Introduction
An evaluation of the national drugs strategy Reducing Harm, Supporting Recovery 2017-2025 was published in July 2025.1 The independent evaluation was commissioned by the Department of Health and carried out over a four-month period by a team of researchers from Grant Thornton Ireland. 

Evaluation goals
As required by the Department of Health’s specification for the evaluation of the national drugs strategy, the findings are reported across four domains that reflect the goals of the evaluation. These four domains are as follows:

1. The impact of the strategy: In relation to the strategy’s goals and strategic priorities, to assess its overall impact in delivering a public health-led and whole-of-government response to drug and alcohol use.
2. Governance and coordination effectiveness: To review the governance and coordination structures involved in the implementation of the strategy, including the contribution of stakeholders (such as civil society and Drug and Alcohol Task Forces), government oversight, and reporting arrangements.
3. Performance against key outcome indicators: To measure the strategy’s performance against key outcome indicators, and to assess the broader impact of substance use on families, communities, and society. Key outcome indicators include:
   •    Prevalence and patterns of drug use
   •    Demand for drug and alcohol treatment services, and
   •    Incidence of drug-related harms, including drug related deaths.
4. Coherence with international drugs strategies: To explore the coherence and synergies between the strategy and relevant international responses. While those listed in the tender document included international responses such as those of the European Union (EU), the European Union Drugs Agency (EUDA), the Pompidou Group, and the British-Irish Council, the evaluation focused on collecting data on the national drugs strategies of seven countries. 
   The evaluation also aimed to inform Ireland’s next drugs strategy by identifying the accomplishments of the 2017–2025 strategy, areas where improvements could be made, and making recommendations to address drugs use in Ireland into the future. 

Methodology
The evaluation used a mixed-methods approach. Data collection included five elements:

1. Context mapping: A mapping of the evolution of drug policy in Ireland, the context in which the 2017–2025 strategy was developed, and any reviews of the strategy carried out to date.
2. Documentation review: A review of documents published since the start of the strategy that explore drug use in Ireland. Sources included: Google Scholar, the Health Research Board’s (HRB’s) National Drugs Library, Lenus, and the Department of Health. Documents were ‘narratively summarised to present the overarching recurring themes, patterns, concepts, and issues raised’ (p. 28).1
3. Data review: A review of some of the national data on drug and alcohol use in Ireland, related to the period 2015–2024. 
4. Stakeholder consultations: Collection and analysis of interviews, focus groups, and written submissions from stakeholders to identify the accomplishments in the lifetime of the strategy, areas for improvement, and suggestions for the future focus of Ireland’s national drugs strategy.
5. International review: Ireland’s national drugs strategy was comparatively reviewed against those of seven other countries. The evaluation team reviewed each country’s strategy and policy orientation, as well as any collaborations with Ireland.

The evaluation findings evolved from two main activities that drew on the data collected:

1. Data integration: The team synthesised the data collected above ‘to identify patterns, confirm validity of stakeholder observations and confirm accuracy of emerging conclusions’ (p. 24).1
2. Findings: The findings were identified across the four domains outlined above.
   Finally, a set of recommendations was generated, based on the data collection and analysis outlined above. 

Evidence review

The findings from the five elements of the evidence review are presented in Chapter 4 of the evaluation report. The chapter provides a summary of each strand of data collection, reflecting the wide-reaching nature of the strategy and the complexity of the data. Two key gaps were identified by the HRB in relation to opioid use. These are discussed in the final section of this article. 

Evaluation findings

Chapter 5 of the evaluation report presents a set of key findings. The authors of the evaluation define a key finding as ‘a distinct thematic element or operational component identified through the evaluation process as being of strategic relevance to the implementation and outcomes of the national drugs strategy (2017–2025)’. These emerged through a mixed-methods approach to bring together the quantitative and qualitative data gathered by the team. The process involved:

‘Data integration: Consolidating all relevant data to establish a comprehensive and robust foundation. 
Pattern identification: Examining the integrated dataset to identify patterns and trends across data types.

Validation: Engaging with Strategic Implementation Group 6 to validate emerging findings, ensuring their accuracy, relevance, and alignment with policy objectives.’ (p. 81).1

A set of findings is presented under each of the four domains outlined above. Each finding is categorised under one of three rating levels, which the evaluation’s authors say reflect the status of implementation and progress, based on the strength of evidence, stakeholder feedback and alignment with the strategy. The ratings are:

Accomplishments: The topic of focus is progressing well and demonstrates strong alignment with the goals of the strategy. Implementation is active and positive developments are either emerging or already evident.

Progress underway: Meaningful steps have been taken in the topic of focus, and implementation is in progress. However, further work is required in order to strengthen delivery, embed practices, and ensure consistency across settings.
Areas for improvement: This rating indicates limited progress to date. Strategic intent may be underdeveloped, and significant work is needed in order to initiate or advance implementation.

Twenty-five key findings were identified across the four domains. Of these, seven were rated as accomplishments, eight as progress underway, and 10 were rated as areas for improvement. Set out below is a summary of the evaluation’s findings for each domain, as presented in the evaluation report.

Domain 1: To assess the overall impact of the strategy, its goals and priorities, in delivering a public health-led and whole-of-government response to drug and alcohol use. 

Accomplishments

• The expansion of harm reduction strategies nationwide: Harm reduction initiatives were seen as a central component of the health-centred approach of the strategy. Stakeholders expressed broad support for this approach and the initiatives identified as having progressed in the lifetime of the strategy – the expanded availability of naloxone, the operation of needle exchange programmes, and the introduction of drug-checking services at festivals. 
• Strong responses to crisis events and emerging drug threats: The response of drug services to the COVID-19 pandemic and the cluster of overdoses linked to nitazines were highlighted as examples of the structures in place to support the capacity for timely, health-oriented interventions in crisis situations. 
  Progress underway
• The provision of integrated and holistic care: Services related to addiction, mental health, housing and criminal justice were reported to operate often in isolation, and therefore were not meeting the complex needs of some service users. However, the evaluators noted the launch of the HSE Model of Care for Dual Diagnosis in 2023 as a positive step towards providing more integrated care.
• Equity of access and inclusion: Stakeholders identified geographic and demographic disparities in access to treatment services. While some promising community-led and peer-driven initiatives that promote recovery and reduce stigma were identified, these were described as often being underfunded.
  Areas for improvement
• Improve prevention and early intervention: Prevention was described as underdeveloped, inconsistent, and lacking in national ownership.
• Embed lived experience in policy and advancing recovery supports.
• The need for better integration of drug policy with problem alcohol use policy: There were concerns that the strategy only gave limited attention to problematic alcohol use and that a more unified approach to alcohol and other drugs was needed.
• The need for legal reform and alternative sanctions: The implementation of alternative sanctions for drug offences was found to be applied inconsistently across the country.
• Sustainable funding and workforce sustainability: There are staff shortages and disruptions in service delivery due to funding issues and restrictive hiring policies. Stakeholders called for multi-annual funding commitments and investment in the workforce.

Domain 2: To review the governance and coordination structures underpinning the strategy, alongside evaluating the contributions of stakeholders, government oversight, and reporting arrangements.

