that one-half of clients (53%) committed an offence while intoxicated, or that alcohol was in
some way associated with the offence, and similarly so for other drug use (48%).3

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Understanding knowledge and attitudes towards alcohol consumption – findings from the Evidence into
Action Alcohol Project (EVID-ACTION)
by Anne Doyle
Introduction


Alcohol use is highest in the World Health Organization (WHO) European region.1 Cancer is the
leading cause of death due to alcohol use in Europe, and yet, awareness of this link between alcohol
use and seven different cancers is low, particularly for breast cancer.2,3 Collaborating with the
European Union (EU), the WHO aims to reduce alcohol use and related harms and increase awareness of
the risks through a project called the WHO-EU Evidence into Action Alcohol Project (EVID-ACTION),
co-funded by the EU as part of Europe’s Beating Cancer Plan.4,5 The project covers 30 countries,
including Ireland, and the focus is on building evidence for the case for alcohol health warning
labels, supporting and sharing experiences and expertise among members, and providing tools and
training to support implementation of screening and brief interventions in a variety of contexts. In
order to gain a better understanding of the current level of knowledge and attitudes towards alcohol
use, a survey was completed in five European countries, including Ireland. The findings from the
Irish sample are presented here.

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Adolescent alcohol use continues to decline: findings from the Health Behaviour in School-aged
Children survey 2022
by Anne Doyle
Background


Much of Western Europe, North America and Australasia have seen a decline in alcohol use among young
people.1-2 This is welcome indeed given that alcohol use is ranked as the second-highest contributor
to disability-adjusted life years (DALYs) among adolescents and young adults aged 10–24 years
globally.3 Alcohol contributes to all of the leading causes of death for young people, including
suicide, road traffic collisions, poisoning and assaults, while long-term use is linked to multiple
types of cancer, cardiovascular disease and liver disease.4,5 The Public Health (Alcohol) Act 2018
aims to reduce population-level alcohol use, but specifically seeks to prevent or delay youth
drinking.6 In order to determine if this phenomenon extends to Irish youths, data from the Health
Behaviour in School-aged Children (HBSC) survey were examined.7

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Courts Service Annual Report 202
by Ciara H Guiney
The Courts Service Annual Report 2023 was published on 23 September 2024. While the report presented
data for all criminal cases arising within the Irish justice system between January and December
2023, this article only reports on 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).

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Frostbite injuries from recreational nitrous oxide use
by Seán Millar
In Ireland and internationally, there has been much attention on the growing popularity of inhaled
nitrous oxide (N2O), colloquially known as ‘laughing gas’ or ‘hippy crack’. Although the prevalence
of nitrous oxide use is not routinely collected in Ireland’s National Drug and Alcohol Surveys, a
web survey (N=4398) conducted in 2021 found that 23.3% of respondents had ever used nitrous oxide,
while a 2022 study (N=1193) of attendees at music festivals in Ireland found that 28% had used it in
the last year.1,2 The popularity of nitrous oxide as a recreational drug can be attributed to the
fact that it is cheap, readily available, and undetectable on routine drug screening. Recreational
users tend to obtain it in small silver canisters known as ‘whippets’ or ‘silver bullets’, which are
attached to a palm-sized ‘nitrous cracker’ to fill a balloon, from which the gas is inhaled.
However, as nitrous oxide is cooled to its gaseous form for inhalation, container mishandling can
cause frostbite injuries to the face and extremities.

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HSE Safer Nightlife programme: feedback on provision of harm reduction outreach in Irish festival
settings
by Seán Millar
The Health Service Executive (HSE) National Social Inclusion Office launched a multicomponent
programme in May 2022 to engage with people who use drugs specifically in festival settings. This
involved a media campaign, the development of resources, recruiting and training volunteers, and
coordinating outreach teams at three specific festivals: Life Festival, Indiependence (Indie), and
Electric Picnic. The aim of the programme was to engage with and support festival attendees in a
non-judgemental way on the topic of substance use and related issues that emerge in nightlife
spaces.

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Prescription drug prescribing trends in Irish prisons, 2012–2020
by Seán Millar
Background and methods


Pharmacotherapy is essential for the delivery of an equivalent standard of care in prison. However,
prescribing can be challenging due to the complex health needs of prisoners and the risk of misuse
of prescription drugs. Misuse, or non-medical use of prescription drugs, refers to the intentional
repurposing of prescribed drugs outside of their intended indication. The drugs identified with the
greatest potential for misuse are prescription opioids, benzodiazepines, Z-drugs, and
gabapentinoids.1-3 Although there is widespread concern regarding the misuse of prescription drugs
in prisons, few studies have examined prescribing trends of prescription drugs with potential for
misuse in prison.



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Responses
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National Drugs Forum 2024
Emerging drug trends: monitoring, communicating, and responding
by Brian Galvin
The 2024 National Drugs Forum was held in Croke Park in Dublin on 14 November. The theme of the
forum was early warning on new drugs and emerging trends. The event provided an opportunity to learn
about recently developed monitoring tools in Ireland and to get a sense of the types of information
that can contribute to knowledge on emerging trends and support preparedness to deal with threats
that might be unfamiliar. Previously experimental techniques, such as wastewater analysis, drug
checking and testing, analysis of syringe residues, and online surveys are now part of Ireland’s
early warning system.





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Women in addiction and domestic violence – the DAVINA project at SAOL
by Lucy Dillon
In the final quarter of 2024, the SAOL Project published two reports on the issues facing women in
addiction who are also experiencing domestic violence. “They said they couldn’t take me because I
was on drugs”: A report examining whether human rights are negated for women in addiction when
accessing domestic violence support and refuge in Ireland was published in October 2024.1 The second
report, Worthy of Love: An evaluation of the DAVINA project, was published in December.2

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European Society for Prevention Research (EUSPR) conference
by Lucy Dillon
The 15th annual conference of the European Society for Prevention Research (EUSPR) was held in
Cremona, Italy from 10 to 13 September 2024. The theme of the conference was ‘prevention in and with
communities’.


EUSPR


The EUSPR promotes the development of prevention science and its application to practice in order to
promote human health and well-being through high-quality research, evidence-based interventions,
policies, and practices.1

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Updates
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Recent publications
Prevalence and current situation


Prevalence and associated risk factors for suicidal ideation, non-suicidal self-injury and suicide
attempt among male construction workers in Ireland
O’Donnell S, Egan T, Clarke N and Richardson N (2024) BMC Public Health, 24(1):1263. Available from:
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Identification of N-pyrrolidino protonitazene in powders sold as heroin and associated with overdose
clusters in Dublin and Cork, Ireland
Killoran S, McNamara S, Kavanagh P, O’Brien J and Lakes R (2024) Drug Test Anal. Available from:
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