National Profile

Ireland’s current national drugs strategy is structured around cross-cutting goals rather than the pillars of the previous national drugs strategy. Its main aims are to minimise the harms caused by the use and misuse of substances and to promote rehabilitation and recovery. Therefore, there is a focus on the need for a range of treatment, rehabilitation, and recovery services using the four-tier model. The strategy also recognises the need for timely access to appropriate services for clients. The current national drugs strategy comes to an end this year.

The Health Service Executive (HSE) is responsible for the provision of all publicly funded drug treatment in Ireland. Drug treatment is therefore provided not only through a network of HSE services (public), but also through non-statutory/voluntary agencies, many of which are funded by the HSE. Some private organisations also provide treatment.

A range of treatment options is available for people with problem drug use, mainly in outpatient settings, but also in residential settings. Almost all opioid agonist treatment (OAT) provided is methadone; however, since November 2017, buprenorphine-based products have been available nationally for patients where clinically appropriate. In 1998, the first formal methadone treatment protocol (MTP) was introduced in order to ensure that treatment for problem opioid use could be provided wherever the demand existed. Outpatient OAT for people with problem opioid use is provided only through specialised HSE outpatient drug treatment clinics, satellite clinics, or specialised general practitioners (GPs) in the community. The first national comprehensive clinical guidelines for OAT were published in 2016.

Trends

The majority of drug treatment (more than 70%) continues to be provided through publicly funded and voluntary outpatient services. Outpatient services include low-threshold and specialised OAT GPs in the community. Inpatient treatment is mainly provided through residential centres run by voluntary agencies.

In 2024, a total of 12,663 treatment entrants were reported. This is a slight increase on the number of cases reported in 2023 (12,597). 

In 2024, cocaine was the most common problem drug reported. The increase in the number of cases presenting for treatment for problem cocaine use continued in 2024. Almost one-quarter of cocaine cases (24.4%) were reported to be due to crack cocaine, which is similar to 2023 (24.2%).

Opioids (mainly heroin) (3,199 cases) were the second most common problem illicit drug used by treatment entrants, followed by cannabis and benzodiazepines. The number of cases reporting problem opioid use peaked in 2010 at 4,929, and there has been an almost consistent downward trend since then.

Cannabis was the third most common problem drug reported in 2024. From 2004 to 2018, cannabis was consistently reported as the second most common main problem drug. The proportion of cases reporting cannabis as their main problem drug peaked at 28.9% in 2015, with the proportion decreasing almost every year since then.