Accomplishments

• Strengthened governance structures to support implementation: The introduction of the Strategic Implementation Groups (SIGs) was perceived to have improved coordination in the implementation of the strategy, as well as engagement in the process among stakeholders.
• Interagency involvement at local and regional level: Civil society organisations and the Drug and Alcohol Task Forces were found to play a key role in implementing the strategy at a community level. They were described as well-positioned to respond to local needs and priorities. Interagency collaboration was reported to have strengthened over the course of the strategy. 

Progress underway

• Strengthening governance and accountability structures: Despite the accomplishments in this area, stakeholders called for more clearly defined roles, mandates, and oversight mechanisms in key structures.
• Enhanced data collection: Integrating timely and consistent data from multiple sources could support broader surveillance and analysis of emerging drug trends, and improved responses.

Areas for improvement

• Inclusion, communication, and lived experiences in decision-making: A disconnect between policy development and the lived experience of people affected was highlighted. The evaluators argued that inclusive decision-making processes could improve the relevance, responsiveness, and trust in the implementation of the strategy.

Domain 3: To evaluate the strategy’s performance against the key outcome indicators of drug prevalence, treatment, and drug poisoning deaths.

The evaluators acknowledge the challenge of attribution when considering the indicators – it is not possible to definitively attribute any trends or changes to the implementation of the strategy. Other external factors may have influenced observed outcomes. Only areas for improvement were identified. The HRB found gaps in the data considered in relation to changes in patterns of drug use in this section of the evaluation, specifically in relation to opioid use. These gaps are discussed in the HRB comments section at the end of this article. 

Areas for improvement

• Changes in patterns of drug use: Cocaine use and polydrug use are both increasing in Ireland, and new substances consistently emerge. More targeted interventions and agile responses are required in order to reduce the risk of harm.
• Incidence of drug-related harms, including drug poisoning deaths: There has been an overall upward trend in the number of drug poisoning deaths between 2012 and 2021. However, there was a 20% decrease in the number of drug poisoning deaths between 2020 and 2021. 
• Outcome measures: The evaluation identifies ‘a critical need for measurable outcomes to assess the effectiveness of policies, interventions, and government expenditure on drug-related issues. Measuring direct effectiveness is challenging due to the need to integrate multiple data sources, inconsistent data collection, time lags, and other factors’ 
  (p. 104).1
• Data on drug-related expenditure: The authors of the evaluation identified unlabelled expenditure and productivity costs as being part of the ‘burden of drug and alcohol misuse’ (p. 104).1 The availability and quality of expenditure data severely constrains the evaluation of the strategy’s performance and any assessment of cost-effectiveness

Domain 4: To explore the alignment of Ireland’s strategy (2017-2025) with relevant international responses.

Accomplishments

• Active engagement with the EU and alignment with broader EU policy frameworks: Ireland actively participates in EU-level working groups, research collaborations, and policy development initiatives. Alignment is illustrated by the emphasis on a health-led and rights-based framework. 
• International cooperation: Ireland plays an active role in the British-Irish Council and the Pompidou Group, and is committed to human rights and sustainable development through United Nations (UN) engagement.
• Effective use of data and early warning systems: The HRB submits national data to the EUDA on an annual basis and participates in the European Early Warning System.

Areas for improvement

• Health-led reform: Further integration is needed of a health-led model underpinned by comprehensive services.
• Integrated and accessible care: It is recommended that opioid agonist treatment (OAT) services be expanded through general practitioners (GPs) and that addiction care be integrated into primary care.
• Inclusive, trauma-informed and youth-focused responses to drug use: The evaluators identify a need for trauma-informed and community-based strategies, and ways to address drug use among students through youth-focused, education-led initiatives.
• Promotion of International Overdose Awareness Day: By promoting this day, help to reduce stigma, remember lives lost, and raise awareness.

Recommendations

The evaluation contains 10 recommendations, divided into three broad themes: people, process and systems. The aim of the recommendations is ‘to guide the next phase of strategic development, ensuring a more coordinated, equitable, and outcomes-focused response to drug use in Ireland’ (p. 117).1 Outlined below are the topline recommendations, as they appear in the report (p. 117–123).1

People

1. Embed an equity lens throughout the national drugs strategy, ensuring culturally appropriate services, and strengthening data systems to monitor the impact on populations.
2. Increase community engagement and service user involvement by embedding participatory approaches in policy-making, service design, and provision of community-based services.
3. Align service delivery with regional needs and enhance the capacity of service providers to ensure equitable and consistent implementation. 

Process

1. Maintain and strengthen coordination and communication between the National Oversight Committee and the SIGs by clarifying roles, improving information-sharing structures, and enhancing transparency in decision-making. 
2. Establish formal mechanisms for interdepartmental collaboration on cross-sectoral issues impacting on drug policy, particularly in areas such as housing, justice, and health. 
3. Continue to strengthen the health-led response by placing a focus on justice system reform, community-based responses, and investment in community safety and trust-building initiatives.

Systems

1. Embed recovery as a central aspect of the national drugs strategy by ensuring equitable access to integrated, peer-led, and person-centred recovery services across all regions.
2. Strengthen prevention and early intervention by investing in evidence-based programmes that address social determinants of drug use, support at-risk youth and families, and embed trauma-informed practice across all services.
3. Strengthen the integration of alcohol within the national drugs strategy by clearly defining roles, responsibilities, and service provisions for the prevention, treatment, and recovery of alcohol-related harm, including the national rollout of integrated community alcohol treatment services.
4. Optimise the use of data by further investing in comprehensive monitoring, evaluation, and research systems to inform evidence-based policy, track progress, and support accountability at all levels.

Limitations

The authors of the evaluation identified a set of limitations to their work which they recognised could impact on the overall evaluation and recommendations.

Short time frame of the evaluation: The ‘accelerated time frame’ of the evaluation (i.e. under four months) ‘posed significant constraints’ on the depth and breadth of analysis that could be carried out (p. 26)1, as well as the team’s ability to identify the nuances of the implementation, outcomes, and the long-term impact of the strategy.

Scope of stakeholder engagement: Despite engaging representatives from various Government Departments and service provider and user organisations, the authors identified the scope of stakeholder consultations as a key limitation in the evaluation. Therefore, they note: ‘this section of the report may not fully capture the diverse experiences and perspectives of all service provider and service user organisations involved in the national drugs strategy’. They describe the different groups as having different perspectives and experiences when discussing the strategy. However, they see as a limitation that ‘these varying viewpoints made it challenging to form a comprehensive and unified conclusion’ (p. 26).1 The HRB would consider that the value of carrying out consultations with different groups is the varying perspectives gained. This can provide an opportunity to analyse areas of overlap and agreement, and possible areas of difference, and the implications of these.

Complexity of the data: The data used to evaluate the strategy are ‘highly complex, encompassing various quantitative and qualitative metrics’ (p. 26).1 The authors found that the complexity was compounded by a need to integrate data from multiple sources, and what they considered to be ‘the outdated nature of some of the available data’ (p. 26),1 the impact of the COVID-19 pandemic on data, and a lack of ‘sufficient granularity’ of some data, limiting their ability to carry out detailed analysis (p. 26).1 

Additional limitations of the evaluation identified by HRB researchers, stemming from those outlined above, are discussed in the section below.

