The Republic of Ireland ranks fourth globally for past-year cocaine use, with 2.4% of the general adult population reporting such use in 2019.1 It ranks second in Europe for lifetime cocaine use among 15–24-year-olds, with such use estimated at 6.8% in 2021.2 National drug treatment surveillance data revealed a 259% increase in cases where cocaine was the main problem drug between 2016 and 2022; in 2022, cocaine surpassed opioids as the leading problem drug, accounting for 34% of all drug treatment cases.3 In addition, among individuals aged 15–24 years, cocaine-related hospital discharges rose by 83% between 2015 and 2019, while cocaine-related deaths increased by 41% between 2007 and 2017.2 However, despite growing concerns about trends in cocaine use in Ireland, there is a lack of longitudinal studies that prospectively examine factors associated with cocaine initiation and use in general youth populations.

Recent research examined individual, family, and socio-environmental exposures associated with incident past-year cocaine use at ages 17 years (n=5965) and 20 years (n=4679) using data from the Growing Up in Ireland study.4 Notable findings from this research, which have been published in the Journal of Adolescent Health, include the following:

• Almost 4% of 17-year-olds and 22.9% of 20-year-olds reported past-year cocaine use.
• Cocaine use increased by 475% between ages 17 and 20 years, and over 75% of those who used cocaine at age 17 years continued to use it at age 20 years.
• Alcohol use at age 14 years or younger was associated with 8 times the odds of cocaine use at age 17 years (odds ratio (OR): 8.0;, 95% confidence interval (CI): 1.7–7.3) and 19 times the odds of cocaine use at age 20 years (OR: 19.2; 95% CI: 8.6–43.2).
• Peer cannabis use was associated with seven times the odds of cocaine use at age 17 years (OR: 7.3;, 95% CI: 2.9–18.3) and double the odds of cocaine use at age 20 years (OR: 2.4; 95% CI: 1.8–3.2).
• Growing up in a neighbourhood where substance use was common doubled the odds of cocaine use at age 17 years (OR: 2.4; 95% CI: 1.3–4.4).

The authors note that the sharp increase in cocaine use between age 17 years and age 20 years suggests that this period is crucial for intervention, and that delaying alcohol initiation and reducing cannabis exposure may help prevent cocaine use later in adolescence and young adulthood. In addition, targeted public health interventions, especially in high-risk environments, may be necessary to curb rising cocaine use.

1    UNODC (2023) Global Report on Cocaine 2023 – Local Dynamics, Global challenges. Geneva: United Nations publications. Available from: https://www.drugsandalcohol.ie/38396/

2    Doyle A, Sunday S, Galvin B and Mongan D (2022) Alcohol and other drug use among children and young people in Ireland: Prevalence, risk and protective factors, consequences, responses, and policies. HRB Overview Series 12. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/36112/

3    O’Neill D, Lyons S and Carew AM (2023) National Drug Treatment Reporting System: 2022 drug treatment demand. HRB StatLink Series 12. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/38794/

4    Brennan MM, Cavallaro M, Mongan D, et al. (2025) Factors associated with cocaine use at 17 and 20 years old: a longitudinal analysis of a nationally representative cohort. J Adolesc Health, 76(3): 488–498. Available from: https://www.drugsandalcohol.ie/42555/