The report found that, while Ireland’s drug and alcohol prevention system has many strengths

– including strong public health legislation around alcohol and drugs, a network of dedicated local practitioners and community-based organisations, and a significant proportion (41%) of quality prevention interventions that are evidence based or strongly evidence informed – the country does not yet have a coherent and fully effective prevention system. The delivery of prevention interventions is fragmented and variable. Prevention interventions are largely organised and delivered by local organisations, resulting in uneven access and inconsistent quality across regions, with good practices often isolated or sparse within the local ecology of prevention activities.

Geographic and demographic coverage is good, at least in terms of there being some distribution throughout the country. However, there is imbalance in delivery in large urban areas, with the majority of interventions located in Dublin and quite a few in surrounding areas. There are also gaps in population coverage. The majority of prevention interventions target adolescents, with much fewer interventions targeting early life and at-risk families. Intervention quality and delivery is ultimately quite variable. Many interventions rely on shortterm engagement and information sharing despite empirical evidence showing that effective prevention involves multiple sessions, is interactive, focuses on skill enhancement and decision-making, and connects to existing structures and institutions.

There is weak infrastructure for programme evaluation and the use of empirical evidence in designing and executing prevention interventions. While many interventions reviewed in the report were described as evidence informed, few provided evidence of this and none had undergone a local outcome evaluation. Existing evaluations focused on organisation and process outcomes rather than substance use-related outcomes. While prevention practitioners show a strong commitment to their work, training is often informal, selfdirected, and resource dependent.

There is a lack of consistency in understanding among those working in the sector around the terms ‘universal’, ‘selective’, and ‘indicated’ risk, and the differences between them. This could undermine policy and planning coherence and programme efficacy, and could result in the inconsistent implementation of responses and monitoring of progress. For example, interventions that fit under the ‘universal’ risk category are often designated as ‘selective’ based on the profile of the community where they are being implemented. This is based on a deep knowledge of the difficulties young people face in particular communities, but incorrectly classifying interventions in terms of risk may result in inconsistency in their application and the use of inappropriate outcomes measures.

The national coordination of prevention activities in Ireland needs to be strengthened. At the time the RePS data were collected, Ireland was in a transitional period in terms of its national drugs strategy and associated structures. A new national drugs strategy was being drafted, and the prevention Strategic Implementation Group had not met in over 12 months. Policy should prioritise developing a national strategic approach to effectively support a prevention system in Ireland. This should include the expansion of prevention interventions in order to capture under-represented groups and areas of delivery, as well as support for the wider delivery of existing interventions that have been found to be effective. There is a need to develop a culture and infrastructure (including funding opportunities) for evaluation training and expertise, stronger professional supports for training in prevention, and opportunities for communities of learning. There is also a need to develop a shared national framework organised around a common terminology of risk.

In conclusion, the report found that Ireland has many features that are the foundation of an effective prevention system. However, current prevention efforts are fragmented, insufficiently coordinated, unevenly distributed, and often isolated from key institutions that could support their efficacy. The system as a whole would benefit from better coordination, stronger investment, coherent pathways for training and development, and an infrastructure prioritising outcome evaluations and the use of empirical evidence.