A RECORD 13,104 cases were treated for problem drug use in Ireland last year, according to a new report from the Health Research Board (HRB).

This is the highest annual number recorded and an increase of almost 1,100 cases compared with 2022.

Last year saw a continued increase in cocaine use among those seeking treatment, especially among women.

Cocaine was listed as the main problem in almost 5,000 cases in 2023. Almost four-in-10 cases involved people who had never been treated before.

The same person could be counted more than once in the figures if they accessed more than one treatment plan in the same calendar year.

The figures included in the report are compiled from statistics in the National Drug Treatment Reporting System (NDTRS) database.

Cocaine was the most common drug reported in cases last year – accounting for one-in-three cases, followed by opioids (mainly heroin), cannabis and benzodiazepines.

Dr Anne Marie Carew, Research Officer at the HRB, said the rise in cocaine use is “changing the landscape in terms of treatment demand in Ireland”.

“Cocaine is the main problem drug for nearly half of new cases to treatment, but also one-in-three cases returning to treatment.

“This is compounded by the fact cocaine is also the second most common additional drug that people seek treatment for along with another drug. This points to a growing future need for treatment for cocaine,” Dr Carew added. 

388% increase in women seeking help

Between 2017 and 2023, there was a 388% increase among women who have sought drug treatment for cocaine – up from 284 cases in 2017 to 1,387 cases in 2023.

Socio-demographic characteristics varied depending on the type of cocaine used, the HRB report notes. Crack, which is cheaper than powder cocaine, is typically more often used by people with lower incomes.

For cases with powder cocaine as the main problem last year, more than one-in-five were female, two-in-five were employed, and the median age entering treatment was 31 years.

For cases where crack cocaine was the main problem in 2023, nearly half were female, just over one-in-20 were employed, and the median age was 39 years.

Dr Carew said the sharp increase in women seeking treatment for cocaine addiction is concerning and “highlights a growing need for prevention measures, especially around crack cocaine”. 

Females entering drug treatment are more likely to be living with dependent children.

“Understanding the complex issues they face will help to identify the integrated services they require to address their specific situations.”

Main cocaine findings

Cocaine was recorded as the main problem in 4,923 cases last year. From 2017 to 2023, there was a 228% increase in the number of cases where cocaine was listed as the main problem drug.

Powder cocaine use increased by 197% during this time, and crack cocaine use increased by 594%.

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Cocaine remained the most common primary drug among new treatment cases in 2023, accounting for almost half (46%) of first-time cases. For previously treated cases, cocaine accounted for one-in-three cases – the highest number recorded to date.

In contrast, the proportion of new cases reporting cannabis or opioids as their main problem drug has decreased.

For those returning to drug treatment, opioids are still the leading problem but the rates have declined. Opioids were the main drug generating treatment demand last year for cases aged 40 years or older.

Polydrug use (where a person is taking more than one drug at the same time) was common and was reported by almost six-in-10 cases (59%) in 2023.

Injecting and sharing

One-in-five cases reported last year involved people who said they had injected drugs (20%). The actual number of cases which involved people injecting increased from 2,264 in 2021 to 2,659 in 2023.

Among cases with opioids as a main problem last, there was a decrease in the proportion of people who were actively injecting at the time (down from 93% in 2017 to 76% in 2023).

Among cases who were currently injecting, there was an increase in cocaine use and polydrug use. Among cases who had injected last year, 40% said they had shared needles and syringes.

Half of cases exiting treatment in 2023 had engaged with the service for three months or longer. More than four-in-10 cases had successfully completed their treatment programme or continued to engage with follow-on treatment programmes elsewhere.

As reported by The Journal last week, Ireland’s first medically supervised injecting facility is expected to finally open by the end of 2024 after years of delays.