ONE IN THREE young drinkers in Ireland have an alcohol use disorder (AUD), but adolescents are beginning to drink alcohol at a later age, according to a new report by the Health Research Board (HRB).

The report, published today, examined alcohol and drug use among young people aged 15-24 years in Ireland, drawing on data from surveys and reports and from health and law enforcement services.

It found that the average age of people first drinking alcohol has increased from 15.6 years in 2002 to 16.6 years in 2019. The number of young people abstaining from alcohol has also increased from 11% in 2002 to 26% in 2019.

However, the report found that 38% of drinkers aged 15-24 years participating in a population survey have an AUD.

AUD is defined as “a problematic pattern of alcohol use that clinically significant impairment or distress”. It can involve heavy and hazardous use leading to increased chances of getting hurt, unsuccessful attempts to quit or cut down, too much time spent on alcohol use or getting over the aftereffects, and continued drinking despite problems caused by drinking.

While the prevalence of binge drinking has decreased, adolescents in Ireland rank 7th out of 35 European countries for reports of being drunk.

The HSE low-risk weekly guidelines for alcohol consumption are currently less than 11 standard drinks (110g pure alcohol) for women, and less than 17 standard drinks (170g pure alcohol) for men, with at least two alcohol-free days.

Almost one-in-three males and one-in-four females aged 15-24 years reported exceeding this limit on a single drinking occasion at least once in the last year.

The report found that one in five (20%) young people reported using an illegal drug in the last year, while over a quarter (27%) said they had used illegal drugs at some point in their lifetime. Males were found to be more likely than females to use illegal drugs.

Cannabis remains the most commonly used drug in Ireland, but the use of stimulants, including ecstasy and cocaine, has increased. According to the report, ecstasy and cocaine use among young people in Ireland was the second highest in Europe.

Cocaine use in the last year among young people in Ireland increased from 3.0% in 2014–15 to 4.4% in 2019-2020.

Cocaine use decreased among young males, from 5.1% in 2014–15 to 4.2% in 2019–20. In contrast, for females, an increase in cocaine use was observed, rising from 0.8% in 2014–15 to 4.5% in 2019–20.

It also found that polydrug use is common, with more than two in five third-level students who were current drug users reporting using two or more substances on the same occasion.

Hospitalisation and treatment

Meanwhile, substance-related hospitalisations and treatment among young people have also increased. Between 2015-2018, hospitalisations due to drug use increased by 26%, while alcohol-related hospitalisations increased by 12%.

Use of alcohol, followed by cannabis and cocaine, were the most common factors in substance-related hospitalisations.

The report found that the increase in cocaine use has resulted in a 171% increase in the number of cases of young people receiving treatment for their cocaine use between 2011-2019. Between 2015-2019, cocaine-related hospitalisations increased by 83%.

Treatment was most commonly received for cannabis use, with 1,229 cases of young people receiving treatment for their cannabis use in 2020.

In 2017, 17 young people died as a result of alcohol and/or drug poisoning. 40 deaths due to traumatic events were among young people who had a history of drug use and/or alcohol dependency, and/or had alcohol implicated in their cause of death.

Nearly half of young driver fatalities with a toxicology result available had a positive toxicology for alcohol.

Mental health impact 

There is a clear link between mental ill health and substance use, evident across data on anxiety, self-harm and suicide, the report states.

Young adults with alcohol dependence are more likely to have severe anxiety, while cannabis users are six times more likely to report mental ill health than those who do not use the drug.

In over one in four self-harm hospital presentations among young people, the individual had been drinking alcohol before or during the self-harm act.

Nearly three in four young people aged 15-24 years who died by suicide had a history of alcohol and/or drug misuse.

The report also found strong links between alcohol and drug misuse and criminal behaviour. 86% of young people referred to Probation Services reported alcohol and/or drug misuse problems.

30% of drug-driving arrests were among those aged 18-24 years, most commonly among young males.

The report states that parental provision of alcohol, parental substance use, and early initiation of alcohol use is linked with risky drinking.

Young people exposed to alcohol marketing are more likely to initiate drinking and engage in binge drinking and drunkenness, while having a positive parental relationship was associated with decreased substance use.

Commenting on the findings, Dr Mairéad O’Driscoll, HRB Chief Executive, said: “Young adults are at a very formative time in life; physically, socially and emotionally. This HRB report provides a clear picture of their behaviour in relation to substance use.

“By monitoring trends over time, the HRB can help inform effective responses that parents, practitioners, educators and policy makers can take to support the health and wellbeing of young people,” she said.

Anne Doyle, HRB Research Officer and lead author of the report, welcomed the finding that young adolescents are starting to drink at a later age.

“However, this HRB report also shows the many challenges and risk factors that young people face in relation to substance use, the need for treatment and the impact of substance use on mental health,” she said.

“The report provides data that enables us to better understand the difficulties faced by young people when substance use is a very real part of society, so that we can identify the protective factors that can help reduce risk.

“This will help strengthen the prevention of drug and alcohol use among children and young people, which is a priority of the National Drug Strategy.”