OVER 7,500 CASES of problem alcohol use were treated in Ireland in 2019, a slight increase from the previous year, according to the latest figures from the Health Research Board (HRB).

Cases of problem alcohol use rose from 7,464 in 2018 to 7,546 in 2019, alongside a rise in the number of cases reporting cocaine as an additional drug.

Almost 70% of cases were classified as alcohol dependent, which refers to a case where there is a strong desire to drink alcohol, difficulties controlling its use, prioritising alcohol over other areas of life, and experiencing a physical withdrawal reaction when use of alcohol is discontinued.

The median age at which cases started drinking was 16, while the median age of cases entering alcohol treatment was 41, the HRB figures show.

Although figures for 2020 are not yet available, concerns have been raised around Ireland about the impact of the Covid-19 pandemic on problem alcohol use.

Speaking to TheJournal.ie, HRB senior researcher Dr Suzi Lyons said that this has been an “unprecedented year”.

“The problem is that the Irish population already had an unhealthy relationship with alcohol, so we do know that during this crisis, people probably did turn to alcohol to try to cope, or if they already had harmful use, they probably increased that use.”

“What we will have to do is look at the data and monitor the trends to see the negative consequences of alcohol use which have been precipitated by Covid-19.”

The median number of standard drinks for women presenting for treatment was 15 in a day, and 20 for men – more in a day than the HSE low risk guidelines advises in a week.

One in five cases that presented for treatment for problem alcohol use report problem use with an additional drug, according to the HRB’s figures.

Cannabis and cocaine use as an additional drug was more frequent among men than women, but women were more likely than men to use benzodiapezepines or opiods alongside alcohol.

Overall, cannabis was the most common additional drug reported in cases of problem alcohol use in 2019.

Although it remained the most common additional drug, the number of cases reporting problem use of cannabis dropped from 1,008 in 2013 to 881 in 2019.

In contrast, the number of cases that present with problem use of cocaine as an additional drug have almost doubled over a seven year period, from 458 in 2013 to 844 in 2019.

“Unfortunately, we’re not surprised, because we’ve also seen an increase in people seeking treatment for cocaine use on its own,” Dr Lyons said.

“It is particularly worrying, because when you mix alcohol and cocaine, what they do in the body is produce a second, more dangerous substance called cocaethylene, which is more toxic then either cocaine or alcohol alone.”

“The person increases their risk of the negative side effects, such heart problems, overdose, or organ damage.”

“This is why mixing alcohol and cocaine is quite a worrying trend.”

Benzodiazepines and opiods were reported as additional drugs in 342 and 206 problem use of alcohol cases respectively.

“Ireland already had a very unhealthy relationship with alcohol, but what we’ve seen in previous trends is that the number of people who had problems with other drugs has been pretty stable, about 1 in 5 over the last seven years, so what we’ll have to do is monitor the trends very closely, because the impact [of Covid-19] is as yet unknown and what will need to do is get that information to say ‘these are the additional services that people need and these are the trends’.”

“We won’t know yet if people are using more drugs along with alcohol, or that their alcohol use is just more problematic,” said Dr Lyons.

Cases recorded each refer to an episode of treatment, rather than a person. This means that one person could be counted more than once in a year if they had two or more treatment episodes in that year.

The number of under-18s presenting for treatment has dropped by over half since 2013, falling from 220 to 107.

Dr Lyons explained that a decrease in the number of under-18s seeking treatment is a good sign, but that it could be due to a number of factors.

“It could be due to a true decrease in the numbers seeking treatment, it could be due to the availability of services, or it could be due to participation in systems.”

“What we have for alcohol is a very large lag between time between people start drinking, which is on average around 16, and time people come for treatment, which is about 40. So, any improvements made or changes to treatment may take some time to appear in our data.”

In 2019, almost two-thirds of cases for problem alcohol use treatment were men.

43% of cases among men drank beer, 37% drank spirits, and 9% drank wine, while 35% of women drank wine, 25% drank spirits, and 19% drank beer.

Nearly half of cases were unemployed, and the number of homeless cases has seen a 29% increase from 507 in 2013 to 654 in 2019.

The number of cases among Irish Travellers increased from 144 in 2013 to 178 in 2019.

The median age of treatment is older for women, at 43 years, than for men, at 40 years.

A third of women who entered treatment for problem alcohol use were 50 or over, compared to a quarter of men.