Date Published: 14 May 2008
Trends in problem drug use in Ireland, 2001 - 2006
A total of 68,754 cases* aged between 15 and 64 years were treated for problem drug use in Ireland between 2001 and 2006. The latest report from the Health Research Board (HRB) shows that almost one in five of these cases (18%) were being treated for the first time. In recent years, problem drug use has become a nationwide issue, rather than being confined largely to Dublin. Across Ireland, the main problem drugs reported by new cases were cannabis (41%), opiates (39%) and cocaine (9%). While the number of new cases reporting cocaine as their main problem drug was still relatively low, it increased considerably, from 43 in 2001 to 342 in 2006, reflecting trends in the 2002/3 and 2006/7 surveys of drug use in the general population.
The number of previously treated cases returning for treatment increased from 2,588 in 2001 to 2,781 in 2006. The number of cases returning for treatment is an indicator of the chronic nature of problem drug use and the level of demand for services into the future. The number of new cases also increased by a small margin, from 2,030 in 2001 to 2,228 in 2006, which reflects recent trends in problem use.
According to Dr Jean Long, Head of the Alcohol and Drug Research Unit at the HRB,
‘This relatively small increase in new cases nationally masks stark trends in HSE areas over the six-year period. For example; the number of new cases increased by 100% in the Western area, which includes Galway, Mayo and Roscommon’.
Between 2001 and 2006 the numbers of new cases in other areas increased by the following percentages:
- 76% in the South Eastern area (Carlow, Kilkenny, Waterford, Wexford and Tipperary South),
- 57% in the Midland area (Offaly, Laois, Longford and Westmeath),
- 37% in the North Eastern area (Cavan, Louth, Meath and Monaghan), and
- 33% in the Mid-Western area (Clare, Limerick and Tipperary North).
The numbers of new cases decreased slightly in the East Coast area (of Dublin and Wicklow), the South Western area (part of Dublin and Wicklow and all of Kildare) and the Southern area (Cork and Kerry).
The main problem drug reported by new cases varied greatly by HSE region. Cases in Dublin North-East and Mid-Leinster reported opiates as their main problem drug, while cases in the South and West regions reported cannabis. Across all four regions, between 7% and 10% of new cases reported cocaine as the main problem drug indicating that cocaine use remained low, but is a nationwide problem.
"Heroin remains the main problem drug reported by new cases in Dublin, in spite of a 31% decrease in the number of new opiate cases who lived in Dublin. This decrease indicates that the heroin epidemic has abated in this area. In contrast, there was a 96% increase in the number of new opiate cases outside Dublin. The latter finding, along with the number of opiate users who are waiting for methadone treatment, indicate that additional methadone treatment places are required outside Dublin," says Dr Long.
Of the 5,191 cases who entered treatment for problem drug use in 2006, half (51%) received counselling, two in every five (39%) received methadone treatment, almost one in five (17%) got a brief intervention and one in seven attended medication-free therapy. In total, over the six years surveyed, 68,754 cases received treatment, the majority (68%) in outpatient settings.
‘In recent years there has been increased awareness of the growing drugs problem in Ireland and the need to have a combination of interventions in place. There has been a concentrated effort through the National Drugs Strategy to increase the volume and range of treatments. This has resulted in the introduction of 2,300 new methadone places and a greater emphasis on brief intervention, counselling, family therapy, aftercare and social reintegration. This is a welcome development, although we need a better balance in the range of treatment interventions available in different parts of Ireland,’ explains Dr Long.
Two other considerations for the provision of treatment are polydrug use (the use of more than one drug) and the increasing number of people of non-Irish nationality seeking treatment.
‘Almost three out of four new cases presenting for treatment used more than one drug, which increases the complexity of the case and is associated with poorer treatment outcomes,’ says Dr Long.
In the West and South HSE regions, where cannabis was the main problem drug, the two most common additional drugs were alcohol and ecstasy. In the North East and Mid-Leinster HSE regions, the two most common drugs taken in addition to opiates were cannabis and cocaine.
‘We examined the association between main problem drugs and additional drugs among new cases and found that the additional problem drugs were linked with the main problem drug. For example, additional drugs used with cannabis and cocaine indicate their link with alcohol and other recreational drugs,’ she says. ‘The data in this paper clearly show an overlap between alcohol and other drug use, highlighting the need for an integrated approach to the management of substance misuse in Ireland,’ she explains.
As drug treatment interventions rely heavily on verbal communication, an increase in the number of new nationalities presenting for treatment points to the need for a multi-lingual approach to treatment provision.
- In general, the profile of a typical drug user was that of a young male, with a low level of education, who was likely to be unemployed and, in a minority of cases, had no stable home.
- Almost one in five (18%) new cases presenting for treatment for problem drug use were under 18 years old.
- Figures indicate that at least half of treated drug users started using drugs when they were 15 years old.
‘These characteristics indicate the importance of accommodation, personal development and education and employment opportunities as part of the drug treatment and reintegration process. These factors were identified in the report of the Working Group on Drugs Rehabilitation and it is essential that the recommendations in this report are implemented,’ Dr Long concluded.
The data presented in this press release are taken from HRB Trends Series 2: Trends in treated problem drug use in Ireland, 2001 to 2006, which is available online in the publications section of the HRB website at www.hrb.ie.
*One case does not necessarily represent one person. There are a large number of people who presented for treatment on more than one occasion during the period under review.
Source(s): Health Research Board (Ireland).