Introduction
An evaluation of the national drugs strategy Reducing Harm, Supporting Recovery 2017-2025 was published in July 2025.1 The independent evaluation was commissioned by the Department of Health and carried out over a four-month period by a team of researchers from Grant Thornton Ireland. 

Evaluation goals
As required by the Department of Health’s specification for the evaluation of the national drugs strategy, the findings are reported across four domains that reflect the goals of the evaluation. These four domains are as follows:

1. The impact of the strategy: In relation to the strategy’s goals and strategic priorities, to assess its overall impact in delivering a public health-led and whole-of-government response to drug and alcohol use.
2. Governance and coordination effectiveness: To review the governance and coordination structures involved in the implementation of the strategy, including the contribution of stakeholders (such as civil society and Drug and Alcohol Task Forces), government oversight, and reporting arrangements.

In May 2025, it was announced that the Joint Oireachtas Committee on Drugs Use had been re-established. On 22 October 2024, the first iteration of the Committee published the Joint Committee on Drugs Use Interim Report,¹ but the dissolution of the Government in November 2024 saw an end to their work. A commitment was made in the Programme for Government 2025 to re-establish the Committee to continue its work.²

In May 2025, the Advisory Council on the Misuse of Drugs (ACMD) in the United Kingdom (UK) published a report titled A Whole-System Response to Drug Prevention in the UK.¹ It is a comprehensive report that reflects on the evidence for the various components of an effective drug prevention system, including for prevention interventions.

While the report’s focus is on the UK, it should be of interest to prevention stakeholders in Ireland. This article is based on both the published report and a presentation made by the Chair of the ACMD, Professor Owen Bowden-Jones, at a seminar held by the the UK-based Drug Education Forum on 19 June 2025.^{1, 2}

While most drug poisoning deaths across Europe involve opioids, benzodiazepines are implicated in many deaths and are frequently present in deaths involving opioids.¹

The benzodiazepines involved in these deaths are not always prescribable benzodiazepines; indeed, one driver behind an increase in drug poisoning deaths, particularly in Scotland, is the emergence of benzodiazepine-type new psychoactive substances (NPS) such as etizolam.² Scotland’s experience with etizolam, and the implications for Irish drug poisoning deaths, were addressed in a letter published in the Irish Journal of Psychological Medicine in 2024.³

The non-medical use of prescription drugs has become a global health concern. Non-medical usage is defined as the taking of prescription drugs, whether obtained by prescription or otherwise, except in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed.¹

A Trendspotter study undertaken between May and September 2019 by Ana Liffey Drug Project and the European Union Drugs Agency (EUDA) Irish National Focal Point identified converging signals of the non-medical use of pharmaceuticals in Ireland.² The user groups identified included high-risk opioid users, prison populations, people with complex and multiple needs, and young people. Among these groups, the motivations for using street tablets were for their intoxicating effects, to enhance desired effects from illicit substances, to help withdrawal symptoms, to improve sleep, and to reduce stress.

A new report from Trinity College Dublin presents a decade-long exploration of non-fatal opioid overdoses (NFODs) in Ireland.¹ Authored by Professor Jo-Hanna Ivers and Neil Dunne, the study combines clinical data, systematic review findings, and policy analysis to shine a light on the evolving nature of opioid-related harm, especially within Dublin’s inner city.

The study found that between 2011 and 2021, over 2,500 NFOD cases were recorded in Ireland’s acute hospitals. Dublin’s inner city, despite accounting for just a fraction of the national population, was disproportionately affected. Heroin was the most implicated opioid until 2020, when methadone, a drug used in opioid agonist treatment, surpassed it in prevalence. Outside the city, other opioids, including prescription and synthetic drugs, emerged as primary contributors to overdose, pointing to different risk environments across urban and rural contexts.

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 (HSE). 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.

Introduction

The main cause of death among people with opioid use disorder (OUD) is drug overdose. OAT is a proven intervention to reduce both drug-related and all-cause mortality. The advantages of OAT can be negated by using other prescribed and non-prescribed substances at the same time during OAT, such as heroin, cocaine or street benzodiazepines and/or other prescribed medications. Polysubstance use is associated with treatment discontinuation and is known as a risk factor for drug overdose. Despite this, there is limited research on the effects of polysubstance use among patients in OAT.

An Irish study sought to address this gap in the research by aiming to (1) examine trends in drug positivity rates in amphetamines, benzodiazepines, cannabis, cocaine and opioids (heroin, morphine and codeine); and (2) identify trends in polysubstance positivity rates for drug combinations associated with increased risk of drug overdose including (a) methadone and benzodiazepines; (b) methadone, benzodiazepines and opioids; (c) methadone, benzodiazepines and cocaine; and (d) methadone, benzodiazepines, opioids and cocaine.¹

On 8 May 2025, Jennifer Murnane O’Connor, Minister for Public Health, Wellbeing and the National Drugs Strategy, together with Jim O’Callaghan, Minister for Justice, launched the national awareness campaign for the DRIVE (Drug-related intimidation and violence engagement) project.^1,2 The key messages associated with the campaign were that drug-related intimidation can happen to anyone but there is help, and by visiting the website driveproject.ie people can find information about safe and confidential services in their local area.

