The United Kingdom has one of the highest rates of drug-related deaths in Europe. The rate of drug deaths in Scotland is the highest among European countries, second only to the overdose rates in North America. The significant number of deaths in the UK can be attributed to a longstanding trend of increase, which is influenced by demographic factors such as the aging population of opioid users. 

Additionally, until recently there has been inadequate investment in drug treatment and harm reduction measures (Dame Carol Black 2021, NRS 2022). Drug and alcohol related deaths in Northern Ireland have more than doubled over the last ten years, reaching the second highest rate of drug deaths, (11 per 100,000 in 2021), in the UK after Scotland. Drug related deaths were highest in 2020 with 218 deaths recorded (decreasing slightly to 213 in 2021), over half (55.5%) of which were men aged between 25-44 years old (NISRA 2022). 

The prevention of each of these deaths is possible, making it essential for the Department of Health, the NI Executive, and society to prioritise this issue. Aside from the human cost, both alcohol and drug use place a significant burden of additional expenditure on public services such as health care, public safety, criminal justice system, and social work. Substance use and related harm cost hundreds of millions of pounds every year in Northern Ireland. In fact, the most recent figures suggest that combined drug and alcohol use cost the society approximately £1billion every year (NIAO, 2021). This financial burden is a result of various factors. Firstly, the healthcare system bears the cost of treating individuals with substance use disorders, including emergency room visits, hospitalisations, and rehabilitation services. Additionally, substance use can lead to a range of health issues, such as liver disease, mental health disorders, and infectious diseases, further increasing healthcare costs. In summary, the financial burden of drug use in Northern Ireland is substantial and encompasses healthcare expenses, public safety costs, criminal justice system expenditures, and social work services. Addressing substance use and its associated harms requires a comprehensive approach that considers both human and economic costs. 

The Preventing Harm, Empowering Recovery Strategy (2021-2031) (Department of Health 2021) was prioritised by the Department of Health in response to a specific commitment arising from the New Decade New Approach Agreement (UK Government and Irish Government 2021) and in response to the Executive’s overarching Programme for Government (NI Executive Office 2021). It also directly links in with the new Mental Health Strategy, 2021-2031(Department of Health 2021). It adopted a co-production approach that encompassed a full review of the previous strategy, a consultation exercise, and a major public consultation exercise.