Health Research Board (HRB) reports rise in demand for cocaine treatment in 2023

The Health Research Board (HRB) recorded the highest annual number of people treated for problem drug use last year. 13,104 cases were reported, an increase of over one thousand compared to 2022.

Cocaine was the most common drug reported, accounting for 1 in 3 cases, followed by opioids, cannabis and benzodiazepines. The data further reported that almost four in ten cases had never been treated before.

A case relates to a treatment episode in the National Drug Treatment Reporting System data system, not a person. This means that according to the HRB, the same person could be counted more than once in the same calendar year if they had more than one treatment episode in that year.

These figures point to a 228% increase in the number of cases where cocaine was the primary problem drug between 2017 and 2023, with 4,923 cases recorded this year. Powder cocaine increased by 197% during last year, and crack cocaine by 594%.

Cocaine is the most common drug reported among new cases entering drug treatment, with rates spiking significantly over the past seven years. There has also been "a steady increase" in the number of cocaine cases returning for treatment.

In contrast to these figures, the proportion of new cases that reported cannabis or opioids as their primary problem drug has decreased.

The data recorded an increase in females who use cocaine; since 2017, there has been a 388% increase among women who have sought drug treatment for cocaine use.

For cases with powder cocaine as the main drug being used, more than one in five were female, two in five were employed, and the median age entering treatment was 31 years old. For cases that report primary use of crack cocaine amongst women, nearly half were female, just over one-in-20 were employed, and the median age was 39 years.

Additionally, the report recorded a decline in return rates for cannabis; for those returning to drug treatment, opioids continue to be the leading problem even though rates have declined. The average age of those seeking treatment for opioid use has further increased from 40 years to 35 years, as was previously recorded.

Among those who use opioids as their primary drug, there was a decrease in the proportion of injecting - from 93% in 2017 to 76% in 2023.

The collected data showed that one in five cases reported that they had ever injected (20%), and according to the HRB, the number of people injecting has increased from 2,264 in 2021 to 2,659 in 2023.

The report also recorded polydrug use (the use of more than one substance) as well as cocaine use amongst those who were currently injecting.

Additionally, the report recorded that amongst those who had injected, 40% had shared needles and syringes.

Half of the cases exiting treatment in 2023 had engaged for three months or longer. More than four in ten cases had successfully completed their treatment programme or continued to engage with follow-up treatment programmes elsewhere.

Responding to the publication of the 2023 drug treatment figures, Tony Duffin CEO of Ana Liffey Drug Project, said,

"Over the period 2017 to 2023, the use of crack cocaine increased by 594% according to the latest treatment figures. Separately, there has been a troubling increase from 2,264 in 2021 to 2,659 in 2023 of people reporting having ever injected. Although there has been a decrease in opioid users currently injecting, the rise in cocaine and polydrug use among injectors is troubling.

"Equally concerning is that 40% of those who have injected reported sharing needles and syringes. These figures highlight trends in drug use that require enhanced Harm Reduction measures be implemented to further protect life, reduce the spread of disease and provide opportunities for people who use drugs.”

Duffin continued, "Also in 2023, the need for enhanced Harm Reduction measures was addressed in Recommendation 36 of the Citizens Assembly on Drugs Use, which called for the more widespread use and rapid adoption of evidence-based approaches to harm reduction.

“With the Citizens Assembly suggesting - supervised Injecting facilities for relevant population centres; significant expansion of drug checking facilities and initiatives, including permanent drug checking facilities and non-festival environments; administration of naloxone, and consideration of safe consumption facilities based on international experience and best practice."

News of Ireland's first medically supervised injecting centre came later last week and is expected to open later this year, more information on the facility is available here.