A new psychoactive substance (NPS) can be described as a new narcotic or psychotropic drug, in pure form or in preparation, that is not controlled by the United Nations drug conventions, but which may pose a public health threat comparable to that posed by substances listed in these conventions. Health harms associated with NPS range from seizures to agitation, aggression, intoxication, acute psychosis as well as dependence.

In order to rapidly detect and assess threats posed by NPS, the European Union Early Warning System (EWS), was established by the European Union Drugs Agency (EUDA) in 1997. The system is composed of a multisectoral, multidisciplinary, and multiagency network, which includes the EUDA, 29 national early warning systems (27 European Union Member States, Turkey, and Norway), Europol and its law enforcement networks, the European Medicines Agency, and the European Commission.

Background

Alcohol use is a major global health burden. However, effective alcohol policies are often challenging to implement due to public and political resistance. Research shows that where public knowledge of the risks associated with alcohol use (particularly about the risk between alcohol and cancer) support for stronger policy measures increases. A study conducted with respondents in five European Union (EU) countries, including Ireland, examined how knowledge of alcohol-related harms influences policy support and whether this relationship differs by policy type.¹

Here, we examine findings from the Irish respondents and how they compare with the four other EU countries.

In early December 2025, the European Commission published the new EU Drugs Strategy.¹ The strategy is structured around five pillars (see Figure 1,) each of which is made up of a set of strategic priorities. It summarises the key priorities and how they relate to delivery at the levels of the European Commission, the European Drugs Agency (EUDA) (and other relevant EU agencies), and Member States. The pillars and key priorities, as presented in the strategy document, are outlined below.

Pillar 1: To enhance EU and national preparedness to anticipate and respond to drug-related health and security threats

Key priorities

The European Commission and Member States, with the support of relevant EU agencies, should:

• facilitate knowledge sharing and the identification of research priorities via research dialogues
• coordinate operational support and dissemination of innovative practices and solutions to relevant actors in the drug sector.

A draft of the new national drugs strategy 2026–2029 was published by the Department of Health in February 2026 for public consultation.¹ It outlines the vision, pillars, principles and enabling measures that will form Ireland’s “integrated, equitable and evidence-based response to drug and harmful alcohol use” (p. 1).¹

A strategy for alcohol and other drugs

As with its predecessor, the draft strategy is concerned with the use of alcohol and other drugs. The draft strategy describes its approach to ‘drug and harmful alcohol use’, with harmful alcohol use defined as “patterns of alcohol use that result in adverse physical or psychological harm or lead to dependency on alcohol, including alcohol use disorder” (p. 7).¹

Background

A report by Alcohol Action Ireland (AAI), the national independent advocate for reducing alcohol harm, outlines a series of 10 recommendations for the Government to act upon in order to reduce road fatalities.¹ The recommendations come in response to the deadliest year on Irish roads since 2014, with 179 fatal collisions claiming 190 lives.

The report opens with a powerful foreword by Donna Price, the founder and president of the Irish Road Victims Association (IRVA), who describes the heartbreaking repercussions of losing someone in a road traffic collision (RTC):

‘The impact does not end with the funeral. It lives on in our shattered lives. In the empty chair at the dinner table, in milestones never reached, in grandchildren never met, in ordinary days that suddenly feel unbearable.’

The Government has committed to a 50% reduction in road deaths and serious injuries by 2030 in the Road Safety Strategy Our Journey Towards Vision Zero.²

A recent study published in the International Journal of Drug Policy examined the early impact of Dublin’s first medically supervised injecting facility, which opened in December 2024 at Merchants Quay Ireland.¹ The facility was introduced as a harm reduction measure to address high rates of overdose and public injecting in Dublin city centre, where opioid-related deaths remain a significant public health concern.

Published in the Irish Journal of Medical Science, a new study highlights the growing neurological consequences of recreational nitrous oxide abuse, particularly among young adults.

Subacute combined degeneration of the cord (SACD) is traditionally associated with vitamin B₁₂ deficiency and affects the posterior and lateral columns of the spinal cord. Nitrous oxide inactivates vitamin B₁₂ by oxidising its cobalt ion, impairing critical metabolic pathways necessary for myelin integrity. This results in neurological dysfunction, often presenting as a myeloneuropathy. A recent single-centre case series study examined nitrous oxide-induced myeloneuropathy in patients presenting to Tallaght University Hospital in Dublin between October 2022 and July 2024.¹

In December 2025, the National Suicide Research Foundation published the 2024 National Self-Harm Registry Ireland annual report.¹ The report contains information relating to every recorded presentation of deliberate self-harm to acute hospital emergency departments in Ireland in 2024, as well as details of complete national coverage of cases treated. All individuals who were alive on admission to hospital following deliberate self-harm were included, along with the methods of deliberate self-harm that were used. Accidental overdoses of medication, street drugs, or alcohol were not included.

The Danger of Viral Exposure (DOVE) Service in the Rotunda Hospital, Dublin was established to meet the specific needs of pregnant women who have or are at risk of blood-borne or sexually transmitted bacterial or viral infections in pregnancy. Exposure may also occur through illicit substance use. Figures from the service for 2024 were published in the hospital’s annual report in 2025.¹

Clinical activity

Figure 1 shows the number of women who booked into the DOVE Service for antenatal care each year during the period 2014–2024. It also shows the diagnosis of viral disease for these women.

The Self-Harm Assessment and Data Analysis (SADA) Project was set up in Ireland in 2016 to provide robust information relating to the incidence and profile of self-harm within prison settings, as well as individual-specific and context-specific risk factors relating to self-harm. In addition, it examines patterns of repeat self-harm (both non-fatal and fatal). The HSE's National Office for Suicide Prevention and the National Suicide Research Foundation assist the Irish Prison Service with data management, data analysis, and reporting.

This article highlights findings from a report presenting data in the analysis of all episodes of self-harm across the Irish prison estate during 2024.¹

Figure 1: HRB National Drugs Library

The HRB National Drugs Library and its specialist librarians support those working to develop the knowledge base around alcohol and other drug use in Ireland. We have an online collection of over 30,000 freely available items, including articles, reports, Oireachtas debates, news, videos and audiocasts. We also provide a range of online resources that enable quick access to data and information. They can all be found on our website at https://www.drugsandalcohol.ie/

Daly FP, Millar SR, Major E and Barrett PM (2025) PLoS ONE, 20, (8). https://www.drugsandalcohol.ie/44072/

Mongan D, Killeen N, Millar SR, Matias J, Keenan E and Galvin B (2025) Int. J. Drug Policy, 145, 105011. https://www.drugsandalcohol.ie/44244/