Published in June 2024, the latest report from the National Drug Treatment Reporting System (NDTRS) presents data on treated problem drug use (excluding alcohol) for the year 2023, as well as trends for the seven-year period from 2017 to 2023.1

Key findings, 2023
In 2022, some 12,009 cases were treated for problem drug use.2 This is the highest annual number of cases recorded by the NDTRS to date. Almost 4 in 10 (37.1%) of those cases were never treated before, while almost 7 in 10 (68.9%) cases were treated in outpatient facilities.

Main problem drug

In 2023, some 13,104 cases were treated for problem drug use. This is the highest annual number of cases recorded by the NDTRS to date, and an increase of more than a thousand cases compared with the previous year.

Much of this increase was driven by demand for treatment for cocaine use, particularly treatment for females. Cocaine was the most common drug reported among new cases entering drug treatment, accounting for almost one-half of new treatment demand. Cocaine was also the most common problem drug generating treatment demand for those aged 20–39 years. Until 2023, opioids had been the main problem drug for cases aged 35 years and over.

More than one-half (57.9%) of cases had been treated previously, and opioids were the most common problem drug among this group. Almost four in 10 (36.6%) of cases were never treated before. In contrast, the proportion of new cases reporting cannabis or opioids as their main problem drug has decreased. Over seven in 10 (71.5%) cases were treated in outpatient facilities.

Main problem drugs generating treatment demand
Cocaine was the most common main problem drug reported in 2023, accounting for one in three (37.6%) of cases. Opioids, mainly heroin, were the second most common main problem drug reported in 2023, accounting for 29.3% of cases. Cannabis was the third most common reported main problem drug, while benzodiazepines was the fourth most common main problem drug reported for the year.

Cocaine
In 2023, some 4,923 cases entered treatment for cocaine. The majority of these (75.6%) required treatment for powder cocaine, with the remainder (24.4%) for crack cocaine. The treatment demand for powder cocaine increased by 16.8% (n=536) from the previous year, while the treatment demand for crack cocaine increased by 33.7% (n=303). Proportionally, females were more likely to require treatment for crack cocaine than powder cocaine (46.2% vs 22.4%). Powder cocaine users were more likely to be employed (40.5%) than crack cocaine users (6.5%). The median age entering treatment was lower for those seeking treatment for powder cocaine than crack (31 years vs 39 years).

Over the period 2017–2023, there was a 228.2% increase in the number of cases where cocaine was the main problem drug. Powder cocaine increased by 197.1% over the period and crack cocaine increased by 594.2%. Between 2017 and 2023, there was a 388.4% increase among females who sought drug treatment for cocaine, from 284 cases in 2017 to 1,387 cases in 2023. Cocaine is the most common drug reported among new cases entering drug treatment, with rates rising significantly over the past 7 years. There is also a steady increase in the number of cocaine cases returning for treatment.

Polydrug use
Polydrug use was common and reported by almost six in 10 cases (59%). The most common additional drug was cannabis (39%), followed by cocaine and alcohol (both 36%), and benzodiazepines (31%). Cocaine has moved up the rankings compared with previous years.

Injecting and sharing
One in five cases reported that they had ever injected (20.3%). The absolute number of cases who had ever injected increased over time (2021: 2,264; 2022: 2,492; 2023: 2,659), despite their proportion decreasing year-on-year, from 29.7% in 2017 to 20.3% in 2023. Among new cases, the proportion that reported ever injecting decreased over the period from 11.0% in 2017 to 4.0% in 2023. However, among previously treated cases the numbers reporting ever injecting have increased since 2020.

There was a decrease in the proportion of cases who inject opioids as the main problem drug, from 92.5% in 2017 to 76.5% in 2023, while there was an increase in cases injecting cocaine. Polydrug injecting over the same period also increased. Among cases who had injected, 39.8% had shared needles and syringes.

Parental status
In 2023, almost one-half of cases (49.9%, n=6535) in drug treatment were parents who had children.

Females entering drug treatment were more likely to have dependent children and to live with children than males.

Eight in 10 of all parents (83.6%, n=5463) were known to have children aged 17 years or younger. More than three in five (62.9%) cases with younger children were males, while almost two in five cases were females (37.1%).

Treatment outcomes
While treatment duration varied by intervention type, one-half of cases exiting treatment in 2023 attended for 81 days or longer. Nearly one-third (29.5%) of cases successfully completed treatment, and 12.2% were referred to other drug and alcohol services for continued support. However, 31.8% of cases did not return for subsequent appointments and 14.0% refused further treatment sessions. At the point of exiting treatment, one in nine cases (11.7%) had either engaged or achieved substantial progress towards their priority care plan goals. However, 6.0% had disengaged from their care plan, if such existed. Most cases (76.3%) did not report having family members or significant others involved in their treatment.

Geographical prevalence of drug treatment demand
Annual prevalence rates of treated problem drug use were calculated per 100,000 of population aged 15–64 years based on Census figures from the Central Statistics Office (CSO).2 Overall prevalence, which includes new cases and those cases returning to treatment, increased from 278.6 per 100,000 in 2017 to 372.9 per 100,000 in 2023. The prevalence of cases was examined by county of residence in 2023 and is presented in Figure 1.

Figure 1: Prevalence of drug treatment cases, 2023, by county of residence

1.   Lynch, T, Condron, I, Lyons S and Carew AM (2024) National Drug Treatment Reporting System: 2023 Drug treatment demand. HRB StatLink Series 18. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/40981/

2.   Population data are taken from the CSO, available from: https://www.cso.ie/en/releasesandpublications/ep/p-pme/populationandmigrationestimatesapril2023/