The Health Research Board (HRB) has reported the highest figures in drug treatment to date with a continued increase in cocaine use evident, especially among females.

In 2023, 13,104 cases* were treated for problem drug use. This is the highest annual number recorded and an increase of more than one thousand cases compared to 2022. Almost four-in-ten cases had never been treated before. Cocaine was the most common drug reported, accounting for one-in-three cases followed by opioids (mainly heroin), cannabis and benzodiazepines.

Commenting on the key findings in the report, HRB Chief Executive, Dr Mairéad O’Driscoll, said:

“In 2023 the HRB recorded the highest number of cases in treatment. This is the result of the sharp rise in cocaine use and an increase in the provision of specific services to treat cocaine use. The data we collate each year helps to understand treatment practices, highlights areas of future need and will underpin action on in relation to prevention.”

Dr Anne Marie Carew, Research Officer at the HRB, said:

“The rise in cocaine use is changing the landscape in terms of treatment demand in Ireland. Cocaine is the main problem drug for nearly half of new cases to treatment, but also one-in-three cases returning to treatment. This is compounded by the fact cocaine is also the second most common additional drug that people seek treatment for along with another drug. This points to a growing future need for treatment for cocaine.”

Main cocaine findings

In 2023, 4,923 cases were recorded with cocaine as a main problem. Over the period 2017 to 2023, there was a 228% increase in the number of cases where cocaine was the main problem drug. Powder cocaine increased by 197% during this time, and crack cocaine increased by 594%.

Cocaine remains the most common main drug among new cases in 2023, accounting for almost half (46%) of new cases.

For previously treated cases, cocaine accounted for one-in-three cases, the highest number recorded to date.

Socio-demographic characteristics varied depending on the type of cocaine used.

  • Between 2017 and 2023 there was a 388% increase among females who have sought drug treatment for cocaine, from 284 cases in 2017 to 1,387 cases in 2023.
  • For cases with powder cocaine as the main problem, more than one-in-five were female, two-in-five were employed, and the median age entering treatment was 31 years.
  • For cases with crack cocaine as the main problem, nearly half were female, just over one-in-20 were employed, and the median age was 39 years.

Commenting on the cocaine profiles, Dr Carew said

“The sharp increase in cocaine cases among females is a concern and highlights a growing need for prevention measures, especially around crack cocaine. Females entering drug treatment are more likely to be living with dependent children. Understanding the complex issues they face will help to identify the integrated services they require to address their specific situations.”

Different profiles for new and previously treated cases
  • Cocaine is the most common drug reported among new cases entering drug treatment, with rates rising significantly over the past seven years.
  • In contrast, the proportion of new cases reporting cannabis or opioids as their main problem drug has decreased.
  • For those returning to drug treatment, opioids are still the leading problem although the rates have declined. There is a steady increase in the number of cocaine cases returning for treatment.
  • Opioids were the main drug generating treatment demand for cases aged 40 years or older, an increase compared to earlier years where it was 35 years or older.
  • Return rates for cannabis have declined.
  • Polydrug use was common and was reported by almost six-in-ten cases (59%).
Injecting and sharing
  • One-in-five cases reported that they had ever injected (20%). The actual number of cases who are injecting is increasing from 2021: 2,264 in 2021 to 2,659 in 2023.
  • Among cases with opioids as a main problem, there was and decrease in the proportion who were currently injecting (from 93% in 2017 to 76% in 2023).
  • Among cases who were currently injecting, there was an increase problem use of cocaine and also polydrug use (more than one substance).
  • Among cases who had injected, 40% had shared needles and syringes.
Treatment outcomes

Half of cases exiting treatment in 2023 had engaged for three months or longer. More than four-in-ten cases had successfully completed their treatment programme or continued to engage with follow on treatment programmes elsewhere. Understanding treatment outcomes better helps inform more targeted services and policies, to improve the well-being of individuals seeking drug treatment.

*It is important to note that each record in the National Drug Treatment Reporting System (NDTRS) database, where this data is drawn from, relates to a treatment episode (a case), and not to a person. This means that the same person could be counted more than once in the same calendar year if they had more than one treatment episode in that year.

ENDS

To receive a copy of the full report, accompanying infographic or further information, or to organise interviews with experts, please contact:

Suzanne Kenny, Communications Officer, Health Research Board

m +353 85 8500494   e skenny@hrb.ie

NOTE TO EDITORS

The Health Research Board (HRB) is Ireland’s lead funding agency supporting innovative health research and delivering data and evidence that improves people’s health and patient care. We are committed to putting people first, and ensuring data and evidence are used in policy and practice to overcome health challenges, advance health systems, and benefit society and economy.

This report describes trends in treated problem drug use (excluding alcohol) for the seven-year period from 2017 to 2023. The data is drawn from the National Drug Treatment Reporting System (NDTRS), the national surveillance system that records and reports on cases of drug and alcohol treatment in Ireland.