HRB comments on the evaluation

The evaluation of the strategy provides valuable insights that will inform the development of the next national drugs strategy. The authors of the evaluation identified a set of limitations, including the short time frame given to the evaluation and the complexity of the data. The HRB recognises these limitations and agrees that they are reflected in parts of the report. Among the limitations, the HRB has identified two gaps in the evidence as presented that it considers important to note. Both gaps relate to opioid use. While relatively few young people are starting to use heroin, there continues to be a considerable cohort of ageing opioid users who will need ongoing OAT treatment and also additional care, given the high prevalence of comorbidities within this population. An accurate understanding of the scale and nature of their treatment needs (for their addiction, mental health, and physical comorbidities) is important, in order to inform the deliberations of the development of the new strategy and ensure that these people’s needs are met. 

Prevalence of opioid use: The prevalence of opioid use is a central feature of the landscape of drug use in Ireland, particularly in the context of the level of harms caused. While the evaluation considers prevalence data gathered through general population surveys, these do not provide adequate insights when exploring opioid use. In order to fill this gap, three studies have been carried out specifically to estimate the prevalence of problematic opioid use in Ireland covering periods from 2011 to 2022.2, 3, 4 The evaluation does not consider the findings of these studies. The overall message of this body of work is that the prevalence of opioid use significantly declined among young people in Ireland over the 10-year period, and the prevalence of opioid use overall stabilised. While recognising that the estimates do not cover all years of the strategy’s lifetime, the HRB considers the three studies to be an important body of evidence, the findings of which should be considered when exploring changes in Ireland’s drugs situation over the course of the national drugs strategy.

Opioid agonist treatment (OAT) and the Central Treatment List (CTL) data: OAT is a key drug treatment service in Ireland. The Central Treatment List (CLT) is the administrative database to regulate the dispensing of OAT in Ireland and is a complete register of all patients receiving OAT (as treatment for problem opioid use) in Ireland. The evaluation did not explore these data. OAT is considered in the context of the National Drug Treatment Reporting System data, and a report on the impact of OAT on people experiencing homelessness. The omission of the CTL data is problematic. For example, CTL data show that approximately 37% of all OAT is provided by GPs (as of 31 December 2024 - unpublished CTL data). This is not fully reflected in the NDTRS data as GPs have limited levels of participation in this system. As a result, the evaluation is not correct in concluding that GPs have ‘limited participation in the provision of OAT’ (p. 113).1 The HRB recognises that there are difficulties in gaining access to an OAT GP in some areas, but the picture is complex.

1. Grant Thornton. (2025) Evaluation of the National Drug Strategy “Reducing Harm, Supporting Recovery 2017-2025”. Dublin: Department of Health. https://www.drugsandalcohol.ie/43790/
2. Hanrahan MT, Millar SR, Mongan D, Lyons S and Galvin B (2025) Prevalence of problematic opioid use in Ireland, 2020–2022. Dublin: Health Research Board. https://www.drugsandalcohol.ie/42700/
3. Hanrahan MT, Millar SR, Phillips KP, Reed T, Mongan D and Perry IJ (2022) Problematic opioid use in Ireland, 2015–2019. Dublin: Health Research Board. https://www.drugsandalcohol.ie/35856/ 
4. Hay G, Jaddoa A, Oyston J, Webster J, Van Hout MC and dos Santos RG (2017) Estimating the prevalence of problematic opiate use in Ireland using indirect statistical methods. Dublin: National Advisory Committee on Drugs and Alcohol. https://www.drugsandalcohol.ie/27233/

In May 2025, it was announced that the Joint Oireachtas Committee on Drugs Use had been re-established. On 22 October 2024, the first iteration of the Committee published the Joint Committee on Drugs Use Interim Report,¹ but the dissolution of the Government in November 2024 saw an end to their work. A commitment was made in the Programme for Government 2025 to re-establish the Committee to continue its work.²

Committee brief

The Joint Committee on Drugs Use was set up by the Government to consider the 36 recommendations in the Report of the Citizens’ Assembly on Drugs Use and to make a reasoned response to each recommendation.³ As mentioned in its Orders of Reference published in April 2025, the re-established Committee will also need to consider the findings of the interim report of the previous Committee.⁴ In a video on the Houses of the Oireachtas website, the Committee’s Chair, Gary Gannon TD, described the Committee as being in ‘an interesting position whereby they need to respond to both reports. The Committee will be ̒going through the recommendations of the Citizens’ Assembly, comparing that against the recommendations of the previous Committee, seeing where it needs more work, more engagements and delivering a really comprehensive programme of works.’⁵ This will then inform the content of its public meetings that began in September 2025. The Committee is required to report to the Oireachtas within 9 months of its first public meeting.

Committee membership

The Committee includes members from across the spectrum of political parties (not just Government parties). The Chair of the Committee is Social Democrats TD Gary Gannon. The other members of the Committee reflect cross-party membership, including Independents, as well as members of the Senate (Seanad Éireann).

1. Joint Committee on Drugs Use (2024) Joint Committee on Drugs Use Interim Report. Dublin: Houses of the Oireachtas. Available from: https://www.drugsandalcohol.ie/42080/
2. Fianna Fáil, Fine Gael, Independent TDs (2025) Draft Programme for Government 2025: Securing Ireland’s Future. Dublin. Available from: https://www.drugsandalcohol.ie/42537/
3. Citizens’ Assembly (2024) Report of the Citizens’ Assembly on Drugs Use. Volume 1. Dublin: Citizens’ Assembly. Available from: https://www.drugsandalcohol.ie/40393/
4. Committee on Standing Orders and Dáil Reform (2025) Report of the Committee on Standing Orders and Dáil Reform: Orders of Reference and Establishment of Committees. Dublin: Houses of the Oireachtas. Available from:
   https://www.drugsandalcohol.ie/43645/
5. Houses of the Oireachtas (2025) The Joint Committee on Drugs Use has been established. Available from:
   https://www.oireachtas.ie/en/press-centre/press-releases/20250529-the-joint-committee-on-drugs-use-has-been-established/

In May 2025, the Advisory Council on the Misuse of Drugs (ACMD) in the United Kingdom (UK) published a report titled A Whole-System Response to Drug Prevention in the UK.¹ It is a comprehensive report that reflects on the evidence for the various components of an effective drug prevention system, including for prevention interventions.

While the report’s focus is on the UK, it should be of interest to prevention stakeholders in Ireland. This article is based on both the published report and a presentation made by the Chair of the ACMD, Professor Owen Bowden-Jones, at a seminar held by the the UK-based Drug Education Forum on 19 June 2025.^{1, 2}

Research aim

The ACMD was commissioned by the UK Government to provide advice on drug prevention for young people aged 11–24 years. The report describes the key foundational principles for long-term drug prevention action for young people, and makes recommendations on:

• ‘a whole-system response to prevention of drug use and related harms, including actions for younger age groups, which have positive effects later in life
• effective labelled (universal, selective and indicated) interventions on prevention, and
• the necessary structural components of a robust drug prevention system’ (p. 3).¹

Methodology

The report is based on a review of national and international literature; evidence gathered from UK services delivering drug prevention activities; and the expertise of a specially formed working group comprising national and international experts in the field.

