Ireland at ‘tipping point’ with problem cocaine use

Cocaine has overtaken heroin as the main problem drug for people seeking treatment for the first time in Ireland, according to the country’s Health Research Board (HRB). There has been a threefold increase in the number of cases seeking treatment for cocaine since 2015, from 1,026 to 3,248 last year.

Records from Ireland’s National Drug Treatment Reporting System (NDTRS) show that almost 11,000 cases were treated for problem drug use last year – the database records treatment episodes rather than people, which means the same person could be counted more than once if they had more than one treatment episode in a year, HRB points out. Two out of five cases were new to treatment, with almost a third seeking treatment for cocaine. ‘In 2021, for the first time, the NDTRS recorded more cocaine (3,248) than heroin (3,168) cases among those treated for drugs as a main problem,’ says the agency.

Women now account for one in four cases reporting cocaine as their main problem drug compared to one in five pre-2020, while crack accounted for 17 per cent of cases where cocaine was the main problem – up from 9 per cent in 2015. Polydrug use accounted for almost 60 per cent of cases overall. Recent years have also seen an increase in drug-related violence in Ireland, as rival gangs battle for control of the lucrative cocaine trade.

‘We are observing a sustained increase in cocaine treatment year-on-year,’ said HRB senior researcher, Dr Suzi Lyons. ‘In 2019 we saw cocaine overtake cannabis as the main problem drug; this year the numbers reported as seeking treatment for cocaine exceed those for heroin – which may mark a tipping point in Irish addiction trends.’ The fact that almost two-thirds were mixing cocaine with other drugs was also a concern as ‘mixing drugs can impact recovery and increase risk of overdose,’ she added. However, there had been ‘some positive developments as regards risk behaviour, with the proportion of cases that had ever injected drugs decreasing from around one-third in 2015 to just over one-fifth in 2021. The reduction is even more notable for new cases, and in 2021 only 4 per cent reported ever injecting compared to 15 per cent in 2015.’

Meanwhile, delegates at the Royal College of Nursing’s (RCN) annual congress have voted to lobby the UK government to introduce safer injection sites. ‘Drug deaths are preventable,’ said RCN Scotland Board member Greg Usrey. ‘Safe injecting services are about reducing harm and providing an opportunity for some of our most vulnerable to engage with services they might not access. We need to push for these facilities to be established and to ensure we have the safeguards in place for nursing staff and others working in these services.’

National Drug Treatment Reporting System: 2015-2021 drug treatment data at

Read the report here

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