In this bulletin, trends in treated problem drug use (excluding alcohol) are described for the seven-year period from 2015 to 2021. The data are 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.

Overview

In the seven-year period, 69,450 cases were treated for problem drug use. The number of cases recorded increased from 9,892 in 2015 to 10,769 in 2021.

• The proportion of new cases was 37.8% in 2015 and 39.1% in 2021.
• In 2021, the majority of cases were treated in outpatient facilities (70.3%), as in previous years.
• Between 2015 and 2021, the proportion of cases treated in residential (inpatient) settings decreased from 18.0% to 12.9%.

Main problem drug (excluding alcohol)

• Opioids (mainly heroin) were the most common main problem drug reported in 2021. The proportion of cases treated for opioids decreased from 47.8% in 2015 to 33.7% in 2021.
• Heroin accounted for 87.3% (3,168) of all opioid cases in 2021.
• Cocaine was the second most common drug reported in 2021, accounting for 30.2% (3,248) of all cases.
• In 2021, for the first time, the NDTRS recorded more cocaine than heroin cases among those treated for drugs as a main problem.
• There was a 216.6% increase in the number of cases treated for cocaine as a main problem, from 1,026 in 2015 to 3,248 in 2021.
• Cocaine was the most common main drug among new cases in 2021, as in 2020.
• Cannabis was the third most common main drug reported in 2021. The proportion of cases treated decreased from 28.2% in 2015 to 21.3% in 2021.
• Benzodiazepines were the main problem drug for 11.3% of cases in 2021, an increase from 8.8% of cases in 2015.

Polydrug use

• Over the period, polydrug use was reported by over half of cases (57.8%).
• The proportion of cases with polydrug use decreased from 60.9% in 2015 to 53.4% in 2018 but increased to 58.2% in 2021.
• Cannabis (42.0%) was the most common additional drug in 2021, followed by cocaine (35.9%), benzodiazepines (35.8%), and alcohol (35.8%).

Risk behaviour

• The proportion of cases that had ever injected decreased from 33.7% in 2015 to 21.0% in 2021.
• In 2021, among cases who had injected, 41.4% had shared needles and syringes. Socio-demographic characteristics
• The median age of cases increased from 30 years in 2015 to 32 years in 2021.
• Seven-in-ten (73.0%) cases reported over the period were male.
• The proportion of cases recorded as homeless increased from 9.2% in 2015 to 12.5% in 2021.
• The proportion of cases with an Irish Traveller ethnicity was 2.9% in 2015 and 3.4% in 2021.
• The proportion of cases recorded as unemployed decreased from 64.4% in 2015 to 58.8% in 2021.
• The proportion of cases in paid employment increased from 8.9% in 2015 to 20.5% in 2021.
• In 2021, 15.8% of cases treated for problem drug use were residing with children aged 17 years or younger.