This report documents the proceedings and outcomes of A Health-Led Response to the Issue of Drugs and Alcohol: Building a Regional System that Delivers for Communities, a three-day Future Search workshop held at the Law Society in Dublin from 24 to 26 June 2026.

The report is presented in Four Distinct Sections.
Section One – Executive Summary
Section Two – Summary of proceedings
Section Three – Common Ground Agreement and Blueprints for Regional Structures
Section Four - Full Narrative Output of Each Session

The workshop was convened by the Department of Health, under the auspices of Jennifer Murnane O'Connor, Minister of State with special responsibility for Public Health, Well Being and the National Drugs Strategy. It was independently facilitated by Michael Donnelly of Second Nature, Co-Director of the Future Search Network, working alongside co-facilitator Tara Haughian, using the Future Search methodology. 

Context and mandate - The workshop's mandate traces back to the Letter of Determination, the directive the Minister for Health issues each year to the Chair of the HSE following the Budget, setting out the government's policy position for the coming year. This year's Letter asked the HSE to create regional structures to coordinate drug and alcohol responses, across both HSE and community-based services, in order to address treatment disparities and support the National Drugs Strategy. This instruction is in turn reflected in the draft National Drugs Strategy itself, which sets out three levels of governance and oversight for the strategy. The third of these levels is the set of regional structures the workshop was convened to design.

The rationale for this approach is to align the new National Drugs Strategy with the wider reform of health services, in support of a "health-led" response, which at its core is the principle that people seeking support for drug use should be viewed and treated with the same regard as people presenting with any other non-acute health condition. Sláintecare, the most significant reform of health and social care in the history of the state, provides the overarching lens through which all services are now organised and funding allocated, and has created the geographical structures, the six HSE Health Regions, through which decisions are made and services delivered. Aligning the drug and alcohol response with these structures offers the opportunity to put it on an equal footing with responses to other health issues; the risk of not doing so is that it remains, in effect, an issue resulting in marginalisation and stigma.

The last substantial review of the structures for delivering drugs policy to communities was the Rabbitte Report, which turns thirty in October. A great deal has changed since then, in the nature of the drug issue itself, once regarded as a largely urban problem, and in Irish society more broadly. The ambition for this workshop is to design structures robust enough not only to support the current National Drugs Strategy but potentially to guide the response for a decade or more beyond it.

Participants and method - In keeping with the Future Search approach of bringing "the whole system in the room," the workshop brought together seventy-three participants drawn from across the sector, organised into nine Stakeholder Groups reflecting the diversity of the field: Lived and Living Experience; Drug and Alcohol Task Forces; Marginalised Groups and Thought Partners; Community Service Providers; Medical Service Providers; Government Departments; HSE; Education and Prevention; and Justice. This breadth of representation was intended to ensure the structures designed would be informed by the full range of perspectives, expertise, and experiences across the system, and that any resulting agreements would carry the legitimacy of having been reached collectively rather than imposed.