The latest data from Ireland’s National Drug Treatment Reporting System (NDTRS) reveals concerning trends in drug treatment demand in Ireland 2024, with the highest number of cases ever recorded seeking support for substance use issues.

Record-Breaking Treatment Numbers

In 2024, Ireland witnessed an unprecedented 13,295 cases entering drug treatment services – the highest annual figure since the NDTRS began monitoring. This represents a significant increase of 191 cases compared to 2023, highlighting the growing need for comprehensive drug treatment services across the country.

The data shows that 35.9% of these cases were individuals seeking treatment for the first time, whilst 58% were returning to services they had previously accessed. This pattern underscores the chronic nature of substance use disorders and the importance of sustained support systems.

Cocaine Dominates Drug Treatment Demand in Ireland 2024

Perhaps most striking in the 2024 data is cocaine’s emergence as the primary substance driving treatment demand. Cocaine accounted for 39.8% of all cases – a substantial 7.4% increase from 2023, rising from 4,923 to 5,289 cases.

Powder cocaine represented the majority of cocaine-related treatments, accounting for three-quarters of all cocaine cases. The demographic profile reveals concerning trends:

• 77.4% of powder cocaine cases were male
• Median age was 32 years
• 38.8% were in paid employment

Crack cocaine cases, whilst fewer in number, presented more severe circumstances:

• 45.6% were female
• Only 7.2% were in employment
• 21.2% were experiencing homelessness

Comprehensive Statistical Overview of Ireland’s Treatment Landscape

Primary Substances Requiring Treatment

The breakdown of main problem substances in drug treatment demand in Ireland 2024 reveals significant shifts:

• Cocaine: 5,289 cases (39.8%) – highest ever recorded
• Opioids: 3,326 cases (25.0%) – primarily heroin (84.9% of opioid cases)
• Cannabis: 2,263 cases (17.0%)
• Benzodiazepines: 1,788 cases (13.4%)

Dramatic Trends Over Eight Years (2017-2024)

The longitudinal data demonstrates alarming escalation patterns:

• Cocaine cases increased by 252.6% from 1,500 cases in 2017 to 5,289 in 2024
• Female cocaine users increased by 426.1% from 284 cases in 2017 to 1,494 in 2024
• Powder cocaine increased by 216.0% over the period
• Crack cocaine surged by 668.2% from 173 cases to 1,329 cases

Conversely, opioid treatment demand decreased from 45.0% of all cases in 2017 to 25.0% in 2024, indicating a significant shift in Ireland’s substance use landscape.

Declining Opioid Cases but Persistent Challenges

Whilst cocaine cases surged, opioid-related treatments decreased from 3,845 in 2023 to 3,326 in 2024. However, opioids remained the second most common substance requiring treatment, with heroin accounting for 84.9% of all opioid cases.

The demographic shift in opioid users is notable:

• Median age increased from 34 years in 2017 to 40 years in 2024
• 50.9% of opioid users were aged 40 or over in 2024
• Only 11.3% were in paid employment
• 16.7% were experiencing homelessness

Detailed Demographic Analysis

Age Distribution Patterns

The 2024 data reveals distinct age-related substance preferences:

• Under 19 years: Cannabis was the primary treatment driver
• 20-44 years: Cocaine dominated treatment demand
• 45+ years: Opioids remained the main concern

The median age across all cases was 34 years, representing a steady increase from 30 years in 2017.

Gender and Employment Statistics

• 69.8% of all cases were male, with 30.0% female
• 21.8% were in paid employment – an increase from 14.3% in 2017
• 63.3% were unemployed
• 11.7% were experiencing homelessness

Educational Background

Educational attainment data highlights concerning patterns:

• 30.3% had ceased education before age 16
• This represents a decrease from 34.9% in 2017, suggesting slight improvements in educational retention

Polydrug Use and Complex Cases

The complexity of modern substance use is evident in polydrug statistics:

• 60.4% of cases reported using multiple substances
• Most common additional substances:
  • Cannabis (40.1%)
  • Cocaine (36.7%)
  • Alcohol (36.2%)
  • Benzodiazepines (30.1%)