Benefits of prevention

The report is grounded in an understanding of the benefits of drug prevention and it makes the case for its prioritisation as a response to drug-related harms. It describes the cost-effective nature of prevention when considering the high cost of drug-related harms to society, that drug prevention activities can have wider societal benefits, and that it supports other government policy priorities.

Current UK drug prevention system

Early on in the report, the authors conclude that a drug prevention system does not currently exist in the UK. Among the issues facing drug prevention in the UK is that there is no coordinated UK-wide strategy, existing drug prevention is poorly funded, there is no clear prioritisation of interventions, there is a lack of a trained workforce, and there are no systems in place to monitor activities or outcomes.

Figure 1: Structural summary of the prevention system map

Source: Advisory Council on the Misuse of Drugs (2025) (p. 12)¹

A systems approach

Based on an examination of the evidence, the authors present an idealised prevention map system (see Figure 1). For each component of the prevention system, they describe the current UK position and present the evidence for what a robust version of each would look like.

Recommendations

Two groups of recommendations are made in the report. The first comprises recommendations that relate to the development, implementation, and evaluation of a whole-system drug prevention approach. The second includes recommendations that relate to specific drug prevention interventions.

What is recommended to develop, implement, and evaluate a whole-system drug prevention approach?

Six recommendations are made to the UK Government to support the establishment of a whole-system drug prevention approach:

1. Undertake a stocktake of the prevention landscape in the UK and how it aligns with international standards, using a tool such as the United Nations Office on Drugs and Crime’s (UNODC’s) Review of Prevention Systems (RePS) tool.
2. Monitor quality by developing a national prevention quality standard, and use a dashboard to monitor delivery locally.
3. Provide ring-fenced, long-term funding at a local level for drug prevention.
4. Support strong local leadership for prevention activities.
5. Support national leadership, ideally through the appointment of a national prevention champion.
6. Develop a competence framework for evidence-based prevention activities (for labelled and unlabelled prevention work).

Which interventions did the authors recommend based on their research?

The report outlines a wide range of interventions and describes features that appear to contribute to their effectiveness. While they name numerous programmes throughout the report that they consider to be evidence based, in their recommendations, the authors summarise the approaches in which they think the UK Government should invest:

• Universal approaches:
  • whole-community approaches
  • whole-school approaches (including links to mental health support teams)
  • parent/carer-based prevention approaches
• Selective interventions:
  • interventions targeting multiple health risk behaviours and comorbidities, in particular common mental health disorders
• Indicated interventions:
  • family-based interventions targeting children and young people’s drug use
  • family-based interventions to support children and young people affected by others’ drug use (e.g. parental drug use).

In addition to interventions, it is also recommended that the UK Government increase funding to support a long-term approach to evaluation, innovation, and research in order to inform the UK’s evidence base.

Concluding comment

This is a comprehensive report that outlines key features of effective prevention and the limitations of the current evidence base in the field. While the report focuses on the UK context, there are many parallels with the Irish context and the recommendations should be of value when considering the status of Ireland’s prevention landscape. The UNODC’s RePS tool is currently being implemented in Ireland with the aim of informing the next national drugs strategy. This represents an important step in understanding and improving drug prevention in Ireland.

1. Advisory Council on the Misuse of Drugs (2025) A Whole-System Response to Drug Prevention in the UK. London: Advisory Council on the Misuse of Drugs. Available from: https://www.drugsandalcohol.ie/43292/
2. Recording of the presentation is available at: https://www.youtube.com/watch?v=cRQmPmzWISs

While most drug poisoning deaths across Europe involve opioids, benzodiazepines are implicated in many deaths and are frequently present in deaths involving opioids.¹

The benzodiazepines involved in these deaths are not always prescribable benzodiazepines; indeed, one driver behind an increase in drug poisoning deaths, particularly in Scotland, is the emergence of benzodiazepine-type new psychoactive substances (NPS) such as etizolam.² Scotland’s experience with etizolam, and the implications for Irish drug poisoning deaths, were addressed in a letter published in the Irish Journal of Psychological Medicine in 2024.³

While etizolam is legally prescribed in some countries, such as Italy and India, it is not sold commercially for medicinal use in most European countries; however, it has appeared on the NPS market and in counterfeit benzodiazepine tablets or ‘street benzos’.² Prior to the emergence of etizolam, phenazepam was the predominant NPS benzodiazepine in the United Kingdom (UK). When phenazepam was regulated in 2012, etizolam, a drug five times more powerful than diazepam,⁴ emerged in its place.⁵

Between 2014 and 2020, Scotland recorded its highest rates of drug poisoning deaths and higher rates than other UK or European countries.² In the past, drug poisoning deaths in Ireland broadly followed the same trends as Scotland; however, in recent years, Ireland has not mirrored the trend nor the record numbers of drug poisoning deaths observed in Scotland. While several factors may explain this divergence in mortality rate trends, one possible element is that the number of deaths where etizolam was implicated remains low in Ireland,⁶ unlike Scotland, where almost 60% of drug misuse deaths involved etizolam in 2021.⁷

The prescribable benzodiazepines diazepam and alprazolam contribute to a greater proportion of deaths in Ireland than they do in Scotland. In 2021, the most seized benzodiazepine in Ireland was alprazolam, followed by diazepam, and a small amount of delorazepam.⁸ The number of drug poisoning deaths in Ireland where a prescribable benzodiazepine was implicated has risen since 2011, ⁶ while the number of such deaths in Scotland has decreased.

In the mid-2000s, due to concerns around the increased prescribing of benzodiazepines, diversion to street markets, and the level of dependence in Scotland, a policy change led to a reduction in prescribing of these drugs. This coincided with the emergence of the NPS drug market, which moved to fill the gap for benzodiazepine-type drugs in Scotland.³ Although a similar change in policy was not implemented in Ireland, a change to the Misuse of Drugs Regulations 2017⁹ did lead to some tightening of benzodiazepine prescription-writing. However, this does not appear to have had an impact on the role of benzodiazepines in poisoning deaths in Ireland.

Scotland has made efforts to address increasing numbers of drug poisoning deaths by expanding treatment access, naloxone availability, and toxicology testing, which seem to have had some effect.² However, while a significant decrease in etizolam-related deaths was recorded in 2022,⁷ bromazolam – another benzodiazepine-type NPS – has increased in use¹⁰ following the control of etizolam.

While the role of benzodiazepines in drug poisoning deaths in Ireland needs to be addressed, the regulation of benzodiazepines is challenging because as soon as one drug is regulated, another NPS can emerge. Any significant change to prescribing practices for benzodiazepines in Ireland must consider the Scottish experience, and any change should include intensive and evidence-based wrap-around psychosocial supports for those who currently use non-prescribed benzodiazepines.

1. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2023) European Drug Report 2023: Trends and Developments. Available from: https://www.emcdda.europa.eu/publications/european-drug-report/2023_en
2. McAuley A, Matheson C and Robertson JR (2022) From the clinic to the street: the changing role of benzodiazepines in the Scottish overdose epidemic. Int J Drug Policy, 100: 103512. 
3. Keenan E, Kelleher C, Lyons S and Sweeney N (2024) Etizolam and Irish drug poisoning deaths. Ir J Psychol Med, 41(4): 506–507. Available from: https://doi.org/10.1017/ipm.2024.38
4. Nielsen S and McAuley A (2020) Etizolam: a rapid review on pharmacology, non-medical use and harms. Drug Alcohol Rev, 39(4): 330–336. Available from: https://doi.org/10.1111/dar.13052
5. Home Office (2011) Import ban of new ‘legal high’ phenazepam introduced. Available from:
   https://www.gov.uk/government/news/import-ban-of-new-legal-high-phenazepam-introduced
6. Health Research Board (2023) Health Research Board reports latest drug-related deaths figures. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/39036/
7. National Records of Scotland (2023) Drug-related Deaths in Scotland in 2022. Available from: https://www.drugsandalcohol.ie/39424/1/drug-related-deaths-22-report.pdf
8. Health Research Board, Irish National Focal Point to the European Monitoring Centre for Drugs and Drug Addiction (2023) Focal Point Ireland: national report for 2022 – drug markets and crime. Dublin: Health Research Board. Available from: https://www.drugsandalcohol.ie/40534/
9. Office of the Attorney General (2017) S.I. No. 173/2017 – Misuse of Drugs Regulations 2017. Dublin: Irish Statute Book. Available from: https://www.irishstatutebook.ie/eli/2017/si/173/made/en/print
10. Public Health Scotland (2023) Rapid Action Drug Alerts and Response (RADAR) quarterly report. Available from: https://publichealthscotland.scot/publications/

The non-medical use of prescription drugs has become a global health concern. Non-medical usage is defined as the taking of prescription drugs, whether obtained by prescription or otherwise, except in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed.¹

A Trendspotter study undertaken between May and September 2019 by Ana Liffey Drug Project and the European Union Drugs Agency (EUDA) Irish National Focal Point identified converging signals of the non-medical use of pharmaceuticals in Ireland.² The user groups identified included high-risk opioid users, prison populations, people with complex and multiple needs, and young people. Among these groups, the motivations for using street tablets were for their intoxicating effects, to enhance desired effects from illicit substances, to help withdrawal symptoms, to improve sleep, and to reduce stress.

A new national study conducted by Durand et al. presents a comprehensive analysis of prescription drug misuse in Ireland between 2010 and 2020, highlighting growing public health concerns around treatment demand, intentional drug overdoses (IDOs), and drug-related deaths (DRDs).³ In this research, which was published in the journal Drug and Alcohol Dependence, four main categories of prescription drugs with high misuse potential were examined: benzodiazepines and Z-drugs, prescription opioids (excluding those used in opioid agonist therapy), gabapentinoids (particularly pregabalin), and psychostimulants. Using three national datasets, the National Drug Treatment Reporting System (NDTRS), the National Self-Harm Registry Ireland (NSHRI), and the National Drug-Related Deaths Index (NDRDI), the research offers a detailed view of the health harms linked to these substances.

The study found that benzodiazepines and Z-drugs consistently accounted for the greatest proportion of harms across all three indicators, making up 341 per 1,000 treatment cases, 408 per 1,000 IDOs, and 546 per 1,000 DRDs. Notably, while the absolute burden remained highest for this group, the annual increase in harms was modest, indicating relative stability over time. However, the study found an alarming increase in the involvement of alprazolam and the novel psychoactive substance etizolam, particularly in fatal overdoses.

In contrast, gabapentinoids, especially pregabalin, emerged as the most rapidly escalating threat. Despite lower initial prevalence, treatment demand linked to gabapentinoids grew by 44% annually, while related DRDs rose 35% each year during the study period. IDOs involving gabapentinoids also increased steadily by 9% per year. This surge coincides with rising prescribing trends and growing misuse in combination with opioids and benzodiazepines, often contributing to lethal outcomes.

Prescription opioids were the second most involved drug class related to DRDs (207 per 1,000) but showed stable trends over time. Tramadol and codeine were the most commonly reported prescription opioids in both overdoses and deaths.

Interestingly, psychostimulants played a negligible role in all three indicators, suggesting that their misuse remains limited in Ireland when compared with other prescription drug classes.

Polydrug use significantly amplified risks across all metrics. The combined misuse of gabapentinoids and benzodiazepines, or opioids, increased sharply, particularly among women. Sex differences were also evident, with women more likely to misuse gabapentinoids and prescription opioids, and men more likely to misuse psychostimulants and certain benzodiazepines.

The research highlights that harms associated with prescription drug misuse pose an urgent public health challenge. The authors suggest that the study’s findings underscore the need for targeted interventions. In particular, clinicians are urged to monitor prescribing practices closely and assess patients’ misuse risk, especially for high-risk combinations. In addition, policy measures, such as reclassifying pregabalin as a controlled drug, enhancing prescription monitoring, and implementing public education campaigns, may help curb the growing tide of prescription drug misuse in Ireland.

1. United Nations Office on Drugs and Crime (2011) The non-medical use of prescription drugs: policy direction issues. New York: United Nations. Available from: https://www.unodc.org/documents/drug-prevention-and-treatment/nonmedical-use-prescription-drugs.pdf
2. Duffin T, Keane M and Millar SR (2020) Street tablet use in Ireland: a Trendspotter study on use, markets, and harms. Dublin: Ana Liffey Drug Project. Available from: https://www.drugsandalcohol.ie/31872/
3. Durand L, Arensman E, Corcoran P, et al. (2025) Harms associated with prescription drug misuse in Ireland: a national observational study of trends in treatment demand, non-fatal intentional drug overdoses and drug related deaths 2010–2020. Drug Alcohol Depend, 272, 112669. Available from: https://www.drugsandalcohol.ie/43321/

A new report from Trinity College Dublin presents a decade-long exploration of non-fatal opioid overdoses (NFODs) in Ireland.¹ Authored by Professor Jo-Hanna Ivers and Neil Dunne, the study combines clinical data, systematic review findings, and policy analysis to shine a light on the evolving nature of opioid-related harm, especially within Dublin’s inner city.

The study found that between 2011 and 2021, over 2,500 NFOD cases were recorded in Ireland’s acute hospitals. Dublin’s inner city, despite accounting for just a fraction of the national population, was disproportionately affected. Heroin was the most implicated opioid until 2020, when methadone, a drug used in opioid agonist treatment, surpassed it in prevalence. Outside the city, other opioids, including prescription and synthetic drugs, emerged as primary contributors to overdose, pointing to different risk environments across urban and rural contexts.

Age demographics also shifted over the decade. In Dublin, the typical NFOD patient has aged, with a declining number of younger people affected. Trends show an increase in female overdose cases, particularly in non-urban areas, which the authors suggest show changing drug use patterns that demand sex-responsive services.

