Introduction

The burden of alcohol and other drugs on the criminal justice system is complex to quantify. Data availability, the difficulty in classifying offences according to the role alcohol and/or other drugs may have played, and the uncertainty of a cause-and-effect relationship all complicate the narrative. However, an extensive body of evidence has consistently shown significant and definite associations between alcohol and other drug use and rates of criminal offences. 

Global evidence estimates that over 50% of perpetrators had been drinking prior to the offence committed.1 A systematic review and meta-analysis found that drug users were 3–4 times more likely to commit a criminal offence than those who do not use drugs.2 Irish data from the Probation Service found that one-half of clients (53%) committed an offence while intoxicated, or that alcohol was in some way associated with the offence, and similarly so for other drug use (48%).3 

Introduction

Alcohol use is highest in the World Health Organization (WHO) European region.1 Cancer is the leading cause of death due to alcohol use in Europe, and yet, awareness of this link between alcohol use and seven different cancers is low, particularly for breast cancer.2,3 Collaborating with the European Union (EU), the WHO aims to reduce alcohol use and related harms and increase awareness of the risks through a project called the WHO-EU Evidence into Action Alcohol Project (EVID-ACTION), co-funded by the EU as part of Europe’s Beating Cancer Plan.4,5 The project covers 30 countries, including Ireland, and the focus is on building evidence for the case for alcohol health warning labels, supporting and sharing experiences and expertise among members, and providing tools and training to support implementation of screening and brief interventions in a variety of contexts. In order to gain a better understanding of the current level of knowledge and attitudes towards alcohol use, a survey was completed in five European countries, including Ireland. The findings from the Irish sample are presented here.

Background 

Much of Western Europe, North America and Australasia have seen a decline in alcohol use among young people.1-2 This is welcome indeed given that alcohol use is ranked as the second-highest contributor to disability-adjusted life years (DALYs) among adolescents and young adults aged 10–24 years globally.3 Alcohol contributes to all of the leading causes of death for young people, including suicide, road traffic collisions, poisoning and assaults, while long-term use is linked to multiple types of cancer, cardiovascular disease and liver disease.4,5 The Public Health (Alcohol) Act 2018 aims to reduce population-level alcohol use, but specifically seeks to prevent or delay youth drinking.6 In order to determine if this phenomenon extends to Irish youths, data from the Health Behaviour in School-aged Children (HBSC) survey were examined.7 

The Courts Service Annual Report 2023 was published on 23 September 2024. While the report presented data for all criminal cases arising within the Irish justice system between January and December 2023, this article only reports on statistics of prosecutions for drug offences.1 The data provided are for overall drug law offences. The Courts Service in Ireland does not distinguish between the different supply offences and possession/use offences (Courts Service, personal communication, 2017). 

In Ireland and internationally, there has been much attention on the growing popularity of inhaled nitrous oxide (N2O), colloquially known as ‘laughing gas’ or ‘hippy crack’. Although the prevalence of nitrous oxide use is not routinely collected in Ireland’s National Drug and Alcohol Surveys, a web survey (N=4398) conducted in 2021 found that 23.3% of respondents had ever used nitrous oxide, while a 2022 study (N=1193) of attendees at music festivals in Ireland found that 28% had used it in the last year.1,2 The popularity of nitrous oxide as a recreational drug can be attributed to the fact that it is cheap, readily available, and undetectable on routine drug screening. Recreational users tend to obtain it in small silver canisters known as ‘whippets’ or ‘silver bullets’, which are attached to a palm-sized ‘nitrous cracker’ to fill a balloon, from which the gas is inhaled. However, as nitrous oxide is cooled to its gaseous form for inhalation, container mishandling can cause frostbite injuries to the face and extremities.

The Health Service Executive (HSE) National Social Inclusion Office launched a multicomponent programme in May 2022 to engage with people who use drugs specifically in festival settings. This involved a media campaign, the development of resources, recruiting and training volunteers, and coordinating outreach teams at three specific festivals: Life Festival, Indiependence (Indie), and Electric Picnic. The aim of the programme was to engage with and support festival attendees in a non-judgemental way on the topic of substance use and related issues that emerge in nightlife spaces.

Background and methods

Pharmacotherapy is essential for the delivery of an equivalent standard of care in prison. However, prescribing can be challenging due to the complex health needs of prisoners and the risk of misuse of prescription drugs. Misuse, or non-medical use of prescription drugs, refers to the intentional repurposing of prescribed drugs outside of their intended indication. The drugs identified with the greatest potential for misuse are prescription opioids, benzodiazepines, Z-drugs, and gabapentinoids.1-3 Although there is widespread concern regarding the misuse of prescription drugs in prisons, few studies have examined prescribing trends of prescription drugs with potential for misuse in prison.