The Irish drug landscape has been significantly changing for some time with many new user groups now existing from a range of social demographics across Irish society. We are currently observing a situation where new drug trends are often not represented in our traditional general population surveys, youth surveys or within our addiction service data. One trend identified through the application of new approaches such as targeted nightlife outreach and local web surveys among people who use drugs [1,2,3] is the use of ketamine which has become a prominent feature of ‘recreational’ drug repertories in Ireland, often used in combination with other ‘club drugs’ for stimulant and euphoric effects when socialising.