The report offers a number of evidence-based recommendations. These include expanding access to psychological and social inclusion supports enhancing methadone monitoring; developing structured overdose risk assessments; and ensuring coordinated care pathways from hospital to community. The authors also suggest that greater naloxone distribution and harm-reduction outreach, especially in high-risk areas, is required.

1. Ivers J and Dunne N (2025) A decade-long exploration of non-fatal opioid overdose 2011 to 2021. Dublin: Trinity College Dublin. Available from: https://www.drugsandalcohol.ie/42646/

The HIPE (Hospital In-Patient Enquiry) scheme is a computer-based health information system, managed by the Economic and Social Research Institute (ESRI) in association with the Department of Health and the Health Service Executive (HSE). It collects demographic, medical, and administrative data on all admissions, discharges, and deaths from acute general hospitals in Ireland. Each HIPE discharge record represents one episode of care; each discharge of a patient, whether from the same or a different hospital, with the same or a different diagnosis, gives rise to a separate HIPE record. The scheme therefore facilitates analysis of hospital activity rather than of the incidence of disease. HIPE does not record information on individuals who attend emergency departments but are not admitted as inpatients. Monitoring of drug-related acute emergencies in the Irish context refers to all admissions for non-fatal overdoses to acute general hospitals in Ireland.

Drug-related emergencies – non-fatal overdoses

Data extracted from the HIPE scheme were analysed to determine trends in non-fatal overdoses in patients discharged from Irish hospitals in 2024.¹ There were 4,441 overdose cases in 2024, of which 60 died in hospital. Only discharged cases are included in this analysis (n=4381). There was a noticeable increase in overdose cases during the years of the COVID-19 pandemic, with the number of discharged overdose cases in 2020 being the highest recorded in 12 years. Since the end of the pandemic, overdose cases have decreased (see Figure 1).

Source: HIPE, Healthcare Pricing Office, 2025

Figure 1: Number of non-fatal overdose cases admitted to Irish hospitals, by year, 2014–2024

Source: HIPE, Healthcare Pricing Office, 2025

Figure 2: Number of non-fatal overdose cases admitted to Irish hospitals, by year and sex, 2014–2024

Sex of overdose cases

Between 2014 and 2024, there were more overdose cases among women than men, with women accounting for 2,406 (54.9%) of all non-fatal overdose cases in 2024 (see Figure 2).

Age group

Between 2015 and 2020, there was a general increase in the number of non-fatal overdose cases in all age groups. As noted in previous years, the incidence of overdose cases in 2024 peaked in the 15–24 years age group (see Figure 3). In 2024, some 32.1% of cases were under 25 years of age.

Toxicology of drug-related acute emergencies

Table 1 presents the positive findings per category of drugs and other substances involved in all cases of overdose in 2024. Non-opioid analgesics were present in 1,457 cases. Paracetamol is included in this drug category and was present in 1,323 cases in 2024. Benzodiazepines and psychotropic agents were taken in 838 and 1,046 cases, respectively. There was evidence of alcohol consumption in 248 cases in 2024. Cases involving alcohol are included in this analysis only when alcohol was used in conjunction with another substance.

Overdoses involving narcotics or hallucinogens

Figure 4 shows positive findings of illicit substances among overdose cases in 2024. Opioids were used in 16.0% (n=702) of cases; cocaine in 7.0% (n=306) of cases; and cannabis in 3.3% (n=146) of cases in 2024. No overdose cases (or five or fewer) involving LSD or other hallucinogens were recorded.

Source: HIPE, Healthcare Pricing Office, 2025

Figure 3: Non-fatal overdose cases admitted to Irish hospitals, by year and age group, 2014–2024

Overdoses classified by intent

For 59.1% (n=2591) of cases in 2024, the overdose was classified as intentional (see Figure 5). For 9.9% (n=434) of cases, classification of intent was not clear.

Table 2 presents the positive findings per category of drugs and other substances involved in cases of intentional self-poisoning in 2024 (n=2591). In 2024, non-opioid analgesics were involved in 1,197 cases, benzodiazepines in 496, and psychotropic agents in 824 cases.

Table 1: Categories of drugs involved in non-fatal overdose cases admitted to Irish hospitals, 2024

Source: HIPE, Healthcare Pricing Office, 2025

Note: The sum of positive findings is greater than the total number of cases, as some cases involved more than one drug or substance.

* Alcohol was only included for cases where any code from any of the other drug categories in this table was also reported.

Source: HIPE, Healthcare Pricing Office, 2025

Figure 4: Narcotics and hallucinogens involved in non-fatal overdose cases admitted to Irish hospitals, 2024

Source: HIPE, Healthcare Pricing Office, 2025

Figure 5: Non-fatal overdose cases admitted to Irish hospitals, classified by intent, 2024

Table 2: Categories of drugs involved in intentional self-poisoning cases admitted to Irish hospitals, 2024

Source: HIPE, Healthcare Pricing Office, 2025. Note: As some discharges may be included in more than one drug category, the total count in this table exceeds the total number of discharges.

* Alcohol was only included for cases where any code from any of the other drug categories in this table was also reported.

~ Five or fewer cases.

1. For further information on HIPE data, visit the Healthcare Pricing Office website: http://www.hpo.ie/ 

Introduction

The main cause of death among people with opioid use disorder (OUD) is drug overdose. OAT is a proven intervention to reduce both drug-related and all-cause mortality. The advantages of OAT can be negated by using other prescribed and non-prescribed substances at the same time during OAT, such as heroin, cocaine or street benzodiazepines and/or other prescribed medications. Polysubstance use is associated with treatment discontinuation and is known as a risk factor for drug overdose. Despite this, there is limited research on the effects of polysubstance use among patients in OAT.

An Irish study sought to address this gap in the research by aiming to (1) examine trends in drug positivity rates in amphetamines, benzodiazepines, cannabis, cocaine and opioids (heroin, morphine and codeine); and (2) identify trends in polysubstance positivity rates for drug combinations associated with increased risk of drug overdose including (a) methadone and benzodiazepines; (b) methadone, benzodiazepines and opioids; (c) methadone, benzodiazepines and cocaine; and (d) methadone, benzodiazepines, opioids and cocaine.¹

Methods

A cross-sectional study design was employed using anonymised individual-level urine drug test (UDT) results from the National Drug Treatment Centre (NDTC) laboratory between 2010 and 2020. The NDTC is the largest specialist addiction clinic in Ireland, with approximately 750 patients attending OAT (primarily methadone) services each year. In line with national guidelines, all patients attending OAT services must provide regular urine samples for drug testing throughout the course of their treatment.

Samples from OAT patients were included if the patient had a minimum of five valid samples, one of which must have been positive for methadone. All urine samples were tested for benzodiazepines, methadone, other opioids, and cocaine using immunoassay testing. Annual positivity rates were calculated by dividing the number of samples tested for each substance and multiplying by 100. In order to evaluate trends in polysubstance positivity rates for drug combinations, mixed-effects logistic regression models were employed. Sensitivity analysis was carried out to assess the impact of COVID-19 on these observed trends.

Findings

A total of 221,564 samples were included over the study period, with an average of 114 samples per patient.

The results showed that methadone was the most commonly detected substance followed by benzodiazepines, cannabis, other opioids, cocaine, and amphetamines. The magnitude of increase was greatest for cocaine, reflecting a weighted annual positivity rate of 12% in 2015, compared with 37% in 2020. In contrast, the detection of opioids decreased from 50% in 2015 to 39% in 2020.

For patterns in polysubstance positivity rates for drug combinations associated with increased risk of drug overdose, the main findings were as follows:

1. Combination of methadone and benzodiazepines was common over the period.
2. Combination of methadone and benzodiazepines with cocaine increased over the period.
3. Combination of methadone, benzodiazepines, opioids and cocaine increased between 2010 and 2020.
4. Combination of methadone and benzodiazepines with opioids decreased over the study period.
5. Patients aged 36 years and over were less likely to test positive for multiple substances.

Limitations

This research only included patients attending the NDTC and focused on drugs that are routinely tested by the NDTC laboratory; therefore, they may not be generalisable outside this setting. In addition, immunoassay tests can be limited in scope, e.g. cannot detect prescription opioids such as tramadol, which could underestimate concurrent opioid use. Another issue which may affect the results is that cannabis and amphetamine testing was at the request of individual doctors, which may have led to some selection bias; moreover, it was not possible to ascertain whether the benzodiazepines were prescribed by a doctor or were sourced at street level. It should also be noted that there was an increase in the number of patients enrolled in OAT during the COVID-19 pandemic, but a decrease in the number of urine samples taken in that period.

Conclusions

The authors state that given the prevalence of polysubstance use among patients in OAT, and its associated risk with overdose fatality, there is a need to introduce measures to address the persistently high use of benzodiazepines and cocaine among this group. They also state that information from urine sampling can be very useful in relation to identifying changes in the trends of drug use over time and that it can inform interventions to help reduce polysubstance use in patients on OAT.

1. Durand L, O’Kane A, Stokes S, Bennett KE, Keenan E and Cousins G (2024) Trends in polysubstance use among patients in methadone maintenance treatment in Ireland: evidence from urine drug testing 2010–2020. J. Subst. Abuse Treat. 167, 209507. https://doi.org/10.1016/j.josat.2024.209507. https://www.drugsandalcohol.ie/41799/

On 8 May 2025, Jennifer Murnane O’Connor, Minister for Public Health, Wellbeing and the National Drugs Strategy, together with Jim O’Callaghan, Minister for Justice, launched the national awareness campaign for the DRIVE (Drug-related intimidation and violence engagement) project.^1,2 The key messages associated with the campaign were that drug-related intimidation can happen to anyone but there is help, and by visiting the website driveproject.ie people can find information about safe and confidential services in their local area.

The DRIVE project is funded by the Drugs Policy, Refugee and Inclusion Health Unit, Department of Health. The launch was chaired by Antoinette Kinsella, Chair, DRIVE Oversight Committee, with additional presentations from Dr Shawna Coxon, Deputy Commissioner, An Garda Síochána; Dr Suzi Lyons (Health Research Board (HRB)) and Siobhan Maher (DRIVE Co-ordinator).

The DRIVE project is the first of its kind in Ireland. It provides a six-pillar model to enable a national interagency response to drug-related intimidation (DRI) and violence. The project includes specialised training, resources, and local capacity building, bringing together community and voluntary groups, An Garda Síochána, Government Departments and other agencies.

The DRIVE project is a data-driven model, with the need to provide accurate data recognised as central to the overall project.³ The HRB is responsible for collecting these data from addiction treatment services nationwide. Since 1 January 2025, this has been facilitated through the National Drug Treatment Reporting System online data collection portal. Accurate and complete data will allow services and policy-makers, for the first time, to understand the prevalence and impact of DRI. Any services that wish to obtain more information on the data collection process should contact ndtrs@hrb.ie

1. Department of Health press release. Available from: https://www.gov.ie/en/department-of-health/
2. More information on the project, the supports available and the national awareness campaign is available from: www.driveproject.ie.
3. DRIVE Oversight Committee (2021) A data-driven intervention model to respond effectively to drug-related intimidation and violence in communities in Ireland. Executive summary. Available from: https://driveproject.ie/wp-content/uploads/2023/01/DRIVE-Model-Executive-Summary.pdf

A recent study has revealed a sharp increase in cocaine use and associated health harms in Ireland over the past two decades. Conducted by a team of researchers from the Health Research Board (HRB); the School of Public Health, University College Cork (UCC); Trinity College Dublin; and the Health Service Executive (HSE), the study used data from five national databases to track trends from 2000 to 2023.

In this research, which has been published in the journal BMC Public Health, findings show that last-year prevalence of cocaine use among 15–64-year-olds in Ireland more than doubled, rising from 1.1% in 2002–03 to 2.4% in 2023.¹ Hospitalisations, psychiatric admissions, treatment episodes, and deaths related to cocaine use have all risen dramatically over this time period. For example, cocaine-related hospital discharges increased from 1.4 per 100,000 population in 2000 to 24.3 in 2022. Treatment entrants reporting cocaine as their main problem drug increased from 1.5 per 100,000 population in 2000 to 93.2 in 2023, while cocaine-related poisoning deaths rose from 0.13 to 2.6 per 100,000 between 2000 and 2020 (see Figures 1, 2 and 3).

Figure 1: Cocaine-related inpatient hospitalisations per 100,000 population in Ireland, 2000–2022

Source: Mongan et al. (2025)

Using joinpoint regression analysis, the researchers identified distinct periods of increase and decrease. Harms generally rose until 2007, declined during the recession years, and surged again from around 2013 onwards. This trend likely reflects both Ireland’s economic recovery and broader increases in cocaine availability and purity across Europe.

The study highlights the growing challenge posed by cocaine use in Ireland. Notably, a large share of cocaine users are young adults, with rising use reported among third-level students. Despite increased seizures by law enforcement, cocaine remains highly accessible.

Figure 2: Treatment episodes involving cocaine per 100,000 population in Ireland, 2000–2023

Source: Mongan et al. (2025)

Figure 3: Cocaine-related deaths per 100,000 population in Ireland, 2000–2020

Source: Mongan et al. (2025)

The authors stress the urgency of targeted prevention and harm reduction, particularly in adolescent and university settings. They also call for expanded treatment capacity, especially given the lack of approved pharmacological therapies for cocaine use disorder. With cocaine use now widespread in Ireland, and with harms accelerating, the researchers conclude that Ireland, and Europe more broadly, must prioritise coordinated public health responses to address this evolving health issue.

In July 2025, the Minister for Children, Disability and Equality, Norma Foley, announced three initiatives to support prevention and early intervention programmes for children and young people in Ireland.¹ They are being funded through the What Works prevention and early intervention initiative. As with previous activities under the What Works initiative, there are synergies with drug prevention activities.

What Works

What Works: Sharing Knowledge, Improving Children’s Futures is an initiative of the Department of Children and Youth Affairs (DCYA) that was launched in June 2019. It was a rebrand of the Quality and Capacity Building Initiative that the DCYA had been developing since 2016. What Works seeks to embed and enhance knowledge and quality in prevention and early intervention activities in children and young people’s policy, service provision, and practice. When it started, there were four core strands to the work: a data working strand; an evidence working strand; a professional development and capacity building working strand; and a quality working strand.²

2025 initiatives

The objective of the three new initiatives ‘is to support prevention and early intervention initiatives and research that will improve outcomes for children and young people experiencing disadvantage, adversity and trauma’.¹ The three initiatives are described as follows:

1. The Enhancing Quality Fund 2025 aims to support organisations to improve the monitoring, evaluation, and analysis of their prevention and early intervention initiatives. It is open to not-for-profit organisations that work with children, young people, and their families, and that have a strong emphasis on prevention and early intervention. Grants of up to €30,000 are available, with a total fund value of €300,000. The closing date for applications was 22 August 2025.
2. Between July and October 2025, a series of four 90-minute webinars will be held that are aimed at commissioners, practitioners, and stakeholders interested in applying evidence-based research to support the development of prevention and early intervention policy and services.³ The webinars will be delivered by the United Kingdom-based organisation Foundations: What Works Centre for Children & Families. Foundations developed the What Works Ireland Evidence Hub, which provides information about prevention and early intervention programmes that have been evaluated and shown to improve outcomes for children and young people, including outcomes related to drug use.⁴
3. The Prevention and Early Intervention Network (PEIN) has developed a learning module aimed at professionals who work with children and families. It is ‘designed to embed a prevention-oriented, child-centred mindset across professional disciplines working with children and families’.¹ The 10 learning units cover themes such as trauma-informed practice, interagency collaboration, and children’s rights. This third initiative provides research funding to evaluate the development, piloting, and implementation of this learning module.

1. Department of Children, Disability and Equality (2025) Minister for Children Disability and Equality Norma Foley announces €330,000 in funding to support Ireland’s Prevention and Early Intervention programmes for children and young people. Available from: https://www.drugsandalcohol.ie/43634/
2. Dillon L (2019) What Works: Sharing Knowledge, Improving Children’s Futures. Drugnet Ireland, 71 (Autumn): 9.
3. For more information on the webinar series and to register for the events, visit 
   https://whatworks.gov.ie/resources/prevention-and-early-intervention-webinars-2025/.
4. The What Works Ireland Evidence Hub can be found at https://whatworks.gov.ie/hub-search/.

The Safe futures: Identifying promising approaches, opportunities and barriers for interventions designed to prevent youth recruitment and participation in European drug markets projects was launched in June 2025.^1,2 It is a 2-year project that aims to identify effective ways to prevent young people’s involvement in European drug markets.

Project team

The project is a collaboration between the European Union Drugs Agency (EUDA) and the Research Evidence into Policy, Programmes and Practice (REPPP) team at the University of Limerick. Through its work, this team will bring together policy-makers, researchers, law enforcement agencies, and practitioners from across Europe to collaborate in a new multidisciplinary Community of Practice with the aim of sharing knowledge and research and of informing and designing future interventions in the field.

Policy context

The prevention of young people from becoming involved in drug markets is a priority for the European Commission and the EUDA. One of the actions (Priority 4, Action 12) of the European Commission’s EU Roadmap to Fight Drug Trafficking and Organised Crime focuses on preventing criminal networks from recruiting children and young people.³ Alongside this, Action 9 of the EU Drugs Action Plan 2021-2025 specifically seeks to reduce recidivism among young drug-related crime offenders.

A European conference on drug-related violence was held in November 2024. Discussions at the event underlined an urgent need for cross-sectoral collaboration in order to address drug-related violence and highlighted that targeted prevention mechanisms should include a focus on preventing young people and other at-risk groups from becoming involved in organised crime.

It is in this policy context that Safe futures has come about.

Project aims and objectives

The overall purpose of the Safe futures project is to enhance drug-related crime prevention efforts in Europe by: ^{1, 2}

• evaluating existing models and strategies for preventing the involvement of young people in drug markets and drug-related crime
• supporting linked network-building activities
• identifying possible facilitators of and barriers to the implementation of programmes in this area.
• The specific objectives of the project are to:
• establish a multidisciplinary and jurisdictional Community of Practice in order to support and contribute to the project’s activities
• conduct a desk review of literature on interventions, initiatives, and evaluations
• identify and review existing examples of practices and interventions
• identify critical success factors of and barriers to the development and implementation of interventions
• develop a conceptual framework and model in order to inform the development and implementation of interventions.

The project outputs are expected to contribute to a better understanding of future research, policy, and developmental needs and to inform future investments in this area at national and European level.¹

1. European Commission (2023) Communication from the Commission to the European Parliament and the Council on the EU roadmap to fight drug trafficking and organised crime. COM(2023) 641 final. Brussels: European Commission. Available from: https://www.drugsandalcohol.ie/39778/
2. European Union Drugs Agency (2025) Launch of ‘Safe futures’: a project tackling the recruitment of young people into drug markets. Available from: https://www.euda.europa.eu/news/2025/launch-safe-futures-project_en REPPP, University of Limerick (2025) Research Evidence into Policy, Programmes and Practice (REPPP) newsletter, (1). Limerick: University of Limerick. Available from: https://www.drugsandalcohol.ie/43641/

Mongan D, Millar S, Brennan M, et al. (2025) Addict. Behav. 161, 108194. https://www.drugsandalcohol.ie/42204/

Duopah YA, Moran L, Elmusharaf K, et al. (2024) BMC Health Serv. Res. 24, 1450. https://www.drugsandalcohol.ie/42321/

James PD, Nash M and Comiskey CM (2024) Int. J. Ment. Health Nurs. 33, (6), pp. 1687-1710.
https://www.drugsandalcohol.ie/42288/

Gribben A, Burke T, Harrington C, et al. (2024) Ir. J. Psychol. Med. 41, (4), pp. 451-459.
https://www.drugsandalcohol.ie/42222/ 

Lynch S, Begley A, McDonnell T, Leahy D, Gavin B and McNicholas F (2024) Ir. J. Psychol. Med.,42, (1), pp. 71-84.
https://www.drugsandalcohol.ie/42290/

Reynolds CME, Cox G, Lyons S, et al. (2025) Addict. Behav. 163, 108267. https://www.drugsandalcohol.ie/42583/

Villani J, Kuosmanen T, McDonagh M, et al. (2024) Ir. J. Psychol. Med. Early Online, pp. 1-9.
https://www.drugsandalcohol.ie/42318/

Hanrahan MT, O’Mahony M, McLoughlin D and Sheahan A (2025) Ir. J. Med. Sci. 194, pp. 375-384.
https://www.drugsandalcohol.ie/42545/

O’Brien P, Gleeson D, Kuntsche E, et al. (2024) Drug and Alcohol Review, 44, (2), pp. 385-388.
https://www.drugsandalcohol.ie/42305/

Filipova V, Hooper D and Kenny P (2024) Drug and Alcohol Review, 44, (2), pp. 389-402.
https://www.drugsandalcohol.ie/42439/