1   Introduction p.6

      1.1    Purpose p.6

      1.2    Background p.6

      1.3    Focus of this report p.7

2   The changing drug market p.7

      2.1    New psychoactive substances (NPS) in Europe p.7

      2.2    Europe’s response to NPS p.8

               2.2.1      European early warning networks p.8

               2.2.2      European regulation p.8

               2.2.3      New developments in the European Union Drugs Agency (EUDA) p.8

               2.2.4      Policy response p.9

               2.2.5      Networking and communication on early warning in Ireland p.9

3   The Irish drug use landscape p.9

      3.1    Changing sociodemographics of people who use drugs p.9

               3.1.1      New drug trends p.10

               3.1.2      Changes in polydrug use behaviour p.10

               3.1.3      Global impacts on Irish drug markets p.11

               3.1.4      NPS use in Ireland p.12

      3.2    Cocaine and crack use p.13

               3.2.1      Drug use indicators p.13

               3.2.2      Health consequences of cocaine use p.14

      3.3    The evolution of cannabis markets: Increased potency and new products p.14

      3.4    The synthetic and Semi synthetic cannabinoids  (SSC) market p.14

      3.5    Ketamine p.15

      3.6    Emergence of synthetic opioids (nitazenes) on the Irish market p.16

4   Responses in Ireland p. 18

      4.1    Drugs in nightlife and festival settings p.18

      4.2    Monitoring and harm reduction in nightlife settings in Ireland p.19

               4.2.1      The HSE Safer Nightlife Programme 2022–2025 p.19

               4.2.2      Outcomes from the HSE Safer Nightlife Programme p.19

               4.2.3      Engagement with the back-of-house drug checking service p.20

               4.2.4      Further development of the HSE Safer Nightlife Programme p.21

5   Emerging drug trends and early warning structures p.21

      5.1    Early Warning and Emerging Trends network p.21

      5.2    Emerging drug trend projects in Ireland p.21

               5.2.1      The National Drug Treatment Centre Emerging Drug Trends Laboratory p.  22

               5.2.2      Wastewater analysis p.22

               5.2.3      The National Response and Alert Group p.22

      5.3    Risk communications p.23

6   Developing preparedness: What is needed? p.24

      6.1    Monitoring and risk communication infrastructure p.24

               6.1.1      Trend validation p.24

               6.1.2      Engagement with people who use drugs p.25

               6.1.3      Garda Síochána consultation p.25

               6.1.4      Early warning platform p.25

               6.1.5      Support for threat assessment and risk communication p.26

      6.2    Developing new monitoring tools p.26

               6.2.1      Incident report form for harm reduction key workers and services p.26

               6.2.2      Hospital toxicosurveillance p.26

      6.3    Building structures to identify emerging trends p.27

               6.3.1      Coordination p.27

               6.3.2      Analytical capacity p.27

               6.3.3      Develop services that meet the needs of the changing drugs phenomenon p.28

               6.3.4      Research p.28

               6.3.5      Foresight p.29

7   Conclusion p.30

References p.31