A recent study has revealed a sharp increase in cocaine use and associated health harms in Ireland over the past two decades. Conducted by a team of researchers from the Health Research Board (HRB); the School of Public Health, University College Cork (UCC); Trinity College Dublin; and the Health Service Executive (HSE), the study used data from five national databases to track trends from 2000 to 2023.

In this research, which has been published in the journal BMC Public Health, findings show that last-year prevalence of cocaine use among 15–64-year-olds in Ireland more than doubled, rising from 1.1% in 2002–03 to 2.4% in 2023.¹

In July 2025, the Minister for Children, Disability and Equality, Norma Foley, announced three initiatives to support prevention and early intervention programmes for children and young people in Ireland.¹ They are being funded through the What Works prevention and early intervention initiative. As with previous activities under the What Works initiative, there are synergies with drug prevention activities.

What Works

What Works: Sharing Knowledge, Improving Children’s Futures is an initiative of the Department of Children and Youth Affairs (DCYA) that was launched in June 2019. It was a rebrand of the Quality and Capacity Building Initiative that the DCYA had been developing since 2016. What Works seeks to embed and enhance knowledge and quality in prevention and early intervention activities in children and young people’s policy, service provision, and practice.

The Safe futures: Identifying promising approaches, opportunities and barriers for interventions designed to prevent youth recruitment and participation in European drug markets projects was launched in June 2025.^1,2 It is a 2-year project that aims to identify effective ways to prevent young people’s involvement in European drug markets.

Project team

The project is a collaboration between the European Union Drugs Agency (EUDA) and the Research Evidence into Policy, Programmes and Practice (REPPP) team at the University of Limerick.

Mongan D, Millar S, Brennan M, et al. (2025) Addict. Behav. 161, 108194. https://www.drugsandalcohol.ie/42204/

Duopah YA, Moran L, Elmusharaf K, et al. (2024) BMC Health Serv. Res. 24, 1450. https://www.drugsandalcohol.ie/42321/

A new Irish study based on the 2020 Planet Youth Survey has revealed that home life dynamics and extracurricular activities significantly influence adolescent cannabis use.¹ Conducted among nearly 5,000 secondary school students in Galway, Mayo, and Roscommon, the research provides insights into factors linked to teenage substance use in Ireland. Speaking about the study, first author Dr Fionn Daly said:

Although adolescent cannabis use is a significant public health concern, there is limited evidence on how the home environment and involvement in extracurricular activities correlate with teenage cannabis use in Ireland. Therefore, we analysed responses from adolescents who participated in the Planet Youth 2020 – Growing Up in the West survey, which was an anonymous questionnaire available to all school-going adolescents residing in the western region of Ireland.

Published in May 2025, the latest report from the National Drug Treatment Reporting System (NDTRS) presents data on treated problem drug use (excluding alcohol) for the year 2024, and on trends for the eight-year period from 2017 to 2024.¹

Key findings 2024

In 2024, 13,295 cases were treated for problem drug use. This is the highest annual number of cases recorded by the NDTRS to date. Cocaine was the most common drug reported among new cases entering drug treatment, accounting for almost one-half of new treatment demand. Cocaine was also the most common problem drug generating treatment demand for those aged 20–44 years. Until 2023, opioids had been the main problem drug for cases aged 35 years and over.

Merchants Quay Ireland (MQI) is a national voluntary agency providing services for homeless people and those who 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 used drugs in Ireland in 2023.¹

In March 2025, the National Suicide Research Foundation published the 2022–2023 National Self-Harm Registry Ireland annual report.¹ The report contains information relating to every recorded presentation of deliberate self-harm to acute hospital emergency departments in Ireland in 2022 and 2023, as well as details of 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.

Organised crime that involves illicit drugs is viewed as the ‘most serious security threat facing Europe today, and the situation is escalating’ (p. 1).¹  On 18 October 2023, the European Commission adopted the EU Roadmap to fight drug trafficking and organised crime.¹ The roadmap is aligned with the European Commission’s ongoing implementation of the European Union (EU) Strategy on Organised Crime 2021-2025,² and the EU Drugs Strategy and Action Plan 2021-2025, ^3,4 hereafter called the EU strategies.

EU strategies and response

The EU strategies outline several ‘holistic EU polices’ that aim to target these threats (p. 2), such as: