Drug treatment services dealt with over 23,000 cases in 2021, an increase of 10% when compared to 2014, a new report has shown.

It also revealed that the main problem drug treated in 2021 was opioids (66%), followed by cocaine (16%) and cannabis (11%).

The report by the HSE National Social Inclusion Office looked at key patterns and trends in drug treatment between 2014 and 2021.

It was developed due to the fact that a number of patients who were receiving opioid agonist treatment (OAT) were being missed in the recordings of the National Drug Treatment Reporting System (NDTRS) as a result of the non-return of forms from certain sectors. As there is an additional statutory requirement for OAT cases to be recorded on a central treatment list, there is a concern that some service providers are opting to record data for OAT on the statutory central treatment list and omitting the NDTRS.

This report combines data from both the NDTRS and central treatment list to provide a comprehensive overview of the current treatment provision for people experiencing drug problems in Ireland.

“By combining data from two sources, the report shows that approximately twice as many people are treated for problem opioid use than any other drug. This is a significant level of service provision and has implications for future resource allocation,” commented Dr David Evans, a research and data officer with the National Social Inclusion Office.

The report showed that in 2021, 23,332 cases received treatment. The main service providers for these cases were outpatient settings (62%) and GPs (22%).

Services experiencing increases in the numbers receiving treatment between  2014 and 2021 includes pharmacies (24%), outpatients (22%) and GPs (10%). Services experiencing a decrease included prisons (50%) and inpatients (4%).

The report noted that with the exception of cocaine, there was an overall decline in new treatment cases between 2014 and 2021. However, new cases for problem cocaine use have tripled since 2014, with the highest number of new cases recorded in 2021.

In 2021, 91% of overall cases involved Irish people (excluding Travellers), 3% of cases involved Travellers, while the remainder were other ethnicities or unknown.

The report also noted that between 2014 and 2021, cocaine treatment rose for all ethnicities, but was greatest among Travellers (525%).

Meanwhile in 2021, 11% of all treatment was for cases experiencing homelessness. The main drugs in these cases were opioids (86%), cocaine (6%) and benzodiazepines (6%). These have all increased since 2014 (by 49%, 925% and 404% respectively.

The report makes a number of recommendations, including:

-Drug treatment data collection should to be streamlined so that treatment providers only have to send returns once for each person receiving treatment

-An ethnic identifier should be introduced to the central treatment list database as a matter of urgency. This should employ the same categories for ethnicity as used by the Central Statistics Office

-Following the evaluation of HSE pilot cocaine treatment programmes, those treatment models that have been successful in addressing harms need to be embedded in treatment services

- Targeted drug treatment programmes aimed at specific marginalised groups need to be considered to help engage them in appropriate care

-Consideration should be given to developing specific treatment programmes for those who are homeless and using substances in problematic ways. Existing programmes in existence internationally should be reviewed to determine if similar services could be developed in Ireland.

“I am pleased to be able to present this third Drugs Insight report that provides clear information on the number of people receiving treatment for drug-related problems in Ireland. We hope to produce such a report on an annual basis and will work with the HRB to progress recommendations in the report,” added Prof Eamon Keenan, HSE national clinical lead for addiction services.

The report can be viewed here.