Risk Behaviours and Public Health Concerns

Injecting Behaviour Trends

Whilst overall injecting rates decreased, significant risks remain:

• 18.7% of cases reported ever injecting (down from 29.7% in 2017)
• 24.1% of those who had ever injected were currently injecting
• 40.3% of ever-injectors had shared needles and syringes

Among current injectors:

• 74.9% were using opioids as their main substance
• 15.7% were using cocaine
• 73.9% were male

Service Provision and Geographic Distribution

Treatment Settings

The distribution of treatment services in 2024:

• Outpatient facilities: 70.1% (9,316 cases)
• Residential facilities: 13.8% (1,837 cases)
• Low threshold services: 10.2% (1,351 cases)
• Prison settings: 4.2% (559 cases)
• General practitioners: 1.7% (232 cases)

Regional Variations

Treatment demand varied significantly across Health Service Executive regions:

• Dublin and North East: 4,649 cases (highest)
• Dublin and Midlands: 3,108 cases
• Dublin and South East: 2,248 cases
• South West: 1,029 cases
• Mid West: 874 cases
• West and North West: 822 cases

Treatment Outcomes and System Performance

Completion and Retention Rates

The effectiveness of treatment interventions shows mixed results:

• 29.0% successfully completed treatment
• 13.5% were referred to other services for continued support
• 32.6% did not return for subsequent appointments
• 13.9% refused further treatment sessions

Care Plan Engagement

• 9.4% achieved substantial progress towards care plan goals
• 3.2% had disengaged from their care plan
• 77.0% did not have family members involved in treatment

Implications for Prevention and Early Intervention

The substantial increase in drug treatment demand in Ireland 2024 emphasises the critical importance of prevention strategies. The data shows that intervention before substance use escalates to treatment-requiring levels could significantly reduce future demand on services.

Prevention Opportunities

Key prevention opportunities identified include:

• Workplace-based programmes: Given 30.9% of cocaine users are employed
• Youth education initiatives: Targeting the under-19 demographic where cannabis dominates
• Community outreach: Addressing the 252.6% increase in cocaine cases over eight years
• Early intervention services: Preventing progression from initial use to treatment-requiring dependency

Emerging Substance Concerns

The 2024 data highlighted several emerging trends requiring attention:

• New psychoactive substances (NPS): 170 cases (49.1% increase from 2023)
• Pregabalin: 167 cases requiring treatment
• Nitrous oxide: 54 cases, with 57.4% aged 17 or under
• Vaping-related issues: 100 cases reported vaping as administration route

Population-Level Impact

Incidence and Prevalence Rates

When adjusted for population aged 15-64 years:

• Treatment incidence: 131.2 per 100,000 population in 2024
• Treatment prevalence: 370.8 per 100,000 population in 2024
• Both figures represent increases from 2017 baseline measurements

Families and Children Affected

The broader social impact is evident in family statistics:

• 52.1% of cases had children of any age
• 5,809 cases had children aged 17 or under
• 38.1% of those with children under 18 were residing with them
• 2,221 cases were living with children under 18 years

System Challenges and Data Quality

Participation Rates

Despite mandatory reporting requirements, participation varies significantly:

• Overall participation: 71.1% of eligible services
• General practitioner participation: Only 43.7%
• Low threshold services: 89.2%-100% participation
• Outpatient and residential services: Near-complete participation

This underrepresentation, particularly among GPs providing opioid agonist treatment, suggests the true scale of treatment demand may be even higher than recorded.

Building Robust Treatment Infrastructure

As Ireland faces its highest ever recorded drug treatment demand in 2024, the comprehensive statistics paint a picture of an evolving and intensifying public health challenge. The shift from opioid to cocaine dominance, the rising numbers of complex polydrug cases, and the persistent social inequalities evident in the data all demand immediate attention.

The 2024 figures serve as both a warning of current challenges and a foundation for evidence-based policy development. With treatment demand increasing across nearly all demographic groups and substance categories, the need for robust prevention strategies has never been more urgent.

Understanding these detailed trends enables communities, healthcare providers, and policymakers to develop targeted interventions that address root causes before treatment becomes necessary, potentially reversing the concerning upward trajectory documented throughout this comprehensive dataset.

Source: dbrecoveryresources